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Sample records for centre based cardiac

  1. Home-based cardiac rehabilitation is as effective as centre-based cardiac rehabilitation among elderly with coronary heart disease: results from a randomised clinical trial

    DEFF Research Database (Denmark)

    Oerkild, Bodil; Frederiksen, Marianne; Hansen, Jorgen Fischer;

    2011-01-01

    in the secondary outcomes of systolic blood pressure (-0.6 mmHg, 95% CI -11.3, 10.0), LDL cholesterol (0.3 mmol/l, 95% CI -0.04, 0.7), HDL cholesterol (0.2 mmol/l, 95% CI -0.01, 0.3), body composition, proportion of smokers and health-related quality of life. A group of patients who did not have an effect......BACKGROUND: participation in centre-based cardiac rehabilitation (CR) is known to reduce morbidity and mortality but participation rates among the elderly are low. Establishing alternative programmes is important, and home-based CR is the predominant alternative. However, no studies have...... investigated the effect of home-based CR among a group of elderly patients with coronary heart disease with a long-term follow-up. METHODS: randomised clinical trial comparing home-based CR with comprehensive centre-based CR among patients = 65 years with coronary heart disease. RESULTS: seventy-five patients...

  2. Cardiac phantom measurement validating the methodology for a cardiac multi-centre trial with positron emission tomography.

    Science.gov (United States)

    Nuyts, Johan; Mortelmans, Luc; Van de Werf, Frans; Djian, Jacques; Sambuceti, Gianmario; Schwaiger, Marcus; Touboul, Paul; Maes, Alex

    2002-12-01

    In an ongoing international multi-centre trial, positron emission tomography (PET) is being used to evaluate the effect of a new P-selectin antagonist on the infarct size in patients with acute myocardial infarction, treated with thrombolysis. Although it is possible to correct for site-dependent factors, it is desirable to reduce these factors to a minimum. Therefore, acquisition and reconstruction protocols have been defined that can be closely followed by all participating centres. The resulting reconstructed images are transferred to the core centre for central processing with semi-automatic software. This paper reports on the multi-centre phantom experiment that was carried out to assess the inter-centre reproducibility of defect size determination with this protocol. Also, the spatial resolution of the short axis slices was examined. In addition, the analysis procedure was applied to normal PET studies to evaluate the specificity of perfusion defect detection. The transmural cold defect in the phantom occupied 14.8% of the left ventricular area. The automated analysis was applied to the phantom measurements from the 14 participating PET cameras. It yielded an accurate estimate of 15.1% with a standard deviation of 0.6%, indicating excellent reproducibility. The spatial resolution in the short axis slices was similar for all PET systems: 9.6+/-0.8 mm. The same procedure produced a defect size of zero in the studies of normal volunteers. This study indicates that cardiac studies from multiple PET systems can be pooled for statistical analysis.

  3. Cardiac phantom measurement validating the methodology for a cardiac multi-centre trial with positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Nuyts, Johan; Mortelmans, Luc; Maes, Alex [Nuclear Medicine, UZ Gasthuisberg, K.U. Leuven, Herestraat 49, 3000 Leuven (Belgium); Van de Werf, Frans [Cardiology, UZ Gasthuisberg, K.U. Leuven, Leuven (Belgium); Djian, Jacques [Wyeth Research, Paris la Defense Cedex (France); Sambuceti, Gianmario [Instituto di Fisiologia Clinica CNR, Pisa (Italy); Schwaiger, Marcus [Nuklearmedizinische Klinik und Poliklinik, TU Muenchen, Muenchen (Germany); Touboul, Paul [Hopital Cardio-Vasculaire et Pneumologique, Lyon (France)

    2002-12-01

    In an ongoing international multi-centre trial, positron emission tomography (PET) is being used to evaluate the effect of a new P-selectin antagonist on the infarct size in patients with acute myocardial infarction, treated with thrombolysis. Although it is possible to correct for site-dependent factors, it is desirable to reduce these factors to a minimum. Therefore, acquisition and reconstruction protocols have been defined that can be closely followed by all participating centres. The resulting reconstructed images are transferred to the core centre for central processing with semi-automatic software. This paper reports on the multi-centre phantom experiment that was carried out to assess the inter-centre reproducibility of defect size determination with this protocol. Also, the spatial resolution of the short axis slices was examined. In addition, the analysis procedure was applied to normal PET studies to evaluate the specificity of perfusion defect detection. The transmural cold defect in the phantom occupied 14.8% of the left ventricular area. The automated analysis was applied to the phantom measurements from the 14 participating PET cameras. It yielded an accurate estimate of 15.1% with a standard deviation of 0.6%, indicating excellent reproducibility. The spatial resolution in the short axis slices was similar for all PET systems: 9.6{+-}0.8 mm. The same procedure produced a defect size of zero in the studies of normal volunteers. This study indicates that cardiac studies from multiple PET systems can be pooled for statistical analysis. (orig.)

  4. Home-based cardiac rehabilitation for people with heart failure

    DEFF Research Database (Denmark)

    Zwisler, Ann Dorthe Olsen; Norten, RJ; Dean, SG;

    2016-01-01

    AIMS: To assess the effectiveness of home-based cardiac rehabilitation (CR) for heart failure compared to either usual medical care (i.e. no CR) or centre-based CR on mortality, morbidity, exercise capacity, health-related quality of life, drop out, adherence rates, and costs. METHODS: Randomised......-related quality of life of heart failure patients compared to usual care. The magnitude of outcome improvement is similar to centre-based CR. Home-based CR appears to be safe with no evidence of increased risk of hospitalisation or death. These findings support the provision of home-based CR for heart failure...

  5. A smartphone based cardiac coherence biofeedback system.

    Science.gov (United States)

    De Jonckheere, J; Ibarissene, I; Flocteil, M; Logier, R

    2014-01-01

    Cardiac coherence biofeedback training consist on slowing one's breathing to 0.1 Hz in order to simulate the baroreflex sensitivity and increase the respiratory sinus arrhythmia efficiency. Several studies have shown that these breathing exercises can constitute an efficient therapy in many clinical contexts like cardiovascular diseases, asthma, fibromyalgia or post-traumatic stress. Such a non-intrusive therapeutic solution needs to be performed on an 8 to 10 weeks period. Even if some heart rate variability based solutions exist, they presented some mobility constrain rendering these cardiac / respiratory control technologies more difficult to perform on a daily used. In this paper, we present a new simplified smartphone based solution allowing people to process efficient cardiac coherence biofeedback exercises. Based on photo-plethysmographic imaging through the smartphone camera, this sensor-less technology allows controlling cardiac coherence biofeedback exercises through a simplified heart rate variability algorithm.

  6. Cardiac magnetic source imaging based on current multipole model

    Institute of Scientific and Technical Information of China (English)

    Tang Fa-Kuan; Wang Qian; Hua Ning; Lu Hong; Tang Xue-Zheng; Ma Ping

    2011-01-01

    It is widely accepted that the heart current source can be reduced into a current multipole. By adopting three linear inverse methods, the cardiac magnetic imaging is achieved in this article based on the current multipole model expanded to the first order terms. This magnetic imaging is realized in a reconstruction plane in the centre of human heart, where the current dipole array is employed to represent realistic cardiac current distribution. The current multipole as testing source generates magnetic fields in the measuring plane, serving as inputs of cardiac magnetic inverse problem. In the heart-torso model constructed by boundary element method, the current multipole magnetic field distribution is compared with that in the homogeneous infinite space, and also with the single current dipole magnetic field distribution.Then the minimum-norm least-squares (MNLS) method, the optimal weighted pseuDOInverse method (OWPIM), and the optimal constrained linear inverse method (OCLIM) are selected as the algorithms for inverse computation based on current multipole model innovatively, and the imaging effects of these three inverse methods are compared. Besides,two reconstructing parameters, residual and mean residual, are also discussed, and their trends under MNLS, OWPIM and OCLIM each as a function of SNR are obtained and compared.

  7. Grand rounds from international lupus centres cardiac abnormalities in SLE : pancarditis

    NARCIS (Netherlands)

    Bijl, M; Brouwer, J; Kallenberg, GGM

    2000-01-01

    Many patients with systemic lupus erythematosus (SLE) develop cardiac manifestations during the course of their disease. Pericarditis is most commonly seen, with a reported prevalence of 60%. Myocardial involvement is present in only a minority of patients. In recent years, due to better noninvasive

  8. Service and business model for technology enabled and home-based cardiac rehabilitation programs.

    Science.gov (United States)

    Sarela, Antti; Whittaker, Frank; Korhonen, Ilkka

    2009-01-01

    Cardiac rehabilitation programs are comprehensive life-style programs aimed at preventing recurrence of a cardiac event. However, the current programs have globally significantly low levels of uptake. Home-based model can be a viable alternative to hospital-based programs. We developed and analysed a service and business model for home based cardiac rehabilitation based on personal mentoring using mobile phones and web services. We analysed the different organizational and economical aspects of setting up and running the home based program and propose a potential business model for a sustainable and viable service. The model can be extended to management of other chronic conditions to enable transition from hospital and care centre based treatments to sustainable home-based care.

  9. Clinical Profile of Patients with Tetralogy of Fallot admitted for Surgery at a Cardiac surgical centre

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    B E Otaigbe

    2011-04-01

    Full Text Available INTRODUCTION: Tetralogy of Fallot (TOF, a conotruncal defect, has been documented to be associated with chromosome abnormalities, single gene syndrome (22q11 microdeletion, known teratogens, with the rest associations being multifactorial. This study was carried out to determine the clinical profile and associated risk factors in patients with TOF admitted for surgical repairs. METHODS: Case files of all patients admitted for Tetralogy of Fallot over a period of one year were retrieved from the Medical Records Department and reviewed. Data on the patients' and their family history and associated cardiac anomalies were noted. RESULTS: There were 54 patients, 37 males and 17 females, with a mean age of 6.8 years +/- 7.1. Sixty percent were born between July and December, 81.5% as full term and 44% as first born. Twenty-six percent were born into consanguineous marriages. Five patients had dysmorphic features. Associated cardiac anomalies included right aortic arch, pulmonary atresia, dextrocardia and left superior vena cavae. CONCLUSION: The associated risk factors noted in this study were male sex, birthdates between July and December, first born and increased paternal age. Other risk factors were consanguinity and specific patterns of cardiovascular diseases associated with 22q 11 deletions. This suggests a multifactorial etiology for TOF. Keywords: associated risk factors, cardiac anomalies, demographic factors, Tetralogy of Fallot

  10. Tertiary centres have improved survival compared to other hospitals in the Copenhagen area after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Søholm, Helle; Wachtell, Kristian; Nielsen, Søren Loumann;

    2013-01-01

    AIMS: Out-of-hospital cardiac arrest (OHCA) has been reported to carry very varying morbidity and mortality. However, it remains unclear whether this is caused by intrinsic factors of the OHCA or due to the level of in-hospital care. The aim of this study is to compare 30-day and long......-term mortality after OHCA at tertiary heart centres and non-tertiary university hospitals. METHODS AND RESULTS: Data from the Copenhagen OHCA registry from June 2002 through December 2010 included a total of 1218 consecutive patients treated by the same mobile emergency care unit (MECU) with either return...... angiography. Therefore, patients with ST-elevation myocardial infarction (n=198) were excluded from the analysis. 30-day mortality was 56% vs. 76% and long term (up to 8years) mortality was 78% vs. 94% for tertiary and non-tertiary hospitals, respectively, both p...

  11. Location-based solutions in the Experience centre

    DEFF Research Database (Denmark)

    Hansen, Dan Witzner; Alapetite, Alexandre; Holdgaard, Nanna

    In this paper we present a prototype system for location-based guiding. A user survey has been conducted and the observations are used to support design choices. The prototype allows for both indoor and outdoor navigation at and in the vicinity of the experience centre NaturBornholm1 in Denmark u...... using a combination of Bluetooth, GPS and QR-codes. Bluetooth and GPS are used for location-based information and QR-codes are used to convey user preferences....

  12. Location-based solutions in the Experience centre

    DEFF Research Database (Denmark)

    Witzner Hansen, Dan; Alapetite, Alexandre Philippe Bernard; Holdgaard, Nanna

    2008-01-01

    In this paper we present a prototype system for location-based guiding. A user survey has been conducted and the observations are used to support design choices. The prototype allows for both indoor and outdoor navigation at and in the vicinity of the experience centre NaturBornholm1 in Denmark u...... using a combination of Bluetooth, GPS and QRcodes. Bluetooth and GPS are used for location-based information and QR-codes are used to convey user preferences....

  13. The China Patient-Centred Evaluative Assessment of Cardiac Events (China PEACE)-Prospective Study of 3-Vessel Disease: rationale and design

    Science.gov (United States)

    Rao, Chenfei; Bongiovanni, Tasce; Li, Xi; Gao, Huawei; Zhang, Heng; Li, Jing; Zhao, Yan; Yuan, Xin; Hua, Kun; Hu, Shengshou; Krumholz, Harlan M; Jiang, Lixin; Zheng, Zhe

    2016-01-01

    Introduction Complex coronary artery disease (left main and three-vessel disease) carries high risks of adverse events and cost burden. However, in China, little is known about which patients are directed toward which treatment strategies and what outcomes are being achieved. Methods and analysis Using the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) research network, this prospective study of three-Vessel Disease, the China PEACE-3VD study, has a plan to consecutively register over 4000 patients with a diagnosis of 3VD and/or left-main disease by elective coronary angiography at 24 large cardiovascular centres in China. We centrally conducted medical record abstraction and SYNTAX Score calculation for all registered patients. The sites invited patients to the prospective cohort, and conducted 1-year follow-up on major events, including cardiac events, symptoms, secondary prevention and quality of life. The estimated entire sample size of eligible patients of 4000 was determined based on both feasibility and consideration of adequate statistical precision for describing the treatment decisions, guidelines adherence and appropriateness of treatment for patients with complex coronary artery diseases. The study is designed to investigate patient, clinician and hospital factors associated with each treatment strategy (percutaneous coronary intervention, coronary artery bypass grafting or medical therapy) as well as appropriateness of treatment choice, current guideline compliance and patient-reported outcomes for patients with complex coronary artery disease in large cardiovascular centres in China, as a foundation for enhanced knowledge in the field and to assist quality improvement initiatives. Ethics and dissemination The study protocol was approved by the ethics committee at the China National Center for Cardiovascular Diseases. Findings will be shared with participating hospitals, policymakers and the academic community, to promote

  14. Recognition of out-of-hospital cardiac arrest by medical dispatchers in emergency medical dispatch centres in two countries

    DEFF Research Database (Denmark)

    Møller, Thea Palsgaard; Andréll, Cecilia; Viereck, Søren;

    2016-01-01

    of the emergency medical services. AIM: To analyse and compare the accuracy of OHCA recognition by medical dispatchers in two countries. METHOD: An observational register-based study collecting data from national cardiac arrest registers in Denmark and Sweden during a six-month period in 2013. Data were analysed....... This raises a discussion of definitions and transparency in general in scientific reporting of OHCA recognition, which is essential if used as quality indicator in emergency medical services.......INTRODUCTION: Survival after out-of-hospital cardiac arrest (OHCA) remains low. Early recognition by emergency medical dispatchers is essential for an effective chain of actions, leading to early cardiopulmonary resuscitation, use of an automated external defibrillator and rapid dispatching...

  15. Location-based solutions in the Experience centre

    DEFF Research Database (Denmark)

    Hansen, Dan Witzner; Alapetite, Alexandre; Holdgaard, Nanna

    2009-01-01

    In this paper we present a prototype system for location-based guiding. A user survey has been conducted and the observations are used to support design choices. The prototype allows for both indoor and outdoor navigation at and in the vicinity of the NaturBornholm' experience centre in Denmark u...... using a combination of Bluetooth, Near Field Communication (NFC), GPS and QR codes. Bluetooth, NFC and GPS are used for location-based information and QR codes are used to convey user preferences....

  16. Cardiac tissue ablation with catheter-based microwave heating.

    Science.gov (United States)

    Rappaport, C

    2004-11-01

    The common condition of atrial fibrillation is often treated by cutting diseased cardiac tissue to disrupt abnormal electrical conduction pathways. Heating abnormal tissue with electromagnetic power provides a minimally invasive surgical alternative to treat these cardiac arrhythmias. Radio frequency ablation has become the method of choice of many physicians. Recently, microwave power has also been shown to have great therapeutic benefit in medical treatment requiring precise heating of biological tissue. Since microwave power tends to be deposited throughout the volume of biological media, microwave heating offers advantages over other heating modalities that tend to heat primarily the contacting surface. It is also possible to heat a deeper volume of tissue with more precise control using microwaves than with purely thermal conduction or RF electrode heating. Microwave Cardiac Ablation (MCA) is used to treat heart tissue that allows abnormal electrical conduction by heating it to the point of inactivation. Microwave antennas that fit within catheter systems can be positioned close to diseased tissue. Specialized antenna designs that unfurl from the catheter within the heart can then radiate specifically shaped fields, which overcome problems such as excessive surface heating at the contact point. The state of the art in MCA is reviewed in this paper and a novel catheter-based unfurling wide aperture antenna is described. This antenna consists of the centre conductor of a coaxial line, shaped into a spiral and insulated from blood and tissue by a non-conductive fluid filled balloon. Initially stretched straight inside a catheter for transluminal guiding, once in place at the cardiac target, the coiled spiral antenna is advanced into the inflated balloon. Power is applied in the range of 50-150 W at the reserved industrial, scientific and medical (ISM) frequency of 915 MHz for 30-90 s to create an irreversible lesion. The antenna is then retracted back into the

  17. Exercise-based cardiac rehabilitation in twelve European countries results of the European cardiac rehabilitation registry

    DEFF Research Database (Denmark)

    Benzer, Werner; Rauch, Bernhard; Schmid, Jean-Paul

    2017-01-01

    AIM: Results from EuroCaReD study should serve as a benchmark to improve guideline adherence and treatment quality of cardiac rehabilitation (CR) in Europe. METHODS AND RESULTS: Data from 2.054 CR patients in 12 European countries were derived from 69 centres. 76% were male. Indication for CR...... were under medication according to current guidelines for the treatment of CV risk factors. A wide range of CR programme designs was found (duration 3 to 24weeks; total number of sessions 30 to 196). Patient programme adherence after admission was high (85%). With reservations that eCRF follow-up data...

  18. A Design-Based introduction to learning centres

    Directory of Open Access Journals (Sweden)

    Anne Kristine Petersen

    2016-05-01

    Full Text Available In the last decades, outskirt areas in Denmark have suffered from depopulation and economic decline, a development that has led to a centralised education system where higher education institutions are vested in a central body in urban areas rather than in rural communities. University College Zealand has initiated a research project in collaboration with three municipalities in the region of Zealand and partners from the Nordic countries, which investigates the potential of municipal learning centres as a means to solve educational challenges in outskirt areas. A municipal learning centre is a physical location owned by a municipality, which offers (asynchronous courses through digital couplings to higher education institutions. The paper presents research findings showing that the development of an ecosystem based on collaboration between municipalities, higher education institutions and private and public businesses is pivotal for achieving a sustainable model for online education in rural areas. Furthermore, the paper presents a series of thinking technologies in the form of models and categories, which can be used as tools for establishing learning centres and designing learning activities for learning centres. --- Kommuner placeret i yderområder i Danmark har i de seneste årtier oplevet affolkning og økonomisk nedgang, og denne udvikling har medvirket til et centraliseret uddannelsessystem, hvor videregående uddannelsesinstitutioner flyttes fra yderområder til større byer. University College Sjælland har igangsat et forskningsprojekt i samarbejde med tre kommuner i Region Sjælland og partnere fra de nordiske lande, som har til formål at undersøge hvorvidt uddannelseskonceptet kommunale læringscentre kan medvirke til at løse uddannelsesudfordringer i landets yderområder. Et kommunalt læringscenter er en fysisk lokation som ejes af en kommune, som gennem læringscenteret kan give borgere mulighed for at tage et kursus eller en

  19. Human Centred Design: a bibliometric overview based on Science Direct

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    Lucas José Garcia

    2016-05-01

    Full Text Available This article aims to realize a bibliometric review on Science Direct to create a outlook about Human Centred Design in order to identify the most significant authors, journals and key-words as well as the most recurrent denomination about the subject. The method employed consist of application of three classical bibliometric laws: the Inverse Square Law of Lotka; the Bradford’s Law of Scattering and; The frequency law of words in a text of Zipf. The results indicate that the subject is not a main subject of Design and related areas and does not have a main author based on Science Direct. The journals covered with more articles about the subject are the International Journal of Industrial Ergonomics and the Applied Ergonomics.

  20. Patient-centred care of patients with ventricular arrhythmias and risk of sudden cardiac death: What do the 2015 European Society of Cardiology guidelines add?

    Science.gov (United States)

    Norekvål, Tone M; Kirchhof, Paulus; Fitzsimons, Donna

    2017-03-01

    Nurses and allied professionals are at the forefront of care delivery in patients with arrythmogenic risk and have a responsibility to deliver care that is focused on their individual needs. The 2015 European Society of Cardiology guideline on prevention of ventricular arrhythmia and sudden cardiac death heralds a step-change in patient and family focus and interdisciplinary involvement. This development reflects a recognition within the European Society of Cardiology that chronic care of patients with cardiovascular conditions can be improved by involving all stakeholders, making use of multidisciplinary interventions, and placing the patient at the centre of the care process. In this article, taskforce contributors discuss the latest evidence and highlight some of the most pertinent issues for nurses involved in patient-centred care of patients and families with ventricular arrhythmias and/or risk of sudden death.

  1. Primary cardiac tumours in a paediatric population: An experience from a tertiary centre with a review of literature

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    Narender Kumar

    2014-01-01

    Full Text Available Background: To observe the histopathological spectrum of primary cardiac tumours in paediatric population those came in Pathology Department over a period of last 16 years. Materials and Methods: During the time period of 16 years (1995-2010, we had received 16 cases of primary cardiac tumours in paediatric patients. The tumour diagnosis and subtyping was done by histopathological examination along with cytochemistry and immunohistochemistry. Results: Benign cardiac tumours were much more common (15 cases than the malignant tumours. Among these, myxoma was the most frequent (13 cases. The other benign cardiac tumours were rhabdomyoma (one case and fibroma (one case. A primary malignant cardiac tumour was diagnosed in one case and was labelled as undifferentiated sarcoma. Conclusions: The present study reveals the pathological spectrum of surgically excised cardiac tumours in the paediatric population in northern India. Although the diagnosis of cardiac masses can be made by routine imaging techniques, but the role of pathologist is important for exact characterisation of tumour subtype.

  2. Acoustic cardiac signals analysis: a Kalman filter–based approach

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    Salleh SH

    2012-06-01

    Full Text Available Sheik Hussain Salleh,1 Hadrina Sheik Hussain,2 Tan Tian Swee,2 Chee-Ming Ting,2 Alias Mohd Noor,2 Surasak Pipatsart,3 Jalil Ali,4 Preecha P Yupapin31Department of Biomedical Instrumentation and Signal Processing, Universiti Teknologi Malaysia, Skudai, Malaysia; 2Centre for Biomedical Engineering Transportation Research Alliance, Universiti Teknologi Malaysia, Johor Bahru, Malaysia; 3Nanoscale Science and Engineering Research Alliance, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand; 4Institute of Advanced Photonics Science, Universiti Teknologi Malaysia, Johor Bahru, MalaysiaAbstract: Auscultation of the heart is accompanied by both electrical activity and sound. Heart auscultation provides clues to diagnose many cardiac abnormalities. Unfortunately, detection of relevant symptoms and diagnosis based on heart sound through a stethoscope is difficult. The reason GPs find this difficult is that the heart sounds are of short duration and separated from one another by less than 30 ms. In addition, the cost of false positives constitutes wasted time and emotional anxiety for both patient and GP. Many heart diseases cause changes in heart sound, waveform, and additional murmurs before other signs and symptoms appear. Heart-sound auscultation is the primary test conducted by GPs. These sounds are generated primarily by turbulent flow of blood in the heart. Analysis of heart sounds requires a quiet environment with minimum ambient noise. In order to address such issues, the technique of denoising and estimating the biomedical heart signal is proposed in this investigation. Normally, the performance of the filter naturally depends on prior information related to the statistical properties of the signal and the background noise. This paper proposes Kalman filtering for denoising statistical heart sound. The cycles of heart sounds are certain to follow first-order Gauss–Markov process. These cycles are observed with additional noise

  3. Occurrence, aetiology and challenges in the management of congestive heart failure in sub-saharan Africa: experience of the Cardiac Centre in Shisong, Cameroon

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    Tantchou Tchoumi Jacques Cabral

    2011-02-01

    Full Text Available INTRODUCTION: The aim of the study was to investigate the occurrence, the aetiology and the management of congestive heart failure in the cardiac centre of the St. Elizabeth catholic general hospital Shisong in Cameroon. METHODS: Between November 2002 and November 2008, a population of 8121 patients was consulted in the referral cardiac centre of St. Elizabeth Catholic General Hospital. Of these patients, 462 were diagnosed with congestive heart failure according to the modified Framingham criteria for the diagnosis of heart failure. Complementary investigations used to confirm and establish the aetiology of the disease were the chest X-ray, electrocardiography, bi-dimensional Doppler echocardiography. RESULTS: The results showed that the occurrence of congestive heart failure in our centre was 5,7%. Congestive heart failure was diagnosed in 198 females and 264 males, aged between 8 and 86 years old (42.5, plus or minus 18 years old. Post rheumatic valvulopathies (14.6% and congenital heart diseases (1.9% were the first aetiologic factor of congestive heart failure in the young, meanwhile cardiomyopathies (8,3% in elderly followed by hypertensive cardiomyopathy (4.4%. Congestive heart failure was also seen in adults with congenital heart diseases in 0.01%. In this zone of Cameroon, we discovered that HIV cardiomyopathy (1.6% and Cor pulmonale (8% were represented, aetiological factors not mentioned in previous studies conducted in urban areas of Cameroon. The mean duration of hospital stay for the compensation treatment was thirteen days, ranging between 7 and 21 days, the mortality being 9.2%. All the medications recommended for the treatment of congestive heart failure are available in our centre but many patients are not compliant to the therapy or cannot afford them. Financial limitation is causing the exacerbation of the disease and premature death. CONCLUSION: Our data show a high incidence of congestive heart failure mainly due to post

  4. Exercise-based cardiac rehabilitation for adults with atrial fibrillation

    DEFF Research Database (Denmark)

    Risom, Signe S; Zwisler, Ann-Dorthe; Johansen, Pernille P

    2017-01-01

    BACKGROUND: Exercise-based cardiac rehabilitation may benefit adults with atrial fibrillation or those who had been treated for atrial fibrillation. Atrial fibrillation is caused by multiple micro re-entry circuits within the atrial tissue, which result in chaotic rapid activity in the atria....... OBJECTIVES: To assess the benefits and harms of exercise-based rehabilitation programmes, alone or with another intervention, compared with no-exercise training controls in adults who currently have AF, or have been treated for AF. SEARCH METHODS: We searched the following electronic databases; CENTRAL...... the benefits and harms of exercise-based cardiac rehabilitation for adults with atrial fibrillation on patient-relevant outcomes....

  5. Characterization of Cardiac Patients Based on the Synergy Model

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    Tavangar

    2014-10-01

    Full Text Available Background Cardiac patients need comprehensive support due to the adverse effects of this disease on different aspects of their lives. Synergy intervention is a model that focuses on patients' requirements. Objectives This study aimed to determine the eightfold characteristic of cardiac patients based on the synergy model that represent their clinical requirements. Materials and Methods In this descriptive cross-sectional study, 40 cardiac patients hospitalized at the cardiac care unit (CCU of Yazd Afshar Hospital were randomly selected. The data were collected by using a two-part check-list including demographic characteristics and also by studying eight characteristics of patients through interviewing and reviewing their records. The results were analyzed using descriptive statistics such as frequency (percentage and analytical statistics such as Spearman and Mann-Whitney test with the SPSS software, version 18. Results The results showed that among patients' internal characteristics, reversibility (70.6%, vulnerability (68.6%, and predictability (80.4% at level 1 (the minimum score had the highest frequency and stability (49% and complexity (54.9% were at level 3 (average score. Among external characteristics participation in decision-making (80.4% at level 1 had the highest frequency while care (62.7% and recourses (98% were at level 3. Conclusions Ignoring any of the eightfold characteristics based on the synergy model interferes with comprehensive support of cardiac patients. Therefore, it is necessary for professional health practitioners, especially nurses, to consider patients' eightfold characteristics in order to provide quality care.

  6. Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

    Science.gov (United States)

    Lehrer, Joanne S.; Lemay, Lise; Bigras, Nathalie

    2015-01-01

    The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings…

  7. Human Centred Design: a bibliometric overview based on Science Direct

    OpenAIRE

    Lucas José Garcia; Giselle Schmidt Alves Díaz Merino; Susana Cristina Domenech; Eugenio Andres Díaz Merino; Adilson Luiz Pinto

    2016-01-01

    This article aims to realize a bibliometric review on Science Direct to create a outlook about Human Centred Design in order to identify the most significant authors, journals and key-words as well as the most recurrent denomination about the subject. The method employed consist of application of three classical bibliometric laws: the Inverse Square Law of Lotka; the Bradford’s Law of Scattering and; The frequency law of words in a text of Zipf. The results indicate that the subject is not a ...

  8. Information and communication technology-based cardiac rehabilitation homecare programs

    Directory of Open Access Journals (Sweden)

    Varnfield M

    2015-04-01

    Full Text Available Marlien Varnfield, Mohanraj KarunanithiAustralian eHealth Research Centre, Commonwealth Scientific and Industrial Research Organization, Royal Brisbane and Women's Hospital, Brisbane, AustraliaAbstract: Cardiac rehabilitation (CR has, for many years, been a highly recommended approach to secondary prevention for patients recovering after a heart attack or heart surgery. These programs are traditionally delivered from a hospital outpatient center. Despite demonstrated benefits and guideline recommendations, CR utilization has been poor, particularly in women, older patients, and ethnic minority groups. To overcome some of the barriers to the traditional delivery of CR, different delivery platforms and approaches have been developed in recent years. In general, Telehealth solutions which have been used to address the delivery of CR services remotely include: 1 patient–provider contact delivered by telephone systems; 2 the Internet, with the majority of patient–provider contact for risk factor management taking place online; and 3 interventions using Smartphones as tools to deliver CR through (independently or in combination with short message service messaging, journaling applications, connected measurement devices, and remote coaching. These solutions have been shown to overcome some of the barriers in CR participation and show potential as alternative or complementary options for individuals that find traditional center-based CR programs difficult to commit to. The major benefits of remote platforms for CR delivery are the ability to deliver these interventions without ongoing face-to-face contact, which provides an opportunity to reach large numbers of people, and the convenience of selecting the timing of cardiovascular disease management sessions. Furthermore, technologies have the potential to deliver long-term follow-up, which programs delivered by health professionals cannot afford to do due to staff shortages and budget restrictions

  9. Speckle Tracking Based Strain Analysis Is Sensitive for Early Detection of Pathological Cardiac Hypertrophy

    OpenAIRE

    Xiangbo An; Jingjing Wang; Hao Li; Zhizhen Lu; Yan Bai; Han Xiao; Youyi Zhang; Yao Song

    2016-01-01

    Cardiac hypertrophy is a key pathological process of many cardiac diseases. However, early detection of cardiac hypertrophy is difficult by the currently used non-invasive method and new approaches are in urgent need for efficient diagnosis of cardiac malfunction. Here we report that speckle tracking-based strain analysis is more sensitive than conventional echocardiography for early detection of pathological cardiac hypertrophy in the isoproterenol (ISO) mouse model. Pathological hypertrophy...

  10. Material-based engineering strategies for cardiac regeneration.

    Science.gov (United States)

    Marion, Mieke H van; Bax, Noortje A M; Spreeuwel, Ariane C C van; van der Schaft, Daisy W J; Bouten, Carlijn V C

    2014-01-01

    Cardiac tissue is composed of muscle and non-muscle cells, surrounded by extracellular matrix (ECM) and spatially organized into a complex three-dimensional (3D) architecture to allow for coordinated contraction and electrical pulse propagation. Despite emerging evidence for cardiomyocyte turnover in mammalian hearts, the regenerative capacity of human cardiac tissue is insufficient to recover from damage, e.g. resulting from myocardial infarction (MI). Instead, the heart 'repairs' lost or injured tissue by ongoing synthesis and remodeling of scar tissue. Conventional therapies and timely (stem) cell delivery to the injured tissue markedly improve short-term function and remodeling, but do not attenuate later stage adverse remodeling, leading to functional deterioration and eventually failure of the heart. Material-based therapies have been successfully used to mechanically support and constrain the post-MI failing heart, preventing it from further remodeling and dilation. When designed to deliver the right microenvironment for endogenous or exogenous cells, as well as the mechanical and topological cues to guide neo-tissue formation, material-based therapies may even reverse remodeling and boost cardiac regeneration. This paper reviews the up-to-date status of material-based cardiac regeneration with special emphasis on 1) the use of bare biomaterials to deliver passive constraints that unload the heart, 2) the use of materials and cells to create engineered cardiac constructs for replacement, support, or regeneration of damaged myocardium, and 3) the development of bio-inspired and bioactive materials that aim to enhance the endogenous regenerative capacity of the heart. As the therapies should function in the infarcted heart, the damaged host environment and engineered in vitro test systems that mimic this environment, are reviewed as well.

  11. Patients' preference for exercise setting and its influence on the health benefits gained from exercise-based cardiac rehabilitation

    DEFF Research Database (Denmark)

    Tang, Lars H.; Berg, Selina Kikkenborg; Christensen, Jan

    2017-01-01

    OBJECTIVE: To assess patient preference for exercise setting and examine if choice of setting influences the long-term health benefit of exercise-based cardiac rehabilitation. METHODS: Patients participating in a randomised controlled trial following either heart valve surgery, or radiofrequency...... and provides similar health benefits. Whilst these findings support that patients should be given the choice between exercise-settings when initiating cardiac rehabilitation, further confirmatory evidence is needed....... ablation for atrial fibrillation were given the choice to perform a 12-week exercise programme in either a supervised centre-based, or a self-management home-based setting. Exercise capacity and physical and mental health outcomes were assessed for up to 24months after hospital discharge. Outcomes between...

  12. Exercise-based cardiac rehabilitation after heart valve surgery

    DEFF Research Database (Denmark)

    Hansen, T B; Zwisler, Ann-Dorthe; Berg, S K

    2015-01-01

    BACKGROUND: Owing to a lack of evidence, patients undergoing heart valve surgery have been offered exercise-based cardiac rehabilitation (CR) since 2009 based on recommendations for patients with ischaemic heart disease in Denmark. The aim of this study was to investigate the impact of CR...... expensive outpatient visits. Further studies should investigate the benefits of CR to heart valve surgery patients as part of a formal cost-utility analysis....

  13. A survey of membrane oxygenator heat-exchanger integrity testing at cardiac surgery centres in Great Britain and Ireland.

    Science.gov (United States)

    Carlton, Matthew; Campbell, John

    2013-11-01

    Membrane oxygenator heat exchanger (HE) device failure is reported to be very low for both short- and long-term extracorporeal devices. All oxygenator manufacturers provide instructions for leak testing of their HE devices prior to patient use. In addition to these recommendations, since 2006 at Nottingham University Hospitals (NUH) we have also additionally pressure tested HE devices prior to use. We conducted a national survey of cardiac centers in Great Britain and Ireland to determine the methods undertaken in individual centers for validation of the integrity of HE devices. Furthermore, we also collected information on the routine maintenance techniques utilized within these centers to inhibit microbial growth in the water used in the heater-cooler units (HCUs). In total, 34 responses were collected from the 57 centers performing cardiac surgery, producing a response rate of 60%. Of the responding centers, 71% are adhering to manufacturer's recommended guidelines of circulating the water through the device for 5 minutes. Of these centers, 17% reported detecting a leak between the HE and membrane compartment of the oxygenator. In responding centers, 29% reported using the pressure test technique. In the centers utilizing pressure testing, 60% reported detecting a leak. This survey reports an association of a greater HE leak detection rate using the pressure test technique compared to using water testing in isolation (p = 0.034). We believe the pressure testing method provides the perfusionist with confidence in the integrity of the HE for short- and long-term circulatory support devices prior to use in both elective and emergency situations.

  14. Creative elements: network-based predictions of active centres in proteins, cellular and social networks

    CERN Document Server

    Csermely, Peter

    2008-01-01

    Active centres and hot spots of proteins have a paramount importance in enzyme action, protein complex formation and drug design. Recently a number of publications successfully applied the analysis of residue networks to predict active centres in proteins. Most real-world networks show a number of properties, such as small-worldness or scale-free degree distribution, which are rather general features of networks from molecules to the society. Based on extensive analogies I propose that the existing findings and methodology enable us to detect active centres in cells, social networks and ecosystems. Members of these active centres are creative elements of the respective networks, which may help them to survive unprecedented, novel challenges, and play a key role in the development, survival and evolvability of complex systems.

  15. Dealing with existential anxiety in exercice-based cardiac rehabilitation

    DEFF Research Database (Denmark)

    P. Simonÿ, Charlotte; Pedersen, Birthe D.; Dreyer, Pia

    2015-01-01

    physically and psychologically challenged, the patients were encouraged to maintain an active lifestyle. Three themes were identified: anxiety regarding exercise, whereby the patients are initially insecure about how to behave with their diseased hearts; encouragement from training together, whereby...... the patients support each other in exercising; and growing confidence in the heart, whereby the patients enjoy being physically active. Conclusions In exercise-based cardiac rehabilitation, patients' insecurity with respect to their heart disease is revealed as an existential anxiety. Through peer support...... and a positive physical perception, the patients gain renewed self-efficacy, helping them to continue their lives in an active and satisfying way. Relevance to clinical practice Knowing that patients are confronted with an existential anxiety during exercise-based cardiac rehabilitation is important because...

  16. Abaqus/Standard-based quantification of human cardiac mechanical properties

    CERN Document Server

    Genet, Martin; Kuhl, Ellen; Guccione, Julius

    2016-01-01

    Computational modeling can provide critical insight into existing and potential new surgical procedures, medical or minimally-invasive treatments for heart failure, one of the leading causes of deaths in the world that has reached epidemic proportions. In this paper, we present our Abaqus/Standard-based pipeline to create subject-specific left ventricular models. We first review our generic left ventricular model, and then the personalization process based on magnetic resonance images. Identification of subject-specific cardiac material properties is done by coupling Abaqus/Standard to the python optimization library NL-Opt. Compared to previous studies from our group, the emphasis is here on the fully implicit solving of the model, and the two-parameter optimization of the passive cardiac material properties.

  17. UICEE Centre for Problem Based Learning (UCPBL) at Aalborg University

    DEFF Research Database (Denmark)

    Fink, Flemming Kobberøe; Enemark, Stig; Moesby, Egon

    2002-01-01

    University is considered to have a strong position in Problem-Based Learning (PBL) with many years of experience. Within engineering education co-operation with industry has also always been a field of high importance for Aalborg University and part of the PBL concept. An increasing number of universities...

  18. Ketamine in adult cardiac surgery and the cardiac surgery Intensive Care Unit: An evidence-based clinical review

    Directory of Open Access Journals (Sweden)

    Michael Mazzeffi

    2015-01-01

    Full Text Available Ketamine is a unique anesthetic drug that provides analgesia, hypnosis, and amnesia with minimal respiratory and cardiovascular depression. Because of its sympathomimetic properties it would seem to be an excellent choice for patients with depressed ventricular function in cardiac surgery. However, its use has not gained widespread acceptance in adult cardiac surgery patients, perhaps due to its perceived negative psychotropic effects. Despite this limitation, it is receiving renewed interest in the United States as a sedative and analgesic drug for critically ill-patients. In this manuscript, the authors provide an evidence-based clinical review of ketamine use in cardiac surgery patients for intensive care physicians, cardio-thoracic anesthesiologists, and cardio-thoracic surgeons. All MEDLINE indexed clinical trials performed during the last 20 years in adult cardiac surgery patients were included in the review.

  19. Cardiac CT for planning redo cardiac surgery: effect of knowledge-based iterative model reconstruction on image quality

    Energy Technology Data Exchange (ETDEWEB)

    Oda, Seitaro [MedStar Washington Hospital Center, Department of Cardiology, Washington, DC (United States); Kumamoto University, Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto (Japan); Weissman, Gaby; Weigold, W. Guy [MedStar Washington Hospital Center, Department of Cardiology, Washington, DC (United States); Vembar, Mani [Philips Healthcare, CT Clinical Science, Cleveland, OH (United States)

    2015-01-15

    The purpose of this study was to investigate the effects of knowledge-based iterative model reconstruction (IMR) on image quality in cardiac CT performed for the planning of redo cardiac surgery by comparing IMR images with images reconstructed with filtered back-projection (FBP) and hybrid iterative reconstruction (HIR). We studied 31 patients (23 men, 8 women; mean age 65.1 ± 16.5 years) referred for redo cardiac surgery who underwent cardiac CT. Paired image sets were created using three types of reconstruction: FBP, HIR, and IMR. Quantitative parameters including CT attenuation, image noise, and contrast-to-noise ratio (CNR) of each cardiovascular structure were calculated. The visual image quality - graininess, streak artefact, margin sharpness of each cardiovascular structure, and overall image quality - was scored on a five-point scale. The mean image noise of FBP, HIR, and IMR images was 58.3 ± 26.7, 36.0 ± 12.5, and 14.2 ± 5.5 HU, respectively; there were significant differences in all comparison combinations among the three methods. The CNR of IMR images was better than that of FBP and HIR images in all evaluated structures. The visual scores were significantly higher for IMR than for the other images in all evaluated parameters. IMR can provide significantly improved qualitative and quantitative image quality at in cardiac CT for planning of reoperative cardiac surgery. (orig.)

  20. School Readiness among Low-Income, Latino Children Attending Family Childcare versus Centre-Based Care

    Science.gov (United States)

    Ansari, Arya; Winsler, Adam

    2012-01-01

    Latino children often struggle in school. Early childhood education programmes are seen as critical for fostering children's school readiness. Latino families often choose family childcare (FCC) over centre-based childcare (CBC), yet little is known about the school readiness of Latino children attending FCC. We compared school readiness over the…

  1. Exercise-based cardiac rehabilitation in patients with heart failure

    DEFF Research Database (Denmark)

    Lewinter, Christian; Doherty, Patrick; Gale, Christopher P;

    2015-01-01

    BACKGROUND: Guidelines recommend exercise-based cardiac rehabilitation (EBCR) for patients with heart failure (HF). However, established research has not investigated the longer-term outcomes including mortality and hospitalisation in light of the contemporary management of HF. METHODS......: This was a systematic review including a meta-analysis of EBCR on all-cause mortality, hospital admission, and standardised exercise capacity using four separate exercise tests in patients with heart failure over a minimum follow-up of six months from January 1999-January 2013. Electronic searches were performed...

  2. Speckle Tracking Based Strain Analysis Is Sensitive for Early Detection of Pathological Cardiac Hypertrophy.

    Science.gov (United States)

    An, Xiangbo; Wang, Jingjing; Li, Hao; Lu, Zhizhen; Bai, Yan; Xiao, Han; Zhang, Youyi; Song, Yao

    2016-01-01

    Cardiac hypertrophy is a key pathological process of many cardiac diseases. However, early detection of cardiac hypertrophy is difficult by the currently used non-invasive method and new approaches are in urgent need for efficient diagnosis of cardiac malfunction. Here we report that speckle tracking-based strain analysis is more sensitive than conventional echocardiography for early detection of pathological cardiac hypertrophy in the isoproterenol (ISO) mouse model. Pathological hypertrophy was induced by a single subcutaneous injection of ISO. Physiological cardiac hypertrophy was established by daily treadmill exercise for six weeks. Strain analysis, including radial strain (RS), radial strain rate (RSR) and longitudinal strain (LS), showed marked decrease as early as 3 days after ISO injection. Moreover, unlike the regional changes in cardiac infarction, strain analysis revealed global cardiac dysfunction that affects the entire heart in ISO-induced hypertrophy. In contrast, conventional echocardiography, only detected altered E/E', an index reflecting cardiac diastolic function, at 7 days after ISO injection. No change was detected on fractional shortening (FS), E/A and E'/A' at 3 days or 7 days after ISO injection. Interestingly, strain analysis revealed cardiac dysfunction only in ISO-induced pathological hypertrophy but not the physiological hypertrophy induced by exercise. Taken together, our study indicates that strain analysis offers a more sensitive approach for early detection of cardiac dysfunction than conventional echocardiography. Moreover, multiple strain readouts distinguish pathological cardiac hypertrophy from physiological hypertrophy.

  3. Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease

    DEFF Research Database (Denmark)

    Anderson, Lindsey; Oldridge, Neil; Thompson, David R

    2016-01-01

    BACKGROUND: Although recommended in guidelines for the management of coronary heart disease (CHD), concerns have been raised about the applicability of evidence from existing meta-analyses of exercise-based cardiac rehabilitation (CR). OBJECTIVES: The goal of this study is to update the Cochrane...... of 20) showed higher levels of health-related quality of life in 1 or more domains following exercise-based CR compared with control subjects. CONCLUSIONS: This study confirms that exercise-based CR reduces cardiovascular mortality and provides important data showing reductions in hospital admissions...... systematic review and meta-analysis of exercise-based CR for CHD. METHODS: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and Science Citation Index Expanded were searched to July 2014. Retrieved papers, systematic reviews, and trial registries were hand-searched. We included...

  4. Exercise-based cardiac rehabilitation for coronary heart disease

    DEFF Research Database (Denmark)

    2016-01-01

    BACKGROUND: Coronary heart disease (CHD) is the single most common cause of death globally. However, with falling CHD mortality rates, an increasing number of people live with CHD and may need support to manage their symptoms and prognosis. Exercise-based cardiac rehabilitation (CR) aims to improve...... outcomes across follow-up, we focused on reporting findings pooled across all trials at their longest follow-up (median 12 months). Exercise-based CR reduced cardiovascular mortality compared with no exercise control (27 trials; risk ratio (RR) 0.74, 95% CI 0.64 to 0.86). There was no reduction in total......-based CR reduces the risk of cardiovascular mortality but not total mortality. We saw a significant reduction in the risk of hospitalisation with CR but not in the risk of MI or revascularisation. We identified further evidence supporting improved HRQL with exercise-based CR. More recent trials were more...

  5. Establishing the macular grading grid by means of fovea centre detection using anatomical-based and visual-based features.

    Science.gov (United States)

    Aquino, Arturo

    2014-12-01

    This paper presents a methodology for establishing the macular grading grid in digital retinal images by means of fovea centre detection. To this effect, visual and anatomical feature-based criteria are combined with the aim of exploiting the benefits of both techniques. First, acceptable fovea centre estimation is obtained by using a priori known anatomical features with respect to the optic disc and the vascular tree. Second, a type of morphological processing is employed in an attempt to improve the obtained fovea centre estimation when the fovea is detectable in the image; otherwise, it is declared indistinguishable and the first result is retained. The methodology was tested on the MESSIDOR and DIARETDB1 databases making use of a distance criterion between the obtained and the real fovea centre. Fovea centres in the brackets between the categories Excellent and Fair (fovea centres primarily accepted as valid in the literature) made up for 98.24% and 94.38% of the cases in the MESSIDOR and DIARETDB1, respectively.

  6. Sex-Based Differences in Cardiac Arrhythmias, ICD Utilisation and Cardiac Resynchronisation Therapy.

    Science.gov (United States)

    Ghani, A; Maas, A H E M; Delnoy, P P H M; Ramdat Misier, A R; Ottervanger, J P; Elvan, A

    2011-01-01

    Many important differences in the presentation and clinical course of cardiac arrhythmias are present between men and women that should be accounted for in clinical practice. In this paper, we review published data on gender differences in cardiac excitable properties, supraventricular tachycardias, ventricular tachycardias, sudden cardiac death, and the utilisation of implantable defibrillators and cardiac resynchronisation therapy. Women have a higher heart rate at rest, and a longer QT interval than men. They further have a narrower QRS complex and lower QRS voltages on the 12-lead ECG with more often non-specific repolarisation abnormalities at rest. Supraventricular tachycardias, such as AV nodal reentrant tachycardia, are twice as frequent in women compared with men. Atrial fibrillation, however, has a 1.5-fold higher prevalence in men. The triggers for idiopathic right ventricular outflow tract tachycardia (VT) initiation are gender specific, i.e. hormonal changes play an important role in the occurrence of these VTs in women. There are clear-cut gender differences in acquired and congenital LQTS. Brugada syndrome affects men more commonly and severely than women. Sudden cardiac death is less prevalent in women at all ages and occurs 10 years later in women than in men. This may be related to the later onset of clinically manifest coronary heart disease in women. Among patients who receive ICDs and CRT devices, women appear to be under-represented, while they may benefit even more from these novel therapies.

  7. Enabling occupation: occupation-based and client centred practice in Occupational Therapy

    Directory of Open Access Journals (Sweden)

    Tatiana Barcelos Pontes

    2016-04-01

    Full Text Available Occupational therapists have always been dedicated to the human occupation study, however the client hasn’t always been seen as an occupational being, with needs, interests and individual goals. The concern for our clients’ engagement in occupation, rather than the acquisition or restoration of performance components, together with the gradual modification of the concept of occupation from work-related activities to purposeful human activity, requires a broadening of our scope of practice. The most current theories related to occupational therapy practice have highlightes the use of client centered and occupational based practices. In occupation-based, client-centred practice the client participates actively in negotiating goals, and client occupational goals are given priority and are placed at the centre of assessment, intervention and outcomes. There are numerous evidences in the literature with significantly positive results supporting these approaches. These approaches are based on the premises that goals and objectives of interventions should be focused in occupation and significant activities to the client and reflect the occupational therapy core values: an occupational-centred perspective that respects client’s choices, goals and values, promoting and supporting the engagement on meaningful activities.

  8. Development of a QFD-based expert system for CNC turning centre selection

    Science.gov (United States)

    Prasad, Kanika; Chakraborty, Shankar

    2015-10-01

    Computer numerical control (CNC) machine tools are automated devices capable of generating complicated and intricate product shapes in shorter time. Selection of the best CNC machine tool is a critical, complex and time-consuming task due to availability of a wide range of alternatives and conflicting nature of several evaluation criteria. Although, the past researchers had attempted to select the appropriate machining centres using different knowledge-based systems, mathematical models and multi-criteria decision-making methods, none of those approaches has given due importance to the voice of customers. The aforesaid limitation can be overcome using quality function deployment (QFD) technique, which is a systematic approach for integrating customers' needs and designing the product to meet those needs first time and every time. In this paper, the adopted QFD-based methodology helps in selecting CNC turning centres for a manufacturing organization, providing due importance to the voice of customers to meet their requirements. An expert system based on QFD technique is developed in Visual BASIC 6.0 to automate the CNC turning centre selection procedure for different production plans. Three illustrative examples are demonstrated to explain the real-time applicability of the developed expert system.

  9. Smartphone-Based Cardiac Rehabilitation Program: Feasibility Study

    Science.gov (United States)

    Chung, Heewon; Yoon, Kwon-Ha; Lee, Jinseok

    2016-01-01

    We introduce a cardiac rehabilitation program (CRP) that utilizes only a smartphone, with no external devices. As an efficient guide for cardiac rehabilitation exercise, we developed an application to automatically indicate the exercise intensity by comparing the estimated heart rate (HR) with the target heart rate zone (THZ). The HR is estimated using video images of a fingertip taken by the smartphone’s built-in camera. The introduced CRP app includes pre-exercise, exercise with intensity guidance, and post-exercise. In the pre-exercise period, information such as THZ, exercise type, exercise stage order, and duration of each stage are set up. In the exercise with intensity guidance, the app estimates HR from the pulse obtained using the smartphone’s built-in camera and compares the estimated HR with the THZ. Based on this comparison, the app adjusts the exercise intensity to shift the patient’s HR to the THZ during exercise. In the post-exercise period, the app manages the ratio of the estimated HR to the THZ and provides a questionnaire on factors such as chest pain, shortness of breath, and leg pain during exercise, as objective and subjective evaluation indicators. As a key issue, HR estimation upon signal corruption due to motion artifacts is also considered. Through the smartphone-based CRP, we estimated the HR accuracy as mean absolute error and root mean squared error of 6.16 and 4.30bpm, respectively, with signal corruption due to motion artifacts being detected by combining the turning point ratio and kurtosis. PMID:27551969

  10. PATIENTS OVERCOME ANXIETY AND ARE ENCOURAGED TO BE PHYSICAL ACTIVE THROUGH EXERCISE-BASED CARDIAC REHABILITATION

    DEFF Research Database (Denmark)

    Simonÿ, Charlotte; Dreyer, Pia; Pedersen, Birthe D.

    into that the heart endures physical activity. In addition to serving as physical guidance, exercise-based cardiac rehabilitation offers valuable mental support. The patients find help to overcome an initial anxiety and move forward towards a physically active life featuring a feeling of improved health and new......Purpose. Patients face demanding and challenging processes when they experience cardiac problems. Exercise-based cardiac rehabilitation is established to enable these patients to move forward to lead a satisfying life. It is recognised that patients fail to join all sessions of the rehabilitation......, and it seems to be crucial to further emphasise the individuals lived experiences when exercise-based cardiac rehabilitation is followed. Hence this study aims to investigate how patients experience exercise-based cardiac rehabilitation in a hospital setting. Methods. This study, which included nine men...

  11. Satellite-based climate information within the WMO RA VI Regional Climate Centre on Climate Monitoring

    Science.gov (United States)

    Obregón, A.; Nitsche, H.; Körber, M.; Kreis, A.; Bissolli, P.; Friedrich, K.; Rösner, S.

    2014-05-01

    The World Meteorological Organization (WMO) established Regional Climate Centres (RCCs) around the world to create science-based climate information on a regional scale within the Global Framework for Climate Services (GFCS). The paper introduces the satellite component of the WMO Regional Climate Centre on Climate Monitoring (RCC-CM) for Europe and the Middle East. The RCC-CM product portfolio is based on essential climate variables (ECVs) as defined by the Global Climate Observing System (GCOS), spanning the atmospheric (radiation, clouds, water vapour) and terrestrial domains (snow cover, soil moisture). In the first part, the input data sets are briefly described, which are provided by the EUMETSAT (European Organisation for the Exploitation of Meteorological Satellites) Satellite Application Facilities (SAF), in particular CM SAF, and by the ESA (European Space Agency) Climate Change Initiative (CCI). In the second part, the derived RCC-CM products are presented, which are divided into two groups: (i) operational monitoring products (e.g. monthly means and anomalies) based on near-real-time environmental data records (EDRs) and (ii) climate information records (e.g. climatologies, time series, trend maps) based on long-term thematic climate data records (TCDRs) with adequate stability, accuracy and homogeneity. The products are provided as maps, statistical plots and gridded data, which are made available through the RCC-CM website (www.dwd.de/rcc-cm).

  12. Acoustic cardiac signals analysis: a Kalman filter-based approach.

    Science.gov (United States)

    Salleh, Sheik Hussain; Hussain, Hadrina Sheik; Swee, Tan Tian; Ting, Chee-Ming; Noor, Alias Mohd; Pipatsart, Surasak; Ali, Jalil; Yupapin, Preecha P

    2012-01-01

    Auscultation of the heart is accompanied by both electrical activity and sound. Heart auscultation provides clues to diagnose many cardiac abnormalities. Unfortunately, detection of relevant symptoms and diagnosis based on heart sound through a stethoscope is difficult. The reason GPs find this difficult is that the heart sounds are of short duration and separated from one another by less than 30 ms. In addition, the cost of false positives constitutes wasted time and emotional anxiety for both patient and GP. Many heart diseases cause changes in heart sound, waveform, and additional murmurs before other signs and symptoms appear. Heart-sound auscultation is the primary test conducted by GPs. These sounds are generated primarily by turbulent flow of blood in the heart. Analysis of heart sounds requires a quiet environment with minimum ambient noise. In order to address such issues, the technique of denoising and estimating the biomedical heart signal is proposed in this investigation. Normally, the performance of the filter naturally depends on prior information related to the statistical properties of the signal and the background noise. This paper proposes Kalman filtering for denoising statistical heart sound. The cycles of heart sounds are certain to follow first-order Gauss-Markov process. These cycles are observed with additional noise for the given measurement. The model is formulated into state-space form to enable use of a Kalman filter to estimate the clean cycles of heart sounds. The estimates obtained by Kalman filtering are optimal in mean squared sense.

  13. Computer-based analysis of cardiac state using entropies, recurrence plots and Poincare geometry.

    Science.gov (United States)

    Chua, K C; Chandran, V; Acharya, U R; Lim, C M

    2008-01-01

    Heart rate variability refers to the regulation of the sinoatrial node, the natural pacemaker of the heart by the sympathetic and parasympathetic branches of the autonomic nervous system. Heart rate variability is important because it provides a window to observe the heart's ability to respond to normal regulatory impulses that affect its rhythm. A computer-based intelligent system for analysis of cardiac states is very useful in diagnostics and disease management. Parameters are extracted from the heart rate signals and analysed using computers for diagnostics. This paper describes the analysis of normal and seven types of cardiac abnormal signals using approximate entropy (ApEn), sample entropy (SampEn), recurrence plots and Poincare plot patterns. Ranges of these parameters for various cardiac abnormalities are presented with an accuracy of more than 95%. Among the two entropies, ApEn showed better performance for all the cardiac abnormalities. Typical Poincare and recurrence plots are shown for various cardiac abnormalities.

  14. Cardiac tissue engineering and regeneration using cell-based therapy

    Directory of Open Access Journals (Sweden)

    Alrefai MT

    2015-05-01

    Full Text Available Mohammad T Alrefai,1–3 Divya Murali,4 Arghya Paul,4 Khalid M Ridwan,1,2 John M Connell,1,2 Dominique Shum-Tim1,2 1Division of Cardiac Surgery, 2Division of Surgical Research, McGill University Health Center, Montreal, QC, Canada; 3King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; 4Department of Chemical and Petroleum Engineering, School of Engineering, University of Kansas, Lawrence, KS, USA Abstract: Stem cell therapy and tissue engineering represent a forefront of current research in the treatment of heart disease. With these technologies, advancements are being made into therapies for acute ischemic myocardial injury and chronic, otherwise nonreversible, myocardial failure. The current clinical management of cardiac ischemia deals with reestablishing perfusion to the heart but not dealing with the irreversible damage caused by the occlusion or stenosis of the supplying vessels. The applications of these new technologies are not yet fully established as part of the management of cardiac diseases but will become so in the near future. The discussion presented here reviews some of the pioneering works at this new frontier. Key results of allogeneic and autologous stem cell trials are presented, including the use of embryonic, bone marrow-derived, adipose-derived, and resident cardiac stem cells. Keywords: stem cells, cardiomyocytes, cardiac surgery, heart failure, myocardial ischemia, heart, scaffolds, organoids, cell sheet and tissue engineering

  15. Availability of, referral to and participation in exercise-based cardiac rehabilitation after heart valve surgery

    DEFF Research Database (Denmark)

    Hansen, Tina B; Berg, Selina K; Sibilitz, Kirstine L;

    2015-01-01

    BACKGROUND: As with ischaemic heart disease, cardiac rehabilitation (CR) is recommended for patients undergoing heart valve surgery; recommendations are based on limited evidence. The organization of CR programmes and factors associated with uptake among patients undergoing heart valve surgery have...

  16. Home- and Hospital-Based Cardiac Rehabilitation Exercise: The Important Role of Physician Recommendation.

    Science.gov (United States)

    Dunn, Susan L; Dunn, L Maureen; Buursma, Madison P; Clark, Jacob A; Vander Berg, Lucas; DeVon, Holli A; Tintle, Nathan L

    2016-09-02

    Exercise reduces morbidity and mortality for patients with heart disease. Despite clear guidelines and known benefits, most cardiac patients do not meet current exercise recommendations. Physician endorsement positively affects patient participation in hospital-based Phase II cardiac rehabilitation programs, yet the importance of physician recommendation for home-based cardiac rehabilitation exercise is unknown. A prospective observational design was used to examine predictors of both home-based and Phase II rehabilitation exercise in a sample of 251 patients with coronary heart disease. Regression analyses were done to examine demographic and clinical characteristics, physical functioning, and patient's report of physician recommendation for exercise. Patients with a strong physician referral, who were married and older, were more likely to participate in Phase II exercise. Increased strength of physician recommendation was the unique predictor of home-based exercise. Further research is needed to examine how health professionals can motivate cardiac patients to exercise in home and outpatient settings.

  17. Hydrogel based injectable scaffolds for cardiac tissue regeneration.

    Science.gov (United States)

    Radhakrishnan, Janani; Krishnan, Uma Maheswari; Sethuraman, Swaminathan

    2014-01-01

    Tissue engineering promises to be an effective strategy that can overcome the lacuna existing in the current pharmacological and interventional therapies and heart transplantation. Heart failure continues to be a major contributor to the morbidity and mortality across the globe. This may be attributed to the limited regeneration capacity after the adult cardiomyocytes are terminally differentiated or injured. Various strategies involving acellular scaffolds, stem cells, and combinations of stem cells, scaffolds and growth factors have been investigated for effective cardiac tissue regeneration. Recently, injectable hydrogels have emerged as a potential candidate among various categories of biomaterials for cardiac tissue regeneration due to improved patient compliance and facile administration via minimal invasive mode that treats complex infarction. This review discusses in detail on the advances made in the field of injectable materials for cardiac tissue engineering highlighting their merits over their preformed counterparts.

  18. The New Zealand Centre for Adverse Reactions Monitoring: a source of practice-based evidence

    Directory of Open Access Journals (Sweden)

    Savage R

    2013-06-01

    Full Text Available The database of the New Zealand Centre for Adverse Reactions Monitoring (CARM is an example of the practice-based evidence discussed in the June issue of the Journal of Primary Health Care. Databases of reported adverse drug reactions (ADRs were established to generate hypotheses to be tested about previously unrecognised adverse reactions and interactions. Occasionally they are sufficient evidence in themselves. They can also identify prescribing practices that might increase the potential for ADRs to occur and provide feedback into guidelines in terms of the consequences of their use or non-use. Well-documented ADR reports can also highlight risk factors, thus providing a valuable contribution to risk benefit assessments in individual patients. Examples are discussed that support the use of ADRs as practice-based evidence in a non-hierarchical system in which case reports and case series, observational studies and randomised clinical trials contribute in a flexible relationship depending on the issue under investigation.

  19. Understanding Acid-Base Concepts: Evaluating the Efficacy of a Senior High School Student-Centred Instructional Program in Indonesia

    Science.gov (United States)

    Rahayu, Sri; Chandrasegaran, A. L.; Treagust, David F.; Kita, Masakazu; Ibnu, Suhadi

    2011-01-01

    This study was a mixed quantitative-qualitative research to evaluate the efficacy of a designed student-centred instructional (DSCI) program for teaching about acids and bases. The teaching innovation was designed based on constructivist, hands-on inquiry and context-based approaches and implemented in seven 45-min lessons with a class of 36 grade…

  20. Communication training for centre-based carers of children with severe or profound disabilities in the Western Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Martha Geiger

    2012-05-01

    Full Text Available The purpose of this paper is to provide a preliminary, qualitative review of an approach to training centre-based carers in supporting basic communication development and providing communication opportunities for the children with severe and profound disabilities in their care. In South Africa, these children are often the most neglected in terms of planning and providing appropriate interventions. For those with severe communication disabilities, an additional lack is in the area of the basic human right to meaningful interactions and communication. Sustainable strategies to provide opportunities for basic communication development of these children are urgently sought. Several effective international and local parent training programmes have been developed, but the urgent need remains to train centre-based carers who are taking care of groups of diversely disabled children in severely under-resourced settings. Non-profit organisations (NPOs have been exploring practical centre-based approaches to skills sharing in physical rehabilitation, activities for daily living, feeding and support for basic communication development. As a freelance speech therapist contracted by four NPOs to implement hands-on training in basic communication for centre-based carers of non-verbal children, the author describes a training approach that evolved over three years, in collaboration with the carers and centre managements. Implications for training (for speech therapists and for community-based rehabilitation workers and for further research are identified.

  1. Nonlinear consensus protocols for multi-agent systems based on centre manifold reduction

    Institute of Scientific and Technical Information of China (English)

    Li Yu-Mei; Guan Xin-Ping

    2009-01-01

    Nonlinear consensus protocols for dynamic directed networks of multi-agent systems with fixed and switching topologies are investigated separately in this paper. Based on the centre manifold reduction technique,nonlinear consensus protocols are presented.We prove that a group of agents can reach a β-consensus,the value of which is the group decision value varying from the minimum and the maximum values of the initial states of the agents.Moreover,we derive the conditions to guarantee that all the agents reach a β-consensus on a desired group decision value.Finally,a simulation study concerning the vertical alignment manoeuvere of a team of unmanned air vehicles is performed.Simulation results show that the nonlinear consensus protocols proposed are more effective than the linear protocols for the formation control of the agents and they are an improvement over existing protocols.

  2. Quality descriptors of optical beams based on centred reduced moments I spot analysis

    CERN Document Server

    Castaneda, R; García-Sucerquia, J

    2003-01-01

    A method for analyzing beam spots is discussed. It is based on the central reduced moments of the spot and its associated density functions. These functions allow us to separately analyze specific spot fractions, in such a way that specific combinations of higher order moments can be interpreted as coordinates of their centre of mass and the length and orientations of their principal axis. So, the descriptors of the associated density functions deal with the quantitative estimation of spot features, such as coma-like and astigmatism-like distortions. To assure high accuracy, background noise suppression and an optimal match of the spot support onto the region [-1,1]x[- 1,1] are performed prior to the calculation of the moments. Simulations were performed for illustrating the method.

  3. Enantiopure Ferrocene-Based Planar-Chiral Iridacycles: Stereospecific Control of Iridium-Centred Chirality.

    Science.gov (United States)

    Arthurs, Ross A; Ismail, Muhammad; Prior, Christopher C; Oganesyan, Vasily S; Horton, Peter N; Coles, Simon J; Richards, Christopher J

    2016-02-24

    Reaction of [IrCp*Cl2 ]2 with ferrocenylimines (Fc=NAr, Ar=Ph, p-MeOC6 H4 ) results in ferrocene C-H activation and the diastereoselective synthesis of half-sandwich iridacycles of relative configuration Sp *,RIr *. Extension to (S)-2-ferrocenyl-4-(1-methylethyl)oxazoline gave highly diastereoselective control over the new elements of planar chirality and metal-based pseudo-tetrahedral chirality, to give both neutral and cationic half-sandwich iridacycles of absolute configuration Sc ,Sp ,RIr . Substitution reactions proceed with retention of configuration, with the planar chirality controlling the metal-centred chirality through an iron-iridium interaction in the coordinatively unsaturated cationic intermediate.

  4. A Cryogenic Radiometry Based Spectral Responsivity Scale at the National Metrology Centre

    Science.gov (United States)

    Xu, Gan; Huang, Xuebo

    This paper describes the spectral responsivity scale established at the National Metrology Centre (NMC) based on cryogenic radiometry. A primary standard - a mechanically pumped cryogenic radiometer together with a set of intensity-stabilised lasers provides traceability for optical power measurement with an uncertainty in the order of 10-4 at 14 discrete wavelengths in the spectral range from 350 nm to 800 nm. A silicon trap detector, with its absolute responsivity calibrated against the cryogenic radiometer is used as a transfer standard for the calibration of other detectors using a specially built spectral comparator. The relative spectral responsivity of a detector at other wavelengths can be determined through the use of a cavity pyroelectric detector and the extrapolation technique. With this scale, NMC is capable to calibrate the spectral responsivity of different type of photo detectors from 250 nm to 1640 nm with an uncertainty range from 3.7% to 0.3%.

  5. Echocardiography and cardiac biomarkers in patients with non-small cell lung cancer treated with platinum-based chemotherapy

    Science.gov (United States)

    Omersa, Daniel; Cufer, Tanja; Marcun, Robert

    2017-01-01

    Abstract Background Non-small cell lung cancer (NSCLC) is the most common type of lung cancer and remains an important cause of cancer death worldwide. Platinum-based chemotherapy (PBC) for NSCLC can modify outcome while the risk of cardiotoxicity remains poorly researched. We aimed to evaluate the incidence and severity of cardiac injury during PBC in patients with NSCLC and to identify patients at risk. Methods This was a single-centre, prospective, observational study of patients with early and advanced stage NSCLC referred for PBC. In addition to standard care, patients were examined and evaluated for cardiotoxicity before the first dose (visit 1), at the last dose (visit 2) and 6 months after the last dose of PBC (visit 3). Cardiotoxicity (at visit 2 and 3) was defined as increase in the ultrasensitive troponin T, N-terminal pro-B type natriuretic peptide or decrease in left ventricular ejection fraction (LVEF). Results Overall, 41 patients (mean age 61 ± 9; 54% men; 68% advanced lung cancer) were included. The median number of PBC cycles was 4. During the study period, there were no incidents of heart failure, and 3 deaths caused by tumour progression were recorded. The mean values of biomarkers and LVEF did not change significantly (p > 0.20). However, 10 (25%) had cardiotoxicity which was independently associated with a history of ischemic heart disease (p = 0.026). Conclusions In NSCLC, cardiac assessment and lifestyle modifications may be pursued in patients with a history of cardiac disease and in patients with longer life expectancy.

  6. Aggregate Size Optimization in Microwells for Suspension-based Cardiac Differentiation of Human Pluripotent Stem Cells

    OpenAIRE

    Bauwens, Celine L.; Toms, Derek; Ungrin, Mark

    2016-01-01

    Cardiac differentiation of human pluripotent stems cells (hPSCs) is typically carried out in suspension cell aggregates. Conventional aggregate formation of hPSCs involves dissociating cell colonies into smaller clumps, with size control of the clumps crudely controlled by pipetting the cell suspension until the desired clump size is achieved. One of the main challenges of conventional aggregate-based cardiac differentiation of hPSCs is that culture heterogeneity and spatial disorganization l...

  7. An active contour framework based on the Hermite transform for shape segmentation of cardiac MR images

    Science.gov (United States)

    Barba-J, Leiner; Escalante-Ramírez, Boris

    2016-04-01

    Early detection of cardiac affections is fundamental to address a correct treatment that allows preserving the patient's life. Since heart disease is one of the main causes of death in most countries, analysis of cardiac images is of great value for cardiac assessment. Cardiac MR has become essential for heart evaluation. In this work we present a segmentation framework for shape analysis in cardiac magnetic resonance (MR) images. The method consists of an active contour model which is guided by the spectral coefficients obtained from the Hermite transform (HT) of the data. The HT is used as model to code image features of the analyzed images. Region and boundary based energies are coded using the zero and first order coefficients. An additional shape constraint based on an elliptical function is used for controlling the active contour deformations. The proposed framework is applied to the segmentation of the endocardial and epicardial boundaries of the left ventricle using MR images with short axis view. The segmentation is sequential for both regions: the endocardium is segmented followed by the epicardium. The algorithm is evaluated with several MR images at different phases of the cardiac cycle demonstrating the effectiveness of the proposed method. Several metrics are used for performance evaluation.

  8. Three-dimensional quantum photonic elements based on single nitrogen vacancy-centres in laser-written microstructures

    CERN Document Server

    Schell, Andreas W; Fischer, Joachim; Henze, Rico; Wolters, Janik; Wegener, Martin; Benson, Oliver

    2013-01-01

    A fully integrated quantum optical technology requires active quantum systems incorporated into resonant optical microstructures and inter-connected in three dimensions via photonic wires. Nitrogen vacancy-centres (NV-centres) in diamond which are excellent photostable room temperature single-photon emitters are ideal candidates for that purpose. Extensive research efforts to couple NV-centres to photonic structures such as optical microresonators, microcavities, and waveguides have been pursued. Strategies for integration range from top-down fabrication via etching of diamond membranes to sophisticated bottom-up assembly of hybrid structures using diamond nanocrystals where the latter approach allows for deterministic coupling. Recently, another approach based on the incorporation of nanodiamonds in soft glass optical fibres via a melting process has been introduced. Here, we utilize two-photon direct laser writing (DLW) to fabricate fully three-dimensional (3D) structures from a photoresist mixed with a sol...

  9. Learning to Use Statistics in Research: A Case Study of Learning in a University-Based Statistical Consulting Centre

    Science.gov (United States)

    McGinn, Michelle K.

    2010-01-01

    This paper presents a qualitative case study of statistical practice in a university-based statistical consulting centre. Naturally occurring conversations and activities in the consulting sessions provided opportunities to observe questions, problems, and decisions related to selecting, using, and reporting statistics and statistical techniques…

  10. Dynamic Data Management Based on Archival Process Integration at the Centre for Environmental Data Archival

    Science.gov (United States)

    Conway, Esther; Waterfall, Alison; Pepler, Sam; Newey, Charles

    2015-04-01

    In this paper we decribe a business process modelling approach to the integration of exisiting archival activities. We provide a high level overview of existing practice and discuss how procedures can be extended and supported through the description of preservation state. The aim of which is to faciliate the dynamic controlled management of scientific data through its lifecycle. The main types of archival processes considered are: • Management processes that govern the operation of an archive. These management processes include archival governance (preservation state management, selection of archival candidates and strategic management) . • Operational processes that constitute the core activities of the archive which maintain the value of research assets. These operational processes are the acquisition, ingestion, deletion, generation of metadata and preservation actvities, • Supporting processes, which include planning, risk analysis and monitoring of the community/preservation environment. We then proceed by describing the feasability testing of extended risk management and planning procedures which integrate current practices. This was done through the CEDA Archival Format Audit which inspected British Atmospherics Data Centre and National Earth Observation Data Centre Archival holdings. These holdings are extensive, comprising of around 2PB of data and 137 million individual files which were analysed and characterised in terms of format based risk. We are then able to present an overview of the risk burden faced by a large scale archive attempting to maintain the usability of heterogeneous environmental data sets. We conclude by presenting a dynamic data management information model that is capable of describing the preservation state of archival holdings throughout the data lifecycle. We provide discussion of the following core model entities and their relationships: • Aspirational entities, which include Data Entity definitions and their associated

  11. Meta-Analyses of Human Cell-Based Cardiac Regeneration Therapies

    DEFF Research Database (Denmark)

    Gyöngyösi, Mariann; Wojakowski, Wojciech; Navarese, Eliano P;

    2016-01-01

    In contrast to multiple publication-based meta-analyses involving clinical cardiac regeneration therapy in patients with recent myocardial infarction, a recently published meta-analysis based on individual patient data reported no effect of cell therapy on left ventricular function or clinical ou...

  12. Neonatal Hearing Screening Programme (NHSP): At A Rural Based Tertiary Care Centre.

    Science.gov (United States)

    Sharma, Yojana; Mishra, Girish; Bhatt, Sushen H; Nimbalkar, Somashekhar

    2015-12-01

    Deafness is the most common curable childhood handicap. It is a well recognised fact that unidentified hearing impairment can adversely affect optimal speech and language development and therefore academic, social and emotional development. Universal neonatal hearing screening programmes are implemented in many developed countries. However it is still in its early stage in India. The incidence of hearing impairment in India is 1-6 per thousand newborns screened (Paediatrics 19:155-165, 1998; Indian J Paediatr 74(6):545-549, 2007; Status of Disability in India, pp 172-185 2000). To determine the incidence of permanent hearing loss of moderate to evere variety in neonates taking care in a tertiary care rural based hospital in Gujarat. It was a non randomised observational study done for duration of 3 years. All neonates born in Shri Krishna Hospital underwent screening using two stage protocols with DPOAE test and final confirmation done with BERA. Total 2534 neonates were screened out of them 52 failed and 2482 (97.94 %) neonates passed in the 1st DPOAE test with 2.05 % refer rate. Total 7 (2 per 1000) neonates were detected with hearing impairment. 10 % neonates had one or other high risk factor. Out of high risk neonates, 1.8 % were diagnosed with hearing impairment in high risk group. Overall the follow-up rate was 72.7 %. Hospital based universal hearing screening of new born before discharge is feasible at a rural based tertiary care centre. Non specialist staff is invaluable in achieving a satisfactory referral rate with two stage hearing screening protocol. However, more efficacious tracking and follow up system is needed to improve the follow up rate for diagnosis.

  13. Ultrabright and efficient single-photon generation based on nitrogen-vacancy centres in nanodiamonds on a solid immersion lens

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, Tim; Gaedeke, Friedemann; Banholzer, Moritz Julian; Benson, Oliver, E-mail: tim.schroeder@physik.hu-berlin.de [Humboldt-Universitaet zu Berlin, Institut fuer Physik, AG Nano Optics Newtonstrasse 15, 12489 Berlin (Germany)

    2011-05-15

    Single photons are fundamental elements for quantum information technologies such as quantum cryptography, quantum information storage and optical quantum computing. Colour centres in diamond have proven to be stable single-photon sources and thus essential components for reliable and integrated quantum information technology. A key requirement for such applications is a large photon flux and a high efficiency. Paying tribute to various attempts to maximize the single-photon flux, we show that collection efficiencies of photons from colour centres can be increased with a rather simple experimental setup. To do so, we spin-coated nanodiamonds containing single nitrogen-vacancy (N-V) colour centres on the flat surface of a ZrO{sub 2} solid immersion lens. We found stable single-photon count rates of up to 853 kcts s{sup -1} at saturation under continuous wave excitation while having access to more than 100 defect centres with count rates from 400 to 500 kcts s{sup -1}. For a blinking defect centre, we found count rates up to 2.4 Mcts s{sup -1} for time intervals of several tens of seconds. It seems to be a general feature that very high rates are accompanied by blinking behaviour. The overall collection efficiency of our setup of up to 4.2% is the highest yet reported for N-V defect centres in diamond. Under pulsed excitation of a stable emitter of 10 MHz, 2.2% of all pulses caused a click on the detector adding to 221 kcts s{sup -1} thus, opening the way towards diamond-based on-demand single-photon sources for quantum applications.

  14. KLIMA 2050: a research-based innovation centre for risk reduction through climate adaptation of infrastructure and buildings

    Science.gov (United States)

    Solheim, Anders; Time, Berit; Kvande, Tore; Sivertsen, Edvard; Cepeda, Jose; Lappegard Hauge, Åshild; Bygballe, Lena; Almås, Anders-Johan

    2016-04-01

    Klima 2050 - Risk reduction through climate adaptation of buildings and infrastructure is a Centre for Research based Innovation (SFI), funded jointly by the Research Council of Norway (RCN) and the partners of the centre. The aim of Klima 2050 is to reduce the societal risks associated with climate changes, including enhanced precipitation and flood water exposure within the built environment. The Centre will strengthen companies' innovation capacity through a focus on long-term research. It is also a clear objective to facilitate close cooperation between Research & Development, performing companies, public entities, and prominent research groups. Emphasis will be placed on development of moisture-resilient buildings, storm-water management, blue-green solutions, mitigation measures for water-triggered landslides, socio-economic incentives and decision-making processes. Both extreme weather and gradual climatic changes will be addressed. The Centre consists of a consortium of 18 partners from three sectors: industry, public entities and research/education organizations. The partners from the industry/private sector include a variety of companies from the building industry. The public entities comprise the most important infrastructure owners in Norway (public roads, railroads, buildings, airports), as well as the directorate for water and energy. The research and education partners are SINTEF Building and Infrastructure, the Norwegian Business School, the Norwegian University of Science and Technology, the Norwegian Meteorological Institute, and the Norwegian Geotechnical Institute. This contribution presents the main research plans and activities of this Centre, which was started in 2015 and will run for 8 years, until 2023. The presentation also includes options for international cooperation in the Centre via PhD and postdoctoral positions, MSc projects and guest-researcher stays with Klima 2050 partners.

  15. Genetic Diversity of Bali Cattle Based on Microsatellite Marker in Indonesian Breeding Centre

    Directory of Open Access Journals (Sweden)

    W. A. Septian

    2015-04-01

    Full Text Available Genetics characterization in livestock based on microsatellite has been widely implemented including for Bali cattle in three different breeding centres in Indonesia. This study aimed to determine diversity of Bali cattle microsatellites in three breeding centers namely BPTU Bali cattle in Bali, BPT-HMT Serading Sumbawa in West Nusa Tenggara, and Village Breeding Center in South Sulawesi. The number of animals used in this study was 95 head of cattle consisted of 32 heads from BPTU Bali Province, 32 heads from BPT-HMT Serading Sumbawa, and 31 heads from Village Barru Breeding Center Barru distric. Microsatellite loci used to determine the diversity was the locus SPS115, INRA037, MM12, and ETH185 based on flourescently labeled fragment method. Data analysis of microsatellite in Bali cattle at three different locations was performed by using POPGEN 1.2, Cervus, and POPTREE2 programs. The results showed that microsatellite diversity in Bali cattle detected 32 alleles from three different locations, and there were specific alleles at each location. Average values of observed heterozygosity (Ho and expected heterozygosity (He were 0.418 and 0.604 respectively, while the average value of polymorphism informative content (PIC was 0.579. The Hardy-Weinberg equilibrium in general suggested that the loci used in the Bali cattle in three populations were in equilibrium, except INRA037 and ETH185. The genetic diversity between populations of Bali cattle was 0.033 (3%, while the inbreeding coefficient index in all populations was 0.296 (29.6 %. Bali cattle phylogeny tree with three populations showed that the populations of Bali cattle in BPTU Bali and VBC Barru had close genetic distance compared to the population of Bali cattle in BPT-HMT Serading Sumbawa. The results of this study provide information that the characteristics of Bali cattle breeding centers in three locations are different, so we need a directed breeding program in each population.

  16. L’implication des organisations non gouvernementales dans les systèmes de santé des pays du Sud: l’exemple du Shisong Cardiac Centre The involvement of NGOs in the health systems in developing countries: the example of Shisong Cardiac Center

    Directory of Open Access Journals (Sweden)

    Butera Gianfranco

    2009-04-01

    Full Text Available Dans le tiers monde, près de 800 000 enfants naissent chaque année avec des cardiopathies congénitales (CC. Plusieurs millions d’enfants y vivent avec des CC corrigeables et une grande majorité décède à cause de l’absence de structure médicale spécialisée dans la correction chirurgicale totale ou palliative. C’est dans cette optique que l’association Associazione bambini cardiopatici nel mondo (Association mondiale des enfants cardiopathes a été créée. Grâce aux efforts de cette association, plus de 500 enfants souffrant de CC ont pu être évacués et soignés à l’hôpital de San Donato et plus 800 dans leur pays. Près de 200 praticiens en provenance des pays du Sud ont dans cette même perspective bénéficiée d’une formation en Italie. Cent quinze missions chirurgicales ont été réalisées dans différents pays: Egypte, Tunisie, Libye, Palestine, Cameroun, Roumanie, Azerbaïdjan, Pérou, Syrie, Yémen, Kurdistan et au Mali. Plusieurs hôpitaux ont été équipés gratuitement. Actuellement, l’association œuvre ardemment pour la réalisation de trois projets essentiels dont l’un est la construction d’un centre cardiaque dans la région de Shisong au Cameroun (Shisong Cardiac Centre. Ce centre cardiaque sera équipé d’appareils de dernière génération permettant de réaliser des investigations et la chirurgie cardiaques. L’inauguration de ce centre est prévue pour Novembre 2009.

  17. MR-Based Cardiac and Respiratory Motion-Compensation Techniques for PET-MR Imaging.

    Science.gov (United States)

    Munoz, Camila; Kolbitsch, Christoph; Reader, Andrew J; Marsden, Paul; Schaeffter, Tobias; Prieto, Claudia

    2016-04-01

    Cardiac and respiratory motion cause image quality degradation in PET imaging, affecting diagnostic accuracy of the images. Whole-body simultaneous PET-MR scanners allow for using motion information estimated from MR images to correct PET data and produce motion-compensated PET images. This article reviews methods that have been proposed to estimate motion from MR images and different techniques to include this information in PET reconstruction, in order to overcome the problem of cardiac and respiratory motion in PET-MR imaging. MR-based motion correction techniques significantly increase lesion detectability and contrast, and also improve accuracy of uptake values in PET images.

  18. Exercise-based cardiac rehabilitation in patients with chronic heart failure : a Dutch practice guideline

    NARCIS (Netherlands)

    Achttien, A.J.; Staal, J.B.; Voort, S. van der; Kemps, H.M.; Koers, H.; Jongert, M.W.A. (Tinus); Hendriks, E.J.M.

    2015-01-01

    Rationale To improve the quality of exercise-based cardiac rehabilitation (CR) in patients with chronic heart failure (CHF) a practice guideline from the Dutch Royal Society for Physiotherapy (KNGF) has been developed. Guideline development A systematic literature search was performed to formulate c

  19. Exercise-based cardiac rehabilitation in patients with chronic heart failure: a Dutch practice guideline

    NARCIS (Netherlands)

    Achttien, R.J.; Staal, J.B.; Voort, S. van der; Kemps, H.M.; Koers, H.; Jongert, M.W.; Hendriks, E.J.

    2015-01-01

    RATIONALE: To improve the quality of exercise-based cardiac rehabilitation (CR) in patients with chronic heart failure (CHF) a practice guideline from the Dutch Royal Society for Physiotherapy (KNGF) has been developed. GUIDELINE DEVELOPMENT: A systematic literature search was performed to formulate

  20. Identification of cardiac myofilament protein isoforms using multiple mass spectrometry based approaches

    NARCIS (Netherlands)

    Kooij, V.; Venkatraman, V.; Kirk, J.A.; Ubaida-Mohien, C.; Graham, D.R.; Faber, M.J.; Eyk, J.E. Van

    2014-01-01

    PURPOSE: The identification of protein isoforms in complex biological samples is challenging. We, therefore, used an MS approach to unambiguously identify cardiac myofilament protein isoforms based on the observation of a tryptic peptide consisting of a sequence unique to a particular isoform. EXPER

  1. MOEMS-based cardiac enzymes detector for acute myocardial infarction

    Science.gov (United States)

    Amritsar, Jeetender; Stiharu, Ion G.; Packirisamy, Muthukumaran; Balagopal, Ganesharam; Li, Xing

    2004-10-01

    Biomedical applications of MOEMS are limited only by the mankind imagination. Precision measurements on minute amounts of biological material could be performed by optical means with a remarkable accuracy. Although available in medical laboratories for general purposes, such analyzers are making their way directly to the users in the form of dedicated equipment. Such an example is a test kit to detect the existence of cardiac enzymes in the blood stream. Apart from the direct users, the medical personnel will make use of such tools given the practicality of the kit. In a large proportion of patients admitted to the hospital suspected of Acute Myocardial Infarction (AMI), the symptoms and electrocardiographic changes are inconclusive. This necessitates the use of biochemical markers of myocardial damage for correct exclusion or conformation of AMI. In this study the concept of MOEMS is applied for the detection of enzyme reaction, in which glass spectrums are scanned optically when enzyme molecules adsorb on their surface. This paper presents the optical behavior of glass spectrums under Horseradish Peroxide (HRP) enzyme reaction. The reported experimental results provide valuable information that will be useful in the development of biosensors for enzymatic detection. This paper also reports the dynamic behavior of different glass spectrums.

  2. Crystalloid-based cardioplegia for minimally invasive cardiac surgery.

    Science.gov (United States)

    Misfeld, Martin; Davierwala, Piroze

    2012-01-01

    With the ever-increasing popularity of minimally invasive (MI) cardiac surgery, procedures like aortic valve replacement, with or without concomitant aortic surgery, and mitral and tricuspid valve procedures are now routinely performed through a minimal-access partial upper sternotomy and right anterolateral small thoracotomy, respectively, in our institution. To have optimal visualization through a small incision, it is extremely important to reduce the number of instruments, retractors, and cannulae passing through the incision to a bare minimum and to avoid repeated manipulation of the operative field. Repeated use of blood cardioplegia to maintain myocardial protection can sometimes prevent the surgeon from executing the aforementioned measures. However, if adequate myocardial protection can be achieved and maintained by administering a single dose of crystalloid cardioplegia, it would help expedite the operation with greater ease. At our institution, myocardial protection during aortic valve surgery is achieved using either blood or crystalloid cardioplegia according to surgeon preference. However, crystalloid cardioplegia has become the standard myocardial protection strategy for performing MI mitral valve surgery. Our experience with crystalloid cardioplegia for MI mitral valve surgery is the focus of this article.

  3. Meta-Analyses of Human Cell-Based Cardiac Regeneration Therapies: Controversies in Meta-Analyses Results on Cardiac Cell-Based Regenerative Studies.

    Science.gov (United States)

    Gyöngyösi, Mariann; Wojakowski, Wojciech; Navarese, Eliano P; Moye, Lemuel À

    2016-04-15

    In contrast to multiple publication-based meta-analyses involving clinical cardiac regeneration therapy in patients with recent myocardial infarction, a recently published meta-analysis based on individual patient data reported no effect of cell therapy on left ventricular function or clinical outcome. A comprehensive review of the data collection, statistics, and the overall principles of meta-analyses provides further clarification and explanation for this controversy. The advantages and pitfalls of different types of meta-analyses are reviewed here. Each meta-analysis approach has a place when pivotal clinical trials are lacking and sheds light on the magnitude of the treatment in a complex healthcare field.

  4. Real-time feedback based control of cardiac restitution using optical mapping.

    Science.gov (United States)

    Kulkarni, Kanchan; Tolkacheva, Elena G

    2015-01-01

    Cardiac restitution is the shortening of the action potential duration with an increase in the heart rate. A shorter action potential duration enables a longer diastolic interval which ensures that the heart gets adequate time to refill with blood. At higher rates however, restitution becomes steep and thus, can lead to unstable electrical activity (alternans) in the heart, leading to fatal cardiac rhythms. It has been proposed that maintaining a shallow slope of cardiac restitution could have potentially anti-arrhythmic effects. Previous studies involved the control of action potential duration (APD) or diastolic interval (DI) in isolated tissue samples based on the feedback from single microelectrode recordings. This limited the spatial resolution of the feedback system. Here, we aimed to develop a real time feedback control system that enabled the detection of APDs from various single pixels based on optical mapping recordings. Stimuli were applied after a predefined fixed DI after detection of an APD. We validated our algorithm using optical mapping movies from an ex-vivo rabbit heart. Thus, we provide an optical mapping based approach for the control of cardiac restitution and a potential means to validate its anti-arrhythmic effects.

  5. Practice what you preach: developing person-centred culture in inpatient mental health settings through strengths-based, transformational leadership.

    Science.gov (United States)

    Beckett, Paul; Field, John; Molloy, Luke; Yu, Nickolas; Holmes, Douglas; Pile, Emily

    2013-08-01

    The experience of nursing staff and consumers in inpatient mental health wards is often reported as being negative. Efforts to improve culture and practice have had limited success, with ineffective leadership, staff resistance, and unresponsive organisational culture identified as common barriers to change. Practice development has been promoted as an approach to developing person-centred culture that enables professional development through participation, learning and empowerment. For person-centred practice to flourish, organisational leadership at all levels must reflect the same principles. In preparation for the opening of a new integrated mental health service, an inpatient mental health team participated in a practice development project. An action research approach was used to facilitate a series of "away days," initially with the nursing team and then other members of the multidisciplinary team (MDT). Transformational leadership principles were adopted in the facilitation of team activities underpinned by strengths and solution-focused practices. Evaluation of the project by staff members was very positive and there was a high level of participation in practice development activities. The project resulted in the creation of a development plan for the ward, which prioritised five key themes: person-centred care, personal recovery, strengths-based principles, and evidence-based and values-based care. The project outcomes highlight the importance of leadership, which parallels the ideals promoted for clinical practice.

  6. Motion adaptive patch-based low-rank approach for compressed sensing cardiac cine MRI.

    Science.gov (United States)

    Yoon, Huisu; Kim, Kyung Sang; Kim, Daniel; Bresler, Yoram; Ye, Jong Chul

    2014-11-01

    One of the technical challenges in cine magnetic resonance imaging (MRI) is to reduce the acquisition time to enable the high spatio-temporal resolution imaging of a cardiac volume within a short scan time. Recently, compressed sensing approaches have been investigated extensively for highly accelerated cine MRI by exploiting transform domain sparsity using linear transforms such as wavelets, and Fourier. However, in cardiac cine imaging, the cardiac volume changes significantly between frames, and there often exist abrupt pixel value changes along time. In order to effectively sparsify such temporal variations, it is necessary to exploit temporal redundancy along motion trajectories. This paper introduces a novel patch-based reconstruction method to exploit geometric similarities in the spatio-temporal domain. In particular, we use a low rank constraint for similar patches along motion, based on the observation that rank structures are relatively less sensitive to global intensity changes, but make it easier to capture moving edges. A Nash equilibrium formulation with relaxation is employed to guarantee convergence. Experimental results show that the proposed algorithm clearly reconstructs important anatomical structures in cardiac cine image and provides improved image quality compared to existing state-of-the-art methods such as k-t FOCUSS, k-t SLR, and MASTeR.

  7. Cell-based therapies for cardiac repair : a meeting report on scientific observations and European regulatory viewpoints

    NARCIS (Netherlands)

    Schüssler-Lenz, Martina; Beuneu, Claire; Menezes-Ferreira, Margarida; Jekerle, Veronika; Bartunek, Jozef; Chamuleau, Steven; Celis, Patrick; Doevendans, Pieter; O'Donovan, Maura; Hill, Jonathan; Hystad, Marit; Jovinge, Stefan; Kyselovič, Ján; Lipnik-Stangelj, Metoda; Maciulaitis, Romaldas; Prasad, Krishna; Samuel, Anthony; Tenhunen, Olli; Tonn, Torsten; Rosano, Giuseppe; Zeiher, Andreas; Salmikangas, Paula

    2016-01-01

    In the past decade, novel cell-based products have been studied in patients with acute and chronic cardiac disease to assess whether these therapies are efficacious in improving heart function and preventing the development of end-stage heart failure. Cardiac indications studied include acute myocar

  8. The development of a hassle-based diagnostic scale for predicting burnout in call centres

    Directory of Open Access Journals (Sweden)

    Willie A. Visser

    2009-04-01

    Full Text Available The aim of this study was to develop a brief daily hassle diagnostic questionnaire that could be used to identify daily hassles for customer service representatives within a call centre environment, and to investigate the relationship between daily hassles and burnout. A crosssectional survey was used with an accidental sample (N = 394 taken from a service and sales call centre. An exploratory factor analysis of the data resulted in a six-factor model of daily hassles consisting of daily demands, continuous change, co-worker hassles, demotivating work environment, transportation hassles and personal concerns. The internal consistency of one factor, namely personal concerns, was low. Exhaustion was best predicted by four categories of daily hassles, namely daily demands, continuous change, a demotivating work environment, and transportation hassles.

  9. A Randomised Controlled Trial of Two Early Intervention Programs for Young Children with Autism: Centre-Based with Parent Program and Home-Based

    Science.gov (United States)

    Roberts, Jacqueline; Williams, Katrina; Carter, Mark; Evans, David; Parmenter, Trevor; Silove, Natalie; Clark, Trevor; Warren, Anthony

    2011-01-01

    This study compares outcomes of early intervention programs for young children with autism; an individualised home-based program (HB), a small group centre-based program for children combined with a parent training and support group (CB) and a non-treatment comparison group (WL). Outcome measures of interest include social and communication skill…

  10. SLA-based optimisation of virtualised resource for multi-tier web applications in cloud data centres

    Science.gov (United States)

    Bi, Jing; Yuan, Haitao; Tie, Ming; Tan, Wei

    2015-10-01

    Dynamic virtualised resource allocation is the key to quality of service assurance for multi-tier web application services in cloud data centre. In this paper, we develop a self-management architecture of cloud data centres with virtualisation mechanism for multi-tier web application services. Based on this architecture, we establish a flexible hybrid queueing model to determine the amount of virtual machines for each tier of virtualised application service environments. Besides, we propose a non-linear constrained optimisation problem with restrictions defined in service level agreement. Furthermore, we develop a heuristic mixed optimisation algorithm to maximise the profit of cloud infrastructure providers, and to meet performance requirements from different clients as well. Finally, we compare the effectiveness of our dynamic allocation strategy with two other allocation strategies. The simulation results show that the proposed resource allocation method is efficient in improving the overall performance and reducing the resource energy cost.

  11. Nanodiamond-based nanostructures for coupling nitrogen-vacancy centres to metal nanoparticles and semiconductor quantum dots

    Science.gov (United States)

    Gong, Jianxiao; Steinsultz, Nat; Ouyang, Min

    2016-06-01

    The ability to control the interaction between nitrogen-vacancy centres in diamond and photonic and/or broadband plasmonic nanostructures is crucial for the development of solid-state quantum devices with optimum performance. However, existing methods typically employ top-down fabrication, which restrict scalable and feasible manipulation of nitrogen-vacancy centres. Here, we develop a general bottom-up approach to fabricate an emerging class of freestanding nanodiamond-based hybrid nanostructures with external functional units of either plasmonic nanoparticles or excitonic quantum dots. Precise control of the structural parameters (including size, composition, coverage and spacing of the external functional units) is achieved, representing a pre-requisite for exploring the underlying physics. Fine tuning of the emission characteristics through structural regulation is demonstrated by performing single-particle optical studies. This study opens a rich toolbox to tailor properties of quantum emitters, which can facilitate design guidelines for devices based on nitrogen-vacancy centres that use these freestanding hybrid nanostructures as building blocks.

  12. Exercise-based cardiac rehabilitation for adults after heart valve surgery

    DEFF Research Database (Denmark)

    Sibilitz, Kirstine Lærum; Berg, Selina Kikkenborg; Tang, Lars Hermann

    2016-01-01

    BACKGROUND: Exercise-based cardiac rehabilitation may benefit heart valve surgery patients. We conducted a systematic review to assess the evidence for the use of exercise-based intervention programmes following heart valve surgery. OBJECTIVES: To assess the benefits and harms of exercise......-based cardiac rehabilitation compared with no exercise training intervention, or treatment as usual, in adults following heart valve surgery. We considered programmes including exercise training with or without another intervention (such as a psycho-educational component). SEARCH METHODS: We searched...... handsearched Web of Science, bibliographies of systematic reviews and trial registers (ClinicalTrials.gov, Controlled-trials.com, and The World Health Organization International Clinical Trials Registry Platform). SELECTION CRITERIA: We included randomised clinical trials that investigated exercise...

  13. Uso de bomba centrífuga no pós-operatório de cirurgia cardíaca Assisted circulation in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Paulo M Pêgo-Fernandes

    1992-12-01

    Full Text Available Nos casos de choque cardiogênico após cirurgia cardíaca com auxílio da circulação extracorpórea retratarlos às drogas e ao balão intra-aórtico, as bombas centrífugas têm sido a primeira opção em vários Serviços. Esse fato deve-se à facilidade de manuseio, de instalação, custo razoável, grande disponibilidade, e alto grau de eficiência. O objetivo deste trabalho é o relato da experiência do Instituto do Coração com 8 pacientes submetidos a essa terapêutica, no período de maio de 1990 a dezembro de 1991. Nesses 8 doentes foi utilizado previamente balão intra-aórtico e feito uso maciço de drogas vasoativas. A idade variou de 54 a 66 anos. Três foram submetidos a revascularização do miocárdio, 2 a correção de aneurisma de ventrículo esquerdo, 2 a troca de valva mitral e 1 a transplante cardíaco. Em 7 a assistência foi de ventrículo esquerdo e em 1 de direito. A duração da assistência variou de 18 a 126 horas. Ocorreram três óbitos em assistência, sendo que dois eram pacientes em "ponte" para transplante que não obtiveram doador, e um morreu por complicações de sangramento e insuficiência renal aguda. Dos 5 (62,5% pacientes retirados da assistência, 2 faleceram tardiamente sendo 1 com pulmão de choque e 1 com complicação neurológica e insuficiência renal. Quando comparamos a evolução clínica com o pico de CKMB, verificamos que os 3 pacientes com pico maior que 80 faleceram, 2 em assistência e 1 tardiamente. Dos 5 doentes com pico de CKMB menor que 80, 4 foram retirados de assistência, com 3 sobreviventes tardios, e o único que morreu em assistência foi por problemas de sangramento. Os 3 (35% pacientes sobreviventes estão no 5º, 9º e 19º meses de seguimento, 2 em classe funcional II e 1 em classe I. A utilização precoce, antes de complicações irreversíveis, da assistência circulatória, deverá permitir resultados progressivamente melhores, nesse grupo de pacientes de alto risco

  14. When Students Take the Lead: Enhancing Quality and Relevance of Higher Education through Innovation in Student-Centred Problem-Based Active Learning

    DEFF Research Database (Denmark)

    2016-01-01

    Student-centred problem-based active learning contributes substantially to the enhancement of students’ competitiveness and employability. It also contributes to research, allowing academic staff to engage in research-based teaching, bringing the latest business and scientific developments directly...... to the students. Student-centred problem-based active learning encourages students to work independently and constructively using academic staff as mentors and supervisors. It is a learning philosophy according to which the learning process is organized in such a way that the students actively engage in finding...... problems and answers to these problems; student-centred active learning also encourages students to pursue their own learning objectives and paths....

  15. Identifying cardiac syncope based on clinical history: a literature-based model tested in four independent datasets.

    Directory of Open Access Journals (Sweden)

    Janneke Berecki-Gisolf

    Full Text Available BACKGROUND: We aimed to develop and test a literature-based model for symptoms that associate with cardiac causes of syncope. METHODS AND RESULTS: Seven studies (the derivation sample reporting ≥2 predictors of cardiac syncope were identified (4 Italian, 1 Swiss, 1 Canadian, and 1 from the United States. From these, 10 criteria were identified as diagnostic predictors. The conditional probability of each predictor was calculated by summation of the reported frequencies. A model of conditional probabilities and a priori probabilities of cardiac syncope was constructed. The model was tested in four datasets of patients with syncope (the test sample from Calgary (n=670; 21% had cardiac syncope, Amsterdam (n=503; 9%, Milan (n=689; 5% and Rochester (3877; 11%. In the derivation sample ten variables were significantly associated with cardiac syncope: age, gender, structural heart disease, low number of spells, brief or absent prodrome, supine syncope, effort syncope, and absence of nausea, diaphoresis and blurred vision. Fitting the test datasets to the full model gave C-statistics of 0.87 (Calgary, 0.84 (Amsterdam, 0.72 (Milan and 0.71 (Rochester. Model sensitivity and specificity were 92% and 68% for Calgary, 86% and 67% for Amsterdam, 76% and 59% for Milan, and 73% and 52% for Rochester. A model with 5 variables (age, gender, structural heart disease, low number of spells, and lack of prodromal symptoms was as accurate as the total set. CONCLUSION: A simple literature-based Bayesian model of historical criteria can distinguish patients with cardiac syncope from other patients with syncope with moderate accuracy.

  16. R&D networks and regional knowledge production: an agent-based simulation of the Austrian competence centres programme

    Directory of Open Access Journals (Sweden)

    Manuela Korber

    2014-06-01

    Full Text Available Publicly funded competence centres have gained high recognition for improving science-industry collaboration. With the requirement for long-term and geographically concentrated R&D, competence centres provide an environment for joint learning and transfer of “sticky” knowledge. The objective of this paper is to investigate how a competence centres programme affects knowledge production in the regional innovation system. In order to address this issue, we draw on a simulation approach and develop an agent-based model of the Vienna Life Sciences innovation system. Companies, research organisations and universities are heterogeneous agents that create scientific publications, patents, as well as high-tech jobs. Simulation runs refer to long-term scenarios regarding the level and duration of public funding. By addressing the complexities of knowledge interaction in the context of the “local buzz” versus “global pipelines” discussion, the results show the potential of empirically calibrated simulation models for ex-ante impact assessment in R&D policy.

  17. Anatomical-based Partial Volume Correction for Low-dose Dedicated Cardiac SPECT/CT

    OpenAIRE

    Liu, Hui; Chan, Chung; Grobshtein, Yariv; Ma, Tianyu; Liu, Yaqiang; Wang, Shi; Stacy, Mitchel R.; Sinusas, Albert J.; Liu, Chi

    2015-01-01

    Due to the limited spatial resolution, partial volume effect (PVE) has been a major degrading factor on quantitative accuracy in emission tomography systems. This study aims to investigate the performance of several anatomical-based partial volume correction (PVC) methods for a dedicated cardiac SPECT/CT system (GE Discovery NM/CT 570c) with focused field-of-view (FOV) over a clinically relevant range of high and low count levels for two different radiotracer distributions. These PVC methods ...

  18. Respiratory motion correction in gated cardiac SPECT using quaternion-based, rigid-body registration

    OpenAIRE

    Parker, Jason G.; Mair, Bernard A.; Gilland, David R.

    2009-01-01

    In this article, a new method is introduced for estimating the motion of the heart due to respiration in gated cardiac SPECT using a rigid-body model with rotation parametrized by a unit quaternion. The method is based on minimizing the sum of squared errors between the reference and the deformed frames resulting from the usual optical flow constraint by using an optimized conjugate gradient routine. This method does not require any user-defined parameters or penalty terms, which simplifies i...

  19. Image-Based Structural Modeling of the Cardiac Purkinje Network

    Directory of Open Access Journals (Sweden)

    Benjamin R. Liu

    2015-01-01

    Full Text Available The Purkinje network is a specialized conduction system within the heart that ensures the proper activation of the ventricles to produce effective contraction. Its role during ventricular arrhythmias is less clear, but some experimental studies have suggested that the Purkinje network may significantly affect the genesis and maintenance of ventricular arrhythmias. Despite its importance, few structural models of the Purkinje network have been developed, primarily because current physical limitations prevent examination of the intact Purkinje network. In previous modeling efforts Purkinje-like structures have been developed through either automated or hand-drawn procedures, but these networks have been created according to general principles rather than based on real networks. To allow for greater realism in Purkinje structural models, we present a method for creating three-dimensional Purkinje networks based directly on imaging data. Our approach uses Purkinje network structures extracted from photographs of dissected ventricles and projects these flat networks onto realistic endocardial surfaces. Using this method, we create models for the combined ventricle-Purkinje system that can fully activate the ventricles through a stimulus delivered to the Purkinje network and can produce simulated activation sequences that match experimental observations. The combined models have the potential to help elucidate Purkinje network contributions during ventricular arrhythmias.

  20. Challenges of cardiac image analysis in large-scale population-based studies.

    Science.gov (United States)

    Medrano-Gracia, Pau; Cowan, Brett R; Suinesiaputra, Avan; Young, Alistair A

    2015-03-01

    Large-scale population-based imaging studies of preclinical and clinical heart disease are becoming possible due to the advent of standardized robust non-invasive imaging methods and infrastructure for big data analysis. This gives an exciting opportunity to gain new information about the development and progression of heart disease across population groups. However, the large amount of image data and prohibitive time required for image analysis present challenges for obtaining useful derived data from the images. Automated analysis tools for cardiac image analysis are only now becoming available. This paper reviews the challenges and possible solutions to the analysis of big imaging data in population studies. We also highlight the potential of recent large epidemiological studies using cardiac imaging to discover new knowledge on heart health and well-being.

  1. Transforming cardiac rehabilitation into broad-based healthy lifestyle programs to combat noncommunicable disease.

    Science.gov (United States)

    Arena, Ross; Lavie, Carl J; Cahalin, Lawrence P; Briggs, Paige D; Guizilini, Solange; Daugherty, John; Chan, Wai-Man; Borghi-Silva, Audrey

    2016-01-01

    The current incidence and prevalence of noncommunicable diseases (NCDs) is currently a cause for great concern on a global scale; future projections are no less disconcerting. Unhealthy lifestyle patterns are at the core of the NCD crisis; physical inactivity, excess body mass, poor nutrition and tobacco use are the primary lifestyle factors that substantially increase the risk of developing one or more NCDs. We have now come to recognize that healthy lifestyle interventions are a medical necessity that should be prescribed to all individuals. Perhaps the most well-established model for healthy lifestyle interventions in the current healthcare model is cardiac rehabilitation. To have any hope of improving the outlook for NCDs on a global scale, what is currently known as cardiac rehabilitation must transform into broad-based healthy lifestyle programing, with a shifted focus on primordial and primary prevention.

  2. Face liveness detection for face recognition based on cardiac features of skin color image

    Science.gov (United States)

    Suh, Kun Ha; Lee, Eui Chul

    2016-07-01

    With the growth of biometric technology, spoofing attacks have been emerged a threat to the security of the system. Main spoofing scenarios in the face recognition system include the printing attack, replay attack, and 3D mask attack. To prevent such attacks, techniques that evaluating liveness of the biometric data can be considered as a solution. In this paper, a novel face liveness detection method based on cardiac signal extracted from face is presented. The key point of proposed method is that the cardiac characteristic is detected in live faces but not detected in non-live faces. Experimental results showed that the proposed method can be effective way for determining printing attack or 3D mask attack.

  3. Web-based multimedia courseware for emergency cardiac patient management simulations.

    Science.gov (United States)

    Ambrosiadou, V; Compton, T; Panchal, T; Polovina, S

    2000-01-01

    This is a multidisciplinary inter-departmental/faculty project between the departments of computer science, electronic, communications and electrical engineering and nursing and paramedic sciences. The objective is to develop a web based multimedia front end to existing simulations of cardiac emergency scenaria. It will be used firstly in the teaching of nurses. The University of Hertfordshire is the only University in Britain using simulations of cardiac emergency scenaria for nurse and paramedic science education and therefore this project will add the multimedia dimension in distributed courses over the web and will assess the improvement in the educational process. The use of network and multimedia technologies, provide interactive learning, immediate feedback to students' responses, individually tailored instructions, objective testing and entertaining delivery. The end product of this project will serve as interactive material to enhance experiential learning for nursing students using the simulations of cardiac emergency scenaria. The emergency treatment simulations have been developed using VisSim and may be compiled as C code. The objective of the project is to provide a web based user friendly multimedia interface in order to demonstrate the way in which patients may be managed in critical situations by applying advanced technological equipment and drug administration. Then the user will be able to better appreciate the concepts involved by running the VisSim simulations. The evaluation group for the proposed software will be the Department of Nursing and Paramedic Sciences About 200 nurses use simulations every year for training purposes as part of their course requirements.

  4. Calibration of robot tool centre point using camera-based system

    Directory of Open Access Journals (Sweden)

    Gordić Zaviša

    2016-01-01

    Full Text Available Robot Tool Centre Point (TCP calibration problem is of great importance for a number of industrial applications, and it is well known both in theory and in practice. Although various techniques have been proposed for solving this problem, they mostly require tool jogging or long processing time, both of which affect process performance by extending cycle time. This paper presents an innovative way of TCP calibration using a set of two cameras. The robot tool is placed in an area where images in two orthogonal planes are acquired using cameras. Using robust pattern recognition, even deformed tool can be identified on images, and information about its current position and orientation forwarded to control unit for calibration. Compared to other techniques, test results show significant reduction in procedure complexity and calibration time. These improvements enable more frequent TCP checking and recalibration during production, thus improving the product quality.

  5. Ultrasensitive cardiac troponin I antibody based nanohybrid sensor for rapid detection of human heart attack.

    Science.gov (United States)

    Bhatnagar, Deepika; Kaur, Inderpreet; Kumar, Ashok

    2017-02-01

    An ultrasensitive cardiac troponin I antibody conjugated with graphene quantum dots (GQD) and polyamidoamine (PAMAM) nanohybrid modified gold electrode based sensor was developed for the rapid detection of heart attack (myocardial infarction) in human. Screen printed gold (Au) electrode was decorated with 4-aminothiophenol for amine functionalization of the Au surface. These amino groups were further coupled with carboxyl functionalities of GQD with EDC-NHS reaction. In order to enhance the sensitivity of the sensor, PAMAM dendrimer was successively embedded on GQD through carbodiimide coupling to provide ultra-high surface area for antibody immobilization. The activated cardiac troponin I (cTnI) monoclonal antibody was immobilized on PAMAM to form nanoprobe for sensing specific heart attack marker cTnI. Various concentrations of cardiac marker, cTnI were electrochemically measured using cyclic voltammetry (CV) and differential pulse voltammetry (DPV) in human blood serum. The modifications on sensor surface were characterized by FTIR and AFM techniques. The sensor is highly specific to cTnI and showed negligible response to non-specific antigens. The sensitivity of the sensor was 109.23μAcm(-2)μg(-1) and lower limit of detection of cTnI was found 20fgmL(-1).

  6. Evaluation of bluetooth low power for physiological monitoring in a home based cardiac rehabilitation program.

    Science.gov (United States)

    Martin, Timothy; Ding, Hang; D'Souza, Matthew; Karunanithi, Mohan

    2012-01-01

    Cardiovascular disease (CVD) is the leading cause of mortality in Australia, and places large burdens on the healthcare system. To assist patients with CVDs in recovering from cardiac events and mediating cardiac risk factors, a home based cardiac rehabilitation program, known as the Care Assessment Platform (CAP), was developed. In the CAP program, patients are required to manually enter health information into their mobile phones on a daily basis. The manual operation is often subject to human errors and is inconvenient for some elderly patients. To improve this, an automated wireless solution has been desired. The objectives of this paper are to investigate the feasibility of implementing the newly released Bluetooth 4.0 (BT4.0) for the CAP program, and practically evaluate BT4.0 communications between a developed mobile application and some emulated healthcare devices. The study demonstrated that BT4.0 addresses usability, interoperability and security for healthcare applications, reduces the power consumption in wireless communication, and improves the flexibility of interface for software development. This evaluation study provides an essential mobile BT4.0 framework to incorporate a large range of healthcare devices for clinical assessment and intervention in the CAP program, and hence it is useful for similar development and research work of other mobile healthcare solutions.

  7. Diversification des exploitations agricoles à base de cacaoyer au Centre Cameroun : mythe ou réalité ?

    Directory of Open Access Journals (Sweden)

    Jagoret P.

    2009-01-01

    Full Text Available Diversification of cocoa farms in the Central Cameroon: myth or reality? A survey was conducted among 1,171 farmers to assess the degree of diversification on cocoa-based farms in the Centre Province of Cameroon, which is the main cocoa producing zone in the country. Fifteen years after the onset of liberalization of the cocoa supply chain, the results showed that area under cocoa predominates in the cropping plan on a farming system scale. The same applied for the contribution made by cocoa income to overall farm functioning. However, a further study carried out on 74 cocoa plantations in that region showed that diversification was more perceptible on the cocoa based production systems. In fact, fruit tree species, which are very often found in cocoa plantations, partly explained the occurrence of substantial agrobiodiversity. A north – south gradient was found in which diversification of the cocoa growing system was significantly greater in the forest – savannah transition zone than in the forest zone. However, it turned out that the process of diversification by planting fruit tree species in cocoa plantations was not a new phenomenon, since it involved all cocoa plantings whatever their age. This research thus relativizes the extent of the diversification strategy adopted by cocoa producers in the Centre Province of Cameroon in response to changes in their socioeconomic environment and the instability of international markets.

  8. 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.

  9. The development of an internet-based outpatient cardiac rehabilitation intervention: a Delphi study

    Directory of Open Access Journals (Sweden)

    Hanley Christine

    2010-06-01

    Full Text Available Abstract Background Face-to-face outpatient cardiac rehabilitation (OCR programs are an important and effective component in the management of cardiovascular disease. However, these programs have low participation rates, especially among patients who live rural or remote. Hence, there is a need to develop OCR programs that provide an alternative to face-to-face contact such as by using the Internet. Only a very limited number of Internet-based OCR programs have been developed and evaluated. Therefore, the purpose of this study was to identify issues that are relevant to the development of an Internet-based OCR intervention. Methods A three-round Delphi study among cardiac rehabilitation experts was conducted. In the first round, 43 experts outlined opinions they had on the development of an online ORC platform into an open-ended electronic questionnaire. In the second round, 42 experts completed a structured (five-point scale electronic questionnaire based on first round results, in which they scored items on their relevance. In the third round, the same experts were asked to re-rate the same items after feedback was given about the group median relevance score to establish a level of consensus. Results After the third round, high consensus was reached in 120 of 162 (74% questionnaire items, of which 93 (57% of 162 items also had high relevance according to the experts. The results indicate that experts strongly agreed on desired website content, data obtained from the patient, and level of interaction with patients that should be part of an Internet-based OCR intervention. Conclusion The high rates of consensus and relevance observed among cardiac rehabilitation experts are an indication that they perceived the development and implementation of an Internet-based ORC intervention as feasible, and as a valuable alternative to face-to-face programs. In many ways the experts indicated that an Internet-based ORC program should mimic a traditional

  10. Profile of stroke patients treated at a community - based rehabilitation centre in a Cape Town health district

    Directory of Open Access Journals (Sweden)

    A. J. Rhoda

    2003-02-01

    Full Text Available Stroke is a leading cause of death and disability in both developed and developing countries. Limited information is available, in South Africa, on the epidemiological profile of stroke survivors requiring rehabilitation. A descriptive study was therefore undertaken to compile, amongst others the demographic and medical profile of stroke patients attending  rehabilitation at a primary health care facility (Bishop Lavis Rehabilitation Centre.  Both medical- and rehabilitation records were reviewed to ensure completeness of information and to minimize missing clinical data bias. Relevant data was  captured on a data capture sheet.  The latter was based on key findings from the literature and developed by the researcher. The mean age of the population of stroke patients studied was 59 years, which is markedly younger than what has been reported globally in the literature. As was expected, hypertension was found to be the most prevalent risk factor. The presence of a combination of risk factors in the  majority of the group (on average, 2.4 risk factors per person warrants the introduction of aggressive health  education and stroke prevention programmes at this primary health care centre.

  11. Detection of Cardiac Biomarkers Using Single Polyaniline Nanowire-Based Conductometric Biosensors

    Directory of Open Access Journals (Sweden)

    Minhee Yun

    2012-05-01

    Full Text Available The detection of myoglobin (Myo, cardiac troponin I (cTnI, creatine kinase-MB (CK-MB, and b-type natriuretic peptide (BNP plays a vital role in diagnosing cardiovascular diseases. Here we present single site-specific polyaniline (PANI nanowire biosensors that can detect cardiac biomarkers such as Myo, cTnI, CK-MB, and BNP with ultra-high sensitivity and good specificity. Using single PANI nanowire-based biosensors integrated with microfluidic channels, very low concentrations of Myo (100 pg/mL, cTnI (250 fg/mL, CK-MB (150 fg/mL, and BNP (50 fg/mL were detected. The single PANI nanowire-based biosensors displayed linear sensing profiles for concentrations ranging from hundreds (fg/mL to tens (ng/mL. In addition, devices showed a fast (few minutes response satisfying respective reference conditions for Myo, cTnI, CK-MB, and BNP diagnosis of heart failure and for determining the stage of the disease. This single PANI nanowire-based biosensor demonstrated superior biosensing reliability with the feasibility of label free detection and improved processing cost efficiency due to good biocompatibility of PANI to monoclonal antibodies (mAbs. Therefore, this development of single PANI nanowire-based biosensors can be applied to other biosensors for cancer or other diseases.

  12. Respiratory motion correction in gated cardiac SPECT using quaternion-based, rigid-body registration.

    Science.gov (United States)

    Parker, Jason G; Mair, Bernard A; Gilland, David R

    2009-10-01

    In this article, a new method is introduced for estimating the motion of the heart due to respiration in gated cardiac SPECT using a rigid-body model with rotation parametrized by a unit quaternion. The method is based on minimizing the sum of squared errors between the reference and the deformed frames resulting from the usual optical flow constraint by using an optimized conjugate gradient routine. This method does not require any user-defined parameters or penalty terms, which simplifies its use in a clinical setting. Using a mathematical phantom, the method was quantitatively compared to the principal axis method, as well as an iterative method in which the rotation matrix was represented by Euler angles. The quaternion-based method was shown to be substantially more accurate and robust across a wide range of extramyocardial activity levels than the principal axis method. Compared with the Euler angle representation, the quaternion-based method resulted in similar accuracy but a significant reduction in computation times. Finally, the quaternion-based method was investigated using a respiratory-gated cardiac SPECT acquisition of a human subject. The motion-corrected image has increased sharpness and myocardial uniformity compared to the uncorrected image.

  13. Detection of cardiac biomarkers using single polyaniline nanowire-based conductometric biosensors.

    Science.gov (United States)

    Lee, Innam; Luo, Xiliang; Huang, Jiyong; Cui, Xinyan Tracy; Yun, Minhee

    2012-05-14

    The detection of myoglobin (Myo), cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), and b-type natriuretic peptide (BNP) plays a vital role in diagnosing cardiovascular diseases. Here we present single site-specific polyaniline (PANI) nanowire biosensors that can detect cardiac biomarkers such as Myo, cTnI, CK-MB, and BNP with ultra-high sensitivity and good specificity. Using single PANI nanowire-based biosensors integrated with microfluidic channels, very low concentrations of Myo (100 pg/mL), cTnI (250 fg/mL), CK-MB (150 fg/mL), and BNP (50 fg/mL) were detected. The single PANI nanowire-based biosensors displayed linear sensing profiles for concentrations ranging from hundreds (fg/mL) to tens (ng/mL). In addition, devices showed a fast (few minutes) response satisfying respective reference conditions for Myo, cTnI, CK-MB, and BNP diagnosis of heart failure and for determining the stage of the disease. This single PANI nanowire-based biosensor demonstrated superior biosensing reliability with the feasibility of label free detection and improved processing cost efficiency due to good biocompatibility of PANI to monoclonal antibodies (mAbs). Therefore, this development of single PANI nanowire-based biosensors can be applied to other biosensors for cancer or other diseases.

  14. Parametrization of activation based cardiac electrophysiology models using bidomain model simulations

    Directory of Open Access Journals (Sweden)

    Stender Birgit

    2016-09-01

    Full Text Available Eikonal models are useful to compute approximate solutions of cardiac excitation propagation in a computationally efficient way. In this work the underlying conduction velocities for different cell types were computed solving the classical bidomain model equations for planar wavefront propagation. It was further investigated how changes in the conductivity tensors within the bidomain model analytically correspond to changes in the conduction velocity. The error in the presence of local front curvature for the derived eikonal model parametrization were analyzed. The conduction velocity simulated based on the bidomain model was overestimated by a maximum of 10%.

  15. 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.

  16. Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Freeman Jennifer

    2012-04-01

    Full Text Available Abstract Background People with Multiple Sclerosis (MS frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK provides preliminary evidence that this approach can improve balance and mobility in ambulant people with MS; further evidence is needed to substantiate these findings to ensure that limited time, energy, finances and resources are used to best effect. This study builds upon the pilot work undertaken in the case series study by implementing a powered randomised controlled study, with the aims of: 1 Establishing the effectiveness of core stability training 2 Comparing core stability training with standardised physiotherapy exercise 3 Exploring underlying mechanisms of change associated with this intervention Methods This is a multi-centre, double blind, block randomised, controlled trial. Eligible participants will be recruited from 4 UK centres. Participants will be randomly allocated to one of three groups: Pilates based core stability training, standardised physiotherapy exercise or contract-relax relaxation sessions (placebo control. All will receive face to face training sessions over a 12 week period; together with a 15 minute daily home programme. All will be assessed by a blinded assessor before training, at the end of the 12 week programme and at 4 week follow-up. The primary outcome measure is the 10 metre timed walk. Secondary outcome measures are the MS walking Scale (MSWS-12, the Functional Reach (forwards and lateral, a 10 point Numerical Rating Scale to determine "Difficulty in carrying a drink when walking", and the Activities-specific Balance Confidence (ABC Scale. In addition, ultrasound imaging of the

  17. Regression-Based Cardiac Motion Prediction From Single-Phase CTA

    DEFF Research Database (Denmark)

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

    2012-01-01

    State of the art cardiac CT enables the acquisition of imaging data of the heart over the entire cardiac cycle at concurrent high spatial and temporal resolution. However, in clinical practice, acquisition is increasingly limited to 3D images. Estimating the shape of the cardiac structures...

  18. The client-centred approach as experienced by male neurological rehabilitation clients in occupational therapy. A qualitative study based on a grounded theory tradition.

    Science.gov (United States)

    Van de Velde, Dominique; Devisch, Ignaas; De Vriendt, Patricia

    2016-08-01

    Purpose To explore the perspectives of male clients in a neurological rehabilitation setting with regard to the occupational therapy they have received and the client-centred approach. Method This study involved a qualitative research design based on the grounded theory tradition. Individual in-depth interviews were used to collect data. Data were analysed using a constant comparative method. Seven male participants from an inpatient neurological setting were included using a theoretical sampling technique. Results Three themes emerged to describe the approach of the therapists to client-centred practice: (a) a shared biomedical focus as the start of the rehabilitation process, (b) the un-simultaneous shift from a biomedical towards a psycho-social focus and (c) formal versus informal nature of gathering client information. Conclusion A client-centred approach entails a shift from the therapist focussing on recovery from the short-term neurological issues towards the long-term consequences of the disease. According to the client, this shift in reasoning must occur at a specific and highly subjective moment during the rehabilitation process. Identifying this moment could strengthen the client-centred approach. Implications for Rehabilitation Client-centred practice entails a shift from recovering the short-term neurological issues towards the long-term psycho-social consequences of the disease. To be effective in client-centred practice, the clients expect from the professional to be an authority with regard to biomedical issues and to be partner with regard to psycho-social issues. Client-centred practice is most likely to be successful when client is susceptible to discuss his psycho-social issues and finding this moment is a challenge for the professional. Using formal methods for goal setting do not necessarily cover all the information needed for a client-centred therapy programme. Rather, using informal methods could lead to a more valid image of the client.

  19. Evaluating an undergraduate interprofessional simulation-based educational module: communication, teamwork, and confidence performing cardiac resuscitation skills

    Directory of Open Access Journals (Sweden)

    Marian Luctkar-Flude

    2010-11-01

    Full Text Available Marian Luctkar-Flude1, Cynthia Baker1, Cheryl Pulling1, Robert McGraw2, Damon Dagnone2, Jennifer Medves1, Carly Turner-Kelly11School of Nursing, Queen’s University, Kingston, Ontario, Canada; 2School of Medicine, Queen’s University, Kingston, Ontario, CanadaPurpose: Interprofessional (IP collaboration during cardiac resuscitation is essential and contributes to patient wellbeing. The purpose of this study is to evaluate an innovative simulation-based IP educational module for undergraduate nursing and medical students on cardiac resuscitation skills.Methods: Nursing and medical trainees participated in a new cardiac resuscitation curriculum involving a 2-hour IP foundational cardiac resuscitation skills lab, followed by three 2-hour IP simulation sessions. Control group participants attended the existing two 2-hour IP simulation sessions. Study respondents (N = 71 completed a survey regarding their confidence performing cardiac resuscitation skills and their perceptions of IP collaboration.Results: Despite a consistent positive trend, only one out of 17 quantitative survey items were significantly improved for learners in the new curriculum. They were more likely to report feeling confident managing the airway during cardiac resuscitation (P = 0.001. Overall, quantitative results suggest that senior nursing and medical students were comfortable with IP communication and teamwork and confident with cardiac resuscitation skills. There were no significant differences between nursing students’ and medical students’ results. Through qualitative feedback, participants reported feeling comfortable learning with students from other professions and found value in the IP simulation sessions.Conclusion: Results from this study will inform ongoing restructuring of the IP cardiac resuscitation skills simulation module as defined by the action research process. Specific improvements that are suggested by these findings include strengthening the team

  20. Cardiac C-arm CT: 4D non-model based heart motion estimation and its application

    Science.gov (United States)

    Prümmer, M.; Fahrig, R.; Wigström, L.; Boese, J.; Lauritsch, G.; Strobel, N.; Hornegger, J.

    2007-03-01

    The combination of real-time fluoroscopy and 3D cardiac imaging on the same C-arm system is a promising technique that might improve therapy planning, guiding, and monitoring in the interventional suite. In principal, to reconstruct a 3D image of the beating heart at a particular cardiac phase, a complete set of X-ray projection data representing that phase is required. One approximate approach is the retrospectively ECG-gated FDK reconstruction (RG-FDK). From the acquired data set of N s multiple C-arm sweeps, those projection images which are acquired closest in time to the desired cardiac phase are retrospectively selected. However, this approach uses only 1/ N s of the obtained data. Our goal is to utilize data from other cardiac phases as well. In order to minimize blurring and motion artifacts, cardiac motion has to be compensated for, which can be achieved using a temporally dependent spatial 3D warping of the filtered-backprojections. In this work we investigate the computation of the 4D heart motion based on prior reconstructions of several cardiac phases using RG-FDK. A 4D motion estimation framework is presented using standard fast non-rigid registration. A smooth 4D motion vector field (MVF) represents the relative deformation compared to a reference cardiac phase. A 4D deformation regridding by adaptive supersampling allows selecting any reference phase independently of the set of phases used in the RG-FDK for a motion corrected reconstruction. Initial promising results from in vivo experiments are shown. The subjects individual 4D cardiac MVF could be computed from only three RG-FDK image volumes. In addition, all acquired projection data were motion corrected and subsequently used for image reconstruction to improve the signal-to-noise ratio compared to RG-FDK.

  1. Improving Low-dose Cardiac CT Images based on 3D Sparse Representation

    Science.gov (United States)

    Shi, Luyao; Hu, Yining; Chen, Yang; Yin, Xindao; Shu, Huazhong; Luo, Limin; Coatrieux, Jean-Louis

    2016-03-01

    Cardiac computed tomography (CCT) is a reliable and accurate tool for diagnosis of coronary artery diseases and is also frequently used in surgery guidance. Low-dose scans should be considered in order to alleviate the harm to patients caused by X-ray radiation. However, low dose CT (LDCT) images tend to be degraded by quantum noise and streak artifacts. In order to improve the cardiac LDCT image quality, a 3D sparse representation-based processing (3D SR) is proposed by exploiting the sparsity and regularity of 3D anatomical features in CCT. The proposed method was evaluated by a clinical study of 14 patients. The performance of the proposed method was compared to the 2D spares representation-based processing (2D SR) and the state-of-the-art noise reduction algorithm BM4D. The visual assessment, quantitative assessment and qualitative assessment results show that the proposed approach can lead to effective noise/artifact suppression and detail preservation. Compared to the other two tested methods, 3D SR method can obtain results with image quality most close to the reference standard dose CT (SDCT) images.

  2. SVM-based classification of LV wall motion in cardiac MRI with the assessment of STE

    Science.gov (United States)

    Mantilla, Juan; Garreau, Mireille; Bellanger, Jean-Jacques; Paredes, José Luis

    2015-01-01

    In this paper, we propose an automated method to classify normal/abnormal wall motion in Left Ventricle (LV) function in cardiac cine-Magnetic Resonance Imaging (MRI), taking as reference, strain information obtained from 2D Speckle Tracking Echocardiography (STE). Without the need of pre-processing and by exploiting all the images acquired during a cardiac cycle, spatio-temporal profiles are extracted from a subset of radial lines from the ventricle centroid to points outside the epicardial border. Classical Support Vector Machines (SVM) are used to classify features extracted from gray levels of the spatio-temporal profile as well as their representations in the Wavelet domain under the assumption that the data may be sparse in that domain. Based on information obtained from radial strain curves in 2D-STE studies, we label all the spatio-temporal profiles that belong to a particular segment as normal if the peak systolic radial strain curve of this segment presents normal kinesis, or abnormal if the peak systolic radial strain curve presents hypokinesis or akinesis. For this study, short-axis cine- MR images are collected from 9 patients with cardiac dyssynchrony for which we have the radial strain tracings at the mid-papilary muscle obtained by 2D STE; and from one control group formed by 9 healthy subjects. The best classification performance is obtained with the gray level information of the spatio-temporal profiles using a RBF kernel with 91.88% of accuracy, 92.75% of sensitivity and 91.52% of specificity.

  3. A hospital based study on causes peculiar of congestive car-diac failure (CCF)

    Institute of Scientific and Technical Information of China (English)

    Hamzullah Khan; Hikmatullah Jan; Mohammad Hafizullah; Mahmoodul Hassan; Adnan Gul

    2008-01-01

    Objective:To determine the frequency of risk factors of congestive cardiac failure in a tertiary care hospital of Peshawar.Methods:This retrospective observational study was conducted in department of Cardiology,Post-graduate Medical Institute,Lady Reading Hospital Peshawar,from March 2005 to September 2007.Relevant information regarding the risk factors of congestive cardiac failure were recorded on questionnaire prepared in accordance with the objectives of the study.Results:1 019 patients with established diagnosis of cardiac fail-ure (based on clinical findings and relevant investigations) were included.Out of total sampling 583 (57.12%)were males and 436(42.78%)were females.The age range of the patients was from 6 years to 82 years with mean age of 48.5 years and mode of age was 45 years.The distribution of causative factors of CCF was:ischemic heart disease (IHD)36.31%,hypertension 26.30%,dilated cardiomyopathy 10.10%,obstr-uctve and restrictive cardiomyopathies 5.39%,valvular heart diseases (VHD)9.32%,congenital heart dis-ease like ventricular septal defects (VSD)4.41%,atrial septal defects (ASD)0.58%,atrial fibrillation (AF)2.25%,constrictive pericardidtis 1.07%,Pericardial effusion 0.68%,chronic obstructive pulmonary disease and pulmonary hypertension 1.47%,thyrotoxicosis 0.68%,complete heart block 0.29% and paget disease in 0.09% cases.Conclusion:Ischemic heart disease,hypertension,cardiomypathies,valvular heart disease and congenital heart disease are major contributor to CCF in our patients.

  4. Depth Attenuation Degree Based Visualization for Cardiac Ischemic Electrophysiological Feature Exploration

    Science.gov (United States)

    Liu, Lei; Zuo, Wangmeng; Zhang, Henggui

    2016-01-01

    Although heart researches and acquirement of clinical and experimental data are progressively open to public use, cardiac biophysical functions are still not well understood. Due to the complex and fine structures of the heart, cardiac electrophysiological features of interest may be occluded when there is a necessity to demonstrate cardiac electrophysiological behaviors. To investigate cardiac abnormal electrophysiological features under the pathological condition, in this paper, we implement a human cardiac ischemic model and acquire the electrophysiological data of excitation propagation. A visualization framework is then proposed which integrates a novel depth weighted optic attenuation model into the pathological electrophysiological model. The hidden feature of interest in pathological tissue can be revealed from sophisticated overlapping biophysical information. Experiment results verify the effectiveness of the proposed method for intuitively exploring and inspecting cardiac electrophysiological activities, which is fundamental in analyzing and explaining biophysical mechanisms of cardiac functions for doctors and medical staff. PMID:28004002

  5. The Educational Technology Centre: A Window to View the Progress of Chinese ICT-Based Higher Education

    Science.gov (United States)

    Zhou, Rong; Xie, Baizhi

    2010-01-01

    In China, after many years, the current status and challenges of e-learning development in higher education have been gradually understood. The educational technology centre (ECT) serves as the key unit to promote e-learning initiatives, but the performance of some centres still trails their foreign counterparts. Under such conditions, the project…

  6. The role of exchange interaction in nitrogen vacancy centre-based magnetometry

    OpenAIRE

    2016-01-01

    We propose a multilayer device comprising of a thin-film-based ferromagnetic hetero-structure (FMH) deposited on a diamond layer doped with nitrogen vacancy centers (NVC's). We find that when the NVC's are in close proximity (1-2 nm) with the FMH, the exchange energy is comparable to, and may even surpass the magnetostatic interaction energy. This calls for the need to consider and utilize both effects in magnetometry based on NVC's in diamond. As the distance between the FMH and NVC is decre...

  7. Novel phase-based noise reduction strategy for quantification of left ventricular function and mass assessment by cardiac CT: Comparison with cardiac magnetic resonance

    Energy Technology Data Exchange (ETDEWEB)

    Wai, Bryan, E-mail: bwai@partners.org [Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Thai, Wai-ee [Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Brown, Heather [Qi Imaging, Redwood City, California (United States); Truong, Quynh A. [Cardiac MR PET CT Program, Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States)

    2013-08-15

    Background: Tube current modulation in retrospective ECG gated cardiac computed tomography (CT) results in increased image noise and may reduce the accuracy of left ventricular (LV) ejection fraction (EF) and mass assessment. Objective: To examine the effects of a novel CT phase-based noise reduction (NR) algorithm on LV EF and mass quantification as compared to cardiac magnetic resonance (CMR). Methods: In 40 subjects, we compared the LV EF and mass between CT and CMR. In a subset of 24 subjects with tube current modulated CT, the effect of phase-based noise reduction strategies on contrast-to-noise ratio (CNR) and the assessment of LV EF and mass was compared to CMR. Results: There was excellent correlation between CT and CMR for EF (r = 0.94) and mass (r = 0.97). As compared to CMR, the limits of agreement improved with increasing strength of NR strategy. There was a systematic underestimation of LV mass by CT compared to CMR with no NR (−10.3 ± 10.1 g) and low NR (−10.3 ± 12.5 g), but was attenuated with high NR (−0.5 ± 8.3 g). Studies without NR had lower CNR compared to low and high NR at both the ES phase and ED phase (all p < 0.01). Conclusions: A high NR strategy on tube current modulated functional cardiac CT improves correlation of EF compared to CMR and reduces variability of EF and mass evaluation by increasing the CNR. In an effort to reduce radiation dose with tube current modulation, this strategy provides better image quality when LV function and mass quantification is needed.

  8. Contributions of School-Based Parenting and Family Literacy Centres in an Early Childhood Service System

    Science.gov (United States)

    Underwood, Kathryn; Trent-Kratz, Marion

    2015-01-01

    Increasingly, governments are seeking ways to integrate early childhood education and care services as a social policy strategy to maximize child and family outcomes. This study examines the role of a school-based parenting and family literacy program to a system of services in one community in Ontario, Canada. Using an appreciative inquiry…

  9. Electrochemical biosensors based on nanofibres for cardiac biomarker detection: A comprehensive review.

    Science.gov (United States)

    Rezaei, Babak; Ghani, Mozhdeh; Shoushtari, Ahmad Mousavi; Rabiee, Mohammad

    2016-04-15

    The vital importance of early and accurate diagnosis of cardiovascular diseases (CVDs) to prevent the irreversible damage or even death of patients has driven the development of biosensor devices for detection and quantification of cardiac biomarkers. Electrochemical biosensors offer rapid sensing, low cost, portability and ease of use. Over the past few years, nanotechnology has contributed to a tremendous improvement in the sensitivity of biosensors. In this review, the authors summarise the state-of-the-art of the application of one particular type of nanostructured material, i.e. nanofibres, for use in electrochemical biosensors for the ultrasensitive detection of cardiac biomarkers. A new way of classifying the nanofibre-based electrochemical biosensors according to the electrical conductance and the type of nanofibres is presented. Some key data from each article reviewed are highlighted, including the mechanism of detection, experimental conditions and the response range of the biosensor. The primary aim of this review is to emphasise the prospects for nanofibres for the future development of biosensors in diagnosis of CVDs as well as considering how to improve their characteristics for application in medicine.

  10. Label-Free Detection of Cardiac Troponin-I Using Carbon Nanofiber Based Nanoelectrode Arrays

    Science.gov (United States)

    Periyakaruppan, Adaikkappan; Koehne, Jessica Erin; Gandhiraman, Ram P.; Meyyappan, M.

    2013-01-01

    A sensor platform based on vertically aligned carbon nanofibers (CNFs) has been developed. Their inherent nanometer scale, high conductivity, wide potential window, good biocompatibility and well-defined surface chemistry make them ideal candidates as biosensor electrodes. A carbon nanofiber (CNF) multiplexed array has been fabricated with 9 sensing pads, each containing 40,000 carbon nanofibers as nanoelectrodes. Here, we report the use of vertically aligned CNF nanoelectrodes for the detection of cardiac Troponin-I for the early diagnosis of myocardial infarction. Antibody, antitroponin, probe immobilization and subsequent binding to human cardiac troponin-I were characterized using electrochemical impedance spectroscopy and cyclic voltammetry techniques. Each step of the modification process resulted in changes in electrical capacitance or resistance to charge transfer due to the changes at the electrode surface upon antibody immobilization and binding to the specific antigen. This sensor demonstrates high sensitivity, down to 0.2 ng/mL, and good selectivity making this platform a good candidate for early stage diagnosis of myocardial infarction.

  11. Development and clinical study of mobile 12-lead electrocardiography based on cloud computing for cardiac emergency.

    Science.gov (United States)

    Fujita, Hideo; Uchimura, Yuji; Waki, Kayo; Omae, Koji; Takeuchi, Ichiro; Ohe, Kazuhiko

    2013-01-01

    To improve emergency services for accurate diagnosis of cardiac emergency, we developed a low-cost new mobile electrocardiography system "Cloud Cardiology®" based upon cloud computing for prehospital diagnosis. This comprises a compact 12-lead ECG unit equipped with Bluetooth and Android Smartphone with an application for transmission. Cloud server enables us to share ECG simultaneously inside and outside the hospital. We evaluated the clinical effectiveness by conducting a clinical trial with historical comparison to evaluate this system in a rapid response car in the real emergency service settings. We found that this system has an ability to shorten the onset to balloon time of patients with acute myocardial infarction, resulting in better clinical outcome. Here we propose that cloud-computing based simultaneous data sharing could be powerful solution for emergency service for cardiology, along with its significant clinical outcome.

  12. Development and feasibility of a smartphone, ECG and GPS based system for remotely monitoring exercise in cardiac rehabilitation.

    Directory of Open Access Journals (Sweden)

    Charles Worringham

    Full Text Available BACKGROUND: Despite its efficacy and cost-effectiveness, exercise-based cardiac rehabilitation is undertaken by less than one-third of clinically eligible cardiac patients in every country for which data is available. Reasons for non-participation include the unavailability of hospital-based rehabilitation programs, or excessive travel time and distance. For this reason, there have been calls for the development of more flexible alternatives. METHODOLOGY AND PRINCIPAL FINDINGS: We developed a system to enable walking-based cardiac rehabilitation in which the patient's single-lead ECG, heart rate, GPS-based speed and location are transmitted by a programmed smartphone to a secure server for real-time monitoring by a qualified exercise scientist. The feasibility of this approach was evaluated in 134 remotely-monitored exercise assessment and exercise sessions in cardiac patients unable to undertake hospital-based rehabilitation. Completion rates, rates of technical problems, detection of ECG changes, pre- and post-intervention six minute walk test (6 MWT, cardiac depression and Quality of Life (QOL were key measures. The system was rated as easy and quick to use. It allowed participants to complete six weeks of exercise-based rehabilitation near their homes, worksites, or when travelling. The majority of sessions were completed without any technical problems, although periodic signal loss in areas of poor coverage was an occasional limitation. Several exercise and post-exercise ECG changes were detected. Participants showed improvements comparable to those reported for hospital-based programs, walking significantly further on the post-intervention 6 MWT, 637 m (95% CI: 565-726, than on the pre-test, 524 m (95% CI: 420-655, and reporting significantly reduced levels of cardiac depression and significantly improved physical health-related QOL. CONCLUSIONS AND SIGNIFICANCE: The system provided a feasible and very flexible alternative form of

  13. European Centre for Disease Prevention and Control.

    Science.gov (United States)

    Evans, Roger

    2014-11-04

    The European Centre for Disease Prevention and Control was set up in 2005 to strengthen Europe's defences against infectious diseases. The centre is an independent agency of the European Union and is based in Stockholm, Sweden.

  14. Three-dimensional cardiac tissue fabrication based on cell sheet technology.

    Science.gov (United States)

    Masuda, Shinako; Shimizu, Tatsuya

    2016-01-15

    Cardiac tissue engineering is a promising therapeutic strategy for severe heart failure. However, conventional tissue engineering methods by seeding cells into biodegradable scaffolds have intrinsic limitations such as inflammatory responses and fibrosis arising from the degradation of scaffolds. On the other hand, we have developed cell sheet engineering as a scaffold-free approach for cardiac tissue engineering. Confluent cultured cells are harvested as an intact cell sheet using a temperature-responsive culture surface. By layering cardiac cell sheets, it is possible to form electrically communicative three-dimensional cardiac constructs. Cell sheet transplantation onto damaged hearts in several animal models has revealed improvements in heart functions. Because of the lack of vasculature, the thickness of viable cardiac cell sheet-layered tissues is limited to three layers. Pre-vascularized structure formation within cardiac tissue and multi-step transplantation methods has enabled the formation of thick vascularized tissues in vivo. Furthermore, development of original bioreactor systems with vascular beds has allowed reconstruction of three-dimensional cardiac tissues with a functional vascular structure in vitro. Large-scale culture systems to generate pluripotent stem cell-derived cardiac cells can create large numbers of cardiac cell sheets. Three-dimensional cardiac tissues fabricated by cell sheet engineering may be applied to treat heart disease and tissue model construction.

  15. Micro-Doppler Effect of Extended Streamlined Targets Based on Sliding Scattering Centre Model

    Directory of Open Access Journals (Sweden)

    Bo Tang

    2016-06-01

    Full Text Available The scattering center of extended streamlined targets can slide when the direction of radiation is changed. The sliding scattering center has influence on the micro-Doppler effect of micro-motion of the extended streamlined target. This paper focused on the micro-Doppler of the extended streamlined target for the bistatic radar. Based on the analysis, the analytical expressions of the micro-Doppler of coning motion with sliding scattering center model were given for bistatic radar. And the results were validated by the simulated results of the scattering field based on the full-wave method of the electromagnetic computation. The results showed that the sliding of the scattering center can make the micro-Doppler be less and distorted, and the influence of the sliding is different for two different types of the sliding scattering centers: sliding on the surface and sliding on the bottom circle. The analytical expressions of the micro-Doppler are helpful to analyze the time-frequency presentations (TFR of the coning motion of the extended streamlined target and to estimate the parameters of the target.

  16. A telepathology based Virtual Reference and Certification Centre for DNA image cytometry.

    Science.gov (United States)

    Haroske, G; Giroud, F; Kunze, K D; Meyer, W

    2000-01-01

    An increasing need for flexible consultation between pathologists, including the application of fast evolving supplementary technologies, has been identified during the last years. Although pathology is already one of the most advanced application of telemedicine there is more to come from the fast evolution towards computerized microscope image analysis: A reproducible quantification of measurable descriptors of the lesions in cells and tissues (so-called biological markers) is an indispensable adjunct to routine diagnostic application. Among such quantitative methods DNA image cytometry is increasingly applied by pathologists for assistance in diagnostics. As for other pathological issues, too, a reference center for the clinical application of DNA image cytometry might be therefore of utmost value for pathologists using that method. Based on advanced telematic technologies, a Virtual Reference and Certification Center (VRCC) could be installed for certifying the cytometry hardware and software, the analytical procedures, and the basic interpretation of the results. It will be designed to be operated as a non-attended service, based on quantification servers accessible via Internet round the clock. The VRCC will supply appropriate standardization and normalization materials and run a GroupWare platform for consensus making by experts.

  17. Adoption of community-based cardiac rehabilitation programs and physical activity following phase III cardiac rehabilitation in Scotland: a prospective and predictive study.

    Science.gov (United States)

    Sniehotta, Falko F; Gorski, Charlotta; Araujo-Soares, Vera

    2010-09-01

    Little is known about levels of physical activity and attendance at phase IV community-based Cardiac Rehabilitation (CR) programs following completion of exercise-focussed, hospital-based phase III CR. This study aims to test, compare and combine the predictive utility of the Common-Sense Self-Regulation Model (CS-SRM) and the extended Theory of Planned Behaviour (TPB) with action planning for two rehabilitation behaviours: physical activity and phase IV CR attendance. Individuals diagnosed with coronary heart disease (n = 103) completed baseline measures of illness perceptions, intentions, perceived behavioural control (PBC), action planning and past physical activity in the last week of a phase III CR program, and 95 participants completed follow-up measures of physical activity and attended phase IV CR (objectively confirmed) 2 months later. Only one predictor (PBC/cyclical timeline) significantly predicted levels and change of physical activity. While illness perceptions were not predictive of phase IV CR attendance, the extended TPB model showed good predictive power with action planning and intention as the most powerful predictors. Amongst participants who planned when and where to attend phase IV CR at the end of phase III rehabilitation, 65.9% subsequently attended a phase IV CR program compared to only 18.5% of those who had not made a plan. This study adds to our understanding of cardiac rehabilitation behaviour after completion of health service delivered programs. Comparing theoretical models and rehabilitation behaviours contributes to the development of behaviour theory.

  18. Chest Pain of Suspected Cardiac Origin: Current Evidence-based Recommendations for Prehospital Care

    Directory of Open Access Journals (Sweden)

    P. Brian Savino

    2015-12-01

    Full Text Available Introduction: In the United States, emergency medical services (EMS protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of chest pain of suspected cardiac origin and to compare these recommendations against the current protocols used by the 33 EMS agencies in the state of California. Methods: We performed a literature review of the current evidence in the prehospital treatment of chest pain and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the chest pain protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were use of supplemental oxygen, aspirin, nitrates, opiates, 12-lead electrocardiogram (ECG, ST segment elevation myocardial infarction (STEMI regionalization systems, prehospital fibrinolysis and β-blockers. Results: The protocols varied widely in terms of medication and dosing choices, as well as listed contraindications to treatments. Every agency uses oxygen with 54% recommending titrated dosing. All agencies use aspirin (64% recommending 325mg, 24% recommending 162mg and 15% recommending either, as well as nitroglycerin and opiates (58% choosing morphine. Prehospital 12- Lead ECGs are used in 97% of agencies, and all but one agency has some form of regionalized care for their STEMI patients. No agency is currently employing prehospital fibrinolysis or β-blocker use. Conclusion: Protocols for chest pain of suspected cardiac origin vary widely across California. The evidence-based recommendations that we present for the prehospital diagnosis and treatment of this condition may be useful for EMS medical directors tasked with creating and revising these protocols.

  19. Theoretical Strength of Face-Centred-Cubic Single Crystal Copper Based on a Continuum Model

    Institute of Scientific and Technical Information of China (English)

    LIU Xiao-Ming; LIU Zhan-Li; YOU Xiao-Chuan; NIE Jun-Feng; ZHUANG Zhuo

    2009-01-01

    The constitutive relation of single crystal copper based on atomistic potential is implemented to capture the nonlinear inter-atomic interactions. Uniaxial loading tests of single crystal copper with inter-atomic potential finite-element model are carried out to determine the corresponding ideal strength using the modified Born stability criteria. Dependence of the ideal strength on the crystallographic orientation is studied, and tension-compression asymmetry in ideal strength is also investigated. The results suggest that asymmetry for yielding strength of nano-materials may result from anisotropic character of crystal instability. Moreover, the results also reveal that the critical resolved shear stress in the direction of slip is not an accurate criterion for the ideal strength since it could not capture the dependence on the loading conditions and hydrostatic stress components for the ideal strength.

  20. Cardiac injuries in car occupants in fatal motor vehicle collisions--an autopsy-based study.

    Science.gov (United States)

    Turk, Elisabeth E; Tsang, Yee-Wah; Champaneri, Anisha; Pueschel, Klaus; Byard, Roger W

    2010-08-01

    Motor vehicle accidents contribute widely to population morbidity and mortality around the world, and cardiac injuries are a major factor determining outcome. Autopsy reports from 380 motor vehicle occupants who died in motor vehicle crashes in Adelaide, Australia, and Hamburg, Germany, over a 6-year period were reviewed, analysing the presence and type of cardiac injuries and their correlation with factors such as crash type, presence of seatbelt/airbag and vehicle speed as well as with the presence of other injuries which might predict the presence of cardiac injuries in a clinical setting. 21.1% had cardiac injuries identified macroscopically autopsy or histology. Cardiac injuries were the only cause of death or contributed to a fatal outcome in 76% of these cases. Sternal fractures and left-sided serial rib fractures were predictive of cardiac injury.

  1. Cardiac motion correction based on partial angle reconstructed images in x-ray CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seungeon; Chang, Yongjin; Ra, Jong Beom, E-mail: jbra@kaist.ac.kr [Department of Electrical Engineering, KAIST, Daejeon 305-701 (Korea, Republic of)

    2015-05-15

    two conjugate PAR images. To evaluate the proposed algorithm, digital XCAT and physical dynamic cardiac phantom datasets are used. The XCAT phantom datasets were generated with heart rates of 70 and 100 bpm, respectively, by assuming a system rotation time of 300 ms. A physical dynamic cardiac phantom was scanned using a slowly rotating XCT system so that the effective heart rate will be 70 bpm for a system rotation speed of 300 ms. Results: In the XCAT phantom experiment, motion-compensated 3D images obtained from the proposed algorithm show coronary arteries with fewer motion artifacts for all phases. Moreover, object boundaries contaminated by motion are well restored. Even though object positions and boundary shapes are still somewhat different from the ground truth in some cases, the authors see that visibilities of coronary arteries are improved noticeably and motion artifacts are reduced considerably. The physical phantom study also shows that the visual quality of motion-compensated images is greatly improved. Conclusions: The authors propose a novel PAR image-based cardiac motion estimation and compensation algorithm. The algorithm requires an angular scan range of less than 360°. The excellent performance of the proposed algorithm is illustrated by using digital XCAT and physical dynamic cardiac phantom datasets.

  2. Design of wavelet-based ECG detector for implantable cardiac pacemakers.

    Science.gov (United States)

    Min, Young-Jae; Kim, Hoon-Ki; Kang, Yu-Ri; Kim, Gil-Su; Park, Jongsun; Kim, Soo-Won

    2013-08-01

    A wavelet Electrocardiogram (ECG) detector for low-power implantable cardiac pacemakers is presented in this paper. The proposed wavelet-based ECG detector consists of a wavelet decomposer with wavelet filter banks, a QRS complex detector of hypothesis testing with wavelet-demodulated ECG signals, and a noise detector with zero-crossing points. In order to achieve high detection accuracy with low power consumption, a multi-scaled product algorithm and soft-threshold algorithm are efficiently exploited in our ECG detector implementation. Our algorithmic and architectural level approaches have been implemented and fabricated in a standard 0.35 μm CMOS technology. The testchip including a low-power analog-to-digital converter (ADC) shows a low detection error-rate of 0.196% and low power consumption of 19.02 μW with a 3 V supply voltage.

  3. Speckle based configuration for simultaneous in vitro inspection of mechanical contractions of cardiac myocyte cells

    Science.gov (United States)

    Golberg, Mark; Fixler, Dror; Shainberg, Asher; Zlochiver, Sharon; Micó, Vicente; Garcia, Javier; Beiderman, Yevgeny; Zalevsky, Zeev

    2013-04-01

    In this manuscript we propose optical lensless configuration for a remote non-contact measuring of mechanical contractions of vast number of cardiac myocytes. All the myocytes were taken from rats, and the measurements were done in an in vitro mode. The optical method is based on temporal analysis of secondary reflected speckle patterns generated in lensless microscope configuration. The processing involves analyzing the movement and the change in the statistics of the generated secondary speckle patterns that are created on top of the cell culture when it is illuminated by a spot of laser beam. The main advantage of the proposed system is the ability to measure many cells simultaneously (approximately one thousand cells) and to extract the statistical data of their movement at once. The presented experimental results also include investigation the effect of isoproteranol on cells contraction process.

  4. Cardiac injuries caused by blunt trauma: an autopsy based assessment of the injury pattern.

    Science.gov (United States)

    Turan, Arzu Akcay; Karayel, Ferah Anik; Akyildiz, Elif; Pakis, Isil; Uzun, Ibrahim; Gurpinar, Kagan; Atilmis, Umit; Kir, Ziya

    2010-01-01

    Nonpenetrating chest trauma with injury to the heart and aorta has become increasingly common, particularly as a result of rapid deceleration in high-speed vehicular accidents, over the past 2-3 decades. The high mortality rate of cardiac injuries and possible late onset complications make blunt cardiac injuries an important challenging point for legal medicine. One hundred and ninety cases with blunt cardiac injuries in a period of 3 years were analyzed retrospectively in terms of patterns of cardiac injury, survival times, and demographic profiles of the cases in this study.

  5. Echocardiographic effects of changing atrioventricular delay in cardiac resynchronization therapy based on displacement

    DEFF Research Database (Denmark)

    Valeur, Nana; Fritz-Hansen, Thomas; Risum, Niels;

    2010-01-01

    In studies showing benefits of cardiac resynchronization therapy (CRT), individual atrioventricular (AV) delays have been optimized using echocardiography. However, the method for AV delay optimization remains controversial....

  6. A registration based approach for 4D cardiac micro-CT using combined prospective and retrospective gating

    Science.gov (United States)

    Badea, Cristian T.; Schreibmann, Eduard; Fox, Tim

    2008-01-01

    Recent advances in murine cardiac studies with three-dimensional cone beam micro-computed tomography (CT) have used either prospective or retrospective gating technique. While prospective gating ensures the best image quality and the highest resolution, it involves longer sampling times and higher radiation dose. Sampling is faster and the radiation dose can be reduced with retrospective gating but the image quality is affected by the limited number of projections with an irregular angular distribution which complicate the reconstruction process, causing significant streaking artifacts. This work involves both prospective and retrospective gating in sampling. Deformable registration is used between a high quality image set acquired with prospective gating with the multiple data sets during the cardiac cycle obtained using retrospective gating. Tests were conducted on a four-dimensional (4D) cardiac mouse phantom and after optimization, the method was applied to in vivo cardiac micro-CT data. Results indicate that, by using our method, the sampling time can be reduced by a factor of 2.5 and the radiation dose can be reduced 35% compared to the prospective sampling while the image quality can be maintained. In conclusion, we proposed a novel solution to 4D cine cardiac micro-CT based on a combined prospective with retrospective gating in sampling and deformable registration post reconstruction that mixed the advantages of both strategies. PMID:18491508

  7. Usefulness of case reports to improve medical knowledge regarding trigemino-cardiac reflex in skull base surgery

    Directory of Open Access Journals (Sweden)

    Sadr-Eshkevari Pooan

    2011-04-01

    Full Text Available Abstract We describe the discovery of the trigemino-cardiac reflex by Schaller in 1999 and the continued improvement of the knowledge about the trigemino-cardiac reflex involved in neurosurgery, especially in skull base surgery, during the past several years. The achieved medical progress could be gained only by the practical experience described by different case reports and later case series that have been published in several principal scientific journals. Additionally, we explain the scientific as well as clinical importance of the communication of the case reports on TCR. Special reference has been given to the validity of the case reports for new phenomena in clinical medicine.

  8. Usefulness of case reports to improve medical knowledge regarding trigemino-cardiac reflex in skull base surgery.

    Science.gov (United States)

    Sandu, Nora; Sadr-Eshkevari, Pooan; Schaller, Bernhard J

    2011-04-15

    We describe the discovery of the trigemino-cardiac reflex by Schaller in 1999 and the continued improvement of the knowledge about the trigemino-cardiac reflex involved in neurosurgery, especially in skull base surgery, during the past several years. The achieved medical progress could be gained only by the practical experience described by different case reports and later case series that have been published in several principal scientific journals. Additionally, we explain the scientific as well as clinical importance of the communication of the case reports on TCR. Special reference has been given to the validity of the case reports for new phenomena in clinical medicine.

  9. The forward and inverse problem of cardiac magnetic fields based on concentric ellipsoid torso-heart model

    Science.gov (United States)

    Wang, Qian; Hua, Ning; Tang, Xue-Zheng; Lu, Hong; Ma, Ping; Tang, Fa-Kuan

    2010-08-01

    This paper constructs a concentric ellipsoid torso-heart model by boundary element method and investigates the impacts of model structures on the cardiac magnetic fields generated by both equivalent primary source-a current dipole and volume currents. Then by using the simulated magnetic fields based on the torso-heart model as input, the cardiac current sources-an array of current dipoles by optimal constrained linear inverse method are constructed. Next, the current dipole array reconstruction considering boundaries are compared with that in an unbounded homogeneous medium. Furthermore, the influence of random noise on reconstruction is also considered and the reconstructing effect is judged by several reconstructing parameters.

  10. A comparison study of atlas-based 3D cardiac MRI segmentation: global versus global and local transformations

    Science.gov (United States)

    Daryanani, Aditya; Dangi, Shusil; Ben-Zikri, Yehuda Kfir; Linte, Cristian A.

    2016-03-01

    Magnetic Resonance Imaging (MRI) is a standard-of-care imaging modality for cardiac function assessment and guidance of cardiac interventions thanks to its high image quality and lack of exposure to ionizing radiation. Cardiac health parameters such as left ventricular volume, ejection fraction, myocardial mass, thickness, and strain can be assessed by segmenting the heart from cardiac MRI images. Furthermore, the segmented pre-operative anatomical heart models can be used to precisely identify regions of interest to be treated during minimally invasive therapy. Hence, the use of accurate and computationally efficient segmentation techniques is critical, especially for intra-procedural guidance applications that rely on the peri-operative segmentation of subject-specific datasets without delaying the procedure workflow. Atlas-based segmentation incorporates prior knowledge of the anatomy of interest from expertly annotated image datasets. Typically, the ground truth atlas label is propagated to a test image using a combination of global and local registration. The high computational cost of non-rigid registration motivated us to obtain an initial segmentation using global transformations based on an atlas of the left ventricle from a population of patient MRI images and refine it using well developed technique based on graph cuts. Here we quantitatively compare the segmentations obtained from the global and global plus local atlases and refined using graph cut-based techniques with the expert segmentations according to several similarity metrics, including Dice correlation coefficient, Jaccard coefficient, Hausdorff distance, and Mean absolute distance error.

  11. [Anesthesia management of geriatric patients with arterial pressure-based cardiac output monitoring FloTrac sensor for emergency surgery].

    Science.gov (United States)

    Yamamoto, Shunsuke; Goto, Koji; Yasuda, Norihisa; Kusaka, Junya; Hidaka, Seigo; Miyakawa, Hiroshi; Noguchi, Takayuki

    2009-06-01

    In cases of emergency surgery for geriatric patients, immediate anesthesia induction and careful intraoperative management is necessary without sufficient preoperative information. We report anesthesia management of a 96-year and a 90-year old patients with FloTrac sensor which is an arterial pressure-based cardiac output monitoring device and is able to manage critical patients effectively and safely during anesthesia.

  12. Anatomical-based partial volume correction for low-dose dedicated cardiac SPECT/CT

    Science.gov (United States)

    Liu, Hui; Chan, Chung; Grobshtein, Yariv; Ma, Tianyu; Liu, Yaqiang; Wang, Shi; Stacy, Mitchel R.; Sinusas, Albert J.; Liu, Chi

    2015-09-01

    Due to the limited spatial resolution, partial volume effect has been a major degrading factor on quantitative accuracy in emission tomography systems. This study aims to investigate the performance of several anatomical-based partial volume correction (PVC) methods for a dedicated cardiac SPECT/CT system (GE Discovery NM/CT 570c) with focused field-of-view over a clinically relevant range of high and low count levels for two different radiotracer distributions. These PVC methods include perturbation geometry transfer matrix (pGTM), pGTM followed by multi-target correction (MTC), pGTM with known concentration in blood pool, the former followed by MTC and our newly proposed methods, which perform the MTC method iteratively, where the mean values in all regions are estimated and updated by the MTC-corrected images each time in the iterative process. The NCAT phantom was simulated for cardiovascular imaging with 99mTc-tetrofosmin, a myocardial perfusion agent, and 99mTc-red blood cell (RBC), a pure intravascular imaging agent. Images were acquired at six different count levels to investigate the performance of PVC methods in both high and low count levels for low-dose applications. We performed two large animal in vivo cardiac imaging experiments following injection of 99mTc-RBC for evaluation of intramyocardial blood volume (IMBV). The simulation results showed our proposed iterative methods provide superior performance than other existing PVC methods in terms of image quality, quantitative accuracy, and reproducibility (standard deviation), particularly for low-count data. The iterative approaches are robust for both 99mTc-tetrofosmin perfusion imaging and 99mTc-RBC imaging of IMBV and blood pool activity even at low count levels. The animal study results indicated the effectiveness of PVC to correct the overestimation of IMBV due to blood pool contamination. In conclusion, the iterative PVC methods can achieve more accurate quantification, particularly for low

  13. Evaluation of a new arterial pressure-based cardiac output device requiring no external calibration

    Directory of Open Access Journals (Sweden)

    Amann Matthias

    2007-11-01

    Full Text Available Abstract Background Several techniques have been discussed as alternatives to the intermittent bolus thermodilution cardiac output (COPAC measurement by the pulmonary artery catheter (PAC. However, these techniques usually require a central venous line, an additional catheter, or a special calibration procedure. A new arterial pressure-based cardiac output (COAP device (FloTrac™, Vigileo™; Edwards Lifesciences, Irvine, CA, USA only requires access to the radial or femoral artery using a standard arterial catheter and does not need an external calibration. We validated this technique in critically ill patients in the intensive care unit (ICU using COPAC as the method of reference. Methods We studied 20 critically ill patients, aged 16 to 74 years (mean, 55.5 ± 18.8 years, who required both arterial and pulmonary artery pressure monitoring. COPAC measurements were performed at least every 4 hours and calculated as the average of 3 measurements, while COAP values were taken immediately at the end of bolus determinations. Accuracy of measurements was assessed by calculating the bias and limits of agreement using the method described by Bland and Altman. Results A total of 164 coupled measurements were obtained. Absolute values of COPAC ranged from 2.80 to 10.80 l/min (mean 5.93 ± 1.55 l/min. The bias and limits of agreement between COPAC and COAP for unequal numbers of replicates was 0.02 ± 2.92 l/min. The percentage error between COPAC and COAP was 49.3%. The bias between percentage changes in COPAC (ΔCOPAC and percentage changes in COAP (ΔCOAP for consecutive measurements was -0.70% ± 32.28%. COPAC and COAP showed a Pearson correlation coefficient of 0.58 (p PAC and ΔCOAP was 0.46 (p Conclusion Although the COAP algorithm shows a minimal bias with COPAC over a wide range of values in an inhomogeneous group of critically ill patients, the scattering of the data remains relative wide. Therefore, the used algorithm (V 1.03 failed to

  14. Understanding exercise behaviour during home-based cardiac rehabilitation: a theory of planned behaviour perspective.

    Science.gov (United States)

    Blanchard, Christopher

    2008-01-01

    Although home-based cardiac rehabilitation (CR) programs have been shown to produce significant increases in exercise capacity, obtaining patient adherence to these programs has been challenging. It is therefore critical to identify key theoretical determinants of exercise during home-based CR in order to inform the development of behavioural interventions that improve adherence. The present study examined the utility of the theory of planned behaviour (TPB) in explaining exercise behaviour during home-based CR. Seventy-six patients who were receiving 6 months of home-based CR completed a TPB questionnaire at the beginning and mid-point of the program and a physical activity scale at the mid-point and end of the program. Path analyses showed that attitude and perceived behavioural control significantly predicted intention for both time intervals (baseline to 3 months, and 3 months to 6 months), whereas subjective norm only predicted intention within the 1st 3 months. Intention significantly predicted implementation intention, which, in turn, significantly predicted exercise for both time intervals. Finally, several underlying accessible beliefs were significantly related to exercise for both time intervals. Therefore, results suggest that the TPB is a potentially useful framework for understanding exercise behaviour during home-based CR.

  15. ASSUMED OXYGEN-CONSUMPTION BASED ON CALCULATION FROM DYE DILUTION CARDIAC-OUTPUT - AN IMPROVED FORMULA

    NARCIS (Netherlands)

    BERGSTRA, A; VANDIJK, RB; HILLEGE, HL; LIE, KI; MOOK, GA

    1995-01-01

    This study was performed because of observed differences between dye dilution cardiac output and the Fick cardiac output, calculated from estimated oxygen consumption according to LaFarge and Miettinen, and to find a better formula for assumed oxygen consumption. In 250 patients who underwent left a

  16. Echocardiographic effects of changing atrioventricular delay in cardiac resynchronization therapy based on displacement

    DEFF Research Database (Denmark)

    Valeur, Nana; Fritz-Hansen, Thomas; Risum, Niels;

    2010-01-01

    In studies showing benefits of cardiac resynchronization therapy (CRT), individual atrioventricular (AV) delays have been optimized using echocardiography. However, the method for AV delay optimization remains controversial.......In studies showing benefits of cardiac resynchronization therapy (CRT), individual atrioventricular (AV) delays have been optimized using echocardiography. However, the method for AV delay optimization remains controversial....

  17. Early detection of cardiac dysfunction in the type 1 diabetic heart using speckle-tracking based strain imaging.

    Science.gov (United States)

    Shepherd, Danielle L; Nichols, Cody E; Croston, Tara L; McLaughlin, Sarah L; Petrone, Ashley B; Lewis, Sara E; Thapa, Dharendra; Long, Dustin M; Dick, Gregory M; Hollander, John M

    2016-01-01

    Enhanced sensitivity in echocardiographic analyses may allow for early detection of changes in cardiac function beyond the detection limits of conventional echocardiographic analyses, particularly in a small animal model. The goal of this study was to compare conventional echocardiographic measurements and speckle-tracking based strain imaging analyses in a small animal model of type 1 diabetes mellitus. Conventional analyses revealed differences in ejection fraction, fractional shortening, cardiac output, and stroke volume in diabetic animals relative to controls at 6-weeks post-diabetic onset. In contrast, when assessing short- and long-axis speckle-tracking based strain analyses, diabetic mice showed changes in average systolic radial strain, radial strain rate, radial displacement, and radial velocity, as well as decreased circumferential and longitudinal strain rate, as early as 1-week post-diabetic onset and persisting throughout the diabetic study. Further, we performed regional analyses for the LV and found that the free wall region was affected in both the short- and long-axis when assessing radial dimension parameters. These changes began 1-week post-diabetic onset and remained throughout the progression of the disease. These findings demonstrate the use of speckle-tracking based strain as an approach to elucidate cardiac dysfunction from a global perspective, identifying left ventricular cardiac regions affected during the progression of type 1 diabetes mellitus earlier than contractile changes detected by conventional echocardiographic measurements.

  18. Minister unveils new nanotech centres

    Science.gov (United States)

    Dumé, Belle

    2009-06-01

    Three new nanotechnology research centres are to be set up in France as part of a €70m government plan to help French companies in the sector. Researchers at the new centres, which will be located in Grenoble, Saclay (near Paris) and Toulouse, will be encouraged to collaborate with industry to develop new nanotech-based products. Dubbed NANO-INNOV, the new plan includes €46m for two new buildings at Saclay, with the rest being used to buy new equipment at the three centres and to fund grant proposals from staff to the French National Research Agency (ANR).

  19. Implementing a multi-professional web-based learning environment for a comprehensive cancer centre: obstacles, solutions and reflections.

    Science.gov (United States)

    Links, Matthew; Sargeant, Chris; Waters, Amy; Liauw, Winston; Thomas, Patrice

    2012-03-01

    There is an urgent need for efficient cancer education programmes to promote safe practice in a comprehensive cancer centre. Educational practice has developed historically in an unplanned and inefficient way. Developments in educational theory and information technology provide an opportunity to develop systems with better educational methodology, better efficiency and potential for better impact on safety outcomes. We have developed such a programme at St. George Comprehensive Cancer Centre in Sydney, Australia, and describe here our experience in the first 2 years of implementing such a programme. In this article, we describe the programme, the obstacles and solutions we encountered and our reflections on the journey so far.

  20. The centre of the action

    CERN Document Server

    2008-01-01

    The CERN Control Centre (CCC) has all the ingredients of an action movie control room: hundreds of screens, technicians buzzing in and out, huge floor-to-ceiling windows revealing the looming vista of a mountain range, flashing lights, microphones… This is the place where not just the LHC, but the whole of CERN’s accelerator complex and technical support is based - truly the centre of the action at CERN.

  1. Nonrigid registration-based coronary artery motion correction for cardiac computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Bhagalia, Roshni; Pack, Jed D.; Miller, James V.; Iatrou, Maria [GE Global Research, Niskayuna, New York 12309 (United States); GE Healthcare, Hoboken, New Jersey 07030 (United States)

    2012-07-15

    Purpose: X-ray computed tomography angiography (CTA) is the modality of choice to noninvasively monitor and diagnose heart disease with coronary artery health and stenosis detection being of particular interest. Reliable, clinically relevant coronary artery imaging mandates high spatiotemporal resolution. However, advances in intrinsic scanner spatial resolution (CT scanners are available which combine nearly 900 detector columns with focal spot oversampling) can be tempered by motion blurring, particularly in patients with unstable heartbeats. As a result, recently numerous methods have been devised to improve coronary CTA imaging. Solutions involving hardware, multisector algorithms, or {beta}-blockers are limited by cost, oversimplifying assumptions about cardiac motion, and populations showing contraindications to drugs, respectively. This work introduces an inexpensive algorithmic solution that retrospectively improves the temporal resolution of coronary CTA without significantly affecting spatial resolution. Methods: Given the goal of ruling out coronary stenosis, the method focuses on 'deblurring' the coronary arteries. The approach makes no assumptions about cardiac motion, can be used on exams acquired at high heart rates (even over 75 beats/min), and draws on a fast and accurate three-dimensional (3D) nonrigid bidirectional labeled point matching approach to estimate the trajectories of the coronary arteries during image acquisition. Motion compensation is achieved by employing a 3D warping of a series of partial reconstructions based on the estimated motion fields. Each of these partial reconstructions is created from data acquired over a short time interval. For brevity, the algorithm 'Subphasic Warp and Add' (SWA) reconstruction. Results: The performance of the new motion estimation-compensation approach was evaluated by a systematic observer study conducted using nine human cardiac CTA exams acquired over a range of average heart

  2. Trigemino-cardiac reflex during skull-base neurosurgeries: a case report

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Khajavi

    2013-11-01

    Full Text Available Background: The Trigemino-cardiac reflex (TCR has been studied as a phenomenon including; bradycardia, arterial hypotension, apnea and gastric hypermotility during manipulation of the peripheral or central parts of the trigeminal nerve.Case presentation: We report a case of a 26-year-old man undergoing surgery for a skull base extra axial tumor in right petrous bone suspected to metastasis of a previous renal cell carcinoma which had been treated four years ago. The patient presented with continuous and unilateral headache and difficulty in swallowing, sensory neural hearing loss, nasal speech and tongue deviation to left side. He underwent general anesthesia with standard monitoring and total intravenous anesthetic technique. The first episode of sudden onset bradycardia and hypotension related to surgical manipulation was detected intraoperatively in which the heart rate spontaneously returned to normal level once the surgical manipulation stopped. However, it repeated several times by beginning of tumor resection and manipulation in the region of trigeminal nerve. The intensity of bradycardia in subsequent episodes of TCR was relatively crescendo and had no fatigability. Finally, it was treated by administration of a single dose of atropine (0.5mg/IV and did not happen again.Conclusion: The risk of TCR should be considered in any neurosurgical intervention involving trigeminal nerve and its branches, especially at the skull base surgeries. The vigilance of the medical team and continuous intraoperative hemodynamic monitoring alerts the surgeons to interrupt surgical maneuvers upon the TCR occurrence, immediately.

  3. A flatness-based control approach to drug infusion for cardiac function regulation

    Science.gov (United States)

    Rigatos, Gerasimos; Zervos, Nikolaos; Melkikh, Alexey

    2016-12-01

    A new control method based on differential flatness theory is developed in this article, aiming at solving the problem of regulation of haemodynamic parameters, Actually control of the cardiac output (volume of blood pumped out by heart per unit of time) and of the arterial blood pressure is achieved through the administered infusion of cardiovascular drugs, such as dopamine and sodium nitroprusside. Time delays between the control inputs and the system's outputs are taken into account. Using the principle of dynamic extension, which means that by considering certain control inputs and their derivatives as additional state variables, a state-space description for the heart's function is obtained. It is proven that the dynamic model of the heart is a differentially flat one. This enables its transformation into a linear canonical and decoupled form, for which the design of a stabilizing feedback controller becomes possible. The proposed feedback controller is of proven stability and assures fast and accurate tracking of the reference setpoints by the outputs of the heart's dynamic model. Moreover, by using a Kalman Filter-based disturbances' estimator, it becomes possible to estimate in real-time and compensate for the model uncertainty and external perturbation inputs that affect the heart's model.

  4. 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 ...

  5. Adverse Effects of Plant Food Supplements and Plants Consumed as Food: Results from the Poisons Centres-Based PlantLIBRA Study.

    Science.gov (United States)

    Lüde, Saskia; Vecchio, Sarah; Sinno-Tellier, Sandra; Dopter, Aymeric; Mustonen, Harriet; Vucinic, Slavica; Jonsson, Birgitta; Müller, Dieter; Veras Gimenez Fruchtengarten, Ligia; Hruby, Karl; De Souza Nascimento, Elizabeth; Di Lorenzo, Chiara; Restani, Patrizia; Kupferschmidt, Hugo; Ceschi, Alessandro

    2016-06-01

    Plant food supplements (PFS) are products of increasing popularity and wide-spread distribution. Nevertheless, information about their risks is limited. To fill this gap, a poisons centres-based study was performed as part of the EU project PlantLIBRA. Multicentre retrospective review of data from selected European and Brazilian poisons centres, involving human cases of adverse effects due to plants consumed as food or as ingredients of food supplements recorded between 2006 and 2010. Ten poisons centres provided a total of 75 cases. In 57 cases (76%) a PFS was involved; in 18 (24%) a plant was ingested as food. The 10 most frequently reported plants were Valeriana officinalis, Camellia sinensis, Paullinia cupana, Melissa officinalis, Passiflora incarnata, Mentha piperita, Glycyrrhiza glabra, Ilex paraguariensis, Panax ginseng, and Citrus aurantium. The most frequently observed clinical effects were neurotoxicity and gastro-intestinal symptoms. Most cases showed a benign clinical course; however, five cases were severe. PFS-related adverse effects seem to be relatively infrequent issues for poisons centres. Most cases showed mild symptoms. Nevertheless, the occurrence of some severe adverse effects and the increasing popularity of PFS require continuous active surveillance, and further research is warranted. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Interventional guidance for cardiac resynchronization therapies: merging anatomic X-ray imaging with functional ultrasound imaging based on mutually-shared landmarks

    Energy Technology Data Exchange (ETDEWEB)

    Manzke, R.; Shechter, G.; Gutierrez, L.; Chan, R.C. [Philips Research North America, Briarcliff Manor, NY (United States); Tournoux, F.; Singh, J.; Picard, M. [Dept. of Cardiology, Massachusetts General Hospital, Harvard Medical School (United States); Brink, B. v.d.; Boomen, R. v.d. [Philips Medical System, Best (Netherlands); Gerard, O. [Philips Medical Systems, Paris (France)

    2007-06-15

    Detailed knowledge of cardiac anatomy and function is required for complex cardiac electrophysiology interventions. Cardiac resynchronization therapies (CRT), for example, requires information about coronary venous anatomy for left ventricular lead placement. In CRT, heart failure patients are equipped with dual-chamber pacemakers in order to improve cardiac output and heart failure symptoms. Cardiac function is mainly assessed with Ultrasound imaging. Fusion of complementary information from X-ray and ultrasound is an essential step towards fully utilizing all available information for CRT guidance. We present an approach for fusion of anatomical information (coronary vein structure) from X-ray with functional information (left ventricular deformation and dynamics) from ultrasound. We propose an image-based fusion approach based on mutually-shared landmarks which enable registration of both imaging spaces without the need for external tracking. (orig.)

  7. Student experience and academic success: comparing a student-centred and a lecture-based course programme

    NARCIS (Netherlands)

    Severiens, S.; Meeuwisse, M.; Born, M.

    2015-01-01

    Past research has shown that, under certain conditions, student-centred and small-scale course programmes result in more academic success. The present study investigates these conditions in further detail. It is examined whether, in comparison to a course programme that is relatively more lecture-ba

  8. Student experience and academic success: comparing a student-centred and a lecture-based course programme

    NARCIS (Netherlands)

    S. Severiens; M. Meeuwisse; M. Born

    2014-01-01

    Past research has shown that, under certain conditions, student-centred and small-scale course programmes result in more academic success. The present study investigates these conditions in further detail. It is examined whether, in comparison to a course programme that is relatively more lecture-ba

  9. Scientific centres in Europe: An analysis of research strength and patterns of specialisation based on bibliometric indicators

    DEFF Research Database (Denmark)

    Matthiessen, C. W.; Schwarz, Annette Winkel

    1999-01-01

    This paper presents the first analysis of scientific strength by output (papers in the Science Citation Index 1994-96) produced by authors from the 'greater' urban regions of Europe, Top lists of European centres are indicated, Four agglomerations constitute the European super-league of science: ...

  10. 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: ...

  11. A polyaniline based ultrasensitive potentiometric immunosensor for cardiac troponin complex detection.

    Science.gov (United States)

    Zhang, Qi; Prabhu, Alok; San, Avdar; Al-Sharab, Jafar F; Levon, Kalle

    2015-10-15

    An ultrasensitive immunosensor based on potentiometric ELISA for the detection of a cardiac biomarker, troponin I-T-C (Tn I-T-C) complex, was developed. The sensor fabrication involves typical sandwich ELISA procedures, while the final signal readout was achieved using open circuit potentiometry (OCP). Glassy carbon (GC) working electrodes were first coated with emulsion-polymerized polyaniline/dinonylnaphthalenesulfonic acid (PANI/DNNSA) and the coated surface was utilized as a transducer layer on which sandwich ELISA incubation steps were performed. An enzymatic reaction between o-phenylenediamine (OPD) and hydrogen peroxide (H2O2) was catalyzed by horseradish peroxidase (HRP) labeled on the secondary antibodies. The polymer transducer charged state was mediated through electron (e(-)) and charge transfers between the transducer and charged species generated by the same enzymatic reaction. Such a change in the polymer transducer led to potential variations against an Ag/AgCl reference electrode as a function of Tn I-T-C complex concentration during incubations. The sequence of OPD and H2O2 additions, electrochemical properties of the PANI/DNNSA layer and non-specific binding prevention were all crucial factors for the assay performance. Under optimized conditions, the assay has a low limit of detection (LOD) ( 6 orders of magnitude), high repeatability (coefficient of variance < 8% for all concentrations higher than 5 pg/mL) and a short detection time (< 10 min).

  12. Human cardiac troponin I sensor based on silver nanoparticle doped microsphere resonator

    Science.gov (United States)

    Saliminasab, Maryam; Bahrampour, Alireza; Zandi, Mohammad Hossein

    2012-12-01

    Human cardiac troponin I (cTnI) is a specific biomarker for diagnosis of acute myocardial infarction (AMI). In this paper, a composite sensing system of an optical microsphere resonator and silver nanoparticles based on surface enhanced Raman scattering (SERS) and stimulated Raman scattering (SRS) techniques towards a point of care diagnostic system for AMI using the cTnI biomarker in HEPES buffered solution (HBS) is proposed. Pump and Raman signals enter the optical fiber coupling into the microsphere, and then SRS occurs in the microsphere. The presence of silver nanoparticles on the microsphere surface provides a tremendous enhancement of the resulting Raman signal through an electromagnetic enhancement of both the laser excitation and Stokes-shifted light of the order of 1010. This enhancement occurs in metals as surface plasmon resonance (SPR), which increases the Raman gain through the SERS effect. Our simulation results show that this sensor presents a linear response for cTnI detection. The calculated enhanced Raman signal can be employed to detect the cTnI molecules around the microsphere.

  13. Cardiac Autonomic Alteration and Metabolic Syndrome: An Ambulatory ECG-based Study in A General Population

    Science.gov (United States)

    Ma, Yan; Tseng, Ping-Huei; Ahn, Andrew; Wu, Ming-Shiang; Ho, Yi-Lwun; Chen, Ming-Fong; Peng, Chung-Kang

    2017-01-01

    Metabolic syndrome (MetS) has been associated with chronic damage to the cardiovascular system. This study aimed to evaluate early stage cardiac autonomic dysfunction with electrocardiography (ECG)-based measures in MetS subjects. During 2012–2013, 175 subjects with MetS and 226 healthy controls underwent ECG recordings of at least 4 hours starting in the morning with ambulatory one-lead ECG monitors. MetS was diagnosed using the criteria defined in the Adult Treatment Panel III, with a modification of waist circumference for Asians. Conventional heart rate variability (HRV) analysis, and complexity index (CI1–20) calculated from 20 scales of entropy (multiscale entropy, MSE), were compared between subjects with MetS and controls. Compared with the healthy controls, subjects with MetS had significantly reduced HRV, including SDNN and pNN20 in time domain, VLF, LF and HF in frequency domain, as well as SD2 in Poincaré analysis. MetS subjects have significantly lower complexity index (CI1–20) than healthy subjects (1.69 ± 0.18 vs. 1.77 ± 0.12, p < 0.001). MetS severity was inversely associated with the CI1–20 (r = −0.27, p < 0.001). MetS is associated with significant alterations in heart rate dynamics, including HRV and complexity. PMID:28290487

  14. Single-Nucleotide Variations in Cardiac Arrhythmias: Prospects for Genomics and Proteomics Based Biomarker Discovery and Diagnostics

    Directory of Open Access Journals (Sweden)

    Ayman Abunimer

    2014-03-01

    Full Text Available Cardiovascular diseases are a large contributor to causes of early death in developed countries. Some of these conditions, such as sudden cardiac death and atrial fibrillation, stem from arrhythmias—a spectrum of conditions with abnormal electrical activity in the heart. Genome-wide association studies can identify single nucleotide variations (SNVs that may predispose individuals to developing acquired forms of arrhythmias. Through manual curation of published genome-wide association studies, we have collected a comprehensive list of 75 SNVs associated with cardiac arrhythmias. Ten of the SNVs result in amino acid changes and can be used in proteomic-based detection methods. In an effort to identify additional non-synonymous mutations that affect the proteome, we analyzed the post-translational modification S-nitrosylation, which is known to affect cardiac arrhythmias. We identified loss of seven known S-nitrosylation sites due to non-synonymous single nucleotide variations (nsSNVs. For predicted nitrosylation sites we found 1429 proteins where the sites are modified due to nsSNV. Analysis of the predicted S-nitrosylation dataset for over- or under-representation (compared to the complete human proteome of pathways and functional elements shows significant statistical over-representation of the blood coagulation pathway. Gene Ontology (GO analysis displays statistically over-represented terms related to muscle contraction, receptor activity, motor activity, cystoskeleton components, and microtubule activity. Through the genomic and proteomic context of SNVs and S-nitrosylation sites presented in this study, researchers can look for variation that can predispose individuals to cardiac arrhythmias. Such attempts to elucidate mechanisms of arrhythmia thereby add yet another useful parameter in predicting susceptibility for cardiac diseases.

  15. Effectiveness of a hospital-based work support intervention for female cancer patients - a multi-centre randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Sietske J Tamminga

    Full Text Available OBJECTIVE: One key aspect of cancer survivorship is return-to-work. Unfortunately, many cancer survivors face problems upon their return-to-work. For that reason, we developed a hospital-based work support intervention aimed at enhancing return-to-work. We studied effectiveness of the intervention compared to usual care for female cancer patients in a multi-centre randomised controlled trial. METHODS: Breast and gynaecological cancer patients who were treated with curative intent and had paid work were randomised to the intervention group (n = 65 or control group (n = 68. The intervention involved patient education and support at the hospital and improvement of communication between treating and occupational physicians. In addition, we asked patient's occupational physician to organise a meeting with the patient and the supervisor to make a concrete gradual return-to-work plan. Outcomes at 12 months of follow-up included rate and time until return-to-work (full or partial, quality of life, work ability, work functioning, and lost productivity costs. Time until return-to-work was analyzed with Kaplan-Meier survival analysis. RESULTS: Return-to-work rates were 86% and 83% (p = 0.6 for the intervention group and control group when excluding 8 patients who died or with a life expectancy of months at follow-up. Median time from initial sick leave to partial return-to-work was 194 days (range 14-435 versus 192 days (range 82-465 (p = 0.90 with a hazard ratio of 1.03 (95% CI 0.64-1.6. Quality of life and work ability improved statistically over time but did not differ statistically between groups. Work functioning and costs did not differ statistically between groups. CONCLUSION: The intervention was easily implemented into usual psycho-oncological care and showed high return-to-work rates. We failed to show any differences between groups on return-to-work outcomes and quality of life scores. Further research is needed to study which

  16. How a structured vibrational environment controls the performance of a photosystem II reaction centre-based photocell

    CERN Document Server

    Stones, Richard; van Grondelle, Rienk; Olaya-Castro, Alexandra

    2016-01-01

    Photosynthetic reaction centres are pigment-protein complexes that can transform photo-induced electronic excitations into stable charge separated states with near-unit quantum efficiency. Here we consider a theoretical photovoltaic device that places a single photosystem II reaction centre between electrodes to investigate how the mean photo-current and its fluctuations depend on the vibrational environment that assists energy and electron transfer. Our results indicate that selective coupling to well resolved vibrational modes does not necessarily offer an advantage in terms of power output but does lead to photo-currents with suppressed noise levels. The exciton manifold and the structured vibrations assisting electron transfer can also support the emergence of a phenomenon akin to dynamical channel blockade, whereby excitonic traps can impose competing routes for population transfer under steady state operation. Our results help characterizing the device-like functionality of these complexes for their pot...

  17. Bioimpedance-based measurement method for simultaneous acquisition of respiratory and cardiac gating signals.

    Science.gov (United States)

    Koivumäki, T; Vauhkonen, M; Kuikka, J T; Hakulinen, M A

    2012-08-01

    Respiratory and cardiac motion artefacts impair the quality and reliability of medical imaging, particularly in nuclear medicine. At worst, the interpretation of distorted images may lead to inadequate or unnecessary treatment. Image artefacts can be minimized by gating the image acquisition according to respiratory phase and cardiac contractions. However, currently there are no clinically established dual-gating methods in nuclear medicine imaging. The aim of this study is to validate a previously determined optimized bioimpedance measurement configuration against traditional respiratory and cardiac measurement systems in 12 volunteers. High agreement and excellent correlations (r = 0.944-0.999) were found between respiratory peak-to-peak amplitudes as well as temporal respiratory and cardiac intervals. Above all, good quality respiratory and cardiac gating signals were obtained from all test subjects with a fairly regular sinus rhythm. Importantly, both signals were acquired simultaneously with a single device. Due to the simplicity of this inexpensive method, the technique has high potential to be adopted for dual-gating in clinical practice in the future.

  18. Image-based motion estimation for cardiac CT via image registration

    Science.gov (United States)

    Cammin, J.; Taguchi, K.

    2010-03-01

    Images reconstructed from tomographic projection data are subject to motion artifacts from organs that move during the duration of the scan. The effect can be reduced by taking the motion into account in the reconstruction algorithm if an estimate of the deformation exists. This paper presents the estimation of the three-dimensional cardiac motion by registering reconstructed images from cardiac quiet phases as a first step towards motion-compensated cardiac image reconstruction. The non-rigid deformations of the heart are parametrized on a coarse grid on the image volume and are interpolated with cubic b-splines. The optimization problem of finding b-spline coefficients that best describe the observed deformations is ill-posed due to the large number of parameters and the resulting motion vector field is sensitive to the choice of initial parameters. Particularly challenging is the task to capture the twisting motion of the heart. The motion vector field from a dynamic computer phantom of the human heart is used to initialize the transformation parameters for the optimization process with realistic starting values. The results are evaluated by comparing the registered images and the obtained motion vector field to the case when the registration is performed without using prior knowledge about the expected cardiac motion. We find that the registered images are similar for both approaches, but the motion vector field obtained from motion estimation initialized with the phantom describes the cardiac contraction and twisting motion more accurately.

  19. Community-based exercise training for people with chronic respiratory and chronic cardiac disease: a mixed-methods evaluation

    Science.gov (United States)

    McNamara, Renae J; McKeough, Zoe J; Mo, Laura R; Dallimore, Jamie T; Dennis, Sarah M

    2016-01-01

    Background Poor uptake and adherence are problematic for hospital-based pulmonary and heart failure rehabilitation programs, often because of access difficulties. The aims of this mixed-methods study were to determine the feasibility of a supervised exercise training program in a community gymnasium in people with chronic respiratory and chronic cardiac disease, to explore the experiences of participants and physiotherapists and to determine if a community venue improved access and adherence to rehabilitation. Methods Adults with chronic respiratory and/or chronic cardiac disease referred to a hospital-based pulmonary and heart failure rehabilitation program were screened to determine their suitability to exercise in a community venue. Eligible patients were offered the opportunity to attend supervised exercise training for 8 weeks in a community gymnasium. Semi-structured interviews were conducted with participants and physiotherapists at the completion of the program. Results Thirty-one people with chronic respiratory and chronic cardiac disease (34% males, mean [standard deviation] age 72 [10] years) commenced the community-based exercise training program. Twenty-two (71%) completed the program. All participants who completed the program, and the physiotherapists delivering the program, were highly satisfied, with reports of the community venue being well-equipped, convenient, and easily accessible. Using a community gymnasium promoted a sense of normality and instilled confidence in some to continue exercising at a similar venue post rehabilitation. However, factors such as cost and lack of motivation continue to be barriers. Conclusion The convenience and accessibility of a community venue for rehabilitation contributed to high levels of satisfaction and a positive experience for people with chronic respiratory and chronic cardiac disease and physiotherapists. PMID:27895476

  20. Multimodal analgesia versus traditional opiate based analgesia after cardiac surgery, a randomized controlled trial

    DEFF Research Database (Denmark)

    Rafiq, Sulman; Steinbrüchel, Daniel Andreas; Wanscher, Michael Jaeger;

    2014-01-01

    BACKGROUND: To evaluate if an opiate sparing multimodal regimen of dexamethasone, gabapentin, ibuprofen and paracetamol had better analgesic effect, less side effects and was safe compared to a traditional morphine and paracetamol regimen after cardiac surgery. METHODS: Open-label, prospective....... 1, p = 0.31). 30-day mortality was 1 vs. 2, p = 0.54. CONCLUSIONS: In patients undergoing cardiac surgery, a multimodal regimen offered significantly better analgesia than a traditional opiate regimen. Nausea and vomiting complaints were significantly reduced. No safety issues were observed...

  1. Sudden Cardiac Death in Young Adults With Previous Hospital-Based Psychiatric Inpatient and Outpatient Treatment

    DEFF Research Database (Denmark)

    Risgaard, Bjarke; Waagstein, Kristine; Winkel, Bo Gregers;

    2015-01-01

    Introduction: Psychiatric patients have premature mortality compared to the general population. The incidence of sudden cardiac death (SCD) in psychiatric patients is unknown in a nationwide setting. The aim of this study was to compare nationwide SCD incidence rates in young individuals with and......Introduction: Psychiatric patients have premature mortality compared to the general population. The incidence of sudden cardiac death (SCD) in psychiatric patients is unknown in a nationwide setting. The aim of this study was to compare nationwide SCD incidence rates in young individuals...

  2. Left ventricular modelling: a quantitative functional assessment tool based on cardiac magnetic resonance imaging

    Science.gov (United States)

    Conti, C. A.; Votta, E.; Corsi, C.; De Marchi, D.; Tarroni, G.; Stevanella, M.; Lombardi, M.; Parodi, O.; Caiani, E. G.; Redaelli, A.

    2011-01-01

    We present the development and testing of a semi-automated tool to support the diagnosis of left ventricle (LV) dysfunctions from cardiac magnetic resonance (CMR). CMR short-axis images of the LVs were obtained in 15 patients and processed to detect endocardial and epicardial contours and compute volume, mass and regional wall motion (WM). Results were compared with those obtained from manual tracing by an expert cardiologist. Nearest neighbour tracking and finite-element theory were merged to calculate local myocardial strains and torsion. The method was tested on a virtual phantom, on a healthy LV and on two ischaemic LVs with different severity of the pathology. Automated analysis of CMR data was feasible in 13/15 patients: computed LV volumes and wall mass correlated well with manually extracted data. The detection of regional WM abnormalities showed good sensitivity (77.8%), specificity (85.1%) and accuracy (82%). On the virtual phantom, computed local strains differed by less than 14 per cent from the results of commercial finite-element solver. Strain calculation on the healthy LV showed uniform and synchronized circumferential strains, with peak shortening of about 20 per cent at end systole, progressively higher systolic wall thickening going from base to apex, and a 10° torsion. In the two pathological LVs, synchronicity and homogeneity were partially lost, anomalies being more evident for the more severely injured LV. Moreover, LV torsion was dramatically reduced. Preliminary testing confirmed the validity of our approach, which allowed for the fast analysis of LV function, even though future improvements are possible. PMID:22670208

  3. CMS Centre at CERN

    CERN Multimedia

    2007-01-01

    A new "CMS Centre" is being established on the CERN Meyrin site by the CMS collaboration. It will be a focal point for communications, where physicists will work together on data quality monitoring, detector calibration, offline analysis of physics events, and CMS computing operations. Construction of the CMS Centre begins in the historic Proton Synchrotron (PS) control room. The historic Proton Synchrotron (PS) control room, Opened by Niels Bohr in 1960, will be reused by CMS to built its control centre. TThe LHC@FNAL Centre, in operation at Fermilab in the US, will work very closely with the CMS Centre, as well as the CERN Control Centre. (Photo Fermilab)The historic Proton Synchrotron (PS) control room is about to start a new life. Opened by Niels Bohr in 1960, the room will be reused by CMS to built its control centre. When finished, it will resemble the CERN Contro...

  4. A systematic review of economic evaluations of cardiac rehabilitation

    Directory of Open Access Journals (Sweden)

    Wong Wai

    2012-08-01

    Full Text Available Abstract Background Cardiac rehabilitation (CR, a multidisciplinary program consisting of exercise, risk factor modification and psychosocial intervention, forms an integral part of managing patients after myocardial infarction (MI, revascularization surgery and percutaneous coronary interventions, as well as patients with heart failure (HF. This systematic review seeks to examine the cost-effectiveness of CR for patients with MI or HF and inform policy makers in Singapore on published cost-effectiveness studies on CR. Methods Electronic databases (EMBASE, MEDLINE, NHS EED, PEDro, CINAHL were searched from inception to May 2010 for published economic studies. Additional references were identified through searching bibliographies of included studies. Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Quality assessment of economic evaluations was undertaken using Drummond’s checklist. Results A total of 22 articles were selected for review. However five articles were further excluded because they were cost-minimization analyses, whilst one included patients with stroke. Of the final 16 articles, one article addressed both centre-based cardiac rehabilitation versus no rehabilitation, as well as home-based cardiac rehabilitation versus no rehabilitation. Therefore, nine studies compared cost-effectiveness between centre-based supervised CR and no CR; three studies examined that between centre- and home based CR; one between inpatient and outpatient CR; and four between home-based CR and no CR. These studies were characterized by differences in the study perspectives, economic study designs and time frames, as well as variability in clinical data and assumptions made on costs. Overall, the studies suggested that: (1 supervised centre-based CR was highly cost-effective and the dominant strategy when compared to no CR; (2 home-based CR was no different from centre-based CR; (3 no difference existed

  5. Host-based Th2 cell therapy for prolongation of cardiac allograft viability.

    Directory of Open Access Journals (Sweden)

    Shoba Amarnath

    Full Text Available Donor T cell transfusion, which is a long-standing approach to prevent allograft rejection, operates indirectly by alteration of host T cell immunity. We therefore hypothesized that adoptive transfer of immune regulatory host Th2 cells would represent a novel intervention to enhance cardiac allograft survival. Using a well-described rat cardiac transplant model, we first developed a method for ex vivo manufacture of rat host-type Th2 cells in rapamycin, with subsequent injection of such Th2.R cells prior to class I and class II disparate cardiac allografting. Second, we determined whether Th2.R cell transfer polarized host immunity towards a Th2 phenotype. And third, we evaluated whether Th2.R cell therapy prolonged allograft viability when used alone or in combination with a short-course of cyclosporine (CSA therapy. We found that host-type Th2.R cell therapy prior to cardiac allografting: (1 reduced the frequency of activated T cells in secondary lymphoid organs; (2 shifted post-transplant cytokines towards a Th2 phenotype; and (3 prolonged allograft viability when used in combination with short-course CSA therapy. These results provide further support for the rationale to use "direct" host T cell therapy for prolongation of allograft viability as an alternative to "indirect" therapy mediated by donor T cell infusion.

  6. Region-Based 4D Tomographic Image Reconstruction: Application to Cardiac X-ray CT

    NARCIS (Netherlands)

    Eyndhoven, G. Van; Batenburg, K.J.; Sijbers, J.

    2015-01-01

    X-ray computed tomography (CT) is a powerful tool for noninvasive cardiac imaging. However, radiation dose is a major issue. In this paper, we propose an iterative reconstruction method that reduces the radiation dose without compromising image quality. This is achieved by exploiting prior knowledge

  7. Multi-layer Attribute Selection and Classification Algorithm for the Diagnosis of Cardiac Autonomic Neuropathy Based on HRV Attributes

    Directory of Open Access Journals (Sweden)

    Herbert F. Jelinek

    2015-12-01

    Full Text Available Cardiac autonomic neuropathy (CAN poses an important clinical problem, which often remains undetected due difficulty of conducting the current tests and their lack of sensitivity. CAN has been associated with growth in the risk of unexpected death in cardiac patients with diabetes mellitus. Heart rate variability (HRV attributes have been actively investigated, since they are important for diagnostics in diabetes, Parkinson's disease, cardiac and renal disease. Due to the adverse effects of CAN it is important to obtain a robust and highly accurate diagnostic tool for identification of early CAN, when treatment has the best outcome. Use of HRV attributes to enhance the effectiveness of diagnosis of CAN progression may provide such a tool. In the present paper we propose a new machine learning algorithm, the Multi-Layer Attribute Selection and Classification (MLASC, for the diagnosis of CAN progression based on HRV attributes. It incorporates our new automated attribute selection procedure, Double Wrapper Subset Evaluator with Particle Swarm Optimization (DWSE-PSO. We present the results of experiments, which compare MLASC with other simpler versions and counterpart methods. The experiments used our large and well-known diabetes complications database. The results of experiments demonstrate that MLASC has significantly outperformed other simpler techniques.

  8. Architecture design of the multi-functional wavelet-based ECG microprocessor for realtime detection of abnormal cardiac events.

    Science.gov (United States)

    Cheng, Li-Fang; Chen, Tung-Chien; Chen, Liang-Gee

    2012-01-01

    Most of the abnormal cardiac events such as myocardial ischemia, acute myocardial infarction (AMI) and fatal arrhythmia can be diagnosed through continuous electrocardiogram (ECG) analysis. According to recent clinical research, early detection and alarming of such cardiac events can reduce the time delay to the hospital, and the clinical outcomes of these individuals can be greatly improved. Therefore, it would be helpful if there is a long-term ECG monitoring system with the ability to identify abnormal cardiac events and provide realtime warning for the users. The combination of the wireless body area sensor network (BASN) and the on-sensor ECG processor is a possible solution for this application. In this paper, we aim to design and implement a digital signal processor that is suitable for continuous ECG monitoring and alarming based on the continuous wavelet transform (CWT) through the proposed architectures--using both programmable RISC processor and application specific integrated circuits (ASIC) for performance optimization. According to the implementation results, the power consumption of the proposed processor integrated with an ASIC for CWT computation is only 79.4 mW. Compared with the single-RISC processor, about 91.6% of the power reduction is achieved.

  9. Perceptual centres in speech - an acoustic analysis

    Science.gov (United States)

    Scott, Sophie Kerttu

    Perceptual centres, or P-centres, represent the perceptual moments of occurrence of acoustic signals - the 'beat' of a sound. P-centres underlie the perception and production of rhythm in perceptually regular speech sequences. P-centres have been modelled both in speech and non speech (music) domains. The three aims of this thesis were toatest out current P-centre models to determine which best accounted for the experimental data bto identify a candidate parameter to map P-centres onto (a local approach) as opposed to the previous global models which rely upon the whole signal to determine the P-centre the final aim was to develop a model of P-centre location which could be applied to speech and non speech signals. The first aim was investigated by a series of experiments in which a) speech from different speakers was investigated to determine whether different models could account for variation between speakers b) whether rendering the amplitude time plot of a speech signal affects the P-centre of the signal c) whether increasing the amplitude at the offset of a speech signal alters P-centres in the production and perception of speech. The second aim was carried out by a) manipulating the rise time of different speech signals to determine whether the P-centre was affected, and whether the type of speech sound ramped affected the P-centre shift b) manipulating the rise time and decay time of a synthetic vowel to determine whether the onset alteration was had more affect on P-centre than the offset manipulation c) and whether the duration of a vowel affected the P-centre, if other attributes (amplitude, spectral contents) were held constant. The third aim - modelling P-centres - was based on these results. The Frequency dependent Amplitude Increase Model of P-centre location (FAIM) was developed using a modelling protocol, the APU GammaTone Filterbank and the speech from different speakers. The P-centres of the stimuli corpus were highly predicted by attributes of

  10. Management of Maternal Cardiac Arrest in the Third Trimester of Pregnancy: A Simulation-Based Pilot Study

    Directory of Open Access Journals (Sweden)

    Jacquelyn Adams

    2016-01-01

    Full Text Available Objective. To evaluate confidence, knowledge, and competence after a simulation-based curriculum on maternal cardiac arrest in an Obstetrics & Gynecologic (OBGYN residency program. Methods. Four simulations with structured debriefing focusing on high yield causes and management of maternal cardiac arrest were executed. Pre- and post-individual knowledge tests (KT and confidence surveys (CS were collected along with group scores of critical performance steps evaluated by content experts for the first and final simulations. Results. Significant differences were noted in individual KT scores (pre: 58.9±8.9 versus post: 72.8±6.1, p=0.01 and CS total scores (pre: 22.2±6.4 versus post: 29.9±3.4, p=0.007. Significant differences were noted in airway management, p=0.008; appropriate cycles of drug/shock-CPR, p=0.008; left uterine displacement, p=0.008; and identifying causes of cardiac arrest, p=0.008. Nonsignificant differences were noted for administration of appropriate drugs/doses, p=0.074; chest compressions, p=0.074; bag-mask ventilation before intubation, p=0.074; and return of spontaneous circulation identification, p=0.074. Groups remained noncompetent in team leader tasks and considering therapeutic hypothermia. Conclusion. This study demonstrated improved OBGYN resident knowledge, confidence, and competence in the management of third trimester maternal cardiac arrest. Several skills, however, will likely require more longitudinal curricular exposure and training to develop and maintain proficiency.

  11. Cardiac Sarcoidosis.

    Science.gov (United States)

    Birnie, David; Ha, Andrew C T; Gula, Lorne J; Chakrabarti, Santabhanu; Beanlands, Rob S B; Nery, Pablo

    2015-12-01

    Studies suggest clinically manifest cardiac involvement occurs in 5% of patients with pulmonary/systemic sarcoidosis. The principal manifestations of cardiac sarcoidosis (CS) are conduction abnormalities, ventricular arrhythmias, and heart failure. Data indicate that an 20% to 25% of patients with pulmonary/systemic sarcoidosis have asymptomatic (clinically silent) cardiac involvement. An international guideline for the diagnosis and management of CS recommends that patients be screened for cardiac involvement. Most studies suggest a benign prognosis for patients with clinically silent CS. Immunosuppression therapy is advocated for clinically manifest CS. Device therapy, with implantable cardioverter defibrillators, is recommended for some patients.

  12. Structural and functional cardiac adaptations to a 10-week school-based football intervention for 9-10-year-old children

    DEFF Research Database (Denmark)

    Krustrup, Peter; Hansen, Peter Riis; Nielsen, Claus Malta

    2014-01-01

    The present study investigated the cardiac effects of a 10-week football training intervention for school children aged 9-10 years using comprehensive transthoracic echocardiography as a part of a larger ongoing study. A total of 97 pupils from four school classes were cluster-randomized into a c...... pressure. In conclusion, a short-term, school-based intervention comprising small-sided football sessions resulted in significant structural and functional cardiac adaptations in pre-adolescent children....

  13. Person-centred reflective practice.

    Science.gov (United States)

    Devenny, Bob; Duffy, Kathleen

    Person-centred health and person-centred care have gained prominence across the UK following the publication of reports on public inquiries exploring failings in care. Self-awareness and participation in reflective practice are recognised as vital to supporting the person-centred agenda. This article presents an education framework for reflective practice, developed and used in one NHS board in Scotland, and based on the tenets of the clinical pastoral education movement. Providing an insight into the usefulness of a spiritual component in the reflective process, the framework provides an opportunity for nurses and other healthcare professionals to examine the spiritual dimensions of patient encounters, their own values and beliefs, and the effect these may have on their practice.

  14. The InterHerz project - a web-based psychological treatment for cardiac patients with depression: study protocol of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Messerli-Bürgy Nadine

    2012-12-01

    Full Text Available Abstract Background Patients with heart disease often suffer from difficulties in psychological adaptation during cardiac rehabilitation. Mood disorders such as depression are known to be highly prevalent in cardiac patients and to have a negative impact on the progression of coronary heart disease. However, cardiac patients have difficulties to get psychological treatments due to low availability and motivational difficulties. Web-based interventions have been proven to be effective in treating depressive symptoms. Deprexis is a promising web-based psychological treatment which was devised for depressed patients. The aim of the study InterHerz is to examine if Deprexis is an effective psychological treatment to reduce stress and depression in cardiac patients. Methods/Design The sample will consist of 80 depressed patients randomized to an intervention group or a waitlist (10 weeks. Patients are recruited via cardiologists, cardiac rehabilitation units and the website of the Swiss Heart Foundation. Patients have access to a guided self-help program in which they work themselves through several modules and receive feedback from a clinical psychologist. Pre- and post-assessments, and a six-month follow-up, are conducted using online questionnaires and diagnostic interviews. Discussion Deprexis is a new web-based treatment which has the potential to help depressed cardiac patients with limited access to psychological treatment to increase their mental health. Trial registration Current Controlled Trials ISRCTN45945396

  15. Radial thresholding to mitigate Laser-Guide-Star aberrations on Centre-of-Gravity-based Shack-Hartmann wavefront sensors

    CERN Document Server

    Lardiere, Olivier; Bradley, Colin; Jackson, Kate; Hampton, Peter

    2009-01-01

    Sodium Laser Guide Stars (LGSs) are elongated sources due to the thickness and the finite distance of the sodium layer. The fluctuations of the sodium layer altitude and atom density profile induce errors on centroid measurements of elongated spots, and generate spurious optical aberrations in closed--loop adaptive optics (AO) systems. According to an analytical model and experimental results obtained with the University of Victoria LGS bench demonstrator, one of the main origins of these aberrations, referred to as LGS aberrations, is not the Centre-of-Gravity (CoG) algorithm itself, but the thresholding applied on the pixels of the image prior to computing the spot centroids. A new thresholding method, termed ``radial thresholding'', is presented here, cancelling out most of the LGS aberrations without altering the centroid measurement accuracy.

  16. Are non-cardiac surgeries safe for dialysis patients? - A population-based retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Yih-Giun Cherng

    Full Text Available BACKGROUND: End-stage renal disease represents a risk complex that complicates surgical results. The surgical outcomes of dialysis patients have been studied in specific fields, but the global features of postoperative adverse outcomes in dialysis patients receiving non-cardiac surgeries have not been examined. METHODS: Taiwan's National Health Insurance Research Database was used to study 8,937 patients under regular dialysis with 8,937 propensity-score matched-pair controls receiving non-cardiac surgery between 2004 and 2007. We investigated the influence of hemodialysis and peritoneal dialysis, effects of hypertension and diabetes, and impact of additional comorbidities on postoperative adverse outcomes. RESULTS: Postoperative mortality in dialysis patients was higher than in controls (odds ratio [OR] 3.33, 95% confidence interval [CI] 2.56 to 4.33 when receiving non-cardiac surgeries. Complications such as acute myocardial infarction, pneumonia, bleeding, and septicemia were significantly increased. Postoperative mortality was significantly increased among peritoneal dialysis patients (OR 2.71, 95% CI 1.70 to 4.31 and hemodialysis patients (OR 3.42, 95% CI 2.62 to 4.47 than in controls. Dialysis patients with both hypertension and diabetes had the highest risk of postoperative complications; these risks increased with number of preoperative medical conditions. Patients under dialysis also showed significantly increased length of hospitalization, more ICU stays and higher medical expenditures. CONCLUSION: Surgical patients under dialysis encountered significantly higher postoperative complications and mortality than controls when receiving non-cardiac surgeries. Different dialysis techniques, pre-existing hypertension/diabetes, and various comorbidities had complication-specific impacts on surgical adverse outcomes. These findings can help surgical teams provide better risk assessment and postoperative care for dialysis patients.

  17. Port Access Cardiac Surgery.

    Science.gov (United States)

    Viganó, Mario; Minzioni, Gaetano; Spreafico, Patrizio; Rinaldi, Mauro; Pasquino, Stefano; Ceriana, Piero; Locatelli, Alessandro

    2000-10-01

    The port-access technique for cardiac surgery was recently developed at Stanford University in California as a less invasive method to perform some cardiac operations. The port-access system has been described in detail elsewhere. It is based on femoral arterial and venous access for cardiopulmonary bypass (CPB) and on the adoption of a specially designed triple-lumen catheter described originally by Peters, and subsequently modified and developed in the definitive configuration called the endoaortic clamp.

  18. 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.

  19. The ideal Atomic Centre; Le Centre Atomique ideal

    Energy Technology Data Exchange (ETDEWEB)

    Mas, R. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1965-07-01

    The author presents considerations which should prove to be of interest to all those who have to design, to construct and to operate a nuclear research centre. A large number of the ideas presented can also be applied to non-nuclear scientific research centres. In his report the author reviews: various problems with which the constructor is faced: ground-plan, infrastructure, buildings and the large units of scientific equipment in the centre, and those problems facing the director: maintenance, production, supplies, security. The author stresses the relationship which ought to exist between the research workers and the management. With this aim in view he proposes the creation of National School for Administration in Research which would train administrative executives for public or private organisations; they would be specialised in the fields of fundamental or applied research. (author) [French] L'auteur propose une base de reflexions a tous ceux qui doivent concevoir, realiser et faire vivre un Centre d'Etudes Nucleaires. Un grand nombre des idees exprimees peut d'ailleurs s'appliquer a un Centre d'Etudes Scientifiques non nucleaires. Dans son ouvrage, l'auteur passe en revue les differents problemes qui se posent au constructeur: plan, masse, infrastructure, batiments et grands appareils du Centre, et ceux qu'a a resoudre le directeur: entretien, fabrication, approvisionnements, securite. L'auteur insiste sur l'aspect des rapports qui doivent exister entre les chercheurs et ceux qui les administrent. Il propose a cette fin la creation d'une Ecole Nationale d'Administration de la Recherche qui formerait des cadres administratifs pour les organismes publics ou prives, specialises dans la Recherche fondamentale ou appliquee. (auteur)

  20. Modeling calcium wave based on anomalous subdiffusion of calcium sparks in cardiac myocytes.

    Directory of Open Access Journals (Sweden)

    Xi Chen

    Full Text Available Ca(2+ sparks and Ca(2+ waves play important roles in calcium release and calcium propagation during the excitation-contraction (EC coupling process in cardiac myocytes. Although the classical Fick's law is widely used to model Ca(2+ sparks and Ca(2+ waves in cardiac myocytes, it fails to reasonably explain the full-width at half maximum(FWHM paradox. However, the anomalous subdiffusion model successfully reproduces Ca(2+ sparks of experimental results. In this paper, in the light of anomalous subdiffusion of Ca(2+ sparks, we develop a mathematical model of calcium wave in cardiac myocytes by using stochastic Ca(2+ release of Ca(2+ release units (CRUs. Our model successfully reproduces calcium waves with physiological parameters. The results reveal how Ca(2+ concentration waves propagate from an initial firing of one CRU at a corner or in the middle of considered region, answer how large in magnitude of an anomalous Ca(2+ spark can induce a Ca(2+ wave. With physiological Ca(2+ currents (2pA through CRUs, it is shown that an initial firing of four adjacent CRUs can form a Ca(2+ wave. Furthermore, the phenomenon of calcium waves collision is also investigated.

  1. A displacement-based finite element formulation for incompressible and nearly-incompressible cardiac mechanics.

    Science.gov (United States)

    Hadjicharalambous, Myrianthi; Lee, Jack; Smith, Nicolas P; Nordsletten, David A

    2014-06-01

    The Lagrange Multiplier (LM) and penalty methods are commonly used to enforce incompressibility and compressibility in models of cardiac mechanics. In this paper we show how both formulations may be equivalently thought of as a weakly penalized system derived from the statically condensed Perturbed Lagrangian formulation, which may be directly discretized maintaining the simplicity of penalty formulations with the convergence characteristics of LM techniques. A modified Shamanskii-Newton-Raphson scheme is introduced to enhance the nonlinear convergence of the weakly penalized system and, exploiting its equivalence, modifications are developed for the penalty form. Focusing on accuracy, we proceed to study the convergence behavior of these approaches using different interpolation schemes for both a simple test problem and more complex models of cardiac mechanics. Our results illustrate the well-known influence of locking phenomena on the penalty approach (particularly for lower order schemes) and its effect on accuracy for whole-cycle mechanics. Additionally, we verify that direct discretization of the weakly penalized form produces similar convergence behavior to mixed formulations while avoiding the use of an additional variable. Combining a simple structure which allows the solution of computationally challenging problems with good convergence characteristics, the weakly penalized form provides an accurate and efficient alternative to incompressibility and compressibility in cardiac mechanics.

  2. Myocardial scaffold-based cardiac tissue engineering: application of coordinated mechanical and electrical stimulations.

    Science.gov (United States)

    Wang, Bo; Wang, Guangjun; To, Filip; Butler, J Ryan; Claude, Andrew; McLaughlin, Ronald M; Williams, Lakiesha N; de Jongh Curry, Amy L; Liao, Jun

    2013-09-03

    Recently, we developed an optimal decellularization protocol to generate 3D porcine myocardial scaffolds, which preserve the natural extracellular matrix structure, mechanical anisotropy, and vasculature templates and also show good cell recellularization and differentiation potential. In this study, a multistimulation bioreactor was built to provide coordinated mechanical and electrical stimulation for facilitating stem cell differentiation and cardiac construct development. The acellular myocardial scaffolds were seeded with mesenchymal stem cells (10(6) cells/mL) by needle injection and subjected to 5-azacytidine treatment (3 μmol/L, 24 h) and various bioreactor conditioning protocols. We found that after 2 days of culturing with mechanical (20% strain) and electrical stimulation (5 V, 1 Hz), high cell density and good cell viability were observed in the reseeded scaffold. Immunofluorescence staining demonstrated that the differentiated cells showed a cardiomyocyte-like phenotype by expressing sarcomeric α-actinin, myosin heavy chain, cardiac troponin T, connexin-43, and N-cadherin. Biaxial mechanical testing demonstrated that positive tissue remodeling took place after 2 days of bioreactor conditioning (20% strain + 5 V, 1 Hz); passive mechanical properties of the 2 day and 4 day tissue constructs were comparable to those of the tissue constructs produced by stirring reseeding followed by 2 weeks of static culturing, implying the effectiveness and efficiency of the coordinated simulations in promoting tissue remodeling. In short, the synergistic stimulations might be beneficial not only for the quality of cardiac construct development but also for patients by reducing the waiting time in future clinical scenarios.

  3. A comparative study of graph-based, eikonal, and monodomain simulations for the estimation of cardiac activation times.

    Science.gov (United States)

    Wallman, Mikael; Smith, Nicolas P; Rodriguez, Blanca

    2012-06-01

    The bidomain and monodomain equations are well established as the standard set of equations for the simulation of cardiac electrophysiological behavior. However, the computational cost of detailed bidomain/monodomain simulations limits their applicability in scenarios where a large number of simulations needs to be performed (e.g., parameter estimation). In this study, we present a graph-based method, which relies on point-to-point path finding to estimate activation times for single points in cardiac tissue with minimal computational costs. To validate our approach, activation times are compared to monodomain simulation results for an anatomically based rabbit ventricular model, incorporating realistic fiber orientation and conduction heterogeneities. Differences in activation times between the graph-based method and monodomain results are less than 10% of the total activation time, and computational performance is orders of magnitude faster with the proposed method when calculating activation times at single points. These results suggest that the graph-based method is well suited for estimating activation times when the need for fast performance justifies a limited loss of accuracy.

  4. Client Centred Desing

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Nielsen, Janni; Levinsen, Karin

    2008-01-01

    In this paper we argue for the use of Client Centred preparation phases when designing complex systems. Through Client Centred Design human computer interaction can extend the focus on end-users to alse encompass the client's needs, context and resources....

  5. Community-based exercise training for people with chronic respiratory and chronic cardiac disease: a mixed-methods evaluation

    Directory of Open Access Journals (Sweden)

    McNamara RJ

    2016-11-01

    Full Text Available Renae J McNamara,1,2 Zoe J McKeough,3 Laura R Mo,3 Jamie T Dallimore,4 Sarah M Dennis3 1Physiotherapy Department, 2Respiratory and Sleep Medicine Department, Prince of Wales Hospital, Randwick, 3Discipline of Physiotherapy, The University of Sydney, Lidcombe, 4Eastern Sydney Medicare Local, Rosebery, NSW, Australia Background: Poor uptake and adherence are problematic for hospital-based pulmonary and heart failure rehabilitation programs, often because of access difficulties. The aims of this mixed-methods study were to determine the feasibility of a supervised exercise training program in a community gymnasium in people with chronic respiratory and chronic cardiac disease, to explore the experiences of participants and physiotherapists and to determine if a community venue improved access and adherence to rehabilitation. Methods: Adults with chronic respiratory and/or chronic cardiac disease referred to a hospital-based pulmonary and heart failure rehabilitation program were screened to determine their suitability to exercise in a community venue. Eligible patients were offered the opportunity to attend supervised exercise training for 8 weeks in a community gymnasium. Semi-structured interviews were conducted with participants and physiotherapists at the completion of the program. Results: Thirty-one people with chronic respiratory and chronic cardiac disease (34% males, mean [standard deviation] age 72 [10] years commenced the community-based exercise training program. Twenty-two (71% completed the program. All participants who completed the program, and the physiotherapists delivering the program, were highly satisfied, with reports of the community venue being well-equipped, convenient, and easily accessible. Using a community gymnasium promoted a sense of normality and instilled confidence in some to continue exercising at a similar venue post rehabilitation. However, factors such as cost and lack of motivation continue to be barriers

  6. Effects of a Home-Based Family-Centred Early Habilitation Program on Neurobehavioural Outcomes of Very Preterm Born Infants: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Michela Poggioli

    2016-01-01

    Full Text Available Preterm children have an increased risk of neurodevelopmental impairments which include psychomotor and language retardation. The objectives of the present retrospective cohort study were to examine the effects of an individually adapted, home-based, and family-centred early developmental habilitation program on neurodevelopmental and behavioural outcomes of very preterm children compared with a standard follow-up at 2 years’ corrected age. Enrolled infants were retrospectively assigned to the intervention group (61 subjects or to the control group (62 subjects depending on whether they had or had not carried out a home-based family-centred early developmental habilitation program focused on environmental enrichment, parent-guided environmental interaction, and infant development. Developmental outcome was assessed for both groups at 24 months’ corrected age using the Bayley Scales of Infant Development 2nd Edition. Intervention significantly improved both cognitive and behavioural outcomes. In addition, males had significantly lower scores than females either before or after treatment. However, the treatment was effective in both genders to the same extent. In conclusion, a timely updated environment suitable to the infant’s developmental needs could provide the best substrate where the parent-infant relationship can be practised with the ultimate goal of achieving further developmental steps.

  7. Family-based cardiac screening in relatives of victims of sudden arrhythmic death syndrome.

    LENUS (Irish Health Repository)

    McGorrian, Catherine

    2013-02-03

    AIMS: Sudden arrhythmic death syndrome (SADS) occurs when a person suffers a sudden, unexpected death, with no cause found at postmortem examination. We aimed to describe the cardiac screening outcomes in a population of relatives of SADS victimsMETHODS AND RESULTS: Prospective and retrospective cohort study of consecutive families attending the Family Heart Screening clinic at the Mater Misericordiae Hospital in Dublin, Ireland, from January 2007 to September 2011. Family members of SADS victims underwent a standard screening protocol. Adjunct clinical and postmortem information was sought on the proband. Families who had an existing diagnosis, or where the proband had epilepsy, were excluded. Of 115 families identified, 73 were found to fit inclusion criteria and were retained for analysis, with data available on 262 relatives. Over half of the screened family members were female, and the mean age was 38.6 years (standard deviation 15.6). In 22 of 73 families (30%), and 36 of 262 family members (13.7%), a potentially inheritable cause of SADS was detected. Of the population screened, 32 patients (12.2%) were treated with medication, and 5 (1.9%) have received implantable cardiac defibrillators. Of the five families with long QT syndrome (LQTS) who had a pathogenic gene mutation identified, three carried two such mutations.CONCLUSION: In keeping with international estimates, 30% of families of SADS victims were found to have a potentially inherited cardiac disease. The most common positive finding was LQTS. Advances in postmortem standards and genetic studies may assist in achieving more diagnoses in these families.

  8. A population-based lifestyle intervention to promote healthy weight and physical activity in people with cardiac disease: The PANACHE (Physical Activity, Nutrition And Cardiac HEalth study protocol

    Directory of Open Access Journals (Sweden)

    Allman-Farinelli Margaret

    2010-04-01

    Full Text Available Abstract Background Maintaining a healthy weight and undertaking regular physical activity are important for the secondary prevention of cardiovascular disease (CVD. However, many people with CVD are overweight and insufficiently active. In addition, in Australia only 20-30% of people requiring cardiac rehabilitation (CR for CVD actually attend. To improve outcomes of and access to CR the efficacy, effectiveness and cost-effectiveness of alternative approaches to CR need to be established. This research will determine the efficacy of a telephone-delivered lifestyle intervention, promoting healthy weight and physical activity, in people with CVD in urban and rural settings. The control group will also act as a replication study of a previously proven physical activity intervention, to establish whether those findings can be repeated in different urban and rural locations. The cost-effectiveness and acceptability of the intervention to CR staff and participants will also be determined. Methods/Design This study is a randomised controlled trial. People referred for CR at two urban and two rural Australian hospitals will be invited to participate. The intervention (healthy weight group will participate in four telephone delivered behavioural coaching and goal setting sessions over eight weeks. The coaching sessions will be on weight, nutrition and physical activity and will be supported by written materials, a pedometer and two follow-up booster telephone calls. The control (physical activity group will participate in a six week intervention previously shown to increase physical activity, consisting of two telephone delivered behavioural coaching and goal setting sessions on physical activity, supported by written materials, a pedometer and two booster phone calls. Data will be collected at baseline, eight weeks and eight months for the intervention group (baseline, six weeks and six months for the control group. The primary outcome is weight change

  9. Trigemino-cardiac reflex during transsphenoidal surgery for pituitary adenomas: methodological description of a prospective skull base study protocol.

    Science.gov (United States)

    Schaller, B J; Weigel, D; Filis, A; Buchfelder, M

    2007-05-29

    A systematic clinical neuroscience protocol is described for the use to examine the trigemino-cardiac reflex (TCR) response in humans. Target neurosurgical conditions are operations that require manipulations around the peripheral and central part of the trigeminal nerve and its branches, e.g. the cerebellopontine angle or the sellar region. To assess the hemodynamic and cardiac responses of patients after TCR initiation, anesthetic monitoring has been applied. The TCR is defined as a drop of more than 20% of the heart rate and the mean arterial blood pressure compared with the baseline values before the stimulus and coinciding with the surgical manipulation at or around any branches of the trigeminal nerve. By help of illustrative cases, we present for the first time preliminary results regarding the differentiation of the TCR in a central and a peripheral induction during transsphenoidal surgery of pituitary adenomas. Based on these results, we can conclude that we have developed a battery of preoperative examination procedures based on event-related diagnostics that was useful to differentiate different subgroups of TCR during transsphenoidal surgery. The presented protocol can be performed directly pre-, intra- and postoperatively and applied for assessment of TCR even in patients with known risk factors.

  10. Myosin light chain 2-based selection of human iPSC-derived early ventricular cardiac myocytes

    Science.gov (United States)

    Bizy, Alexandra; Guerrero-Serna, Guadalupe; Hu, Bin; Ponce-Balbuena, Daniela; Willis, B. Cicero; Zarzoso, Manuel; Ramirez, Rafael J.; Sener, Michelle F.; Mundada, Lakshmi V.; Klos, Matthew; Devaney, Eric J.; Vikstrom, Karen L.; Herron, Todd J.; Jalife, José

    2014-01-01

    Applications of human induced pluripotent stemcell derived-cardiac myocytes (hiPSC-CMs) would be strengthened by the ability to generate specific cardiac myocyte (CM) lineages. However, purification of lineage-specific hiPSC-CMs is limited by the lack of cell marking techniques. Here, we have developed an iPSC-CM marking system using recombinant adenoviral reporter constructs with atrial- or ventricular-specific myosin light chain-2 (MLC-2) promoters. MLC-2a and MLC-2v selected hiPSC-CMs were purified by fluorescence-activated cell sorting and their biochemical and electrophysiological phenotypes analyzed. We demonstrate that the phenotype of both populations remained stable in culture and they expressed the expected sarcomeric proteins, gap junction proteins and chamber-specific transcription factors. Compared to MLC-2a cells, MLC-2v selected CMs had larger action potential amplitudes and durations. In addition, by immunofluorescence, we showed that MLC-2 isoform expression can be used to enrich hiPSC-CM consistent with early atrial and ventricularmyocyte lineages. However, only the ventricular myosin light chain-2 promoter was able to purify a highly homogeneous population of iPSC-CMs. Using this approach, it is now possible to develop ventricular-specific disease models using iPSC-CMs while atrial-specific iPSC-CM cultures may require additional chamber-specific markers. PMID:24095945

  11. Application of intraoperative arterial pressure-based cardiac output monitoring for patients undergoing coronary artery bypass grafting surgery

    Institute of Scientific and Technical Information of China (English)

    LU Jia-kai; ZHU Chen; JING He; WANG Yi-jun; QING En-ming

    2012-01-01

    Background For patients undergoing off-pump coronary artery bypass grafting (OPCABG),it is important to establish a hemodynamic monitoring system to obtain powerful parameters for better intraoperative treatment.This study aimed to observe the clinical feasibility of artedal pressure-based cardiac output (APCO) for cardiac output (CO) monitoring and to evaluate the correlation between APCO and pulmonary artery catheter (PAC) for CO measurement for patients undergoing OPCABG intraoperatively.Methods Fifty patients of Amedcan Society of Anaesthesiologists (ASA) classification Ⅱ-Ⅲ,undergoing elective OPCABG at Beijing Anzhen Hospital were randomly enrolled into this study.All patients were assigned to CO monitoring by PAC and APCO simultaneously.Patients with pacemaker,severe valvular heart disease,left ventdcular ejection fraction (EF) <40%,cardiac arrhythmias,peripheral vascular disease,application of intra-aortic balloon pump (IABP) and emergent diversion to cardiac pulmonary bypass were excluded.The radial artery wavaform was analyzed to estimate the stroke volume (SV) and heart rate (HR) continuously.CO was calculated as SV x HR; other derived parameters were cardiac index (CI),stroke volume index (SVI),systemic vascular resistance (SVR),and systemic vascular resistance index (SVRI).PAC was placed via right internal jugular vein and the correct position was confirmed by PAC waveforms.Continuous cardiac output (CCO),CI and other hemodynamic parameters were monitored at following 5 time points:immediate after anesthesia induction (baseline value),anastomosis of left intemal mammary artery to left anterior descending artery (LAD),anastomosis of left circumflex (LCX),anastomosis of posterior descending artery (PDA) and immediate after sternal closure.Results In the 50 patients,preoperative echocardiography measured left ventricular EF was (52.8±11.5)%,and 35 patients (70%) showed regional wall motion abnormalities.The correlation coefficient of CO

  12. Cardiac cameras.

    Science.gov (United States)

    Travin, Mark I

    2011-05-01

    Cardiac imaging with radiotracers plays an important role in patient evaluation, and the development of suitable imaging instruments has been crucial. While initially performed with the rectilinear scanner that slowly transmitted, in a row-by-row fashion, cardiac count distributions onto various printing media, the Anger scintillation camera allowed electronic determination of tracer energies and of the distribution of radioactive counts in 2D space. Increased sophistication of cardiac cameras and development of powerful computers to analyze, display, and quantify data has been essential to making radionuclide cardiac imaging a key component of the cardiac work-up. Newer processing algorithms and solid state cameras, fundamentally different from the Anger camera, show promise to provide higher counting efficiency and resolution, leading to better image quality, more patient comfort and potentially lower radiation exposure. While the focus has been on myocardial perfusion imaging with single-photon emission computed tomography, increased use of positron emission tomography is broadening the field to include molecular imaging of the myocardium and of the coronary vasculature. Further advances may require integrating cardiac nuclear cameras with other imaging devices, ie, hybrid imaging cameras. The goal is to image the heart and its physiological processes as accurately as possible, to prevent and cure disease processes.

  13. The IGU Knowledge Centre

    NARCIS (Netherlands)

    Huizing, Bernardus

    2005-01-01

    This article describes an innovative service for members of the International Gas Union - IGU. The IGU Knowledge Centre provides members with relevant information and data. In this article is described why, how and where.

  14. Virtual particle therapy centre

    CERN Multimedia

    2015-01-01

    Particle therapy is an advanced technique of cancer radiation therapy, using protons or other ions to target the cancerous mass. This advanced technique requires a multi-disciplinary team working in a specialised centre. 3D animation: Nymus3D

  15. Home-based versus hospital-based cardiac rehabilitation after myocardial infarction or revascularisation: design and rationale of the Birmingham Rehabilitation Uptake Maximisation Study (BRUM: a randomised controlled trial [ISRCTN72884263

    Directory of Open Access Journals (Sweden)

    Lane Deirdre

    2003-09-01

    Full Text Available Abstract Background Cardiac rehabilitation following myocardial infarction reduces subsequent mortality, but uptake and adherence to rehabilitation programmes remains poor, particularly among women, the elderly and ethnic minority groups. Evidence of the effectiveness of home-based cardiac rehabilitation remains limited. This trial evaluates the effectiveness and cost-effectiveness of home-based compared to hospital-based cardiac rehabilitation. Methods/design A pragmatic randomised controlled trial of home-based compared with hospital-based cardiac rehabilitation in four hospitals serving a multi-ethnic inner city population in the United Kingdom was designed. The home programme is nurse-facilitated, manual-based using the Heart Manual. The hospital programmes offer comprehensive cardiac rehabilitation in an out-patient setting. Patients We will randomise 650 adult, English or Punjabi-speaking patients of low-medium risk following myocardial infarction, coronary angioplasty or coronary artery bypass graft who have been referred for cardiac rehabilitation. Main outcome measures Serum cholesterol, smoking cessation, blood pressure, Hospital Anxiety and Depression Score, distance walked on Shuttle walk-test measured at 6, 12 and 24 months. Adherence to the programmes will be estimated using patient self-reports of activity. In-depth interviews with non-attendees and non-adherers will ascertain patient views and the acceptability of the programmes and provide insights about non-attendance and aims to generate a theory of attendance at cardiac rehabilitation. The economic analysis will measure National Health Service costs using resource inputs. Patient costs will be established from the qualitative research, in particular how they affect adherence. Discussion More data are needed on the role of home-based versus hospital-based cardiac rehabilitation for patients following myocardial infarction and revascularisation, which would be provided by the

  16. The role of the sexual assault centre.

    LENUS (Irish Health Repository)

    Eogan, Maeve

    2013-02-01

    Sexual Assault Centres provide multidisciplinary care for men and women who have experienced sexual crime. These centres enable provision of medical, forensic, psychological support and follow-up care, even if patients chose not to report the incident to the police service. Sexual Support Centres need to provide a ring-fenced, forensically clean environment. They need to be appropriately staffed and available 24 hours a day, 7 days a week to allow prompt provision of medical and supportive care and collection of forensic evidence. Sexual Assault Centres work best within the context of a core agreed model of care, which includes defined multi-agency guidelines and care pathways, close links with forensic science and police services, and designated and sustainable funding arrangements. Additionally, Sexual Assault Centres also participate in patient, staff and community education and risk reduction. Furthermore, they contribute to the development, evaluation and implementation of national strategies on domestic, sexual and gender-based violence.

  17. Sudden Cardiac Death in Brazil: A Community-Based Autopsy Series (2006-2010

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    Maria Fernanda Braggion-Santos

    2015-02-01

    Full Text Available Background: Sudden cardiac death (SCD is a sudden unexpected event, from a cardiac cause, that occurs in less than one hour after the symptoms onset, in a person without any previous condition that would seem fatal or who was seen without any symptoms 24 hours before found dead. Although it is a relatively frequent event, there are only few reliable data in underdeveloped countries. Objective: We aimed to describe the features of SCD in Ribeirão Preto, Brazil (600,000 residents according to Coroners’ Office autopsy reports. Methods: We retrospectively reviewed 4501 autopsy reports between 2006 and 2010, to identify cases of SCD. Specific cause of death as well as demographic information, date, location and time of the event, comorbidities and whether cardiopulmonary resuscitation (CPR was attempted were collected. Results: We identified 899 cases of SCD (20%; the rate was 30/100000 residents per year. The vast majority of cases of SCD involved a coronary artery disease (CAD (64% and occurred in men (67%, between the 6th and the 7th decades of life. Most events occurred during the morning in the home setting (53.3% and CPR was attempted in almost half of victims (49.7%. The most prevalent comorbidity was systemic hypertension (57.3%. Chagas’ disease was present in 49 cases (5.5%. Conclusion: The majority of victims of SCD were men, in their sixties and seventies and the main cause of death was CAD. Chagas’ disease, an important public health problem in Latin America, was found in about 5.5% of the cases.

  18. 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.

  19. Students′ satisfaction to hybrid problem-based learning format for basic life support/advanced cardiac life support teaching

    Directory of Open Access Journals (Sweden)

    Geetanjali Chilkoti

    2016-01-01

    Full Text Available Background and Aims: Students are exposed to basic life support (BLS and advanced cardiac life support (ACLS training in the first semester in some medical colleges. The aim of this study was to compare students′ satisfaction between lecture-based traditional method and hybrid problem-based learning (PBL in BLS/ACLS teaching to undergraduate medical students. Methods: We conducted a questionnaire-based, cross-sectional survey among 118 1 st -year medical students from a university medical college in the city of New Delhi, India. We aimed to assess the students′ satisfaction between lecture-based and hybrid-PBL method in BLS/ACLS teaching. Likert 5-point scale was used to assess students′ satisfaction levels between the two teaching methods. Data were collected and scores regarding the students′ satisfaction levels between these two teaching methods were analysed using a two-sided paired t-test. Results: Most students preferred hybrid-PBL format over traditional lecture-based method in the following four aspects; learning and understanding, interest and motivation, training of personal abilities and being confident and satisfied with the teaching method (P < 0.05. Conclusion: Implementation of hybrid-PBL format along with the lecture-based method in BLS/ACLS teaching provided high satisfaction among undergraduate medical students.

  20. 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.

  1. A three-dimensional model-based partial volume correction strategy for gated cardiac mouse PET imaging

    Science.gov (United States)

    Dumouchel, Tyler; Thorn, Stephanie; Kordos, Myra; DaSilva, Jean; Beanlands, Rob S. B.; deKemp, Robert A.

    2012-07-01

    Quantification in cardiac mouse positron emission tomography (PET) imaging is limited by the imaging spatial resolution. Spillover of left ventricle (LV) myocardial activity into adjacent organs results in partial volume (PV) losses leading to underestimation of myocardial activity. A PV correction method was developed to restore accuracy of the activity distribution for FDG mouse imaging. The PV correction model was based on convolving an LV image estimate with a 3D point spread function. The LV model was described regionally by a five-parameter profile including myocardial, background and blood activities which were separated into three compartments by the endocardial radius and myocardium wall thickness. The PV correction was tested with digital simulations and a physical 3D mouse LV phantom. In vivo cardiac FDG mouse PET imaging was also performed. Following imaging, the mice were sacrificed and the tracer biodistribution in the LV and liver tissue was measured using a gamma-counter. The PV correction algorithm improved recovery from 50% to within 5% of the truth for the simulated and measured phantom data and image uniformity by 5-13%. The PV correction algorithm improved the mean myocardial LV recovery from 0.56 (0.54) to 1.13 (1.10) without (with) scatter and attenuation corrections. The mean image uniformity was improved from 26% (26%) to 17% (16%) without (with) scatter and attenuation corrections applied. Scatter and attenuation corrections were not observed to significantly impact PV-corrected myocardial recovery or image uniformity. Image-based PV correction algorithm can increase the accuracy of PET image activity and improve the uniformity of the activity distribution in normal mice. The algorithm may be applied using different tracers, in transgenic models that affect myocardial uptake, or in different species provided there is sufficient image quality and similar contrast between the myocardium and surrounding structures.

  2. Quality of Life and Physical Ability Changes After Hospital-Based Cardiac Rehabilitation in Patients With Myocardial Infarction

    Science.gov (United States)

    2017-01-01

    Objective To evaluate the effect of hospital-based cardiac rehabilitation (CR) on quality of life (QOL) and physical ability in patients with myocardial infarction (MI). Methods Patients with MI who were referred to the Cardiac Health and Rehabilitation Center 2 weeks after percutaneous coronary intervention were divided into CR and non-CR groups. The CR group performed supervised exercises 3 times a week for 2 months. QOL assessment, using the 36-item Short-Form Health Survey (SF-36) and physical ability evaluation were performed at the beginning and end of CR. Results The CR group demonstrated statistically significant improvements in physical functioning (PF), physical role functioning (RP), bodily pain (BP), general health perceptions (GH), vitality (VT), social role functioning (SF), emotional role functioning (RE), mental health (MH), physical component summary (PCS), and mental component summary (MCS). The non-CR group showed improvement in RP. Secondary outcomes, including resting heart rate (RHR), maximal oxygen consumption (VO2max), metabolic equivalent of task (MET), maximal exercise time (ETmax), stage 3 Borg rating of perceived exertion (3RPE), maximal Borg rating of perceived exertion (RPEmax), and stage 3 rate pressure product (3RPP), improved in the CR group. The non-CR group showed improvements in VO2max, MET, ETmax, and 3RPE. There were significant differences in improvements in PF, RP, BP, VT, SF, MH, MCS, RHR, VO2max, MET, ETmax, 3RPE, and 3RPP between the two groups. Conclusion Male patients with MI demonstrated improvements in QOL and physical ability following hospital-based CR; the impact on the mental component was greater than that on the physical component. PMID:28289644

  3. Generation of human secondary cardiospheres as a potent cell processing strategy for cell-based cardiac repair.

    Science.gov (United States)

    Cho, Hyun-Jai; Lee, Ho-Jae; Chung, Yeon-Ju; Kim, Ju-Young; Cho, Hyun-Ju; Yang, Han-Mo; Kwon, Yoo-Wook; Lee, Hae-Young; Oh, Byung-Hee; Park, Young-Bae; Kim, Hyo-Soo

    2013-01-01

    Cell therapy is a promising approach for repairing damaged heart. However, there are large rooms to be improved in therapeutic efficacy. We cultured a small quantity (5-10 mg) of heart biopsy tissues from 16 patients who received heart transplantation. We produced primary and secondary cardiospheres (CSs) using repeated three-dimensional culture strategy and characterized the cells. Approximately 5000 secondary CSs were acquired after 45 days. Genetic analysis confirmed that the progenitor cells in the secondary CSs originated from the innate heart, but not from extra-cardiac organs. The expressions of Oct4 and Nanog were significantly induced in secondary CSs compared with adherent cells derived from primary CSs. Those expressions in secondary CSs were higher in a cytokine-deprived medium than in a cytokine-supplemented one, suggesting that formation of the three-dimensional structure was important to enhance stemness whereas supplementation with various cytokines was not essential. Signal blocking experiments showed that the ERK and VEGF pathways are indispensable for sphere formation. To optimize cell processing, we compared four different methods of generating spheres. Method based on the hanging-drop or AggreWell™ was superior to that based on the poly-d-lysine-coated dish or Petri dish with respect to homogeneity of the product, cellular potency and overall simplicity of the process. When transplanted into the ischemic myocardium of immunocompromised mice, human secondary CSs differentiated into cardiomyocytes and endothelial cells. These results demonstrate that generation of secondary CSs from a small quantity of adult human cardiac tissue is a feasible and effective cell processing strategy to improve the therapeutic efficacy of cell therapy.

  4. Mathematical models based on transfer functions to estimate tissue temperature during RF cardiac ablation in real time.

    Science.gov (United States)

    Alba-Martínez, Jose; Trujillo, Macarena; Blasco-Gimenez, Ramon; Berjano, Enrique

    2012-01-01

    Radiofrequency cardiac ablation (RFCA) has been used to treat certain types of cardiac arrhythmias by producing a thermal lesion. Even though a tissue temperature higher than 50ºC is required to destroy the target, thermal mapping is not currently used during RFCA. Our aim was thus to develop mathematical models capable of estimating tissue temperature from tissue characteristics acquired or estimated at the beginning of the procedure (electrical conductivity, thermal conductivity, specific heat and density) and the applied voltage at any time. Biological tissue was considered as a system with an input (applied voltage) and output (tissue temperature), and so the mathematical models were based on transfer functions relating these variables. We used theoretical models based on finite element method to verify the mathematical models. Firstly, we solved finite element models to identify the transfer functions between the temperature at a depth of 4 mm and a constant applied voltage using a 7Fr and 4 mm electrode. The results showed that the relationships can be expressed as first-order transfer functions. Changes in electrical conductivity only affected the static gain of the system, while specific heat variations produced a change in the dynamic system response. In contrast, variations in thermal conductivity modified both the static gain and the dynamic system response. Finally, to assess the performance of the transfer functions obtained, we conducted a new set of computer simulations using a controlled temperature protocol and considering the temperature dependence of the thermal and electrical conductivities, i.e. conditions closer to those found in clinical use. The results showed that the difference between the values estimated from transfer functions and the temperatures obtained from finite element models was less than 4ºC, which suggests that the proposed method could be used to estimate tissue temperature in real time.

  5. Predictors of Self-Care Behaviors among Diabetic Patients Referred to Yazd Diabetes Research Centre Based on Extended Health Belief Model

    Directory of Open Access Journals (Sweden)

    MH Baghianimoghadam

    2007-12-01

    Full Text Available Introduction: Diabetes is the most common disease related to metabolism disorders with long term complications. It needs lifelong specific self-care, as it causes a promotion in quality of life and decreases disease costs. The Health Belief Model (HBM is a psychological model that attempts to explain and predict health behaviors. This is done by focusing on the attitudes and beliefs of individuals. The model has been used for studying diabetes self care behaviors. The aim of this study was determination of predictors of self-care behaviors among diabetes patients referred to Yazd diabetes research centre based on extended health belief model. Methods: This cross-sectional study carried out on 120 diabetic patients referred to Yazd diabetes research centre who were entered in the study by convenience sampling. A questionnaire was used for data collection with a private interview which included questions regarding extended health belief model constructs including perceived benefits, barriers, severity, sensitivity, threat, self-efficacy, social support, metabolic control and locus of control and some demographic variables. Results: There was a positive significant correlation between model variable of perceived benefits, severity, sensitivity, threat, self-efficacy, social support, metabolic control and internal locus of control with self-care behaviors, and also a negative significant correlation between perceived barriers (P=0.001,chance locus of control (P=0.037 and self-care behaviors. The above variables explained 45.3 % of variance in diabetes self-care behaviors, with self-efficacy as the strongest predictor. Conclusion: The results of this study approved the effectiveness of extended health belief model in predicting self-care behaviors among diabetic patients, which can therefore be used as a framework for designing and implementing educational intervention programs for control of diabetes.

  6. Associations between attention, affect and cardiac activity in a single yoga session for female cancer survivors: an enactive neurophenomenology-based approach.

    Science.gov (United States)

    Mackenzie, Michael J; Carlson, Linda E; Paskevich, David M; Ekkekakis, Panteleimon; Wurz, Amanda J; Wytsma, Kathryn; Krenz, Katie A; McAuley, Edward; Culos-Reed, S Nicole

    2014-07-01

    Yoga practice is reported to lead to improvements in quality of life, psychological functioning, and symptom indices in cancer survivors. Importantly, meditative states experienced within yoga practice are correlated to neurophysiological systems that moderate both focus of attention and affective valence. The current study used a mixed methods approach based in neurophenomenology to investigate associations between attention, affect, and cardiac activity during a single yoga session for female cancer survivors. Yoga practice was associated with a linear increase in associative attention and positive affective valence, while shifts in cardiac activity were related to the intensity of each yoga sequence. Changes in attention and affect were predicted by concurrently assessed cardiac activity. Awareness of breathing, physical movement, and increased relaxation were reported by participants as potential mechanisms for yoga's salutary effects. While yoga practice shares commonalities with exercise and relaxation training, yoga may serve primarily as a promising meditative attention-affect regulation training methodology.

  7. Clinical feasibility of a myocardial signal intensity threshold-based semi-automated cardiac magnetic resonance segmentation method

    Energy Technology Data Exchange (ETDEWEB)

    Varga-Szemes, Akos; Schoepf, U.J.; Suranyi, Pal; De Cecco, Carlo N.; Fox, Mary A. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Muscogiuri, Giuseppe [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); University of Rome ' ' Sapienza' ' , Department of Medical-Surgical Sciences and Translational Medicine, Rome (Italy); Wichmann, Julian L. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Cannao, Paola M. [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); University of Milan, Scuola di Specializzazione in Radiodiagnostica, Milan (Italy); Renker, Matthias [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Kerckhoff Heart and Thorax Center, Bad Nauheim (Germany); Mangold, Stefanie [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Eberhard-Karls University Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Ruzsics, Balazs [Royal Liverpool and Broadgreen University Hospitals, Department of Cardiology, Liverpool (United Kingdom)

    2016-05-15

    To assess the accuracy and efficiency of a threshold-based, semi-automated cardiac MRI segmentation algorithm in comparison with conventional contour-based segmentation and aortic flow measurements. Short-axis cine images of 148 patients (55 ± 18 years, 81 men) were used to evaluate left ventricular (LV) volumes and mass (LVM) using conventional and threshold-based segmentations. Phase-contrast images were used to independently measure stroke volume (SV). LV parameters were evaluated by two independent readers. Evaluation times using the conventional and threshold-based methods were 8.4 ± 1.9 and 4.2 ± 1.3 min, respectively (P < 0.0001). LV parameters measured by the conventional and threshold-based methods, respectively, were end-diastolic volume (EDV) 146 ± 59 and 134 ± 53 ml; end-systolic volume (ESV) 64 ± 47 and 59 ± 46 ml; SV 82 ± 29 and 74 ± 28 ml (flow-based 74 ± 30 ml); ejection fraction (EF) 59 ± 16 and 58 ± 17 %; and LVM 141 ± 55 and 159 ± 58 g. Significant differences between the conventional and threshold-based methods were observed in EDV, ESV, and LVM measurements; SV from threshold-based and flow-based measurements were in agreement (P > 0.05) but were significantly different from conventional analysis (P < 0.05). Excellent inter-observer agreement was observed. Threshold-based LV segmentation provides improved accuracy and faster assessment compared to conventional contour-based methods. (orig.)

  8. Meta-Analysis of Cell-based CaRdiac stUdiEs (ACCRUE) in patients with acute myocardial infarction based on individual patient data

    DEFF Research Database (Denmark)

    Gyöngyösi, Mariann; Wojakowski, Wojciech; Lemarchand, Patricia

    2015-01-01

    RATIONALE: The meta-Analysis of Cell-based CaRdiac study is the first prospectively declared collaborative multinational database, including individual data of patients with ischemic heart disease treated with cell therapy. OBJECTIVE: We analyzed the safety and efficacy of intracoronary cell ther...... randomized trials in patients with recent AMI revealed that intracoronary cell therapy provided no benefit, in terms of clinical events or changes in left ventricular function. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01098591....

  9. Sudden cardiac arrest risk stratification based on 24-hour Holter ECG statistics.

    Science.gov (United States)

    Kasahara, Keisuke; Shiobara, Masahito; Nakamura, Saya; Yamashiro, Koichiro; Yana, Kazuo; Ono, Takuya

    2015-08-01

    This study examined the feasibility of using indices obtained from a long term Holter ECG record for sudden cardiac arrest (SCA) risk stratification. The ndices tested were the QT-RR interval co-variability and the alternans ratio percentile (ARP(θ)) which is defined as the θ(th) percentile of alternans ratios over a 24 hour period. The QT-RR interval co-variabilities are evaluated by the serial correlation coefficient between QT and RR trend sequences (QTRC). Previously reported Kalman filter technique and a simple smoothing spline method for the trend estimation are compared. Parameter θ in the alternans ratio percentile index was optimized to achieve the best classification accuracy. These indices were estimated from 26 cardiovascular outpatients for Holter ECG record. Patients were classified into high and low risk groups according to their clinical diagnosis, and the obtained indices were compared with those of 25 control subjects. A risk stratification using the two indices QTRC and ARP(θ) yielded an average sensitivity of 0.812 and a specificity of 0.925. The sensitivities and specificities of all three categories exceeded 0.8 except for the sensitivity to detect the high-risk patient group. Other short-term ECG parameters may need to be incorporated in order to improve the sensitivity.

  10. Gender-Based Differences in Cardiac Remodeling and ILK Expression after Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Renato Rodrigues Sofia

    2014-08-01

    Full Text Available Background: Gender can influence post-infarction cardiac remodeling. Objective: To evaluate whether gender influences left ventricular (LV remodeling and integrin-linked kinase (ILK after myocardial infarction (MI. Methods: Female and male Wistar rats were assigned to one of three groups: sham, moderate MI (size: 20-39% of LV area, and large MI (size: ≥40% of LV area. MI was induced by coronary occlusion, and echocardiographic analysis was performed after six weeks to evaluate MI size as well as LV morphology and function. Real-time RT-PCR and Western blot were used to quantify ILK in the myocardium. Results: MI size was similar between genders. MI resulted in systolic dysfunction and enlargement of end-diastolic as well as end-systolic dimension of LV as a function of necrotic area size in both genders. Female rats with large MI showed a lower diastolic and systolic dilatation than the respective male rats; however, LV dysfunction was similar between genders. Gene and protein levels of ILK were increased in female rats with moderate and large infarctions, but only male rats with large infarctions showed an altered ILK mRNA level. A negative linear correlation was evident between LV dimensions and ILK expression in female rats with large MI. Conclusions: Post-MI ILK expression is altered in a gender-specific manner, and higher ILK levels found in females may be sufficient to improve LV geometry but not LV function.

  11. A computational model-based validation of Guyton's analysis of cardiac output and venous return curves

    Science.gov (United States)

    Mukkamala, R.; Cohen, R. J.; Mark, R. G.

    2002-01-01

    Guyton developed a popular approach for understanding the factors responsible for cardiac output (CO) regulation in which 1) the heart-lung unit and systemic circulation are independently characterized via CO and venous return (VR) curves, and 2) average CO and right atrial pressure (RAP) of the intact circulation are predicted by graphically intersecting the curves. However, this approach is virtually impossible to verify experimentally. We theoretically evaluated the approach with respect to a nonlinear, computational model of the pulsatile heart and circulation. We developed two sets of open circulation models to generate CO and VR curves, differing by the manner in which average RAP was varied. One set applied constant RAPs, while the other set applied pulsatile RAPs. Accurate prediction of intact, average CO and RAP was achieved only by intersecting the CO and VR curves generated with pulsatile RAPs because of the pulsatility and nonlinearity (e.g., systemic venous collapse) of the intact model. The CO and VR curves generated with pulsatile RAPs were also practically independent. This theoretical study therefore supports the validity of Guyton's graphical analysis.

  12. Donation after cardiac death liver transplantation: Graft quality evaluation based on pretransplant liver biopsy.

    Science.gov (United States)

    Xia, Weiliang; Ke, Qinghong; Wang, Ye; Feng, Xiaowen; Guo, Haijun; Wang, Weilin; Zhang, Min; Shen, Yan; Wu, Jian; Xu, Xiao; Yan, Sheng; Zheng, Shusen

    2015-06-01

    Donation after cardiac death (DCD) liver grafts are associated with inferior clinical outcomes and high discard rates because of poor graft quality. We investigated the predictive value of DCD liver biopsy for the pretransplant graft quality evaluation. DCD liver transplants that took place between October 2010 and April 2014 were included (n = 127). Histological features of graft biopsy samples were analyzed to assess risk factors for graft survival. Macrovesicular steatosis ≥ 20% [hazard ratio (HR) = 2.973; P = 0.045] and sinusoidal neutrophilic infiltrate (HR = 6.969; P = 0.005) were confirmed as independent risk factors for graft survival; hepatocellular swelling, vacuolation, and necrosis failed to show prognostic value. Additionally, a donor serum total bilirubin level ≥ 34.2 μmol/L was also associated with a lower probability of graft survival. Our analysis indicates that macrovesicular steatosis ≥ 20% and sinusoidal neutrophilic infiltrate are novel and useful histological markers for DCD liver grafts with unacceptable quality. This finding can be used by transplant surgeons to improve DCD liver acceptance protocols.

  13. Cardiac arrhythmias in recently diagnosed hypertensive patients at first presentation: an electrocardiographic-based study.

    Science.gov (United States)

    Ejim, E C; Ike, S O; Anisiuba, B C; Essien, I O; Onwubere, B J; Ikeh, V O

    2012-01-01

    Various forms of cardiac arrhythmias have been documented in hypertensive subjects, and hypertension is an important risk factor for the development of atrial and ventricular arrhythmias and sudden death. Electrocardiography at rest easily documents significant arrhythmias in patients, and this study was carried out to determine the types and frequency of arrhythmias in hypertensive subjects at first presentation in the Hypertension Clinics of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. The study was hospitalbased and retrospective in nature. The resting 12lead ECG reports of 346 consecutive hypertensive subjects seen at the Hypertension clinics of the UNTH Enugu over a 14 month period were retrieved from the case files and studied. Other information obtained from the case files included the age and gender of the subjects. The mean age of the subjects was 57.3 years. Ninety-five of the subjects had arrhythmias representing 27% of the study population, out of which fifty-five were males (57.9%) and forty were females (42.1%). However 26.9% of all the male subjects had arrhythmias while 28.2% of all the females had arrhythmias. Multiple ventricular ectopics, sinus tachycardia, sinus bradycardia and atrial fibrillation were the most prevalent arrhythmias. This study showed that a significant proportion of hypertensive subjects present initially with significant rhythm disturbances.

  14. Gender-Based Differences in Cardiac Remodeling and ILK Expression after Myocardial Infarction

    Energy Technology Data Exchange (ETDEWEB)

    Sofia, Renato Rodrigues [Programa de Pós-graduação em Ciências da Reabilitação - Universidade Nove de Julho (Uninove), São Paulo, SP (Brazil); Departamento de Cardiologia - Universidade Federal de São Paulo, São Paulo, SP (Brazil); Serra, Andrey Jorge, E-mail: andreyserra@gmail.com; Silva, Jose Antonio Jr [Programa de Pós-graduação em Ciências da Reabilitação - Universidade Nove de Julho (Uninove), São Paulo, SP (Brazil); Antonio, Ednei Luiz [Departamento de Cardiologia - Universidade Federal de São Paulo, São Paulo, SP (Brazil); Manchini, Martha Trindade [Programa de Pós-graduação em Ciências da Reabilitação - Universidade Nove de Julho (Uninove), São Paulo, SP (Brazil); Oliveira, Fernanda Aparecida Alves de [Departamento de Cardiologia - Universidade Federal de São Paulo, São Paulo, SP (Brazil); Teixeira, Vicente Paulo Castro [Departamento de Patologia - Universidade Federal de São Paulo, São Paulo, SP (Brazil); Tucci, Paulo José Ferreira [Departamento de Cardiologia - Universidade Federal de São Paulo, São Paulo, SP (Brazil)

    2014-08-15

    Gender can influence post-infarction cardiac remodeling. To evaluate whether gender influences left ventricular (LV) remodeling and integrin-linked kinase (ILK) after myocardial infarction (MI). Female and male Wistar rats were assigned to one of three groups: sham, moderate MI (size: 20-39% of LV area), and large MI (size: ≥40% of LV area). MI was induced by coronary occlusion, and echocardiographic analysis was performed after six weeks to evaluate MI size as well as LV morphology and function. Real-time RT-PCR and Western blot were used to quantify ILK in the myocardium. MI size was similar between genders. MI resulted in systolic dysfunction and enlargement of end-diastolic as well as end-systolic dimension of LV as a function of necrotic area size in both genders. Female rats with large MI showed a lower diastolic and systolic dilatation than the respective male rats; however, LV dysfunction was similar between genders. Gene and protein levels of ILK were increased in female rats with moderate and large infarctions, but only male rats with large infarctions showed an altered ILK mRNA level. A negative linear correlation was evident between LV dimensions and ILK expression in female rats with large MI. Post-MI ILK expression is altered in a gender-specific manner, and higher ILK levels found in females may be sufficient to improve LV geometry but not LV function.

  15. Alginate-polyester comacromer based hydrogels as physiochemically and biologically favorable entities for cardiac tissue engineering.

    Science.gov (United States)

    Thankam, Finosh G; Muthu, Jayabalan

    2015-11-01

    The physiochemical and biological responses of tissue engineering hydrogels are crucial in determining their desired performance. A hybrid comacromer was synthesized by copolymerizing alginate and poly(mannitol fumarate-co-sebacate) (pFMSA). Three bimodal hydrogels pFMSA-AA, pFMSA-MA and pFMSA-NMBA were synthesized by crosslinking with Ca(2+) and vinyl monomers acrylic acid (AA), methacrylic acid (MA) and N,N'-methylene bisacrylamide (NMBA), respectively. Though all the hydrogels were cytocompatible and exhibited a normal cell cycle profile, pFMSA-AA exhibited superior physiochemical properties viz non-freezable water content (58.34%) and water absorption per unit mass (0.97 g water/g gel) and pore length (19.92±3.91 μm) in comparing with other two hydrogels. The increased non-freezable water content and water absorption of pFMSA-AA hydrogels greatly influenced its biological performance, which was evident from long-term viability assay and cell cycle proliferation. The physiochemical and biological favorability of pFMSA-AA hydrogels signifies its suitability for cardiac tissue engineering.

  16. British Council, Work-Based Learning Research Centre and Islamic University Gaza E-Learning Workshop: Five Years on

    Science.gov (United States)

    Basiel, Anthony; Commins, Ralph

    2010-01-01

    This article describes the process for training Palestinians in Gaza on developing e-learning courses using WebCT. The training was delivered at a distance using information and communications technologies. The project used a problem-based approach to introduce e learning concepts and practice for the pedagogy of online content, learning theory,…

  17. The World Heritage Centr

    Directory of Open Access Journals (Sweden)

    Ayman G. Abdel Tawab

    2014-09-01

    Full Text Available New Gourna Village, which is located inside one of the World Heritage Sites in Egypt, has never been recognized as an element contributing to the site’s Outstanding Universal Value. The recognition of the village as a contributing element is reliant on the successful assessment of its authenticity and integrity. Responding to the dramatically declining integrity of the village, the World Heritage Centre has carried out an architectural study to guide the potential conservation works in the property. The study has recommended that a group of objectives and two approaches to the conservation of the village should be adopted. One of these two approaches has been concerned with the conservation of the village according to the architect’s original intentions and principles. The previous approach can be called the principles-based approach. The main aim of this study was to examine the agreement of the World Heritage Centre’s objectives and their proposed principles-based approach to the conservation of the village with the aim to improve its chance in meeting the conditions of authenticity and integrity. The study approached the previous aim by assessing, by means of a proposed methodology; the level of significance, authenticity and integrity of the property. Based on the previous assessment, a list of conservation interventions was proposed to improve the property’s chance in meeting the conditions of authenticity and integrity. Finally, the World Heritage Centre’s recommended approaches and objectives were examined against the previous proposed conservation interventions. The findings indicated the possibility to adopt the principles-based approach to the conservation of New Gourna Village, as well as the other World Heritage Centre’s objectives, without limiting the property’s chance in meeting the conditions of authenticity and integrity. The study recommends to carry out further studies that are concerned with the identification

  18. Academic Drug Discovery Centres

    DEFF Research Database (Denmark)

    Kirkegaard, Henriette Schultz; Valentin, Finn

    2014-01-01

    Academic drug discovery centres (ADDCs) are seen as one of the solutions to fill the innovation gap in early drug discovery, which has proven challenging for previous organisational models. Prior studies of ADDCs have identified the need to analyse them from the angle of their economic and organi......Academic drug discovery centres (ADDCs) are seen as one of the solutions to fill the innovation gap in early drug discovery, which has proven challenging for previous organisational models. Prior studies of ADDCs have identified the need to analyse them from the angle of their economic...... their performance....

  19. Town Centre Redevelopment Strategies

    DEFF Research Database (Denmark)

    Vagnby, Bo Hellisen

    After many years of urban growth Danish downtowns are facing some important choices. Shall the stake one-sidedly be on the town centres as driving forces for growth and 'city marketing', or do they still have a role to play in a broader socio-economic context? In the paper we look back on eight...... during late years, where increased internationalisation is in focus and where it seems as if the social dimension of the town centre planning is slipping out of the hands of the urban planners....

  20. CMCC Data Distribution Centre

    Science.gov (United States)

    Aloisio, Giovanni; Fiore, Sandro; Negro, A.

    2010-05-01

    The CMCC Data Distribution Centre (DDC) is the primary entry point (web gateway) to the CMCC. It is a Data Grid Portal providing a ubiquitous and pervasive way to ease data publishing, climate metadata search, datasets discovery, metadata annotation, data access, data aggregation, sub-setting, etc. The grid portal security model includes the use of HTTPS protocol for secure communication with the client (based on X509v3 certificates that must be loaded into the browser) and secure cookies to establish and maintain user sessions. The CMCC DDC is now in a pre-production phase and it is currently used only by internal users (CMCC researchers and climate scientists). The most important component already available in the CMCC DDC is the Search Engine which allows users to perform, through web interfaces, distributed search and discovery activities by introducing one or more of the following search criteria: horizontal extent (which can be specified by interacting with a geographic map), vertical extent, temporal extent, keywords, topics, creation date, etc. By means of this page the user submits the first step of the query process on the metadata DB, then, she can choose one or more datasets retrieving and displaying the complete XML metadata description (from the browser). This way, the second step of the query process is carried out by accessing to a specific XML document of the metadata DB. Finally, through the web interface, the user can access to and download (partially or totally) the data stored on the storage device accessing to OPeNDAP servers and to other available grid storage interfaces. Requests concerning datasets stored in deep storage will be served asynchronously.

  1. Feasibility of an exercise intervention for fatigued breast cancer patients at a community-based cardiac rehabilitation program

    Science.gov (United States)

    De Jesus, Stefanie; Fitzgeorge, Lyndsay; Unsworth, Karen; Massel, David; Suskin, Neville; Prapavessis, Harry; Sanatani, Michael

    2017-01-01

    Purpose Exercise is beneficial to quality of life after cancer treatment, yet few cancer survivors meet exercise guidelines. Our study sought to determine the feasibility of an oncology rehabilitation exercise program embedded within a cardiac rehabilitation program. Methods Patients who rated their fatigue >4/10 after completion of adjuvant chemotherapy for breast cancer were screened for eligibility and the outcomes were assessed (Piper Fatigue Scale, Functional Assessment of Cancer Therapy-Breast [FACT-B], Edmonton Symptom Assessment System, body composition, stress test, and physical activity measurement [accelerometer]). Participants received individualized exercise prescription. Following the 16-week program, repeat assessment plus patient acceptance and satisfaction survey was completed. The primary end point was the composite of accrual rate >25%, program adherence >80%, and mean compliance with accelerometer use >80%. Results Twenty of 24 screened patients consented to the study and completed the baseline assessment. Adherence was 30.3%. Mean accelerometer use was 3.88/7 days (78%). Fatigue at baseline was rated at 4.82/10, and at 3.59 (p = 0.09) after the intervention. Overall well-being (FACT-B) score changed from 92.7 to 98.3 (p = 0.05). There were no significant changes in body composition (except for bone mineral content), aerobic exercise capacity, or activity patterns. Conclusion Although the primary outcome was not met, our study indicates that an oncology exercise rehabilitation program can be incorporated into an existing cardiac rehabilitation program. Based on feedback received, we propose that in order to achieve exercise goals, frequent, encouraging, and tailored feedback and group sessions to foster a sense of community may additionally be needed to strengthen adherence to a prescribed exercise program. PMID:28228661

  2. Cardiac Rehabilitation

    Science.gov (United States)

    ... your risk of future heart problems, and to improve your health and quality of life. Cardiac rehabilitation programs increase ... exercise routine at home or at a local gym. You may also continue to ... health concerns. Education about nutrition, lifestyle and weight loss ...

  3. Developing a User-Centred Planning Tool for Young Adults with Development Disorders: A Research-Based Teaching Project.

    Science.gov (United States)

    Ribu, Kirsten; Patel, Tulpesh

    2016-01-01

    People with development disorders, for instance autism, need structured plans to help create predictability in their daily lives. Digital plans can facilitate enhanced independency, learning, and quality of life, but existing apps are largely general purpose and lack the flexibility required by this specific but heterogeneous user group. Universal design is both a goal and a process and should be based on a holistic approach and user-centered design, interacting with the users in all stages of the development process. At Oslo and Akershus University College (HiOA) we conducted a research-based teaching project in co-operation with the Department of Neuro-habilitation at Oslo University Hospital (OUS) with two employees acting as project managers and students as developers. Three groups of Computer Science bachelor students developed digital prototypes for a planning tool for young adults with pervasive development disorders, who live either with their families or in supervised residences, and do not receive extensive public services. The students conducted the initial planning phase of the software development process, focusing on prototyping the system requirements, whilst a professional software company programmed the end solution. The goal of the project was to develop flexible and adaptive user-oriented and user-specific app solutions for tablets that can aid this diverse user group in structuring daily life, whereby, for example, photos of objects and places known to the individual user replace general pictures or drawings, and checklists can be elaborate or sparse as necessary. The three student groups worked independently of each other and created interactive working prototypes based on tests, observations and short interviews with end users (both administrators and residents) and regular user feedback from the project managers. Three very different solutions were developed that were of high enough quality that an external software company were able to

  4. Inhaled nitric oxide in cardiac surgery: Evidence or tradition?

    Science.gov (United States)

    Benedetto, Maria; Romano, Rosalba; Baca, Georgiana; Sarridou, Despoina; Fischer, Andreas; Simon, Andre; Marczin, Nandor

    2015-09-15

    Inhaled nitric oxide (iNO) therapy as a selective pulmonary vasodilator in cardiac surgery has been one of the most significant pharmacological advances in managing pulmonary hemodynamics and life threatening right ventricular dysfunction and failure. However, this remarkable story has experienced a roller-coaster ride with high hopes and nearly universal demonstration of physiological benefits but disappointing translation of these benefits to harder clinical outcomes. Most of our understanding on the iNO field in cardiac surgery stems from small observational or single centre randomised trials and even the very few multicentre trials fail to ascertain strong evidence base. As a consequence, there are only weak clinical practice guidelines on the field and only European expert opinion for the use of iNO in routine and more specialised cardiac surgery such as heart and lung transplantation and left ventricular assist device (LVAD) insertion. In this review the authors from a specialised cardiac centre in the UK with a very high volume of iNO usage provide detailed information on the early observations leading to the European expert recommendations and reflect on the nature and background of these recommendations. We also provide a summary of the progress in each of the cardiac subspecialties for the last decade and initial survey data on the views of senior anaesthetic and intensive care colleagues on these recommendations. We conclude that the combination of high price tag associated with iNO therapy and lack of substantial clinical evidence is not sustainable on the current field and we are risking loosing this promising therapy from our daily practice. Overcoming the status quo will not be easy as there is not much room for controlled trials in heart transplantation or in the current atmosphere of LVAD implantation. However, we call for international cooperation to conduct definite studies to determine the place of iNO therapy in lung transplantation and high

  5. The GSO Data Centre

    CERN Document Server

    Paletou, F; Génot, V; Rouillard, A; Petit, P; Palacios, A; Caux, E; Wakelam, V

    2015-01-01

    Hereafter we describe the activities of the $Grand \\, Sud-Ouest$ Data Centre operated for INSU/CNRS by the OMP-IRAP and the Universit\\'e Paul Sabatier (Toulouse), in a collaboration with the OASU-LAB (Bordeaux) and OREME-LUPM (Montpellier).

  6. Implementing Responsibility Centre Budgeting

    Science.gov (United States)

    Vonasek, Joseph

    2011-01-01

    Recently, institutes of higher education (universities) have shown a renewed interest in organisational structures and operating methodologies that generate productivity and innovation; responsibility centre budgeting (RCB) is one such process. This paper describes the underlying principles constituting RCB, its origin and structural elements, and…

  7. ATLAS Visitors Centre

    CERN Multimedia

    claudia Marcelloni

    2009-01-01

    ATLAS Visitors Centre has opened its shiny new doors to the public. Officially launched on Monday February 23rd, 2009, the permanent exhibition at Point 1 was conceived as a tour resource for ATLAS guides, and as a way to preserve the public’s opportunity to get a close-up look at the experiment in action when the cavern is sealed.

  8. Curbing Malnutrition and Micronutrient Defi ciencies in India… Food Based Strategies at the Centre of a Holistic Approach

    Directory of Open Access Journals (Sweden)

    Ravi Prakash Upadhyay

    2011-10-01

    Full Text Available India has the largest number of undernourished people in the world. Malnutrition is a major problem with nearly 55% of the pre-school children and one-third of women in the age group 15–49 years being underweight. The problem of malnutrition is causing an economic pullback as India tends to lose 3–4% of the Gross Domestic Product (GDP in terms of loss of productivity. This glaring problem of malnutrition and micronutrient defi ciencies is multi-factorial. Important causes include lack of improvement in agricultural productivity owing to inadequate resources, lack of education and inadequate job opportunities. Increased informal workforce due to rural-urban migration along with unplanned growth of slums is one of the key issues in the urban set-up. Other factors catalyzing the problem include overpopulation, gender inequality, inadequate distribution of food through public distribution mechanisms and lack of coherent nutrition policies. The government policies should focus on growth in agriculture and on improving the food storing facilities. An accurate targeting of “in need” population, so that they get food at substantially low price along with introduction of holistic employment schemes is required. Nutrition based programmes should have in-built system of evaluation based on key nutritional indicators. Social determinants of health such as water, sanitation and women empowerment also have to be addressed to achieve long term gains in the health of the community. Community awareness and mass movement is required to ensure that demographic dividend might not turn into demographic nightmare. Keeping in view that nutrition is not a ‘stand alone’ subject, a multisectoral approach is needed.

  9. NIPS–NORMA station—A combined facility for neutron-based nondestructive element analysis and imaging at the Budapest Neutron Centre

    Energy Technology Data Exchange (ETDEWEB)

    Kis, Zoltán, E-mail: kis.zoltan@energia.mta.hu; Szentmiklósi, László; Belgya, Tamás

    2015-04-11

    Neutron attenuation, scattering or radiative capture are used in various non-destructive methods to gain morphological, structural, elemental or isotopic information about the sample under study. The combined use of position-sensitive prompt gamma-ray detection (i.e. prompt gamma-ray activation imaging, PGAI) and neutron radiography/tomography (NR/NT) makes it possible to determine the 3D distribution of major elements and to visualize internal structures of heterogeneous objects in a non-destructive way. Based on earlier experience, the first ever permanent facility for this purpose, NIPS–NORMA, was constructed at the Budapest Neutron Centre, Hungary in 2012. The installation consists of a well-shielded, Compton-suppressed HPGe detector; a CCD-camera based imaging equipment and a motorized positioning system with sample support. Conventional PGAA measurements and NR/NT imaging using guided cold neutrons are the basic methods that form the basis of the more sophisticated experimental method called NR/NT-driven PGAI. The current status of the experimental station and its characteristics are described in the present paper.

  10. Hand-movement-based in-vehicle driver/front-seat passenger discrimination for centre console controls

    Science.gov (United States)

    Herrmann, Enrico; Makrushin, Andrey; Dittmann, Jana; Vielhauer, Claus; Langnickel, Mirko; Kraetzer, Christian

    2010-01-01

    Successful user discrimination in a vehicle environment may yield a reduction of the number of switches, thus significantly reducing costs while increasing user convenience. The personalization of individual controls permits conditional passenger enable/driver disable and vice versa options which may yield safety improvement. The authors propose a prototypic optical sensing system based on hand movement segmentation in near-infrared image sequences implemented in an Audi A6 Avant. Analyzing the number of movements in special regions, the system recognizes the direction of the forearm and hand motion and decides whether driver or front-seat passenger touch a control. The experimental evaluation is performed independently for uniformly and non-uniformly illuminated video data as well as for the complete video data set which includes both subsets. The general test results in error rates of up to 14.41% FPR / 16.82% FNR and 17.61% FPR / 14.77% FNR for driver and passenger respectively. Finally, the authors discuss the causes of the most frequently occurring errors as well as the prospects and limitations of optical sensing for user discrimination in passenger compartments.

  11. A VEGF delivery system targeting MI improves angiogenesis and cardiac function based on the tropism of MSCs and layer-by-layer self-assembly.

    Science.gov (United States)

    Liu, Ge; Li, Li; Huo, Da; Li, Yanzhao; Wu, Yangxiao; Zeng, Lingqing; Cheng, Panke; Xing, Malcolm; Zeng, Wen; Zhu, Chuhong

    2017-05-01

    Myocardial infarction (MI) is a serious ischemic condition affecting many individuals around the world. Vascular endothelial growth factor (VEGF) is considered a promising factor for enhancing cardiac function by promoting angiogenesis. However, the lack of a suitable method of VEGF delivery to the MI area is a serious challenge. In this study, we screened a suitable delivery carrier with favorable biocompatibility that targeted the MI area using the strategy of an inherent structure derived from the body and that was based on characteristics of the MI. Mesenchymal stem cells (MSCs) are important infiltrating cells that are derived from blood and have an inherent tropism for the MI zone. We hypothesized that VEGF-encapsulated MSCs targeting MI tissue could improve cardiac function by angiogenesis based on the tropism of the MSCs to the MI area. We first developed VEGF-encapsulated MSCs using self-assembled gelatin and alginate polyelectrolytes to improve angiogenesis and cardiac function. In vitro, the results showed that VEGF-encapsulated MSCs had a sustained release of VEGF and tropism to SDF-1. In vivo, VEGF-encapsulated MSCs migrated to the MI area, enhanced cardiac function, perfused the infarcted area and promoted angiogenesis. These preclinical findings suggest that VEGF-loaded layer-by-layer self-assembled encapsulated MSCs may be a promising and minimally invasive therapy for treating MI. Furthermore, other drugs loaded to layer-by-layer self-assembled encapsulated MSCs may be promising therapies for treating other diseases.

  12. Hospital-based comprehensive cardiac rehabilitation versus usual care among patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease: 12-month results of a randomized clinical trial

    DEFF Research Database (Denmark)

    Zwisler, Ann-Dorthe Olsen; Soja, Anne Merete Boas; Rasmussen, Søren

    2008-01-01

    BACKGROUND: Current guidelines broadly recommend comprehensive cardiac rehabilitation (CCR), although evidence for this is still limited. We investigated the 12-month effect of hospital-based CCR versus usual care (UC) for a broadly defined group of cardiac patients within the modern therapeutic ...

  13. Perceptions and Expectations of Staffs from Training Services Provided by NISOC's Training centre Based on SERVQUAL Model

    Directory of Open Access Journals (Sweden)

    Hossain Hamzeh

    2015-10-01

    Full Text Available Introduction: The evaluation of training services quality in training centers is one of the major steps in improving quality. Deciding the amount of difference between the present condition and expected condition can facilitate the promotion of training services quality. Methods: This study was a descriptive–survey. The population size was the 1217 learners attending the on-the-job training courses in training centers (computer, Technical-specific and management in the Training and Development Department of National Iranian South Oil Company (NISOC in the second half of 2014. The sample volume was decided 292 people using the Cochran Formula (1977.The sample size of each training center was chosen based on the percentage of the learners in the population size using the random-stratified method. The data collection was done via SERVQUAL standard questionnaire. The questionnaire measured the gap in the five dimensions of service quality. The data were analyzed using SPSS software as well as conducting descriptive statistics, Wilcoxon and Kruskal-Wallis Test. Results and Analysis: The findings showed no gaps for the two dimensions of empathy and reliability and a negative one for the tangible (-0.66, responsiveness (-0.41 and assurance (-1.44. No difference was found between the quality of training services in training centers. Conclusion: Although the mean of percent condition is higher than the average(4.01 but the observed gap between the expectations and perceptions proves that the learners expectation for the provided services were not fulfilled. As a result it is suggested that for establishing the customer-care culture, the dimensions which had the biggest gap be prioritized when allocating the budget.

  14. Real-time x-ray fluoroscopy-based catheter detection and tracking for cardiac electrophysiology interventions

    Energy Technology Data Exchange (ETDEWEB)

    Ma Yingliang; Housden, R. James; Razavi, Reza; Rhode, Kawal S. [Division of Imaging Sciences and Biomedical Engineering, King' s College London, London SE1 7EH (United Kingdom); Gogin, Nicolas; Cathier, Pascal [Medisys Research Group, Philips Healthcare, Paris 92156 (France); Gijsbers, Geert [Interventional X-ray, Philips Healthcare, Best 5680 DA (Netherlands); Cooklin, Michael; O' Neill, Mark; Gill, Jaswinder; Rinaldi, C. Aldo [Department of Cardiology, Guys and St. Thomas' Hospitals NHS Foundation Trust, London SE1 7EH (United Kingdom)

    2013-07-15

    Purpose: X-ray fluoroscopically guided cardiac electrophysiology (EP) procedures are commonly carried out to treat patients with arrhythmias. X-ray images have poor soft tissue contrast and, for this reason, overlay of a three-dimensional (3D) roadmap derived from preprocedural volumetric images can be used to add anatomical information. It is useful to know the position of the catheter electrodes relative to the cardiac anatomy, for example, to record ablation therapy locations during atrial fibrillation therapy. Also, the electrode positions of the coronary sinus (CS) catheter or lasso catheter can be used for road map motion correction.Methods: In this paper, the authors present a novel unified computational framework for image-based catheter detection and tracking without any user interaction. The proposed framework includes fast blob detection, shape-constrained searching and model-based detection. In addition, catheter tracking methods were designed based on the customized catheter models input from the detection method. Three real-time detection and tracking methods are derived from the computational framework to detect or track the three most common types of catheters in EP procedures: the ablation catheter, the CS catheter, and the lasso catheter. Since the proposed methods use the same blob detection method to extract key information from x-ray images, the ablation, CS, and lasso catheters can be detected and tracked simultaneously in real-time.Results: The catheter detection methods were tested on 105 different clinical fluoroscopy sequences taken from 31 clinical procedures. Two-dimensional (2D) detection errors of 0.50 {+-} 0.29, 0.92 {+-} 0.61, and 0.63 {+-} 0.45 mm as well as success rates of 99.4%, 97.2%, and 88.9% were achieved for the CS catheter, ablation catheter, and lasso catheter, respectively. With the tracking method, accuracies were increased to 0.45 {+-} 0.28, 0.64 {+-} 0.37, and 0.53 {+-} 0.38 mm and success rates increased to 100%, 99

  15. Cardiac Calcification

    Directory of Open Access Journals (Sweden)

    Morteza Joorabian

    2011-05-01

    Full Text Available There is a spectrum of different types of cardiac"ncalcifications with the importance and significance"nof each type of cardiac calcification, especially"ncoronary artery calcification. Radiologic detection of"ncalcifications within the heart is quite common. The"namount of coronary artery calcification correlates"nwith the severity of coronary artery disease (CAD."nCalcification of the aortic or mitral valve may indicate"nhemodynamically significant valvular stenosis."nMyocardial calcification is a sign of prior infarction,"nwhile pericardial calcification is strongly associated"nwith constrictive pericarditis. A spectrum of different"ntypes of cardiac calcifications (linear, annular,"ncurvilinear,... could be seen in chest radiography and"nother imaging modalities. So a carful inspection for"ndetection and reorganization of these calcifications"nshould be necessary. Numerous modalities exist for"nidentifying coronary calcification, including plain"nradiography, fluoroscopy, intravascular ultrasound,"nMRI, echocardiography, and conventional, helical and"nelectron-beam CT (EBCT. Coronary calcifications"ndetected on EBCT or helical CT can be quantifie,"nand a total calcification score (Cardiac Calcification"nScoring may be calculated. In an asymptomatic"npopulation and/or patients with concomitant risk"nfactors like diabetes mellitus, determination of the"npresence of coronary calcifications identifies the"npatients at risk for future myocardial infarction and"ncoronary artery disease. In patients without coronary"ncalcifications, future cardiovascular events could"nbe excluded. Therefore, detecting and recognizing"ncalcification related to the heart on chest radiography"nand other imaging modalities such as fluoroscopy, CT"nand echocardiography may have important clinical"nimplications.

  16. Image-based reconstruction of three-dimensional myocardial infarct geometry for patient-specific modeling of cardiac electrophysiology

    Energy Technology Data Exchange (ETDEWEB)

    Ukwatta, Eranga, E-mail: eukwatt1@jhu.edu; Arevalo, Hermenegild; Pashakhanloo, Farhad; Prakosa, Adityo; Vadakkumpadan, Fijoy [Institute for Computational Medicine, Johns Hopkins University, Baltimore, Maryland 21205 and Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21205 (United States); Rajchl, Martin [Department of Computing, Imperial College London, London SW7 2AZ (United Kingdom); White, James [Stephenson Cardiovascular MR Centre, University of Calgary, Calgary, Alberta T2N 2T9 (Canada); Herzka, Daniel A.; McVeigh, Elliot [Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21205 (United States); Lardo, Albert C. [Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21205 and Division of Cardiology, Johns Hopkins Institute of Medicine, Baltimore, Maryland 21224 (United States); Trayanova, Natalia A. [Institute for Computational Medicine, Johns Hopkins University, Baltimore, Maryland 21205 (United States); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21205 (United States); Department of Biomedical Engineering, Johns Hopkins Institute of Medicine, Baltimore, Maryland 21205 (United States)

    2015-08-15

    Purpose: Accurate three-dimensional (3D) reconstruction of myocardial infarct geometry is crucial to patient-specific modeling of the heart aimed at providing therapeutic guidance in ischemic cardiomyopathy. However, myocardial infarct imaging is clinically performed using two-dimensional (2D) late-gadolinium enhanced cardiac magnetic resonance (LGE-CMR) techniques, and a method to build accurate 3D infarct reconstructions from the 2D LGE-CMR images has been lacking. The purpose of this study was to address this need. Methods: The authors developed a novel methodology to reconstruct 3D infarct geometry from segmented low-resolution (Lo-res) clinical LGE-CMR images. Their methodology employed the so-called logarithm of odds (LogOdds) function to implicitly represent the shape of the infarct in segmented image slices as LogOdds maps. These 2D maps were then interpolated into a 3D image, and the result transformed via the inverse of LogOdds to a binary image representing the 3D infarct geometry. To assess the efficacy of this method, the authors utilized 39 high-resolution (Hi-res) LGE-CMR images, including 36 in vivo acquisitions of human subjects with prior myocardial infarction and 3 ex vivo scans of canine hearts following coronary ligation to induce infarction. The infarct was manually segmented by trained experts in each slice of the Hi-res images, and the segmented data were downsampled to typical clinical resolution. The proposed method was then used to reconstruct 3D infarct geometry from the downsampled images, and the resulting reconstructions were compared with the manually segmented data. The method was extensively evaluated using metrics based on geometry as well as results of electrophysiological simulations of cardiac sinus rhythm and ventricular tachycardia in individual hearts. Several alternative reconstruction techniques were also implemented and compared with the proposed method. Results: The accuracy of the LogOdds method in reconstructing 3D

  17. A web-based programme for person-centred learning and support designed for preschool children with long-term illness: a pilot study of a new intervention.

    Science.gov (United States)

    Hellström, Anna-Lena; Simeonsdotter Svensson, Agneta; Pramling Samuelsson, Ingrid; Jenholt Nolbris, Margaretha

    2012-01-01

    For children living with long-term illness, school age is a risk period with regard to psychosocial ill health and poor compliance with treatment. There is a need for methods to promote health, well-being, and self-esteem. This study describes a new concept for supporting children, person-centred web-based learning and support, which has been tested in 12 preschool children and incorporates learning about feelings, relationships, and the right to integrity. SKYPE was used for conversations between the child and the web teacher. Methods. The programme was developed and tested in two steps. The conversations were tape-recorded and analysed using phenomenography. The questions addressed concerned the quality of the intervention process: accessibility of intervention, learning content and support, and identification of measurable items and patterns. Findings. The children found it interesting to communicate with their web teacher using SKYPE. The story about Max and Sara served as a good basis for discussion, and development was found in the learning process. The children were able to talk about relations and feelings and developed an understanding for use in new situations in their daily lives. Items and patterns that are useful for research and documentation were identified, for example, well-being, resources, needs, and wishes.

  18. Elderly Care Centre

    Science.gov (United States)

    Wagiman, Aliani; Haja Bava Mohidin, Hazrina; Ismail, Alice Sabrina

    2016-02-01

    The demand for elderly centre has increased tremendously abreast with the world demographic change as the number of senior citizens rose in the 21st century. This has become one of the most crucial problems of today's era. As the world progress into modernity, more and more people are occupied with daily work causing the senior citizens to lose the care that they actually need. This paper seeks to elucidate the best possible design of an elderly care centre with new approach in order to provide the best service for them by analysing their needs and suitable activities that could elevate their quality of life. All these findings will then be incorporated into design solutions so as to enhance the living environment for the elderly especially in Malaysian context.

  19. A designated centre for people with disabilities operated by SOS Kilkenny Ltd, Kilkenny

    LENUS (Irish Health Repository)

    Hogan, T S

    2012-10-01

    Pulseless electrical activity occurs when organised or semi-organised electrical activity of the heart persists but the product of systemic vascular resistance and the increase in systemic arterial flow generated by the ejection of the left venticular stroke volume is not sufficient to produce a clinically detectable pulse. Pulseless electrical activity encompasses a very heterogeneous variety of severe circulatory shock states ranging in severity from pseudo-cardiac arrest to effective cardiac arrest. Outcomes of cardiopulmonary resuscitation for pulseless electrical activity are generally poor. Impairment of cardiac filling is the limiting factor to cardiac output in many scenarios of pulseless electrical activity, including extreme vasodilatory shock states. There is no evidence that external cardiac compression can increase cardiac output when impaired cardiac filling is the limiting factor to cardiac output. If impaired cardiac filling is the limiting factor to cardiac output and the heart is effectively ejecting all the blood returning to it, then external cardiac compression can only increase cardiac output if it increases venous return and cardiac filling. Repeated cardiac compression asynchronous with the patient\\'s cardiac cycle and raised mean intrathoracic pressure due to chest compression can be expected to reduce rather than to increase cardiac filling and therefore to reduce rather than to increase cardiac output in such circumstances. The hypothesis is proposed that the performance of external cardiac compression will have zero or negative effect on cardiac output in pulseless electrical activity when impaired cardiac filling is the limiting factor to cardiac output. External cardiac compression may be both directly and indirectly harmful to significant sub-groups of patients with pulseless electrical activity. We have neither evidence nor theory to provide comfort that external cardiac compression is not harmful in many scenarios of pulseless

  20. Simulation study of a magnetocardiogram based on a virtual heart model: effect of a cardiac equivalent source and a volume conductor

    Institute of Scientific and Technical Information of China (English)

    Shou Guo-Fa; Xia Ling; Ma Ping; Tang Fa-Kuan; Dai Ling

    2011-01-01

    In this paper, we present a magnetocardiogram (MCG) simulation study using the boundary element method (BEM) and based on the virtual heart model and the realistic human volume conductor model. The different contributions of cardiac equivalent source models and volume conductor models to the MCG are deeply and comprehensively investigated. The single dipole source model, the multiple dipoles source model and the equivalent double layer (EDL) source model are analysed and compared with the cardiac equivalent source models. Meanwhile, the effect of the volume conductor model on the MCG combined with these cardiac equivalent sources is investigated. The simulation results demonstrate that the cardiac electrophysiological information will be partly missed when only the single dipole source is taken, while the EDL source is a good option for MCG simulation and the effect of the volume conductor is smallest for the EDL source. Therefore, the EDL source is suitable for the study of MCG forward and inverse problems, and more attention should be paid to it in future MCG studies.

  1. Pattern-based approach to fetal congenital cardiovascular anomalies using the transverse aortic arch view on prenatal cardiac MRI

    Energy Technology Data Exchange (ETDEWEB)

    Dong, Su-Zhen; Zhu, Ming [Shanghai Jiaotong University School of Medicine, Department of Radiology, Shanghai Children' s Medical Center, Shanghai (China)

    2015-05-01

    Fetal echocardiography is the imaging modality of choice for prenatal diagnosis of congenital cardiovascular anomalies. However, echocardiography has limitations. Fetal cardiac magnetic resonance imaging (MRI) has the potential to complement US in detecting congenital cardiovascular anomalies. This article draws on our experience; it describes the transverse aortic arch view on fetal cardiac MRI and important clues on an abnormal transverse view at the level of the aortic arch to the diagnosis of fetal congenital cardiovascular anomalies. (orig.)

  2. Exercise-based cardiac rehabilitation for adults after Heart valve surgery (protocol)

    DEFF Research Database (Denmark)

    Lærum Sibilitz, Kristine; Berg, Selina Kikkenborg; Tang, Lars Hermann

    2013-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the benefits and harms of exercise-based intervention programmes (exercise-based interventions alone or in combination with psycho-educational components), compared to no intervention, or treatment...... as usual, in adults who have had heart valve surgery. In this review we will focus on programmes that include an exercise-based intervention with, or without, another rehabilitation component (such as a psycho-educational component)....

  3. Tele-centres in Ghana

    DEFF Research Database (Denmark)

    Falch, Morten

    2004-01-01

    Tele-centres offer a low cost opportunity for the many who cannot afford their own phone or Internet connection. This paper presents a field study of tele-centres in Ghana and analyses how they contribute to universal access.......Tele-centres offer a low cost opportunity for the many who cannot afford their own phone or Internet connection. This paper presents a field study of tele-centres in Ghana and analyses how they contribute to universal access....

  4. Robust temporal resolution of MSCT cardiac scan by rotation-time update scheme based on analysis of patient ECG database

    Science.gov (United States)

    Glasberg, S.; Farjon, D.; Ankry, M.; Eisenbach, S.; Shnapp, M.; Altman, A.

    2007-03-01

    We have analyzed 144 ECG wave-forms that were taken during cardiac CT exams to determine in retrospect the optimized timing for updating the gantry rotation-time. A score was defined, according to the number of heart beats during X-ray on, which fulfill the temporal resolution (tR)condition, tR<100mSec. The temporal resolution calculation was based on dual-cycle π/2 sector segmentation, where the data required for any image is collected during two heart cycle. The results yield a significant improvement of the tR score with the rotation-time update method relative to using a fixed minimal rotation-time of the gantry. The analysis suggest that full heart scan with better than 100mSec temporal resolution per slice can routinely be achieved in 128 slices MSCT scanner by performing gantry rotation-time -update after patient starts its breath hold. At these conditions the required breath-hold time is expected to be less than 15 seconds.

  5. Implementation of a phase detection algorithm for dynamic cardiac computed tomography analysis based on time dependent contrast agent distribution.

    Directory of Open Access Journals (Sweden)

    Carsten Kendziorra

    Full Text Available This paper presents a phase detection algorithm for four-dimensional (4D cardiac computed tomography (CT analysis. The algorithm detects a phase, i.e. a specific three-dimensional (3D image out of several time-distributed 3D images, with high contrast in the left ventricle and low contrast in the right ventricle. The purpose is to use the automatically detected phase in an existing algorithm that automatically aligns the images along the heart axis. Decision making is based on the contrast agent distribution over time. It was implemented in KardioPerfusion--a software framework currently being developed for 4D CT myocardial perfusion analysis. Agreement of the phase detection algorithm with two reference readers was 97% (95% CI: 82-100%. Mean duration for detection was 0.020 s (95% CI: 0.018-0.022 s, which was 800 times less than the readers needed (16±7 s, p<03001. Thus, this algorithm is an accurate and fast tool that can improve work flow of clinical examinations.

  6. Population-based evaluation of a suggested anatomic and clinical classification of congenital heart defects based on the International Paediatric and Congenital Cardiac Code

    Directory of Open Access Journals (Sweden)

    Goffinet François

    2011-10-01

    Full Text Available Abstract Background Classification of the overall spectrum of congenital heart defects (CHD has always been challenging, in part because of the diversity of the cardiac phenotypes, but also because of the oft-complex associations. The purpose of our study was to establish a comprehensive and easy-to-use classification of CHD for clinical and epidemiological studies based on the long list of the International Paediatric and Congenital Cardiac Code (IPCCC. Methods We coded each individual malformation using six-digit codes from the long list of IPCCC. We then regrouped all lesions into 10 categories and 23 subcategories according to a multi-dimensional approach encompassing anatomic, diagnostic and therapeutic criteria. This anatomic and clinical classification of congenital heart disease (ACC-CHD was then applied to data acquired from a population-based cohort of patients with CHD in France, made up of 2867 cases (82% live births, 1.8% stillbirths and 16.2% pregnancy terminations. Results The majority of cases (79.5% could be identified with a single IPCCC code. The category "Heterotaxy, including isomerism and mirror-imagery" was the only one that typically required more than one code for identification of cases. The two largest categories were "ventricular septal defects" (52% and "anomalies of the outflow tracts and arterial valves" (20% of cases. Conclusion Our proposed classification is not new, but rather a regrouping of the known spectrum of CHD into a manageable number of categories based on anatomic and clinical criteria. The classification is designed to use the code numbers of the long list of IPCCC but can accommodate ICD-10 codes. Its exhaustiveness, simplicity, and anatomic basis make it useful for clinical and epidemiologic studies, including those aimed at assessment of risk factors and outcomes.

  7. Perspectives on recycling centres and future developments.

    Science.gov (United States)

    Engkvist, I-L; Eklund, J; Krook, J; Björkman, M; Sundin, E

    2016-11-01

    The overall aim of this paper is to draw combined, all-embracing conclusions based on a long-term multidisciplinary research programme on recycling centres in Sweden, focussing on working conditions, environment and system performance. A second aim is to give recommendations for their development of new and existing recycling centres and to discuss implications for the future design and organisation. Several opportunities for improvement of recycling centres were identified, such as design, layout, ease with which users could sort their waste, the work environment, conflicting needs and goals within the industry, and industrialisation. Combining all results from the research, which consisted of different disciplinary aspects, made it possible to analyse and elucidate their interrelations. Waste sorting quality was recognized as the most prominent improvement field in the recycling centre system. The research identified the importance of involving stakeholders with different perspectives when planning a recycling centre in order to get functionality and high performance. Practical proposals of how to plan and build recycling centres are given in a detailed checklist.

  8. The Burundi Heart Centre: From concept to design.

    Science.gov (United States)

    Backhaus, Julia; Yacoub, Lisa; Kambaris, Angelique; Wright, Gavin; Yacoub, Magdi H

    2015-01-01

    Burundi is one of the world's poorest nations, which is also reflected in its relative lack of cardiac facilities, particularly those catering to young children and adults. The authors discuss current efforts to build "The Burundi Heart Centre" to help address this challenge. In particular, they highlight how the project can act as a case study for a sustainable architecture that involves local people and uses locally available materials in a contemporary and innovative way.

  9. Ultra-bright and efficient single photon generation based on N-V centres in nanodiamonds on a solid immersion lens

    CERN Document Server

    Schröder, Tim; Banholzer, Moritz Julian; Benson, Oliver

    2010-01-01

    Single photons are fundamental elements for quantum information technologies such as quantum cryptography, quantum information storage and optical quantum computing. Colour centres in diamond have proven to be stable single photon sources and thus essential components for reliable and integrated quantum information technology. A key requirement for such applications is a large photon flux and a high efficiency. Paying tribute to various attempts to maximise the single photon flux we show that collection efficiencies of photons from colour centres can be increased with a rather simple experimental setup. To do so we spin-coated nanodiamonds containing single nitrogen-vacancy colour centres on the flat surface of a ZrO2 solid immersion lens. We found stable single photon count rates of up to 853 kcts/s at saturation under continuous wave excitation while having excess to more than 100 defect centres with count rates from 400 kcts/s to 500 kcts/s. For a blinking defect centre we found count rates up to 2.4 Mcts/...

  10. Heart-brain interactions in cardiac arrhythmia.

    Science.gov (United States)

    Taggart, P; Critchley, H; Lambiase, P D

    2011-05-01

    This review examines current knowledge of the effects of higher brain centres and autonomic control loops on the heart with particular relevance to arrhythmogenesis. There is now substantial evidence that higher brain function (cortex), the brain stem and autonomic nerves affect cardiac electrophysiology and arrhythmia, and that these may function as an interactive system. The roles of mental stress and emotion in arrhythmogenesis and sudden cardiac death are no longer confined to the realms of anecdote. Advances in molecular cardiology have identified cardiac cellular ion channel mutations conferring vulnerability to arrhythmic death at the myocardial level. Indeed, specific channelopathies such as long QT syndrome and Brugada syndrome are selectively sensitive to either sympathetic or vagal stimulation. There is increasing evidence that afferent feedback from the heart to the higher centres may affect efferent input to the heart and modulate the cardiac electrophysiology. The new era of functional neuroimaging has identified the central neural circuitry in this brain-heart axis. Since precipitants of sudden fatal arrhythmia are frequently environmental and behavioural, central pathways translating stress into autonomic effects on the heart might be considered as therapeutic targets. These brain-heart interactions help explain the apparent randomness of sudden cardiac events and provide new insights into future novel therapies to prevent sudden death.

  11. Incidence and management of diaphragmatic palsy in patients after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Mehta Yatin

    2008-01-01

    Full Text Available Background: Diaphragm is the most important part of the respiratory system. Diaphragmatic palsy following cardiac surgery is not uncommon and can cause deterioration of pulmonary functions and attendant pulmonary complications. Objectives: Aim of this study was to observe the incidence of diaphragmatic palsy after off pump coronary artery bypass grafting (OPCAB as compared to conventional CABG and to assess the efficacy of chest physiotherapy on diaphragmatic palsy in post cardiac surgical patients. Design and Setting: An observational prospective interventional study done at a tertiary care cardiac centre. Patients: 2280 consecutive adult patients who underwent cardiac surgery from February 2005 to august 2005. Results: 30 patients out of 2280 (1.31% developed diaphragmatic palsy. Patients were divided based on the presence or absence of symptoms viz. breathlessness at rest or exertion or with the change of posture along with hypoxemia and / or hypercapnia. Group I included 14 patients who were symptomatic (CABG n=13, post valve surgery n=1, While Group II included 16 asymptomatic patients (CABG n=12, post valve surgery n=4, 9 patients (64% from Group I (n=14 and 4 patients (25% from group II showed complete recovery from diaphragmatic palsy as demonstrated ultrasonographically. Conclusion: The incidence of diaphragmatic palsy was remarkably less in our adult cardiac surgical patients because most of the cardiac surgeries were performed off pump and intensive chest physiotherapy beginning shortly after extubation helped in complete or near complete recovery of diaphragmatic palsy. Chest Physiotherapy led to marked improvement in functional outcome following post cardiac surgery diaphragmatic palsy. We also conclude that ultrasonography is a simple valuable bed-side tool for rapid diagnosis of diaphragmatic palsy

  12. Segmented medical images based simulations of Cardiac electrical activity and electrocardiogram: a model comparison

    OpenAIRE

    Pierre, Charles; Rousseau, Olivier; Bourgault, Yves

    2009-01-01

    The purposes of this work is to compare the action potential and electrocardiogram computed with the monodomain and bidomain models, using a patient-based two-dimensional geometry of the heart-torso. The pipeline from CT scans to image segmentation with an in-house level set method, then to mesh generation is detailed in the article. Our segmentation technique is based on a new iterative Chan-Vese method. The bidomain model and its approximation called the ``adapted'' monodomain model are nex...

  13. A Novel Point-of-Care Smartphone Based System for Monitoring the Cardiac and Respiratory Systems

    Science.gov (United States)

    Sohn, Kwanghyun; Merchant, Faisal M.; Sayadi, Omid; Puppala, Dheeraj; Doddamani, Rajiv; Sahani, Ashish; Singh, Jagmeet P.; Heist, E. Kevin; Isselbacher, Eric M.; Armoundas, Antonis A.

    2017-01-01

    Cardio-respiratory monitoring is one of the most demanding areas in the rapidly growing, mobile-device, based health care delivery. We developed a 12-lead smartphone-based electrocardiogram (ECG) acquisition and monitoring system (called “cvrPhone”), and an application to assess underlying ischemia, and estimate the respiration rate (RR) and tidal volume (TV) from analysis of electrocardiographic (ECG) signals only. During in-vivo swine studies (n = 6), 12-lead ECG signals were recorded at baseline and following coronary artery occlusion. Ischemic indices calculated from each lead showed statistically significant (p mobile platform. PMID:28327645

  14. Problem-Based Learning Used in the Context of Cardiac Rehabilitation: Different Scenes and Different Roles

    Science.gov (United States)

    Hjelmfors, Lisa; Abrandt Dahlgren, Madeleine; Kärner, Anita; Tingström, Pia

    2014-01-01

    Several studies show that how patients have difficulties in changing lifestyle even though such changes are essential because they are suffering from a life-threatening disease. Coronary artery disease (CAD) patients met 13 times during a year and used problem-based learning (PBL) to improve their empowerment and self-efficacy in making lifestyle…

  15. Rapid, high sensitivity, point-of-care test for cardiac troponin based on optomagnetic biosensor

    NARCIS (Netherlands)

    Dittmer, W.U.; Evers, T.H.; Hardeman, W.M.; Huijnen-Keur, W.M.; Kamps, R.; De Kievit, P.; Neijzen, J.H.M.; Sijbers, M.J.J.; Nieuwenhuis, J.H.; Hefti, M.H.; Dekkers, D.; Martens, M.

    2010-01-01

    BACKGROUND: We present a handheld integrated device based on a novel magnetic-optical technology for the sensitive detection of cardiactroponin I, a biomarker for the positive diagnosis of myocardial infarct, in a finger-prick blood sample. The test can be performed with a turn-around time of 5 min

  16. Label-free cardiac contractility monitoring for drug screening applications based on compact high-speed lens-free imaging

    Science.gov (United States)

    Pauwelyn, Thomas; Reumers, Veerle; Vanmeerbeeck, Geert; Stahl, Richard; Janssens, Stefan; Lagae, Liesbet; Braeken, Dries; Lambrechts, Andy

    2015-03-01

    Cardiotoxicity is the major cause of drug withdrawal from the market, despite rigorous toxicity testing during the drug development process. Existing safety screening techniques, some of which are based on simplified cellular assays, others on electrical (impedance) or optical (fluorescent microscopy) measurements, are either too limited in throughput or offer too poor predictability of toxicity to be applied on large numbers of compounds in the early stage of drug development. We present a compact optical system for direct (label-free) monitoring of fast cellular movements that enable low cost and high throughput drug screening. Our system is based on a high-speed lens-free in-line holographic microscope. When compared to a conventional microscope, the system can combine adequate imaging resolution (5.5 μm pixel pitch) with a large field-of-view (63.4 mm2) and high speed (170 fps) to capture physical cell motion in real-time. This combination enables registration of cardiac contractility parameters such as cell contraction frequency, total duration, and rate and duration of both contraction and relaxation. The system also quantifies conduction velocity, which is challenging in existing techniques. Additionally, to complement the imaging hardware we have developed image processing software that extracts all the contractility parameters directly from the raw interference images. The system was tested with varying concentration of the drug verapamil and at 100 nM, showed a decrease in: contraction frequency (-23.3% +/- 13%), total duration (-21% +/- 5%), contraction duration (-19% +/- 6%) and relaxation duration (-21% +/- 8%). Moreover, contraction displacement ceased at higher concentrations.

  17. Combination of CD34-positive cell subsets with infarcted myocardium-like matrix stiffness: a potential solution to cell-based cardiac repair.

    Science.gov (United States)

    Zhang, Shuning; Ma, Xin; Yao, Kang; Zhu, Hong; Huang, Zheyong; Shen, Li; Qian, Juying; Zou, Yunzeng; Sun, Aijun; Ge, Junbo

    2014-06-01

    Detection of the optimal cell transplantation strategy for myocardial infarction (MI) has attracted a great deal of attention. Commitment of engrafted cells to angiogenesis within damaged myocardium is regarded as one of the major targets in cell-based cardiac repair. Bone marrow-derived CD34-positive cells, a well-characterized population of stem cells, might represent highly functional endothelial progenitor cells and result in the formation of new blood vessels. Recently, physical microenvironment (extracellular matrix stiffness) around the engrafted cells was found to exert an essential impact on their fate. Stem cells are able to feel and respond to the tissue-like matrix stiffness to commit to a relevant lineage. Notably, the infarct area after MI experiences a time-dependent stiffness change from flexible to rigid. Our previous observations demonstrated myocardial stiffness-dependent differentiation of the unselected bone marrow-derived mononuclear cells (BMMNCs) along endothelial lineage cells. Myocardial stiffness (~42 kPa) within the optimal time domain of cell engraftment (at week 1 to 2) after MI provided a more favourable physical microenvironment for cell specification and cell-based cardiac repair. However, the difference in tissue stiffness-dependent cell differentiation between the specific cell subsets expressing and no expressing CD34 phenotype remains uncertain. We presumed that CD34-positive cell subsets facilitated angiogenesis and subsequently resulted in cardiac repair under induction of infarcted myocardium-like matrix stiffness compared with CD34-negative cells. If the hypothesis were true, it would contribute greatly to detect the optimal cell subsets for cell therapy and to establish an optimized therapy strategy for cell-based cardiac repair.

  18. MATERNAL MORTALITY IN A TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Harpreet

    2013-06-01

    Full Text Available ABSTRACT: Maternal Mortality in A Tertiary Care Centre. OBJECTIVE: To study maternal mortality and the complications leading to maternal death. METHODS: A retrospective study of hospital record to study maternal mortality and its causes over 3 years from January 2010 to December 2012. RESULTS: There were a total of 58 maternal deaths out of 2823 live births giving a maternal mortality ratio of 2054.55 per one lakh live births. Unbooked and late referrals account for 77.58% of maternal deaths. The majority of deaths around 75.86% were in 20-30 years age group. Haemorrhage was the commonest causes of death (24.12% followed by sepsis (18.96% and pregnancy induced hypertension 15.51% Anemia contributed to the most common indirect cause of maternal morality. CONCLUSION: Haemorrhage, sepsis and pregnancy induced hypertension including eclampsia were the direct major causes of death. Anaemia and cardiac diseases were other indirect causes of death.

  19. Examining the relationship between exercise tolerance and isoproterenol-based cardiac reserve in murine models of heart failure.

    Science.gov (United States)

    Richards, Daniel A; Bao, Weike; Rambo, Mary V; Burgert, Mark; Jucker, Beat M; Lenhard, Stephen C

    2013-05-01

    The loss of cardiac reserve is, in part, responsible for exercise intolerance in late-stage heart failure (HF). Exercise tolerance testing (ETT) has been performed in mouse models of HF; however, treadmill performance and at-rest cardiac indexes determined by magnetic resonance imaging (MRI) rarely correlate. The present study adopted a stress-MRI technique for comparison with ETT in HF models, using isoproterenol (ISO) to evoke cardiac reserve responses. Male C57BL/6J mice were randomly subjected to myocardial infarction (MI), transverse aortic constriction (TAC), or sham surgery under general anesthesia. Mice underwent serial ETT on a graded treadmill with follow-up ISO stress-MRI. TAC mice showed consistent exercise intolerance, with a 16.2% reduction in peak oxygen consumption vs. sham at 15-wk postsurgery (WPS). MI and sham mice had similar peak oxygen consumption from 7 WPS onward. Time to a respiratory exchange ratio of 1.0 correlated with ETT distance (r = 0.64; P WPS [10.1 ± 3.9% change (Δ) and 8.9 ± 3.5%Δ in MI and TAC, respectively, compared with 32.0 ± 3.5%Δ in sham; P WPS in terms of ejection fraction or cardiac output. In addition, ETT did not correlate with cardiac indexes under ISO stress. In conclusion, ISO stress was unable to reflect consistent differences in ETT between HF and healthy mice, suggesting cardiac-specific indexes are not the sole factors in defining exercise intolerance in mouse HF models.

  20. Left Ventricle: Fully Automated Segmentation Based on Spatiotemporal Continuity and Myocardium Information in Cine Cardiac Magnetic Resonance Imaging (LV-FAST

    Directory of Open Access Journals (Sweden)

    Lijia Wang

    2015-01-01

    Full Text Available CMR quantification of LV chamber volumes typically and manually defines the basal-most LV, which adds processing time and user-dependence. This study developed an LV segmentation method that is fully automated based on the spatiotemporal continuity of the LV (LV-FAST. An iteratively decreasing threshold region growing approach was used first from the midventricle to the apex, until the LV area and shape discontinued, and then from midventricle to the base, until less than 50% of the myocardium circumference was observable. Region growth was constrained by LV spatiotemporal continuity to improve robustness of apical and basal segmentations. The LV-FAST method was compared with manual tracing on cardiac cine MRI data of 45 consecutive patients. Of the 45 patients, LV-FAST and manual selection identified the same apical slices at both ED and ES and the same basal slices at both ED and ES in 38, 38, 38, and 41 cases, respectively, and their measurements agreed within -1.6±8.7 mL, -1.4±7.8 mL, and 1.0±5.8% for EDV, ESV, and EF, respectively. LV-FAST allowed LV volume-time course quantitatively measured within 3 seconds on a standard desktop computer, which is fast and accurate for processing the cine volumetric cardiac MRI data, and enables LV filling course quantification over the cardiac cycle.

  1. Fast catheter segmentation from echocardiographic sequences based on segmentation from corresponding X-ray fluoroscopy for cardiac catheterization interventions.

    Science.gov (United States)

    Wu, Xianliang; Housden, James; Ma, YingLiang; Razavi, Benjamin; Rhode, Kawal; Rueckert, Daniel

    2015-04-01

    Echocardiography is a potential alternative to X-ray fluoroscopy in cardiac catheterization given its richness in soft tissue information and its lack of ionizing radiation. However, its small field of view and acoustic artifacts make direct automatic segmentation of the catheters very challenging. In this study, a fast catheter segmentation framework for echocardiographic imaging guided by the segmentation of corresponding X-ray fluoroscopic imaging is proposed. The complete framework consists of: 1) catheter initialization in the first X-ray frame; 2) catheter tracking in the rest of the X-ray sequence; 3) fast registration of corresponding X-ray and ultrasound frames; and 4) catheter segmentation in ultrasound images guided by the results of both X-ray tracking and fast registration. The main contributions include: 1) a Kalman filter-based growing strategy with more clinical data evalution; 2) a SURF detector applied in a constrained search space for catheter segmentation in ultrasound images; 3) a two layer hierarchical graph model to integrate and smooth catheter fragments into a complete catheter; and 4) the integration of these components into a system for clinical applications. This framework is evaluated on five sequences of porcine data and four sequences of patient data comprising more than 3000 X-ray frames and more than 1000 ultrasound frames. The results show that our algorithm is able to track the catheter in ultrasound images at 1.3 s per frame, with an error of less than 2 mm. However, although this may satisfy the accuracy for visualization purposes and is also fast, the algorithm still needs to be further accelerated for real-time clinical applications.

  2. Cardiac Arrhythmias Classification Method Based on MUSIC, Morphological Descriptors, and Neural Network

    Directory of Open Access Journals (Sweden)

    2009-03-01

    Full Text Available An electrocardiogram (ECG beat classification scheme based on multiple signal classification (MUSIC algorithm, morphological descriptors, and neural networks is proposed for discriminating nine ECG beat types. These are normal, fusion of ventricular and normal, fusion of paced and normal, left bundle branch block, right bundle branch block, premature ventricular concentration, atrial premature contraction, paced beat, and ventricular flutter. ECG signal samples from MIT-BIH arrhythmia database are used to evaluate the scheme. MUSIC algorithm is used to calculate pseudospectrum of ECG signals. The low-frequency samples are picked to have the most valuable heartbeat information. These samples along with two morphological descriptors, which deliver the characteristics and features of all parts of the heart, form an input feature vector. This vector is used for the initial training of a classifier neural network. The neural network is designed to have nine sample outputs which constitute the nine beat types. Two neural network schemes, namely multilayered perceptron (MLP neural network and a probabilistic neural network (PNN, are employed. The experimental results achieved a promising accuracy of 99.03% for classifying the beat types using MLP neural network. In addition, our scheme recognizes NORMAL class with 100% accuracy and never misclassifies any other classes as NORMAL.

  3. Cardiac Arrhythmias Classification Method Based on MUSIC, Morphological Descriptors, and Neural Network

    Science.gov (United States)

    Naghsh-Nilchi, Ahmad R.; Kadkhodamohammadi, A. Rahim

    2009-12-01

    An electrocardiogram (ECG) beat classification scheme based on multiple signal classification (MUSIC) algorithm, morphological descriptors, and neural networks is proposed for discriminating nine ECG beat types. These are normal, fusion of ventricular and normal, fusion of paced and normal, left bundle branch block, right bundle branch block, premature ventricular concentration, atrial premature contraction, paced beat, and ventricular flutter. ECG signal samples from MIT-BIH arrhythmia database are used to evaluate the scheme. MUSIC algorithm is used to calculate pseudospectrum of ECG signals. The low-frequency samples are picked to have the most valuable heartbeat information. These samples along with two morphological descriptors, which deliver the characteristics and features of all parts of the heart, form an input feature vector. This vector is used for the initial training of a classifier neural network. The neural network is designed to have nine sample outputs which constitute the nine beat types. Two neural network schemes, namely multilayered perceptron (MLP) neural network and a probabilistic neural network (PNN), are employed. The experimental results achieved a promising accuracy of 99.03% for classifying the beat types using MLP neural network. In addition, our scheme recognizes NORMAL class with 100% accuracy and never misclassifies any other classes as NORMAL.

  4. Eikonal-based initiation of fibrillatory activity in thin-walled cardiac propagation models.

    Science.gov (United States)

    Herlin, Antoine; Jacquemet, Vincent

    2011-12-01

    Reentrant arrhythmias can be simulated in electrophysiological models of electrical impulse propagation governed by a reaction-diffusion system. To facilitate the initiation of a large number of independent episodes of simulated arrhythmias with controllable level of complexity, a new approach is proposed for thin-walled geometries in which depolarization wave dynamics is essentially two-dimensional. Points representing phase singularities are first randomly distributed over the epicardial surface and are assigned a topological charge (direction of rotation). A qualitatively-correct phase map is then reconstructed on the whole surface by interpolation. The eikonal-diffusion equation is used to iteratively regularize the phase map based on a priori information on wavefront propagation. An initial condition for the reaction-diffusion model is created from the resulting phase map with multiple functional/anatomical reentries. Results in an atrial model demonstrate the ability to generate statistical realizations of the same dynamics and to vary the level of complexity measured by the number of phase singularities. A library of 100 simulations with an average number of phase singularities ranging from 1 to 10 is created. An extension to volumetric patient-specific atrial models including fiber orientation and a fast conducting system is presented to illustrate possible applications.

  5. Evaluation of Cardiac Function in Patients with Liver Cirrhosis: A Hospital Based Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Kamal Naik

    2014-09-01

    Methodology: This was ahospital based cross-sectional study, carried out under the department of medicine, SMIMER, Surat. All patients were informed about the study and their verbal consent was obtained. Patients fulfilling the inclusion criteria (n=50 were taken into study and all patients were studied for the clinical profile, laboratory investigation, imaging study like chest X-ray and Ultrasonography abdomen and 2D echocardiography. All patients were hospitalized and blood pressure and heart rate were measured. Result: History of alcohol consumption was found in 36(72% of the patients. Most common symptoms were ascitis, jaundice and malena. Mean total count was 7144(+/-1568. Mean blood urea level was 38.4(+/-19.78 while mean serum creatinin was 1.0(+/-0.72. Mean albumin level was 2.9 (+/-0.81. Mean serum billirubin total, direct and indirect was 6.1(+/-8.08, 4.35(+/-5.98, 1.8(+/-2.19 respectively. Diastolic dysfunction was present in about 66% (33 out of 50 of patients. Conclusion: The patients of cirrhosis develop cirrhotic cardiomyopathy and this cirrhotic cardiomyopathy was not related to the etiology of liver cirrhosis. [Natl J Med Res 2014; 4(3.000: 208-211

  6. Complexity-Measure-Based Sequential Hypothesis Testing for Real-Time Detection of Lethal Cardiac Arrhythmias

    Directory of Open Access Journals (Sweden)

    Chen Szi-Wen

    2007-01-01

    Full Text Available A novel approach that employs a complexity-based sequential hypothesis testing (SHT technique for real-time detection of ventricular fibrillation (VF and ventricular tachycardia (VT is presented. A dataset consisting of a number of VF and VT electrocardiogram (ECG recordings drawn from the MIT-BIH database was adopted for such an analysis. It was split into two smaller datasets for algorithm training and testing, respectively. Each ECG recording was measured in a 10-second interval. For each recording, a number of overlapping windowed ECG data segments were obtained by shifting a 5-second window by a step of 1 second. During the windowing process, the complexity measure (CM value was calculated for each windowed segment and the task of pattern recognition was then sequentially performed by the SHT procedure. A preliminary test conducted using the database produced optimal overall predictive accuracy of . The algorithm was also implemented on a commercial embedded DSP controller, permitting a hardware realization of real-time ventricular arrhythmia detection.

  7. Cardiac autonomic changes in middle-aged women: identification based on principal component analysis.

    Science.gov (United States)

    Trevizani, Gabriela A; Nasario-Junior, Olivassé; Benchimol-Barbosa, Paulo R; Silva, Lilian P; Nadal, Jurandir

    2016-07-01

    The purpose of this study was to investigate the application of the principal component analysis (PCA) technique on power spectral density function (PSD) of consecutive normal RR intervals (iRR) aiming at assessing its ability to discriminate healthy women according to age groups: young group (20-25 year-old) and middle-aged group (40-60 year-old). Thirty healthy and non-smoking female volunteers were investigated (13 young [mean ± SD (median): 22·8 ± 0·9 years (23·0)] and 17 Middle-aged [51·7 ± 5·3 years (50·0)]). The iRR sequence was collected during ten minutes, breathing spontaneously, in supine position and in the morning, using a heart rate monitor. After selecting an iRR segment (5 min) with the smallest variance, an auto regressive model was used to estimate the PSD. Five principal component coefficients, extracted from PSD signals, were retained for analysis according to the Mahalanobis distance classifier. A threshold established by logistic regression allowed the separation of the groups with 100% specificity, 83·2% sensitivity and 93·3% total accuracy. The PCA appropriately classified two groups of women in relation to age (young and Middle-aged) based on PSD analysis of consecutive normal RR intervals.

  8. 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...

  9. A prospective web-based patient-centred interactive study of long-term disabilities, disabilities perception and health-related quality of life in patients with multiple sclerosis in The Netherlands: the Dutch Multiple Sclerosis Study protocol

    OpenAIRE

    Jongen, P.J.; Heerings, M.; Lemmens, W.A.; Donders, R.; Van de Zande, A.; Noort, E.; Kool, A.

    2015-01-01

    BACKGROUND: In the past two decades the widespread use of disease modifying drugs with moderate to strong efficacy has changed the natural course of multiple sclerosis (MS). Health care professionals, researchers, patient organizations and health authorities are in need of recent information about the objectified and subjective long-term clinical outcomes in MS patients. Such information is scarce. METHODS/DESIGN: We started a prospective, web-based, patient-centred, interactive study of long...

  10. A cancer help centre.

    Science.gov (United States)

    Daniel, R

    1996-06-01

    The diagnosis of cancer can be shattering to all involved. The treatment of cancer is intense and often very challenging. Prevailing attitudes to cancer are sometimes fearful, negative and depressing. This combination may leave those affected by cancer shocked, disorientated and without hope. Even worse than this, on asking consultants 'What can I do to help myself?' patients are frequently told 'Absolutely nothing'--crushing in one fell swoop their remaining fighting spirit. Not so in the case of Penny Brohn, who, when faced with the diagnosis of breast cancer, travelled the world to find alternative cancer treatments, and having successfully brought her own cancer under control, dedicated her life to creating a Centre for others wishing to fight their disease.

  11. Stavanger Squash Centre, Norway

    Energy Technology Data Exchange (ETDEWEB)

    Rostvik, H. [Sunlab/ABB, Stavanger (Norway)

    1999-07-01

    Although Stavanger is the technological and financial oil-capital of Norway, the Stavanger Squash Centre was until recently the largest solar building in Norway, with 120 m{sup 2} of collectors. The active, building-integrated, solar air collector in the 45 {sup o} roof facing 15 {sup o} east of due south, has now been delivering solar-heated hot water for the showers for 15 years. The solar system consists of several standard products put together in a new way. Monitoring has shown that the system produced 18,000 kWh/m{sup 2} a (150 kWh/m{sub coll} {sup 2}a). If operated as planned, it could have had a solar contribution of 45,000 kWh/a) (375 kWh/m{sub coll} {sup 2}a), resulting in a 19% solar fraction of total demand. (author)

  12. A new classifier-based strategy for in-silico ion-channel cardiac drug safety assessment

    Directory of Open Access Journals (Sweden)

    Hitesh eMistry

    2015-03-01

    Full Text Available There is currently a strong interest in using high-throughput in-vitro ion-channel screening data to make predictions regarding the cardiac toxicity potential of a new compound in both animal and human studies. A recent FDA think tank encourages the use of biophysical mathematical models of cardiac myocytes for this prediction task. However, it remains unclear whether this approach is the most appropriate. Here we examine five literature data-sets that have been used to support the use of four different biophysical models and one statistical model for predicting cardiac toxicity in numerous species using various endpoints. We propose a simple model that represents the balance between repolarisation and depolarisation forces and compare the predictive power of the model against the original results (leave-one-out cross-validation. Our model showed equivalent performance when compared to the four biophysical models and one statistical model. We therefore conclude that this approach should be further investigated in the context of early cardiac safety screening when in-vitro potency data is generated.

  13. Risk of cardiac valvulopathy with use of bisphosphonates: a population-based, multi-country case-control study

    NARCIS (Netherlands)

    P.M. Coloma (Preciosa); M.A.J. de Ridder (Maria); I. Bezemer (Irene); R.M.C. Herings (Ron); R. Gini (Rosa); S. Pecchioli (Serena); L. Scotti (Lorenza); P.R. Rijnbeek (Peter); M. Mosseveld (Mees); J. van der Lei; G. Trifirò (Gianluca); M.C.J.M. Sturkenboom (Miriam)

    2016-01-01

    textabstractSummary: Analyses of healthcare data from 30 million individuals in three countries showed that current use of bisphosphonates may be associated with a small increased risk of cardiac valvulopathy (vs. those not exposed within the previous year), although confounding cannot be entirely r

  14. 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

  15. Normal cardiac function in mice with supraphysiological cardiac creatine levels.

    Science.gov (United States)

    Santacruz, Lucia; Hernandez, Alejandro; Nienaber, Jeffrey; Mishra, Rajashree; Pinilla, Miguel; Burchette, James; Mao, Lan; Rockman, Howard A; Jacobs, Danny O

    2014-02-01

    Creatine and phosphocreatine levels are decreased in heart failure, and reductions in myocellular phosphocreatine levels predict the severity of the disease and portend adverse outcomes. Previous studies of transgenic mouse models with increased creatine content higher than two times baseline showed the development of heart failure and shortened lifespan. Given phosphocreatine's role in buffering ATP content, we tested the hypothesis whether elevated cardiac creatine content would alter cardiac function under normal physiological conditions. Here, we report the creation of transgenic mice that overexpress the human creatine transporter (CrT) in cardiac muscle under the control of the α-myosin heavy chain promoter. Cardiac transgene expression was quantified by qRT-PCR, and human CrT protein expression was documented on Western blots and immunohistochemistry using a specific anti-CrT antibody. High-energy phosphate metabolites and cardiac function were measured in transgenic animals and compared with age-matched, wild-type controls. Adult transgenic animals showed increases of 5.7- and 4.7-fold in the content of creatine and free ADP, respectively. Phosphocreatine and ATP levels were two times as high in young transgenic animals but declined to control levels by the time the animals reached 8 wk of age. Transgenic mice appeared to be healthy and had normal life spans. Cardiac morphometry, conscious echocardiography, and pressure-volume loop studies demonstrated mild hypertrophy but normal function. Based on our characterization of the human CrT protein expression, creatine and phosphocreatine content, and cardiac morphometry and function, these transgenic mice provide an in vivo model for examining the therapeutic value of elevated creatine content for cardiac pathologies.

  16. High-Throughput Assessment of Drug Cardiac Safety Using a High-Speed Impedance Detection Technology-Based Heart-on-a-Chip

    Directory of Open Access Journals (Sweden)

    Xi Zhang

    2016-07-01

    Full Text Available Drug cardiac safety assessments play a significant role in drug discovery. Drug-induced cardiotoxicity is one of the main reasons for drug attrition, even when antiarrhythmic drugs can otherwise effectively treat the arrhythmias. Consequently, efficient drug preclinical assessments are needed in the drug industry. However, most drug efficacy assessments are performed based on electrophysiological tests of cardiomyocytes in vitro and cannot effectively provide information on drug-induced dysfunction of cardiomyocyte beating. Here we present a heart-on-a-chip device for evaluating the drug cardiac efficacy using a high-speed impedance detection technology. Verapamil and doxorubicin were utilized to test this heart-on-a-chip, and multiple parameters of cardiomyocyte beating status are used to reveal the effects of drugs. The results show that drug efficacy or cardiotoxicity can be determined by this heart-on-a-chip. We believe this heart-on-a-chip will be a promising tool for the preclinical assessment of drug cardiac efficacy.

  17. Call Centre- Computer Telephone Integration

    Directory of Open Access Journals (Sweden)

    Dražen Kovačević

    2012-10-01

    Full Text Available Call centre largely came into being as a result of consumerneeds converging with enabling technology- and by the companiesrecognising the revenue opportunities generated by meetingthose needs thereby increasing customer satisfaction. Regardlessof the specific application or activity of a Call centre, customersatisfaction with the interaction is critical to the revenuegenerated or protected by the Call centre. Physical(v, Call centreset up is a place that includes computer, telephone and supervisorstation. Call centre can be available 24 hours a day - whenthe customer wants to make a purchase, needs information, orsimply wishes to register a complaint.

  18. Evaluation of cardiac blood blow, metabolism and sympathetic nerve function in patients with cardiac failure using PET and SPECT. Prognostic diagnosis based on the analysis of aggravating factors of the disease

    Energy Technology Data Exchange (ETDEWEB)

    Ishida, Yoshio; Shimozu, Junko; Yasumura, Yoshio; Nagatani, Kenzo; Miyatake, Kunio [National Cardiovascular Center, Suita, Osaka (Japan)

    1998-02-01

    Focusing on the failure of energy metabolism, which is assumed to be attributed to the cardiac muscle disorder of a patient with cardiac failure, the characteristics and diagnostic significance of the metabolic disorders of cadiac muscles were investigated in those patients. The diagnostic efficacy of {beta}-methyl iodophenyl pentadecanoic acid (BMIPP) which is a imaging agent for lipid metabolism in the cardiac muscle was assessed in the clinical states of cardiac failure due to pulmonary hypertension. Even if there was a considerable increase in the mean pulmonary arterial pressure (mPAP), the initial accumulation of BMIPP linearly increased, similarly to the increase in the accumulation of MIBI, a blood flow agent. The initial accumulation of BMIPP was thought to reflect a thicken cardiac muscle and/or increased blood flow. Also, its washing-out rate was suggested to be usable as an clinical indicator to estimate the loading of ventricular pressure. (M.N.)

  19. 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.)

  20. 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

  1. Derivation of cardiac output and alveolar ventilation rate based on energy expenditure measurements in healthy males and females.

    Science.gov (United States)

    Brochu, Pierre; Brodeur, Jules; Krishnan, Kannan

    2012-08-01

    Physiologically based pharmacokinetic modeling and occupational exposure assessment studies often use minute ventilation rates (VE), alveolar ventilation rates (VA) and cardiac outputs (Q) that are not reflective of the physiological variations encountered during the aggregate daytime activities of individuals from childhood to adulthood. These variations of VE, VA and Q values were determined for healthy normal-weight individuals aged 5-96 years by using two types of published individual data that were measured in the same subjects (n = 902), namely indirect calorimetry measurements and the disappearance rates of oral doses of deuterium (²H) and heavy-oxygen (¹⁸O) in urine monitored by gas-isotope-ratio mass spectrometry. Arteriovenous oxygen content differences (0.051-0.082 ml of O₂ consumed ml⁻¹ of blood) and ratios of the physiological dead space to the tidal volume (0.232-0.419) were determined for oxygen consumption rates (0.157-0.806 l min⁻¹) required by minute energy expenditures ranging from 0.76 to 3.91 kcal min⁻¹. Generally higher values for the 2.5th up to the 99th percentile for VE (0.132-0.774 l kg⁻¹ min⁻¹, 4.42-21.69 l m⁻² min⁻¹), VA (0.093-0.553 l kg⁻¹ min⁻¹, 3.09-15.53 l m⁻² min⁻¹), Q (0.065-0.330 l kg⁻¹ min⁻¹, 2.17 to 9.46 l m⁻² min⁻¹) and ventilation-perfusion ratios (1.12-2.16) were found in children and teenagers aged 5-<16.5 years compared with older individuals. The distributions of cardiopulmonary parameters developed in this study should be useful in facilitating a scientifically sound characterization of the inter-individual differences in the uptake and health risks of lipophilic air pollutants, particularly as they relate to younger children.

  2. Council celebrates CERN Control Centre

    CERN Multimedia

    2006-01-01

    With the unveiling of its new sign, the CERN Control Centre was officially inaugurated on Thursday 16 March. To celebrate its startup, CERN Council members visited the sleek centre, a futuristic-looking room filled with a multitude of monitoring screens.

  3. Creation of a bioreactor for the application of variable amplitude mechanical stimulation of fibrin gel-based engineered cardiac tissue.

    Science.gov (United States)

    Morgan, Kathy Y; Black, Lauren D

    2014-01-01

    This chapter details the creation of three-dimensional fibrin hydrogels as an engineered myocardial tissue and introduces a mechanical stretch bioreactor system that allows for the cycle-to-cycle variable amplitude mechanical stretch of the constructs as a method of conditioning the constructs to be more similar to native tissue. Though mechanical stimulation has been established as a standard method of improving construct development, most studies have been performed under constant frequency and constant amplitude, even though variability is a critical aspect of healthy cardiac physiology. The introduction of variability in other organ systems has demonstrated beneficial effects to cell function in vitro. We hypothesize that the introduction of variability in engineered cardiac tissue could have a similar effect.

  4. Ambulatory ECG-based T-wave alternans and heart rate turbulence can predict cardiac mortality in patients with myocardial infarction with or without diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Li-na Ren

    2012-09-01

    Full Text Available Abstract Background Many patients who survive a myocardial infarction (MI remain at risk of sudden cardiac death despite revascularization and optimal medical treatment. We used the modified moving average (MMA method to assess the utility of T-wave alternans (TWA and heart rate turbulence (HRT as risk markers in MI patients with or without diabetes mellitus (DM. Methods We prospectively enrolled 248 consecutive patients: 96 with MI (post-MI patients; 77 MI with DM (post-MI + DM patients; 75 controls without cardiovascular disease (group control. Both TWA and HRT were measured on ambulatory electrocardiograms (AECGs. HRT was assessed by two parameters ─ turbulence onset (TO and turbulence slope (TS. HRT was considered positive when both TO ≥0% and TS ≤2.5 ms/R-R interval were met. The endpoint was cardiac mortality. Results TWA values differed significantly between MI and controls. Post-MI + DM patients had higher TWA values than post-MI patients (58 ± 21 μV VS 52 ± 18 μV, P = 0.029. Impaired HRT--increased TO and decreased TS were observed in MI patients with or without DM. During follow-up of 578 ± 146 days, cardiac death occurred in ten patients and three of them suffered sudden cardiac death (SCD. Multivariate analysis determined that a HRT-positive outcome [HR (95% CI: 5.01, 1.33–18.85; P = 0.017], as well as the combination of abnormal TWA (≥47 μV and positive HRT had significant association with the endpoint [HR (95% CI: 9.08, 2.21–37.2; P = 0.002]. Conclusion This study indicates that AECGs-based TWA and HRT can predict cardiac mortality in MI patients with or without DM. Combined analysis TWA and HRT may be a convenient and useful method of identifying patients at high risk for cardiovascular death.

  5. Reference values for the incremental shuttle walk test in patients with cardiovascular disease entering exercise-based cardiac rehabilitation.

    Science.gov (United States)

    Cardoso, Fernando M F; Almodhy, Meshal; Pepera, Garyfalia; Stasinopoulos, Dimitrios M; Sandercock, Gavin R H

    2017-01-01

    The incremental shuttle walk test (ISWT) is used to assess functional capacity of patients entering cardiac rehabilitation. Factors such as age and sex account for a proportion of the variance in test performance in healthy individuals but there are no reference values for patients with cardiovascular disease. The aim of this study was to produce reference values for the ISWT. Participants were n = 548 patients referred to outpatient cardiac rehabilitation who underwent a clinical examination and performed the ISWT. We used regression to identify predictors of performance and produced centile values using the generalised additive model for location, scale and shape model. Men walked significantly further than women (395 ± 165 vs. 269 ± 118 m; t = 9.5, P sex. Age (years) was the strongest predictor of performance in men (β = -5.9; 95% CI: -7.1 to -4.6 m) and women (β = -4.8; 95% CI: -6.3 to 3.3). Centile curves demonstrated a broadly linear decrease in expected ISWT values in males (25-85 years) and a more curvilinear trend in females. Patients entering cardiac rehabilitation present with highly heterogeneous ISWT values. Much of the variance in performance can be explained by patients' age and sex. Comparing absolute values with age-and sex-specific reference values may aid interpretation of ISWT performance during initial patient assessment at entry to cardiac rehabilitation.

  6. Posttraumatic growth in patients who survived cardiac surgery: the predictive and mediating roles of faith-based factors.

    Science.gov (United States)

    Ai, Amy L; Hall, Daniel; Pargament, Kenneth; Tice, Terrence N

    2013-04-01

    Despite the growing knowledge of posttraumatic growth, only a few studies have examined personal growth in the context of cardiac health. Similarly, longitudinal research is lacking on the implications of religion/spirituality for patients with advanced cardiac diseases. This paper aims to explore the effect of preoperative religious coping on long-term postoperative personal growth and potential mediation in this effect. Analyses capitalized on a preoperative survey and medical indices from the Society of Thoracic Surgeons' National Database of patients undergoing cardiac surgery. Participants in the current follow-up study completed a mailed survey 30 months after surgery. Hierarchical regression analysis was performed to evaluate the extent to which preoperative use of religious coping predicted growth at follow-up, after controlling for key demographics, medical indices, mental health, and protective factors. Predictors of posttraumatic growth at follow-up were positive religious coping and a living status without a partner. Medical indices, optimistic expectations, social support, and other religious factors were unrelated to posttraumatic growth. Including religious factors diminished effects of gender, age, and race. Including perceived spiritual support completely eliminated the role of positive religious coping, indicating mediation. Preoperative positive religious coping may have a long-term effect on postoperative personal growth, explainable by higher spiritual connections as a part of significance-making. These results suggest that spirituality may play a favorable role in cardiac patients' posttraumatic growth after surviving a life-altering operation. The elimination of demographic effects may help explain previously mixed findings concerning the association between these factors and personal growth.

  7. Opportunity Centred Learning: An Innovation in Enterprise Education?

    Science.gov (United States)

    Rae, David

    2003-01-01

    This paper describes an approach called opportunity centred learning that has been developed by the author and applied in the field of enterprise education. The relationship between opportunity centred learning and existing theory and practice in learning and education is outlined in comparison with problem-based learning and action learning, and…

  8. Differences Between Women and Men in Phase I Cardiac Rehabilitation After Acute Myocardial Infarction: A Nationwide Population-Based Analysis.

    Science.gov (United States)

    Lin, Wen-Chih; Ho, Chung-Han; Tung, Li-Chen; Ho, Chi-Che; Chou, Willy; Wang, Chun-Hou

    2016-01-01

    Although numerous studies have investigated gender-related differences in patients who have had an acute myocardial infarction (AMI), few studies have examined the gender-related differences among inpatients receiving Phase I inpatient cardiac rehabilitation following AMI.Using data from the Taiwan National Health Insurance Research Database, this study analyzed 6713 adult patients who received inpatient cardiac rehabilitation following AMI between 2002 and 2011. The differences in comorbidity, medical service use, and prognosis between the male and female patients were analyzed to determine whether the comorbidities affecting their prognoses differed.Female patients accounted for 23.18% of the sample, had a higher average age, and exhibited severe comorbidities; furthermore, they had significantly more days of hospitalization and days in an intensive care unit than did male patients. The gender-related differences in hospital mortality rate and 30-day mortality rate were nonsignificant, but female patients exhibited a significantly higher 1-year mortality rate. Moreover, the risk for 1-year mortality was higher among female patients with moderate or severe renal disease (odds ratio: 1.94, 95% confidence interval: 1.29-2.92) than among their male counterparts. However, the 1-year mortality rate for the female patients did not increase after all risk factors were adjusted.Gender-related differences in age, comorbidity, and prognosis were confirmed in AMI patients receiving Phase I inpatient cardiac rehabilitation. In addition, gender-related differences were observed in the comorbidity risk factors affecting prognosis. However, being female did not affect the prognosis.

  9. Luminescence properties of IR-emitting bismuth centres in SiO{sub 2}-based glasses in the UV to near-IR spectral region

    Energy Technology Data Exchange (ETDEWEB)

    Firstova, E G; Vel' miskin, V V; Firstov, S V; Dianov, E M [Fiber Optics Research Center, Russian Academy of Sciences, Moscow (Russian Federation); Bufetov, I A [Moscow Institute of Physics and Technology (State University), Dolgoprudnyi, Moscow Region (Russian Federation); Khopin, V F; Gur' yanov, A N [G.G.Devyatykh Institute of Chemistry of High-Purity Substances, Russian Academy of Sciences, Nizhnii Novgorod (Russian Federation); Bufetova, G A [A M Prokhorov General Physics Institute, Russian Academy of Sciences, Moscow (Russian Federation); Nishchev, K N [N.P. Ogarev Mordovia State University, Physics and Chemistry Institute, Saransk (Russian Federation)

    2015-01-31

    We have studied UV excitation spectra of IR luminescence in bismuth-doped glasses of various compositions and obtained energy level diagrams of IR-emitting bismuth-related active centres (BACs) associated with silicon and germanium atoms up to ∼5.2 eV over the ground level. A possible energy level diagram of the BACs in phosphosilicate glass has been proposed. The UV excitation peaks for the IR luminescence of the BACs in the glasses have been shown to considerably overlap with absorption bands of the Bi{sup 3+} ion, suggesting that Bi{sup 3+} may participate in BAC formation. (optical fibres)

  10. Luminescence properties of IR-emitting bismuth centres in SiO2-based glasses in the UV to near-IR spectral region

    Science.gov (United States)

    Firstova, E. G.; Bufetov, I. A.; Khopin, V. F.; Vel'miskin, V. V.; Firstov, S. V.; Bufetova, G. A.; Nishchev, K. N.; Gur'yanov, A. N.; Dianov, E. M.

    2015-01-01

    We have studied UV excitation spectra of IR luminescence in bismuth-doped glasses of various compositions and obtained energy level diagrams of IR-emitting bismuth-related active centres (BACs) associated with silicon and germanium atoms up to ~5.2 eV over the ground level. A possible energy level diagram of the BACs in phosphosilicate glass has been proposed. The UV excitation peaks for the IR luminescence of the BACs in the glasses have been shown to considerably overlap with absorption bands of the Bi3+ ion, suggesting that Bi3+ may participate in BAC formation.

  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. Feasibility of free-breathing, GRAPPA-based, real-time cardiac cine assessment of left-ventricular function in cardiovascular patients at 3 T

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Xiaomei, E-mail: xiaomeizhunanjing@163.com [Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistrasse 15, 81377 Munich (Germany); Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, 300, Guangzhou Road, 210029 Nanjing, Jiangsu (China); Schwab, Felix, E-mail: flixschwab@googlemail.com [Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistrasse 15, 81377 Munich (Germany); Marcus, Roy, E-mail: Roy.Marcus@med.uni-muenchen.de [Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistrasse 15, 81377 Munich (Germany); Hetterich, Holger, E-mail: Holger.Hetterich@med.uni-muenchen.de [Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistrasse 15, 81377 Munich (Germany); Theisen, Daniel, E-mail: daniel.theisen@me.com [Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistrasse 15, 81377 Munich (Germany); Kramer, Harald, E-mail: Harald.Kramer@med.uni-muenchen.de [Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistrasse 15, 81377 Munich (Germany); Notohamiprodjo, Mike, E-mail: Mike.Notohamiprodjo@med.lmu.de [Department of Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Schlett, Christopher L., E-mail: Christopher.Schlett@med.uni-heidelberg.de [Department of Radiology, University of Heidelberg, Neuenheimer Feld 110, 69120 Heidelberg (Germany); Nikolaou, Konstantin, E-mail: Konstantin.Nikolaou@med.uni-tuebingen.de [Department of Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany); Reiser, Maximilian F., E-mail: Maximilian.Reiser@med.uni-muenchen.de [Institute of Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistrasse 15, 81377 Munich (Germany); and others

    2015-05-15

    Highlights: • Grappa-based real time cine cardiac MRI is feasible for assessment of left ventricular function. • Significant underestimation of systolic function, peak ejection and filling rates needs to be considered. • Heart rate is the only positive predictor of the deviation of obtained parameters. - Abstract: Objectives: To determine the feasibility of free-breathing, GRAPPA-based, real-time (RT) cine 3 T cardiac magnetic resonance imaging (MRI) with high acceleration factors for the assessment of left-ventricular function in a cohort of patients as compared to conventional segmented cine imaging. Materials and methods: In this prospective cohort study, subjects with various cardiac conditions underwent MRI involving two RT cine sequences (high resolution and low resolution) and standard segmented cine imaging. Standard qualitative and quantitative parameters of left-ventricular function were quantified. Results: Among 25 subjects, 24 were included in the analysis (mean age: 50.5 ± 21 years, 67% male, 25% with cardiomyopathy). RT cine derived quantitative parameters of volumes and left ventricular mass were strongly correlated with segmented cine imaging (intraclass correlation coefficient [ICC]: >0.72 for both RT cines) but correlation for peak ejection and filling rates were moderate to poor for both RT cines (ICC < 0.40). Similarly, RT cines significantly underestimated peak ejection and filling rates (>103.2 ± 178 ml/s). Among patient-related factors, heart rate was strongly predictive for deviation of measurements (p < 0.05). Conclusions: RT cine MRI at 3 T is feasible for qualitative and quantitative assessment of left ventricular function for low and high-resolution sequences but results in significant underestimation of systolic function, peak ejection and filling rates.

  13. The role of the Arrhythmia Team, an integrated, multidisciplinary approach to treatment of patients with cardiac arrhythmias: results of the European Heart Rhythm Association survey.

    Science.gov (United States)

    Fumagalli, Stefano; Chen, Jian; Dobreanu, Dan; Madrid, Antonio Hernandez; Tilz, Roland; Dagres, Nikolaos

    2016-04-01

    Management of patients with cardiac arrhythmias is increasingly complex because of continuous technological advance and multifaceted clinical conditions associated with ageing of the population, the presence of co-morbidities and the need for polypharmacy. The aim of this European Heart Rhythm Association Scientific Initiatives Committee survey was to provide an insight into the role of the Arrhythmia Team, an integrated, multidisciplinary approach to management of patients with cardiac arrhythmias. Forty-eight centres from 18 European countries replied to the Web-based questionnaire. The presence of an Arrhythmia Team was reported by 44% of the respondents, whereas 17% were not familiar with this term. Apart from the electrophysiologist, health professionals who should belong to such teams, according to the majority of the respondents, include a clinical cardiologist, a nurse, a cardiac surgeon, a heart failure specialist, a geneticist, and a geriatrician. Its main activity should be dedicated to the management of patients with complex clinical conditions or refractory or inherited forms of arrhythmias. When present, the Arrhythmia Team was considered helpful by 95% of respondents; the majority of centres (79%) agreed that it should be implemented. The Arrhythmia Team seems to be connected to important expectations in the management of cardiac arrhythmias. The efficacy of such an integrated and multidisciplinary approach should be encouraged and tested in clinical practice.

  14. The group-based social skills training SOSTA-FRA in children and adolescents with high functioning autism spectrum disorder - study protocol of the randomised, multi-centre controlled SOSTA - net trial

    Directory of Open Access Journals (Sweden)

    Freitag Christine M

    2013-01-01

    Full Text Available Abstract Background Group-based social skills training (SST has repeatedly been recommended as treatment of choice in high-functioning autism spectrum disorder (HFASD. To date, no sufficiently powered randomised controlled trial has been performed to establish efficacy and safety of SST in children and adolescents with HFASD. In this randomised, multi-centre, controlled trial with 220 children and adolescents with HFASD it is hypothesized, that add-on group-based SST using the 12 weeks manualised SOSTA–FRA program will result in improved social responsiveness (measured by the parent rated social responsiveness scale, SRS compared to treatment as usual (TAU. It is further expected, that parent and self reported anxiety and depressive symptoms will decline and pro-social behaviour will increase in the treatment group. A neurophysiological study in the Frankfurt HFASD subgroup will be performed pre- and post treatment to assess changes in neural function induced by SST versus TAU. Methods/design The SOSTA – net trial is designed as a prospective, randomised, multi-centre, controlled trial with two parallel groups. The primary outcome is change in SRS score directly after the intervention and at 3 months follow-up. Several secondary outcome measures are also obtained. The target sample consists of 220 individuals with ASD, included at the six study centres. Discussion This study is currently one of the largest trials on SST in children and adolescents with HFASD worldwide. Compared to recent randomised controlled studies, our study shows several advantages with regard to in- and exclusion criteria, study methods, and the therapeutic approach chosen, which can be easily implemented in non-university-based clinical settings. Trial registration ISRCTN94863788 – SOSTA – net: Group-based social skills training in children and adolescents with high functioning autism spectrum disorder.

  15. Temporal Trends in Coverage of Historical Cardiac Arrests Using a Volunteer-Based Network of Automated External Defibrillators Accessible to Laypersons and Emergency Dispatch Centers

    DEFF Research Database (Denmark)

    Hansen, Carolina Malta; Lippert, Freddy Knudsen; Wissenberg, Mads

    2014-01-01

    public cardiac arrest coverage in high- and low-risk areas. METHODS AND RESULTS: All public cardiac arrests (1994-2011) and all registered AEDs (2007-2011) in Copenhagen, Denmark, were identified and geocoded. AED coverage of cardiac arrests was defined as historical arrests ≤100 m from an AED. High...

  16. 25 years Nuclear Research Centre

    Energy Technology Data Exchange (ETDEWEB)

    Harde, R.

    1981-07-01

    On June 12, the Karlsruhe Nuclear Research Centre celebrated its 25th anniversary. The Centre was founded on July 19, 1956. The importance of this institution became apparent by the large number of prominent guests, at the head, the Federal President, Karl Carstens. Minister President Spaeth and the Federal Minister for Research and Technology, von Buelow, appreciated the achievements obtained by this big science centre of nuclear technology. The ceremony held in the State theatre of Baden-Wuerttemberg gave testimony of an impressing confession in favour of nuclear energy. Excerpts from the speech of the Chairman of the Managing Board, Prof. Harde, are quoted.

  17. Cardiac tamponade (image)

    Science.gov (United States)

    Cardiac tamponade is a condition involving compression of the heart caused by blood or fluid accumulation in the space ... they cannot adequately fill or pump blood. Cardiac tamponade is an emergency condition that requires hospitalization.

  18. What Is Cardiac Rehabilitation?

    Science.gov (United States)

    ANSWERS by heart Treatments + Tests What Is Cardiac Rehabilitation? A cardiac rehabilitation (rehab) program takes place in a hospital or ... special help in making lifestyle changes. During your rehabilitation program you’ll… • Have a medical evaluation to ...

  19. Four-Group Classification Based on Fibrinogen Level and Fibrin Polymerization Associated With Postoperative Bleeding in Cardiac Surgery.

    Science.gov (United States)

    Kawashima, Shingo; Suzuki, Yuji; Sato, Tsunehisa; Kikura, Mutsuhito; Katoh, Takasumi; Sato, Shigehito

    2016-10-01

    Fibrinogen and fibrin formation have a key role in perioperative hemostasis. The aim of this study is to examine the association of postoperative hemostasis with a combined evaluation of the fibrinogen level and fibrin polymerization in cardiac surgery. We retrospectively classified 215 consecutive cardiac surgery patients into 4 groups (Fuji-san classification) that were divided by fibrinogen level fibrinogen thromboelastometry value at 10 minutes with rotational thromboelastometry <6 mm (ie, low fibrin polymerization) at the warming of cardiopulmonary bypass. Four groups resulted; group I, the acceptable range (n = 85); group II, only hypofibrinogenemia (<150 mg/dL, ≥6 mm, n = 63); group III, hypofibrinogenemia and low fibrin polymerization (<150 mg/dL, <6 mm, n = 60); and group IV, only low fibrin polymerization (≥150 mg/dL, <6 mm, n = 7). The risk of chest tube drainage volume greater than 500 mL within the first 24 hours after surgery (with group I as the reference) was increased in group II (odds ratio [OR], 3.3; 95% confidence interval [CI], 1.5-7.4; P < .01) and group III (OR, 8.5; 95% CI, 3.5-21.7; P < .01), and the risk greater than 1000 mL (with group I as the reference) was increased in group III (OR, 4.0; 95% CI, 1.1-17.3; P = .03) and group IV (OR, 23.1; 95% CI, 3.2-201.0; P < .01). Intraoperative blood transfusions were decreased by 24.5%, after stratifying the starting amount of fresh frozen plasma by the 4-group classification in the recent consecutive 65 (30.2%) patients (P < .01). The 4-group classification is associated with postoperative bleeding and may improve the quality of perioperative blood transfusion in cardiac surgery.

  20. Model-based correction for scatter and tailing effects in simultaneous 99mTc and 123I imaging for a CdZnTe cardiac SPECT camera

    Science.gov (United States)

    Holstensson, M.; Erlandsson, K.; Poludniowski, G.; Ben-Haim, S.; Hutton, B. F.

    2015-04-01

    An advantage of semiconductor-based dedicated cardiac single photon emission computed tomography (SPECT) cameras when compared to conventional Anger cameras is superior energy resolution. This provides the potential for improved separation of the photopeaks in dual radionuclide imaging, such as combined use of 99mTc and 123I . There is, however, the added complexity of tailing effects in the detectors that must be accounted for. In this paper we present a model-based correction algorithm which extracts the useful primary counts of 99mTc and 123I from projection data. Equations describing the in-patient scatter and tailing effects in the detectors are iteratively solved for both radionuclides simultaneously using a maximum a posteriori probability algorithm with one-step-late evaluation. Energy window-dependent parameters for the equations describing in-patient scatter are estimated using Monte Carlo simulations. Parameters for the equations describing tailing effects are estimated using virtually scatter-free experimental measurements on a dedicated cardiac SPECT camera with CdZnTe-detectors. When applied to a phantom study with both 99mTc and 123I, results show that the estimated spatial distribution of events from 99mTc in the 99mTc photopeak energy window is very similar to that measured in a single 99mTc phantom study. The extracted images of primary events display increased cold lesion contrasts for both 99mTc and 123I.

  1. Injectable biodegradable hybrid hydrogels based on thiolated collagen and oligo(acryloyl carbonate)-poly(ethylene glycol)-oligo(acryloyl carbonate) copolymer for functional cardiac regeneration.

    Science.gov (United States)

    Xu, Guohui; Wang, Xiaolin; Deng, Chao; Teng, Xiaomei; Suuronen, Erik J; Shen, Zhenya; Zhong, Zhiyuan

    2015-03-01

    Injectable biodegradable hybrid hydrogels were designed and developed based on thiolated collagen (Col-SH) and multiple acrylate containing oligo(acryloyl carbonate)-b-poly(ethylene glycol)-b-oligo(acryloyl carbonate) (OAC-PEG-OAC) copolymers for functional cardiac regeneration. Hydrogels were readily formed under physiological conditions (37°C and pH 7.4) from Col-SH and OAC-PEG-OAC via a Michael-type addition reaction, with gelation times ranging from 0.4 to 8.1 min and storage moduli from 11.4 to 55.6 kPa, depending on the polymer concentrations, solution pH and degrees of substitution of Col-SH. The collagen component in the hybrid hydrogels retained its enzymatic degradability against collagenase, and the degradation time of the hydrogels increased with increasing polymer concentration. In vitro studies showed that bone marrow mesenchymal stem cells (BMSCs) exhibited rapid cell spreading and extensive cellular network formation on these hybrid hydrogels. In a rat infarction model, the infarcted left ventricle was injected with PBS, hybrid hydrogels, BMSCs or BMSC-encapsulating hybrid hydrogels. Echocardiography demonstrated that the hybrid hydrogels and BMSC-encapsulating hydrogels could increase the ejection fraction at 28 days compared to the PBS control group, resulting in improved cardiac function. Histology revealed that the injected hybrid hydrogels significantly reduced the infarct size and increased the wall thickness, and these were further improved with the BMSC-encapsulating hybrid hydrogel treatment, probably related to the enhanced engraftment and persistence of the BMSCs when delivered within the hybrid hydrogel. Thus, these injectable hybrid hydrogels combining intrinsic bioactivity of collagen, controlled mechanical properties and enhanced stability provide a versatile platform for functional cardiac regeneration.

  2. 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.

  3. Cardiac sodium channelopathies

    NARCIS (Netherlands)

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

    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

  4. A web-based intervention (RESTORE) to support self-management of cancer-related fatigue following primary cancer treatment: a multi-centre proof of concept randomised controlled trial

    OpenAIRE

    Foster, Claire; Grimmett, Chloe; May, Christine M.; Ewings, Sean; Myall, Michelle; Hulme, Claire; Smith, Peter W.; Powers, Cassandra; Calman, Lynn; Armes, Jo; Breckons, Matthew; Corner, Jessica; Fenlon, Deborah; Batehup, Lynn; Lennan, Elaine

    2015-01-01

    Purpose: Cancer-related fatigue (CRF) is a frequent and distressing symptom experienced after cancer treatment. RESTORE is the first web-based resource designed to enhance self-efficacy to manage CRF following curative-intent treatment. The aim of this study is to test the proof of concept and inform the design of an effectiveness trial.\\ud \\ud Methods: A multi-centre parallel-group two-armed (1:1) exploratory randomised controlled trial (RCT) with qualitative process evaluation was employed ...

  5. Clinical advances on Cardiac Insuffiency

    Directory of Open Access Journals (Sweden)

    Angel Julio Romero Cabrera

    2007-06-01

    Full Text Available Cardiac insuffiency is a complex clinical syndrome which constitutes a common final path to get in by the majority of the cardiac diseases. Studies based on the communitarian surveys shows that from 30 to 40 % of the patients decease within the first year of the diagnosis. The rest of the patients (from 60 to 70 % die within the 5 years after being diagnosed. For this reason it has been called as the ¨cancer of cardiology¨. The objective of this article is to update the advances reached in the clinical and therapeutic aspects of this important syndrome.

  6. Evaluation of a New Shirt-Based Electrocardiogram Device for Cardiac Screening in Soccer Players: Comparative Study With Treadmill Ergospirometry

    Science.gov (United States)

    Fabregat-Andres, Oscar; Munoz-Macho, Adolfo; Adell-Beltran, Guillermo; Ibanez-Catala, Xavier; Macia, Agustin; Facila, Lorenzo

    2014-01-01

    Background Prevention of cardiac events during competitive sports is fundamental. New technologies with remote monitoring systems integrated into clothing could facilitate the screening of heart disease. Our aim was to evaluate the feasibility of Nuubo system during a field stress test performed by soccer players, comparing results with treadmill ergospirometry as test reference. Methods Nineteen male professional soccer players (19.2 ± 1.6 years) were studied. Wireless electrocardiographic monitoring during a Yo-Yo intermittent recovery test level 1 in soccer field and subsequent analysis of arrhythmias were firstly performed. Subsequently, in a period no longer than 4 weeks, each player underwent cardiopulmonary exercise testing in hospital. Results During Yo-Yo test, electrocardiogram (ECG) signal was interpretable in 16 players (84.2%). In the other three players, ECG artifacts did not allow a proper analysis. Estimation of maximum oxygen consumption was comparable between two exercise tests (VO2 max 53.3 ± 2.4 vs. 53.7 ± 3.0 mL/kg/min for Yo-Yo test and ergometry respectively; intra-class correlation coefficient 0.84 (0.63 - 0.93), P < 0.001). No arrhythmias were detected in any player during both tests. Conclusions The use of Nuubo’s technology allows an accurate single-lead electrocardiographic recording and estimation of reliable performance variables during exercise testing in field, and provides a new perspective to cardiac remote monitoring in collective sports.

  7. 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...

  8. The Centres for Environment-friendly Energy Research (FME)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    High expectations for Norway's Centres for Environment-friendly Energy Research (FME).The FME centres address a broad range of areas, allcentral to developing the energy sector of the future. The activities of the eight centres established in 2009 focus on renewable energy, raising energy efficiency, energy planning, and carbon capture and storage (CCS). In 2011 three new FME centres were established which focus on social science-related energy research. The FME scheme is a direct follow-up of the broad-based political agreement on climate policy achieved in the Storting in January 2008, and of the national RandD Energi21 strategy submitted in February 2008 to the Ministry of Petroleum and Energy. In April 2008 the Research Council of Norway's Executive Board decided to launch a process to establish centres for environment-friendly energy research, and a funding announcement was issued that same year. In 2010 it was decided that additional FME centres would be established in the field of social science-related energy research. After a thorough assessment of each project (based on feasibility, scientific merit, potential to generate value creation and innovation, and composition of the consortium) eight applicants were selected to become FME centres in February 2009. A new call for proposals was issued in 2010, and three more centres were awarded FME status in February 2011. The objective of the FME scheme is to establish time-limited research centres which conduct concentrated, focused and long-term research of high international calibre in order to solve specific challenges in the energy sphere. The selected centres must exhibit higher goals, a longer-term perspective and a more concentrated focus than is required under other funding instruments for the same scientific area. The make-up of the centres is critical to achieving this objective. The centres bring together Norway's leading research institutions and key players in private enterprise, the

  9. Holter monitoring for the screening of cardiac disease in diabetes mellitus: The non-invasive Holter monitoring observation of new cardiac events in diabetics study.

    Science.gov (United States)

    Nakao, Yoko M; Ueshima, Kenji; Nohara, Ryuji; Mizunuma, Yoshimi; Segawa, Ikuo; Tanaka-Mizuno, Sachiko; Yasuno, Shinji; Nakao, Kazuwa; Hiramori, Katsuhiko; Kihara, Yasuki

    2015-11-01

    We investigated the usefulness of Holter monitoring to detect cardiac disease and predict future cardiovascular risk in asymptomatic diabetic patients. This is a multi-centre, prospective study in 406 asymptomatic diabetic patients. They were categorized into three groups based on findings of Holter monitoring. A total of 377 met inclusion criteria and were classified as low (n = 172), moderate (n = 136) and high risk (n = 69). In total, 86 in moderate and 53 in high risk receive further evaluation. In total, 29 in moderate and 25 in high risk were diagnosed as cardiac disease and 12 required additional treatment, including coronary intervention. Over 1.8 years of mean follow-up, 11 (16.5 per 1000 person-years) experienced cardiovascular events. The cumulative incidence in moderate and high risk was higher than that in low risk (p = 0.029 and p = 0.014, respectively). Our study suggests that Holter monitoring may be a useful screening tool to detect cardiac disease and predict future cardiovascular risk in asymptomatic diabetic patients.

  10. CMS Centres Worldwide - a New Collaborative Infrastructure

    CERN Document Server

    Taylor, Lucas

    2011-01-01

    Webcasts, and generic Web tools such as CMS-TV for broadcasting live monitoring and outreach information. Being Web-based and experiment-independent, these systems could easily be extended to other organizations. We describe the experiences of using CMS Centres Worldwide in the CMS data-taking operations as well as for major media events with several hundred TV channels, radio stations, and many more press journalists simultaneously around the world.

  11. Mechanisms of cardiac pain.

    Science.gov (United States)

    Foreman, Robert D; Garrett, Kennon M; Blair, Robert W

    2015-04-01

    Angina pectoris is cardiac pain that typically is manifested as referred pain to the chest and upper left arm. Atypical pain to describe localization of the perception, generally experienced more by women, is referred to the back, neck, and/or jaw. This article summarizes the neurophysiological and pharmacological mechanisms for referred cardiac pain. Spinal cardiac afferent fibers mediate typical anginal pain via pathways from the spinal cord to the thalamus and ultimately cerebral cortex. Spinal neurotransmission involves substance P, glutamate, and transient receptor potential vanilloid-1 (TRPV1) receptors; release of neurokinins such as nuclear factor kappa b (NF-kb) in the spinal cord can modulate neurotransmission. Vagal cardiac afferent fibers likely mediate atypical anginal pain and contribute to cardiac ischemia without accompanying pain via relays through the nucleus of the solitary tract and the C1-C2 spinal segments. The psychological state of an individual can modulate cardiac nociception via pathways involving the amygdala. Descending pathways originating from nucleus raphe magnus and the pons also can modulate cardiac nociception. Sensory input from other visceral organs can mimic cardiac pain due to convergence of this input with cardiac input onto spinothalamic tract neurons. Reduction of converging nociceptive input from the gallbladder and gastrointestinal tract can diminish cardiac pain. Much work remains to be performed to discern the interactions among complex neural pathways that ultimately produce or do not produce the sensations associated with cardiac pain.

  12. Optical control of cardiac cell excitability based on two-photon infrared absorption of AzoTAB

    CERN Document Server

    Shcherbakov, D; Erofeev, I; Astafiev, A

    2014-01-01

    Recent studies of AzoTAB activity in excitable cell cultures have shown that this substance is able to control excitability depending on isomer, cis or trans, predominating in the cellular membrane. Control of isomerization can be performed noninvasively by UV-visual radiation. At the same time it is well-known that azobenezenes can be effectively transformed from one isomer into another by two-photon absorption. Current work is devoted to the study of trans-AzoTAB two-photon transformation in aqueous solution and inside primal neonatal contractive rat cardiomyocytes. In accordance with results obtained Azo-TAB can be used as a probe for two-photon optical control of cardiac excitability.

  13. Algorithms based on CWT and classifiers to control cardiac alterations and stress using an ECG and a SCR.

    Science.gov (United States)

    Villarejo, María Viqueira; Zapirain, Begoña García; Zorrilla, Amaia Méndez

    2013-05-10

    This paper presents the results of using a commercial pulsimeter as an electrocardiogram (ECG) for wireless detection of cardiac alterations and stress levels for home control. For these purposes, signal processing techniques (Continuous Wavelet Transform (CWT) and J48) have been used, respectively. The designed algorithm analyses the ECG signal and is able to detect the heart rate (99.42%), arrhythmia (93.48%) and extrasystoles (99.29%). The detection of stress level is complemented with Skin Conductance Response (SCR), whose success is 94.02%. The heart rate variability does not show added value to the stress detection in this case. With this pulsimeter, it is possible to prevent and detect anomalies for a non-intrusive way associated to a telemedicine system. It is also possible to use it during physical activity due to the fact the CWT minimizes the motion artifacts.

  14. Correlation of CT-based regional cardiac function (SQUEEZ) with myocardial strain calculated from tagged MRI: an experimental study.

    Science.gov (United States)

    Pourmorteza, Amir; Chen, Marcus Y; van der Pals, Jesper; Arai, Andrew E; McVeigh, Elliot R

    2016-05-01

    The objective of this study was to investigate the correlation between local myocardial function estimates from CT and myocardial strain from tagged MRI in the same heart. Accurate detection of regional myocardial dysfunction can be an important finding in the diagnosis of functionally significant coronary artery disease. Tagged MRI is currently a reference standard for noninvasive regional myocardial function analysis; however, it has practical drawbacks. We have developed a CT imaging protocol and automated image analysis algorithm for estimating regional cardiac function from a few heartbeats. This method tracks the motion of the left ventricular (LV) endocardial surface to produce local function maps: we call the method Stretch Quantification of Endocardial Engraved Zones (SQUEEZ). Myocardial infarction was created by ligation of the left anterior descending coronary artery for 2 h followed by reperfusion in canine models. Tagged and cine MRI scans were performed during the reperfusion phase and first-pass contrast enhanced CT scans were acquired. The average delay between the CT and MRI scans was myocardial strain (Ecc) was calculated from the tagged MRI data. The agreement between peak systolic Ecc and SQUEEZ was investigated in 162 segments in the 9 hearts. Linear regression and Bland-Altman analysis was used to assess the correlation between the two metrics of local LV function. The results show good agreement between SQUEEZ and Ecc: (r = 0.71, slope = 0.78, p function. The good agreement between the estimates of local myocardial function obtained from CT SQUEEZ and tagged MRI provides encouragement to investigate the use of SQUEEZ for measuring regional cardiac function at a low clinical dose in humans.

  15. Simulations of the cardiac action potential based on the Hodgkin-Huxley kinetics with the use of Microsoft Excel spreadsheets.

    Science.gov (United States)

    Wu, Sheng-Nan

    2004-03-31

    The purpose of this study was to develop a method to simulate the cardiac action potential using a Microsoft Excel spreadsheet. The mathematical model contained voltage-gated ionic currents that were modeled using either Beeler-Reuter (B-R) or Luo-Rudy (L-R) phase 1 kinetics. The simulation protocol involves the use of in-cell formulas directly typed into a spreadsheet. The capability of spreadsheet iteration was used in these simulations. It does not require any prior knowledge of computer programming, although the use of the macro language can speed up the calculation. The normal configuration of the cardiac ventricular action potential can be well simulated in the B-R model that is defined by four individual ionic currents, each representing the diffusion of ions through channels in the membrane. The contribution of Na+ inward current to the rate of depolarization is reproduced in this model. After removal of Na+ current from the model, a constant current stimulus elicits an oscillatory change in membrane potential. In the L-R phase 1 model where six types of ionic currents were defined, the effect of extracellular K+ concentration on changes both in the time course of repolarization and in the time-independent K+ current can be demonstrated, when the solutions are implemented in Excel. Using the simulation protocols described here, the users can readily study and graphically display the underlying properties of ionic currents to see how changes in these properties determine the behavior of the heart cell. The method employed in these simulation protocols may also be extended or modified to other biological simulation programs.

  16. Establishment of a prediction model of changing trends in cardiac hypertrophy disease based on microarray data screening.

    Science.gov (United States)

    Ma, Caiyan; Ying, Yongjun; Zhang, Tianjie; Zhang, Wei; Peng, Hui; Cheng, Xufeng; Xu, Lin; Tong, Hong

    2016-05-01

    The aim of the present study was to construct a mathematical model to predict the changing trends of cardiac hypertrophy at gene level. Microarray data were downloaded from Gene Expression Omnibus database (accession, GSE21600), which included 35 samples harvested from the heart of Wistar rats on postoperative days 1 (D1 group), 6 (D6 group) and 42 (D42 group) following aorta ligation and sham operated Wistar rats, respectively. Each group contained six samples, with the exception of the samples harvested from the aorta ligated group after 6 days, where n=5. Differentially expressed genes (DEGs) were identified using a Limma package in R. Hierarchical clustering analysis was performed on common DEGs in order to construct a linear equation between the D1 and D42 groups, using linear discriminant analysis. Subsequent verification was performed using receiver operating characteristic (ROC) curve and the measurement data at day 42. A total of 319, 44 and 57 DEGs were detected in D1, D6 and D42 sample groups, respectively. AKIP1, ANKRD23, LTBP2, TGF-β2 and TNFRSF12A were identified as common DEGs in all groups. The predicted linear equation between D1 and D42 group was calculated to be y=1.526×-186.671. Assessment of the ROC curve demonstrated that the area under the curve was 0.831, with a specificity and sensitivity of 0.8. As compared with the predictive and measurement data at day 42, the consistency of the two sets of data was 76.5%. In conclusion, the present model may contribute to the early prediction of changing trends in cardiac hypertrophy disease at gene level.

  17. Child Care Centres.

    Science.gov (United States)

    Australian Dept. of Labour and National Service, Melbourne. Women's Bureau.

    Based on a survey of legislation relating to full-day care for preschool children of working mothers and a study of records, this report: (1) covers the number of registered child care centers in Australia and the number of children being served, (2) sets the conditions applying to registration of centers, (3) indicates the extent and levels of…

  18. Patient-centred Prevention among PAD Patients

    DEFF Research Database (Denmark)

    Pii, Kathrine Hoffmann

    2014-01-01

    Intro: This paper discusses a central professional dilemma in patient-centred education: on one hand the concern for ensuring patients autonomy and right to make their own decisions regarding their treatment and, on the other hand, a concern for getting patients to make the “right” decisions......-centredness is thus promoted as a way to organize health more effectively (in terms of cost and treatment outcomes) and as a way to ensure patients’ autonomy and fundamental right to make their own decisions regarding their treatment. Critical voices within social and nursing theory have however argued...... of a patient-centred prevention programme aimed at PAD patients, which includes medical treatment as well as individual nurse-led lifestyle-oriented conversations (inspired by psychological theory and methods such as Motivational Interviewing). Method: The findings are based on four months ethnographic field...

  19. Institutional profile: the London Centre for Nanotechnology.

    Science.gov (United States)

    Weston, David; Bontoux, Thierry

    2009-12-01

    Located in the London neighborhoods of Bloomsbury and South Kensington, the London Centre for Nanotechnology is a UK-based multidisciplinary research center that operates at the forefront of science and technology. It is a joint venture between two of the world's leading institutions, UCL and Imperial College London, uniting their strong capabilities in the disciplines that underpin nanotechnology: engineering, the physical sciences and biomedicine. The London Centre for Nanotechnology has a unique operating model that accesses and focuses the combined skills of the Departments of Chemistry, Physics, Materials, Medicine, Electrical and Electronic Engineering, Mechanical Engineering, Chemical Engineering, Biochemical Engineering and Earth Sciences across the two universities. It aims to provide the nanoscience and nanotechnology required to solve major problems in healthcare, information processing, energy and the environment.

  20. Emergency Centre Organization and Automated Triage System

    CERN Document Server

    Golding, Dan; Marwala, Tshilidzi

    2008-01-01

    The excessive rate of patients arriving at accident and emergency centres is a major problem facing South African hospitals. Patients are prioritized for medical care through a triage process. Manual systems allow for inconsistency and error. This paper proposes a novel system to automate accident and emergency centre triage and uses this triage score along with an artificial intelligence estimate of patient-doctor time to optimize the queue order. A fuzzy inference system is employed to triage patients and a similar system estimates the time but adapts continuously through fuzzy Q-learning. The optimal queue order is found using a novel procedure based on genetic algorithms. These components are integrated in a simple graphical user interface. Live tests could not be performed but simulations reveal that the average waiting time can be reduced by 48 minutes and priority is given to urgent patients

  1. [The development process of colon cancer centres].

    Science.gov (United States)

    Sahm, M; Wesselmann, S; Kube, R; Schöffel, N; Pross, M; Lippert, H; Kahl, S

    2013-02-01

    Colon carcinomas are the most common malignant tumours in the Western world. Important findings about the overall quality of medical care have been reported in multi-centre observational studies. A quality enhancement of therapeutic care can be achieved by an additional increase in diagnostic and therapeutic measures in the interdisciplinary setting. The development of colon cancer centres improves the chance to objectively observe the results of medical care induced by the development of an interdisciplinary and cross-sectoral unit that includes a comprehensive medical care for patients. The implementation of the current medical findings based on evidence in clinical routine, the inspection of the usage of guidelines by external specialists as part of an audit and the continuous correction of analysed deficits in the course of treatment guarantee a continuous improvement of service.

  2. 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.

  3. Non-cardiac QTc-prolonging drugs and the risk of sudden cardiac death

    NARCIS (Netherlands)

    Straus, SMJM; Sturkenboom, MCJM; Bleumink, GS; van der Lei, J; de Graeff, PA; Kingma, JH; Stricker, BHC

    2005-01-01

    Aims To assess the association between the use of non-cardiac QTc-prolonging drugs and the risk of sudden cardiac death. Methods and results A population-based case-control study was performed in the Integrated Primary Care Information (IPCI) project, a longitudinal observational database with compl

  4. Construction of the Wigner Data Centre

    CERN Document Server

    2013-01-01

    A remote extension of the CERN data centre has recently been inaugurated. Hosted at the Wigner Research Centre for Physics in Hungary, it provides extra computing power required to cover CERN’s needs. This video presents the construction of the Wigner Data Centre from initial demolishing work through to its completion and details the major technical characteristics of the Data Centre.

  5. The experience of work in a call centre environment

    Directory of Open Access Journals (Sweden)

    Sanet Hauptfleisch

    2006-02-01

    Full Text Available This qualitative research study explored the work experience in a call centre environment in an information technology call centre based in South Africa, which service foreign customers exclusively. Three data collection methods were used, namely narratives, in-depth interviews with call centre consultants, and observation. Following a grounded theory approach, four themes were elicited, namely the perceptions of team members, uncertainty created by a constantly changing environment, perceived distances due to management practices, and depersonalisation experienced while actually dealing with customers. In addition to this, the reported impact of these themes on work performance was explored and compared to existing research.

  6. Label-free detection of cardiac troponin-I using gold nanoparticles functionalized single-walled carbon nanotubes based chemiresistive biosensor

    Science.gov (United States)

    Rajesh, Sharma, Vikash; Puri, Nitin K.; Singh, Rajiv K.; Biradar, Ashok M.; Mulchanadani, Ashok

    2013-11-01

    We report a specific and ultrasensitive, label-free chemiresistive biosensor based on mercaptopropionic acid capped gold nanoparticles (GNP) functionalized single walled carbon nanotube (SWNT) hybrid for the detection of cardiac specific biomarker troponin-I (cTnI). GNPs were attached to SWNTs through a molecular linker 1-pyrenemethylamine. The highly specific cTnI antibody was covalently immobilized on GNPs through capping agent using carbodiimide coupling reaction. The cTnI interaction to its corresponding antibody was studied with respect to changes in conductance in SWNTs channel, and a detailed field-effect transistor characteristic was delineated. The device exhibited a linear response to cTnI from 0.01 to 10 ng ml-1.

  7. Field programmable gate array-based real-time optical Doppler tomography system for in vivo imaging of cardiac dynamics in the chick embryo

    DEFF Research Database (Denmark)

    Thrane, Lars; Larsen, Henning Engelbrecht; Norozi, Kambiz

    2009-01-01

    We demonstrate a field programmable gate-array-based real-time optical Doppler tomography system. A complex-valued bandpass filter is used for the first time in optical coherence tomography signal processing to create the analytic signal. This method simplifies the filter design, and allows...... efficient and compact implementation by combining the conversion to an analytic signal with a pulse shaping function without the need for extra resources as compared to the Hilbert transform method. The conversion of the analytic signal to amplitude and phase is done by use of the coordinate rotation...... digital computer (CORDIC) algorithm, which is an efficient algorithm that maps well to the field programmable gate array. Flow phantom experiments, and the use of this system for in vivo imaging of cardiac dynamics in the chick embryo, are presented. We demonstrate the visualization of blood flow...

  8. External cardiac compression may be harmful in some scenarios of pulseless electrical activity.

    LENUS (Irish Health Repository)

    Hogan, T S

    2012-10-01

    Pulseless electrical activity occurs when organised or semi-organised electrical activity of the heart persists but the product of systemic vascular resistance and the increase in systemic arterial flow generated by the ejection of the left venticular stroke volume is not sufficient to produce a clinically detectable pulse. Pulseless electrical activity encompasses a very heterogeneous variety of severe circulatory shock states ranging in severity from pseudo-cardiac arrest to effective cardiac arrest. Outcomes of cardiopulmonary resuscitation for pulseless electrical activity are generally poor. Impairment of cardiac filling is the limiting factor to cardiac output in many scenarios of pulseless electrical activity, including extreme vasodilatory shock states. There is no evidence that external cardiac compression can increase cardiac output when impaired cardiac filling is the limiting factor to cardiac output. If impaired cardiac filling is the limiting factor to cardiac output and the heart is effectively ejecting all the blood returning to it, then external cardiac compression can only increase cardiac output if it increases venous return and cardiac filling. Repeated cardiac compression asynchronous with the patient\\'s cardiac cycle and raised mean intrathoracic pressure due to chest compression can be expected to reduce rather than to increase cardiac filling and therefore to reduce rather than to increase cardiac output in such circumstances. The hypothesis is proposed that the performance of external cardiac compression will have zero or negative effect on cardiac output in pulseless electrical activity when impaired cardiac filling is the limiting factor to cardiac output. External cardiac compression may be both directly and indirectly harmful to significant sub-groups of patients with pulseless electrical activity. We have neither evidence nor theory to provide comfort that external cardiac compression is not harmful in many scenarios of pulseless

  9. External cardiac compression may be harmful in some scenarios of pulseless electrical activity.

    Science.gov (United States)

    Hogan, T S

    2012-10-01

    Pulseless electrical activity occurs when organised or semi-organised electrical activity of the heart persists but the product of systemic vascular resistance and the increase in systemic arterial flow generated by the ejection of the left venticular stroke volume is not sufficient to produce a clinically detectable pulse. Pulseless electrical activity encompasses a very heterogeneous variety of severe circulatory shock states ranging in severity from pseudo-cardiac arrest to effective cardiac arrest. Outcomes of cardiopulmonary resuscitation for pulseless electrical activity are generally poor. Impairment of cardiac filling is the limiting factor to cardiac output in many scenarios of pulseless electrical activity, including extreme vasodilatory shock states. There is no evidence that external cardiac compression can increase cardiac output when impaired cardiac filling is the limiting factor to cardiac output. If impaired cardiac filling is the limiting factor to cardiac output and the heart is effectively ejecting all the blood returning to it, then external cardiac compression can only increase cardiac output if it increases venous return and cardiac filling. Repeated cardiac compression asynchronous with the patient's cardiac cycle and raised mean intrathoracic pressure due to chest compression can be expected to reduce rather than to increase cardiac filling and therefore to reduce rather than to increase cardiac output in such circumstances. The hypothesis is proposed that the performance of external cardiac compression will have zero or negative effect on cardiac output in pulseless electrical activity when impaired cardiac filling is the limiting factor to cardiac output. External cardiac compression may be both directly and indirectly harmful to significant sub-groups of patients with pulseless electrical activity. We have neither evidence nor theory to provide comfort that external cardiac compression is not harmful in many scenarios of pulseless

  10. Big Surveys, Big Data Centres

    Science.gov (United States)

    Schade, D.

    2016-06-01

    Well-designed astronomical surveys are powerful and have consistently been keystones of scientific progress. The Byurakan Surveys using a Schmidt telescope with an objective prism produced a list of about 3000 UV-excess Markarian galaxies but these objects have stimulated an enormous amount of further study and appear in over 16,000 publications. The CFHT Legacy Surveys used a wide-field imager to cover thousands of square degrees and those surveys are mentioned in over 1100 publications since 2002. Both ground and space-based astronomy have been increasing their investments in survey work. Survey instrumentation strives toward fair samples and large sky coverage and therefore strives to produce massive datasets. Thus we are faced with the "big data" problem in astronomy. Survey datasets require specialized approaches to data management. Big data places additional challenging requirements for data management. If the term "big data" is defined as data collections that are too large to move then there are profound implications for the infrastructure that supports big data science. The current model of data centres is obsolete. In the era of big data the central problem is how to create architectures that effectively manage the relationship between data collections, networks, processing capabilities, and software, given the science requirements of the projects that need to be executed. A stand alone data silo cannot support big data science. I'll describe the current efforts of the Canadian community to deal with this situation and our successes and failures. I'll talk about how we are planning in the next decade to try to create a workable and adaptable solution to support big data science.

  11. Assessment on 900–1300 MWe PWRs of the ASTEC-based simulation tool of SGTR thermal-hydraulics for the IRSN Emergency Technical Centre

    Energy Technology Data Exchange (ETDEWEB)

    Foucher, L., E-mail: laurent.foucher@irsn.fr [Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSN-RES/SAG, Cadarache, Saint-Paul-lez-Durance 13115 (France); Cousin, F.; Fleurot, J. [Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSN-RES/SAG, Cadarache, Saint-Paul-lez-Durance 13115 (France); Brethes, S. [Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP-CRI/SESUC, Cadarache, Saint-Paul-lez-Durance 13115 (France)

    2014-06-01

    In the event of an accident occurring in a nuclear power plant (NPP), being able to predict the amount of released radioactive substances in the environment is of prime importance. Depending on the severity of the accident, it can be necessary to quickly and efficiently protect the population and the surrounding environment from the associated radiological consequences. In France, the IRSN Emergency Technical Centre provides a technical support in decision making in case of a nuclear accident. The main objectives are to evaluate and predict the plant behaviour and radioactive releases during the accident. Different types of complementary tools are used: expert assessments, pre-calculated databases, simulation tools, etc. In the case of Steam Generator Tube Rupture (SGTR) accidents that may lead to significant radioactive releases to the atmosphere through the steam generator relief valves, IRSN is currently improving the simulation tools for diagnosis in crisis management. The objective is to adapt the thermal-hydraulic and FP behaviour modules of the severe accident integral code ASTEC V2.0, jointly developed by IRSN and its German counterpart GRS, to crisis management requirements. These requirements impose a fast running, highly reliable (accurate physical results), flexible and simple tool. This paper summarizes the results of the benchmarks between the ASTEC V2.0 thermal-hydraulic module and the CATHARE 2 (V2.5) French reference thermal-hydraulics code on several SGTR scenarios both for PWR 900 and 1300 MWe, with a particular emphasis on the computational time and physical models assessment. The overall agreement between both codes is good on the primary and secondary circuit thermal-hydraulic parameters. Moreover, the reliability and fast computational time of the thermal-hydraulic module of ASTEC V2.0 code appeared very satisfactory and in accordance with the requirements of an emergency tool.

  12. Simulation of steady state and transient cardiac muscle response experiments with a Huxley-based contraction model.

    Science.gov (United States)

    Negroni, Jorge A; Lascano, Elena C

    2008-08-01

    A cardiac muscle model is presented with the purpose of representing a wide range of mechanical experiments at constant and transient Ca(2+) concentration. Modifications of a previous model were: weak and power attached crossbridge states, a troponin system involving three consecutive regulatory troponin-tropomyosin units acting together in Ca(2+) kinetics and detachment constants depending on crossbridge length. This model improved cooperativity (Hill coefficient close to 4) and the force-velocity relationship, and incorporated the representation of the four phases of muscle response to length and force steps, isotonic shortening and isosarcometric contractions, preserving previous satisfactory results. Moreover, experimentally reported effects, such as length dependence on Ca(2+) affinity, the decreased cooperativity at higher Ca(2+) concentrations, temperature effects on the stiffness-frequency relationship and the isometric internal shortening due to series elasticity, were obtained. In conclusion, the model is more comprehensive than a previous version because it is able to represent a wider variety of steady state experiments, the mechanical variables in twitches can be adequately related to intracellular Ca(2+), and all the simulations were performed with the same set of parameters.

  13. A High-Performance Fluorescence Immunoassay Based on the Relaxation of Quenching, Exemplified by Detection of Cardiac Troponin I

    Directory of Open Access Journals (Sweden)

    Seung-Wan Kim

    2016-05-01

    Full Text Available The intramolecular fluorescence self-quenching phenomenon is a major drawback in developing high-performance fluorometric biosensors which use common fluorophores as signal generators. We propose two strategies involving liberation of the fluorescent molecules by means of enzymatic fragmentation of protein or dehybridization of double-stranded DNA. In the former, bovine serum albumin (BSA was coupled with the fluorescent BODIPY dye (Red BSA, and then immobilized on a solid surface. When the insolubilized Red BSA was treated with proteinase K (10 units/mL for 30 min, the fluorescent signal was significantly increased (3.5-fold compared to the untreated control. In the second case, fluorophore-tagged DNA probes were linked to gold nanoparticles by hybridization with capture DNA strands densely immobilized on the surface. The quenched fluorescence signal was recovered (3.7-fold by thermal dehybridization, which was induced with light of a specific wavelength (e.g., 530 nm for less than 1 min. We next applied the Red BSA self-quenching relaxation technique employing enzymatic fragmentation to a high-performance immunoassay of cardiac troponin I (cTnI in a microtiter plate format. The detection limit was 0.19 ng/mL cTnI, and the fluorescent signal was enhanced approximately 4.1-fold compared with the conventional method of direct measurement of the fluorescent signal from a non-fragmented fluorophore-labeled antibody.

  14. A High-Performance Fluorescence Immunoassay Based on the Relaxation of Quenching, Exemplified by Detection of Cardiac Troponin I.

    Science.gov (United States)

    Kim, Seung-Wan; Cho, Il-Hoon; Park, Ji-Na; Seo, Sung-Min; Paek, Se-Hwan

    2016-01-01

    The intramolecular fluorescence self-quenching phenomenon is a major drawback in developing high-performance fluorometric biosensors which use common fluorophores as signal generators. We propose two strategies involving liberation of the fluorescent molecules by means of enzymatic fragmentation of protein or dehybridization of double-stranded DNA. In the former, bovine serum albumin (BSA) was coupled with the fluorescent BODIPY dye (Red BSA), and then immobilized on a solid surface. When the insolubilized Red BSA was treated with proteinase K (10 units/mL) for 30 min, the fluorescent signal was significantly increased (3.5-fold) compared to the untreated control. In the second case, fluorophore-tagged DNA probes were linked to gold nanoparticles by hybridization with capture DNA strands densely immobilized on the surface. The quenched fluorescence signal was recovered (3.7-fold) by thermal dehybridization, which was induced with light of a specific wavelength (e.g., 530 nm) for less than 1 min. We next applied the Red BSA self-quenching relaxation technique employing enzymatic fragmentation to a high-performance immunoassay of cardiac troponin I (cTnI) in a microtiter plate format. The detection limit was 0.19 ng/mL cTnI, and the fluorescent signal was enhanced approximately 4.1-fold compared with the conventional method of direct measurement of the fluorescent signal from a non-fragmented fluorophore-labeled antibody.

  15. Goal-directed fluid optimization based on stroke volume variation and cardiac index during one-lung ventilation in patients undergoing thoracoscopy lobectomy operations: a pilot study

    Directory of Open Access Journals (Sweden)

    Jian Zhang

    2013-07-01

    Full Text Available OBJECTIVES: This pilot study was designed to utilize stroke volume variation and cardiac index to ensure fluid optimization during one-lung ventilation in patients undergoing thoracoscopic lobectomies. METHODS: Eighty patients undergoing thoracoscopic lobectomy were randomized into either a goal-directed therapy group or a control group. In the goal-directed therapy group, the stroke volume variation was controlled at 10%±1%, and the cardiac index was controlled at a minimum of 2.5 L.min-1.m-2. In the control group, the MAP was maintained at between 65 mm Hg and 90 mm Hg, heart rate was maintained at between 60 BPM and 100 BPM, and urinary output was greater than 0.5 mL/kg-1/h-1. The hemodynamic variables, arterial blood gas analyses, total administered fluid volume and side effects were recorded. RESULTS: The PaO2/FiO2-ratio before the end of one-lung ventilation in the goal-directed therapy group was significantly higher than that of the control group, but there were no differences between the goal-directed therapy group and the control group for the PaO2/FiO2-ratio or other arterial blood gas analysis indices prior to anesthesia. The extubation time was significantly earlier in the goal-directed therapy group, but there was no difference in the length of hospital stay. Patients in the control group had greater urine volumes, and they were given greater colloid and overall fluid volumes. Nausea and vomiting were significantly reduced in the goal-directed therapy group. CONCLUSION: The results of this study demonstrated that an optimization protocol, based on stroke volume variation and cardiac index obtained with a FloTrac/Vigileo device, increased the PaO2/FiO2-ratio and reduced the overall fluid volume, intubation time and postoperative complications (nausea and vomiting in thoracic surgery patients requiring one-lung ventilation.

  16. 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.

  17. LDE centres: sprint or marathon?

    NARCIS (Netherlands)

    Bonger, S.; Van Rein, E.

    2015-01-01

    The aim of the Strategic Leiden-Delft-Erasmus Alliance, established by the three universities in 2012, was to improve research and education and competitiveness. Projects are intended to develop from the ground up, which led to the establishment of eight joint centres in 2013. A quick look around re

  18. Dynamic analysis of house price diffusion across Asian financial centres

    OpenAIRE

    Nanda, Anupam; Yeh, Jia-Huey

    2012-01-01

    The aim of this paper is to explore effects of macroeconomic variables on house prices and also, the lead-lag relationships of real estate markets to examine house price diffusion across Asian financial centres. The analysis is based on the Global Vector Auto-Regression (GVAR) model estimated using quarterly data for six Asian financial centres (Hong Kong, Tokyo, Seoul, Singapore, Taipei and Bangkok) from 1991Q1 to 2011Q2. The empirical results indicate that the global economic conditions pla...

  19. Glycaemic control and antidiabetic treatment trends in primary care centres in patients with type 2 diabetes mellitus during 2007–2013 in Catalonia: a population-based study

    Science.gov (United States)

    Mata-Cases, Manel; Franch-Nadal, Josep; Real, Jordi; Mauricio, Dídac

    2016-01-01

    Objectives To assess trends in prescribing practices of antidiabetic agents and glycaemic control in patients with type 2 diabetes mellitus (T2DM). Design Cross-sectional analysis using yearly clinical data and antidiabetic treatments prescribed obtained from an electronic population database. Setting Primary healthcare centres, including the entire population attended by the Institut Català de la Salut in Catalonia, Spain, from 2007 to 2013. Participants Patients aged 31–90 years with a diagnosis of T2DM. Results The number of registered patients with T2DM in the database was 257 072 in 2007, increasing up to 343 969 in 2013. The proportion of patients not pharmacologically treated decreased by 9.7% (95% CI −9.48% to −9.92%), while there was an increase in the percentage of patients on monotherapy (4.4% increase; 95% CI 4.16% to 4.64%), combination therapy (2.8% increase; 95% CI 2.58% to 3.02%), and insulin alone or in combination (increasing 2.5%; 95% CI 2.2% to 2.8%). The use of metformin and dipeptidyl peptidase-IV inhibitors increased gradually, while sulfonylureas, glitazones and α-glucosidase inhibitors decreased. The use of glinides remained stable, and the use of glucagon-like peptide-1 receptor agonists was still marginal. Regarding glycaemic control, there were no relevant differences across years: mean glycated haemoglobin (HbA1c) value was around 7.2%; the percentage of patients reaching an HbA1c≤7% target ranged between 52.2% and 55.6%; and those attaining their individualised target from 72.8% to 75.7%. Conclusions Although the proportion of patients under pharmacological treatment increased substantially over time and there was an increase in the use of combination therapies, there have not been relevant changes in glycaemic control during the 2007–2013 period in Catalonia. PMID:27707830

  20. Is levosimendan effective in paediatric heart failure and post-cardiac surgeries?

    Science.gov (United States)

    Angadi, Ullas; Westrope, Claire; Chowdhry, Mohammed F

    2013-10-01

    A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was 'do children with heart failure post-cardiac surgery undergoing treatment with levosimendan have an acceptable haemodynamic improvement?' The use of levosimendan as a vasoactive drug is an accepted intervention for patients with altered haemodynamics post-cardiac surgeries. However, the role of levosimendan and its efficacy have been debated. Eleven relevant papers were identified, which represented the best evidence to answer the question. The author, journal, date, country of publication and relevant outcomes are tabulated. The 11 studies comprised 3 randomized trials, 2 of which compared levosimendan and milrinone. A single-centre randomized study that included 40 infants showed that cardiac output (CO) and cardiac index (CI) increased overtime in the levosimendan group compared with the milrinone group. The significant interaction for CO (P = 0.005) and CI (P = 0.007) indicated different time courses in the two groups. A similar, European randomized study undertaken on neonates (n = 63) showed better lactate levels [P = 0.015 (intensive care admission); P = 0.048 (after 6 h) with low inotropic scores in the levosimendan group. Although the length of mechanical ventilation and mortality were less, this was statistically insignificant. A retrospective cohort analysis (n = 13) in children reported a reduced use of dobutamine and improvement in the ejection fraction from 29.8 to 40.5% (P = 0.015) with the use of levosimendan. In a questionnaire-based study from Finland, 61.1% of respondents felt that it had saved the lives of some children when the other treatments had failed. No study reported any adverse effect attributable to use of levosimendan. In conclusion, the above studies were in favour of levosimendan as a safe and feasible drug providing potential clinical benefit in low cardiac output syndrome (LCOS) and post-cardiac surgeries when

  1. The CCCB is a cultural centre, not a tourist centre

    Directory of Open Access Journals (Sweden)

    Elena Xirau

    2004-04-01

    Full Text Available Last February, Barcelona's Centre of Contemporary Culture (CCCB celebrated its first ten years in existence. During this time, this institution has looked to be a showcase to the most modern and innovative cultural expressions focused on reflecting on the concept of the city. In this interview, Josep Ramoneda offers his personal view, as the CCCB's director. He talks of how this cultural project was born, of how the concept of the institution took shape in the CCCB, of its relations with Barcelona's Strategic Plan, of how the project has evolved, of the architectural remodelling of the Casa de la Caritat building for its conversion into a cultural centre, of the relations with other institutions and its future.

  2. SU-E-J-134: Optimizing Technical Parameters for Using Atlas Based Automatic Segmentation for Evaluation of Contour Accuracy Experience with Cardiac Structures From NRG Oncology/RTOG 0617

    Energy Technology Data Exchange (ETDEWEB)

    Yu, J; Gong, Y; Bar-Ad, V; Giaddui, T; Galvin, J; Xiao, Y [Thomas Jefferson University, Philadelphia, PA (United States); Hu, C [NRG oncology, Philadelphia, PA (United States); Gore, E; Wheatley, M [Medical College of Wisconsin, Milwaukee, WI (United States); Witt, J; Robinson, C; Bradley, J [Washington University in St. Louis School of Medicine, St. Louis, MO (United States); Kong, F [Georgia Regents University, Augusta, GA (Georgia)

    2015-06-15

    Purpose: Accurate contour delineation is crucial for radiotherapy. Atlas based automatic segmentation tools can be used to increase the efficiency of contour accuracy evaluation. This study aims to optimize technical parameters utilized in the tool by exploring the impact of library size and atlas number on the accuracy of cardiac contour evaluation. Methods: Patient CT DICOMs from RTOG 0617 were used for this study. Five experienced physicians delineated the cardiac structures including pericardium, atria and ventricles following an atlas guideline. The consistency of cardiac structured delineation using the atlas guideline was verified by a study with four observers and seventeen patients. The CT and cardiac structure DICOM files were then used for the ABAS technique.To study the impact of library size (LS) and atlas number (AN) on automatic contour accuracy, automatic contours were generated with varied technique parameters for five randomly selected patients. Three LS (20, 60, and 100) were studied using commercially available software. The AN was four, recommended by the manufacturer. Using the manual contour as the gold standard, Dice Similarity Coefficient (DSC) was calculated between the manual and automatic contours. Five-patient averaged DSCs were calculated for comparison for each cardiac structure.In order to study the impact of AN, the LS was set 100, and AN was tested from one to five. The five-patient averaged DSCs were also calculated for each cardiac structure. Results: DSC values are highest when LS is 100 and AN is four. The DSC is 0.90±0.02 for pericardium, 0.75±0.06 for atria, and 0.86±0.02 for ventricles. Conclusion: By comparing DSC values, the combination AN=4 and LS=100 gives the best performance. This project was supported by NCI grants U24CA12014, U24CA180803, U10CA180868, U10CA180822, PA CURE grant and Bristol-Myers Squibb and Eli Lilly.

  3. Systems biology and cardiac arrhythmias.

    Science.gov (United States)

    Grace, Andrew A; Roden, Dan M

    2012-10-27

    During the past few years, the development of effective, empirical technologies for treatment of cardiac arrhythmias has exceeded the pace at which detailed knowledge of the underlying biology has accumulated. As a result, although some clinical arrhythmias can be cured with techniques such as catheter ablation, drug treatment and prediction of the risk of sudden death remain fairly primitive. The identification of key candidate genes for monogenic arrhythmia syndromes shows that to bring basic biology to the clinic is a powerful approach. Increasingly sophisticated experimental models and methods of measurement, including stem cell-based models of human cardiac arrhythmias, are being deployed to study how perturbations in several biologic pathways can result in an arrhythmia-prone heart. The biology of arrhythmia is largely quantifiable, which allows for systematic analysis that could transform treatment strategies that are often still empirical into management based on molecular evidence.

  4. Automated Segmentation of Cardiac Magnetic Resonance Images

    DEFF Research Database (Denmark)

    Stegmann, Mikkel Bille; Nilsson, Jens Chr.; Grønning, Bjørn A.

    2001-01-01

    is based on determination of the left-ventricular endocardial and epicardial borders. Since manual border detection is laborious, automated segmentation is highly desirable as a fast, objective and reproducible alternative. Automated segmentation will thus enhance comparability between and within cardiac...... studies and increase accuracy by allowing acquisition of thinner MRI-slices. This abstract demonstrates that statistical models of shape and appearance, namely the deformable models: Active Appearance Models, can successfully segment cardiac MRIs....

  5. Cardiac Procedures and Surgeries

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Cardiac Procedures and Surgeries Updated:Sep 16,2016 If you've had ... degree of coronary artery disease (CAD) you have. Cardiac Procedures and Surgeries Angioplasty Also known as Percutaneous Coronary Interventions [PCI], ...

  6. [Advances in cardiac pacing].

    Science.gov (United States)

    de Carranza, María-José Sancho-Tello; Fidalgo-Andrés, María Luisa; Ferrer, José Martínez; Mateas, Francisco Ruiz

    2012-01-01

    This article contains a review of the current status of remote monitoring and follow-up involving cardiac pacing devices and of the latest developments in cardiac resynchronization therapy. In addition, the most important articles published in the last year are discussed.

  7. 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...

  8. A relational conceptual framework for multidisciplinary health research centre infrastructure

    Directory of Open Access Journals (Sweden)

    Johnson Joy L

    2010-10-01

    Full Text Available Abstract Although multidisciplinary and team-based approaches are increasingly acknowledged as necessary to address some of the most pressing contemporary health challenges, many researchers struggle with a lack of infrastructure to facilitate and formalise the requisite collaborations. Specialised research centres have emerged as an important organisational solution, yet centre productivity and sustainability are frequently dictated by the availability and security of infrastructure funds. Despite being widely cited as a core component of research capacity building, infrastructure as a discrete concept has been rather analytically neglected, often treated as an implicit feature of research environments with little specification or relegated to a narrow category of physical or administrative inputs. The terms research infrastructure, capacity, and culture, among others, are deployed in overlapping and inconsistent ways, further obfuscating the crucial functions of infrastructure specifically and its relationships with associated concepts. The case is made for an expanded conceptualisation of research infrastructure, one that moves beyond conventional 'hardware' notions. Drawing on a case analysis of NEXUS, a multidisciplinary health research centre based at the University of British Columbia, Canada, a conceptual framework is proposed that integrates the tangible and intangible structures that interactively underlie research centre functioning. A relational approach holds potential to allow for more comprehensive accounting of the returns on infrastructure investment. For those developing new research centres or seeking to reinvigorate existing ones, this framework may be a useful guide for both centre design and evaluation.

  9. Preliminary experience on the implementation of computed tomography (CT)-based image guided brachytherapy (IGBT) of cervical cancer using high-dose-rate (HDR) Cobalt-60 source in University of Malaya Medical Centre (UMMC)

    Science.gov (United States)

    Jamalludin, Z.; Min, U. N.; Ishak, W. Z. Wan; Malik, R. Abdul

    2016-03-01

    This study presents our preliminary work of the computed tomography (CT) image guided brachytherapy (IGBT) implementation on cervical cancer patients. We developed a protocol in which patients undergo two Magnetic Resonance Imaging (MRI) examinations; a) prior to external beam radiotherapy (EBRT) and b) prior to intra-cavitary brachytherapy for tumour identification and delineation during IGBT planning and dosimetry. For each fraction, patients were simulated using CT simulator and images were transferred to the treatment planning system. The HR-CTV, IR-CTV, bladder and rectum were delineated on CT-based contouring for cervical cancer. Plans were optimised to achieve HR-CTV and IR-CTV dose (D90) of total EQD2 80Gy and 60Gy respectively, while limiting the minimum dose to the most irradiated 2cm3 volume (D2cc) of bladder and rectum to total EQD2 90Gy and 75Gy respectively. Data from seven insertions were analysed by comparing the volume-based with traditional point- based doses. Based on our data, there were differences between volume and point doses of HR- CTV, bladder and rectum organs. As the number of patients having the CT-based IGBT increases from day to day in our centre, it is expected that the treatment and dosimetry accuracy will be improved with the implementation.

  10. Biological Inspiration in Human Centred Robotics

    Institute of Scientific and Technical Information of China (English)

    HU Huo-sheng; LIU Jin-dong; Calderon Carlos A

    2004-01-01

    Human centred robotics (HCR) concerns with the development of various kinds of intelligent systems and robots that will be used in environments coexisting with humans. These systems and robots will be interactive and useful assistants/companions for people in different ages, situations, activities and environments in order to improve the quality of life. This paper presents the autors' current research work toward the development of advanced theory and technologies for HCR applications, based on inspiration from biological systems. More specifically, both bio-mimetic system modelling and robot learning by imitation are discussed respectively, and some preliminary results are demonstrated.

  11. The use of dialogue tools to promote dialogue-based and person-centred patient education for people with type 2 diabetes

    DEFF Research Database (Denmark)

    K. Jensen, Natasja; Pals, Regitze A. S.; Willaing, Ingrid

    2016-01-01

    Objectives: To explore educator experiences of implementing dialogue tools in practice to engender participatory patient education. Methods: Data were collected through qualitative interviews with 31 educators and 20 ethnographic observations of group-based education sessions at eight education s...

  12. Iterative deconvolution of simultaneous {sup 99m}Tc and {sup 201}Tl projection data measured on a CdZnTe-based cardiac SPECT scanner

    Energy Technology Data Exchange (ETDEWEB)

    Kacperski, Krzysztof; Erlandsson, Kjell; Ben-Haim, Simona; Hutton, Brian F, E-mail: k.kacperski@zfm.coi.pl [Institute of Nuclear Medicine, University College London, London (United Kingdom)

    2011-03-07

    We present a method of correcting self-scatter and crosstalk effects in simultaneous technetium-99m/thallium-201 stress/rest myocardial perfusion (single photon emission computed tomography) SPECT scans. The method, which is in essence a hybrid between the triple energy window method and scatter modelling, is based on a model of spatial and spectral distribution of projection counts in several selected energy windows. The parameters of the model are determined from measurements of thin rod sources in air when no in-object scatter or attenuation effects are present. The model equations are solved using the iterative maximum likelihood expectation maximization algorithm in the projection space to find estimates of the primary photopeak counts of both radionuclides. The method has been developed particularly for a novel dedicated cardiac camera based on CdZnTe pixellated detectors, although it can also be adapted to a conventional scintillator camera. The method has been validated in anthropomorphic phantom experiments. Significant improvement in defect contrast has been observed with only moderate increase in image noise. The application of the method to patient data is illustrated.

  13. Iterative deconvolution of simultaneous 99mTc and 201Tl projection data measured on a CdZnTe-based cardiac SPECT scanner

    Science.gov (United States)

    Kacperski, Krzysztof; Erlandsson, Kjell; Ben-Haim, Simona; Hutton, Brian F.

    2011-03-01

    We present a method of correcting self-scatter and crosstalk effects in simultaneous technetium-99m/thallium-201 stress/rest myocardial perfusion (single photon emission computed tomography) SPECT scans. The method, which is in essence a hybrid between the triple energy window method and scatter modelling, is based on a model of spatial and spectral distribution of projection counts in several selected energy windows. The parameters of the model are determined from measurements of thin rod sources in air when no in-object scatter or attenuation effects are present. The model equations are solved using the iterative maximum likelihood expectation maximization algorithm in the projection space to find estimates of the primary photopeak counts of both radionuclides. The method has been developed particularly for a novel dedicated cardiac camera based on CdZnTe pixellated detectors, although it can also be adapted to a conventional scintillator camera. The method has been validated in anthropomorphic phantom experiments. Significant improvement in defect contrast has been observed with only moderate increase in image noise. The application of the method to patient data is illustrated.

  14. Flipping the advanced cardiac life support classroom with team-based learning: comparison of cognitive testing performance for medical students at the University of California, Irvine, United States

    Directory of Open Access Journals (Sweden)

    Megan Boysen-Osborn

    2016-02-01

    Full Text Available Purpose: It aimed to find if written test results improved for advanced cardiac life support (ACLS taught in flipped classroom/team-based Learning (FC/TBL vs. lecture-based (LB control in University of California-Irvine School of Medicine, USA. Methods: Medical students took 2010 ACLS with FC/TBL (2015, compared to 3 classes in LB (2012-14 format. There were 27.5 hours of instruction for FC/TBL model (TBL 10.5, podcasts 9, small-group simulation 8 hours, and 20 (12 lecture, simulation 8 hours in LB. TBL covered 13 cardiac cases; LB had none. Seven simulation cases and didactic content were the same by lecture (2012-14 or podcast (2015 as was testing: 50 multiple-choice questions (MCQ, 20 rhythm matchings, and 7 fill-in clinical cases. Results: 354 students took the course (259 [73.1%] in LB in 2012-14, and 95 [26.9%] in FC/TBL in 2015. Two of 3 tests (MCQ and fill-in improved for FC/TBL. Overall, median scores increased from 93.5% (IQR 90.6, 95.4 to 95.1% (92.8, 96.7, P=0.0001. For the fill-in test: 94.1% for LB (89.6, 97.2 to 96.6% for FC/TBL (92.4, 99.20 P=0.0001. For MC: 88% for LB (84, 92 to 90% for FC/TBL (86, 94, P=0.0002. For the rhythm test: median 100% for both formats. More students failed 1 of 3 tests with LB vs. FC/TBL (24.7% vs. 14.7%, and 2 or 3 components (8.1% vs. 3.2%, P=0.006. Conversely, 82.1% passed all 3 with FC/TBL vs. 67.2% with LB (difference 14.9%, 95% CI 4.8-24.0%. Conclusion: A FC/TBL format for ACLS marginally improved written test results.

  15. Flipping the advanced cardiac life support classroom with team-based learning: comparison of cognitive testing performance for medical students at the University of California, Irvine, United State

    Science.gov (United States)

    2016-01-01

    Purpose: It aimed to find if written test results improved for advanced cardiac life support (ACLS) taught in flipped classroom/team-based Learning (FC/TBL) vs. lecture-based (LB) control in University of California-Irvine School of Medicine, USA. Methods: Medical students took 2010 ACLS with FC/TBL (2015), compared to 3 classes in LB (2012-14) format. There were 27.5 hours of instruction for FC/TBL model (TBL 10.5, podcasts 9, small-group simulation 8 hours), and 20 (12 lecture, simulation 8 hours) in LB. TBL covered 13 cardiac cases; LB had none. Seven simulation cases and didactic content were the same by lecture (2012-14) or podcast (2015) as was testing: 50 multiple-choice questions (MCQ), 20 rhythm matchings, and 7 fill-in clinical cases. Results: 354 students took the course (259 [73.1%] in LB in 2012-14, and 95 [26.9%] in FC/TBL in 2015). Two of 3 tests (MCQ and fill-in) improved for FC/TBL. Overall, median scores increased from 93.5% (IQR 90.6, 95.4) to 95.1% (92.8, 96.7, P=0.0001). For the fill-in test: 94.1% for LB (89.6, 97.2) to 96.6% for FC/TBL (92.4, 99.20 P=0.0001). For MC: 88% for LB (84, 92) to 90% for FC/TBL (86, 94, P=0.0002). For the rhythm test: median 100% for both formats. More students failed 1 of 3 tests with LB vs. FC/TBL (24.7% vs. 14.7%), and 2 or 3 components (8.1% vs. 3.2%, P=0.006). Conversely, 82.1% passed all 3 with FC/TBL vs. 67.2% with LB (difference 14.9%, 95% CI 4.8-24.0%). Conclusion: A FC/TBL format for ACLS marginally improved written test results. PMID:26893399

  16. Cardiac tumors: echo assessment.

    Science.gov (United States)

    Mankad, Rekha; Herrmann, Joerg

    2016-12-01

    Cardiac tumors are exceedingly rare (0.001-0.03% in most autopsy series). They can be present anywhere within the heart and can be attached to any surface or be embedded in the myocardium or pericardial space. Signs and symptoms are nonspecific and highly variable related to the localization, size and composition of the cardiac mass. Echocardiography, typically performed for another indication, may be the first imaging modality alerting the clinician to the presence of a cardiac mass. Although echocardiography cannot give the histopathology, certain imaging features and adjunctive tools such as contrast imaging may aid in the differential diagnosis as do the adjunctive clinical data and the following principles: (1) thrombus or vegetations are the most likely etiology, (2) cardiac tumors are mostly secondary and (3) primary cardiac tumors are mostly benign. Although the finding of a cardiac mass on echocardiography may generate confusion, a stepwise approach may serve well practically. Herein, we will review such an approach and the role of echocardiography in the assessment of cardiac masses.

  17. Fully automated intrinsic respiratory and cardiac gating for small animal CT

    Energy Technology Data Exchange (ETDEWEB)

    Kuntz, J; Baeuerle, T; Semmler, W; Bartling, S H [Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg (Germany); Dinkel, J [Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Zwick, S [Department of Diagnostic Radiology, Medical Physics, Freiburg University (Germany); Grasruck, M [Siemens Healthcare, Forchheim (Germany); Kiessling, F [Chair of Experimental Molecular Imaging, RWTH-Aachen University, Medical Faculty, Aachen (Germany); Gupta, R [Department of Radiology, Massachusetts General Hospital, Boston, MA (United States)], E-mail: j.kuntz@dkfz.de

    2010-04-07

    A fully automated, intrinsic gating algorithm for small animal cone-beam CT is described and evaluated. A parameter representing the organ motion, derived from the raw projection images, is used for both cardiac and respiratory gating. The proposed algorithm makes it possible to reconstruct motion-corrected still images as well as to generate four-dimensional (4D) datasets representing the cardiac and pulmonary anatomy of free-breathing animals without the use of electrocardiogram (ECG) or respiratory sensors. Variation analysis of projections from several rotations is used to place a region of interest (ROI) on the diaphragm. The ROI is cranially extended to include the heart. The centre of mass (COM) variation within this ROI, the filtered frequency response and the local maxima are used to derive a binary motion-gating parameter for phase-sensitive gated reconstruction. This algorithm was implemented on a flat-panel-based cone-beam CT scanner and evaluated using a moving phantom and animal scans (seven rats and eight mice). Volumes were determined using a semiautomatic segmentation. In all cases robust gating signals could be obtained. The maximum volume error in phantom studies was less than 6%. By utilizing extrinsic gating via externally placed cardiac and respiratory sensors, the functional parameters (e.g. cardiac ejection fraction) and image quality were equivalent to this current gold standard. This algorithm obviates the necessity of both gating hardware and user interaction. The simplicity of the proposed algorithm enables adoption in a wide range of small animal cone-beam CT scanners.

  18. Occupational therapy in hospital based care in the Netherlands: a comparison of occupational therapy in general care (nursing homes, rehabilitation centres and general hospitals) and psychiatric care.

    NARCIS (Netherlands)

    Driessen, M.J.; Dekker, J.; Zee, J. van der; Lankhorst, G.

    1996-01-01

    The case of a 26-year old woman with Chronic Fatigue Syndrome (CFS) is presented. Multidimensional assessment showing severe debilitating fatigue and considerable psychological, social and occupational impairment confirmed the diagnosis. Cognitive behavior therapy (CBT) was based on a tested causal

  19. Measuring Gender (In)Equality: Introducing the Gender, Institutions and Development Data Base (GID). OECD Development Centre Working Paper No. 247

    Science.gov (United States)

    Jutting, Johannes P.; Morrisson, Christian; Dayton-Johnson, Jeff; Drechsler, Denis

    2006-01-01

    Efforts to establish, test and analyse hypotheses regarding cross-country variations in women's economic status are hampered by the lack of a readily accessible and easily used information resource on the various dimensions of gender inequality. Addressing this gap, this paper introduces the Gender, Institutions and Development data base (GID)…

  20. Respiratory gating in cardiac PET

    DEFF Research Database (Denmark)

    Lassen, Martin Lyngby; Rasmussen, Thomas; Christensen, Thomas E

    2016-01-01

    of our study was to compare the resulting imaging quality by the use of a time-based respiratory gating system in two groups administered either adenosine or dipyridamole as the pharmacological stress agent. METHODS AND RESULTS: Forty-eight patients were randomized to adenosine or dipyridamole cardiac...... stress (82)RB-PET. Respiratory rates and depths were measured by a respiratory gating system in addition to registering actual respiratory rates. Patients undergoing adenosine stress showed a decrease in measured respiratory rate from initial to later scan phase measurements [12.4 (±5.7) vs 5.6 (±4......BACKGROUND: Respiratory motion due to breathing during cardiac positron emission tomography (PET) results in spatial blurring and erroneous tracer quantification. Respiratory gating might represent a solution by dividing the PET coincidence dataset into smaller respiratory phase subsets. The aim...

  1. Women Labour in Call Centres: Understanding Characteristics of Work

    Directory of Open Access Journals (Sweden)

    Gulten Dursun

    2014-07-01

    Full Text Available This paper is concerned with the work experiences of women employees in info-service-based offices as telephone call centres. Call centres have grown rapidly in Tur-key in recent years, creating a large number of new jobs. In particular, it is concerned with the question of whether call centre jobs are offering women new opportunities for career progression, or whether a more common bias is taking place in which women are being drawn into highly routinized jobs. The collection of data was carried out so-urcing a heterogeneous plurality of instruments. Our research confirms that work pro-cesses in call centres are close association of surveillance technologies (technologic panoptican, exploitation and high levels of discipline, highly repetitive and heavily mo-nitored, and that the association with the assembly line and Taylorism have dominated much of the rhetoric on call centres. In addition, we have observed that, the structure of women’s employment in the call centre industry tends to polarise.

  2. Left-handed surgical instruments - a guide for cardiac surgeons.

    Science.gov (United States)

    Burdett, Clare; Theakston, Maureen; Dunning, Joel; Goodwin, Andrew; Kendall, Simon William Henry

    2016-08-19

    For ease of use and to aid precision, left-handed instruments are invaluable to the left-handed surgeon. Although they exist, they are not available in many surgical centres. As a result, most operating theatre staff (including many left-handers) have little knowledge of their value or even application. With specific reference to cardiac surgery, this article addresses the ways in which they differ, why they are needed and what is required - with tips on use.

  3. Multi-atlas-based segmentation with local decision fusion--application to cardiac and aortic segmentation in CT scans.

    NARCIS (Netherlands)

    Isgum, I.; Staring, M.; Rutten, A.; Prokop, M.; Viergever, M.A.; Ginneken, B. van

    2009-01-01

    A novel atlas-based segmentation approach based on the combination of multiple registrations is presented. Multiple atlases are registered to a target image. To obtain a segmentation of the target, labels of the atlas images are propagated to it. The propagated labels are combined by spatially varyi

  4. Mesenchymal Stem Cells as a Biological Drug for Heart Disease: Where Are We With Cardiac Cell-Based Therapy?

    Science.gov (United States)

    Sanina, Cristina; Hare, Joshua M

    2015-07-17

    Cell-based treatment represents a new generation in the evolution of biological therapeutics. A prototypic cell-based therapy, the mesenchymal stem cell, has successfully entered phase III pivotal trials for heart failure, signifying adequate enabling safety and efficacy data from phase I and II trials. Successful phase III trials can lead to approval of a new biological therapy for regenerative medicine.

  5. Development of a competency-based formative progress test with student-generated MCQs: Results from a multi-centre pilot study

    Directory of Open Access Journals (Sweden)

    Wagener, Stefan

    2015-10-01

    Full Text Available Introduction: Progress tests provide students feedback on their level of proficiency over the course of their medical studies. Peer-assisted learning and competency-based education have become increasingly important in medical education. Although progress tests have been proven to be useful as a longitudinal feedback instrument, there are currently no progress tests that have been created in cooperation with students or that focus on competency in medical education.In this study, we investigated the extent to which students can be included in the development of a progress test and demonstrated that aspects of knowledge related to competency can be represented on a competency-based progress test.Methods: A two-dimensional blueprint for 144 multiple-choice questions (MCQs covering groups of medical subjects and groups of competency areas was generated by three expert groups for developing the competency-based progress test. A total of 31 students from seven medical schools in Germany actively participated in this exercise. After completing an intensive and comprehensive training programme, the students generated and reviewed the test questions for the competency-based progress test using a separate platform of the ItemManagementSystem (IMS. This test was administered as a formative test to 469 students in a pilot study in November 2013 at eight medical schools in Germany. The scores were analysed for the overall test and differentiated according to the subject groups and competency areas.Results: A pool of more than 200 MCQs was compiled by the students for pilot use, of which 118 student-generated MCQs were used in the progress test. University instructors supplemented this pool with 26 MCQs, which primarily addressed the area of scientific skills. The post-review showed that student-generated MCQs were of high quality with regard to test statistic criteria and content. Overall, the progress test displayed a very high reliability. When the

  6. Molecular Basis of Cardiac Myxomas

    Directory of Open Access Journals (Sweden)

    Pooja Singhal

    2014-01-01

    Full Text Available Cardiac tumors are rare, and of these, primary cardiac tumors are even rarer. Metastatic cardiac tumors are about 100 times more common than the primary tumors. About 90% of primary cardiac tumors are benign, and of these the most common are cardiac myxomas. Approximately 12% of primary cardiac tumors are completely asymptomatic while others present with one or more signs and symptoms of the classical triad of hemodynamic changes due to intracardiac obstruction, embolism and nonspecific constitutional symptoms. Echocardiography is highly sensitive and specific in detecting cardiac tumors. Other helpful investigations are chest X-rays, magnetic resonance imaging and computerized tomography scan. Surgical excision is the treatment of choice for primary cardiac tumors and is usually associated with a good prognosis. This review article will focus on the general features of benign cardiac tumors with an emphasis on cardiac myxomas and their molecular basis.

  7. Management based on exhaled nitric oxide levels adjusted for atopy reduces asthma exacerbations in children: A dual centre randomized controlled trial.

    Science.gov (United States)

    Petsky, Helen L; Li, Albert M; Au, Chun T; Kynaston, Jennifer A; Turner, Catherine; Chang, Anne B

    2015-06-01

    While several randomized control trials (RCTs) have evaluated the use of fractional exhaled nitric oxide (FeNO) to improve asthma outcomes, none used FeNO cut-offs adjusted for atopy, a determinant of FeNO levels. In a dual center RCT, we assessed whether a treatment strategy based on FeNO levels, adjusted for atopy, reduces asthma exacerbations compared with the symptoms-based management (controls). Children with asthma from hospital clinics of two hospitals were randomly allocated to receive an a-priori determined treatment hierarchy based on symptoms or FeNO levels. There was a 2-week run-in period and they were then reviewed 10 times over 12-months. The primary outcome was the number of children with exacerbations over 12-months. Sixty-three children were randomized (FeNO = 31, controls = 32); 55 (86%) completed the study. Although we did achieve our planned sample size, significantly fewer children in the FeNO group (6 of 27) had an asthma exacerbation compared to controls (15 of 28), P = 0.021; number to treat for benefit = 4 (95% CI 3-24). There was no difference between groups for any secondary outcomes (quality of life, symptoms, FEV1 ). The final daily inhaled corticosteroids (ICS) dose was significantly (P = 0.037) higher in the FeNO group (median 400 µg, IQR 250-600) compared to the controls (200, IQR100-400). Taking atopy into account when using FeNO to tailor asthma medications is likely beneficial in reducing the number of children with severe exacerbations at the expense of increased ICS use. However, the strategy is unlikely beneficial for improving asthma control. A larger study is required to confirm or refute our findings.

  8. Generation of bioartificial heart tissue by combining a three-dimensional gel-based cardiac construct with decellularized small intestinal submucosa.

    Science.gov (United States)

    Vukadinovic-Nikolic, Zlata; Andrée, Birgit; Dorfman, Suzanne E; Pflaum, Michael; Horvath, Tibor; Lux, Marco; Venturini, Letizia; Bär, Antonia; Kensah, George; Lara, Angelica Roa; Tudorache, Igor; Cebotari, Serghei; Hilfiker-Kleiner, Denise; Haverich, Axel; Hilfiker, Andres

    2014-02-01

    The in vitro generation of a bioartificial cardiac construct (CC) represents a promising tool for the repair of ischemic heart tissue. Several approaches to engineer cardiac tissue in vitro have been conducted. The main drawback of these studies is the insufficient size of the resulting construct for clinical applications. The focus of this study was the generation of an artificial three-dimensional (3D), contractile, and suturable myocardial patch by combining a gel-based CC with decellularized porcine small intestinal submucosa (SIS), thereby engineering an artificial tissue of 11 cm² in size. The alignment and morphology of rat neonatal cardiomyocytes (rCMs) in SIS-CC complexes were investigated as well as the re-organization of primary endothelial cells which were co-isolated in the rCM preparation. The ability of a rat heart endothelial cell line (RHE-A) to re-cellularize pre-existing vessel structures within the SIS or a biological vascularized matrix (BioVaM) was determined. SIS-CC contracted spontaneously, uniformly, and rhythmically with an average rate of 200 beats/min in contrast to undirected contractions observed in CC without SIS support. rCM exhibited an elongated morphology with well-defined sarcomeric structures oriented along the longitudinal axis in the SIS-CC, whereas round-shaped and random-arranged rCM were observed in CC. Electric coupling of rCM was demonstrated by microelectrode array measurements. A dense network of CD31⁺/eNOS⁺ cells was detected as permeating the whole construct. Superficial supplementation of RHE-A cells to SIS-CC led to the migration of these cells through the CC, resulting in the re-population of pre-existing vessel structures within the decelluarized SIS. By infusion of RHE-A cells into the BioVaM venous and arterial pedicles, a re-population of the BioVaM vessel bed as well as distribution of RHE-A cells throughout the CC was achieved. Rat endothelial cells within the CC were in contact with RHE-A cells

  9. High resolution three-dimensional cardiac perfusion imaging using compartment-based k-t principal component analysis

    DEFF Research Database (Denmark)

    Vitanis, Viton; Manka, Robert; Giese, Daniel;

    2011-01-01

    -t principal component analysis reconstructions. Comparison of the two methods based on rest and stress three-dimensional perfusion data acquired with 2.3 × 2.3 × 10 mm(3) during a 225 msec acquisition window in patients confirms the findings and demonstrates the potential of compartment-based k-t principal...... permits three-dimensional perfusion imaging at 10-fold nominal acceleration. Using numerical simulations, it is shown that the compartment-based method results in accurate representations of dynamic signal intensity changes with significant improvements of temporal fidelity in comparison to conventional k...

  10. Research projects of the Finnish Centre for Radiation and Nuclear Safety 1996-1997; Saeteilyturvakeskuksen tutkimushankkeet 1996-1997

    Energy Technology Data Exchange (ETDEWEB)

    Mustonen, R.; Koponen, H. [eds.

    1996-02-01

    The research activities of the Finnish Centre for Radiation and Nuclear Safety (STUK) are based on the Centre`s primary task of preventing and restricting adverse effects of radiation. As a rule, studies concerning nuclear safety (part 1 of the publication) are studies originating from the regulatory function of STUK; these are directed and funded by the Centre but the Centre does not carry them out itself. In contrast, studies dealing with radiation exposure and health risks (part 2 of the publication) are conducted by the Centre itself, often in cooperation with some other research institute or university. Results of these studies are published in open scientific literature.

  11. Feasibility and Acceptability of Utilizing a Smartphone Based Application to Monitor Outpatient Discharge Instruction Compliance in Cardiac Disease Patients around Discharge from Hospitalization

    Directory of Open Access Journals (Sweden)

    Aimee M. Layton

    2014-01-01

    Full Text Available The purpose of this study was to determine the feasibility and acceptability of utilizing a smartphone based application to monitor compliance in patients with cardiac disease around discharge. For 60 days after discharge, patients’ medication compliance, physical activity, follow-up care, symptoms, and reading of education material were monitored daily with the application. 16 patients were enrolled in the study (12 males, 4 females, age 55 ± 18 years during their hospital stay. Five participants were rehospitalized during the study and did not use the application once discharged. Seven participants completed 1–30 days and four patients completed >31 days. For those 11 patients, medication reminders were utilized 37% (1–30-day group and 53% (>31-day group of the time, education material was read 44% (1–30 and 53% (>31 of the time, and physical activity was reported 25% (1–30 and 42% (>31 of the time. Findings demonstrated that patients with stable health utilized the application, even if only minimally. Patients with decreased breath sounds by physical exam and who reported their health as fair to poor on the day of discharge were less likely to utilize the application. Acceptability of the application to report health status varied among the stable patients.

  12. Scheduling participants of Assessment Centres

    DEFF Research Database (Denmark)

    Lysgaard, Jens; Løber, Janni

      Assessment Centres are used as a tool for psychologists and coaches to observe a number of dimensions in a person's behaviour and test his/her potential within a number of chosen focus areas. This is done in an intense course, with a number of different exercises which expose each participant......'s ability level in the chosen focus areas. The participants are observed by assessors with the purpose of gathering material for reaching a conclusion on each participant's personal profile. We consider the particular case that arises at the company Human Equity (www.humanequity.dk), where Assessment...

  13. Cardiac Tumors; Tumeurs cardiaques

    Energy Technology Data Exchange (ETDEWEB)

    Laissy, J.P.; Fernandez, P. [Centre Hospitalier Universitaire Bichat Claude Bernard, Service d' Imagerie, 76 - Rouen (France); Mousseaux, E. [Hopital Europeen Georges Pompidou (HEGP), Service de Radiologie Cardio Vasculaire et Interventionnelle, 75 - Paris (France); Dacher, J.N. [Centre Hospitalier Universitaire Charles Nicolle, 75 - Rouen (France); Crochet, D. [Centre Hospitalier Universitaire, Hopital Laennec, Centre Hemodynamique, Radiologie Thoracique et Vasculaire, 44 - Nantes (France)

    2004-04-01

    Metastases are the most frequent tumors of the heart even though they seldom are recognized. Most primary cardiac tumors are benign. The main role of imaging is to differentiate a cardiac tumor from thrombus and rare pseudo-tumors: tuberculoma, hydatid cyst. Echocardiography is the fist line imaging technique to detect cardiac tumors, but CT and MRl arc useful for further characterization and differential diagnosis. Myxoma of the left atrium is the most frequent benign cardiac tumor. It usually is pedunculated and sometimes calcified. Sarcoma is the most frequent primary malignant tumor and usually presents as a sessile infiltrative tumor. Lymphoma and metastases are usually recognized by the presence of known tumor elsewhere of by characteristic direct contiguous involvement. Diagnosing primary and secondary pericardial tumors often is difficult. Imaging is valuable for diagnosis, characterization, pre-surgical evaluation and follow-up. (author)

  14. 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...

  15. Multi-atlas-based segmentation with local decision fusion--application to cardiac and aortic segmentation in CT scans.

    Science.gov (United States)

    Isgum, Ivana; Staring, Marius; Rutten, Annemarieke; Prokop, Mathias; Viergever, Max A; van Ginneken, Bram

    2009-07-01

    A novel atlas-based segmentation approach based on the combination of multiple registrations is presented. Multiple atlases are registered to a target image. To obtain a segmentation of the target, labels of the atlas images are propagated to it. The propagated labels are combined by spatially varying decision fusion weights. These weights are derived from local assessment of the registration success. Furthermore, an atlas selection procedure is proposed that is equivalent to sequential forward selection from statistical pattern recognition theory. The proposed method is compared to three existing atlas-based segmentation approaches, namely 1) single atlas-based segmentation, 2) average-shape atlas-based segmentation, and 3) multi-atlas-based segmentation with averaging as decision fusion. These methods were tested on the segmentation of the heart and the aorta in computed tomography scans of the thorax. The results show that the proposed method outperforms other methods and yields results very close to those of an independent human observer. Moreover, the additional atlas selection step led to a faster segmentation at a comparable performance.

  16. Prevalence and risk factors for vitamin C deficiency in north and south India: a two centre population based study in people aged 60 years and over.

    Directory of Open Access Journals (Sweden)

    Ravilla D Ravindran

    Full Text Available BACKGROUND: Studies from the UK and North America have reported vitamin C deficiency in around 1 in 5 men and 1 in 9 women in low income groups. There are few data on vitamin C deficiency in resource poor countries. OBJECTIVES: To investigate the prevalence of vitamin C deficiency in India. DESIGN: We carried out a population-based cross-sectional survey in two areas of north and south India. Randomly sampled clusters were enumerated to identify people aged 60 and over. Participants (75% response rate were interviewed for tobacco, alcohol, cooking fuel use, 24 hour diet recall and underwent anthropometry and blood collection. Vitamin C was measured using an enzyme-based assay in plasma stabilized with metaphosphoric acid. We categorised vitamin C status as deficient (28 µmol/L. We investigated factors associated with vitamin C deficiency using multivariable Poisson regression. RESULTS: The age, sex and season standardized prevalence of vitamin C deficiency was 73.9% (95% confidence Interval, CI 70.4,77.5 in 2668 people in north India and 45.7% (95% CI 42.5,48.9 in 2970 from south India. Only 10.8% in the north and 25.9% in the south met the criteria for adequate levels. Vitamin C deficiency varied by season, and was more prevalent in men, with increasing age, users of tobacco and biomass fuels, in those with anthropometric indicators of poor nutrition and with lower intakes of dietary vitamin C. CONCLUSIONS: In poor communities, such as in our study, consideration needs to be given to measures to improve the consumption of vitamin C rich foods and to discourage the use of tobacco.

  17. Role of Circulating Fibrocytes in Cardiac Fibrosis

    Institute of Scientific and Technical Information of China (English)

    Rong-Jie Lin; Zi-Zhuo Su; Shu-Min Liang; Yu-Yang Chen; Xiao-Rong Shu; Ru-Qiong Nie; Jing-Feng Wang

    2016-01-01

    Objective: It is revealed that circulating fibrocytes are elevated in patients/animals with cardiac fibrosis, and this review aims to provide an introduction to circulating fibrocytes and their role in cardiac fibrosis.Data Sources: This review is based on the data from 1994 to present obtained from PubMed.The search terms were "circulating fibrocytes" and "cardiac fibrosis".Study Selection: Articles and critical reviews, which are related to circulating fibrocytes and cardiac fibrosis, were selected.Results: Circulating fibrocytes, which are derived from hematopoietic stem cells, represent a subset of peripheral blood mononuclear cells exhibiting mixed morphological and molecular characteristics ofhematopoietic and mesenchymal cells (CD34+/CD45+/collagen I+).They can produce extracellular matrix and many cytokines.It is shown that circulating fibrocytes participate in many fibrotic diseases, including cardiac fibrosis.Evidence accumulated in recent years shows that aging individuals and patients with hypertension, heart failure, coronary heart disease, and atrial fibrillation have more circulating fibrocytes in peripheral blood and/or heart tissue, and this elevation of circulating fibrocytes is correlated with the degree of fibrosis in the hearts.Conclusions: Circulating fibrocytes are effector cells in cardiac fibrosis.

  18. Surface Electrocardiogram Predictors of Sudden Cardiac Arrest

    Science.gov (United States)

    Abdelghani, Samy A.; Rosenthal, Todd M.; Morin, Daniel P.

    2016-01-01

    Background: Heart disease is a major cause of death in industrialized nations, with approximately 50% of these deaths attributable to sudden cardiac arrest. If patients at high risk for sudden cardiac arrest can be identified, their odds of surviving fatal arrhythmias can be significantly improved through prophylactic implantable cardioverter defibrillator placement. This review summarizes the current knowledge pertaining to surface electrocardiogram (ECG) predictors of sudden cardiac arrest. Methods: We conducted a literature review focused on methods of predicting sudden cardiac arrest through noninvasive electrocardiographic testing. Results: Several electrocardiographic-based methods of risk stratification of sudden cardiac arrest have been studied, including QT prolongation, QRS duration, fragmented QRS complexes, early repolarization, Holter monitoring, heart rate variability, heart rate turbulence, signal-averaged ECG, T wave alternans, and T-peak to T-end. These ECG findings have shown variable effectiveness as screening tools. Conclusion: At this time, no individual ECG finding has been found to be able to adequately stratify patients with regard to risk for sudden cardiac arrest. However, one or more of these candidate surface ECG parameters may become useful components of future multifactorial risk stratification calculators. PMID:27660578

  19. Stem cells for cardiac repair: an introduction

    Institute of Scientific and Technical Information of China (English)

    Bastiaan C du Pr(e); Pieter A Doevendans; Linda W van Laake

    2013-01-01

    Cardiovascular disease is a major cause of morbidity and mortality throughout the world. Most cardiovascular diseases, such as ischemic heart disease and cardiomyopathy, are associated with loss of functional cardiomyocytes. Unfortunately, the heart has a limited regenerative capacity and is not able to replace these cardiomyocytes once lost. In recent years, stem cells have been put forward as a potential source for cardiac regeneration. Pre-clinical studies that use stem cell-derived cardiac cells show promising results. The mechanisms, though, are not well understood, results have been variable, sometimes transient in the long term, and often without a mechanistic explanation. There are still several major hurdles to be taken. Stem cell-derived cardiac cells should resemble original cardiac cell types and be able to integrate in the damaged heart. Integration requires administration of stem cell-derived cardiac cells at the right time using the right mode of delivery. Once delivered, transplanted cells need vascularization, electrophysiological coupling with the injured heart, and prevention of immunological rejection. Finally, stem cell therapy needs to be safe, reproducible, and affordable. In this review, we will give an introduction to the principles of stem cell based cardiac repair.

  20. Stem cell sources for cardiac regeneration.

    Science.gov (United States)

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

    2008-03-01

    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 cardiomyocytes to ameliorate the injured myocardium, compensate for the loss of ventricular mass and contractility and eventually restore cardiac function. An array of cell types has been explored in this respect, including skeletal muscle, bone marrow derived stem cells, embryonic stem cells (ESC) and more recently cardiac progenitor cells. The best-studied cell types are mouse and human ESC cells, which have undisputedly been demonstrated to differentiate into cardiomyocyte and vascular lineages and have been of great help to understand the differentiation process of pluripotent cells. However, due to their immunogenicity, risk of tumor development and the ethical challenge arising from their embryonic origin, they do not provide a suitable cell source for a regenerative therapy approach. A better option, overcoming ethical and allogenicity problems, seems to be provided by bone marrow derived cells and by the recently identified cardiac precursors. This report will overview current knowledge on these different cell types and their application in cardiac regeneration and address issues like implementation of delivery methods, including tissue engineering approaches that need to be developed alongside.

  1. Role of Circulating Fibrocytes in Cardiac Fibrosis

    Science.gov (United States)

    Lin, Rong-Jie; Su, Zi-Zhuo; Liang, Shu-Min; Chen, Yu-Yang; Shu, Xiao-Rong; Nie, Ru-Qiong; Wang, Jing-Feng; Xie, Shuang-Lun

    2016-01-01

    Objective: It is revealed that circulating fibrocytes are elevated in patients/animals with cardiac fibrosis, and this review aims to provide an introduction to circulating fibrocytes and their role in cardiac fibrosis. Data Sources: This review is based on the data from 1994 to present obtained from PubMed. The search terms were “circulating fibrocytes” and “cardiac fibrosis”. Study Selection: Articles and critical reviews, which are related to circulating fibrocytes and cardiac fibrosis, were selected. Results: Circulating fibrocytes, which are derived from hematopoietic stem cells, represent a subset of peripheral blood mononuclear cells exhibiting mixed morphological and molecular characteristics of hematopoietic and mesenchymal cells (CD34+/CD45+/collagen I+). They can produce extracellular matrix and many cytokines. It is shown that circulating fibrocytes participate in many fibrotic diseases, including cardiac fibrosis. Evidence accumulated in recent years shows that aging individuals and patients with hypertension, heart failure, coronary heart disease, and atrial fibrillation have more circulating fibrocytes in peripheral blood and/or heart tissue, and this elevation of circulating fibrocytes is correlated with the degree of fibrosis in the hearts. Conclusions: Circulating fibrocytes are effector cells in cardiac fibrosis. PMID:26831236

  2. Cardiac imaging in adults

    Energy Technology Data Exchange (ETDEWEB)

    Jaffe, C.C.

    1987-01-01

    This book approaches adult cardiac disease from the correlative imaging perspective. It includes chest X-rays and angiographs, 2-dimensional echocardiograms with explanatory diagrams for clarity, plus details on digital radiology, nuclear medicine techniques, CT and MRI. It also covers the normal heart, valvular heart disease, myocardial disease, pericardial disease, bacterial endocarditis, aortic aneurysm, cardiac tumors, and congenital heart disease of the adult. It points out those aspects where one imaging technique has significant superiority.

  3. 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.

  4. Post cardiac injury syndrome

    DEFF Research Database (Denmark)

    Nielsen, S L; Nielsen, F E

    1991-01-01

    The post-pericardiotomy syndrome is a symptom complex which is similar in many respects to the post-myocardial infarction syndrome and these are summarized under the diagnosis of the Post Cardiac Injury Syndrome (PCIS). This condition, which is observed most frequently after open heart surgery, i...... on the coronary vessels, with cardiac tamponade and chronic pericardial exudate. In the lighter cases, PCIS may be treated with NSAID and, in the more severe cases, with systemic glucocorticoid which has a prompt effect....

  5. Autonomic cardiac innervation

    OpenAIRE

    Hasan, Wohaib

    2013-01-01

    Autonomic cardiac neurons have a common origin in the neural crest but undergo distinct developmental differentiation as they mature toward their adult phenotype. Progenitor cells respond to repulsive cues during migration, followed by differentiation cues from paracrine sources that promote neurochemistry and differentiation. When autonomic axons start to innervate cardiac tissue, neurotrophic factors from vascular tissue are essential for maintenance of neurons before they reach their targe...

  6. 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

  7. Neighbourhood Centres – Organisation, Management and Finance

    DEFF Research Database (Denmark)

    Larsen, Jacob Norvig

    public subsidy. Some of the centres have high number of users on a daily basis, whereas others are only rarely used. It is explored how organisation, management and financial set-up differs among the centres. Quantitative data on financial issues and annual accounts of fifteen centres were analysed......From the late 1990s neighbourhood centres were brought to the fore of public urban regen-eration policy, because they were seen as a means to accelerate the formation of social capital in deprived urban neighbourhoods. A number of such local community centres were established with substantial...... to identify different financial models and analyse economic sustainability. As regards organisational and management models data were collected through documentary sources and by means of personal interviews and field visits to ten centres. Even within the analysed limited population of centres economic...

  8. 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.

  9. Driver-centred vehicle automation: using network analysis for agent-based modelling of the driver in highly automated driving systems.

    Science.gov (United States)

    Banks, Victoria A; Stanton, Neville A

    2016-11-01

    To the average driver, the concept of automation in driving infers that they can become completely 'hands and feet free'. This is a common misconception, however, one that has been shown through the application of Network Analysis to new Cruise Assist technologies that may feature on our roads by 2020. Through the adoption of a Systems Theoretic approach, this paper introduces the concept of driver-initiated automation which reflects the role of the driver in highly automated driving systems. Using a combination of traditional task analysis and the application of quantitative network metrics, this agent-based modelling paper shows how the role of the driver remains an integral part of the driving system implicating the need for designers to ensure they are provided with the tools necessary to remain actively in-the-loop despite giving increasing opportunities to delegate their control to the automated subsystems. Practitioner Summary: This paper describes and analyses a driver-initiated command and control system of automation using representations afforded by task and social networks to understand how drivers remain actively involved in the task. A network analysis of different driver commands suggests that such a strategy does maintain the driver in the control loop.

  10. Improvement of cardiac contractile function by peptide-based inhibition of NF-κB in the utrophin/dystrophin-deficient murine model of muscular dystrophy

    Directory of Open Access Journals (Sweden)

    Guttridge Denis C

    2011-05-01

    Full Text Available Abstract Background Duchenne muscular dystrophy (DMD is an inherited and progressive disease causing striated muscle deterioration. Patients in their twenties generally die from either respiratory or cardiac failure. In order to improve the lifespan and quality of life of DMD patients, it is important to prevent or reverse the progressive loss of contractile function of the heart. Recent studies by our labs have shown that the peptide NBD (Nemo Binding Domain, targeted at blunting Nuclear Factor κB (NF-κB signaling, reduces inflammation, enhances myofiber regeneration, and improves contractile deficits in the diaphragm in dystrophin-deficient mdx mice. Methods To assess whether cardiac function in addition to diaphragm function can be improved, we investigated physiological and histological parameters of cardiac muscle in mice deficient for both dystrophin and its homolog utrophin (double knockout = dko mice treated with NBD peptide. These dko mice show classic pathophysiological hallmarks of heart failure, including myocyte degeneration, an impaired force-frequency response and a severely blunted β-adrenergic response. Cardiac contractile function at baseline and frequencies and pre-loads throughout the in vivo range as well as β-adrenergic reserve was measured in isolated cardiac muscle preparations. In addition, we studied histopathological and inflammatory markers in these mice. Results At baseline conditions, active force development in cardiac muscles from NBD treated dko mice was more than double that of vehicle-treated dko mice. NBD treatment also significantly improved frequency-dependent behavior of the muscles. The increase in force in NBD-treated dko muscles to β-adrenergic stimulation was robustly restored compared to vehicle-treated mice. However, histological features, including collagen content and inflammatory markers were not significantly different between NBD-treated and vehicle-treated dko mice. Conclusions We conclude

  11. The new AMS control centre

    CERN Multimedia

    Anaïs Schaeffer

    2011-01-01

    Construction work for the future AMS control room began in November 2010 and should be finished this June. The new building, which will have been completed in record time thanks to the professionalism of the project team, will soon be ready to receive the initial data from the AMS experiment.     Luigi Scibile and Michael Poehler, from the GS department, at the AMS control centre construction site.   The Alpha Magnetic Spectrometer (AMS) is due to wing its way towards the International Space Station (ISS) on board the shuttle Discovery in April. Mainly intended for research on antimatter and dark matter, the data collected by AMS will be sent to Houston in the United States and then directly to CERN’s new Building 946. Construction work for the AMS control centre building on the Route Gentner at CERN’s Prévessin site started in November 2010 and must be completed in time to receive the first data from the spectrometer in June. “It normall...

  12. Facilitating needs based cancer care for people with a chronic disease: Evaluation of an intervention using a multi-centre interrupted time series design

    Directory of Open Access Journals (Sweden)

    Sibbritt David

    2010-01-01

    Full Text Available Abstract Background Palliative care should be provided according to the individual needs of the patient, caregiver and family, so that the type and level of care provided, as well as the setting in which it is delivered, are dependent on the complexity and severity of individual needs, rather than prognosis or diagnosis 1. This paper presents a study designed to assess the feasibility and efficacy of an intervention to assist in the allocation of palliative care resources according to need, within the context of a population of people with advanced cancer. Methods/design People with advanced cancer and their caregivers completed bi-monthly telephone interviews over a period of up to 18 months to assess unmet needs, anxiety and depression, quality of life, satisfaction with care and service utilisation. The intervention, introduced after at least two baseline phone interviews, involved a training medical, nursing and allied health professionals at each recruitment site on the use of the Palliative Care Needs Assessment Guidelines and the Needs Assessment Tool: Progressive Disease - Cancer (NAT: PD-C; b health professionals completing the NAT: PD-C with participating patients approximately monthly for the rest of the study period. Changes in outcomes will be compared pre-and post-intervention. Discussion The study will determine whether the routine, systematic and regular use of the Guidelines and NAT: PD-C in a range of clinical settings is a feasible and effective strategy for facilitating the timely provision of needs based care. Trials registration ISRCTN21699701

  13. Korean guidelines for the appropriate use of cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Jin [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul(Korea, Republic of); Yong, Hwan Seok [Dept. of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul(Korea, Republic of); Kim, Sung Mok [Dept. of Radiology, amsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Jung A [Dept. of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of); Hong, Yoo Jin [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2015-04-15

    The development of cardiac CT has provided a non-invasive alternative to echocardiography, exercise electrocardiogram, and invasive angiography and cardiac CT continues to develop at an exponential speed even now. The appropriate use of cardiac CT may lead to improvements in the medical performances of physicians and can reduce medical costs which eventually contribute to better public health. However, until now, there has been no guideline regarding the appropriate use of cardiac CT in Korea. We intend to provide guidelines for the appropriate use of cardiac CT in heart diseases based on scientific data. The purpose of this guideline is to assist clinicians and other health professionals in the use of cardiac CT for diagnosis and treatment of heart diseases, especially in patients at high risk or suspected of heart disease.

  14. Comparison of traditional advanced cardiac life support (ACLS) course instruction vs. a scenario-based, performance oriented team instruction (SPOTI) method for Korean paramedic students.

    Science.gov (United States)

    Lee, Christopher C; Im, Mark; Kim, Tae Min; Stapleton, Edward R; Kim, Kyuseok; Suh, Gil Joon; Singer, Adam J; Henry, Mark C

    2010-01-01

    Current Advanced Cardiac Life Support (ACLS) course instruction involves a 2-day course with traditional lectures and limited team interaction. We wish to explore the advantages of a scenario-based performance-oriented team instruction (SPOTI) method to implement core ACLS skills for non-English-speaking international paramedic students. The objective of this study was to determine if scenario-based, performance-oriented team instruction (SPOTI) improves educational outcomes for the ACLS instruction of Korean paramedic students. Thirty Korean paramedic students were randomly selected into two groups. One group of 15 students was taught the traditional ACLS course. The other 15 students were instructed using a SPOTI method. Each group was tested using ACLS megacode examinations endorsed by the American Heart Association. All 30 students passed the ACLS megacode examination. In the traditional ACLS study group an average of 85% of the core skills were met. In the SPOTI study group an average of 93% of the core skills were met. In particular, the SPOTI study group excelled at physical examination skills such as airway opening, assessment of breathing, signs of circulation, and compression rates. In addition, the SPOTI group performed with higher marks on rhythm recognition compared to the traditional group. The traditional group performed with higher marks at providing proper drug dosages compared to the SPOTI students. However, the students enrolled in the SPOTI method resulted in higher megacode core compliance scores compared to students trained in traditional ACLS course instruction. These differences did not achieve statistical significance due to the small sample size.

  15. Efficient generation of human embryonic stem cell-derived cardiac progenitors based on tissue-specific enhanced green fluorescence protein expression.

    Science.gov (United States)

    Szebényi, Kornélia; Péntek, Adrienn; Erdei, Zsuzsa; Várady, György; Orbán, Tamás I; Sarkadi, Balázs; Apáti, Ágota

    2015-01-01

    Cardiac progenitor cells (CPCs) are committed to the cardiac lineage but retain their proliferative capacity before becoming quiescent mature cardiomyocytes (CMs). In medical therapy and research, the use of human pluripotent stem cell-derived CPCs would have several advantages compared with mature CMs, as the progenitors show better engraftment into existing heart tissues, and provide unique potential for cardiovascular developmental as well as for pharmacological studies. Here, we demonstrate that the CAG promoter-driven enhanced green fluorescence protein (EGFP) reporter system enables the identification and isolation of embryonic stem cell-derived CPCs. Tracing of CPCs during differentiation confirmed up-regulation of surface markers, previously described to identify cardiac precursors and early CMs. Isolated CPCs express cardiac lineage-specific transcripts, still have proliferating capacity, and can be re-aggregated into embryoid body-like structures (CAG-EGFP(high) rEBs). Expression of troponin T and NKX2.5 mRNA is up-regulated in long-term cultured CAG-EGFP(high) rEBs, in which more than 90% of the cells become Troponin I positive mature CMs. Moreover, about one third of the CAG-EGFP(high) rEBs show spontaneous contractions. The method described here provides a powerful tool to generate expandable cultures of pure human CPCs that can be used for exploring early markers of the cardiac lineage, as well as for drug screening or tissue engineering applications.

  16. [Psychosomatic aspects of cardiac arrhythmias].

    Science.gov (United States)

    Siepmann, Martin; Kirch, Wilhelm

    2010-07-01

    Emotional stress facilitates the occurrence of cardiac arrhythmias including sudden cardiac death. The prevalence of anxiety and depression is increased in cardiac patients as compared to the normal population. The risk of cardiovascular mortality is enhanced in patients suffering from depression. Comorbid anxiety disorders worsen the course of cardiac arrhythmias. Disturbance of neurocardiac regulation with predominance of the sympathetic tone is hypothesized to be causative for this. The emotional reaction to cardiac arrhythmias is differing to a large extent between individuals. Emotional stress may result from coping with treatment of cardiac arrhythmias. Emotional stress and cardiac arrhythmias may influence each other in the sense of a vicious circle. Somatoform cardiac arrhythmias are predominantly of psychogenic origin. Instrumental measures and frequent contacts between physicians and patients may facilitate disease chronification. The present review is dealing with the multifaceted relationships between cardiac arrhythmias and emotional stress. The underlying mechanisms and corresponding treatment modalities are discussed.

  17. High prevalence of cardiac involvement in patients with myotonic dystrophy type 1

    DEFF Research Database (Denmark)

    Petri, Helle; Witting, Nanna; Ersbøll, Mads Kristian;

    2014-01-01

    .02). CONCLUSION: The cardiac phenotype of DM1 includes a high prevalence of conduction disorders, arrhythmias and risk factors of SCD. Systematic cardiac screening with ECG, Holter-monitoring and echocardiography is needed in order to make a proper characterization of cardiac involvement in DM1....... of controls. Thus, the optimal strategy for assessing cardiac involvement in DM1 is unclear. METHOD: In this large single-centre study, we evaluated 129 unselected DM1 patients (49.6% men), mean (SD) age 44 (14.7) years with family history, physical examination, electrocardiogram (ECG), echocardiography......, Holter-monitoring and muscle strength testing. RESULTS: Cardiac involvement was found in 71 patients (55%) and included: 1) Conduction abnormalities: atrio-ventricular block grade I (AVB grade I) (23.6%), AVB grade II (5.6%), right/left bundle branch block (5.5/3.2%) and prolonged QTc (7.2%); 2...

  18. Assessing health centre systems for guiding improvement in diabetes care

    Directory of Open Access Journals (Sweden)

    Robinson Gary

    2005-08-01

    Full Text Available Abstract Background Aboriginal people in Australia experience the highest prevalence of diabetes in the country, an excess of preventable complications and early death. There is increasing evidence demonstrating the importance of healthcare systems for improvement of chronic illness care. The aims of this study were to assess the status of systems for chronic illness care in Aboriginal community health centres, and to explore whether more developed systems were associated with better quality of diabetes care. Methods This cross-sectional study was conducted in 12 Aboriginal community health centres in the Northern Territory of Australia. Assessment of Chronic Illness Care scale was adapted to measure system development in health centres, and administered by interview with health centre staff and managers. Based on a random sample of 295 clinical records from attending clients with diagnosed type 2 diabetes, processes of diabetes care were measured by rating of health service delivery against best-practice guidelines. Intermediate outcomes included the control of HbA1c, blood pressure, and total cholesterol. Results Health centre systems were in the low to mid-range of development and had distinct areas of strength and weakness. Four of the six system components were independently associated with quality of diabetes care: an increase of 1 unit of score for organisational influence, community linkages, and clinical information systems, respectively, was associated with 4.3%, 3.8%, and 4.5% improvement in adherence to process standards; likewise, organisational influence, delivery system design and clinical information systems were related to control of HbA1c, blood pressure, and total cholesterol. Conclusion The state of development of health centre systems is reflected in quality of care outcome measures for patients. The health centre systems assessment tool should be useful in assessing and guiding development of systems for improvement of

  19. AN EXPERIENCE OF FACILITY-BASED MANAGEMENT OF SEVERE ACUTE MALNUTRITION IN CHILDREN AGED BETWEEN 0-59 MONTHS ADOPTING THE WORLD HEALTH ORGANIZATION RECOMMENDATIONS AT NUTRITION REHABILITATION CENTRE, ANANTHAPURAMU

    Directory of Open Access Journals (Sweden)

    Praveen Deen Kumar

    2016-04-01

    Full Text Available BACKGROUND Severe Acute Malnutrition (SAM increases significantly the risk of death in children under five years of age. It can be an indirect cause of child death by increasing the case fatality rate in children suffering from common illness such as diarrhoea, pneumonia. AIMS The aim of this study is to know the effectiveness of facility based management of children with Severe Acute Malnutrition at Nutrition Rehabilitation Centres (NRCs. SETTINGS AND DESIGN The study was done in the Department of Paediatrics, Government General Hospital at Ananthapuramu as a prospective observational study. METHODS AND MATERIALS A total of 195 patients were selected under Severe Acute Malnutrition as per WHO Child Growth Standards by observing for bilateral pitting oedema and/or MUAC _15% admission weight, while 50 (32.7% did not attain target weight gain (non-recovered. CONCLUSION This study will help to improve the functional activities of NRCs. Conducting audits after such studies will aid in implementation of newer guidelines, which will enhance the functional outcome of NRCs. Such NRCs will greatly help to reduce the under-five child mortality rate.

  20. Terrestrial and aquatic baseline study and monitoring programme for CO2 Technology Centre Mongstad

    OpenAIRE

    Grung, Merete; Garmo, Øyvind; Myking, Tor; Øyen, Bernt-Håvard; Blom, Hans H.; Ranneklev, Sissel; Wright, Richard Frederic; Heegaard, Einar; Schei, Fride Høistad

    2012-01-01

    CO2 Technology Centre Mongstad will be the world’s largest test centre for testing and development of CO2 capture technology. The emissions to the atmosphere from CO2 Technology Centre Mongstad contain amines and may in addition contain or lead to the formation of degradation products from amine-based CO2 capture technology. An environmental baseline survey was conducted in 2011 prior to the operation. The survey performed is broad, and describes in detail the environmental situation both in ...

  1. Gains from child-centred Early Childhood Education: Evidence from a Dutch pilot programme

    OpenAIRE

    Bauchmüller, R.

    2012-01-01

    Early Childhood Education (ECE) programmes are presumed to have positive effects in particular for children who are at risk of failing during their school careers. However, there is disagreement on whether such programmes should be more teacher and curriculum based or rather centred on the individual child. In this paper I study child-centred ECE programmes that are used at preschools in the Dutch province of Limburg, which is in fact mainly a study of 'Speelplezier', a new child-centred prog...

  2. Referring patients for consideration of device treatment of sudden cardiac death and heart failure: incorporating evidence-based therapies within the Canadian health care system.

    Science.gov (United States)

    Gillis, Anne M

    2005-05-01

    The growing use of the implantable cardioverter defibrillator (ICD) in Canada reflects the impact that primary and secondary prevention trials have had in demonstrating the superiority of the ICD over medical therapy in the prevention of sudden cardiac death in high-risk populations. Currently, there are significant regional disparities in ICD implantation in Canada. These disparities may reflect a lack of regional ICD implant and follow-up programs, and capping of funding for ICDs. In addition to increased funding for ICD systems, more resources are required to perform device implantations and follow patients over the long-term. Potentially eligible patients should be referred to an electrophysiologist for consideration of ICD therapy for the prevention of sudden cardiac death or to an electrophysiologist/ heart failure specialist for the consideration of combination cardiac resynchronization and ICD therapy for the management of refractory heart failure.

  3. Paediatric cardiac intensive care unit: current setting and organization in 2010.

    Science.gov (United States)

    Fraisse, Alain; Le Bel, Stéphane; Mas, Bertrand; Macrae, Duncan

    2010-10-01

    Over recent decades, specialized paediatric cardiac intensive care has emerged as a central component in the management of critically ill, neonatal, paediatric and adult patients with congenital and acquired heart disease. The majority of high-volume centres (dealing with over 300 surgical cases per year) have dedicated paediatric cardiac intensive care units, with the smallest programmes more likely to care for paediatric cardiac patients in mixed paediatric or adult intensive care units. Specialized nursing staff are also a crucial presence at the patient's bedside for quality of care. A paediatric cardiac intensive care programme should have patients (preoperative and postoperative) grouped together geographically, and should provide proximity to the operating theatre, catheterization laboratory and radiology department, as well as to the regular ward. Age-appropriate medical equipment must be provided. An optimal strategy for running a paediatric cardiac intensive care programme should include: multidisciplinary collaboration and involvement with paediatric cardiology, anaesthesia, cardiac surgery and many other subspecialties; a risk-stratification strategy for quantifying perioperative risk; a personalized patient approach; and anticipatory care. Finally, progressive withdrawal from heavy paediatric cardiac intensive care management should be institutionalized. Although the countries of the European Union do not share any common legislation on the structure and organization of paediatric intensive care or paediatric cardiac intensive care, any paediatric cardiac surgery programme in France that is agreed by the French Health Ministry must perform at least '150 major procedures per year in children' and must provide a 'specialized paediatric intensive care unit'.

  4. Powering the Future Data Centre

    DEFF Research Database (Denmark)

    Zhang, Zhe

    2010-01-01

    . Considering the input impendence of fuel cell and super-cap, the small-signal stability of cascaded converter is analyzed. The system small-signal model is rebuilt and controllers for current loop and voltage loop are designed to obtain good transient performance. Through analysis and synthesis......The extended run Uninterruptible Power Supply system (UPSs) which powered by fuel cells and supercapcitors, is a promising solution for future data centre to obtain environmentfriendly energy efficient and cost effective. There are many challenges in power electronic interface circuits, because...... of the characteristics of these two power sources: long warm-up stage and low dynamics for fuel cell, and variable terminal voltage for supercapacitors. The motivation for this project was to find ways which can overcome those limitations to integrate fuel cells and supercapcitors to the system with high efficiency...

  5. Cardiac radiology: centenary review.

    Science.gov (United States)

    de Roos, Albert; Higgins, Charles B

    2014-11-01

    During the past century, cardiac imaging technologies have revolutionized the diagnosis and treatment of acquired and congenital heart disease. Many important contributions to the field of cardiac imaging were initially reported in Radiology. The field developed from the early stages of cardiac imaging, including the use of coronary x-ray angiography and roentgen kymography, to nowadays the widely used echocardiographic, nuclear medicine, cardiac computed tomographic (CT), and magnetic resonance (MR) applications. It is surprising how many of these techniques were not recognized for their potential during their early inception. Some techniques were described in the literature but required many years to enter the clinical arena and presently continue to expand in terms of clinical application. The application of various CT and MR contrast agents for the diagnosis of myocardial ischemia is a case in point, as the utility of contrast agents continues to expand the noninvasive characterization of myocardium. The history of cardiac imaging has included a continuous process of advances in our understanding of the anatomy and physiology of the cardiovascular system, along with advances in imaging technology that continue to the present day.

  6. Attention! Cardiac tamponade may be caused by underlying Castleman's disease.

    Science.gov (United States)

    Atay, Hilmi; Kelkitli, Engin; Okuyucu, Muhammed; Yildiz, Levent; Turgut, Mehmet

    2015-05-01

    Castleman's disease is a rarely observed lymphoproliferative disease. In the literature, various signs and symptoms of the disease have been reported; one of these is secondary cardiac tamponade. We describe the case of a 41-year-old man who developed cardiac tamponade during examination, and who was later diagnosed with Castleman's disease, based on his lymph node biopsies.

  7. Cardiac monitoring in patients with syncope: making that elusive diagnosis.

    Science.gov (United States)

    Subbiah, Rajesh; Chia, Pow-Li; Gula, Lorne J; Klein, George J; Skanes, Allan C; Yee, Raymond; Krahn, Andrew D

    2013-11-01

    Elucidating the cause of syncope is often a diagnostic challenge. At present, there is a myriad of ambulatory cardiac monitoring modalities available for recording cardiac rhythm during spontaneous symptoms. We provide a comprehensive review of these devices and discuss strategies on how to reach the elusive diagnosis based on current evidencebased recommendations.

  8. Serum long-chain n-3 polyunsaturated fatty acids, mercury, and risk of sudden cardiac death in men: a prospective population-based study.

    Directory of Open Access Journals (Sweden)

    Jyrki K Virtanen

    Full Text Available OBJECTIVES: Fish consumption has been associated with reduced risk of cardiovascular diseases (CVD, especially sudden cardiac death (SCD. Fish is the major source of long-chain n-3 polyunsaturated fatty acids (PUFA eicosapentaenoic acid and docosahexaenoic acid. It is also a major source of methylmercury, which was associated with increased risk of CVD in this study population. Impact of interaction between long-chain n-3 PUFA and methylmercury on the SCD risk is unknown. METHODS: A total of 1857 men from the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor study, aged 42-60 years and free of CVD at baseline in 1984-1989, were studied. Serum long-chain n-3 PUFA was used as the marker for long-chain n-3 PUFA intake and hair mercury as the marker for mercury exposure. RESULTS: During the mean follow-up of 20.1 years, 91 SCD events occurred. In the multivariate Cox proportional hazards regression models, serum long-chain n-3 PUFA concentration was not associated with the risk of SCD until hair mercury was accounted for; then the hazard ratio (HR in the highest vs. lowest tertile was 0.54 [95% confidence interval (CI 0.32 to 0.91, p for trend = 0.046]. When the analyses were stratified by hair mercury content, among those with lower hair mercury, each 0.5 percentage unit increase in the serum long-chain n-3 PUFA was associated with HR of 0.77 (95% CI 0.64 to 0.93, whereas no association was seen among those with higher hair mercury (p for interaction = 0.01. Among the individual long-chain n-3 PUFA, docosahexaenoic acid was most strongly associated with the risk. CONCLUSION: High exposure to mercury may reduce the benefits of long-chain n-3 PUFA on SCD.

  9. Non-invasive stratification of postinfarction rats based on degree of cardiac dysfunction using magnetic resonance imaging and echocardiography.

    Science.gov (United States)

    Aronsen, Jan Magnus; Espe, Emil Knut Stenersen; Skårdal, Kristine; Hasic, Almira; Zhang, Lili; Sjaastad, Ivar

    2017-02-10

    The myocardial infarction (MI) rat model plays a crucial role in modern cardiovascular research, but the inherent heterogeneity of this model represents a challenge. We sought to identify subgroups among the post-MI rats, and establish simple non-invasive stratification protocols for such subgroups. Six weeks after induction of MI, 49 rats underwent non-invasive examinations using magnetic resonance imaging (MRI) and echocardiography. 12 sham-operated rats served as controls. Increased end-diastolic left ventricular (LV) pressure and lung weight served as indicators for congestive heart failure (CHF). A clustering algorithm using thirteen non-invasive and invasive parameters was used to identify distinct groups among the animals. The cluster analysis revealed four distinct post-MI phenotypes; two without congestion but with different degree of LV dilatation, and two with different degree of congestion and right ventricular (RV) affection. Among the MRI parameters, RV mass emerged as robust non-invasive marker of CHF with 100% specificity/sensitivity. Moreover, LV infarct size and RV ejection fraction further predicted subgroup among the non-CHF and CHF rats with excellent specificity/sensitivity. Of the echocardiography parameters, left atrial diameter predicted CHF. Moreover, MRI-derived LV end-diastolic diameter predicted the subgroups among the non-CHF rats. We propose two simple non-invasive schemes to stratify post-MI rats, based on the degree of heart failure; one for MRI and one for echocardiography.

  10. Criteria of Categorizing Logistics and Distribution Centres

    OpenAIRE

    Darko Babić; Anđelko Šćukanec; Kristijan Rogic

    2011-01-01

    Logistics and distribution centres represent very significant infrastructure elements of the macro-logistic system. The creation of the logistics and distribution centres and their connection into a wide (global) network have resulted in the creation of conditions for an adequate distribution of labour and significant increase in the productivity of all the logistics elements and processes, noting that the logistics and distribution centres in this concept have a superregional significance. ...

  11. Smart work centres in rural areas

    DEFF Research Database (Denmark)

    Lorentzen, Anne Birte

    This paper discusses the establishment of telework centres as an element in local development strategies in rural areas, with a particular view to two new telework centres in region North Denmark. The paper argues that telework centres do not represent an easy solution to problems of local develo...... development and environmental sustainability, and further, that technology may not even be the most important feature needed to make them function as such....

  12. Activities of Radiation Protection Centre in 2000

    CERN Document Server

    Radiat. Prot. Cent. Vilnius

    2001-01-01

    Description of the activities of Radiation Protection Centre in 2000 is presented. Radiation Protection Centre is responsible for radiation protection issues. Currently there are six departments at Radiation Protection Centre: two in Vilnius - Department of Radiation Protection Supervision and Control and Department of Programs and Expertise, and four in the districts. Brief information on subject controlled by each departments is provided focusing on main achievements and events.

  13. 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

  14. CADC and CANFAR: Extending the role of the data centre

    Science.gov (United States)

    Gaudet, Severin

    2015-12-01

    Over the past six years, the CADC has moved beyond the astronomy archive data centre to a multi-service system for the community. This evolution is based on two major initiatives. The first is the adoption of International Virtual Observatory Alliance (IVOA) standards in both the system and data architecture of the CADC, including a common characterization data model. The second is the Canadian Advanced Network for Astronomical Research (CANFAR), a digital infrastructure combining the Canadian national research network (CANARIE), cloud processing and storage resources (Compute Canada) and a data centre (Canadian Astronomy Data Centre) into a unified ecosystem for storage and processing for the astronomy community. This talk will describe the architecture and integration of IVOA and CANFAR services into CADC operations, the operational experiences, the lessons learned and future directions

  15. Criteria of Categorizing Logistics and Distribution Centres

    Directory of Open Access Journals (Sweden)

    Darko Babić

    2011-07-01

    Full Text Available Logistics and distribution centres represent very significant infrastructure elements of the macro-logistic system. The creation of the logistics and distribution centres and their connection into a wide (global network have resulted in the creation of conditions for an adequate distribution of labour and significant increase in the productivity of all the logistics elements and processes, noting that the logistics and distribution centres in this concept have a superregional significance. This paper represents the summary (results of the research that was carried out on a large number of logistics and distribution centres with the aim of considering the complexity and the issues related to the logistics and distribution centres and the distribution network, their elements and action of the subsystems according to the following criteria: spatial, technical, technological, and organizational, with the aim of defining the categorisation model of the logistics and distribution centres. The analysis of the selected data collected during the research has resulted in defining of the categorisation model of the logistics and distribution centres which foresees six categories. Each of the foreseen categories has been defined according to the set model by the mentioned traffic, technical and technological, and organisational characteristics and the level of service. This is precisely where the application of the categorisation model of the logistics and distribution centres can be found, which will define the relevant categories of the centres applicable in the creation of effective distribution

  16. Toward a Student-Centred Process of Teaching Arithmetic

    Science.gov (United States)

    Eriksson, Gota

    2011-01-01

    This article describes a way toward a student-centred process of teaching arithmetic, where the content is harmonized with the students' conceptual levels. At school start, one classroom teacher is guided in recurrent teaching development meetings in order to develop teaching based on the students' prerequisites and to successively learn the…

  17. Benefits of human-centred design in open innovation projects

    NARCIS (Netherlands)

    Steen, M.G.D.; Aarts, O.A.J.; Broekman, C.C.M.T.

    2012-01-01

    Human-centred design (HCD) is a form of open innovation in which researchers and designers cooperate with (potential) users or customers, e.g. in co-design workshops, interviews, user tests and trials. Based on a case study of two open innovation projects in which HCD activities were organized (TA2

  18. Centre of Excellence in Territorial Management and Cadastre (CENTRIC

    Directory of Open Access Journals (Sweden)

    Oana Popescu

    2016-06-01

    Full Text Available The establishment of a Centre of Excellence specialized in land management, mapping and cadastre is expected to promote synergies between science and technology based on the use of advanced information and communication technologies. CENTRIC will act as a knowledge transfer and innovation hub for multiple national and international networks.

  19. Fractures of the mandibular coronoid process: a two centres study

    NARCIS (Netherlands)

    Boffano, P.; Kommers, S.C.; Roccia, F.; Gallesio, C.; Forouzanfar, T.

    2014-01-01

    The aim of this study was to assess the characteristics of patients with coronoid fractures treated in two European centres over 10 years and to briefly review the literature. This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with m

  20. Being a 'Modern Indian' in an Offshore Centre in Bangalore

    DEFF Research Database (Denmark)

    Gertsen, Martine Cardel; Zølner, Mette

    2014-01-01

    . The analysis is based upon the study of an off–shore service centre in Bangalore that performs financial services for an MNC headquartered in Denmark. The identification with the MNC and its corporate culture expressed by local employees is conveyed as being connected to external self–enhancement (belonging...

  1. Strategies for the prevention of sudden cardiac death during sports.

    Science.gov (United States)

    Corrado, Domenico; Drezner, Jonathan; Basso, Cristina; Pelliccia, Antonio; Thiene, Gaetano

    2011-04-01

    Sudden cardiac death of a young athlete is the most tragic event in sports and devastates the family, the sports medicine team, and the local community. Such a fatality represents the first manifestation of cardiac disease in up to 80% of young athletes who remain asymptomatic before sudden cardiac arrest occurs; this explains the limited power of screening modalities based solely on history and physical examination. The long-running Italian experience showed that electrocardiogram (ECG) screening definitively improves the sensitivity of pre-participation evaluation for heart diseases and substantially reduces the risk of death in the athletic field (primary prevention). However, some cardiac conditions, such as coronary artery diseases, present no abnormalities on 12-lead ECG. Moreover, cardiac arrest due to non-penetrating chest injury (commotio cordis) cannot be prevented by screening. This justifies the efforts for implementing programmes of early external defibrillation of unpredictable arrhythmic cardiac arrest. This article reviews the epidemiology of sudden cardiac arrest in the athlete in terms of incidence, sport-related risk, underlying causes, and the currently available prevention programmes such as pre-participation screening and early external defibrillation by using automated external defibrillators. The best strategy is to combine synergistically primary prevention of sudden cardiac death by pre-participation identification of athletes affected by at-risk cardiomyopathies and secondary prevention with back-up defibrillation of unpredictable sudden cardiac arrest on the athletic field.

  2. 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...... for the situation at hand. Due to challenging circumstances, the cost assessment turned out to be ex-post and top-down. RESULTS: Cost per treatment sequence is estimated to be approximately euro 976, whereas the incremental cost (compared with usual care) is approximately euro 682. The cost estimate is uncertain...... 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....

  3. Toothache of cardiac origin.

    Science.gov (United States)

    Kreiner, M; Okeson, J P

    1999-01-01

    Pain referred to the orofacial structures can sometimes be a diagnostic challenge for the clinician. In some instances, a patient may complain of tooth pain that is completely unrelated to any dental source. This poses a diagnostic and therapeutic problem for the dentist. Cardiac pain most commonly radiates to the left arm, shoulder, neck, and face. In rare instances, angina pectoris may present as dental pain. When this occurs, an improper diagnosis frequently leads to unnecessary dental treatment or, more significantly, a delay of proper treatment. This delay may result in the patient experiencing an acute myocardial infarction. It is the dentist's responsibility to establish a proper diagnosis so that the treatment will be directed toward the source of pain and not to the site of pain. This article reviews the literature concerning referred pain of cardiac origin and presents a case report of toothache of cardiac origin.

  4. Cardiac mitochondria exhibit dynamic functional clustering

    Directory of Open Access Journals (Sweden)

    Felix Tobias Kurz

    2014-09-01

    Full Text Available Multi-oscillatory behavior of mitochondrial inner membrane potential ΔΨm in self-organized cardiac mitochondrial networks can be triggered by metabolic or oxidative stress. Spatio-temporal analyses of cardiac mitochondrial networks have shown that mitochondria are heterogeneously organized in synchronously oscillating clusters in which the mean cluster frequency and size are inversely correlated, thus suggesting a modulation of cluster frequency through local inter-mitochondrial coupling. In this study, we propose a method to examine the mitochondrial network's topology through quantification of its dynamic local clustering coefficients. Individual mitochondrial ΔΨm oscillation signals were identified for each cardiac myocyte and cross-correlated with all network mitochondria using previously described methods (Kurz et al., 2010. Time-varying inter-mitochondrial connectivity, defined for mitochondria in the whole network whose signals are at least 90% correlated at any given time point, allowed considering functional local clustering coefficients. It is shown that mitochondrial clustering in isolated cardiac myocytes changes dynamically and is significantly higher than for random mitochondrial networks that are constructed using the Erdös-Rényi model based on the same sets of vertices. The network's time-averaged clustering coefficient for cardiac myocytes was found to be 0.500 ± 0.051 (N=9 versus 0.061 ± 0.020 for random networks, respectively. Our results demonstrate that cardiac mitochondria constitute a network with dynamically connected constituents whose topological organization is prone to clustering. Cluster partitioning in networks of coupled oscillators has been observed in scale-free and chaotic systems and is therefore in good agreement with previous models of cardiac mitochondrial networks (Aon et al., 2008.

  5. 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

  6. 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

  7. Association between high-sensitivity cardiac troponin T and N-terminal pro-brain natriuretic peptide in a community based population

    Institute of Scientific and Technical Information of China (English)

    Xu Ruyi; Ye Ping; Luo Leiming; Sheng Li; Wu Hongmei; Xiao Wenkai; Zheng Jin

    2014-01-01

    Background N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) are excellent biomarkers for detecting heart failure and subclinical myocardial injury.However,it remains unclear whether subclinical myocardial injury is associated with NT-proBNP elevation in a community based population.Methods In a community based study,levels of hs-cTnT and of NT-proBNP were determined in 1 497 participants older than 45 years.The lower detection limit of the hs-cTnT assay used in the present study was 0.003 ng/ml.The association of hs-cTnT levels and NT-proBNP levels was analyzed.Results When the subjects with undetectable (<0.003 ng/ml),intermediate (0.003-0.014 ng/ml),and elevated (≥0.014 ng/ml) levels of hs-cTnT were compared (r=0.175,P <0.001),a strong association between the hs-cTnT levels and NT-proBNP levels was observed (β=-0.206,P <0.001; β=-0.118,P <0.001,respectively).In multivariable analyses,older age and hs-cTnT were positively and independently associated with NT-proBNP levels (β=0.341,P <0.001; β=0.143,P <0.001,respectively),and male gender and the levels of eGFR were inversely and independently associated with NT-proBNP levels.When the subjects with normal or elevated NT-proBNP were analyzed separately,the hs-cTnT level was not an independent predictor for the NT-proBNP level in the normal NT-proBNP group,whereas the hs-cTnT level was the only independent predictor for NT-proBNP level in the elevated NT-proBNP group (β=0.399,P <0.01).Conclusions In this community based population,NT-proBNP elevation was common.In addition to female gender and older age,subclinical myocardial injury indicated by the hs-cTnT level was another important factor in NT-proBNP elevation.

  8. Lung transplantation from donor of cardiac death and donation after brain death in one centre Ⅲ: 4 cases report%单中心心脏死亡和脑死亡供肺肺移植临床经验总结

    Institute of Scientific and Technical Information of China (English)

    毛文君; 陈静瑜; 郑明峰; 吴波; 叶书高; 刘峰

    2012-01-01

    Objective To summarize the clinical experience ot harvesting and using the lungs from donation after brain death (DBD) and donation after cardiac death (DCD,Maastricht category Ⅳ) in China.Methods Eleven potential DBDs and DCDs were evaluated by our transplant group preoperatively,including 6 cases of DCDs and 5 cases of DBDs,and all of them received the tests of sputum culture bedside bronchoscopy,chest X rays,and blood gas analysis.After clear evaluation,1 case of DCD and 2 cases of DBD were discharged from the group for bilateral inflammatory infiltration and poor oxygenation index,and one case of DCD was precluded due to long warm ischemic time (>60min).The donor lungs from remaining 7 cases were harvested successfully after the declaration of brain death or cardiac death.The preoperative lymphocytotoxic cross match test was negative,ABO blood types were compatible,and the donors were all suitable for the transplant procedure.Results Seven lung transplants were performed successfully under ECMO support,including 5 cases of bilateral lung transplantation and 2 cases of single lung transplantation.One patient was complicated with severe infection and died of sepsis on postoperative day (POD) 39,and one was succumbed to multiple organ failure.Two patients suffered of acute rejection on POD 30 and POD 19,respectively,and obtained improvements by bolus steroid therapy.The remaining 3 patients all recovered uneventfully.During a follow up period,all the patients lived an active life style with high quality of life.The mean survival time was 23.3 months (3-51 months).Conclusion The DCD and DBD may be one of the available donor resources for lung transplantation after efficient management of the potential donors and detailed preoperative evaluation in China.%目的 总结单中心脑死亡器官捐赠(DBD)和心脏死亡器官捐赠(DCD)的供肺获取以及肺移植的临床经验.方法 11例潜在器官捐献供者进行了术前评估,所有供者均进行痰

  9. 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.

  10. Incidence, Causes, and Outcomes of Out-of-Hospital Cardiac Arrest in Children A Comprehensive, Prospective, Population-Based Study in the Netherlands

    NARCIS (Netherlands)

    A. Bardai; J. Berdowski; C. van der Werf; M.T. Blom; M. Ceelen; I.M. van Langen; J.G.P. Tijssen; A.A.M. Wilde; R.W. Koster; H.L. Tan

    2011-01-01

    Objectives This study sought to determine comprehensively the incidence of pediatric out-of-hospital cardiac arrest (OHCA) and its contribution to total pediatric mortality, the causes of pediatric OHCA, and the outcome of resuscitation of pediatric OHCA patients. Background There is a paucity of co

  11. 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.

  12. 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).

  13. Cardiac computed tomography core syllabus of the European Association of Cardiovascular Imaging (EACVI).

    Science.gov (United States)

    Nieman, Koen; Achenbach, Stephan; Pugliese, Francesca; Cosyns, Bernard; Lancellotti, Patrizio; Kitsiou, Anastasia

    2015-04-01

    The European Association of Cardiovascular Imaging (EACVI) Core Syllabus for Cardiac Computed Tomography (CT) is now available online. The syllabus lists key elements of knowledge in Cardiac CT. It represents a framework for the development of training curricula and provides expected knowledge-based learning outcomes to the Cardiac CT trainees.

  14. Cardiac tissue-based sensing array for studying on signal conduction and drugs analysis%心肌组织传感阵列在信号传导及药物分析中的应用

    Institute of Scientific and Technical Information of China (English)

    陈庆梅; 李蓉; 肖丽丹; 刘清君; 王平

    2012-01-01

    为了对心肌组织的搏动信号及其传导进行实时监测与分析,设计一种用于离体心肌组织电生理检测的组织传感阵列.根据组织/器件耦合原理,该传感阵列能够检测伴随心肌细胞搏动产生的场电位的变化.利用组织传感阵列,同步采集多通道的心肌信号并观察心血管药物盐酸肾上腺素和氯化乙酰胆碱对搏动信号的影响.实验结果显示:离体心肌组织及切片表现出良好的搏动和信号传导;盐酸肾上腺素和氯化乙酰胆碱对心肌组织搏动信号的幅度、频率、持续时间甚至信号的传导分别表现出兴奋和抑制作用.说明组织传感阵列技术对离体心肌组织搏动信号的提取是可行的,并且对心肌信号的传导及药物作用分析非常有用.%To real-time monitor the beating signals of the cardiac tissues and investigate the signal propagation, an in vitro cardiac tissue-based sensing array was developed for monitoring the electrophysiological activities. According to the coupling principle between tissues and sensors, the sensing array can detect the changes of the field potentials with the mechanical beatings of the cardiac cells. With the tissue-based sensing array, the multi-channel data was acquired synchronously and the effect of Adrenaline Hydrochloride and Acetylcholine Chloride on the beating signals was observed. Experiment results showed that the in vitro cardiac tissues and slices took on good beatings as well as the propagation. Adrenaline Hydrochloride and Acetylcholine Chloride respectively had exciting and relaxing action on signals' amplitude, frequency, duration and even the signal conduction. In conclusion, the tissue-based sensing array technique is feasible to measure the beating signals of the in vitro cardiac tissues, and is quite advantageous to study the signal conduction and drugs screening.

  15. Echocardiography to magnetic resonance image registration for use in image-guided cardiac catheterization procedures

    Energy Technology Data Exchange (ETDEWEB)

    Ma Yingliang; Penney, Graeme P; Razavi, Reza; Rhode, Kawal S [Division of Imaging Sciences, King' s College, London SE1 7EH (United Kingdom); Rinaldi, C Aldo; Cooklin, Mike [Department of Cardiology, Guy' s and St Thomas' NHS Foundation Trust, London, SE1 7EH (United Kingdom)], E-mail: y.ma@kcl.ac.uk

    2009-08-21

    We present a robust method to register three-dimensional echocardiography (echo) images to magnetic resonance images (MRI) based on anatomical features, which is designed to be used in the registration pipeline for overlaying MRI-derived roadmaps onto two-dimensional live x-ray images during cardiac catheterization procedures. The features used in image registration are the endocardial surface of the left ventricle and the centre line of the descending aorta. The MR-derived left ventricle surface is generated using a fully automated algorithm, and the echo-derived left ventricle surface is produced using a semi-automatic segmentation method provided by the QLab software (Philips Healthcare) that it is routinely used in clinical practice. We test our method on data from six volunteers and four patients. We validated registration accuracy using two methods: the first calculated a root mean square distance error using expert identified anatomical landmarks, and the second method used catheters as landmarks in two clinical electrophysiology procedures. Results show a mean error of 4.1 mm, which is acceptable for our clinical application, and no failed registrations were observed. In addition, our algorithm works on clinical data, is fast and only requires a small amount of manual input, and so it is applicable for use during cardiac catheterization procedures.

  16. Data analysis in cardiac arrhythmias.

    Science.gov (United States)

    Rodrigo, Miguel; Pedrón-Torecilla, Jorge; Hernández, Ismael; Liberos, Alejandro; Climent, Andreu M; Guillem, María S

    2015-01-01

    Cardiac arrhythmias are an increasingly present in developed countries and represent a major health and economic burden. The occurrence of cardiac arrhythmias is closely linked to the electrical function of the heart. Consequently, the analysis of the electrical signal generated by the heart tissue, either recorded invasively or noninvasively, provides valuable information for the study of cardiac arrhythmias. In this chapter, novel cardiac signal analysis techniques that allow the study and diagnosis of cardiac arrhythmias are described, with emphasis on cardiac mapping which allows for spatiotemporal analysis of cardiac signals.Cardiac mapping can serve as a diagnostic tool by recording cardiac signals either in close contact to the heart tissue or noninvasively from the body surface, and allows the identification of cardiac sites responsible of the development or maintenance of arrhythmias. Cardiac mapping can also be used for research in cardiac arrhythmias in order to understand their mechanisms. For this purpose, both synthetic signals generated by computer simulations and animal experimental models allow for more controlled physiological conditions and complete access to the organ.

  17. Biosynthesis of cardiac natriuretic peptides

    DEFF Research Database (Denmark)

    Goetze, Jens Peter

    2010-01-01

    Cardiac-derived peptide hormones were identified more than 25 years ago. An astonishing amount of clinical studies have established cardiac natriuretic peptides and their molecular precursors as useful markers of heart disease. In contrast to the clinical applications, the biogenesis of cardiac...

  18. Cardiac involvement in canine babesiosis : review article

    Directory of Open Access Journals (Sweden)

    R.G. Lobetti

    2005-06-01

    Full Text Available Cardiac dysfunction in canine babesiosis has traditionally been regarded as a rare complication, with the majority of lesions reported as incidental findings at post-mortem examination. Recent studies have, however, demonstrated cardiac lesions in canine babesiosis. Cardiac troponins, especially troponin I, are sensitive markers of myocardial injury in canine babesiosis, and the magnitude of elevation of plasma troponin I concentrations appears to be proportional to the severity of the disease. ECG changes in babesiosis are similar to the pattern described for myocarditis and myocardial ischaemia and together with histopathological findings indicate that the heart suffers from the same pathological processes described in other organs in canine babesiosis, namely inflammation and hypoxia. The clinical application of the ECG appears to be limited and thus cardiovascular assessment should be based on functional monitoring rather than an ECG tracing. On cardiac histopathology from dogs that succumbed to babesiosis, haemorrhage, necrosis, inflammation and fibrin microthrombi in the myocardium were documented, all of which would have resulted in ECG changes and elevations in cardiac troponin. Myocardial damage causes left ventricular failure, which will result in hypotension and an expansion of the plasma volume due to homeostatic mechanisms.

  19. Cardiac troponins and high-sensitivity cardiac troponin assays.

    Science.gov (United States)

    Conrad, Michael J; Jarolim, Petr

    2014-03-01

    Measurement of circulating cardiac troponins I and T has become integral to the diagnosis of myocardial infarction. This article discusses the structure and function of the troponin complex and the release of cardiac troponin molecules from the injured cardiomyocyte into the circulation. An overview of current cardiac troponin assays and their classification according to sensitivity is presented. The diagnostic criteria, role, and usefulness of cardiac troponin for myocardial infarction are discussed. In addition, several examples are given of the usefulness of high-sensitivity cardiac troponin assays for short-term and long-term prediction of adverse events.

  20. Association of glomerular filtration rate with high-sensitivity cardiac troponin T in a community-based population study in Beijing.

    Directory of Open Access Journals (Sweden)

    Fan Wang

    Full Text Available BACKGROUND: Reduced renal function is an independent risk factor for cardiovascular disease mortality, and persistently elevated cardiac troponin T (cTnT is frequently observed in patients with end-stage renal disease. In the general population the relationship between renal function and cTnT levels may not be clear because of the low sensitivity of the assay. In this study, we investigated the level of cTnT using a highly sensitive assay (hs-cTnT and evaluated the association of estimated glomerular filtration rate (eGFR with detectable hs-cTnT levels in a community-based population. METHODS: The serum hs-cTnT levels were measured in 1365 community dwelling population aged ≥45 years in Beijing, China. eGFR was determined by the Chinese modifying modification of diet in renal disease (C-MDRD equation. RESULTS: With the highly sensitive assay, cTnT levels were detectable (≥3pg/mL in 744 subjects (54.5%. The result showed that eGFR was associated with Log hs-cTnT (r = -0.14, P20% and other prognostic indicators, moderate to severe reduced eGFR was independently associated with detectable hs-cTnT, whereas normal to mildly reduced eGFR was not independently associated with detectable hs-cTnT. In addition, after adjustment for other risk factors, the high predicted Framingham CHD risk was associated with detectable hs-cTnT in the subjects with different quartile levels of eGFR. CONCLUSION: The levels of hs-cTnT are detectable in a community-based Chinese population and low eGFR is associated with detectable hs-cTnT. Moreover, eGFR and high predicted Framingham CHD risk are associated with detectable hs-cTnT in subjects with moderate-to-severe reduced renal function.

  1. Numerical models based on a minimal set of sarcolemmal electrogenic proteins and an intracellular Ca(2+) clock generate robust, flexible, and energy-efficient cardiac pacemaking.

    Science.gov (United States)

    Maltsev, Victor A; Lakatta, Edward G

    2013-06-01

    Recent evidence supports the idea that robust and, importantly, FLEXIBLE automaticity of cardiac pacemaker cells is conferred by a coupled system of membrane ion currents (an "M-clock") and a sarcoplasmic reticulum (SR)-based Ca(2+) oscillator ("Ca(2+)clock") that generates spontaneous diastolic Ca(2+) releases. This study identified numerical models of a human biological pacemaker that features robust and flexible automaticity generated by a minimal set of electrogenic proteins and a Ca(2+)clock. Following the Occam's razor principle (principle of parsimony), M-clock components of unknown molecular origin were excluded from Maltsev-Lakatta pacemaker cell model and thirteen different model types of only 4 or 5 components were derived and explored by a parametric sensitivity analysis. The extended ranges of SR Ca(2+) pumping (i.e. Ca(2+)clock performance) and conductance of ion currents were sampled, yielding a large variety of parameter combination, i.e. specific model sets. We tested each set's ability to simulate autonomic modulation of human heart rate (minimum rate of 50 to 70bpm; maximum rate of 140 to 210bpm) in response to stimulation of cholinergic and β-adrenergic receptors. We found that only those models that include a Ca(2+)clock (including the minimal 4-parameter model "ICaL+IKr+INCX+Ca(2+)clock") were able to reproduce the full range of autonomic modulation. Inclusion of If or ICaT decreased the flexibility, but increased the robustness of the models (a relatively larger number of sets did not fail during testing). The new models comprised of components with clear molecular identity (i.e. lacking IbNa & Ist) portray a more realistic pacemaking: A smaller Na(+) influx is expected to demand less energy for Na(+) extrusion. The new large database of the reduced coupled-clock numerical models may serve as a useful tool for the design of biological pacemakers. It will also provide a conceptual basis for a general theory of robust, flexible, and energy

  2. Numerical models based on a minimal set of sarcolemmal electrogenic proteins and an intracellular Ca2+ clock generate robust, flexible, and energy-efficient cardiac pacemaking

    Science.gov (United States)

    Maltsev, Victor A.; Lakatta, Edward G.

    2015-01-01

    Recent evidence supports the idea that robust and, importantly, FLEXIBLE automaticity of cardiac pacemaker cells is conferred by a coupled system of membrane ion currents (an “M-clock”) and a sarcoplasmic reticulum (SR)-based Ca2+ oscillator (“Ca2+clock”) that generates spontaneous diastolic Ca2+ releases. This study identified numerical models of a human biological pacemaker that features robust and flexible automaticity generated by a minimal set of electrogenic proteins and a Ca2+clock. Following the Occam’s razor principle (principle of parsimony), M-clock components of unknown molecular origin were excluded from Maltsev-Lakatta pacemaker cell model and thirteen different model types of only 4 or 5 components were derived and explored by a parametric sensitivity analysis. The extended ranges of SR Ca2+ pumping (i.e. Ca2+clock performance) and conductance of ion currents were sampled, yielding a large variety of parameter combination, i.e. specific model sets. We tested each set’s ability to simulate autonomic modulation of human heart rate (minimum rate of 50 to 70 bpm; maximum rate of 140 to 210 bpm) in response to stimulation of cholinergic and β-adrenergic receptors. We found that only those models that include a Ca2+clock (including the minimal 4-parameter model “ICaL+IKr+INCX+Ca2+clock”) were able to reproduce the full range of autonomic modulation. Inclusion of If or ICaT decreased the flexibility, but increased the robustness of the models (a relatively larger number of sets did not fail during testing). The new models comprised of components with clear molecular identity (i.e. lacking IbNa & Ist) portray a more realistic pacemaking: A smaller Na+ influx is expected to demand less energy for Na+ extrusion. The new large database of the reduced coupled-clock numerical models may serve as a useful tool for the design of biological pacemakers. It will also provide a conceptual basis for a general theory of robust, flexible, and energy

  3. Laparoscopic adrenalectomy: Single centre experience.

    LENUS (Irish Health Repository)

    O'Farrell, N J

    2012-02-01

    BACKGROUND: Laparoscopic adrenalectomy is an attractive alternative to the traditional open approach in the surgical excision of an adrenal gland. It has replaced open adrenalectomy in our institution and we review our experience to date. METHODS: All cases of laparoscopic adrenalectomies in our hospital over eight years (from 2001 to May 2009) were retrospectively reviewed. Patient demographics, diagnosis, length of hospital stay, histology and all operative and post-operative details were evaluated. RESULTS: Fifty-five laparoscopic adrenalectomies (LA) were performed on 51 patients over eight years. The mean age was 48 years (Range 16-86 years) with the male: female ratio 1:2. Twenty-three cases had a right adrenalectomy, 24 had a left adrenalectomy and the remaining four patients had bilateral adrenalectomies. 91% were successfully completed laparoscopically with five converted to an open approach. Adenomas (functional and non functional) were the leading indication for LA, followed by phaeochromocytomas. Other indications for LA included Cushing\\'s disease, adrenal malignancies and rarer pathologies. There was one mortality from necrotising pancreatitis following a left adrenalectomy for severe Cushing\\'s disease, with subsequent death 10 days later. CONCLUSION: Laparoscopic adrenalectomy is effective for the treatment of adrenal tumours, fulfilling the criteria for the ideal minimally invasive procedure. It has replaced the traditional open approach in our centre and is a safe and effective alternative. However, in the case of severe Cushing\\'s disease, laparoscopic adrenalectomy has the potential for significant adverse outcomes and mortality.

  4. Position Control of Motion Compensation Cardiac Catheters

    Science.gov (United States)

    Kesner, Samuel B.; Howe, Robert D.

    2011-01-01

    Robotic catheters have the potential to revolutionize cardiac surgery by enabling minimally invasive structural repairs within the beating heart. This paper presents an actuated catheter system that compensates for the fast motion of cardiac tissue using 3D ultrasound image guidance. We describe the design and operation of the mechanical drive system and catheter module and analyze the catheter performance limitations of friction and backlash in detail. To mitigate these limitations, we propose and evaluate mechanical and control system compensation methods, including inverse and model-based backlash compensation, to improve the system performance. Finally, in vivo results are presented that demonstrate that the catheter can track the cardiac tissue motion with less than 1 mm RMS error. The ultimate goal of this research is to create a fast and dexterous robotic catheter system that can perform surgery on the delicate structures inside of the beating heart. PMID:21874124

  5. Cardiac nonrigid motion analysis from image sequences

    Institute of Scientific and Technical Information of China (English)

    LIU Huafeng

    2006-01-01

    Noninvasive estimation of the soft tissue kinematics properties from medical image sequences has many important clinical and physiological implications, such as the diagnosis of heart diseases and the understanding of cardiac mechanics. In this paper, we present a biomechanics based strategy, framed as a priori constraints for the ill-posed motion recovery problema, to realize estimation of the cardiac motion and deformation parameters. By constructing the heart dynamics system equations from biomechanics principles, we use the finite element method to generate smooth estimates.of heart kinematics throughout the cardiac cycle. We present the application of the strategy to the estimation of displacements and strains from in vivo left ventricular magnetic resonance image sequence.

  6. Improving cardiac myocytes performance by CNTs platforms

    Directory of Open Access Journals (Sweden)

    Valentina eMartinelli

    2013-09-01

    Full Text Available The application of nanotechnology to the cardiovascular system has increasingly caught scientists’ attention as a potentially powerful tool for the development of new generation devices able to interface, repair or boost the performance of cardiac tissue. Carbon nanotubes (CNTs are considered as promising materials for nanomedicine applications in general and have been recently tested towards excitable cell growth. CNTs are cylindrically shaped structures made up of rolled-up graphene sheets, with unique electrical, thermal and mechanical properties, able to effectively conducting electrical current in electrochemical interfaces. CNTs-based scaffolds have been recently found to support the in vitro growth of cardiac cells: in particular, their ability to improve cardiomyocytes proliferation, maturation and electrical behavior are making CNTs extremely attractive for the development and exploitation of interfaces able to impact on cardiac cells physiology and function.

  7. Danish Anaesthesia Allergy Centre - preliminary results

    DEFF Research Database (Denmark)

    Garvey, L H; Roed-Petersen, J; Menné, T

    2001-01-01

    BACKGROUND: Anaphylactoid reactions in anaesthesia are rare and should ideally be investigated in specialist centres. At Gentofte University Hospital, we established such a centre in 1998 as a joint venture between the Departments of Anaesthesiology and Dermatology. We present the methodology, di...

  8. Oil Trading Centre to Reopen in Shanghai

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    @@ Chinese oil companies will likely resume activities at the oil trading centre in Shanghai this year, a move to further liberalize the once tightly controlled oil market. The centre will trade forward contracts for refined oil products,including gasoline, diesel oil, kerosene and fuel oil, industrial sources said.

  9. The Press Research Centre, 1956-1976.

    Science.gov (United States)

    Press Research Centre, Krakow (Poland).

    In 1956, the Press Research Centre was established in Cracow, Poland by a group of journalists and publishers, for the purpose of instituting press research that would have practical applications. The aims of the Centre were to conduct studies on the history of the Polish press, the contemporary press, press readership, and editorial techniques.…

  10. Validation and Modification of a Prediction Model for Acute Cardiac Events in Patients With Breast Cancer Treated With Radiotherapy Based on Three-Dimensional Dose Distributions to Cardiac Substructures.

    Science.gov (United States)

    van den Bogaard, Veerle A B; Ta, Bastiaan D P; van der Schaaf, Arjen; Bouma, Angelique B; Middag, Astrid M H; Bantema-Joppe, Enja J; van Dijk, Lisanne V; van Dijk-Peters, Femke B J; Marteijn, Laurens A W; de Bock, Gertruida H; Burgerhof, Johannes G M; Gietema, Jourik A; Langendijk, Johannes A; Maduro, John H; Crijns, Anne P G

    2017-01-17

    Purpose A relationship between mean heart dose (MHD) and acute coronary event (ACE) rate was reported in a study of patients with breast cancer (BC). The main objective of our cohort study was to validate this relationship and investigate if other dose-distribution parameters are better predictors for ACEs than MHD. Patients and Methods The cohort consisted of 910 consecutive female patients with BC treated with radiotherapy (RT) after breast-conserving surgery. The primary end point was cumulative incidence of ACEs within 9 years of follow-up. Both MHD and various dose-distribution parameters of the cardiac substructures were collected from three-dimensional computed tomography planning data. Results The median MHD was 2.37 Gy (range, 0.51 to 15.25 Gy). The median follow-up time was 7.6 years (range, 0.1 to 10.1 years), during which 30 patients experienced an ACE. The cumulative incidence of ACE increased by 16.5% per Gy (95% CI, 0.6 to 35.0; P = .042). Analysis showed that the volume of the left ventricle receiving 5 Gy (LV-V5) was the most important prognostic dose-volume parameter. The most optimal multivariable normal tissue complication probability model for ACEs consisted of LV-V5, age, and weighted ACE risk score per patient (c-statistic, 0.83; 95% CI, 0.75 to 0.91). Conclusion A significant dose-effect relationship was found for ACEs within 9 years after RT. Using MHD, the relative increase per Gy was similar to that reported in the previous study. In addition, LV-V5 seemed to be a better predictor for ACEs than MHD. This study confirms the importance of reducing exposure of the heart to radiation to avoid excess risk of ACEs after radiotherapy for BC.

  11. 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...

  12. Cardiac Risk Assessment

    Science.gov (United States)

    ... Risk Assessment Related tests: Lipid Profile , VLDL Cholesterol , hs-CRP , Lp(a) Overview | Common Questions | Related Pages What ... cardiac risk include: High-sensitivity C-reactive protein (hs-CRP) : Studies have shown that measuring CRP with a ...

  13. 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.

  14. 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

  15. Perceptions of cardiac rehabilitation patients, specialists and rehabilitation programs regarding cardiac rehabilitation wait times

    Directory of Open Access Journals (Sweden)

    Grace Sherry L

    2012-08-01

    Full Text Available Abstract Background In 2006, the Canadian Cardiovascular Society (CCS Access to Care Working Group recommended a 30-day wait time benchmark for cardiac rehabilitation (CR. The objectives of the current study were to: (1 describe cardiac patient perceptions of actual and ideal CR wait times, (2 describe and compare cardiac specialist and CR program perceptions of wait times, as well as whether the recommendations are appropriate and feasible, and (3 investigate actual wait times and factors that CR programs perceive to affect these wait times. Methods Postal and online surveys to assess perceptions of CR wait times were administered to CR enrollees at intake into 1 of 8 programs, all CCS member cardiac specialists treating patients indicated for CR, and all CR programs listed in Canadian directories. Actual wait times were ascertained from the Canadian Cardiac Rehabilitation Registry. The design was cross-sectional. Responses were described and compared. Results Responses were received from 163 CR enrollees, 71 cardiac specialists (9.3% response rate, and 92 CR programs (61.7% response rate. Patients reported that their wait time from hospital discharge to CR initiation was 65.6 ± 88.4 days (median, 42 days, while their ideal median wait time was 28 days. Most patients (91.5% considered their wait to be acceptable, but ideal wait times varied significantly by the type of cardiac indication for CR. There were significant differences between specialist and program perceptions of the appropriate number of days to wait by most indications, with CR programs perceiving shorter waits as appropriate (p  Conclusions Wait times following access to cardiac rehabilitation are prolonged compared with consensus recommendations, and yet are generally acceptable to most patients. Wait times following percutaneous coronary intervention in particular may need to be shortened. Future research is required to provide an evidence base for wait time

  16. Pre-transplantation specification of stem cells to cardiac lineage for regeneration of cardiac tissue.

    Science.gov (United States)

    Mayorga, Maritza; Finan, Amanda; Penn, Marc

    2009-03-01

    Myocardial infarction (MI) is a lead cause of mortality in the Western world. Treatment of acute MI is focused on restoration of antegrade flow which inhibits further tissue loss, but does not restore function to damaged tissue. Chronic therapy for injured myocardial tissue involves medical therapy that attempts to minimize pathologic remodeling of the heart. End stage therapy for chronic heart failure (CHF) involves inotropic therapy to increase surviving cardiac myocyte function or mechanical augmentation of cardiac performance. Not until the point of heart transplantation, a limited resource at best, does therapy focus on the fundamental problem of needing to replace injured tissue with new contractile tissue. In this setting, the potential for stem cell therapy has garnered significant interest for its potential to regenerate or create new contractile cardiac tissue. While to date adult stem cell therapy in clinical trials has suggested potential benefit, there is waning belief that the approaches used to date lead to regeneration of cardiac tissue. As the literature has better defined the pathways involved in cardiac differentiation, preclinical studies have suggested that stem cell pretreatment to direct stem cell differentiation prior to stem cell transplantation may be a more efficacious strategy for inducing cardiac regeneration. Here we review the available literature on pre-transplantation conditioning of stem cells in an attempt to better understand stem cell behavior and their readiness in cell-based therapy for myocardial regeneration.

  17. Australian Teaching and Learning Centres through the Eyes of Their Directors: Characteristics, Capacities and Constraints

    Science.gov (United States)

    Palmer, Stuart; Holt, Dale; Challis, Di

    2010-01-01

    This paper is based on research to identify common factors that contribute to the effective strategic leadership of teaching and learning centres. The second of three phases of data collection involved a survey of Directors of Australian teaching and learning centres. The data collected were quantitatively analysed using a range of descriptive,…

  18. A person-centred segmentation study in elderly care : Towards efficient demand-driven care

    NARCIS (Netherlands)

    Eissens-van der Laan, Monique; van Offenbeek, Marjolein; Broekhuis, Manda; Slaets, Joris

    2014-01-01

    Providing patients with more person-centred care without increasing costs is a key challenge in healthcare. A relevant but often ignored hindrance to delivering person-centred care is that the current segmentation of the population and the associated organization of healthcare supply are based on di

  19. A guided tour in CNAO, the Italian National Centre for Hadron Therapy

    CERN Multimedia

    TERA foundation; Paola Catapano

    2010-01-01

    The Italian National Centre for Hadron Therapy in Pavia has just been inaugurated. The centre was created based on a research project carried out at CERN under the leadership of Ugo Amaldi. Interviews to President Borloni, Scientific Director Sandro Rossi and Head of operations Marco Pullia are included.

  20. Combination of European System for Cardiac Operative Risk Evaluation (EuroSCORE) and Cardiac Surgery Score (CASUS) to Improve Outcome Prediction in Cardiac Surgery.

    Science.gov (United States)

    Doerr, Fabian; Heldwein, Matthias B; Bayer, Ole; Sabashnikov, Anton; Weymann, Alexander; Dohmen, Pascal M; Wahlers, Thorsten; Hekmat, Khosro

    2015-08-17

    BACKGROUND We hypothesized that the combination of a preoperative and a postoperative scoring system would improve the accuracy of mortality prediction and therefore combined the preoperative 'additive EuroSCORE' (European system for cardiac operative risk evaluation) with the postoperative 'additive CASUS' (Cardiac Surgery Score) to form the 'modified CASUS'. MATERIAL AND METHODS We included all consecutive adult patients after cardiac surgery during January 2007 and December 2010 in our prospective study. Our single-centre study was conducted in a German general referral university hospital. The original additive and the 'modified CASUS' were tested using calibration and discrimination statistics. We compared the area under the curve (AUC) of the receiver characteristic curves (ROC) by DeLong's method and calculated overall correct classification (OCC) values. RESULTS The mean age among the total of 5207 patients was 67.2 ± 10.9 years. Whilst the ICU mortality was 5.9% we observed a mean length of ICU stay of 4.6 ± 7.0 days. Both models demonstrated excellent discriminatory power (mean AUC of 'modified CASUS': ≥ 0.929; 'additive CASUS': ≥ 0.920), with no significant differences according to DeLong. Neither model showed a significant p-value (cardiac surgery by combining a preoperative and a postoperative scoring system. A separate calculation of the two individual elements is therefore recommended.

  1. In-hospital cardiac arrest is associated with use of non-antiarrhythmic QTc-prolonging drugs

    DEFF Research Database (Denmark)

    De Bruin, Marie L; Langendijk, Pim N J; Koopmans, Richard P;

    2007-01-01

    a case-control study in which patients, for whom intervention of the advanced life support resuscitation team was requested for cardiac arrest between 1995 and 2003 in the Academic Medical Centre, Amsterdam, were compared with controls regarding current use of non-antiarrhythmic QTc-prolonging drugs...... should be made aware of the fact that these non-antiarrhythmic drugs may be hazardous, so that potential risks can be weighed against treatment benefits and additional cardiac surveillance can be requested, if necessary....

  2. Histopathological semi-quantitative evaluation of kidney injury of donation after cardiac death (DCD) by cryosections of zero biopsy——a double centre and control clinical trial%零点活组织检查冷冻切片组织病理学半定量评分评估DCD供肾损伤的意义

    Institute of Scientific and Technical Information of China (English)

    马俊杰; 李光辉; 徐璐; 杨海峰; 曹荣华; 桂泽红; 方佳丽; 张磊; 陈正

    2013-01-01

    目的 探讨零点活组织检查冷冻切片组织病理学半定量评分在心死亡器官捐赠(DCD)供肾损伤程度评估中的临床意义.方法 2005年7月到2009年12月实施的DCD供肾获取16例,记录供者死亡时血肌酐(SCr),供肾热、冷缺血时间,用零点活组织检查供肾组织冷冻切片的组织学半定量评分对供肾进行评级.观察符合人组条件的受者移植后肾功能恢复时间、移植肾功能恢复延迟(DGF)发生率、急性排斥反应(AR)发生率、平均Scr及受者和移植肾存活率,以及感染、肿瘤、糖尿病等术后并发症发病率等.结果 DCD供者16例,按供肾评分分为A、B、C3级.A级供者年龄和热缺血时间明显低于B级和C级,C级的热缺血时间和死亡时Scr明显高于A与B级.21例受者分别接受来自14例供者的21个肾脏(其中A级13个,B级8个,C级未应用于移植).接受A级供肾移植者DGF发生率和移植肾存活率明显优于B级受者.移植后3个月和3年时A级受者Scr优于B级受者.结论 根据供肾零点活组织检查的组织学改变,可以进行DCD供肾损伤的初步评估;影响组织学评分因素可能因素包括年龄、热缺血时间、供肾获取时的Scr等;组织学评分高的供肾移植后恢复较好,受者GDF发生率和严重程度较低.%Objective Through two-center,and controlled clinical study,we have made histopathological evaluations of semi-quantitative method by cryosections of zero biopsy,and combining with donor age,gender,ischemia time,biochemical parameters at death to assess donation after cardiac death (DCD) kidney injury and to establish the histopathological criterion for clinical acceptance or rejection of DCD kidney.Also we want to discover the relationships between the degree of donor renal injury and transplanted renal prognosis,and to verify clinical significance and modify the criterion of histopathological semi-quantitative evaluation of DCD kidney frozen section.Method The serum

  3. Irradiation of left breast and cardiac risk: fundamentals for a prospective study; Irradiation du sein gauche et risque cardiaque: bases pour une etude prospective

    Energy Technology Data Exchange (ETDEWEB)

    Untereiner, M.; Frederick, B.; Burie, D.; Philippi, S.; Joseph, S.; Harzee, L.; Hoziel, D.; Eschenbrenner, A.; Meyer, P. [Centre Francois-Baclesse, Esch-sur-Alzette (Luxembourg); Gibeau, L.; Laurent-Daniel, F.; Libert, S.; Fressancourt, C. [Centre Gray, 59 - Maubeuge (France)

    2010-10-15

    As the delineation of the anterior interventricular artery and of the heart is to be taken into account during irradiations of the left beast, in order to limit cardiotoxicity, the authors discuss the results of previous studies which highlighted this risk, and notably in a retrospective assessment of dose-volume histograms of the anterior interventricular artery and of the heart which concerned 162 left breast irradiations. This last study allowed cardiac tolerance thresholds to be defined. Short communication

  4. Toward microendoscopy-inspired cardiac optogenetics in vivo: technical overview and perspective

    Science.gov (United States)

    Klimas, Aleksandra; Entcheva, Emilia

    2014-08-01

    The ability to perform precise, spatially localized actuation and measurements of electrical activity in the heart is crucial in understanding cardiac electrophysiology and devising new therapeutic solutions for control of cardiac arrhythmias. Current cardiac imaging techniques (i.e. optical mapping) employ voltage- or calcium-sensitive fluorescent dyes to visualize the electrical signal propagation through cardiac syncytium in vitro or in situ with very high-spatiotemporal resolution. The extension of optogenetics into the cardiac field, where cardiac tissue is genetically altered to express light-sensitive ion channels allowing electrical activity to be elicited or suppressed in a precise cell-specific way, has opened the possibility for all-optical interrogation of cardiac electrophysiology. In vivo application of cardiac optogenetics faces multiple challenges and necessitates suitable optical systems employing fiber optics to actuate and sense electrical signals. In this technical perspective, we present a compendium of clinically relevant access routes to different parts of the cardiac electrical conduction system based on currently employed catheter imaging systems and determine the quantitative size constraints for endoscopic cardiac optogenetics. We discuss the relevant technical advancements in microendoscopy, cardiac imaging, and optogenetics and outline the strategies for combining them to create a portable, miniaturized fiber-based system for all-optical interrogation of cardiac electrophysiology in vivo.

  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. Multi-centre parallel arm randomised controlled trial to assess the effectiveness and cost-effectiveness of a group-based cognitive behavioural approach to managing fatigue in people with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Green Colin

    2010-06-01

    Full Text Available Abstract Background Fatigue is one of the most commonly reported and debilitating symptoms of multiple sclerosis (MS; approximately two-thirds of people with MS consider it to be one of their three most troubling symptoms. It may limit or prevent participation in everyday activities, work, leisure, and social pursuits, reduce psychological well-being and is one of the key precipitants of early retirement. Energy effectiveness approaches have been shown to be effective in reducing MS-fatigue, increasing self-efficacy and improving quality of life. Cognitive behavioural approaches have been found to be effective for managing fatigue in other conditions, such as chronic fatigue syndrome, and more recently, in MS. The aim of this pragmatic trial is to evaluate the clinical and cost-effectiveness of a recently developed group-based fatigue management intervention (that blends cognitive behavioural and energy effectiveness approaches compared with current local practice. Methods/Design This is a multi-centre parallel arm block-randomised controlled trial (RCT of a six session group-based fatigue management intervention, delivered by health professionals, compared with current local practice. 180 consenting adults with a confirmed diagnosis of MS and significant fatigue levels, recruited via secondary/primary care or newsletters/websites, will be randomised to receive the fatigue management intervention or current local practice. An economic evaluation will be undertaken alongside the trial. Primary outcomes are fatigue severity, self-efficacy and disease-specific quality of life. Secondary outcomes include fatigue impact, general quality of life, mood, activity patterns, and cost-effectiveness. Outcomes in those receiving the fatigue management intervention will be measured 1 week prior to, and 1, 4, and 12 months after the intervention (and at equivalent times in those receiving current local practice. A qualitative component will examine what

  7. Holistic design : learning from the Learning Centre

    Energy Technology Data Exchange (ETDEWEB)

    Simon, C. [Charles Simon Architect and Planner, Eden Mills, ON, (Canada); McKee, C. [Kitchener-Waterloo YMCA Outdoor Services, ON (Canada)

    2004-08-01

    The energy efficiency of several solar technologies currently in operation at the Kitchener-Waterloo YMCA's Environmental Learning Centre was evaluated. The off-grid earth-sheltered building dug into a south-facing slope features a sod roof, and protection from north winds by coniferous tree plantations. Passive solar strategies are evaluated, including average indoor temperatures and lighting requirements in both summer and winter. Also evaluated were the centre's ventilation systems, windows and passive heat recovery ventilators (HRVs), solar collectors, masonry heaters, and photovoltaic panels. The centre's composting toilets and use of the Living Machine{sup TM} were also discussed and details of the centre's building materials were provided. Ten straw-bale cabins are currently under construction at the centre, using passive solar strategies for heating, ventilation and cooling and combination propane fired/solar hot water heaters, straw bale building envelope and wood frame roof. Further suggestions for the centre's potential uses, and an outline of the centre's ongoing priorities were outlined. 4 refs.

  8. Paradoxical hypertension with cardiac tamponade.

    Science.gov (United States)

    Argulian, Edgar; Herzog, Eyal; Halpern, Dan G; Messerli, Franz H

    2012-10-01

    Subacute (medical) tamponade develops over a period of days or even weeks. Previous studies have shown that subacute tamponade is uncommonly associated with hypotension. On the contrary, many of those patients are indeed hypertensive at initial presentation. We sought to determine the prevalence and predictors of hypertensive cardiac tamponade and hemodynamic response to pericardial effusion drainage. We conducted a retrospective study of patients who underwent pericardial effusion drainage for subacute pericardial tamponade. Diagnosis of pericardial tamponade was established by the treating physician based on clinical data and supportive echocardiographic findings. Patients were defined as hypertensive if initial systolic blood pressure (BP) was ≥140 mm Hg. Thirty patients with subacute tamponade who underwent pericardial effusion drainage were included in the analysis. Eight patients (27%) were hypertensive with a mean systolic BP of 167 compared to 116 mm Hg in 22 nonhypertensive patients. Hypertensive patients with tamponade were more likely to have advanced renal disease (63% vs 14%, p tamponade after pericardial effusion drainage. Those results are consistent with previous studies with an estimated prevalence of hypertensive tamponade from 27% to 43%. In conclusion, a hypertensive response was observed in approximately 1/3 of patients with subacute pericardial tamponade. Relief of cardiac tamponade commonly resulted in a decrease in BP.

  9. Predictive Modeling of Cardiac Ischemia

    Science.gov (United States)

    Anderson, Gary T.

    1996-01-01

    The goal of the Contextual Alarms Management System (CALMS) project is to develop sophisticated models to predict the onset of clinical cardiac ischemia before it occurs. The system will continuously monitor cardiac patients and set off an alarm when they appear about to suffer an ischemic episode. The models take as inputs information from patient history and combine it with continuously updated information extracted from blood pressure, oxygen saturation and ECG lines. Expert system, statistical, neural network and rough set methodologies are then used to forecast the onset of clinical ischemia before it transpires, thus allowing early intervention aimed at preventing morbid complications from occurring. The models will differ from previous attempts by including combinations of continuous and discrete inputs. A commercial medical instrumentation and software company has invested funds in the project with a goal of commercialization of the technology. The end product will be a system that analyzes physiologic parameters and produces an alarm when myocardial ischemia is present. If proven feasible, a CALMS-based system will be added to existing heart monitoring hardware.

  10. Evaluation of respiratory and cardiac motion correction schemes in dual gated PET/CT cardiac imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lamare, F., E-mail: frederic.lamare@chu-bordeaux.fr; Fernandez, P. [Univ. Bordeaux, INCIA, UMR 5287, F-33400 Talence (France); CNRS, INCIA, UMR 5287, F-33400 Talence (France); Service de Médecine Nucléaire, Hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux (France); Le Maitre, A.; Visvikis, D. [INSERM, UMR1101, LaTIM, Université de Bretagne Occidentale, 29609 Brest (France); Dawood, M.; Schäfers, K. P. [European Institute for Molecular Imaging, University of Münster, Mendelstr. 11, 48149 Münster (Germany); Rimoldi, O. E. [Vita-Salute University and Scientific Institute San Raffaele, Milan, Italy and CNR Istituto di Bioimmagini e Fisiologia Molecolare, Milan (Italy)

    2014-07-15

    observed in the performance of the two motion models considered. Superior image SNR and contrast were seen using the affine respiratory motion model in combination with the diastole cardiac bin in comparison to the use of the whole cardiac cycle. In contrast, when simultaneously correcting for cardiac beating and respiration, the elastic respiratory motion model outperformed the affine model. In this context, four cardiac bins associated with eight respiratory amplitude bins seemed to be adequate. Conclusions: Considering the compensation of respiratory motion effects only, both affine and elastic based approaches led to an accurate resizing and positioning of the myocardium. The use of the diastolic phase combined with an affine model based respiratory motion correction may therefore be a simple approach leading to significant quality improvements in cardiac PET imaging. However, the best performance was obtained with the combined correction for both cardiac and respiratory movements considering all the dual-gated bins independently through the use of an elastic model based motion compensation.

  11. Review of CERN Data Centre Infrastructure

    CERN Document Server

    Andrade, P; van Eldik, J; McCance, G; Panzer-Steindel, B; Coelho dos Santos, M; Traylen, S; Schwickerath, U

    2012-01-01

    The CERN Data Centre is reviewing strategies for optimizing the use of the existing infrastructure and expanding to a new data centre by studying how other large sites are being operated. Over the past six months, CERN has been investigating modern and widely-used tools and procedures used for virtualisation, clouds and fabric management in order to reduce operational effort, increase agility and support unattended remote data centres. This paper gives the details on the project’s motivations, current status and areas for future investigation.

  12. Modelling total energy costs of sports centres

    Energy Technology Data Exchange (ETDEWEB)

    Boussabaine, A.H.; Kirkham, R.J.; Grew, R.J. [Liverpool Univ., School of Architecture and Building Engineering, Liverpool (United Kingdom)

    1999-12-07

    Providing and maintaining safe and comfortable conditions in sport centres raises many issues, particularly cost. The paper gives an overview of the factors associated with sport centre servicing and attempts to highlight the governing factors associated with this, particularly energy costs. A total of 19 sport centres in the City of Liverpool in the UK are investigated, using data elicited from the Liverpool Leisure Services Directorate. The energy operating costs were analysed using statistical methods. Six models were developed to predict total energy costs. Testing and validation results showed a high level of model accuracy. The models would be of use to professionals involved in feasibility studies at the design stage. (Author)

  13. Potential of Natural Ventilation in Shopping Centres

    DEFF Research Database (Denmark)

    Diederichsen, Alice; Friis, Kristina; Brohus, Henrik;

    2008-01-01

    The indoor environmental quality (IEQ) is a fundamental requirement for a well performing shopping centre. This paper contains a pilot study of the potential of using hybrid ventilation (a combination of automatically controlled natural and mechanical ventilation - respectively NV and MV......) in shopping centres with focus on both the achieved IEQ and energy consumptions for air movement. By thermal building simulations it is found that there exists an interesting potential for hybrid ventilation of shopping centres, which can lead to great savings in the electrical energy consumptions...... for ventilation and cooling without compromising IEQ....

  14. New centre for intelligent mining systems

    Energy Technology Data Exchange (ETDEWEB)

    Gibson, W.

    2002-10-01

    A Centre for Intelligent Mining Systems has been opened by the University of Alberta's Computing Science Department, a collaborative effort by the University and Syncrude Canada Ltd. The objective of the new Centre is to apply technologies in the area of artificial intelligence and robotics to the problems of surface mining. The Centre has already attracted attention from other players within the industry and a long-term funding proposal by a consortium that includes Syncrude is in the works. Noranda Inc and Inco Inc have also shown interest.

  15. Planetary Radars Operating Centre PROC

    Science.gov (United States)

    Catallo, C.; Flamini, E.; Seu, R.; Alberti, G.

    2007-12-01

    Planetary exploration by means of radar systems, mainly using Ground Penetrating Radars (GPR) plays an important role in Italy. Numerous scientific international space programs are currently carried out jointly with ESA and NASA by Italian Space Agency, the scientific community and the industry. Three important experiments under Italian leadership ( designed and manufactured by the Italian industry), provided by ASI either as contribution to ESA programs either within a NASA/ASI joint venture framework, are now operating: MARSIS on-board Mars Express, SHARAD on-board Mars Reconnaissance Orbiter and CASSINI Radar on-board Cassini spacecraft. In order to support all the scientific communities, institutional customers and experiment teams operation three Italian dedicated operational centers have been realized, namely SHOC, (Sharad Operating Centre), MOC (Marsis Operating Center) and CASSINI PAD ( Processing Altimetry Data). Each center is dedicated to a single instrument management and control, data processing and distribution. Although they had been conceived to operate autonomously and independently one from each other, synergies and overlaps have been envisaged leading to the suggestion of a unified center, the Planetary Radar Processing Center (PROC). PROC is conceived in order to include the three operational centers, namely SHOC, MOC and CASSINI PAD, either from logistics point of view and from HW/SW capabilities point of view. The Planetary Radar Processing Center shall be conceived as the Italian support facility to the scientific community for on-going and future Italian planetary exploration programs. Therefore, scalability, easy use and management shall be the design drivers. The paper describes how PROC is designed and developed, to allow SHOC, MOC and CASSINI PAD to operate as before, and to offer improved functionalities to increase capabilities, mainly in terms of data exchange, comparison, interpretation and exploitation. Furthermore, in the frame of

  16. Cardiac nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Gerson, M.C.

    1987-01-01

    The book begins with a review of the radionuclide methods available for evaluating cardiac perfusion and function. The authors discuss planar and tomographic thallium myocardial imaging, first-pass and equilibrium radionuclide angiography, and imaging with infarct-avid tracers. Several common but more specialized procedures are then reviewed: nonogemetric measurement of left ventricular volume, phase (Fourier) analysis, stroke volume ratio, right ventricular function, and diastolic function. A separate chapter is devoted to drug interventions and in particular the use of radionuclide ventriculography to monitor doxorubicin toxicity and therapy of congestive heart failure. The subsequent chapters provide a comprehensive guide to test selection, accuracy, and results in acute myocardial infarction, in postmyocardial infarction, in chronic coronary artery disease, before and after medical or surgical revascularization, in valvular heart disease, in cardiomyopathies, and in cardiac trauma.

  17. 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.

  18. Cardiac arrhythmias in pregnancy.

    Science.gov (United States)

    Knotts, Robert J; Garan, Hasan

    2014-08-01

    As more women with repaired congenital heart disease survive to their reproductive years and many other women are delaying pregnancy until later in life, a rising concern is the risk of cardiac arrhythmias during pregnancy. Naturally occurring cardiovascular changes during pregnancy increase the likelihood that a recurrence of a previously experienced cardiac arrhythmia or a de novo arrhythmia will occur. Arrhythmias should be thoroughly investigated to determine if there is a reversible etiology, and risks/benefits of treatment options should be fully explored. We discuss the approach to working up and treating various arrhythmias during pregnancy with attention to fetal and maternal risks as well as treatment of fetal arrhythmias. Acute management in stable patients includes close monitoring and intravenous pharmacologic therapy, while DC cardioversion should be used to terminate arrhythmias in hemodynamically unstable patients. Long-term management may require continued oral antiarrhythmic therapy, with particular attention to fetal safety, to prevent complications associated with arrhythmias.

  19. Fractures of the mandibular coronoid process: a two centres study.

    Science.gov (United States)

    Boffano, Paolo; Kommers, Sofie C; Roccia, Fabio; Gallesio, Cesare; Forouzanfar, Tymour

    2014-10-01

    The aim of this study was to assess the characteristics of patients with coronoid fractures treated in two European centres over 10 years and to briefly review the literature. This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures and surgically treated in two European centres between 2001 and 2010. During the 10 years, 1818 patients and 523 patients with maxillofacial fractures were admitted to the two centres respectively: 21 patients (16 males, 5 females) were admitted with 21 coronoid fractures and 28 associated maxillofacial fractures. A mean age of 42.1 years was observed. The fractures were mainly the result of motor vehicle accidents, followed by assaults and falls. The most frequently observed associated maxillofacial fracture was a zygomatic fracture (13 fractures). In both centres, mandibular coronoid fractures are treated unless a severe dislocation of the fractured coronoid is observed or a functional mandibular impairment is encountered. Conservative treatment can be used, together with the open reduction and internal fixation of associated fractures. The crucial point is to prevent ankylosis, which may be prevented by correct and early postoperative physiotherapy and mandibular function.

  20. Towards Human-Centred Design

    Science.gov (United States)

    Bannon, Liam J.

    The field of HCI has evolved and expanded dramatically since its origin in the early 1980’s. The HCI community embraces a large community of researchers and practitioners around the world, from a variety of disciplinary backgrounds in the human and social sciences, engineering and informatics, and more recently, the arts and design disciplines. This kaleidoscope of cultures and disciplines as seen at INTERACT Conferences provides a rich pool of resources for examining our field. Applications are increasingly exploring our full range of sensory modalities, and merging the digital and physical worlds. WiFi has opened up a huge design space for mobile applications. A focus on usability of products and services has been complemented by an emphasis on engagement, enjoyment and experience. With the advent of ubiquitous computing, and the emergence of “The Internet of Things”, new kinds of more open infrastructures make possible radically new kinds of applications. The sources of innovation have also broadened, to include human and social actors outside of the computing and design organizations. The question is to what extent is our mainstream thinking in the HCI field ready for the challenges of this Brave New World? Do the technological and social innovations that we see emerging require us to re-shape, or even, re-create, our field, or is it a case of a more gradual evolution and development of that which we already know? In this closing Keynote, I will provide a perspective on the evolution and development of the HCI field, looking backwards as well as forwards, in order to determine what are some of the changes of significance in the field. This “broad-brush” approach to what I term “ human-centred design” will be complemented by the examination of specific projects and applications, to help anchor some of the discussion. Areas such as user-centred design, participatory design, computer-supported cooperative work and learning, and interaction design, in