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Sample records for highest bnp level

  1. Can venous ProBNP levels predict placenta accreta?

    Science.gov (United States)

    Ersoy, Ali Ozgur; Oztas, Efser; Ozler, Sibel; Ersoy, Ebru; Erkenekli, Kudret; Uygur, Dilek; Caglar, Ali Turhan; Danisman, Nuri

    2016-12-01

    Placenta previa (PP) is a potential life-threatening pregnancy complication. Pro-brain natriuretic peptide (ProBNP), creatine kinase (CK), cardiac form of CK (CK-MB) and Troponin I are circulatory biomarkers related to cardiac functions. We aimed to determine whether these biomarkers are related to PP and placenta accreta. In this case-control study, fifty-four pregnant women who attended our tertiary care center for perinatology with the diagnosis of PP totalis, and of them, 14 patients with placenta accreta were recruited as the study groups. Forty-six uncomplicated control patients who were matched for age, BMI were also included. Maternal venous ProBNP, CK, CK-MB and Troponin I levels were compared between the three groups. Obstetric history characteristics were comparable among groups, generally. CK and CK-MB levels were similar among three groups. Troponin I levels in the previa and accreta groups were significantly higher than the controls. ProBNP levels in the accreta group were significantly higher than other two groups. The multivariate regression model revealed that ProBNP could predict placental adhesion anomalies. Troponin I and ProBNP levels in PP cases were higher than controls and ProBNP could predict placenta accreta.

  2. Analysis of OLAB, BNP and CRP levels in the plasma of patients with cardiovascular disease

    International Nuclear Information System (INIS)

    Du Tongxin; Wang Zizheng; Wang Shukui; Fu Lei; Luo Jun

    2004-01-01

    To explore the mechanism of coronary heart disease and the effect of therapy on unstable angina pectoris (UAP) OLAB, brain natriuretic peptide (BNP) and supersensitive C reaction protein(CRP) levels in the plasma of patients with coronary heart disease were detected. The OLAB, BNP and CRP levels and their correlations in the plasma of 124 patients with coronary heart disease and 30 controls were determined by chemiluminescence and ELISA technique, respectively. The OLAB, BNP and CRP levels of 48 UAP patients after PTCA were also analyzed. The BNP and CRP levels of patients with coronary heart disease, especially acute myocardial infarction (AMI) and UAP patients to stable angina pectoris (SAP) patients were higher than those of controls (P<0.01). The OLAB levels in AMI patients was higher than UAP, SAP and controls (P<0.05). There was a significant difference of OLAB, BNP and CRP levels in UAP patients before and after PTCA therapy (P<0.05). OLAB, BNP and CRP, which is involved in the developing procedure of coronary heart disease, may be used to predict the long-term cardiac function recover. OLAB, BNP and CRP levels in UAP patients were decreased significantly after PTCA and may also be considered as the therapy effect observing markers. OLAB takes part in the whole procedure of coronary atherosclerosis and the occurrence and ending of AMI. (authors)

  3. Changes in Serum NT-Pro BNP and Left Atrial BNP Levels after Percutaneous Transvenous Mitral Commissurotomy in Sinus Rhythm Versus Atrial Firilation

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    Leili Pourafkari

    2014-10-01

    Full Text Available Introduction: Natriuretic peptides are secreted from the heart in response to increased wall stress. Their levels are expected to be increased in patients with mitral stenosis (MS due tohigh left atrium (LA pressure and pulmonary artery pressure (PAP. Percutaneous transvenousmitral commissurotomy (PTMC if successful is pursued by a rapid decrease in LA pressure andsubsequent decrease in pulmonary artery pressure. The concurrent changes in natriuretic peptidelevels could be affected with heart rhythm.Methods: Forty five patients with severe rheumatic MS undergoing PTMC were enrolled. Weevaluated the serum NT-Pro BNP levels before and 24 hours after PTMC. BNP levels were alsomeasured from the blood samples obtained from LA before and 20 minutes after the procedure.Changes in biomarkers were assessed based on heart rhythm and success of the procedure.Results: While serum NT-Pro BNP levels showed significant decrease 24 hours after theprocedure (P= 0.04, BNP levels taken 20 minutes after PTMC from LA were similar to theirbaseline concentrations (P= 0.26. NT-Pro BNP levels decreased 51.7±182.86 pg/ml for SR and123.4±520 pg/ml for AF (P= 0.68.Conclusion: Immediate changes in BNP levels did not predict the success of procedure probablydue to the additional balloon inflation attempts in LA in several patients and half-life of BNP. BNPlevels obtained later may be of more value considering the half-life of this marker. Heart rhythmwas not found to influence the changes in biomarker levels. BNP and NT-pro BNP changes werenot found to predict success of the procedure.

  4. Effect of sinus rhythm restoration on plasma brain natriuretic peptide (BNP) levels in patients with atrial fibrillation

    International Nuclear Information System (INIS)

    An Liping; Jin Zhexiu; Zhang Chengqiu

    2005-01-01

    Objective: To study the changes of plasma brain natriuretic peptide (BNP) levels before and after sinus rhythm restoration in patients with paroxysmal or persistent atrial fibrillation (AF) but normal left ventricle function and to explore the role of BNP in AF. Methods: Plasma BNP levels were measured with RIA in 68 patients and 34 controls. Results: Twenty four hours after successful cardioversion, plasma BNP levels decreased significantly in all the patients. The 30 patients with paroxysmal atrial fibrillation were all restored to sinus rhythm and levels of plasma BNP dropped from 96±42pg/ml to 28 ±21pg/ml. Of the 38 patients with persistent atrial fibrillation, 28 of them were restored to sinus rhythm, in whom levels of plasma BNP dropped from 73±38pg/ml to 38±25pg/ml. Conclusion: The presence of AF should be taken into consideration when interpreting plasma BNP levels in patients with heart disease. (authors)

  5. NT-proBNP and troponin T levels differ after haemodialysis with a low versus high flux membrane

    OpenAIRE

    Laveborn, Emilie; Lindmark, Krister; Skagerlind, Malin; Stegmayr, Bernd

    2015-01-01

    BACKGROUND: Brain natriuretic peptide (BNP), N-terminal-proBNP (NT-proBNP), and high sensitive cardiac troponin T (TnT) are markers that are elevated in chronic kidney disease and correlate with increased risk of mortality. Data are conflicting on the effect of biomarker levels by hemodialysis (HD).Our aim was to clarify to what extent HD with low-flux (LF) versus high-flux (HF) membranes affects the plasma levels of BNP, NT-proBNP, and TnT. METHODS AND MATERIALS: 31 HD patients were included...

  6. Relationship of plasma level of NT- ProBNP with development of AF in CABG patients

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    Tanaray B

    2010-10-01

    Full Text Available "nBackground: Studies of the association between post operative AF and Plasma level of NT- Pro BNP have reported conflicting findings. The aim of the present study was evaluation of the association between post coronary bypass graft- Atrial Fibrillation (AF and Plasma level of NT- ProBNP as an independent risk factor of AF development in patients undergoing coronary artery bypass graft."n "nMethods: In a cohort study, 79 patients with sinus rhythm who admitted in Imam Khomeini Hospital in Tehran, Iran, during February 2009 and February 2010 for CABG are included the study and followed for developing post operative AF rhythm."n "nResults: Post operative AF was found in 17.7% of patients. The peak time from the operation to the first AF episode was in second post op day in ten patients (71.4%. The serum level of ProBNP in patients with AF was significantly higher (1624± 647 versus 221± 238 pg/ml, p< 0/0001. Increased age, Increased LA size and high plasma level of ProBNP were associated with increased risk for post op AF. After adjustment of risk factors, plasma level of ProBNP was the most important risk factor with odds ratio of 15.34 with CI 95% 1.77-132.95 and then LA diameter with odds ratio of 6.11 with CI 95% 0.99-37.42 was independently correlated with post op AF. Correlation between plasma level of ProBNP with age and LA size was seen too (LA size r = 0.0281, p= 0.012. Between age and ProBNP (r= 0.337, p= 0.002. The best cut off point for plasma ProBNP as a predictor of post op AF was 854 pg/ml."n "nConclusion: Increased level of preoperative ProBNP levels could be an independent predictor of post operative Atrial Fibrillation.

  7. Prognostic threshold levels of NT-proBNP testing in primary care

    DEFF Research Database (Denmark)

    Rosenberg, J.; Schou, M.; Gustafsson, F.

    2008-01-01

    AIMS: Chronic heart failure (HF) is a common condition with a poor prognosis. As delayed diagnosis and treatment of HF patients in primary care can be detrimental, risk-stratified waiting lists for echocardiography might optimize resource utilization. We investigated whether a prognostic threshold...... level of the cardiac peptide, NT-proBNP, could be identified. METHODS AND RESULTS: From 2003-2005, 5875 primary care patients with suspected HF (median age 73 years) had NT-proBNP analysed in the Copenhagen area. Eighteen percent died and 20% had a cardiovascular (CV) hospitalization (median follow....../mL) was associated with an 80% (95% CI: 20-190, P = 0.01) increased mortality risk after adjustment for age, sex, previous hospitalization, CV diseases, and chronic diseases. CONCLUSION: We identified prognostic threshold levels for mortality and CV hospitalization for NT-proBNP in primary care patients suspected...

  8. ABCD2 score and BNP level in patients with TIA and cerebral stroke.

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    Mortezabeigi, H R; Taghizadeh, A; Talebi, M; Amini, K; Goldust, M

    2013-11-01

    Scoring systems have been designed to help physicians in early prediction of cerebral stroke following Transitional Ischemic Attack (TIA). ABCD2 system is one of these scoring systems. Considering increase of brain natriuretic peptide following cerebral ischemic stroke, BNP level may be associated with incidence of ischemic stroke following TIA. The present study evaluates ABCD2 score, BNP level in patients with TIA and incidence of cerebral stroke. This cross sectional-analytical study evaluated 78 patients with TIA. ABCD2 score was calculated for all patients based on some criteria including age, blood pressure, clinical manifestations (speech/motor disorder), symptoms duration and diabetes. BNP level was measured at the reference laboratory when the patient referred to the treatment center. The patients were followed up for 6 months considering incidence of cerebral stroke and TIA. Mean age of the patients was 66.53 +/- 13.08 years and the sample was consisted of 62.8% male and 37.2% female patients. Mean BNP level and mean ABCD2 score was 611.31 +/- 125.61 and 4.61 +/- 10.99 in all patients, respectively. During follow-up period, TIA recurrence and cerebral stroke were, respectively seen in 11.5 and 3.8% of cases. Mortality was reported in 5.1% of the patients. BNP was significantly higher in cases with recursive TIA (p = 0.03). But, there was not any difference considering ABCD2 score (p = 0.38). BNP is capable of predicting TIA recurrence following first TIA and it can be used in this case.

  9. Relationship between plasma BNP level and perfusion and function of the left ventricle in patients with coronary artery disease

    International Nuclear Information System (INIS)

    Celinski, R.; Cholewinski, W.; Stefaniak, B.; Tarkowska, A.; Grzywa-Celinska, A.

    2004-01-01

    Elevation of the plasma BNP is known to occur in heart failure. However, some observations suggest that in patients with CAD an increase in BNP level may be caused also by the myocardial ischaemia. The study population comprised 79 patients with CAD, aged on average 59.6, and 18 healthy volunteers (CG). In patients with CAD g SPECT was performed using 99mT c tetrofosmin and myocardial perfusion and function were assessed quantitatively. Plasma BNP was measured using immunoradiometric method and was analyzed according to LVEF, EDV, ESV and two perfusion parameters: SCD and TPD. In all patients with CAD perfusion defects were found at rest. BNP concentration was significantly higher in CAD than in CG. In the group with dLVEF plasma BNP was distinctly higher than in that with nVEF but that difference was not significant. In pts with dLVEF significant correlation was found between BNP concentration on one hand and LVEF, EDV and ESV on the other. No significant relationships were observed between plasma BNP and both perfusion parameters. In patients with CAD the increase in plasma BNP level is related to the disorders of the left ventricular contractility, to the systolic function impairment first of all. Myocardial ischaemia without concomitant contractility disorders does not lead to elevation of BNP level. (author)

  10. B-type natriuretic peptide (BNP serum levels in rats after forced repeated swimming stress

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    Almira Hadžovic-Džuvo

    2011-02-01

    Full Text Available Aim To estimate the effects of forced repeated swimming stress on BNP serum levels in rats. Methods Adult male Wistar rats weighting between 280-330 g were divided into two groups: control group (n =8 and stress group (n =8. Rats in the stress group were exposed to forced swimming stress daily, for 7 days. The rats were forced to swim in plastic tanks (90 cm wide, 120 cm deep containing tap water (temperature ca. 25°C. The depth of water was 40 cm. Duration of each swimming session progressively increased from 10 minutes on the irst day to 40 minutes on days 6 and 7. Rats were sacriiced and blood was drawn from abdominal aorta for BNP analysis immediately after the last swimming session. B-type natriuretic serum level was determined by ELISA method using RAT BNP-32 kit (Phoenix Pharmaceutical Inc.. Results There was no statistically signiicant difference between mean BNP serum level in the stress group after the swimming period (0.81±0.14 ng/ml as compared to the unstressed group of rats (0.8 ±0.08ng/ml. After the swimming period mean body weight slightly decreased in the stress group in comparison with values before stress period (296.3 g vs.272.8 g, but this difference was not statistically signiicant. The stress period had no inluence on food intake in the stress rat group. Conclusion The workload consisting of 40-minutes long swimming session is not suficient to provoke BNP release from myocardium in rats.

  11. B-type natriuretic peptide (BNP) serum levels in rats after forced repeated swimming stress.

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    Hadzovic-Dzuvo, Almira; Valjevac, Amina; Avdagić, Nesina; Lepara, Orhan; Zaćiragić, Asija; Jadrić, Radivoj; Alajbegović, Jasmin; Prnjavorac, Besim

    2011-02-01

    To estimate the effects of forced repeated swimming stress on BNP serum levels in rats. Adult male Wistar rats weighting between 280-330 g were divided into two groups: control group (n = 8) and stress group (n = 8). Rats in the stress group were exposed to forced swimming stress daily, for 7 days. The rats were forced to swim in plastic tanks (90 cm wide, 120 cm deep) containing tap water (temperature ca. 25 degrees C). The depth of water was 40 cm. Duration of each swimming session progressively increased from 10 minutes on the first day to 40 minutes on days 6 and 7. Rats were sacrificed and blood was drawn from abdominal aorta for BNP analysis immediately after the last swimming session. B-type natriuretic serum level was determined by ELISA method using RAT BNP-32 kit (Phoenix Pharmaceutical Inc.). There was no statistically significant difference between mean BNP serum level in the stress group after the swimming period (0.81 +/- 0.14 ng/ml) as compared to the unstressed group of rats (0.8 +/- 0.08 ng/ml). After the swimming period mean body weight slightly decreased in the stress group in comparison with values before stress period (296.3 g vs. 272.8 g), but this difference was not statistically significant. The stress period had no influence on food intake in the stress rat group. The workload consisting of 40-minutes long swimming session is not sufficient to provoke BNP release from myocardium in rats.

  12. Clinical significance of determination of changes of serum APN, BNP and ANF levels after treatment in patients with heart failure

    International Nuclear Information System (INIS)

    Ge Hengsong; Hu Min; Gao Xinchun

    2011-01-01

    Objective: To explore the significance of changes on serum APN, BNP and ANF levels after treatment in patients with heart failure. Methods: Serum BNP, ANF(with RIA) serum APN (with ELISA) levels were determined in 30 patients with heart failure both before and after treatment as well as in 35 normal controls. Results: Before treatment, serum APN level was significantly lower than those in controls (P<0.01), but serum BNP, ANF levels were apparently higher (P<0.01). After 1 month of treatment, the levels dropped markedly, but still remained obviously higher (P<0.05). Conclusion: Serum APN, BNP and ANF levels were closely related to the process of heart failure and were of clinical value of monitoring therapeutic effect and prognosis. (authors)

  13. An obesity drug sibutramine reduces brain natriuretic peptide (BNP) levels in severely obese patients.

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    Taner Ertugrul, D; Yavuz, B; Okhan Akin, K; Arif Yalcin, A; Ata, N; Kucukazman, M; Algul, B; Dal, K; Sinan Deveci, O; Tutal, E

    2010-03-01

    Sibutramine is a selective inhibitor of the reuptake of monoamines. Plasma levels of brain natriuretic peptide (BNP) appear to be inversely associated with body mass index (BMI) in subjects with and without heart failure for reasons that remain unexplained. The aim of this study was to investigate the possible influence of sibutramine treatment on BNP levels in severely obese patients. Fifty-two severely obese female patients with BMI > 40 kg/m(2) were included to this study. The women were recommended to follow a weight-reducing daily diet of 25 kcal/kg of ideal body weight. During the treatment period, all patients were to receive 15 mg of sibutramine once a day. Blood chemistry tests were performed before the onset of the medication and after 12 weeks of treatment. None of the subjects was withdrawn from the study because of the adverse effects of sibutramine. Body weight (108.8 +/- 13.3 kg vs. 101.7 +/- 15.6 kg, p sibutramine treatment. Total cholesterol (5.19 +/- 0.90 mmol/l vs. 4.82 +/- 1.05 mmol/l respectively; p sibutramine treatment. Further randomised studies are needed to be conducted to clarify the relationship between sibutramine and BNP.

  14. Study on the relationship between plasma BNP levels and left cardiac function in patients with heart failure

    International Nuclear Information System (INIS)

    Yin Xin; Xu Dandan; Wu Chunxu

    2005-01-01

    Objective: To investigate the relationship between plasma brain natriuretic peptide (BNP) levels and cardiac function in patients with heart failure. Methods: Plasma levels of BNP (with IRMA) and left cardiac function parameters (examined with echocardiogram) were obtained in 80 patients with heart failure at admission and repeatedly examined in 43 of them later after 2w treatment a swell as in 30 controls. Results: The plasma BNP levels increased along with the deterioration of cardiac function, with significant differences among the patients with different cardiac function grades (P<0.01). After 2w treatment, the plasma BNP levels were significantly lower than those before (P<0.01). The plasma levels of BNP were negatively correlated with left ventricular ejection fraction (LVEF) and left ventricle fraction shortening, but positively correlated with left ventricular end-systolic diameter (LVSd) and left ventricular end-diastolic diameter (LVDd). Conclusion: Plasma levels of BNP were closely related to the severity of heart failure and could serve as a biochemical marker for assessing the left cardiac function. (authors)

  15. Study on the clinical significance of determination of serum brain natriuretic peptide (BNP) levels in patients with heart failure

    International Nuclear Information System (INIS)

    Ji Naijun; Mei Yibeng; Fan Bifu; Chen Donghai; Guan Lihua; Gao Meiying; Tong Lijun; Li Fuyuan; Pan Jiongwei

    2004-01-01

    Objective: To study the clinical significance of the changes of serum BNP levels in patients with heart failure (HF). Methods: Serum BNP levels in 88 patients with HF(NYHA II-IV), 20 patients with compensated cardiac function (NYHA I) and 30 controls were determined with RIA. Results: The serum BNP levels in patients with HF (264±63.9 pmol/L) were significantly higher than those in patients with compensated cardiac function (NYHA I, 11.6±4.7 pmol/L, t=2.133, p 0.05). As the cardiac function deteriorated from NYHA II to NYHA IV, the BNP levels increased consecutively with significant differences from each other (F=2.595, p<0.05). BNP levels in patients with acute left heart failure were significantly higher than those in patients with chronic heart failure (t=2.268, p<0.05) and fell promptly at relief of the attack (p<0.05). Conclusion: Determination of serum BNP levels in patients with HF was helpful to the study of the severity and prognosis of the disease

  16. ANP and BNP plasma levels in patients with rheumatic mitral stenosis after percutaneous balloon mitral valvuloplasty

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    Łukasz Mazurkiewicz

    2017-03-01

    Full Text Available Introduction: Atrial (ANP and B-type (BNP natriuretic peptides are hormones secreted by the heart as a response to volume expansion and pressure overload. Aim: To assess the changes of ANP and BNP after percutaneous balloon mitral valvuloplasty (PBMV and to investigate factors associated with endpoints. Material and methods: The study included 96 patients (90.7% females, age 51.6 ±12.2 years with rheumatic mitral valve stenosis (mitral valve area (MVA 1.18 (1.01–1.33 cm2, mean mitral gradient (MMG 8.2 (7.1–9.2 mm Hg, NYHA 2.09 (1.9–2.5. Patients were followed up for 29.1 months for the search of endpoints. Results : The PBMV was successful in all cases. After the procedure MVA increased (1.18–1.78 cm2, p < 0.01 and pulmonary capillary wedge pressure (PCWP decreased (29.8–21.8 mm Hg, p < 0.01. Concentration of ANP significantly rose 30 min after the PBMV (79.2 vs. 134.2 pg/ml, p = 0.012 and dropped significantly after 24 h (134.2 vs. 70.4 pg/ml, p = 0.01. Furthermore, after 36 months concentration of ANP did not differ from the baseline value (p = NS. BNP concentration at day 1 was lower than at baseline (94.5 vs. 80.2 pg/ml, p = 0.032. Moreover, during the follow-up period BNP continued to fall at all time points. In univariate analysis parameters associated with endpoint occurrence were baseline PAP (p = 0.023, baseline PCWP (p = 0.022, baseline NYHA (p = 0.041 and increase in 6-minute walk test (6MWT (p = 0.043. In multivariate analysis the only factor associated with endpoint occurrence was baseline NYHA (HR = 1.52, 95% CI: –1.3–1.91, p = 0.022. Conclusions : Patients with MS had increased levels of both BNP and ANP. Baseline NYHA class was found to be associated with outcomes after the procedure.

  17. Changes of BNP, ANP, ET and CRP levels in the plasma of patients with acute myocardial infarction

    International Nuclear Information System (INIS)

    Du Tongxing; Wang Zizheng; Wang Shukui; Luo Jun

    2004-01-01

    To explore the pathogenesis and provide evidence for the diagnosis, therapy and prognosis of acute myocardial infarction (AMI) by observing the levels of brain natriuretic peptide (BNP), endothelins (ET), C-reactive protein (CRP) and atrial natriuretic peptide (ANP) in plasma of the patients, BNP, ET, CRP and ANP levels in plasma of 46 AMI patients before and after therapy and 30 normal controls were detected by ELISA and immunoradiometric assay, respectively. Results showed that there were significant differences in BNP, ET, CRP and ANP levels in patients with AMI before and after therapy (P 0.05) after thrombolysis and other supporting therapy, the decreased BNP, ET and CRP were still significantly higher than those of control ( P<0.05). The changes of BNP, ANP, ET and CRP indicate that they involved in the occurrence and development of AMI, especially in the formation and disruption of atheromatous plaque and thrombosis. So the detection of BNP, ANP, ET and CRP levels was significant to the diagnosis, therapy and prognosis judgement

  18. Troponin T and NT ProBNP Levels in Gestational, Type 1 and Type 2 Diabetic Mothers and Macrosomic Infants.

    Science.gov (United States)

    Mert, Mustafa Kurthan; Satar, Mehmet; Özbarlas, Nazan; Yaman, Akgün; Özgünen, Fatma Tuncay; Asker, Hüseyin Selim; Çekinmez, Eren Kale; Tetiker, Tamer

    2016-01-01

    This study compares NT proBNP and troponin T levels in umbilical cord arterial blood and postnatal echocardiographic findings for infants of gestational and pregestational diabetic mothers and macrosomic infants. Twenty-seven infants of pregestational diabetic mothers, 61 infants of gestational diabetic mothers and 37 macrosomic infants of nondiabetic mothers were prospectively enrolled in this study along with a control group of 58 healthy infants of mothers without any pregestational or gestational disorders as the control group. All enrollees were born after 34 weeks of gestation. For this study, umbilical cord blood was drawn during delivery to determine NT proBNP and troponin T levels. Echocardiography was performed 24-72 h after the delivery. Umbilical cord troponin T and NT proBNP levels were found to be higher in the diabetic and macrosomic groups than in the control group (all of them p gestational infants of diabetic mothers groups (r = 0.564 and r = 0.560, respectively, p gestational diabetic mothers were divided into two groups according to HbA1c levels in the third trimester as good (6.1 %) metabolic control. In the good and suboptimal metabolic control diabetic groups, NT proBNP levels were also positively correlated with interventricular septum thickness (r = 0.536 and r = 0.576, respectively, p mothers and the control group, the myocardial performance index of macrosomic infants was lower than that of the control group (p = 0.017). Cardiac biomarkers (NT proBNP and troponin T) were elevated in infants of diabetic mothers and macrosomic infants. While there was a positive correlation between NT proBNP levels and cardiac structure in infants of pregestational and gestational diabetic mothers, there was no relationship between NT proBNP levels and cardiac function.

  19. An elevated level of BNP in plasma is related to the development of good collateral circulation in coronary artery disease.

    Science.gov (United States)

    Xi, Wei-Wei; Cheng, Gang; Lv, Shumin; Gao, Qinqin; Bu, Gang; Zhou, Ying; Xu, Geng

    2011-12-01

    B-type natriuretic peptide (BNP) was recently demonstrated to be a potential stimulator of angiogenesis and arteriogenesis. The correlation between BNP level and collateral formation in patients with coronary artery disease (CAD) has not been reported. The study included 311 consecutive patients who underwent coronary angiography were divided into three groups according to coronary angiography and collateral formation: normal group (100 patients with normal coronary angiographic findings); poor collateral group (116 patients with at least one coronary stenosis of ≥75% without visible collateral circulation); and good collateral group (95 patients with at least one coronary stenosis of ≥75% with well-developed collateral circulation). Collateral score was analyzed using the Cohen-Rentrop classification. Plasma BNP levels were 45.77 ± 4.66 pg/ml, 116.40 ± 28.15 pg/ml, and 254.20 ± 42.85 pg/ml for patients in normal, poor collateral, and good collateral groups, respectively. Plasma BNP levels in the latter were significantly higher than in the normal group (p collateral group (p collateral group and poor collateral group when compared with left ventricular ejection fraction (LVEF), left ventricular dimensions at end diastole (LVEDd), age, severity of angiographic disease, and other cardiovascular risk factors. After adjustment in the multiple ordinal logistic regression model, plasma BNP levels showed a strong independent association with collateral Cohen-Rentrop score (χ(2 )= 5.636, OR = 1.002, 95% CI 1.000-1.004, p = 0.018). An elevated level of BNP in plasma is independently associated with collateral development; patients with good collaterals tend to have a higher BNP level.

  20. Do optimally ripe blackberries contain the highest levels of metabolites?

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    Mikulic-Petkovsek, Maja; Koron, Darinka; Zorenc, Zala; Veberic, Robert

    2017-01-15

    Five blackberry cultivars were selected for the study ('Chester Thornless', 'Cacanska Bestrna', 'Loch Ness', 'Smoothstem' and 'Thornfree') and harvested at three different maturity stages (under-, optimal- and over-ripe). Optimally ripe and over-ripe blackberries contained significantly higher levels of total sugars compared to under-ripe fruit. 'Loch Ness' cultivar was characterized by 2.2-2.6-fold higher levels of total sugars than other cultivars and consequently, the highest sugar/acids ratio. 'Chester Thornless' stands out as the cultivar with the highest level of vitamin C in under-ripe (125.87mgkg(-1)) and optimally mature fruit (127.66mgkg(-1)). Maturity stage significantly affected the accumulation of phenolic compounds. The content of total anthocyanins increased for 43% at optimal maturity stage and cinnamic acid derivatives for 57% compared to under-ripe fruit. Over-ripe blackberries were distinguished by the highest content of total phenolics (1251-2115mg GAE kg(-1) FW) and greatest FRAP values (25.9-43.2mM TE kg(-1) FW). Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Significance of changes of levels of plasma proBNP1-76 in patients with chronic pulmonary heart disease

    International Nuclear Information System (INIS)

    Li Guizhong; Xu Hua; Cao Jun; Jiang Wei; Pang Yongzheng; Tang Chaoshu

    2003-01-01

    Objective: To investigate the significance of the changes levels of plasma proBNP 1-76 in patients with COPD and chronic pulmonary heart disease. Methods: Plasma proBNP 1-76 levels were determined with radioimmunoassay in patients with CHPD (n=23), COPD (n=24) and 32 controls. Results: The concentrations of plasma proBNP 1-76 in patients with chronic obstructive pulmonary disease were significantly increased (vs controls, p 1-76 (r=0.541, p 1-76 , right inferior pulmonary artery diameter, right ventricle out flow tract diameter and right ventricle anterior wall thickness in patients with chronic pulmonary heart disease were increased significantly (vs COPD patients and controls, p 1-76 (r=0.477, p 1-76 is an early marker of right ventricular hypertrophy and right ventricular dysfunction, measurement of which is useful in the management of patients with chronic pulmonary heart disease in daily practice

  2. NT-ProBNP levels, water and sodium homeostasis in healthy men: effects of 7 days of dry immersion.

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    Navasiolava, Nastassia M; Pajot, Aurelie; Gallois, Yves; Pastushkova, Ludmila Kh; Kulchitsky, Vladimir A; Gauquelin-Koch, Guillemette; Kozlovskaya, Inesa B; Heer, Martina; Hand, Olga; Larina, Irina M; Custaud, Marc-Antoine

    2011-09-01

    Immersion is a useful tool for studying fluid-volume homeostasis. Natriuretic peptides play a vital role in renal, humoral, and cardiovascular regulation under changing environmental conditions. We hypothesized that dry immersion would rapidly induce a new steady state for water and sodium metabolism, and that serum NT-proBNP levels, a proxy measure for brain natriuretic peptide (BNP), would decrease during long-term dry immersion and increase during recovery. Eight healthy young men were studied before, during, and after 7 days of dry immersion. Body weight, water balance, and plasma volume changes were evaluated. Plasma and serum samples were analyzed for active renin, NT-proBNP, aldosterone, electrolytes, osmolality, total protein, and creatinine. Urine samples were analyzed to determine levels of electrolytes, osmolality, creatinine, and free cortisol. A stand test was performed before and after dry immersion to evaluate cardiovascular deconditioning. Long-term dry immersion induced acute changes in water and sodium homeostasis on day 1, followed by a new steady state. Plasma volume decreased significantly during dry immersion. The serum levels of NT-proBNP increased significantly in recovery (10 ± 3 ng/L before dry immersion vs. 26 ± 5 ng/L on the fourth recovery day). Heart rate in the standing position was significantly greater after immersion. Results suggest that chronic dry immersion rapidly induced a new level of water-electrolyte homeostasis. The increase in NT-proBNP levels during the recovery period may be related to greater cardiac work and might reflect the degree of cardiovascular deconditioning.

  3. Clinical Significance of Determination of the Serum Levels of NT-proBNP and hs-CRP in Patients with Acute Coronary Syndrome

    International Nuclear Information System (INIS)

    Zheng Zhaojun; Zheng Jing; Sun Weili; Yuan Yuan; Tao Jian; Li Weipeng

    2010-01-01

    To explore the clinical significance the serum levels of N-Terminal proB-Type natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) in patients with acute coronary syndrome,the serum levels of NT-proBNP and hs-CRP in patients and normal controls were determined by ECi Immunity Analyzer and radioimmunoassay respectively. The results showed that the serum levels of NT-proBNP and hs-CRP in patients with acute coronary syndrome were significantly higher than that of controls (P<0.05). The diagnostic specificity for acute coronary syndrome was 100% by combined detection of NT-proBNP and hs-CRP. The results suggest that the combined detection of serum NT-proBNP and hs-CRP levels are very important to evaluate heart function in patients with acute coronary syndrome. (authors)

  4. Polymorphisms in the B-type natriuretic peptide (BNP) gene are associated with NT-proBNP levels but not with diabetic nephropathy or mortality in type 1 diabetic patients

    DEFF Research Database (Denmark)

    Lajer, Maria Stenkil; Tarnow, Lise; Jorsal, Anders

    2007-01-01

    BACKGROUND: Circulating N-terminal pro-brain natriuretic peptide (NT-proBNP) levels are elevated in patients with diabetic nephropathy and independently predict excess cardiovascular morbidity and mortality. Therefore, we investigated the association between two polymorphisms -381T/C and 1551G....../A of the BNP gene, plasma NT-proBNP levels and mortality prognosis in 380 type 1 diabetic patients with and without diabetic nephropathy. METHODS: In a prospective observational follow-up study, 197 type 1 diabetic patients with diabetic nephropathy {121 men, age [mean (SD)] 41 +/- 9.5 years, duration...... of diabetes 28 +/- 8.0 years, glomerular filtration rate 67 +/- 28 ml/min/1.73 m2}, and a matched control group of 183 patients with longstanding type 1 diabetes and persistent normoalbuminuria (111 men, age 43 +/- 10.0 years, duration of diabetes 27 +/- 8.3 years) were followed for 12.6 (0.0-12.9) years...

  5. Níveis NT-Pro-BNP e resposta ao exercício em pacientes com fluxo lento coronariano NT-Pro-BNP levels and their response to exercise in patients with slow coronary flow

    Directory of Open Access Journals (Sweden)

    Mustafa Yurtdaş

    2012-12-01

    patients with angina was higher than those without angina (76.8 ± 17.8 pg/mL vs. 63.8±17.5 pg/mL p=0.041. NT-Pro-BNP concentration in 11 patients with ST depression was also higher than those without ST depression (82.4 ± 17.3 pg/mL vs. 63.3 ± 16.1 pg/mL p=0.004. Median post-exercise increases in NT-Pro-BNP (Δ NT-Pro-BNP were higher in the SCF group than in the control group (Δ NT-Pro-BNP: 19.8±7.7 pg/mL vs. 5.7±4.5 pg/mL p<0.0001. CONCLUSION: The results of this study suggest that there may be an important pathophysiologic link between the severity of SCF (microvascular or epicardial coronary artery dysfunction and the level of circulating NT-Pro-BNP in SCF patients.

  6. Níveis NT-Pro-BNP e resposta ao exercício em pacientes com fluxo lento coronariano NT-Pro-BNP levels and their response to exercise in patients with slow coronary flow

    Directory of Open Access Journals (Sweden)

    Mustafa Yurtdaş

    2012-01-01

    patients with angina was higher than those without angina (76.8 ± 17.8 pg/mL vs. 63.8±17.5 pg/mL p=0.041. NT-Pro-BNP concentration in 11 patients with ST depression was also higher than those without ST depression (82.4 ± 17.3 pg/mL vs. 63.3 ± 16.1 pg/mL p=0.004. Median post-exercise increases in NT-Pro-BNP (Δ NT-Pro-BNP were higher in the SCF group than in the control group (Δ NT-Pro-BNP: 19.8±7.7 pg/mL vs. 5.7±4.5 pg/mL p<0.0001. CONCLUSION: The results of this study suggest that there may be an important pathophysiologic link between the severity of SCF (microvascular or epicardial coronary artery dysfunction and the level of circulating NT-Pro-BNP in SCF patients.

  7. Clinical significance of determination of changes of serum Hcy, ET and BNP levels After treatment in patients with pregnancy induced hypertension (PIH)

    International Nuclear Information System (INIS)

    He Hongling

    2010-01-01

    Objective: To study the clinical significance of changes of serum Hcy, ET and BNP levels after treatment in patients with pregnancy induced hypertension(PIH). Methods: Serum Hcy (with ELISA), ET and BNP (with RIA) levels were determined in 32 patients with PIH both before and after treatment as well as in 35 controls. Results: Before treatment, serum Hcy, ET and BNP levels in patients with PIH were significantly higher than those in controls (P < 0.01). After 1 month of treatment the levels dropped markedly, but still remained significantly higher(P < 0.05). Conclusion: Serum Hcy, ET and BNP levels were closely related to the diseases process of PIH and were of prognostic values. (authors)

  8. Variability of NT‐proBNP plasma and urine levels in patients with stable heart failure: a 2‐year follow‐up study

    Science.gov (United States)

    Cortés, Raquel; Rivera, Miguel; Salvador, Antonio; Bertomeu, Vicente; de Burgos, Fernando García; Roselló‐Lletí, Esther; Portolés, Manuel; Payá, Rafael; Martínez‐Dolz, Luis; Climent, Vicente

    2007-01-01

    Objectives To examine N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) variability in plasma and urine samples of patients with stable heart failure (HF) during a 24‐month follow‐up. Design Prospective study. Setting Teaching hospital based study. Patients 74 clinically and functionally stable patients (NYHA class 2±0.5) out of 114 patients diagnosed with HF were followed up, and NT‐proBNP plasma and urine levels were measured at baseline, 12 and 24 months. Results Significant differences in mean urinary levels (p<0.01) were found during follow‐up, but no changes were found in plasma. Bland–Altman plots showed few variations in plasma percentages in the three intervals (stage I–basal; stage II–stage I; stage II–basal) with a coefficient of reproducibility (CR) of 22%, 21% and 25%, respectively. Changes in NT‐proBNP urinary levels had a CR of 7.1%, 6.8% and 9.4% at the three intervals, respectively. A good correlation was found between plasma and urinary levels of NT‐proBNP (p<0.001) and between the different NT‐proBNP plasma (p<0.001) and urine measurements (p<0.001). Conclusions NT‐proBNP plasma and urine levels show good stability in a 24‐month follow‐up of patients with stable heart failure. Thus, assessment of urinary and plasma NT‐proBNP concentrations may be a useful tool for monitoring patients with HF during follow‐up. The results suggest that variations in peptide concentrations exceeding 22% in plasma and 7% in urine in a 12‐month follow‐up and 25% and 9% in a 24‐month follow‐up may indicate pathophysiological changes. PMID:17488774

  9. Effect of a regimen of optimal medical therapy on brain natriuretic peptide (BNP) levels in heart failure in the Pakistani population

    International Nuclear Information System (INIS)

    Hussain, S.; Kayani, M.; Munir, R

    2012-01-01

    Objective: To document the effect of optimal medical therapy (OMT) on BNP levels in heart failure in Pakistani population. Methodology: In this Quasi experimental study, 75 consecutive stage C heart failure patients that had not been on OMT were included. These patients had been referred to AFIC-NIHD Heart Transplantation Department for assessment regarding heart transplantation. Initial assessments were carried out in hospital. Patients who were on OMT already were excluded. The prescription (carvedilol, lisinopril, spironolactone) was introduced as in patient as per pre defined protocol after clinical, imaging and lab evaluation. The patients were followed up in clinic and the dose escalation was done at regular intervals in out patients department. Clinical and lab variables were collected included BNP levels before starting treatment and 4 weeks after treatment. Results : Males were 75% and females were 25%. Mean age was 38.69 +- 12.98 years (range 18-70 years). Mean Ejection fraction was 23.9% (range 15 - 34%). At one month clinical status of all patients improved except one. The patients had improved from NYHA class-III to NYHA class-II of dyspnoea. The mean baseline BNP level was 1331 pg/ mL, and the BNP level 4 weeks after the OMT trial was 951.9 pg/mL. This reduction was statistically significant (p=0.016). Conclusion: OMT improves the BNP levels within a span of one month in patients with advanced systolic heart failure. This also correlated with the clinical improvement in the patients, and it was observed that BNP levels helped to monitor patients objectively and adjust OMT. (author)

  10. Red Cell Distribution Width and Serum BNP Level Correlation in Diabetic Patients with Cardiac Failure: A Cross - Sectional Study.

    Science.gov (United States)

    A R, Subhashree

    2014-06-01

    Red cell distribution width (RDW) is a red cell measurement given by fully automated hematology analyzers. It is a measure of heterogeneity in the size of circulating erythrocytes. Studies have shown that it is a prognostic marker in non - anemic diabetic patients with symptomatic cardiovascular disease but its correlation with cardiac failure in diabetics has not been studied so far. Moreover, studies have also shown that a higher RDW may reflect an underlying inflammatory state. Since Diabetes is a pro inflammatory state there is a possibility that it might have an influence on the RDW values even when there is no cardiac failure, but research data on this aspect is lacking. B-type natriuretic peptide (BNP) is a proven marker for cardiac failure whose values are comparable with echo cardio graphic findings in assessing the left ventricular dysfunction. This study aimed to find out the correlation between RDW% and serum BNP levels in Diabetics with heart failure (cases) when compared to those without failure (controls). Further, we compared the RDW % values of the cases with controls. Settings and Design : The study was approved by institutional ethical and research committee. A cross-sectional study was conducted with patients attending the Diabetes clinic of a tertiary care hospital in Chennai, India, during the period of October to December 2013. Hundred known cases of type II Diabetes mellitus attending Diabetes centre of the Hospital, with clinical and Echo cardio graphic features of cardiac failure were included as cases. Hundred age and gender matched diabetics with negative history of cardiovascular disease and with normal Echo cardio graphic features were included as controls. Informed consent was obtained from all the cases and controls. Demographic data and clinical history were gathered from all the cases and controls by using a standardized self - administered questionnaire. Biochemical and hematological parameters which included Fasting and

  11. NT-pro-BNP levels in patients with acute pulmonary embolism are correlated to right but not left ventricular volume and function.

    Science.gov (United States)

    Pasha, Sharif M; Klok, Frederikus A; van der Bijl, Noortje; de Roos, Albert; Kroft, Lucia J M; Huisman, Menno V

    2012-08-01

    N-terminal pro-Brain Natriuretic Peptide (NT-pro-BNP) is primarily secreted by left ventricular (LV) stretch and wall tension. Notably, NT-pro-BNP is a prognostic marker in acute pulmonary embolism (PE), which primarily stresses the right ventricle (RV). We sought to evaluate the relative contribution of the RV to NT-pro-BNP levels during PE. A post-hoc analysis of an observational prospective outcome study in 113 consecutive patients with computed tomography (CT)-proven PE and 226 patients in whom PE was clinically suspected but ruled out by CT. In all patients RV and LV function was established by assessing ECG-triggered-CT measured ventricular end-diastolic-volumes and ejection fraction (EF). NT-pro-BNP was assessed in all patients. The correlation between RV and LV end-diastolic-volumes and systolic function was evaluated by multiple linear regression corrected for known confounders. In the PE cohort increased RVEF (β-coefficient (95% confidence interval [CI]) -0.044 (± -0.011); p<0.001) and higher RV end-diastolic-volume (β-coefficient 0.005 (± 0.001); p<0.001) were significantly correlated to NT-pro-BNP, while no correlation was found with LVEF (β-coefficient 0.005 (± 0.010); p=0.587) and LV end-diastolic-volume (β-coefficient -0.003 (± 0.002); p=0.074). In control patients without PE we found a strong correlation between NT-pro-BNP levels and LVEF (β-coefficient -0.027 (± -0.006); p<0.001) although not LV end-diastolic-volume (β-coefficient 0.001 (± 0.001); p=0.418). RVEF (β-coefficient -0.002 (± -0.006); p=0.802) and RV end-diastolic-volume (β-coefficient <0.001 (± 0.001); p=0.730) were not correlated in patients without PE. In PE patients, lower RVEF and higher RV end-diastolic-volume were significantly correlated to NT-pro-BNP levels as compared to control patients without PE. These observations provide pathophysiological ground for the well-known prognostic value of NT-pro-BNP in acute PE.

  12. Association of the Aspartate Aminotransferase to Alanine Aminotransferase Ratio with BNP Level and Cardiovascular Mortality in the General Population: The Yamagata Study 10-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Miyuki Yokoyama

    2016-01-01

    Full Text Available Background. Early identification of high risk subjects for cardiovascular disease in health check-up is still unmet medical need. Cardiovascular disease is characterized by the superior increase in aspartate aminotransferase (AST to alanine aminotransferase (ALT. However, the association of AST/ALT ratio with brain natriuretic peptide (BNP levels and cardiovascular mortality remains unclear in the general population. Methods and Results. This longitudinal cohort study included 3,494 Japanese subjects who participated in a community-based health check-up, with a 10-year follow-up. The AST/ALT ratio increased with increasing BNP levels. And multivariate logistic analysis showed that the AST/ALT ratio was significantly associated with a high BNP (≥100 pg/mL. There were 250 all-cause deaths including 79 cardiovascular deaths. Multivariate Cox proportional hazard regression analysis revealed that a high AST/ALT ratio (>90 percentile was an independent predictor of all-cause and cardiovascular mortality after adjustment for confounding factors. Kaplan-Meier analysis demonstrated that cardiovascular mortality was higher in subjects with a high AST/ALT ratio than in those without. Conclusions. The AST/ALT ratio was associated with an increase in BNP and was predictive of cardiovascular mortality in a general population. Measuring the AST/ALT ratio during routine health check-ups may be a simple and cost-effective marker for cardiovascular mortality.

  13. Brain natriuretic peptide precursor (NT-pro-BNP) levels predict for clinical benefit to sunitinib treatment in patients with metastatic renal cell carcinoma

    International Nuclear Information System (INIS)

    Papazisis, Konstantinos T; Kortsaris, Alexandros H; Kontovinis, Lukas F; Papandreou, Christos N; Kouvatseas, George; Lafaras, Christos; Antonakis, Evangelos; Christopoulou, Maria; Andreadis, Charalambos; Mouratidou, Despoina

    2010-01-01

    Sunitinib is an oral, multitargeted tyrosine kinase inhibitor that has been approved for the treatment of metastatic renal cell carcinoma. Although the majority of sunitinib-treated patients receive a clinical benefit, almost a third of the patients will not respond. Currently there is no available marker that can predict for response in these patients. We estimated the plasma levels of NT-pro-BNP (the N-terminal precursor of brain natriuretic peptide) in 36 patients that were treated with sunitinib for metastatic clear-cell renal carcinoma. From the 36 patients, 9 had progressive disease and 27 obtained a clinical benefit (objective response or disease stabilization). Increases in plasma NT-pro-BNP were strongly correlated to clinical outcome. Patients with disease progression increased plasma BNP at statistically significant higher levels than patients that obtained a clinical benefit, and this was evident from the first 15 days of treatment (a three-fold increase in patients with progressive disease compared to stable NT-pro-BNP levels in patients with clinical benefit, p < 0.0001). Median progression-free survival was 12.0 months in patients with less than 1.5 fold increases (n = 22) and 3.9 months in patients with more than 1.5 fold increases in plasma NT-pro-BNP (n = 13) (log-rank test, p = 0.001). This is the first time that a potential 'surrogate marker' has been reported with such a clear correlation to clinical benefit at an early time of treatment. Due to the relative small number of accessed patients, this observation needs to be further addressed on larger cohorts. More analyses, including multivariate analyses are needed before such an observation can be used in clinical practice

  14. NT-proBNP levels, atherosclerosis and vascular function in asymptomatic type 2 diabetic patients with microalbuminuria: peripheral reactive hyperaemia index but not NT-proBNP is an independent predictor of coronary atherosclerosis

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Wiinberg, Niels; Hansen, Peter R

    2011-01-01

    Intensive multifactorial treatment aimed at cardiovascular (CV) risk factor reduction in type 2 diabetic patients with microalbuminuria can diminish fatal and non-fatal CV. Plasma N-terminal (NT)-proBNP predicts CV mortality in diabetic patients but the utility of P-NT-proBNP in screening for ath......-media thickness (CIMT)>0.90 mm, ankle-brachial index...

  15. Highest manageable level of radioactivity in the waste storage facilities of power plants

    International Nuclear Information System (INIS)

    Elkert, J.; Lennartsson, R.

    1991-01-01

    This project presents and discusses an investigation of the highest level of radioactivity possible to handle in the waste storage facilities. The amount of radioactivity, about 0.1% of the fuel inventory, is the same in both of the cases but the amount of water is very different. The hypothetical accident was supposed to be damage of the reactor fuel caused by loss of coolant. (K.A.E.)

  16. NT-proBNP levels, atherosclerosis and vascular function in asymptomatic type 2 diabetic patients with microalbuminuria: peripheral reactive hyperaemia index but not NT-proBNP is an independent predictor of coronary atherosclerosis

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Wiinberg, Niels; Hansen, Peter R

    2011-01-01

    for atherosclerosis is unclear. We examined the interrelationship between P-NT-proBNP, presence of atherosclerosis and/or vascular dysfunction in the coronary, carotid and peripheral arteries in asymptomatic type 2 diabetic patients with microalbuminuria that received intensive multifactorial treatment. METHODS...... AND RESULTS: P-NT-proBNP was measured in 200 asymptomatic type 2 patients without known cardiac disease that received intensive multifactorial treatment for CV risk reduction. Patients were examined for coronary, carotid and peripheral atherosclerosis, as defined by coronary calcium score=400, carotid intima...

  17. Highest PBDE levels (max 63 ppm) yet found in biota measured in seabird eggs from San Francisco Bay

    Energy Technology Data Exchange (ETDEWEB)

    She, J.; Holden, A.; Tanner, M.; Sharp, M.; Hooper, K. [Department of Toxic Substances Control, Berkeley, CA (United States). Hazardous Materials Lab.; Adelsbach, T. [Environmental Contaminants Division, Sacramento Fish and Wildlife Office, US Fish and Wildlife Service, Sacramento, CA (United States)

    2004-09-15

    High levels of polybrominated diphenylethers (PBDEs) have been found in humans and wildlife from the San Francisco Bay Area, with levels in women among the highest in the world, and levels in piscivorous seabird eggs at the ppm level. Seabirds are useful for monitoring and assessing ecosystem health at various times and places because they occupy a high trophic level in the marine food web, are long-lived, and are generally localized near their breeding and non-breeding sites. In collaboration with the US Fish and Wildlife Services (USFWS), we are carrying out a three-year investigation of dioxin, PCB and PBDE levels in eggs from fish-eating seabirds. Year 1 (2002) PBDE measurements from 73 bird eggs were reported at Dioxin2003. Year 2 (2003) PBDE measurements from 45 samples are presented in this report. The highest PBDE level measured in eggs was 63 ppm, lipid, which is the highest PBDE level, yet reported in biota.

  18. The antioxidant level of Alaska's wild berries: high, higher and highest

    Directory of Open Access Journals (Sweden)

    Roxie Rodgers Dinstel

    2013-08-01

    Full Text Available Background . In the last few years, antioxidants have become the stars of the nutritional world. Antioxidants are important in terms of their ability to protect against oxidative cell damage that can lead to conditions, such as Alzheimer's disease, cancer and heart disease – conditions also linked with chronic inflammation. The antioxidant and anti-inflammatory effects of Alaska's wild berries may have the potential to help prevent these diseases. Objective . To discover the antioxidant levels of Alaska wild berries and the ways these antioxidant levels translate when preservation methods are applied to the berry. Design . This research centred on both the raw berries and products made from the berries. In the first year, a variety of wild berries were tested to discover their oxygen radical absorption capacity (ORAC in the raw berries. The second level of the research project processed 4 different berries – blueberries, lingonberries, salmonberries, highbush cranberries – into 8 or 9 products made from these berries. The products were tested for both ORAC as well as specific antioxidants. Results . The Alaska wild berries collected and tested in the first experiment ranged from 3 to 5 times higher in ORAC value than cultivated berries from the lower 48 states. For instance, cultivated blueberries have an ORAC scale of 30. Alaska wild dwarf blueberries measure 85. This is also higher than lower 48 wild blueberries, which had a score of 61. All of the Alaskan berries tested have a level of antioxidant considered nutritionally valuable, ranging from 19 for watermelon berries to 206 for lingonberries on the ORAC scale. With the processed products made from 4 Alaska wild berries, one of the unexpected outcomes of the research was that the berries continued to have levels of antioxidants considered high, despite the effects of commonly used heat-processing techniques. When berries were dehydrated, per gram ORAC values increased. Conclusion

  19. Preparing Norfolk Area Students for America's Second Highest Sea Level Rise

    Science.gov (United States)

    Dunbar, R. R.

    2017-12-01

    The nonprofit Elizabeth River Project located in Hampton Roads, Virginia was awarded a 3-year national NOAA Environmental Literacy award 2016-2019 to teach 21,000 K-12 youth how to help restore one of the most polluted rivers on the Chesapeake Bay and to help create a resilient community that is facing impacts from the rising seas and changing climate. Through a community collaboration, partners are also creating perhaps the nation's first Youth Resilience Strategy with a vision, goals, best practices and resources on engaging youth to help create resilient cities facing environmental and economic changes. During Year 1, 7,000 elementary students held field investigations aboard the floating classroom Learning Barge and at Paradise Creek Nature Park and helped restore wetland restoration sites. Students performed inquiry based investigations, learned stewardship actions to help create resilience and showed a 40% increase in knowledge. Year 1 best practices in teaching resilience include youth: getting out of the classroom, discovering how rain water travels, performing bioblitzes and water quality testing, engaging in hands-on GreenSTEM activities, using investigation tools, creating innovative solutions to retain and reuse rain water, creating art and voicing their opinions on creating a resilient community.Lessons learned include developing engaging inquiry questions based on creating a resilient community. These included: "What are the impact of rising tides?", "How can sea level rise affect river animals?", "How can we be safe and prepare for extreme weather and flooding as the sea level rises?", "How has the way people worked with the Elizabeth River changed?", "How could sea level rise affect the Elizabeth River's water quality?", "How hot might the air temperature get by 2050 and what can we do to keep it cooler?", "What does this park show us about sea level rise and other ways our climate is changing?", "How do trees help make our park and community

  20. Highest Plasma Phenylalanine Levels in (Very Premature Infants on Intravenous Feeding; A Need for Concern.

    Directory of Open Access Journals (Sweden)

    Ernesto Cortés-Castell

    Full Text Available To analyse the association in newborns between blood levels of phenylalanine and feeding method and gestational age.This observational, cross-sectional study included a sample of 11,829 infants between 2008 and 2013 in a Spanish region. Data were recorded on phenylalanine values, feeding method [breast, formula, mixed (breast plus formula, or partial or fully intravenous feeding], gestational age in weeks (<32, 32-37, ≥37, gender and days since birth at the moment of blood collection. Outcomes were [phenylalanine] and [phenylalanine] ≥95th percentile. Associations were analysed using multivariate models [linear (means difference and logistic regression (adjusted odds ratios].Higher phenylalanine values were associated with lower gestational age (p<0.001 and with intravenous feeding (p<0.001.The degree of prematurity and intravenous feeding influenced the plasma concentration of phenylalanine in the newborn. Caution should be taken in [phenylalanine] for newborns with intravenous feeding, monitoring them carefully. Very preterm infants given the recommended amount of amino acids should also be strictly monitored. These findings should be taken into consideration and call for adapting the amounts to the needs of the infant.

  1. Knowledge Management and Politics at the Highest Level: An Exploratory Analysis

    Directory of Open Access Journals (Sweden)

    Eduardo TOMÉ

    2015-06-01

    Full Text Available This paper analyses Knowledge Management (KM as a political activity, made by the great political leaders of the world. We try to examine if at the macro political level KM is made, and how. The research is interesting because given that we live in a Knowledge Society, in the Information Era, it is more or less obvious that the political leaders should also do KM. However we don’t know of any previous study on KM and world leaders and this paper wants to be a first step to fill that gap. As a methodology we use literature review: given this one is a first preliminary study we use data we found online and in databases like EBSCO. We divide the analysis in two main parts: theoretical ideas, and application. In the theoretical part we aim at distinguishing KM as made by managers from KM made by politicians. The second part is itself divided in two segments: the past and the present times; in the second segment we illustrate our ideas with the example of President Barack Obama. We observe, rather surprisingly, how much it has been over-looked by scholars; KM always was and nowadays is pervasive in the activity of the world political leaders. Furthermore, the importance of KM made by world political leaders is so great that it should prompt the making of detailed studies in order to improve the world governance. The study has the limitation of relying on documents, insights and texts, and not on interviews. It should be followed by studies of a more qualitative and participative nature. We believe it would be very interesting to make such studies and that they would help improving the democracies in the 21st century and beyond.

  2. Prenatal Clinical Assessment of NT-proBNP as a Diagnostic Tool for Preeclampsia, Gestational Hypertension and Gestational Diabetes Mellitus.

    Directory of Open Access Journals (Sweden)

    Pawel Sadlecki

    Full Text Available Common complications of pregnancy include preeclampsia (PE, gestational hypertension (GH and gestational diabetes mellitus (GDM. Hypertensive disorders (PE/GH and GDM may result in greater maternal, fetal and neonatal morbidity and mortality. Women with PE/GH, one of the most common causes of heart burden in an obstetrical setting, present with elevated serum levels of BNP and NT-proBNP. The aim of this study was to shed more light on the role of NT-proBNP in pathophysiology of PE, GH and GDM. The study included 156 pregnant women with singleton pregnancies. A total of 26 women developed arterial hypertension during pregnancy, 14 were diagnosed with PE, and GDM was detected in 81 patients. The control group included 35 women with uncomplicated pregnancies, normal arterial blood pressure and normal glucose concentrations. Patients with GH presented with significantly higher serum concentrations of NT-proBNPthan normotensive women (65.5 vs. 37.4 pg/ml; p = 0.0136. Serum levels of NT-proBNP in patients with PE were the highest of all the analyzed subsets, being significantly higher than in women without this condition (89.00 vs. 37.4pg/ml,p = 0,0136. However, women with and without GDM did not differ significantly in terms of their serum NT-proBNPconcentrations. Serum NT-proBNP (pg/ml (p = 0.0001 and BMI (p<0.0001 turned out to be independent predictors of GH on multivariate logistic regression analysis.Moreover, serum NT-proBNP (pg/ml was identified as an independent indicator of PE (p = 0.0016. A significant inverse correlation was found between birth weight and maternal serum NT-proBNP concentrations. In our opinion, NT-proBNP can be a useful clinical marker of GH and PE. Determination of NT-proBNP levels may be helpful in identification of patients with PE and GH and in their qualification for intensive treatment; this in turn, may be reflected by better neonatal outcomes.

  3. Extreme groundwater levels caused by extreme weather conditions - the highest ever measured groundwater levels in Middle Germany and their management

    Science.gov (United States)

    Reinstorf, F.; Kramer, S.; Koch, T.; Pfützner, B.

    2017-12-01

    Extreme weather conditions during the years 2009 - 2011 in combination with changes in the regional water management led to maximum groundwater levels in large areas of Germany in 2011. This resulted in extensive water logging, with problems especially in urban areas near rivers, where water logging produced huge problems for buildings and infrastructure. The acute situation still exists in many areas and requires the development of solution concepts. Taken the example of the Elbe-Saale-Region in the Federal State of Saxony-Anhalt, were a pilot research project was carried out, the analytical situation, the development of a management tool and the implementation of a groundwater management concept are shown. The central tool is a coupled water budget - groundwater flow model. In combination with sophisticated multi-scale parameter estimation, a high-resolution groundwater level simulation was carried out. A decision support process with an intensive stakeholder interaction combined with high-resolution simulations enables the development of a management concept for extreme groundwater situations in consideration of sustainable and environmentally sound solutions mainly on the base of passive measures.

  4. Levels of NT-proBNP, markers of low-grade inflammation, and endothelial dysfunction during spironolactone treatment in patients with diabetic kidney disease

    DEFF Research Database (Denmark)

    Nielsen, Stine; Schjoedt, Katrine J; Rossing, Kasper

    2013-01-01

    with spironolactone 25 mg and placebo daily for 60 days.Outcome measures:Changes in inflammatory (hsCRP, s-ICAM, TNFα, IL-6, IL-8, Serum amyloid A, IL1β), endothelial dysfunction (sE-selectin, s-ICAM1, s-VCAM1, VWF, p-selectin, s-thrombomodulin) and NT-proBNP after each treatment period. RESULTS: During...

  5. Unexplained week-to-week variation in BNP and NT-proBNP is low in chronic heart failure patients during steady state

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Nielsen, Per H

    2006-01-01

    BACKGROUND: The usefulness of brain-natriuretic-peptide (BNP) and N-terminal-pro-brain-natriuretic-peptide (NT-proBNP) for monitoring of chronic heart failure (CHF) patients has been questioned because of high levels of unexplained variation. AIMS: Week-to-week total variance (CV(T)), unexplained...

  6. ACHIEVEMENT OF THE HIGHEST LEVEL OF SAFETY AND HEALTH AT WORK AND THE SATISFACTION OF EMPLOYEES IN THE TEXTILE INDUSTRY

    Directory of Open Access Journals (Sweden)

    Snezana Urosevic

    2016-12-01

    Full Text Available Safety and health at work involves the exercise of such working conditions that take certain measures and activities in order to protect the life and health of employees. The interest of society, of all stakeholders and every individual is to achieve the highest level of safety and health at work, to unwanted consequences such as injuries, occupational diseases and diseases related to work are reduced to a minimum, and to create the conditions work in which employees have a sense of satisfaction in the performance of their professional duties. Textile industry is a sector with higher risk, because the plants of textile industry prevailing unfavorable microclimate conditions: high air temperature and high humidity, and often insufficient illumination of rooms and increased noise. The whole line of production in the textile industry, there is a risk of injury, the most common with mechanical force, or gaining burns from heat or chemicals. All of these factors are present in the process of production and processing of textiles and the same may affect the incidence of occupational diseases of workers, absenteeism, reduction of their working capacity and productivity. With the progress of the textile industry production increases in the number of hazardous and harmful substances that may pose a potential danger to the employee in this branch of the economy as well as the harmful impact on the environment. Therefore, it is important to give special attention to these problems.

  7. NT-proBNP and diastolic left ventricular function in patients with Marfan syndrome

    Directory of Open Access Journals (Sweden)

    Petra Gehle

    2016-09-01

    Conclusions: MFS patients presenting with normal ejection fraction show disturbed diastolic function and higher NT-proBNP levels, which is partly explained by aortic Z-score. Assessment of diastolic function and NT-proBNP levels may therefore detect early abnormalities and guide surveillance and prevention management of patients with MFS.

  8. Clinical research on correlation between BNP and left cardiac function in patients with heart failure

    International Nuclear Information System (INIS)

    Yin Xin; Xu Dandan; Wu Chunxu

    2005-01-01

    To investigate the correlation between brain natriuretic peptide (BNP) and the cardiac function in patients with heart failure(HF), the plasma level of BNP was determined by IRMA and the left cardiac function parameters were measured on echocardiogram in patients with different grade of HF. The results showed that the plasma level of BNP elevated with the worsening of heart failure (NYHA classification). The plasma levels of BNP were negatively correlated with left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVDd). The plasma level of BNP increases significantly along with the severity of HF classified by NYHA, and might be a biochemical parameter for evaluating the left ventricular function. (authors)

  9. NT-proBNP concentrations in mountain marathoners.

    Science.gov (United States)

    Banfi, Giuseppe; Lippi, Giuseppe; Susta, Daniele; Barassi, Alessandra; D'Eril, Gianvico Melzi; Dogliotti, Giada; Corsi, Massimiliano M

    2010-05-01

    The 76 amino acid N-terminal proB-type natriuretic peptide (NT-proBNP) is proposed for evaluating and monitoring heart pathologies characterized by myocardial wall stress. Strenuous exercise might generate transitory ischemia, myocardial stress, and diastolic left ventricular dysfunction, possibly inducing an increase of some biochemical parameter concentrations. An alert has been claimed owing to biochemical and instrumental signs of heart dysfunction in recreational athletes during marathon races. We studied the behaviour of NT-proBNP in 15 mountain marathoners before and after a race. The concentrations of the parameter were lower than that observed in controls at rest and were similar to that observed in professional soccer and rugby players. The concentrations significantly increased after the race. NT-proBNP is low at rest in professional athletes, and the increase after physical exercise is physiological. The marathoners, even when performing races in a high-altitude environment, show NT-proBNP concentrations similar to those of athletes from other sports disciplines, characterized by low levels of effort and by a mix of aerobic and anaerobic metabolism. The increase of NT-proBNP is linked to strenuous physical exercise and to heavy heart effort, testified also by an increase of troponin I. However, the role of the NT-proBNP could be important to screen recreational and professional marathoners to avoid possible heart problems and sudden cardiac death in subjects with occult heart disease. The results of the present study are relevant to the design and evaluation of training programs for improving strength and function of professional marathoners.

  10. BNP and NT-proBNP, Predictors of 1-Year Mortality in Nursing Home Residents

    NARCIS (Netherlands)

    Barents, Maaike; Hillege, Hans H. L.; van der Horst, Iwan C. C.; de Boer, Rudolph A.; Koster, J.; Muskiet, Frits A. J.; de Jongste, Mike J. L.

    2008-01-01

    Objectives: To investigate 1-year mortality prediction of B type natriuretic peptide (BNP) and N terminal-proBNP (NT-proBNP) in institutionalized elderly with multiple morbidities. Design: Prospective cross-sectional study. Setting: One nursing home. Participants: Ninety-three residents (mean age 81

  11. Solving The Longstanding Problem Of Low-Energy Nuclear Reactions At the Highest Microscopic Level - Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Quaglioni, S. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-09-22

    A 2011 DOE-NP Early Career Award (ECA) under Field Work Proposal (FWP) SCW1158 supported the project “Solving the Long-Standing Problem of Low-Energy Nuclear Reactions at the Highest Microscopic Level” in the five-year period from June 15, 2011 to June 14, 2016. This project, led by PI S. Quaglioni, aimed at developing a comprehensive and computationally efficient framework to arrive at a unified description of structural properties and reactions of light nuclei in terms of constituent protons and neutrons interacting through nucleon-nucleon (NN) and three-nucleon (3N) forces. Specifically, the project had three main goals: 1) arriving at the accurate predictions for fusion reactions that power stars and Earth-based fusion facilities; 2) realizing a comprehensive description of clustering and continuum effects in exotic nuclei, including light Borromean systems; and 3) achieving fundamental understanding of the role of the 3N force in nuclear reactions and nuclei at the drip line.

  12. Relation of Renal Function with Left Ventricular Systolic Function and NT-proBNP Level and Its Prognostic Implication in Heart Failure with Preserved versus Reduced Ejection Fraction: an analysis from the Korean Heart Failure (KorHF) Registry.

    Science.gov (United States)

    Park, Chan Soon; Park, Jin Joo; Oh, Il-Young; Yoon, Chang-Hwan; Choi, Dong-Ju; Park, Hyun-Ah; Kang, Seok-Min; Yoo, Byung-Su; Jeon, Eun-Seok; Kim, Jae-Joong; Cho, Myeong-Chan; Chae, Shung Chull; Ryu, Kyu-Hyung; Oh, Byung-Hee

    2017-09-01

    The relationship between ejection fraction (EF), N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and renal function is unknown as stratified by heart failure (HF) type. We investigated their relation and the prognostic value of renal function in heart failure with preserved ejection fraction (HFpEF) vs. reduced ejection fraction (HFrEF). NT-proBNP, glomerular filtration rate (GFR), and EF were obtained in 1,932 acute heart failure (AHF) patients. HFrEF was defined as EFrenal dysfunction as GFRrenal dysfunction: 30≤GFRrenal dysfunction: GFRrenal dysfunction did not differ between HFpEF and HFrEF (49% vs. 52%, p=0.210). Patients with renal dysfunction had higher 12-month mortality in both HFpEF (7.9% vs. 15.2%, log-rank p=0.008) and HFrEF (8.6% vs. 16.8%, log-rank prenal dysfunction was an independent predictor of 12-month mortality (hazard ratio [HR], 2.08; 95% confidence interval [CI], 1.40-3.11). When stratified according to EF: the prognostic value of severe renal dysfunction was attenuated in HFpEF patients (HR, 1.46; 95% CI, 0.66-3.21) contrary to HFrEF patients (HR, 2.43; 95% CI, 1.52-3.89). In AHF patients, the prevalence of renal dysfunction did not differ between HFpEF and HFrEF patients. However, the prognostic value of renal dysfunction was attenuated in HFpEF patients.

  13. Dental Care Presents The Highest Level Of Financial Barriers, Compared To Other Types Of Health Care Services.

    Science.gov (United States)

    Vujicic, Marko; Buchmueller, Thomas; Klein, Rachel

    2016-12-01

    The Affordable Care Act is improving access to and the affordability of a wide range of health care services. While dental care for children is part of the law's essential health benefits and state Medicaid programs must cover it, coverage of dental care for adults is not guaranteed. As a result, even with the recent health insurance expansion, many Americans face financial barriers to receiving dental care that lead to unmet oral health needs. Using data from the 2014 National Health Interview Survey, we analyzed financial barriers to a wide range of health care services. We found that irrespective of age, income level, and type of insurance, more people reported financial barriers to receiving dental care, compared to any other type of health care. We discuss policy options to address financial barriers to dental care, particularly for adults. Project HOPE—The People-to-People Health Foundation, Inc.

  14. Education Pays Off! On Transition to Work for 25 Year Olds in Norway with Upper Secondary Education or Lower as Their Highest Educational Level

    Science.gov (United States)

    Markussen, Eifred

    2017-01-01

    In this article we examine the relationship between educational level and position in the labour market at age 25 for those who have completed upper secondary education or lower as their highest educational level. Whilst completion of upper secondary education is widely regarded as being important, we find that early and lasting work experience…

  15. The Significance of the Cardiac Peptide NT-proBNP in the Assessment of Risk for Myocardial Revascularization in Patients with Decreased Left Ventricular Ejection Fraction

    Directory of Open Access Journals (Sweden)

    V. V. Moroz

    2010-01-01

    Full Text Available Objective: to substantiate a procedure for predicting the severity of postperfusion acute heart failure (AHF from the baseline level of NT-proBNP during myocardial revascularization in patients with a left ventricular ejection fraction (LVEF of less than 35%. Subjects and materials. Fifty-six patients with a LVEF of less than 35% were examined. A total of 3.5±0.1 (range 2—4 coronary arteries were shunted under cardio-pulmonary bypass (CPB (71.0±5.5 min. The concentration of NT-proBNP was measured before surgery (Cardiac Reader®, Roche. Mortality rates, sympathomimetic agents’ dosages required after EC, and the frequency of use of intraaortic balloon pumping (IABP were analyzed. Results. A good clinical course was observed in 47 cases (Group 1. AHF was recorded in 9 patients (Group 2. Comparative analysis demonstrated that the preoperative concentration of NT-proBNP (871±111 pg/ml in Group 1 and 1946±236 pg/ml in Group 2 was of the highest prognostic value as compared with the traditional indicators (p=0.0015. Patients with a NT-proBNP concentration of less than 600 pg/ml did not virtually need inotropic therapy after EC. In a group with a biomarker level of 600—1200 mg/ml, the infusion of dopamine and dobutamine achieved the traditional cardiotonic dosages and every three patients needed epinephrine. With NT-proBNP of 1200-2000 pg/ml, mortality from AHF was 15.4%; a need for epinephrine and IABC was 46.4 and 7.7%, respectively. The peptide concentration of more than 2000 pg/ml indicated the extremely high risk of severe AHF. In the postperfusion period, each patient was given epinephrine and an IABC system was installed in half of them. In this group mortality achieved 50%. Conclusion. It is expedient to determine a preoperative NT-proBNP concentration in a LVEF of less than 35% to predict AHF to be occurred after myocardial revascularization. The concentration of less than 1200 pg/ml may be considered to be a safe level of the

  16. Rise and fall of NT-proBNP in aortic valve intervention.

    Science.gov (United States)

    Hultkvist, Henrik; Holm, Jonas; Svedjeholm, Rolf; Vánky, Farkas

    2018-01-01

    To describe the dynamics of N-terminal pro-B-type natriuretic peptide (NT-proBNP) from preoperative evaluation to 6-month follow-up in patients undergoing aortic valve intervention, and to evaluate NT-proBNP with regard to 1-year mortality. At preoperative evaluation, we prospectively included 462 patients accepted for aortic valve intervention. The median time to surgical aortic valve replacement (SAVR; n=336) or transcatheter aortic valve implantation (TAVI; n=126) was 4 months. NT-proBNP was measured at enrolment for preoperative evaluation, on the day of surgery, postoperatively on day 1, day 3 and at the 6-month follow-up. Subgroups of patients undergoing SAVR with aortic regurgitation and aortic stenosis with and without coronary artery bypass were also analysed. NT-proBNP remained stable in all subgroups during the preoperative waiting period, but displayed a substantial transient early postoperative increase with a peak on day 3 except in the TAVI group, which peaked on day 1. At the 6-month follow-up, NT-proBNP had decreased to or below the preoperative level in all groups. In the SAVR group, NT-proBNP preoperatively and on postoperative days 1 and 3 revealed significant discriminatory power with regard to 1-year mortality (area under the curve (AUC)=0.79, P=0.0001; AUC=0.71, P=0.03; and AUC=0.79, P=0.002, respectively). This was not found in the TAVI group, which had higher levels of NT-proBNP both preoperatively and at the 6-month follow-up compared with the SAVR group. The dynamic profile of NT-proBNP differed between patients undergoing TAVI and SAVR. NT-proBNP in the perioperative course was associated with increased risk of 1-year mortality in SAVR but not in TAVI.

  17. [Is BNP assay useful for the diagnosis of acute dyspnea in emergencies departments?].

    Science.gov (United States)

    Lakhdhar, Rim; Hamouda, Chokri; Ben Ammar, Lotfi; Majed, Kamel; Moncef, Fekih; Kaabachi, Naziha; Drissa, Habiba; Borsali Falfoul, Nebiha

    2013-01-01

    It would be interesting to the emergency doctor to have at his disposal a helpful diagnostic tool like brain natriuretic peptide (BNP). Such assay is simple, available and reliable. To report our experience on the role of BNP in the etiological diagnosis of acute dyspnea (AD) in emergency room (ER) and to assess the cost-effectiveness ratio of such diagnosis strategy. A prospective study conducted in the ER of Rabta university teaching hospital of Tunis, from March 1st to June 20th 2010, involving 30 consecutive patients presenting to the emergency for AD. All patients underwent echocardiography in their acute phase and benefited from the dosage of BNP during the first 4 hours. The echocardiography parameters were collected by a single operator who was unaware of the results of the BNP dosage. The mean age of patients was 72.8years with a sex ratio of 1.5. AD was of orthopnea type in 9 cases and stage III NYHA dyspnea in the other patients. Clinical and radiological signs of left heart failure were noted in 30% of cases. Ultrasound data have objectified systolic dysfunction in 4 cases, diastolic in 3 cases and systolic plus diastolic in 10 cases. The BNP levels were below 100 pg/ml in 10 cases with pulmonary origin of the AD. A BNP level between 100 and 400 pg/ml was noted in 3 cases. In our study, the clinical probability of AHF prior to performing the test was estimated at 53% and estimated at 100% after the BNP assay. The BNP assay has reduced the length of stay in the emergency department 4 to 5 days and saved nearly 50% of the cost of care per patient. The BNP assay, has allowed us to confirm the AHF all cases. Given the prognostic value and economic benefit of this test we recommend its use in ER of our country.

  18. A novel bioassay for the activity determination of therapeutic human brain natriuretic peptide (BNP.

    Directory of Open Access Journals (Sweden)

    Lei Yu

    Full Text Available BACKGROUND: Recombinant human brain natriuretic peptide (rhBNP is an important peptide-based therapeutic drug indicated for the treatment of acute heart failure. Accurate determination of the potency of therapeutic rhBNP is crucial for the safety and efficacy of the drug. The current bioassay involves use of rabbit aortic strips, with experiments being complicated and time-consuming and markedly variable in results. Animal-less methods with better precision and accuracy should be explored. We have therefore developed an alternative cell-based assay, which relies on the ability of BNP to induce cGMP production in HEK293 cells expressing BNP receptor guanylyl cyclase-A. METHODOLOGY/PRINCIPAL FINDINGS: An alternative assay based on the measurement of BNP-induced cGMP production was developed. Specifically, the bioassay employs cells engineered to express BNP receptor guanylyl cyclase-A (GCA. Upon rhBNP stimulation, the levels of the second messager cGMP in these cells drastically increased and subsequently secreted into culture supernatants. The quantity of cGMP, which corresponds to the rhBNP activity, was determined using a competitive ELISA developed by us. Compared with the traditional assay, the novel cell-based assay demonstrated better reproducibility and precision. CONCLUSION/SIGNIFICANCE: The optimized cell-based assay is much simpler, more rapid and precise compared with the traditional assay using animal tissues. To our knowledge, this is the first report on a novel and viable alternative assay for rhBNP potency analysis.

  19. BNP was Associated with Ischemic Myocardial Scintigraphy and Death in Patients at Chest Pain Unit

    Energy Technology Data Exchange (ETDEWEB)

    Azevedo, Jader Cunha de, E-mail: jadercazevedo@gmail.com [Universidade Federal Fluminense, Niterói, Rio de Janeiro, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Centro Universitário de Volta Redonda, Rio de Janeiro, RJ (Brazil); Reis, Bruno Cezario Costa; Barreto, Nathalia Monerat P.B. [Centro Universitário de Volta Redonda, Rio de Janeiro, RJ (Brazil); F, Diogenes S. Junior; Prezotti, Lais S. [Universidade Federal Fluminense, Niterói, Rio de Janeiro, RJ (Brazil); Procaci, Victor Rebelo; Octaviano, Vivian Werneck [Centro Universitário de Volta Redonda, Rio de Janeiro, RJ (Brazil); Volschan, Andre [Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Mesquita, Evandro Tinoco; Mesquita, Claudio Tinoco [Universidade Federal Fluminense, Niterói, Rio de Janeiro, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil)

    2015-01-15

    Recent studies have suggested that B-type Natriuretic Peptide (BNP) is an important predictor of ischemia and death in patients with suspected acute coronary syndrome. Increased levels of BNP are seen after episodes of myocardial ischemia and may be related to future adverse events. To determine the prognostic value of BNP for major cardiac events and to evaluate its association with ischemic myocardial perfusion scintigraphy (MPS). This study included retrospectively 125 patients admitted to the chest pain unit between 2002 and 2006, who had their BNP levels measured on admission and underwent CPM for risk stratification. BNP values were compared with the results of the MPS. The chi-square test was used for qualitative variables and the Student t test, for quantitative variables. Survival curves were adjusted using the Kaplan-Meier method and analyzed by using Cox regression. The significance level was 5%. The mean age was 63.9 ± 13.8 years, and the male sex represented 51.2% of the sample. Ischemia was found in 44% of the MPS. The mean BNP level was higher in patients with ischemia compared to patients with non-ischemic MPS (188.3 ± 208.7 versus 131.8 ± 88.6; p = 0.003). A BNP level greater than 80 pg/mL was the strongest predictor of ischemia on MPS (sensitivity = 60%, specificity = 70%, accuracy = 66%, PPV = 61%, NPV = 70%), and could predict medium-term mortality (RR = 7.29, 95% CI: 0.90-58.6; p = 0.045) independently of the presence of ischemia. BNP levels are associated with ischemic MPS findings and adverse prognosis in patients presenting with acute chest pain to the emergency room, thus, providing important prognostic information for an unfavorable clinical outcome.

  20. Introduction of an NT-proBNP assay to an acute admission unit--a 2-year audit.

    LENUS (Irish Health Repository)

    Murtagh, Gillian

    2012-02-01

    BACKGROUND: The differential diagnosis of dyspnoea is difficult due to the low predictive value of clinical and laboratory parameters. The elevated levels of NT-proBNP in congestive heart failure may improve diagnostic accuracy. We have evaluated the effect of the introduction of an NT-proBNP assay on hospital length of stay (LOS) and mortality. METHODS: There were 11,853 AMAU patient episodes in the 22 months study period (March 2005-Dec 2006). An NT-proBNP assay was requested in 657 (5.5%) of these. Comparison between categorical variables such as diagnosis, NT-proBNP testing, LOS, and in-hospital mortality was made using Chi-square tests. Literature review suggested that an NT-proBNP cut-off >or=5000 ng\\/L should predict acute in-patient mortality. Logistic regression analysis was used to examine the association between such an elevated NT-proBNP level and outcomes. RESULTS: Of the 396 patients with NT-proBNP <5000 ng\\/L, 8.1% died compared with 22.5% of the 178 patients dying with values >or=5000 ng\\/L (p<0.0001). An NT-proBNP >or=5000 ng\\/L was predictive of both LOS >or=9 days (odds ratios (OR) 1.54 (95% CI 1.06, 2.24: p=0.02) and LOS >or=14 days (OR=1.87 (95% CI 1.29, 2.71: p=0.0009). NT-proBNP requests increased over time, from 2.6% to 8.2% of all patients; the result fell in the diagnostic range for CHF in 60% of requests. CONCLUSION: The introduction of an NT-proBNP was reflected in an appropriate but rapidly increasing pattern of requests from clinicians. High NT-proBNP levels predicted in-hospital mortality and longer LOS in an acute medical population.

  1. NT-proBNP in cardiac surgery: a new tool for the management of our patients?

    Science.gov (United States)

    Reyes, Guillermo; Forés, Gloria; Rodríguez-Abella, R Hugo; Cuerpo, Gregorio; Vallejo, José Luis; Romero, Carlos; Pinto, Angel

    2005-06-01

    Our aim was to determine NT-proBNP levels in patients undergoing cardiac surgery and if those levels are related to any of the baseline clinical characteristics of patients before surgery or any of the outcomes or events after surgery. Prospective, analytic study including 83 consecutive patients undergoing cardiac surgery. Preoperatory and postoperatory data were collected. NT-proBNP levels were measured before surgery, the day of surgery, twice the following day and every 24 h until a total of nine determinations. Venous blood was obtained by direct venipuncture and collected into serum separator tubes. Samples were centrifuged within 20 min from sampling and stored for a maximum of 12 h at 2-8 degrees C before the separation of serum. Serum was stored frozen at -40 degrees C and thawed only once at the time of analysis. Mean age was 65+/-11.8 years. An Euroscore 6 was found in 30% of patients. NYHA classification was as follows: I:27.7%; II:47%; III:25.3%. Preoperative atrial fibrilation occurred in 20.5% of patients. After surgery 18.1% of patients required inotropes. Only one death was recorded. A great variability was found in preoperative NT-proBNP levels; 759.9 (S.D.:1371.1); CI 95%: 464.9 to 1054.9 pg/ml, with a wide range (6.39-8854). Median was 366.5 pg/ml. Preoperative NT-proBNP levels were unrelated to the type of surgery (CABG vs. others), sex, age and any of the cardiovascular risk factors. NT-proBNP levels were higher in high risk patients (Euroscore 6); (P=0.021), worse NYHA class (P=0.020) and patients with preoperative atrial fibrilation (m 1767 (2205) vs m 621 (1017); P=0.001). After surgery NT-proBNP levels started increasing the following day until the fourth day (P=0.03), decreasing afterwards (P=0.019). These levels were significantly higher in patients requiring inotropes after surgery (P<0.001). We did not find any relationship between NT-proBNP levels and complications rate (P=0.59). Preoperative NT-proBNP levels depend on preoperative

  2. NT-proBNP on Cobas h 232 in point-of-care testing

    DEFF Research Database (Denmark)

    Gils, Charlotte; Ramanathan, R.; Breindahl, T.

    2015-01-01

    Background. NT-proBNP may be useful for ruling out heart failure in primary health care. In this study we examined the analytical quality of NT-proBNP in primary health care on the Cobas h 232 point-of-care instrument compared with measurements performed in a hospital laboratory. Materials...... and methods. Blood samples requested for NT-proBNP were collected in primary health care (n = 95) and in a hospital laboratory (n = 107). NT-proBNP was measured on-site on Cobas h 232 instruments both in primary health care centres and at the hospital laboratory and all samples were also analyzed...... with a comparison method at the hospital. Precision, trueness, accuracy, and lot-variation were determined at different concentration levels and evaluated according to acceptance criteria. Furthermore user-friendliness was assessed by questionnaires. Results. For Cobas h 232 repeatability CV was 8...

  3. NT-pro-BNP is an independent predictor of mortality in patients with end-stage renal disease.

    Science.gov (United States)

    Svensson, M; Gorst-Rasmussen, A; Schmidt, E B; Jorgensen, K A; Christensen, J H

    2009-04-01

    Patients with end-stage renal disease (ESRD) have an increased mortality from cardiovascular disease (CVD). N-terminal pro-brain natriuretic peptide (NT-pro-BNP) is an independent predictor of mortality in patients with ischemic heart disease and congestive heart failure. Previous data have shown markedly elevated levels of NT-pro-BNP in patients with ESRD, while the prognostic value of elevated levels of NT-pro-BNP in patients with ESRD is largely unknown. The aim of the present study was to examine if the level of NT-pro-BNP predicts mortality in patients with ERSD and CVD. We prospectively followed 206 patients with ESRD and documented CVD. Levels of NT-pro-BNP were measured at baseline, and patients were followed for 2 years or until they reached the predefined endpoint of all-cause mortality. During follow-up, the total mortality was 44% (90/206). Patients who died were followed for a median of 314 days (interquartile range 179 - 530). Using Cox regression analysis, age, female sex, systolic blood pressure, dialysis efficiency and plasma levels of NT-pro-BNP were independent prognostic risk factors of mortality. In receiver operating characteristic curve analysis a cut off value for NT-pro-BNP was determined. Patients with values of NT-pro-BNP above 12.200 pg/ml had a 3 times higher risk of death than patients below the cut-off value (HR 3.05 95% CI 1.96 - 4.77, p pro-BNP, NT-pro-BNP is still an independent predictor of mortality and might add prognostic information in patients with ESRD and documented CVD.

  4. Predictors of in vitro fertilization outcomes in women with highest follicle-stimulating hormone levels ≥ 12 IU/L: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Lina N Huang

    Full Text Available The purpose of this study is to evaluate factors predictive of outcomes in women with highest follicle-stimulating hormone (FSH levels ≥ 12 IU/L on basal testing, undergoing in vitro fertilization (IVF.A prospective cohort study was conducted at Stanford University Hospital in the Reproductive Endocrinology and Infertility Center for 12 months. Women age 21 to 43 undergoing IVF with highest FSH levels on baseline testing were included. Donor/Recipient and frozen embryo cycles were excluded from this study. Prognostic factors evaluated in association with clinical pregnancy rates were type of infertility diagnosis and IVF stimulation parameters.The current study found that factors associated with clinical pregnancy were: increased number of mature follicles on the day of triggering, number of oocytes retrieved, number of Metaphase II oocytes if intracytoplasmic sperm injection was done, and number of embryos developed 24 hours after retrieval.Our findings suggest that it would be beneficial for women with increased FSH levels to attempt a cycle of IVF. Results of ovarian stimulation, especially embryo quantity appear to be the best predictors of IVF outcomes and those can only be obtained from a cycle of IVF. Therefore, increased basal FSH levels should not discourage women from attempting a cycle of IVF.

  5. Highest priority in Pakistan.

    Science.gov (United States)

    Adil, E

    1968-01-01

    Responding to the challenge posed by its population problem, Pakistan's national leadership gave the highest priority to family planning in its socioeconomic development plan. In Pakistan, as elsewhere in the world, the first family planning effort originated in the private sector. The Family Planning Association of Pakistan made a tentative beginning in popularizing family planning in the country. Some clinics were opened and some publicity and education were undertaken to emphasize the need for family limitation. It was recognized soon that the government needed to assume the primarily responsibility if family planning efforts were to be successful. For the 1st plan period, 1955-60, about $10 million was allocated by the central government in the social welfare sector for voluntary family planning. The level of support continued on the same basis during the 2nd plan, 1960-65, but has been raised 4-fold in the 1965-70 scheme of family planning. Pakistan's Family Planning Association continues to play vital collaborative roles in designing and pretesting of prototype publicity material, involvement of voluntary social workers, and functional research in the clinical and public relations fields. The real breakthrough in the program came with the 3rd 5-year plan, 1965-70. High priority assigned to family planning is reflected by the total initial budget of Rs.284 million (about $60,000,000) for the 5-year period. Current policy is postulated on 6 basic assumptions: family planning efforts need to be public relations-oriented; operations should be conducted through autonomous bodies with decentralized authority at all tiers down to the grassroots level, for expeditious decision making; monetary incentives play an important role; interpersonal motivation in terms of life experience of the clientele through various contacts, coupled with mass media for publicity, can produce a sociological breakthrough; supplies and services in all related disciplines should be

  6. Ultra-Sensitive NT-proBNP Quantification for Early Detection of Risk Factors Leading to Heart Failure

    Directory of Open Access Journals (Sweden)

    Keum-Soo Song

    2017-09-01

    Full Text Available Cardiovascular diseases such as acute myocardial infarction and heart failure accounted for the death of 17.5 million people (31% of all global deaths in 2015. Monitoring the level of circulating N-terminal proBNP (NT-proBNP is crucial for the detection of people at risk of heart failure. In this article, we describe a novel ultra-sensitive NT-proBNP test (us-NT-proBNP that allows the quantification of circulating NT-proBNP in 30 min at 25 °C in the linear detection range of 7.0–600 pg/mL. It is a first report on the application of a fluorescence bead labeled detection antibody, DNA-guided detection method, and glass fiber membrane platform for the quantification of NT-proBNP in clinical samples. Limit of blank, limit of detection, and limit of quantification were 2.0 pg/mL, 3.7 pg/mL, and 7 pg/mL, respectively. The coefficient of variation was found to be less than 10% in the entire detection range of 7–600 pg/mL. The test demonstrated specificity for NT-proBNP without interferences from bilirubin, intra-lipid, biotin, and hemoglobin. The serial dilution test for plasma samples containing various NT-proBNP levels showed the linear decrement in concentration with the regression coefficient of 0.980–0.998. These results indicate that us-NT-proBNP test does not suffer from the interference of the plasma components for the measurement of NT-proBNP in clinical samples.

  7. The relationship between BNP, NTproBNP and echocardiographic measurements of systemic blood flow in very preterm infants.

    Science.gov (United States)

    König, K; Guy, K J; Walsh, G; Drew, S M; Watkins, A; Barfield, C P

    2014-04-01

    Preterm infants are at risk of circulatory compromise following birth. Functional neonatal echocardiography including superior vena cava (SVC) flow is increasingly used in neonatal medicine, and low SVC flow has been associated with adverse outcome. However, echocardiography is not readily available in many neonatal units and B-type natriuretic peptides (BNPs) may be useful in guiding further cardiovascular assessment. This study investigated the relationship between BNP, N-terminal pro-BNP (NTproBNP) and echocardiographic measurements of systemic blood flow in very preterm infants. This is a prospective observational study. Sixty preterm infants flow, left and right ventricular output (LVO and RVO). Statistical analysis included simple linear regression of BNP and NTproBNP with echocardiographic measures and multiple regression including potential confounding variables. Mean (s.d.) gestational age at birth was 27(5) (2(1)) weeks, median (interquartile range, IQR) birth weight was 995 (845 to 1175) grams. Neither BNP nor NTproBNP correlated with SVC flow (BNP 95% confidence interval (CI) -0.0014 to 0.013, P=0.12; NTproBNP 95% CI -0.00069 to 0.01, P=0.085); LVO (BNP 95% CI -0.00078 to 0.0072, P=0.11; NTproBNP 95% CI -0.0034 to 0.0034, P=0.99); RVO (BNP 95% CI -0.00066 to 0.0058, P=0.12; NTproBNP 95% CI -0.0012 to 0.0044, P=0.25); or FS (BNP 95% CI -0.053 to 0.051, P=0.96; NTproBNP 95% CI -0.061 to 0.019, P=0.3). Multivariate linear regression did not significantly alter results. In this cohort of very preterm infants, BNP and NTproBNP did not correlate with echocardiographic measurements of systemic blood flow within the first 72 h of life.

  8. Mortality and preoperative cardiac function in vascular amputees: an N-terminal pro-brain natriuretic peptide (NT-proBNP) pilot study

    OpenAIRE

    Riemersma, Marcel; Dijkstra, Pieter U.; van Veldhuisen, Dirk Jan; Muskiet, Frits A. J.; van den Dungen, Jan A. M. M.; Geertzen, Jan H. B.

    2008-01-01

    Objective: To determine preoperative ventricular function in vascular amputees by measuring N-terminal pro-brain natriuretic peptide (NT-proBNP) and to analyse the relationship between NT-proBNP levels and 30-day postoperative mortality. Design: Prospective pilot study. Subjects and methods: In 19 patients planned for a lower limb amputation for nonreconstructable peripheral arterial disease NT-proBNP was measured the day before amputation. Results: Four amputees died within 30 days after the...

  9. NT-proBNP, Cardiometabolic Risk Factors, and Nutritional Status in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Jacques Ducros

    2017-01-01

    Full Text Available Background. We aimed to evaluate the association between NT-proBNP and malnutrition in HD patients while taking into account the four established categories of parameters for diagnosis of protein energy wasting (PEW. Methods. A cross-sectional study was performed in Afro-Caribbean dialysis patients. One component in each of the 4 categories for the wasting syndrome was retained: serum albumin ≤ 38 g/L, BMI ≤ 23 Kg/m2, serum creatinine ≤ 818 µmol/L, and normalized protein catabolic rate (nPCR ≤ 0.8 g/kg/day. NT-proBNP was assessed using a chemiluminescence immunoassay. Two multivariate logistic regression models were performed to determine the parameters associated with high NT-proBNP concentrations. Results. In 207 HD patients, 16.9% had PEW (at least three components. LVEF lower than 60% was found in 13.8% of patients. NT-proBNP levels ranged from 125 to 33144 pg/mL. In model 1, high levels of NT-proBNP (≥6243 pg/mL were independently associated with PEW OR 14.2 (3.25–62.4, male gender 2.80 (1.22–6.57, hsCRP > 5 mg/L 3.90 (1.77–8.57, and dialysis vintage > 3 years 3.84 (1.35–10.8. In model 2, LVEF OR was 0.93 (0.88–0.98. NT-proBNP concentrations were significantly higher when the PEW component number was higher. Conclusion. In dialysis patients, high NT-proBNP levels must draw attention to cardiac function but also to nutritional status.

  10. Relationship between CCR and NT-proBNP in Chinese HF patients, and their correlations with severity of HF.

    Science.gov (United States)

    Lu, Zhigang; Wang, Bo; Wang, Yunliang; Qian, Xueqing; Zheng, Wei; Wei, Meng

    2014-01-01

    To evaluate the relationship between creatinine clearance rate (CCR) and the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in heart failure (HF) patients and their correlations with HF severity. Two hundred and one Chinese patients were grouped according to the New York Heart Association (NYHA) classification as NYHA 1-2 and 3-4 groups and 135 cases out of heart failure patients as control group. The following variables were compared among these three groups: age, sex, body mass index (BMI), smoking status, hypertension, diabetes, NT-proBNP, creatinine (Cr), uric acid (UA), left ventricular end-diastolic diameter (LVEDD), and CCR. The biomarkers of NT-proBNP, Cr, UA, LVEDD, and CCR varied significantly in the three groups, and these variables were positively correlated with the NHYA classification. The levels of NT-proBNP and CCR were closely related to the occurrence of HF and were independent risk factors for HF. At the same time, there was a significant negative correlation between the levels of NT-proBNP and CCR. The area under the receiver operating characteristic curve suggested that the NT-proBNP and CCR have high accuracy for diagnosis of HF and have clinical diagnostic value. NT-proBNP and CCR may be important biomarkers in evaluating the severity of HF.

  11. Highest energy cosmic rays

    International Nuclear Information System (INIS)

    Nikolskij, S.

    1984-01-01

    Primary particles of cosmic radiation with highest energies cannot in view of their low intensity be recorded directly but for this purpose the phenomenon is used that these particles interact with nuclei in the atmosphere and give rise to what are known as extensive air showers. It was found that 40% of primary particles with an energy of 10 15 to 10 16 eV consist of protons, 12 to 15% of helium nuclei, 15% of iron nuclei, the rest of nuclei of other elements. Radiation intensity with an energy of 10 18 to 10 19 eV depends on the direction of incoming particles. Maximum intensity is in the direction of the centre of the nearest clustre of galaxies, minimal in the direction of the central area of our galaxy. (Ha)

  12. The NT-ProBNP Test in Subjects with End-Stage Renal Disease on Hemodialysis Presenting with Acute Dyspnea: Is Knowing Worth the Cost?

    Directory of Open Access Journals (Sweden)

    Shaffer R. S. Mok

    2013-01-01

    Full Text Available Background. The NT-ProBNP/BNP test has been validated as a marker for determining the etiology of acute dyspnea. In the setting of end-stage renal disease on hemodialysis (ESRD on HD, the utility of the NT-ProBNP/BNP test has not been validated. This study examines the clinical utility of the NT-ProBNP test in the setting of ESRD on HD patients presenting with acute dyspnea. Methods. A retrospective case series of 250 subjects were admitted to Cooper University Hospital, 07/2010-03/2011, with ESRD and HD presenting with dyspnea. The incidences of echocardiography, cardiology consultation, and NT-ProBNP elevated and normal were examined. Correlation coefficients were calculated for NT-ProBNP with age (years, estimated dry weight (kg, amount of fluid removed (L, and ejection fraction (EF in % among other echocardiography parameters. Results. Of the total sample 235 patients had NT-ProBNP levels performed. Cardiology consults were placed in 68.8% and 58% who underwent echocardiography. Of those for whom an echocardiography was performed estimated mean EFs of 54.6%, 50.8%, and 61.7% were observed among the NT-ProBNP elevated group, normal group, and no NT-ProBNP group, respectively. No differences were detected in all other echocardiography measurements. No correlation was observed between NT-ProBNP and age (, baseline EDW (, amount of fluid removed (, or EF (. Conclusion. In the setting of ESRD on HD, the NT-ProBNP test has no clinical utility in determining the etiology of acute dyspnea. This can be demonstrated through echocardiographic and therapeutic parameters measured in this study.

  13. NT-proBNP, echocardiographic abnormalities and subclinical coronary artery disease in high risk type 2 diabetic patients

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Hansen, Peter R; Wiinberg, Niels

    2012-01-01

    -NT-proBNP and the putative residual abnormalities in such patients are not well described. This study examined echocardiographic measurements of LV hypertrophy, atrial dilatation and LV dysfunction and their relation to P-NT-proBNP levels or subclinical coronary artery disease (CAD) in type 2 diabetic patients......Intensive multifactorial treatment aimed at prevention of cardiovascular (CV) disease may reduce left ventricular (LV) echocardiographic abnormalities in diabetic subjects. Plasma N-terminal (NT)-proBNP predicts CV mortality in diabetic patients but the association between P...

  14. A Wide Band Gap Polymer with a Deep Highest Occupied Molecular Orbital Level Enables 14.2% Efficiency in Polymer Solar Cells.

    Science.gov (United States)

    Li, Sunsun; Ye, Long; Zhao, Wenchao; Yan, Hongping; Yang, Bei; Liu, Delong; Li, Wanning; Ade, Harald; Hou, Jianhui

    2018-05-21

    To simultaneously achieve low photon energy loss ( E loss ) and broad spectral response, the molecular design of the wide band gap (WBG) donor polymer with a deep HOMO level is of critical importance in fullerene-free polymer solar cells (PSCs). Herein, we developed a new benzodithiophene unit, i.e., DTBDT-EF, and conducted systematic investigations on a WBG DTBDT-EF-based donor polymer, namely, PDTB-EF-T. Due to the synergistic electron-withdrawing effect of the fluorine atom and ester group, PDTB-EF-T exhibits a higher oxidation potential, i.e., a deeper HOMO level (ca. -5.5 eV) than most well-known donor polymers. Hence, a high open-circuit voltage of 0.90 V was obtained when paired with a fluorinated small molecule acceptor (IT-4F), corresponding to a low E loss of 0.62 eV. Furthermore, side-chain engineering demonstrated that subtle side-chain modulation of the ester greatly influences the aggregation effects and molecular packing of polymer PDTB-EF-T. With the benefits of the stronger interchain π-π interaction, the improved ordering structure, and thus the highest hole mobility, the most symmetric charge transport and reduced recombination are achieved for the linear decyl-substituted PDTB-EF-T (P2)-based PSCs, leading to the highest short-circuit current density and fill factor (FF). Due to the high Flory-Huggins interaction parameter (χ), surface-directed phase separation occurs in the P2:IT-4F blend, which is supported by X-ray photoemission spectroscopy results and cross-sectional transmission electron microscope images. By taking advantage of the vertical phase distribution of the P2:IT-4F blend, a high power conversion efficiency (PCE) of 14.2% with an outstanding FF of 0.76 was recorded for inverted devices. These results demonstrate the great potential of the DTBDT-EF unit for future organic photovoltaic applications.

  15. Highest Resolution Gaspra Mosaic

    Science.gov (United States)

    1992-01-01

    This picture of asteroid 951 Gaspra is a mosaic of two images taken by the Galileo spacecraft from a range of 5,300 kilometers (3,300 miles), some 10 minutes before closest approach on October 29, 1991. The Sun is shining from the right; phase angle is 50 degrees. The resolution, about 54 meters/pixel, is the highest for the Gaspra encounter and is about three times better than that in the view released in November 1991. Additional images of Gaspra remain stored on Galileo's tape recorder, awaiting playback in November. Gaspra is an irregular body with dimensions about 19 x 12 x 11 kilometers (12 x 7.5 x 7 miles). The portion illuminated in this view is about 18 kilometers (11 miles) from lower left to upper right. The north pole is located at upper left; Gaspra rotates counterclockwise every 7 hours. The large concavity on the lower right limb is about 6 kilometers (3.7 miles) across, the prominent crater on the terminator, center left, about 1.5 kilometers (1 mile). A striking feature of Gaspra's surface is the abundance of small craters. More than 600 craters, 100-500 meters (330-1650 feet) in diameter are visible here. The number of such small craters compared to larger ones is much greater for Gaspra than for previously studied bodies of comparable size such as the satellites of Mars. Gaspra's very irregular shape suggests that the asteroid was derived from a larger body by nearly catastrophic collisions. Consistent with such a history is the prominence of groove-like linear features, believed to be related to fractures. These linear depressions, 100-300 meters wide and tens of meters deep, are in two crossing groups with slightly different morphology, one group wider and more pitted than the other. Grooves had previously been seen only on Mars's moon Phobos, but were predicted for asteroids as well. Gaspra also shows a variety of enigmatic curved depressions and ridges in the terminator region at left. The Galileo project, whose primary mission is the

  16. Gaspra - Highest Resolution Mosaic

    Science.gov (United States)

    1992-01-01

    This picture of asteroid 951 Gaspra is a mosaic of two images taken by the Galileo spacecraft from a range of 5,300 kilometers (3,300 miles), some 10 minutes before closest approach on October 29, 1991. The Sun is shining from the right; phase angle is 50 degrees. The resolution, about 54 meters/pixel, is the highest for the Gaspra encounter and is about three times better than that in the view released in November 1991. Additional images of Gaspra remain stored on Galileo's tape recorder, awaiting playback in November. Gaspra is an irregular body with dimensions about 19 x 12 x 11 kilometers (12 x 7.5 x 7 miles). The portion illuminated in this view is about 18 kilometers (11 miles) from lower left to upper right. The north pole is located at upper left; Gaspra rotates counterclockwise every 7 hours. The large concavity on the lower right limb is about 6 kilometers (3.7 miles) across, the prominent crater on the terminator, center left, about 1.5 kilometers (1 mile). A striking feature of Gaspra's surface is the abundance of small craters. More than 600 craters, 100-500 meters (330-1650 feet) in diameter are visible here. The number of such small craters compared to larger ones is much greater for Gaspra than for previously studied bodies of comparable size such as the satellites of Mars. Gaspra's very irregular shape suggests that the asteroid was derived from a larger body by nearly catastrophic collisions. Consistent with such a history is the prominence of groove-like linear features, believed to be related to fractures. These linear depressions, 100-300 meters wide and tens of meters deep, are in two crossing groups with slightly different morphology, one group wider and more pitted than the other. Grooves had previously been seen only on Mars's moon Phobos, but were predicted for asteroids as well. Gaspra also shows a variety of enigmatic curved depressions and ridges in the terminator region at left. The Galileo project, whose primary mission is the

  17. Mortality and preoperative cardiac function in vascular amputees : an N-terminal pro-brain natriuretic peptide (NT-proBNP) pilot study

    NARCIS (Netherlands)

    Riemersma, Marcel; Dijkstra, Pieter U.; van Veldhuisen, Dirk Jan; Muskiet, Frits A. J.; van den Dungen, Jan A. M. M.; Geertzen, Jan H. B.

    Objective: To determine preoperative ventricular function in vascular amputees by measuring N-terminal pro-brain natriuretic peptide (NT-proBNP) and to analyse the relationship between NT-proBNP levels and 30-day postoperative mortality. Design: Prospective pilot study. Subjects and methods: In 19

  18. The predictive value of plasma biomarkers in discharged heart failure patients: role of plasma NT-proBNP.

    Science.gov (United States)

    Leto, Laura; Testa, Marzia; Feola, Mauro

    2016-04-01

    Natriuretic peptides (NPs) have demonstrated their value to support clinical diagnosis of heart failure (HF); furthermore they are also studied for their prognostic role using them to guide appropriate management strategies. The present review gathers available evidence on prognostic role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients hospitalized for acute decompensated heart failure (ADHF). We searched Medline for English-language studies with the sequent key-words: "acute heart failure/acute decompensated heart failure", "NT-proBNP/N-terminal pro-B type natriuretic peptide" and "prognosis/mortality/readmission". Almost 30 studies were included. NT-proBNP plasma levels at admission are strongly associated with all-cause short-term mortality (2-3 months), mid-term (6-11 months) or long- term mortality (more than one year) of follow-up. Regarding the prognostic power on cardiac death fewer data are available with uncertain results. NT-proBNP at discharge demonstrated its prognostic role for all-cause mortality at mid and long-term follow-up. The relation between NT-proBNP at discharge and cardiovascular mortality or composite end-point is under investigation. A decrease in NT-proBNP values during hospitalization provided prognostic prospects mainly for cardiovascular mortality and HF readmission. A 30% variation in NT-proBNP levels during in-hospital stay seemed to be an optimal cut-off for prognostic role. SNT-proBNP plasma levels proved to have a strong correlation with all-cause mortality, cardiovascular mortality, morbidity and composite outcomes in patients discharged after an ADHF. A better definition of the correct time of serial measurements and the cut-off values might be the challenge for the future investigations.

  19. BNP predicts chemotherapy-related cardiotoxicity and death

    DEFF Research Database (Denmark)

    Skovgaard, Dorthe; Hasbak, Philip; Kjaer, Andreas

    2014-01-01

    ventriculography (MUGA) or echocardiography. However, the plasma cardiac biomarker B-type natriuretic peptide (BNP) has been suggested for early identification of cardiac dysfunction. The aim of the study was to compare LVEF obtained by MUGA and plasma BNP as predictors of developing congestive heart failure (CHF...... death. In multivariate Cox analysis both BNP and LVEF were independent predictors of CHF while age remained the only independent predictor of overall death. CONCLUSION: In cancer patients treated with cardiotoxic chemotherapy both BNP and LVEF can significantly predict subsequent hospitalization...... with CHF. In addition, BNP and not LVEF has a prognostic value in detecting overall death. This prospective study based on the hitherto largest study population supports BNP as a clinical relevant method for monitoring chemotherapy-related cardiac failure and death....

  20. Is proBNP a Reliable Marker for the Evaluation of Fluid Load in Patients Undergoing Continuous Renal Replacement Therapy?

    Directory of Open Access Journals (Sweden)

    Seher Erdogan

    2016-11-01

    Full Text Available Aim: Pro-B type natriuretic peptide (proBNP has been defined as a volume marker in hemodialysis patients. In the present study we aimed to evaluate the role of serum proBNP levels to indicate fluid load in patients undergoing continuous renal replacement therapy (CRRT due to overhydration. Material and Method: Patients who were admitted to a tertiary 7-bed pediatric intensive care unit and underwent CRRT due to overhydration were included in the study. Results: The study was conducted with 15 girls (53.6% and 13 boys (46.4%. The mean age was 61.46±56.13 months (range, 2-183 months; the mean CRRT administration time was 20.8±14.9 hours (range, 5-60 hours; and the mean percentage of fluid extracted from the body was 8.43 ± 4.51% (range, 2.5-20%. CRRT was administered to 12 patients because of fluid overload (42.9% and to 12 (57.1% because of fluid load accompanied by uremia.. There was a statistically significant difference between body weight, urea, and creatinine levels of patients before and after treatment (p= 0.001. The mean proBNP level was 23.306 ± 13.943 pg/mL immediately before CRRT and the mean proBNP after CRRT was 22.178 ± 15.473 pg/mL. There was no statistically significant difference between the initial and final proBNP levels (p= 0.756. With the exception of serum sodium levels, there was no correlation between the final proBNP levels and body weight, urea, and creatinine (p>0.05. Similarly, there was also no correlation between initial proBNP levels and fluid load (p= 0.602 or between the percentage of extracted fluid and final proBNP levels (p= 0.155. Discussion: There was no significant correlation between the fluid load and initial proBNP levels or with the extracted fluid percentage and final proBNP levels in patients undergoing CRRT because of fluid overload.In conclusion, no appropriate marker was determined to evaluate cumulative fluid load and the extracted liquid volume.

  1. NT-proBNP in unstable coronary artery disease--experiences from the FAST, GUSTO IV and FRISC II trials.

    Science.gov (United States)

    Jernberg, Tomas; James, Stefan; Lindahl, Bertil; Stridsberg, Mats; Venge, Per; Wallentin, Lars

    2004-03-15

    Risk stratification is important in patients with unstable coronary artery disease (CAD), i.e. unstable angina or non-ST-elevation myocardial infarction. This article focuses on the emerging role of N-terminal pro brain natriuretic peptide (NT-proBNP) and the results from the FAST, GUSTO IV and FRISC II trials. In the FAST study, NT-proBNP was measured on admission in 755 patients admitted because of symptoms suggestive of unstable CAD. Follow up was performed after 40 months. The GUSTO IV and the FRISC II-trials included patients with unstable CAD and NT-proBNP was analyzed in 6806 and 2019 patients, with follow up after 1 and 2 years, respectively. In the FAST study, patients in the 2nd, 3rd, and 4th NT-proBNP quartile had a relative risk of subsequent death of 4.2 (1.6-11.1), 10.7 (4.2-26.8) and 26.6 (10.8-65.5), respectively. In the GUSTO IV trial, increasing quartiles of NT-proBNP were related to short and long term mortality which at 1 year was; 1.8%, 3.9%, 7.7% and 19.2% (P<0.001), respectively. In multivariable analyses including well-known predictors of outcome, NT-proBNP level was independently associated to mortality in all three studies. In the FRISC II trial, the NT-proBNP level, especially if combined with a marker of inflammation, identified those with the greatest benefit from an early invasive strategy. NT-proBNP is strongly associated with mortality in patients with suspected or confirmed unstable CAD and, combined with a marker of inflammation, seems helpful in identifying those with greatest benefit from an early invasive strategy.

  2. Comparison of Abbott AxSYM and Roche Elecsys 2010 for measurement of BNP and NT-proBNP.

    Science.gov (United States)

    Chien, Tzu-I; Chen, Hui-Hou; Kao, Jau-Tsuen

    2006-07-15

    B-type natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are small cardiac hormones released from the heart. They can be used as an important aid to diagnose congestive heart failure (CHF). We compared the performances of the Abbott AxSYM and Roche Elecsys 2010 for the measurement of BNP and NT-proBNP. The first method uses a microparticle enzyme-linked immunoassay, whereas the other uses chemiluminescent immunometric assay. The CVs using pooled sera ranged from 3.7% to 12.7% for the AxSYM and 0.9% to 2.2% for the Elecsys 2010. The Passing and Bablok regression was Elecsys 2010 NT-proBNP=7.23xAxSYM BNP+2.53. The BNP in EDTA plasma was more stable than in serum. The immunoreactivity difference of NT-proBNP in serum or EDTA plasma was within 10% when stored at 4 degrees Celsius or 25 degrees Celsius for 72 h. Receiver operating characteristic (ROC) curves were different for both assays, and the areas under the curves were 0.704 and 0.841 for the AxSYM and Elecsys 2010 method, respectively. Both assays were not entirely specific for heart failure. The precision and stability for NT-proBNP was better than for BNP in serum. It is important to use method-appropriate reference ranges (or cutoff) for the BNP and NT-proBNP, respectively, in the assessment of CHF.

  3. Evaluation of NT-proBNP concentrations during exercise in asymptomatic patients with severe high-gradient aortic stenosis.

    Science.gov (United States)

    Dobrowolski, Piotr; Lech, Agnieszka; Klisiewicz, Anna; Hoffman, Piotr

    2016-08-11

    INTRODUCTION The effect of asymptomatic severe aortic stenosis (ASAS) on N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels ar rest and during exercise, as well as their relevance for clinical practice remain controversial.  OBJECTIVES The aim of this study was to test the hypothesis of whether the evaluation of NT-proBNP concentrations during exercise provides additional information about the severity of aortic stenosis and left ventricular remodeling in patients with ASAS. PATIENTS AND METHODS A total of 50 patients with ASAS (mean age, 38.4 ±18.1 years) and 21 healthy subjects (mean age, 43.4 ±10.6 years) were enrolled. Rest and exercise echocardiography was performed to evaluate maximum velocity (Vmax), mean aortic gradient (AG), and aortic valve area (AVA). The left ventricular mass index (LVMI) was calculated. NT-proBNP concentrations at rest and during exercise were assessed, and the difference between the 2 values was calculated (ΔNT-proBNP). RESULTS NT-proBNP and ΔNT-proBNP levels at rest and during exercise were significantly higher in the ASAS group compared with the control group. In the ASAS group, NT-proBNP levels at rest significantly correlated with LVMI (r = 0.432; P <0.0001), AVA (r = -0.408; P <0.0001), Vmax (r = 0.375; P = 0.002), and mean AG (r = 0.257; P = 0.03). NT-proBNP levels during exercise significantly correlated with LVMI (r = 0.432; P <0.0001), mean AG (r = 0.401; P = 0.001), and AVA (r = -0.375; P = 0.001). In the multivariate logistic regression model, the factors independently associated with NT-proBNP both at rest and during exercise were age, AVA, and LVMI. CONCLUSIONS NT-proBNP levels at rest provide valuable information for identifying patients with more advanced left ventricular hypertrophy secondary to severe aortic stenosis. NT-proBNP levels during exercise do not provide new information on the severity of AS.

  4. Lowest cost due to highest productivity and highest quality

    Science.gov (United States)

    Wenk, Daniel

    2003-03-01

    Since global purchasing in the automotive industry has been taken up all around the world there is one main key factor that makes a TB-supplier today successful: Producing highest quality at lowest cost. The fact that Tailored Blanks, which today may reach up to 1/3 of a car body weight, are purchased on the free market but from different steel suppliers, especially in Europe and NAFTA, the philosophy on OEM side has been changing gradually towards tough evaluation criteria. "No risk at the stamping side" calls for top quality Tailored- or Tubular Blank products. Outsourcing Tailored Blanks has been starting in Japan but up to now without any quality request from the OEM side like ISO 13919-1B (welding quality standard in Europe and USA). Increased competition will automatically push the quality level and the ongoing approach to combine high strength steel with Tailored- and Tubular Blanks will ask for even more reliable system concepts which enables to weld narrow seams at highest speed. Beside producing quality, which is the key to reduce one of the most important cost driver "material scrap," in-line quality systems with true and reliable evaluation is going to be a "must" on all weld systems. Traceability of all process related data submitted to interfaces according to customer request in combination with ghost-shift-operation of TB systems are tomorrow's state-of-the-art solutions of Tailored Blank-facilities.

  5. The association between disease activity and NT-proBNP in 238 patients with rheumatoid arthritis: a 10-year longitudinal study

    Science.gov (United States)

    Provan, Sella A; Angel, Kristin; Ødegård, Sigrid; Mowinckel, Petter; Atar, Dan; Kvien, Tore K

    2008-01-01

    Introduction Disease activity in patients with rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality, of which N-terminal pro-brain natriuretic peptide (NT-proBNP) is a predictor. Our objective was to examine the cross-sectional and longitudinal associations between markers of inflammation, measures of RA disease activity, medication used in the treatment of RA, and NT-proBNP levels (dependent variable). Methods Two hundred thirty-eight patients with RA of less than 4 years in duration were followed longitudinally with three comprehensive assessments of clinical and radiographic data over a 10-year period. Serum samples were frozen and later batch-analyzed for NT-proBNP levels and other biomarkers. Bivariate, multivariate, and repeated analyses were performed. Results C-reactive protein (CRP) levels at baseline were cross-sectionally associated with NT-proBNP levels after adjustment for age and gender (r2 adjusted = 0.23; P < 0.05). At the 10-year follow-up, risk factors for cardiovascular disease were recorded. Duration of RA and CRP levels were independently associated with NT-proBNP in the final model that was adjusted for gender, age, and creatinine levels (r2 adjusted = 0.38; P < 0.001). In the longitudinal analyses, which adjusted for age, gender, and time of follow-up, we found that repeated measures of CRP predicted NT-proBNP levels (P < 0.001). Conclusion CRP levels are linearly associated with levels of NT-proBNP in cross-sectional and longitudinal analyses of patients with RA. The independent associations of NT-proBNP levels and markers of disease activity with clinical cardiovascular endpoints need to be further investigated. PMID:18573197

  6. [Expression of proBNP and NT-proBNP in Sudden Death of Coronary Heart Disease].

    Science.gov (United States)

    Zeng, Q; Sun, R F; Li, Z; Zhai, L Q; Liu, M Z; Guo, X J; Gao, C R

    2017-10-01

    To study the expression change of pro-brain natriuretic peptide (proBNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in sudden death of coronary atherosclerotic heart disease, and to explore its application in forensic diagnosis. Myocardial and blood samples were collected from normal control group, sudden death of coronary atherosclerotic heart disease group and single coronary stenosis group (20 cases in each group). The expression of proBNP in myocardial samples were detected by immunohistochemical staining and Western blotting, and that of BNP mRNA were detected by reverse transcription PCR (RT-PCR). The content of NT-proBNP in plasma were detected by ELISA. Immunohistochemical staining showed positive expression of proBNP in both sudden death of coronary atherosclerotic heart disease group and single coronary stenosis group. There was no positive expression in normal control group. For sudden death of coronary atherosclerotic heart disease group and single coronary stenosis group, the relative expression of proBNP protein and BNP mRNA in myocardial tissue and the NT-proBNP content in plasma were higher than that of normal control group ( P heart disease group was higher than that of single coronary stenosis group ( P heart disease and determine whether the sudden death due to coronary atherosclerotic heart disease. Copyright© by the Editorial Department of Journal of Forensic Medicine

  7. Impact of underlying heart disease per se on the utility of preoperative NT-proBNP in adult cardiac surgery.

    Directory of Open Access Journals (Sweden)

    Huiqi Jiang

    Full Text Available The primary aim was to investigate the role of underlying heart disease on preoperative NT-proBNP levels in patients admitted for adult cardiac surgery, after adjusting for the known confounders age, gender, obesity and renal function. The second aim was to investigate the predictive value of preoperative NT-proBNP with regard to severe postoperative heart failure (SPHF and postoperative mortality.A retrospective cohort study based on preoperative NT-proBNP measurements in an unselected cohort including all patients undergoing first time surgery for coronary artery disease (CAD; n = 2226, aortic stenosis (AS; n = 406 or mitral regurgitation (MR; n = 346 from April 2010 to August 2016 in the southeast region of Sweden (n = 2978. Concomitant procedures were not included, with the exception of Maze or tricuspid valve procedures.Preoperative NT-proBNP was 1.67 times (p<0.0001 and 1.41 times (p<0.0001 higher in patients with AS or MR respectively, than in patients with CAD after adjusting for confounders. NT-proBNP demonstrated significant discrimination with regard to SPHF in CAD (AUC = 0.79, 95%CI 0.73-0.85, p<0.0001, MR (AUC = 0.80, 95%CI 0.72-0.87, p<0.0001 and AS (AUC = 0.66, 95%CI 0.51-0.81, p = 0.047. In CAD patients NT-proBNP demonstrated significant discrimination with regard to postoperative 30-day or in-hospital mortality (AUC = 0.78; 95%CI 0.71-0.85, p<0.0001. The number of deaths was too few in the AS and MR group to permit analysis. Elevated NT-proBNP emerged as an independent risk factor for SPHF, and postoperative mortality in CAD.Patients with AS or MR have higher preoperative NT-proBNP than CAD patients even after adjusting for confounders. The predictive value of NT-proBNP with regard to SPHF was confirmed in CAD and MR patients but was less convincing in AS patients.

  8. NT-proBNP (N-Terminal pro-B-Type Natriuretic Peptide)-Guided Therapy in Acute Decompensated Heart Failure: PRIMA II Randomized Controlled Trial (Can NT-ProBNP-Guided Therapy During Hospital Admission for Acute Decompensated Heart Failure Reduce Mortality and Readmissions?).

    Science.gov (United States)

    Stienen, Susan; Salah, Khibar; Moons, Arno H; Bakx, Adrianus L; van Pol, Petra; Kortz, R A Mikael; Ferreira, João Pedro; Marques, Irene; Schroeder-Tanka, Jutta M; Keijer, Jan T; Bayés-Genis, Antoni; Tijssen, Jan G P; Pinto, Yigal M; Kok, Wouter E

    2018-04-17

    The concept of natriuretic peptide guidance has been extensively studied in patients with chronic heart failure (HF), with only limited success. The effect of NT-proBNP (N-terminal probrain natriuretic peptide)-guided therapy in patients with acute decompensated HF using a relative NT-proBNP target has not been investigated. This study aimed to assess whether NT-proBNP-guided therapy of patients with acute decompensated HF using a relative NT-proBNP target would lead to improved outcomes compared with conventional therapy. We conducted a prospective randomized controlled trial to study the impact of in-hospital guidance for acute decompensated HF treatment by a predefined NT-proBNP target (>30% reduction from admission to discharge) versus conventional treatment. Patients with acute decompensated HF with NT-proBNP levels >1700 ng/L were eligible. After achieving clinical stability, 405 patients were randomized to either NT-proBNP-guided or conventional treatment (1:1). The primary end point was dual: a composite of all-cause mortality and HF readmissions in 180 days and the number of days alive out of the hospital in 180 days. Secondary end points were all-cause mortality within 180 days, HF readmissions within 180 days, and a composite of all-cause mortality and HF readmissions within 90 days. Significantly more patients in the NT-proBNP-guided therapy group were discharged with an NT-proBNP reduction of >30% (80% versus 64%, P =0.001). Nonetheless, NT-proBNP-guided therapy did not significantly improve the combined event rate for all-cause mortality and HF readmissions (hazard ratio, 0.96; 95% confidence interval, 0.72-1.37; P =0.99) or the median number of days alive outside of the hospital (178 versus 179 days for NT-proBNP versus conventional patients, P =0.39). Guided therapy also did not significantly improve any of the secondary end points. The PRIMA II trial (Can NT-ProBNP-Guided Therapy During Hospital Admission for Acute Decompensated Heart Failure

  9. Modest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes.

    LENUS (Irish Health Repository)

    Phelan, Dermot

    2012-11-01

    In asymptomatic subjects B-type natriuretic peptide (BNP) is associated with adverse cardiovascular outcomes even at levels well below contemporary thresholds used for the diagnosis of heart failure. The mechanisms behind these observations are unclear. We examined the hypothesis that in an asymptomatic hypertensive population BNP would be associated with sub-clinical evidence of cardiac remodeling, inflammation and extracellular matrix (ECM) alterations. We performed transthoracic echocardiography and sampled coronary sinus (CS) and peripheral serum from patients with low (n = 14) and high BNP (n = 27). Peripheral BNP was closely associated with CS levels (r = 0.92, p<0.001). CS BNP correlated significantly with CS levels of markers of collagen type I and III turnover including: PINP (r = 0.44, p = 0.008), CITP (r = 0.35, p = 0.03) and PIIINP (r = 0.35, p = 0.001), and with CS levels of inflammatory cytokines including: TNF-α (r = 0.49, p = 0.002), IL-6 (r = 0.35, p = 0.04), and IL-8 (r = 0.54, p<0.001). The high BNP group had greater CS expression of fibro-inflammatory biomarkers including: CITP (3.8±0.7 versus 5.1±1.9, p = 0.007), TNF-α (3.2±0.5 versus 3.7±1.1, p = 003), IL-6 (1.9±1.3 versus 3.4±2.7, p = 0.02) and hsCRP (1.2±1.1 versus 2.4±1.1, p = 0.04), and greater left ventricular mass index (97±20 versus 118±26 g\\/m(2), p = 0.03) and left atrial volume index (18±2 versus 21±4, p = 0.008). Our data provide insight into the mechanisms behind the observed negative prognostic impact of modest elevations in BNP and suggest that in an asymptomatic hypertensive cohort a peripheral BNP measurement may be a useful marker of an early, sub-clinical pathological process characterized by cardiac remodeling, inflammation and ECM alterations.

  10. Modest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes.

    Directory of Open Access Journals (Sweden)

    Dermot Phelan

    Full Text Available In asymptomatic subjects B-type natriuretic peptide (BNP is associated with adverse cardiovascular outcomes even at levels well below contemporary thresholds used for the diagnosis of heart failure. The mechanisms behind these observations are unclear. We examined the hypothesis that in an asymptomatic hypertensive population BNP would be associated with sub-clinical evidence of cardiac remodeling, inflammation and extracellular matrix (ECM alterations. We performed transthoracic echocardiography and sampled coronary sinus (CS and peripheral serum from patients with low (n = 14 and high BNP (n = 27. Peripheral BNP was closely associated with CS levels (r = 0.92, p<0.001. CS BNP correlated significantly with CS levels of markers of collagen type I and III turnover including: PINP (r = 0.44, p = 0.008, CITP (r = 0.35, p = 0.03 and PIIINP (r = 0.35, p = 0.001, and with CS levels of inflammatory cytokines including: TNF-α (r = 0.49, p = 0.002, IL-6 (r = 0.35, p = 0.04, and IL-8 (r = 0.54, p<0.001. The high BNP group had greater CS expression of fibro-inflammatory biomarkers including: CITP (3.8±0.7 versus 5.1±1.9, p = 0.007, TNF-α (3.2±0.5 versus 3.7±1.1, p = 003, IL-6 (1.9±1.3 versus 3.4±2.7, p = 0.02 and hsCRP (1.2±1.1 versus 2.4±1.1, p = 0.04, and greater left ventricular mass index (97±20 versus 118±26 g/m(2, p = 0.03 and left atrial volume index (18±2 versus 21±4, p = 0.008. Our data provide insight into the mechanisms behind the observed negative prognostic impact of modest elevations in BNP and suggest that in an asymptomatic hypertensive cohort a peripheral BNP measurement may be a useful marker of an early, sub-clinical pathological process characterized by cardiac remodeling, inflammation and ECM alterations.

  11. Catching the Highest Energy Neutrinos

    Energy Technology Data Exchange (ETDEWEB)

    Stanev, Todor [Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, DE 19716 (United States)

    2011-08-15

    We briefly discuss the possible sources of ultrahigh energy neutrinos and the methods for their detection. Then we present the results obtained by different experiments for detection of the highest energy neutrinos.

  12. NT-proBNP and Circulating Inflammation Markers in Prediction of a Normal Myocardial Scintigraphy in Patients with Symptoms of Coronary Artery Disease

    DEFF Research Database (Denmark)

    Rathcke, C.N.; Kjøller, Erik; Fogh-Andersen, N.

    2010-01-01

    with an intermediate risk of CAD or with known CAD with renewed suspicion of ischemia were referred to MPI. Blood samples were analyzed for N-terminal fragment of the prohormone brain natriuretic peptide (NT-proBNP), YKL-40, IL-6, matrix metalloproteinase 9 (MMP-9) and high sensitive C-reactive protein (hs......CRP). Patients with myocardial perfusion defects had elevated levels of NT-proBNP (p95% regardless of existing CAD. Conclusions: 20-25% of patients suspected of CAD could have been spared a MPI by using a NT-proBNP cut-off concentration at 25 ng/l with a negative predictive value >95%. NT-proBNP has...

  13. Predictive value of NT-proBNP for 30-day mortality in patients with non-ST-elevation acute coronary syndromes: a comparison with the GRACE and TIMI risk scores.

    Science.gov (United States)

    Schellings, Dirk Aam; Adiyaman, Ahmet; Dambrink, Jan-Henk E; Gosselink, At Marcel; Kedhi, Elvin; Roolvink, Vincent; Ottervanger, Jan Paul; Van't Hof, Arnoud Wj

    2016-01-01

    The biomarker N-terminal pro-brain natriuretic peptide (NT-proBNP) predicts outcome in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS). Whether NT-proBNP has incremental prognostic value beyond established risk strategies is still questionable. To evaluate the predictive value of NT-proBNP for 30-day mortality over and beyond the Global Registry of Acute Coronary Events (GRACE) and Thrombolysis In Myocardial Infarction (TIMI) risk scores in patients with NSTE-ACS. Patients included in our ACS registry were candidates. NT-proBNP levels on admission were measured and the GRACE and TIMI risk scores were assessed. We compared the predictive value of NT-proBNP to both risk scores and evaluated whether NT-proBNP improves prognostication by using receiver operator curves and measures of discrimination improvement. A total of 1324 patients were included and 50 patients died during follow-up. On logistic regression analysis NT-proBNP and the GRACE risk score (but not the TIMI risk score) both independently predicted mortality at 30 days. The predictive value of NT-proBNP did not differ significantly compared to the GRACE risk score (area under the curve [AUC]) 0.85 vs 0.87 p =0.67) but was considerably higher in comparison to the TIMI risk score (AUC 0.60 p risk score by adding NT-proBNP did not improve prognostication: AUC 0.86 ( p =0.57), integrated discrimination improvement 0.04 ( p =0.003), net reclassification improvement 0.12 ( p =0.21). In patients with NSTE-ACS, NT-proBNP and the GRACE risk score (but not the TIMI risk score) both have good and comparable predictive value for 30-day mortality. However, incremental prognostic value of NT-proBNP beyond the GRACE risk score could not be demonstrated.

  14. BNP molecular forms and processing by the cardiac serine protease corin.

    Science.gov (United States)

    Ichiki, Tomoko; Huntley, Brenda K; Burnett, John C

    2013-01-01

    The cardiac hormone, B-type natriuretic peptide (BNP), is one of human natriuretic peptides which possesses cardiorenal protective actions and is used as a therapeutic and a biomarker for heart failure (HF). Its prohormone, proBNP1_108, is processed by the proNPs convertases, corin or furin, to inactive NT-proBNP1_76 and active BNP1-32. Paradoxically, circulating NT-proBNP and BNP are elevated in HF leading to the use of BNP as a sensitive and predictive marker of HF. This paradox may be explained by the "nonspecific" nature of conventional assays and/or a relative deficiency state of "active BNP" as characterized by an increase in inactive proBNP_108 and a decrease in active BNP1-32. Therefore, understanding the regulation of proBNP1_108 processing and the role of the convertase corin may be important in understanding the physiology of HF. Corin is expressed in heart and kidney and may play an important role in regulating blood pressure and remodeling of the heart. The processing of proBNP1_108 by corin may be controlled by O-linked glycosylation of proBNP1-108. A potential impairment of proBNP1lo8 processing in HF may be linked to dysregulation of the convertase corin, which may offer therapeutic opportunities to control proBNPlo0s processing and its activation in HF.

  15. NT-pro-BNP is associated with inducible myocardial ischemia in mildly symptomatic type 2 diabetic patients

    NARCIS (Netherlands)

    Wiersma, Jacobijne J.; van der Zee, P. Marc; van Straalen, Jan P.; Fischer, Johan C.; van Eck-Smit, Berthe L. F.; Tijssen, Jan G. P.; Trip, Mieke D.; Piek, Jan J.; Verberne, Hein J.

    2010-01-01

    Baseline levels of N-terminal fragment of the brain natriuretic peptide prohormone (NT-pro-BNP) are associated with myocardial ischemia in non-diabetic patients with stable angina pectoris. A total of 281 patients with diabetes mellitus type 2 and stable angina pectoris underwent myocardial

  16. BNP but Not s-cTnln is associated with cardioembolic aetiology and predicts short and long term prognosis after cerebrovascular events.

    Directory of Open Access Journals (Sweden)

    Nicole Nigro

    Full Text Available We analyzed the prognostic value of b-type natriuretic peptide (BNP and sensitive cardiac Troponin (s-cTnI in patients with ischemic stroke or transient ischemic attack (TIA and their significance in predicting stroke aetiology.In a prospectively enrolled cohort we measured BNP and s-cTnI levels upon admission. Primary endpoints were mortality, unfavorable functional outcome and stroke recurrence after 90 days and after 12 months. Secondary endpoint was cardioembolic aetiology.In 441 patients BNP but not s-cTnI remained an independent predictor for death with an adjusted HR of 1.2 (95% CI 1.1-1.4 after 90 days and 1.2 (95% CI 1.0-1.3 after one year. The comparison of the Area under Receiver Operating Characteristic (AUROC of model A (age, NIHSS and model B (age, NIHSS, BNP showed an improvement in the prediction of mortality (0.85 (95% CI 0.79-0.90 vs. 0.86 (95% CI 0.81-0.92, Log Rank p = 0.004. Furthermore the category free net reclassification improvement (cfNRI when adding BNP to the multivariate model was 57.5%, p<0.0001. For the prediction of functional outcome or stroke recurrence both markers provided no incremental value. Adding BNP to a model including age, atrial fibrillation and heart failure lead to a higher discriminatory accuracy for identification of cardioembolic stroke than the model without BNP (AUC 0.75 (95% CI 0.70-0.80 vs. AUC 0.79, (95% CI 0.75-0.84, p = 0.008.BNP is an independent prognostic maker for overall mortality in patients with ischemic stroke or TIA and may improve the diagnostic accuracy to identify cardioembolic aetiology.ClinicalTrials.gov NCT00390962.

  17. Superior Predictive Value for NTproBNP Compared with High Sensitivity cTnT in Dialysis Patients: A Pilot Prospective Observational Study

    Directory of Open Access Journals (Sweden)

    Luminita Voroneanu

    2014-12-01

    Full Text Available Background/Aims: The clinical utility of the new biomarker, high sensitivity cardiac T troponin (hs-cTnT is still unclear in dialysis patients. Furthermore, the prognostic value of combining N-terminal pro-B-type natriuretic peptide (NT-pro-BNP and hs-cTnT has not been explored so far. The objective of this pilot study was to determine the utility of hs-cTnT alone versus hs-cTnT in combination with NT-proBNP for predicting death in a stable hemodialysis cohort. Methods: A prospective observational pilot study including 98 chronic asymptomatic hemodialysis patients with a follow up period of 24 months was designed. The cut-off values for NT-proBNP and hs-cTnT were calculated using receiver operating characteristic (ROC analysis, using mortality as an end-point. Based on the cut-off values, the cohort was divided into four groups. Group 1 - NT-proBNP 69.48 ng/l; group 3 - NT-proBNP > 14275 pg/ml and hs-cTnT 14275 pg/ml and hs-cTnT > 69.48 ng/l. Survival for each group was determined using the Kaplan-Meier method and Cox regression analysis. Results: During the follow-up period 16 patients died. According to the ROC curves analysis, the cut-off point for hs-cTnT and for NT-proBNP were 69.43 ng/l (AUC = 0.618; p = 0.04 and 14275 pg/ml (AUC = 0.722; p = 0.003, respectively. In univariate Cox analysis, both hs-cTnT (HR = 3.34; p = 0.016 and NT-proBNP (HR = 5.94; p = 0.01 were predictors of death. In the multivariable Cox proportional hazards model, only NT-pro-BNP levels above the cut-off value remained an independent predictor of all-cause mortality. The combined elevation of both biomarkers did not improve significantly the prognostic value compared with NT-proBNP alone (HR = 6.15 versus HR =4 .78; p = 0.338. Conclusion: NT-pro-BNP is a strong predictor of overall mortality in asymptomatic hemodialysis patients. The addition of hs-cTnT did not improve the prognostic accuracy compared with NT proBNP alone.

  18. Head-to-head comparison of BNP and IL-6 as markers of clinical and experimental heart failure: Superiority of BNP.

    Science.gov (United States)

    Birner, Christoph M; Ulucan, Coskun; Fredersdorf, Sabine; Rihm, Munhie; Löwel, Hannelore; Stritzke, Jan; Schunkert, Heribert; Hengstenberg, Christian; Holmer, Stephan; Riegger, Günter; Luchner, Andreas

    2007-11-01

    Activation of BNP and IL-6 are hallmarks of left ventricular (LV) dysfunction and congestive heart failure (CHF). To assess the relative activation of BNP and IL-6 in clinical and experimental heart failure, we performed a human study in which plasma N-terminal proBNP (NT-proBNP) and IL-6 were measured in a large group of patients in the chronic phase after myocardial infarction (MI) and an animal study in which LV gene expression of BNP and IL-6 was assessed in rapid ventricular pacing-induced heart failure. In the human study, NT-proBNP and IL-6 were measured by non-extracted, enzyme-linked immunoassay in 845 subjects (n=468 outpatients after MI, MONICA MI register Augsburg; and 377 siblings without MI, control). NT-proBNP (295+/-23pg/mL vs. CTRL 84+/-8, PNT-proBNP was significantly correlated with several cardiac structural and functional parameters (EF, LVMI, history of MI, CHF symptoms; all PNT-proBNP with a greater sensitivity, specificity, and ROC-area (85%, 88%, and 0.87, respectively) as compared to IL-6 (69%, 53%, and 0.67, respectively). In the animal study, IL-6 and BNP expression were both significantly elevated in CHF (both PBNP. In addition, BNP mRNA expression displayed a stronger inverse correlation with LV function (r=-0.74; Pheart failure but to a significantly lesser degree than that of BNP. Both the stronger expression of BNP and the better correlation with LV function provide the molecular basis for a diagnostic superiority of NT-proBNP in clinical LV dysfunction and heart failure.

  19. Short term variation in NTproBNP after lifestyle intervention in severe obesity.

    Directory of Open Access Journals (Sweden)

    Debora Fedele

    Full Text Available Natriuretic peptides are not only involved in cardiovascular adaption to various conditions, but also in metabolic diseases. We performed this study to assess the effect of a very short time of lifestyle inpatient intervention on NTproBNP values in normotensive subjects with severe obesity and normal cardiac function.We recruited 14 consecutive obese normotensive subjects with normal cardiac function who were aged 30 years and more and were referred to inpatient rehabilitation in an academic clinic over a two months period. They were examined at baseline and after a 3-weeks program including dietary intervention with hypocaloric diet and assisted personalized physical aerobic and anaerobic activities and compared to age, sex and BMI-matched control subjects under usual care.BMI significantly decreased (40.8 ±1.6 vs 42.3 ± 1.6 kg/m2, p <0.0001. Median reduction in body weight was 4.9 kg (interquartile range 2.4-5.2 kg. After diet and exercise-induced weight loss, plasma NTproBNP levels showed an almost two-fold increase, which was statistically significant (28.2 ± 12.3 vs 17.2 ± 13.2 ng/L, p = 0.01, and particularly relevant in the subgroup with NT-proBNP values below median values compared to those with higher values (p = 0.02. No significant variations were found in control subjects (18.0 ± 13.0 vs 16.5 ± 11.2 ng/L, p = 0.18. The lipid profile was significantly ameliorated, and both HbA1c and insulin levels showed a marginally non-significant decrease after treatment.An almost two-fold increase in NTproBNP levels was evident after a very short time period of lifestyle intervention in normotensive severe obese patients without cardiac disease. This finding might have clinical relevance, considering the role of NT-proBNP as risk factor of impaired glucose tolerance.

  20. NT-pro-BNP is associated with inducible myocardial ischemia in mildly symptomatic type 2 diabetic patients.

    Science.gov (United States)

    Wiersma, Jacobijne J; van der Zee, P Marc; van Straalen, Jan P; Fischer, Johan C; van Eck-Smit, Berthe L F; Tijssen, Jan G P; Trip, Mieke D; Piek, Jan J; Verberne, Hein J

    2010-11-19

    Baseline levels of N-terminal fragment of the brain natriuretic peptide prohormone (NT-pro-BNP) are associated with myocardial ischemia in non-diabetic patients with stable angina pectoris. A total of 281 patients with diabetes mellitus type 2 and stable angina pectoris underwent myocardial perfusion scintigraphy (MPS). Myocardial ischemia on MPS was present in 140 (50%) patients. These ischemic patients had significantly higher NT-pro-BNP levels compared with patients without ischemia: 183 pg/ml (64-324 pg/ml) vs. 88 pg/ml (34-207 pg/ml), respectively (ppro-BNP ≥180 pg/ml was an independent predictor of the presence of myocardial ischemia (OR 2.36, 95%CI 1.40-3.97, p=0.001). Possible confounding factors such as age and creatinine clearance were of no influence on the predictive value in this specific patient population. These findings strengthen the idea that NT-pro-BNP may be of value in the early detection of diabetic patients with hemodynamic significant coronary artery disease. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  1. NTproBNP in insulin-resistance mediated conditions: overweight/obesity, metabolic syndrome and diabetes. The population-based Casale Monferrato Study.

    Science.gov (United States)

    Baldassarre, Stefano; Fragapani, Salvatore; Panero, Antonio; Fedele, Debora; Pinach, Silvia; Lucchiari, Manuela; Vitale, Anna Rita; Mengozzi, Giulio; Gruden, Gabriella; Bruno, Graziella

    2017-09-25

    NTproBNP and BNP levels are reduced in obese subjects, but population-based data comparing the pattern of this relationship in the full spectrum of insulin-resistance mediated conditions, overweight/obesity, metabolic syndrome and diabetes, are limited. The study-base were 3244 individuals aged 45-74 years, none of whom had heart failure, 1880 without diabetes and 1364 with diabetes, identified as part of two surveys of the population-based Casale Monferrato Study. All measurements were centralized. We examined with multiple linear regression and cubic regression splines the relationship between NTproBNP and BMI, independently of known risk factors and confounders. A logistic regression analysis was also performed to assess the effect of overweight/obesity (BMI ≥ 25 kg/m 2 ), diabetes and metabolic syndrome on NTproBNP values. Out of the overall cohort of 3244 people, overweight/obesity was observed in 1118 (59.4%) non-diabetic and 917 (67.2%) diabetic subjects, respectively. In logistic regression, compared to normal weight individuals, those with a BMI ≥ 25 kg/m 2 had a OR of 0.70 (95% CI 0.56-0.87) of having high NTproBNP values, independently of diabetes. As interaction between diabetes and NTproBNP was evident (p obesity or metabolic syndrome enhanced fourfold and over the OR of having high NTproBNP levels, while the presence of metabolic syndrome alone had a more modest effect (OR 1.54, 1.18-2.01) even after having excluded individuals with CVD. In the non-diabetic cohort, obesity/overweight and HOMA-IR ≥ 2.0 decreased to a similar extent the ORs of high NTproBNP [0.76 (0.60-0.95) and 0.74 (0.59-0.93)], but the association between overweight/obesity and NTproBNP was no longer significant after the inclusion into the model of HOMA-IR, whereas CRP > 3 mg/dl conferred a fully adjusted OR of 0.65 (0.49-0.86). NT-proBNP levels are lower in overweight/obesity, even in those with diabetes. Both insulin-resistance and chronic low-grade inflammation

  2. Ruling out cardiac failure: Cost-benefit analysis of a sequential testing strategy with NT-proBNP before echocardiography

    Science.gov (United States)

    Ferrandis, Maria-José; Ryden, Ingvar; Lindahl, Tomas L.

    2013-01-01

    Objectives To estimate the possible economic benefit of a sequential testing strategy with NT-proBNP to reduce the number of echocardiographies. Methods Retrospective study in a third-party payer perspective. The costs were calculated from three Swedish counties: Blekinge, Östergötland, and Uppland. Two cut-off levels of NT-proBNP were used: 400 and 300 pg/mL. The cost-effectiveness of the testing strategy was estimated through the short-term cost avoidance and reduction in demand for echocardiographies. Results The estimated costs for NT-proBNP tests and echocardiographies per county were reduced by 33%–36% with the 400 pg/mL cut-off and by 28%–29% with the 300 pg/mL cut-off. This corresponded to a yearly cost reduction of approximately €2–5 million per million inhabitants in these counties. Conclusion The use of NT-proBNP as a screening test could substantially reduce the number of echocardiographies in the diagnostic work-up of patients with suspected cardiac failure, as well as the associated costs. PMID:23230860

  3. The importance of apoptotic activity and plasma NT-proBNP levels in patients with acute exacerbation of decompensated heart failure and their relation to different drugs and comorbidities

    International Nuclear Information System (INIS)

    Sarimehmetoglu, A. C.; Gultekin, N.; Yildiz, A.; Kocas, C.; Ersanli, M.; Kucukates, E.

    2014-01-01

    Objective: To demonstrate the presence and importance of apoptotic activity in heart failure during acute exacerbations and to investigate the effects of different drugs used and co-morbidities on levels of N-Terminal pro-Brain Natriuretic Peptide and apoptotic activity on admission and during hospitalisation. Methods: The descriptive study was conducted at the emergency department of Istanbul University Cardiology Institute between October 2010 and May 2011 and comprised patients with complaints of shortness of breath, and who were evaluated as acutely exacerbated decompensated heart failure with an aetiology of ischaemic or dilated cardiomyopathy. Apoptotic activity and N-Terminal pro-Brain Natriuretic Peptide levels were measured on admission and on the seventh day of treatment. SPSS 15 was used for statistical analysis. Results: Of the 89 patients in the study, 67(75%) were males. Overall mean age of the study sample was 61+-12 years. Patients who had N-Terminal pro-Brain Natriuretic Peptide levels higher than 6000 pg/ml on admission had greater in-patient mortality rate (p<0.001). N-Terminal pro-Brain Natriuretic Peptide levels decreased significantly on the seventh day of treatment compared to the admission values (p<0.012). Apoptotic activity levels, although not statistically significant, increased on the seventh day compared with admission values (p<0.12). Apoptotic activity levels on the 7th day were associated with in-patient deaths (p<0.002). Dopamine infusion in the treatment group during hospitalisation significantly increased apoptotic activity (p<0.035), whereas there was a trend towards decreased apoptotic activity levels with spironolactone (p<0.07). Treatment with beta-blockers did not change apoptotic activity levels (p<0.751), whereas lack of beta-blocker therapy increased apoptotic activity (p<0.02). Conclusion: N-Terminal pro-Brain Natriuretic Peptide may be an important risk predictor in decompensated heart failure exacerbations during

  4. Up to the highest peak!

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    In the early hours of this morning, the beam energy was ramped up to 3.5 TeV, a new world record and the highest energy for this year’s run. Now operators will prepare the machine to make high-energy collisions later this month. CERN Operations Group leader Mike Lamont (foreground) and LHC engineer in charge Alick Macpherson in the CERN Control Centre early this morning. At 5:23 this morning, Friday 19 March, the energy of both beams in the LHC was ramped up to 3.5 TeV, a new world record. During the night, operators had tested the performance of the whole machine with two so-called ‘dry runs’, that is, without beams. Given the good overall response, beams were injected at around 3:00 a.m. and stabilized soon after. The ramp started at around 4:10 and lasted about one hour. Over the last couple of weeks, operation of the LHC at 450 GeV has become routinely reproducible. The operators were able to test and optimize the beam orbit, the beam collimation, the injection and ext...

  5. NT-proBNP as Marker of Ventricular Dilatation and Pulmonary Regurgitation After Surgical Correction of Tetralogy of Fallot: A MRI Validation Study.

    Science.gov (United States)

    Paolino, Annalisa; Hussain, Tarique; Pavon, Antonio; Velasco, Maria Nieves; Uribe, Sergio; Ordoñez, Antonio; Valverde, Israel

    2017-02-01

    The goal of this study is to evaluate whether NT-proBNP plasma levels may help as a screening biomarker for monitoring right ventricular dilatation, pulmonary regurgitation and the onset of heart failure in patients with repaired Tetralogy of Fallot. Our single-centre observational prospective study involved 43 patients (15.1 years, SD = 8) with corrected Tetralogy of Fallot. Data collection included: clinical parameters (electrocardiogram, chest X-ray, NYHA scale, time since last surgery), biochemistry (NT-proBNP levels) and MRI values (ventricular volumetry, pulmonary flow assessment). Mean time since last surgery was 13.5 years (SD = 7.8). There was a statistically significant correlation between the NT-proBNP levels (187.4 pg/ml, SD = 154.9) and right ventricular dilatation for both the right ventricular end-diastolic volume (124.9 ml/m 2 , SD = 31.2) (Pearson = 0.19, p Tetralogy of Fallot, NT-proBNP levels correlate with right ventricular dilatation and the degree of pulmonary regurgitation. Ambulatory determination of NT-proBNP might be an easy, readily available and cost-effective alternative for MRI follow-up evaluation of these patients.

  6. Improved early risk stratification of patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention using a combination of serum soluble ST2 and NT-proBNP.

    Directory of Open Access Journals (Sweden)

    Jongwook Yu

    Full Text Available Although soluble suppression of tumorigenicity 2 (sST2 in serum is known to be associated with ischemic heart disease and heart failure, data regarding its prognostic impact in ST-segment elevation myocardial infarction (STEMI is limited. We evaluated the prognostic impacts of serum sST2 and other serum biomarkers in STEMI patients undergoing primary percutaneous coronary intervention (PCI.Consecutive all 323 patients with STEMI that underwent primary PCI were enrolled. Blood tests and samples were obtained in an emergency room. The primary endpoint was 1-year major adverse cardiovascular and cerebrovascular events (MACCEs, defined as a composite of cardiovascular death, non-fatal MI, non-fatal stroke, and ischemia-driven revascularization.Mean age was 59.1±13.1 years (men 84%. MACCE (20 cardiovascular deaths, 7 non-fatal MI, 4 non-fatal stroke, 7 ischemia-driven revascularizations occurred in 38 patients (12%. After adjusting for confounding factors, Cox regression analysis revealed that high serum sST2 (>75.8 ng/mL mean value, adjusted hazard ratio 2.098, 95% CI 1.008-4.367, p = 0.048 and high serum NT-proBNP level (>400 pg/mL, adjusted hazard ratio 2.606, 95% CI 1.086-6.257, p = 0.032 at the time of presentation independently predicted MACCE within a year of primary PCI. Furthermore, when high serum sST2 level was combined with high serum NT-proBNP level, the hazard ratio of MACCE was highest (adjusted hazard ratio 7.93, 95% CI 2.97-20.38, p<0.001.Elevated serum levels of sST2 or NT-proBNP at the time of presentation were found to predict 1-year MACCE independently and elevated serum levels of sST2 plus NT-proBNP were associated with even poorer prognosis in patients with STEMI undergoing primary PCI.

  7. BRAIN NATRIURETIC PEPTIDE (BNP: BIOMARKER FOR RISK STRATIFICATION AND FUNCTIONAL RECOVERY PREDICTION IN ISCHEMIC STROKE

    Directory of Open Access Journals (Sweden)

    STANESCU Ioana

    2015-02-01

    Full Text Available Functional outcome after cardiovascular and cerebrovascular events is traditionally predicted using demographic and clinical variables like age, gender, blood pressure, cholesterol levels, diabetes status, smoking habits or pre-existing morbidity. Identification of new variables will improve the risk stratification of specific categories of patients. Numerous blood-based biomarkers associated with increased cardiovascular risk have been identified; some of them even predict cardiovascular events. Investigators have tried to produce prediction models by incorporating traditional risk factors and biomarkers. (1. Widely-available, rapidly processed and less expensive biomarkers could be used in the future to guide management of complex cerebrovascular patients in order to maximize their recovery (2 Recently, studies have demonstrated that biomarkers can predict not only the risk for a specific clinical event, but also the risk of death of vascular cause and the functional outcome after cardiovascular or cerebrovascular events. Early prediction of fatal outcome after stroke may improve therapeutic strategies (such as the use of more aggressive treatments or inclusion of patients in clinical trials and guide decision-making processes in order to maximize patient’s chances for survival and recovery. (3 Long term functional outcome after stroke is one of the most difficult variables to predict. Elevated serum levels of brain natriuretic peptide (BNP are powerful predictor of outcomes in patients with cardiovascular disease (heart failure, atrial fibrillation. Potential role of BNP in predicting atrial fibrillation occurrence, cardio-embolic stroke and post-stroke mortality have been proved in many studies. However, data concerning the potential role of BNP in predicting short term and long term functional outcomes after stroke remain controversial.

  8. Hypertension-Related Gene Polymorphisms of G-Protein-Coupled Receptor Kinase 4 Are Associated with NT-proBNP Concentration in Normotensive Healthy Adults

    Directory of Open Access Journals (Sweden)

    Junichi Yatabe

    2012-01-01

    Full Text Available G protein-coupled receptor kinase 4 (GRK4 with activating polymorphisms desensitize the natriuric renal tubular D1 dopamine receptor, and these GRK4 polymorphisms are strongly associated with salt sensitivity and hypertension. Meanwhile, N-terminal pro-B-type natriuretic peptide (NT-proBNP may be useful in detecting slight volume expansion. However, relations between hypertension-related gene polymorphisms including GRK4 and cardiovascular indices such as NT-proBNP are not clear, especially in healthy subjects. Therefore, various hypertension-related polymorphisms and cardiovascular indices were analyzed in 97 normotensive, healthy Japanese adults. NT-proBNP levels were significantly higher in subjects with two or more GRK4 polymorphic alleles. Other hypertension-related gene polymorphisms, such as those of renin-angiotensin-aldosterone system genes, did not correlate with NT-proBNP. There was no significant association between any of the hypertension-related gene polymorphisms and central systolic blood pressure, cardioankle vascular index, augmentation index, plasma aldosterone concentration, or an oxidative stress marker, urinary 8-OHdG. Normotensive individuals with GRK4 polymorphisms show increased serum NT-proBNP concentration and may be at a greater risk of developing hypertension and cardiovascular disease.

  9. B-type natriuretic peptide (BNP) affects the initial response to intravenous glucose: a randomised placebo-controlled cross-over study in healthy men.

    Science.gov (United States)

    Heinisch, B B; Vila, G; Resl, M; Riedl, M; Dieplinger, B; Mueller, T; Luger, A; Pacini, G; Clodi, M

    2012-05-01

    B-type natriuretic peptide (BNP) is a hormone released from cardiomyocytes in response to cell stretching and elevated in heart failure. Recent observations indicate a distinct connection between chronic heart failure and diabetes mellitus. This study investigated the role of BNP on glucose metabolism. Ten healthy volunteers (25 ± 1 years; BMI 23 ± 1 kg/m(2); fasting glucose 4.6 ± 0.1 mmol/l) were recruited to a participant-blinded investigator-open placebo-controlled cross-over study, performed at a university medical centre. They were randomly assigned (sequentially numbered opaque sealed envelopes) to receive either placebo or 3 pmol kg(-1) min(-1) BNP-32 intravenously during 4 h on study day 1 or 2. One hour after beginning the BNP/placebo infusion, a 3 h intravenous glucose tolerance test (0.33 g/kg glucose + 0.03 U/kg insulin at 20 min) was performed. Plasma glucose, insulin and C-peptide were frequently measured. Ten volunteers per group were analysed. BNP increased the initial glucose distribution volume (13 ± 1% body weight vs 11 ± 1%, p < 0.002), leading to an overall reduction in glucose concentration (p < 0.001), particularly during the initial 20 min of the test (p = 0.001), accompanied by a reduction in the initial C-peptide levels (1.42 ± 0.13 vs 1.62 ± 0.10 nmol/l, p = 0.015). BNP had no impact on beta cell function, insulin clearance or insulin sensitivity and induced no adverse effects. Intravenous administration of BNP increases glucose initial distribution volume and lowers plasma glucose concentrations following a glucose load, without affecting beta cell function or insulin sensitivity. These data support the theory that BNP has no diabetogenic properties, but improves metabolic status in men, and suggest new questions regarding BNP-induced differences in glucose availability and signalling in various organs/tissues. ClinicalTrials.gov: NCT01324739 The study was funded by Jubilée Fonds of the Austrian National Bank (OeNB-Fonds).

  10. Cardiac function in offspring of women with diabetes using fetal ECG, umbilical cord blood pro-BNP, and neonatal interventricular septal thickness

    DEFF Research Database (Denmark)

    Halse, Karen; Lindegaard, Marie Louise Skakkebæk; Amer-Wahlin, Isis

    2013-01-01

    were included prospectively. Umbilical cord blood pro-BNP concentrations were measured immediately after delivery (n=68) and echocardiography was performed in the newborns (n=75). Fetal ECG in combination with cardiotocography, that is STAN technology was also performed during labor. Results......Objective: Increased pro-brain natriuretic peptide (BNP) concentrations in newborns of diabetic women are associated with fetal stress, and fetal ECG changes often occur in labor in diabetic women. These findings could reflect a degree of fetal cardiomyopathy. We aimed to explore possible relations......: The concentration of umbilical cord blood pro-BNP was associated positively with the neonatal cardiac interventricular septal thickness (P=0.025) and associated negatively with umbilical cord blood pH levels (P=0.036). Fetal ECG changes (STAN events) were recorded in 22 of 53 labors where STAN was used (42...

  11. A New Method for Blood NT-proBNP Determination Based on a Near-infrared Point of Care Testing Device with High Sensitivity and Wide Scope.

    Science.gov (United States)

    Zhang, Xiao Guang; Shu, Yao Gen; Gao, Ju; Wang, Xuan; Liu, Li Peng; Wang, Meng; Cao, Yu Xi; Zeng, Yi

    2017-06-01

    To develop a rapid, highly sensitive, and quantitative method for the detection of NT-proBNP levels based on a near-infrared point-of-care diagnostic (POCT) device with wide scope. The lateral flow assay (LFA) strip of NT-proBNP was first prepared to achieve rapid detection. Then, the antibody pairs for NT-proBNP were screened and labeled with the near-infrared fluorescent dye Dylight-800. The capture antibody was fixed on a nitrocellulose membrane by a scribing device. Serial dilutions of serum samples were prepared using NT-proBNP-free serum series. The prepared test strips, combined with a near-infrared POCT device, were validated by known concentrations of clinical samples. The POCT device gave the output of the ratio of the intensity of the fluorescence signal of the detection line to that of the quality control line. The relationship between the ratio value and the concentration of the specimen was plotted as a work curve. The results of 62 clinical specimens obtained from our method were compared in parallel with those obtained from the Roche E411 kit. Based on the log-log plot, the new method demonstrated that there was a good linear relationship between the ratio value and NT-proBNP concentrations ranging from 20 pg/mL to 10 ng/mL. The results of the 62 clinical specimens measured by our method showed a good linear correlation with those measured by the Roche E411 kit. The new LFA detection method of NT-proBNP levels based on the near-infrared POCT device was rapid and highly sensitive with wide scope and was thus suitable for rapid and early clinical diagnosis of cardiac impairment. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  12. Relation of left ventricular function, mass, and volume to NT-proBNP in type 1 diabetic patients

    DEFF Research Database (Denmark)

    Astrup, A.S.; Kim, W.Y.; Tarnow, L.

    2008-01-01

    OBJECTIVES: To measure left ventricular mass (LVM), left ventricular volumes, and left ventricular function (LVF) in a cohort of type 1 diabetic patients and to correlate measures of imaging to NH(2)-terminal pro-brain natriuretic peptide (NT-proBNP). RESEARCH DESIGN AND METHODS: In a cross......-sectional study, all patients with type 1 diabetes underwent cardiovascular magnetic resonance imaging. We included 63 patients with diabetic nephropathy and 73 patients with normoalbuminuria. RESULTS: All patients had normal global LVF. LVM was increased in patients with diabetic nephropathy compared...... is identified in asymptomatic type 1 diabetic patients with nephropathy compared with normoalbuminuric patients. Elevated levels of NT-proBNP were associated with increased LVM, which are both markers of increased cardiovascular risk Udgivelsesdato: 2008/5...

  13. Endurance exercise-induced changes in BNP concentrations in cardiovascular patients versus healthy controls.

    Science.gov (United States)

    Aengevaeren, Vincent L; Hopman, Maria T E; Thijssen, Dick H J; van Kimmenade, Roland R; de Boer, Menko-Jan; Eijsvogels, Thijs M H

    2017-01-15

    Healthy athletes demonstrated increased B-type natriuretic peptide (BNP) concentrations following exercise, but it is unknown whether these responses are exaggerated in individuals with cardiovascular risk factors (CVRF) or disease (CVD). We compared exercise-induced increases in BNP between healthy controls (CON) and individuals with CVRF or CVD. Furthermore, we aimed to identify predictors for BNP responses. Serum BNP concentrations were measured in 191 participants (60±12yrs) of the Nijmegen Marches before (baseline) and immediately after 4 consecutive days of walking exercise (30-50km/day). CVRF (n=54) was defined as hypertension, hypercholesterolemia, obesity or smoking and CVD (n=55) was defined as a history of myocardial infarction, heart failure, atrial fibrillation or angina pectoris. Individuals walked 487±79min/day at 65±10% of their maximum heart rate. Baseline BNP concentrations were higher for CVD (median: 28.1pg/ml; interquartile range: 13-50, p0.05). Predictors for post-exercise BNP (R 2 =0.77) were baseline BNP, beta-blocker use and age. Prolonged moderate-intensity walking exercise increases BNP concentrations in CVD participants, but not in CVRF and CON. BNP increases were small, and did not accumulate across consecutive days of exercise. These findings suggest that prolonged walking exercise for multiple consecutive days is feasible with minimal effect on myocardial stretch, even for participants with CVD. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  14. The ability of NT-proBNP to detect chronic heart failure and predict all-cause mortality is higher in elderly Chinese coronary artery disease patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Fu S

    2013-04-01

    Full Text Available Shihui Fu, Leiming Luo, Ping Ye, Shuangyan Yi, Yuan Liu, Bing Zhu, Liang Wang, Tiehui Xiao, Yongyi Bai Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China Objective: To analyze the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP and renal function, and compare the ability and cut-off thresholds of NT-proBNP to detect chronic heart failure (CHF and predict mortality in elderly Chinese coronary artery disease (CAD patients with and without chronic kidney disease (CKD. Methods: The study included 999 CAD patients older than 60 years. The endpoint was all-cause mortality over a mean follow-up period of 417 days. Results: The median age was 86 years (range: 60–104 years, and the median NT-proBNP level was 409.8 pg/mL. CKD was present in 358 patients. Three hundred and six patients were positive for CHF. One hundred and ten CKD patients and 105 non-CKD patients died. Not only CKD, but also estimated glomerular filtration rate independently affected NT-proBNP. NT-proBNP detected CHF with a cut-off value of 298.4 pg/mL in non-CKD patients and a cut-off value of 435.7 pg/mL in CKD patients. NT-proBNP predicted death with a cut-off value of 369.5 pg/mL in non-CKD patients and a cut-off value of 2584.1 pg/mL in CKD patients. The NT-proBNP level was significantly related to the prevalence of CHF and all-cause mortality in CAD patients with and without CKD; this effect persisted after adjustment. The crude and multiple adjusted hazard ratios of NT-proBNP to detect CHF and predict mortality were significantly higher in patients with CKD compared with the remainder of the population. The addition of NT-proBNP to the three-variable and six-variable models generated a significant increase in the C-statistic. Conclusion: Amongst elderly Chinese CAD patients, there was an independently inverse association between NT-proBNP and renal function. With the higher cutoff points, NT-proBNP

  15. Cardiac biomarkers in neonatology: BNP/NTproBNP, troponin I/T, CK-MB and myoglobin – a systematic review

    Directory of Open Access Journals (Sweden)

    Rita P. Teixeira

    2017-06-01

    Full Text Available Cardiac biomarkers play a central role in myocardial injury and heart failure in adult patients, but their clinical relevance in neonatology has not been clearly stablished. The aim of this systematic review was to evaluate the recent literature on B-type natriuretic peptide (BNP/N-terminal-pro-BNP (NTproBNP, troponin I/T, Creatine Kinase-MB (CK-MB and myoglobin and their relationship with different pathologies of the newborn. A total of 67 articles were included to undergo data extraction, after a first text and abstract analysis and a second full-text analysis, using the PubMed database.Evidence shows that cardiac biomarkers are a useful and fast diagnostic tool with great potential for becoming as important as clinical and echocardiographic findings in pathologies of the heart. BNP/NTproBNP and troponin I/T demonstrated to be the ones with greater value. BNP/NTproBNP is of particular significance in the diagnosis and management of patent ductus arteriosus, as it has a good correlation with diagnosis, treatment and prognosis. Troponin T may be a beneficial additional marker for this disease, correlating with ductal significance and treatment response. Moreover, BNP/NTproBNP can be used, with other clinical and laboratory findings, in the diagnosis and as a guide for treatment in pulmonary hypertension and in the diagnosis and management of cardiac sequela in bronchopulmonary dysplasia. Troponin I/T finds its clinical importance in perinatal asphyxia as a marker of myocardial injury and a reliable indicator of severity and mortality. Further studies with larger cohort populations are needed for stablishing the cutoff values specific for each neonatal pathology allowing its early and proper management.

  16. Endurance exercise-induced changes in BNP concentrations in cardiovascular patients versus healthy controls

    NARCIS (Netherlands)

    Aengevaeren, V.L.; Hopman, M.T.E.; Thijssen, D.H.J.; Kimmenade, R.R.J. van; Boer, M.J. de; Eijsvogels, T.M.H.

    2017-01-01

    BACKGROUND: Healthy athletes demonstrated increased B-type natriuretic peptide (BNP) concentrations following exercise, but it is unknown whether these responses are exaggerated in individuals with cardiovascular risk factors (CVRF) or disease (CVD). We compared exercise-induced increases in BNP

  17. The relation between electrocardiographic ST-T changes and NT-proBNP in patients with acute ischemic stroke

    DEFF Research Database (Denmark)

    Jensen, Jesper K; Korsholm, Lars; Høilund-Carlsen, Poul Flemming

    2007-01-01

    BACKGROUND: ST-segment depression and T-wave inversion (ST-T changes) in the electrocardiogram (ECG) and raised levels of natriuretic peptide have been observed in acute ischemic stroke patients. It is unknown whether any relation between ST-T changes and raised levels of natriuretic peptides...... in patients with an acute ischemic stroke exists. METHODS: Serial measurements of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) and 12-lead ECGs were obtained in 192 consecutive patients with an acute ischemic stroke without ischemic heart disease, atrial fibrillation, heart- or renal failure...

  18. Influence of Erythropoietin Dose and Albumin Level on the Plasma Brain Natriuretic Peptide in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Alsuwaida Abdulkareem

    2006-01-01

    Full Text Available Brain natriuretic peptide (BNP levels increase in patients with congestive heart failure. Theoretically, BNP levels can be helpful in the determination of the "dry weight" of hemodialysis patients. To evaluate the effect of hemodialysis on the plasma concentration of BNP and to determine the factors that affect BNP levels during hemodialysis in patients with chronic renal failure, we studied five stable patients with chronic renal failure. A total of 15 blood samples were obtained for BNP levels at 24, 48 and 72 hours after the last hemodialysis session. The plasma BNP levels did not change significantly either with ultrafiltration volume or with time since last dialysis. However, the BNP levels correlated positively with the erythropoietin (EPO dose (r=0.98, P< 0.001 and negatively with the serum albumin levels (r = 0.94, P=0.02. Univariate analysis showed that the EPO dose (P=0.001 and the albumin level (P=0.02 were significant predictors of BNP level. Adjusted multivariate analysis showed significant interaction between the EPO dose and the albumin level (P=0.01, P=0.03 respectively. In conclusion: the plasma BNP levels were not significantly influenced by ultrafiltration volume or time since last dialysis. However, the BNP levels may be a useful prognostic parameter for assessing the risk of cardiovascular morbidity and mortality in hemodialysis patients.

  19. Echo and BNP serial assessment in ambulatory heart failure care: Data on loop diuretic use and renal function

    Directory of Open Access Journals (Sweden)

    Frank Lloyd Dini

    2016-12-01

    Full Text Available We compared the follow-up data on loop diuretic use and renal function, as assessed by serum creatinine levels, and the estimated glomerular filtration rate (eGFR, of two groups of consecutive ambulatory HF patients: 1 the clinically-guided group, in which management was clinically driven based on the institutional protocol of the HF Unit of the Cardiovascular and Thoracic Department of Pisa (standard of care and 2 the echo and B-type natriuretic peptide (BNP guided group (patients conforming to the protocol of the Network Labs Ultrasound (NEBULA in HF Study Group: Pisa, Perugia, Pavia; Verona, Auckland, and Veruno, in which therapy was delivered according to the serial assessment of BNP and echocardiography. Patients whose follow-up was based on standard of care had a significant higher prevalence of worsening renal function, that was likely related to higher diuretic dosages, whilst, a better management of renal function was observed in the echo-BNP-guided group. The data is related to “Echo and natriuretic peptide guided therapy improves outcome and reduces worsening renal function in systolic heart failure: An observational study of 1137 outpatients” (A. Simioniuc, E. Carluccio, S. Ghio, A. Rossi, P. Biagioli, G. Reboldi, G.G. Galeotti, F. Lu, C. Zara, G. Whalley, P.G. Temporelli, F.L. Dini, 2016; K.J. Harjai, H.K. Dinshaw, E. Nunez, M. Shah, H. Thompson, T. Turgut, H.O. Ventura, 1999; A. Ahmed, A. Husain, T.E. Love, G. Gambassi, L.J. Dell׳Italia, G.S. Francis, M. Gheorghiade, R.M. Allman, S. Meleth, R.C. Bourge, 2006 [1–3].

  20. Echo and BNP serial assessment in ambulatory heart failure care: Data on loop diuretic use and renal function.

    Science.gov (United States)

    Dini, Frank Lloyd; Simioniuc, Anca; Carluccio, Erberto; Ghio, Stefano; Rossi, Andrea; Biagioli, Paolo; Reboldi, Gianpaolo; Galeotti, Gian Giacomo; Lu, Fei; Zara, Cornelia; Whalley, Gillian; Temporelli, Pier Luigi

    2016-12-01

    We compared the follow-up data on loop diuretic use and renal function, as assessed by serum creatinine levels, and the estimated glomerular filtration rate (eGFR), of two groups of consecutive ambulatory HF patients: 1) the clinically-guided group, in which management was clinically driven based on the institutional protocol of the HF Unit of the Cardiovascular and Thoracic Department of Pisa (standard of care) and 2) the echo and B-type natriuretic peptide (BNP) guided group (patients conforming to the protocol of the Network Labs Ultrasound (NEBULA) in HF Study Group: Pisa, Perugia, Pavia; Verona, Auckland, and Veruno), in which therapy was delivered according to the serial assessment of BNP and echocardiography. Patients whose follow-up was based on standard of care had a significant higher prevalence of worsening renal function, that was likely related to higher diuretic dosages, whilst, a better management of renal function was observed in the echo-BNP-guided group. The data is related to "Echo and natriuretic peptide guided therapy improves outcome and reduces worsening renal function in systolic heart failure: An observational study of 1137 outpatients" (A. Simioniuc, E. Carluccio, S. Ghio, A. Rossi, P. Biagioli, G. Reboldi, G.G. Galeotti, F. Lu, C. Zara, G. Whalley, P.G. Temporelli, F.L. Dini, 2016; K.J. Harjai, H.K. Dinshaw, E. Nunez, M. Shah, H. Thompson, T. Turgut, H.O. Ventura, 1999; A. Ahmed, A. Husain, T.E. Love, G. Gambassi, L.J. Dell׳Italia, G.S. Francis, M. Gheorghiade, R.M. Allman, S. Meleth, R.C. Bourge, 2006) [1], [2], [3].

  1. Factors Associated with Bovine Neonatal Pancytopenia (BNP) in Calves: A Case-Control Study

    Science.gov (United States)

    Lambton, Sarah L.; Colloff, Adrian D.; Smith, Richard P.; Caldow, George L.; Scholes, Sandra F. E.; Willoughby, Kim; Howie, Fiona; Ellis-Iversen, Johanne; David, Graham; Cook, Alasdair J. C.; Holliman, Andrew

    2012-01-01

    Bovine neonatal pancytopenia (BNP; previously known as idiopathic haemorrhagic diathesis and commonly known as bleeding calf syndrome) is a novel haemorrhagic disease of young calves which has emerged in a number of European countries during recent years. Data were retrospectively collected during June to November 2010 for 56 case calves diagnosed with BNP between 17 March and 7 June of the same year. These were compared with 58 control calves randomly recruited from herds with no history of BNP. Multivariable logistic regression analysis showed that increased odds of a calf being a BNP case were associated with its dam having received PregSure® BVD (Pfizer Animal Health) vaccination prior to the birth of the calf (odds ratio (OR) 40.78, p<0.001) and its herd of origin being located in Scotland (OR 9.71, p = 0.006). Decreased odds of a calf being a BNP case were associated with the calf having been kept outside (OR 0.11, p = 0.006). The longer that a cattle herd had been established on the farm was also associated with decreased odds of a calf in that herd being a BNP case (OR 0.97, p = 0.011). PMID:22606224

  2. Extracellular Matrix Biomarker, Fibulin-1, Is Closely Related to NT-proBNP and Soluble Urokinase Plasminogen Activator Receptor in Patients with Aortic Valve Stenosis (The SEAS Study)

    DEFF Research Database (Denmark)

    Kruger, Ruan; Rasmussen, Lars M; Argraves, William S

    2014-01-01

    associated with subclinical atherosclerosis. Therefore, we aimed to explore the interplay between these biomarkers and mild to moderate aortic valve stenosis (AS). METHODS: In 374 patients with mild to moderate AS, we investigated the relationship of fibulin-1 with NT-proBNP, levels of suPAR and the degree.......01), and suPAR (βyear0 = 0.09, p = 0.26, βyear1 = 0.23, βyear4 = 0.21, both plevels of fibulin-1 were independently associated with higher levels of suPAR and NT-proBNP especially in patients with lower AVAI, suggesting...

  3. EL "MÁS ALTO NIVEL POSIBLE": UN DERECHO ASIMÉTRICO O "MAIS ALTO NÍVEL POSSÍVEL": UM DIREITO ASSIMÉTRICO THE "HIGHEST LEVEL POSSIBLE": AN ASYMMETRIC RIGHT

    Directory of Open Access Journals (Sweden)

    Stefano Semplici

    beneficência; elevar o "golden standard" da assistência sanitária, inclusive em países com menores recursos disponíveis, rechaçando a ideia que a diferença esteja em linha de principio insuperável; aproximar-se globalmente dos diversos fatores que, determinando a qualidade da vida e as relações pessoais e sociais, contribuam também para estabelecer os níveis de saúde, assim como modos e objetivos da mesma relação terapêutica.There is an evident contradiction between what has been stated in Guidelines, Declarations and other international documents and actual facts. Already in WHO statutes, valid since 1948, "enjoying the maximum degree of health possible" is recognized as "one of the fundamental human rights". In present world there are countries in which life expectancy is near 80 years while in others 8 of 10 persons die before 60: the difference of what is "possible" is too big to be accepted. In order to reduce this distance an articulate strategy is necessary in three dimensions: to rethink the relation between legal and moral rights, which avoids to confine social rights simply to the good will or beneficence field; to raise health care golden standard, even in countries with minor available resources, rejecting the idea that the difference lies in an insuperable principle; and a global approach to diverse factors that, determining quality of life and personal and social relations, they also contribute to establish health levels, as well as ways and goals of the therapeutic relation itself.

  4. Ingestion of colostrum from specific cows induces Bovine Neonatal Pancytopenia (BNP in some calves

    Directory of Open Access Journals (Sweden)

    Carlin Annette

    2011-02-01

    Full Text Available Abstract Background Since 2006, cases of haemorrhagic diathesis in young calves have been observed with a much higher incidence than previously known. The syndrome, now uniformly called Bovine Neonatal Pancytopenia (BNP, is characterized by multiple (external and internal haemorrhages, thrombocytopenia, leukocytopenia, and bone marrow depletion. Although various infectious and toxicological causes of bleeding disorders in calves have been ruled out, the aetiology of BNP remains unknown. However, field observations have led to the hypothesis that the aetiological principle may be transmitted to calves via colostrum. The objective of the present study was to verify whether ingestion of colostrum from dams of known BNP calves can elicit signs of BNP and typical haematological findings in conveniently selected neonatal calves. Six such calves received one feeding of colostrum (or a mixture of colostrum batches from dams of known BNP calves. As controls, another six conveniently selected calves from herds which had never had a BNP case received one feeding of colostrum from their own dams. Haematological and clinical parameters were monitored. Results One of the six experimental calves never showed any haematological, clinical or pathological evidence of BNP. In the other five calves, thrombocyte and leukocyte counts dropped within a few hours following ingestion of colostrum. Of those, three calves developed clinical signs of BNP, their post-mortem examination revealed bone marrow depletion. Of the remaining two calves, a pair of mixed twins, marked thrombocytopenia and recurrent leukocytopenia was evident in one, in which only slight changes in the bone marrow were detected, while in the other thrombocyte counts dropped, but rebounded later, and no bone marrow changes were noted. Thrombocyte counts of the experimental calves were statistically significantly lower than those of the control calves at 2 hours post ingestion of colostrum and at every

  5. The highest spin discrete levels in 131,132Ce

    International Nuclear Information System (INIS)

    Paul, E S; Choy, P T W; Andreoiu, C; Boston, A J; Evans, A O; Fox, C; Gros, S; Nolan, P J; Rainovski, G; Sampson, J A; Scraggs, H C; Walker, A; Appelbe, D E; Joss, D T; Simpson, J; Gizon, J; Astier, A; Buforn, N; Prevost, A; Redon, N; Stezowski, O; Nyako, B M; Sohler, D; Timar, J; Zolnai, L; Bazzacco, D; Lunardi, S; Petrache, C M; Bednarczyk, P; Curien, D; Kintz, N; Ragnarsson, I

    2006-01-01

    The three superdeformed (SD) bands in 132 Ce and the two SD bands in 131 Ce have been extended to higher spin following experiments with the EUROBALL IV spectrometer. The two SD bands in 131 Ce have been linked together. However, despite the relatively high population intensity of the bands (up to 5% of the respective channel), it has not been possible to unambiguously link any of the five SD bands into the low-spin, normally deformed structures of 131,132 Ce

  6. English Learners: Reaching the Highest Level of English Literacy.

    Science.gov (United States)

    Garcia, Gilbert C., Ed.

    This collection of papers examines the critical literacy development of English learners, focusing on English reading instruction in an immersion setting, English language development, and cultural issues pertaining to English learners in and out of the classroom. The 16 papers include the following: (1) "Reading and the Bilingual Student: Fact…

  7. Effect of PCI on inflammatory factors, cTnI, MMP-9 and NT-pro BNP in patients with unstable angina pectoris

    Directory of Open Access Journals (Sweden)

    Ke-Tong Liu

    2016-05-01

    Full Text Available Objective: To investigate the effect of PCI on inflammatory factors, cTnI, MMP-9and NTpro BNP in patients with unstable angina pectoris. Methods: A total of 80 unstable angina pectoris patients were divided into observation group (40 cases and control group (40 cases. The observation group was given the therapy of PCI, and the control group was given coronary angiography. To observe the of inflammatory factors, cTnI, MMP-9 and NT-pro BNP were tested and compared before and after operation. Results: At 24 h after operation, CRP and IL-18 levels were increased significantly after treatment inoperation groups, there was no difference on inflammatory factors in control group, and had significant difference on inflammatory factors in two groups; At 24 h after operation, cTnI, MMP-9 and NT-pro BNP levels were increased significantly after treatment inoperation groups, there was no difference on inflammatory factors in control group, and had significant difference on inflammatory factors in two groups. Conclusion: PCI therapy can induce inflammation and myocardial injury in patients with unstable angina pectoris.

  8. Changes of plasma ET and BNP contents in patients suffering from essential hypertension with atrial fibrillation (AF)

    International Nuclear Information System (INIS)

    Zhang Suhua

    2003-01-01

    Objective: To study the changes of plasma ET and BNP contents in patients suffering from essential hypertension with atrial fibrillation. Methods: Plasma ET and BNP contents were measured with IRMA in 130 patients with essential hypertension (48 with AF and 82 with out AF) and 56 controls. Results: The plasma contents of ET and BNP in patients with AF were significantly higher than those in controls (p<0.001). Conclusion: Further study in the changes of plasma ET and BNP contents in patients suffering from essential hypertension would be of great clinical importance in the prevention and treatment of the disease

  9. Safety and efficacy of the perioperative administration of recombinant human brain natriuretic peptide (rhBNP: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Hua P

    2018-02-01

    Full Text Available Ping Hua,1 Jianyang Liu,2 Jun Tao,1 Xifeng Lin,1 Rongjun Zou,1 Dingwen Zhang,1 Songran Yang3,4 1Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 2Department of Vascular Surgery, Henan Provincial People’s Hospital, Zhengzhou, 3The Biobank of Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 4Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China Objective: Retrospective studies and a meta-analysis were performed to evaluate the safety and effectiveness of the perioperative administration of recombinant human brain natriuretic peptide (rhBNP during cardiac surgery under extracorporeal circulation. Methods: Computerized literature searches were performed in Medline, Embase, The Cochrane Library, CNKI, CBM, and WANFANG to find randomized controlled trials (RCTs related to the perioperative administration of rhBNP during cardiac surgery starting from the database inception until December 2016. Two researchers independently performed study screening, information extraction, and quality evaluation according to the inclusion/exclusion criteria, and a meta-analysis was performed using RevMan 5.2 software. Results: A total of 12 studies were analyzed, including 12 RCTs and 727 patients. The meta-analysis results indicated that the perioperative administration of rhBNP could reduce the occurrence rate of postoperative complications, length of intensive care unit (ICU stay, length of hospital stay, and serum creatinine (Scr levels, and increase the 24-hour urine volume; however, it did not affect the postoperative mortality rate. Conclusion: The perioperative administration of rhBNP during cardiac surgery was safe and effective, and could improve the prognosis of the patients. Keywords: recombinant human brain natriuretic peptide, perioperative administration, meta-analysis

  10. Origin of the highest energy cosmic rays

    Energy Technology Data Exchange (ETDEWEB)

    Biermann, Peter L.; Ahn, Eun-Joo; Medina-Tanco, Gustavo; Stanev, Todor

    2000-06-01

    Introducing a simple Galactic wind model patterned after the solar wind we show that back-tracing the orbits of the highest energy cosmic events suggests that they may all come from the Virgo cluster, and so probably from the active radio galaxy M87. This confirms a long standing expectation. Those powerful radio galaxies that have their relativistic jets stuck in the interstellar medium of the host galaxy, such as 3C147, will then enable us to derive limits on the production of any new kind of particle, expected in some extensions of the standard model in particle physics. New data from HIRES will be crucial in testing the model proposed here.

  11. Directional clustering in highest energy cosmic rays

    International Nuclear Information System (INIS)

    Goldberg, Haim; Weiler, Thomas J.

    2001-01-01

    An unexpected degree of small-scale clustering is observed in highest-energy cosmic ray events. Some directional clustering can be expected due to purely statistical fluctuations for sources distributed randomly in the sky. This creates a background for events originating in clustered sources. We derive analytic formulas to estimate the probability of random cluster configurations, and use these formulas to study the strong potential of the HiRes, Auger, Telescope Array and EUSO-OWL-AirWatch facilities for deciding whether any observed clustering is most likely due to nonrandom sources. For a detailed comparison to data, our analytical approach cannot compete with Monte Carlo simulations, including experimental systematics. However, our derived formulas do offer two advantages: (i) easy assessment of the significance of any observed clustering, and most importantly, (ii) an explicit dependence of cluster probabilities on the chosen angular bin size

  12. The highest energies in the Universe

    International Nuclear Information System (INIS)

    Rebel, H.

    2006-01-01

    There are not many issues of fundamental importance which have induced so many problems for astrophysicists like the question of the origin of cosmic rays. This radiation from the outer space has an energy density comparable with that of the visible starlight or of the microwave background radiation. It is an important feature of our environment with many interesting aspects. A most conspicuous feature is that the energy spectrum of cosmic rays seems to have no natural end, though resonant photopion production with the cosmic microwave background predicts a suppression of extragalactic protons above the so-called Greisen-Zatsepin-Kuz’min cutoff at about EGZK = 5 × 10"1"9 eV. In fact the highest particle energies ever observed on the Earth, stem from observations of Ultrahigh Energy Cosmic Rays (E > 3 × 10"1"9 eV). But the present observations by the AGASA and HiRes Collaborations, partly a matter of debate, are origin of a number of puzzling questions, where these particles are coming from, by which gigantic acceleration mechanism they could gain such tremendous energies and how they have been able to propagate to our Earth. These questions imply serious problems of the understanding of our Universe. There are several approaches to clarify the mysteries of the highest energies and to base the observations on larger statistical accuracy. The Pierre Auger Observatory, being in installation in the Pampa Amarilla in the Province Mendoza in Argentina, is a hybrid detector, combining a large array of water Cerenkov detectors (registering charged particles generated in giant extended air showers) with measurements of the fluorescence light produced during the air shower development. This contribution will illustrate the astrophysical motivation and the current status of the experimental efforts, and sketch the ideas about the origin of these particles.

  13. Effects of the whole-body cryotherapy on NTproBNP, hsCRP and troponin I in athletes.

    Science.gov (United States)

    Banfi, Giuseppe; Melegati, Gianluca; Barassi, Alessandra; d'Eril, Gianlodovico Melzi

    2009-11-01

    Whole-body cryotherapy refers to brief exposure to very cold air for treating symptoms of various illnesses. In sports medicine, whole-body cryotherapy is administered to improve recovery from muscular trauma. As specific studies are lacking, we measured cardiac markers in 10 top-level rugby players of the Italian National team before and after a 1-week course of daily sessions of whole-body cryotherapy. All subjects continued with the same training workload as that of the previous weeks. N-terminal pro B-type natriuretic peptide (NTproBNP) levels increased but remained within the normal range, whilst troponin I (TnI) and high sensitivity C-reactive protein (hsCRP) were unchanged. Whole-body cryotherapy did not impair cardiac function in this sample of elite athletes.

  14. ANP, BNP and D-dimer predict right ventricular dysfunction in patients with acute pulmonary embolism

    DEFF Research Database (Denmark)

    Borgwardt, Henrik Gutte; Mortensen, Jann; Jensen, Claus V

    2010-01-01

    The aim of this study was to predict right ventricular dysfunction (RVD) using plasma concentration of D-dimer, pro-atrial natriuretic peptide (pro-ANP), brain natriuretic peptide (BNP), endothelin-1 (ET-1) and cardiac troponin I (TNI) in patients with pulmonary embolism (PE).......The aim of this study was to predict right ventricular dysfunction (RVD) using plasma concentration of D-dimer, pro-atrial natriuretic peptide (pro-ANP), brain natriuretic peptide (BNP), endothelin-1 (ET-1) and cardiac troponin I (TNI) in patients with pulmonary embolism (PE)....

  15. Vasoactive Peptide Levels after Change of Dialysis Mode

    Directory of Open Access Journals (Sweden)

    Fredrik Uhlin

    2015-10-01

    Full Text Available Background/Aims: Plasma concentrations of the N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP are increased in end-stage renal disease. Improvement in hemodynamic stability has been reported when switching from hemodialysis (HD to on-line hemodiafiltration (ol-HDF. The aim of this study was to investigate plasma concentrations of NT-proBNP, BNP and neuropeptide Y (NPY during a 1-year follow-up, after a change from high-flux HD to postdilution ol-HDF. Additional variables were also studied, e.g. pulse wave velocity and ordinary clinical parameters. Method: We conducted a prospective, single-center study including 35 patients who were switched from HD to HDF. Plasma concentrations of NT-proBNP, BNP and NPY before and after dialysis were measured at baseline (i.e. HD and at 1, 2, 4, 6 and 12 months on HDF. Results: All three peptide levels decreased significantly during HD and HDF when comparing concentrations before and after dialysis. Mean absolute value (before/after and relative decrease (% before versus after dialysis was 13.697/9.497 ng/l (31% for NT-proBNP, 62/40 ng/ml (35% for BNP and 664/364 pg/l (45% for NPY. No significant differences were observed when comparing predialysis values over time. However, postdialysis NT-proBNP concentration showed a significant decrease of 48% over time after the switch to HDF. Conclusion: The postdialysis plasma levels of NT-proBNP, BNP and NPY decreased significantly during both dialysis modes when compared to before dialysis. The postdialysis lowering of NT-proBNP increased further over time after the switch to ol-HDF; the predialysis levels were unchanged, suggesting no effect on its production in the ventricles of the heart.

  16. NT-proBNP is associated with fibulin-1 in Africans

    DEFF Research Database (Denmark)

    Kruger, R; Schutte, R; Huisman, H W

    2012-01-01

    , expressed in elastin-containing fibres of blood vessels, and also in the heart. Due to an alarming prevalence of hypertensive heart disease in black South Africans, we investigated the associations of NT-proBNP with fibulin-1 and markers of arterial stiffness in Africans and Caucasians....

  17. Possible (enzymatic) routes and biological sites for metabolic reduction of BNP7787, a new protector against cisplatin-induced side-effects.

    NARCIS (Netherlands)

    Verschraagen, M.; Boven, E.; Torun, E; Hausheer, FH; Vijgh, van der WJ

    2004-01-01

    Disodium 2,2'-dithio-bis-ethane sulfonate (BNP7787) is under investigation as a potential new chemoprotector against cisplatin-induced nephrotoxicity. The selective protection of BNP7787 appears to arise from the preferential uptake of the drug in the kidneys, where BNP7787 would undergo

  18. The prognostic value of individual NT-proBNP values in chronic heart failure does not change with advancing age.

    Science.gov (United States)

    Frankenstein, L; Clark, A L; Goode, K; Ingle, L; Remppis, A; Schellberg, D; Grabs, F; Nelles, M; Cleland, J G F; Katus, H A; Zugck, C

    2009-05-01

    It is unclear whether age-related increases in N-terminal pro-brain natriuretic peptide (NT-proBNP) represent a normal physiological process-possibly affecting the prognostic power-of NT-proBNP-or reflect age-related subclinical pathological changes. To determine the effect of age on the short-term prognostic value of NT-proBNP in patients with chronic heart failure (CHF). Prospective observational study with inclusion and matching of consecutive patients aged >65 years (mean (SD) 73.1 (6.0) years) to patients <65 years (53.7 (8.6) years) with respect to NT-proBNP, New York Heart Association stage, sex and aetiology of CHF (final n = 443). University hospital outpatient departments in the UK and Germany. Chronic stable heart failure due to systolic left ventricular dysfunction. None. All-cause mortality. In both age groups, NT-proBNP was a significant univariate predictor of mortality, and independent of age, sex and other established risk markers. The prognostic information given by NT-proBNP was comparable between the two groups, as reflected by the 1-year mortality of 9% in both groups. The prognostic accuracy of NT-proBNP as judged by the area under the receiver operating characteristics curve for the prediction of 1-year mortality was comparable for elderly and younger patients (0.67 vs 0.71; p = 0.09). NT-proBNP reflects disease severity in elderly and younger patients alike. In patients with chronic stable heart failure, the NT-proBNP value carries the same 1-year prognostic information regardless of the age of the patient.

  19. Rationalization of the electric power utilization for the ferro-alloy production at the HEK 'Jugohrom' by means of the follow up and restriction of the highest level loading as well as automatic processing system for the involved electric power (Macedonia)

    International Nuclear Information System (INIS)

    Koevski, Doncho

    2001-01-01

    The relations between the electro energetic system and the energetic generally, as well as the chronic energetic crisis, the electric power price, provoked to analyse the application of the economic use forms of the electric power. This paper presents the way of rationalisation of the electric power utilization for the ferro-alloy production in Jugohrom. This is done by appointing the measuring system, control and limitation of the highest level loading as well as automatic processing system for the involved electric power. (Original)

  20. Rationalization of the electric power utilization for the ferro-alloy production at the HEK 'Jugohrom' by means of the follow up and restriction of the highest level loading as well as automatic processing system for the involved electric power (Macedonia)

    International Nuclear Information System (INIS)

    Koevski, Doncho

    2002-01-01

    The relations between the electro energetic system and the energetic generally, as well as the chronic energetic crisis, the electric power price, provoked to analyse the application of the economic use forms of the electric power. This paper presents the way of rationalisation of the electric power utilization for the ferro-alloy production in Jugohrom. This is done by appointing the measuring system, control and limitation of the highest level loading as well as automatic processing system for the involved electric power. (Original)

  1. Can NT-proBNP be used as a criterion for heart failure hospitalization in emergency room?

    Directory of Open Access Journals (Sweden)

    Tuba Cimilli Ozturk

    2011-01-01

    Conclusions: NT-proBNP can be used as an easy diagnostic method for congestive heart failure. A certain cut-off value may be determined in further multi-centre controlled trials with larger patient groups.

  2. Plasma NT-proBNP mirrors the deleterious cardiovascular and renal continuum in hypertension.

    Science.gov (United States)

    Courand, Pierre-Yves; Harbaoui, Brahim; Bècle, Clément; Mouly-Bertin, Carine; Lantelme, Pierre

    2017-03-01

    Background The aims of this study were (a) to test the ability of N-terminal pro-brain natriuretic peptide (NT-proBNP) to detect subclinical target organ damage (TOD) denoted by left ventricular hypertrophy (LVH), aortic stiffness or renal damage and (b) to test its reproducibility in two different conditions in an ancillary study. Methods The study included 837 patients (50.9% men) with hypertension aged 50 ± 24 years with a median 24-h ambulatory blood pressure (BP) of 148/90 mmHg. LVH was assessed by transthoracic echocardiography and echocardiography, aortic stiffness was assessed by carotid-femoral pulse wave (PWV) measurements and renal dysfunction by measurements of the estimated glomerular filtration rate (eGFR) and microalbuminuria. Results After the exclusion of patients with a history of heart failure, NT-proBNP was independently correlated with sex, systolic BP, primary hypertension, PWV, LVH and eGFR, but not with microalbuminuria. The median (interquartile range) NT-proBNP increased gradually according to the number of target organs damaged: 42 (24-70), 77 (39-151), 141 (81-250) and 334 (177-556) pg/mL, for damage to 0, 1, 2 and 3 target organs, respectively ( p secondary hypertension. A threshold at 90 pg/mL for men and 142 pg/mL in women had a specificity of 95% to detect at least one TOD (areas under ROC curve 0.790 and 0.783, respectively). The reproducibility of NT-proBNP was fairly good in this setting ( r = 0.952, p hypertension.

  3. Very Long-Term Prognostic Role of Admission BNP in Non-ST Segment Elevation Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Fernando Bassan

    2016-01-01

    Full Text Available Abstract Background: BNP has been extensively evaluated to determine short- and intermediate-term prognosis in patients with acute coronary syndrome, but its role in long-term mortality is not known. Objective: To determine the very long-term prognostic role of B-type natriuretic peptide (BNP for all-cause mortality in patients with non-ST segment elevation acute coronary syndrome (NSTEACS. Methods: A cohort of 224 consecutive patients with NSTEACS, prospectively seen in the Emergency Department, had BNP measured on arrival to establish prognosis, and underwent a median 9.34-year follow-up for all-cause mortality. Results: Unstable angina was diagnosed in 52.2%, and non-ST segment elevation myocardial infarction, in 47.8%. Median admission BNP was 81.9 pg/mL (IQ range = 22.2; 225 and mortality rate was correlated with increasing BNP quartiles: 14.3; 16.1; 48.2; and 73.2% (p 72 years (OR = 3.79, 95% CI = 1.62-8.86, p = 0.002, BNP ≥ 100 pg/mL (OR = 6.24, 95% CI = 2.95-13.23, p < 0.001 and estimated glomerular filtration rate (OR = 0.98, 95% CI = 0.97-0.99, p = 0.049 were independent late-mortality predictors. Conclusions: BNP measured at hospital admission in patients with NSTEACS is a strong, independent predictor of very long-term all-cause mortality. This study allows raising the hypothesis that BNP should be measured in all patients with NSTEACS at the index event for long-term risk stratification.

  4. Relation of N-Terminal Pro B-Type Natriuretic Peptide Levels After Symptom-Limited Exercise to Baseline and Ischemia Levels

    NARCIS (Netherlands)

    van der Zee, P. Marc; Verberne, Hein J.; van Spijker, Rianne C.; van Straalen, Jan P.; Fischer, Johan C.; Sturk, Augueste; van Eck-Smit, Berthe L. F.; de Winter, Robbert J.

    2009-01-01

    Circulating levels of B-type natriuretic peptide (BNP) and the amino-terminal portion of the prohormone (NT-proBNP) have been reported to increase immediately after myocardial ischemia. The association between extent of exercise-induced myocardial ischemia measured using myocardial perfusion

  5. Serum N-terminal-pro-brain natriuretic peptide level and its clinical implications in patients with atrial fibrillation.

    Science.gov (United States)

    Bai, Mei; Yang, Jiefu; Li, Yingying

    2009-12-01

    Brain natriuretic peptide (BNP) is increasingly being used for screening and monitoring of congestive heart failure. However, the role of BNP in patients with atrial fibrillation (AF) and normal left ventricular function has not been determined. This study investigates serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level and its clinical implications in patients with AF. Serum NT-proBNP levels were measured by enzyme-linked immunosorbent assay (ELISA) and transthoracic echocardiography was performed in 136 subjects (90 cases with AF and 46 cases with sinus rhythm [SR]). Subjects were excluded if they had a history of myocardial infarction, cardiomyopathy, rheumatic heart disease, or hyperthyroidism that preceded the onset of AF. Controls (n = 30) were from a healthy outpatient primary care population. Potential determinants of serum NT-proBNP levels were identified by univariate and multivariate analyses. Individuals with AF had higher serum NT-proBNP levels (689.56 +/- 251.87 fmol/ml) than those with SR (456.11 +/- 148.14 fmol/ml, P NT-proBNP levels (P > 0.05). The regression model of serum NT-proBNP levels and clinical predictors showed that presence of AF, older age, and larger right atrial diameter were independently predictive of higher serum NT-proBNP values. Patients with AF were associated with increased serum NT-proBNP levels. Examining the change of serum NT-proBNP levels is helpful to evaluate the cardiac function in patients with AF. Copyright 2009 Wiley Periodicals, Inc.

  6. The fifty highest cited papers in anterior cruciate ligament injury.

    Science.gov (United States)

    Vielgut, Ines; Dauwe, Jan; Leithner, Andreas; Holzer, Lukas A

    2017-07-01

    The anterior cruciate ligament (ACL) is one of the most common injured knee ligaments and at the same time, one of the most frequent injuries seen in the sport orthopaedic practice. Due to the clinical relevance of ACL injuries, numerous papers focussing on this topic including biomechanical-, basic science-, clinical- or animal studies, were published. The purpose of this study was to determine the most frequently cited scientific articles which address this subject, establish a ranking of the 50 highest cited papers and analyse them according to their characteristics. The 50 highest cited articles related to Anterior Cruciate Ligament Injury were searched in Thomson ISI Web of Science® by the use of defined search terms. All types of scientific papers with reference to our topic were ranked according to the absolute number of citations and analyzed for the following characteristics: journal title, year of publication, number of citations, citation density, geographic origin, article type and level of evidence. The 50 highest cited articles had up to 1624 citations. The top ten papers on this topic were cited 600 times at least. Most papers were published in the American Journal of Sports Medicine. The publication years spanned from 1941 to 2007, with the 1990s and 2000s accounting for half of the articles (n = 25). Seven countries contributed to the top 50 list, with the USA having by far the most contribution (n = 40). The majority of articles could be attributed to the category "Clinical Science & Outcome". Most of them represent a high level of evidence. Scientific articles in the field of ACL injury are highly cited. The majority of these articles are clinical studies that have a high level of evidence. Although most of the articles were published between 1990 and 2007, the highest cited articles in absolute and relative numbers were published in the early 1980s. These articles contain well established scoring- or classification systems. The

  7. Efficacy of trimetazidine combining with metoprolol on plasma BNP in coronary heart disease patients with heart failure

    Directory of Open Access Journals (Sweden)

    Ping Li

    2016-01-01

    Full Text Available Objective: To explore the effect of combined application of trimetazidine and metoprolol on plasma BNP in coronary heart disease patients with heart failure and the clinical efficacy. Methods: A total of 140 cases of coronary heart disease patients with heart failure treated in Cardiology Department of our hospital from May 2012 to January 2015 were selected and divided into study group and control group by random number table method. The control group received digitalis, diuretics, ACEI (angiotensin-converting enzyme inhibitor and other conventional drugs for treatment, the study group received combined use of trimetazidine and metoprolol on the basis of routine treatment of the control group, and treatment duration was 12 weeks. Then plasma BNP, systolic blood pressure, heart rate, left ventricular end diastolic diameter (LVEDD, left ventricular end systolic end (LVESD and left ventricular ejection fraction (LVEF of two groups before and after treatment were statistically analyzed, and the overall effect was evaluated. Results: Before treatment, there were no significant differences in plasma BNP, blood pressure, heart rate, LVEDD, LVESD and LVEF between the two groups; after treatment, plasma BNP, blood pressure, heart rate, LVEDD and LVESD of both groups decreased and LVEF increased, but the changes in study group were better than those in control group. Conclusion: Trimetazidine combined with metoprolol has better application effect in plasma BNP decrease and heart function improvement in coronary heart disease patients with heart failure.

  8. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 4: Prognostic value of B-type natriuretic peptides (BNP and NT-proBNP) in community-acquired pneumonia.

    Science.gov (United States)

    Hodgson, David; Nee, Patrick; Sultan, Laith

    2012-10-01

    A short cut review was carried out to establish the prognostic value of B-type natriuretic peptides (BNP and NT-proBNP) in community acquired pneumonia (CAP). Three cohort studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line was that B-type natriuretic peptides have prognostic value in CAP but further prospective studies were needed to assess their application in clinical practice.

  9. NEW POSSIBILITIES FOR EVALUATION OF SEVERITY AND PROGNOSIS IN PATIENTS WITH CHRONIC HEART FAILURE BASED ON N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE PLASMA LEVEL

    Directory of Open Access Journals (Sweden)

    A. S. Galjavich

    2009-01-01

    Full Text Available Aim. To study an importance of plasma N-terminal pro-brain natriuretic peptide (N-proBNP in evaluation of severity and prognosis in patients with chronic heart failure (CHF of ischemic genesis.Material and methods. 77 patients (60 men and 17 women; 59,4±10,7 y.o. with CHF of ischemic genesis were included in the study. All patients had sinus rhythm and history of Q wave myocardial infarction. Standard examination was performed to all patients. Besides N-proBNP plasma level and patients yearly survival were evaluated.Results. N-proBNP plasma level had direct correlation with clinical indices (exercise tolerance, blood pressure, heart rate and echocardiographic heart sizes. N-proBNP plasma level had relationship with prognosis of CHF patients. Baseline N-proBNP level was more than 2 times higher in died patients in comparison with survived patients. The yearly survival rate of CHF patients was 51,3% if N-proBNP level had been more than 400 fmol/ml (>15% of normal value. The clinico-laboratory index (based on N-proBNP plasma level of severity and prognosis in CHF patients was developed.Conclusion. The clinico-laboratory index based on N-proBNP plasma level is easy to use and can improve medical practice.

  10. NEW POSSIBILITIES FOR EVALUATION OF SEVERITY AND PROGNOSIS IN PATIENTS WITH CHRONIC HEART FAILURE BASED ON N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE PLASMA LEVEL

    Directory of Open Access Journals (Sweden)

    A. S. Galjavich

    2016-01-01

    Full Text Available Aim. To study an importance of plasma N-terminal pro-brain natriuretic peptide (N-proBNP in evaluation of severity and prognosis in patients with chronic heart failure (CHF of ischemic genesis.Material and methods. 77 patients (60 men and 17 women; 59,4±10,7 y.o. with CHF of ischemic genesis were included in the study. All patients had sinus rhythm and history of Q wave myocardial infarction. Standard examination was performed to all patients. Besides N-proBNP plasma level and patients yearly survival were evaluated.Results. N-proBNP plasma level had direct correlation with clinical indices (exercise tolerance, blood pressure, heart rate and echocardiographic heart sizes. N-proBNP plasma level had relationship with prognosis of CHF patients. Baseline N-proBNP level was more than 2 times higher in died patients in comparison with survived patients. The yearly survival rate of CHF patients was 51,3% if N-proBNP level had been more than 400 fmol/ml (>15% of normal value. The clinico-laboratory index (based on N-proBNP plasma level of severity and prognosis in CHF patients was developed.Conclusion. The clinico-laboratory index based on N-proBNP plasma level is easy to use and can improve medical practice.

  11. Compatibility of Firm Positioning Strategy and Website Content: Highest

    Directory of Open Access Journals (Sweden)

    Evla MUTLU KESİCİ

    2017-07-01

    Full Text Available Corporate websites are essential platforms through which firms introduce their goods and services on B2B and B2C level, express financial information for the stakeholders and share corporate values, purposes and activities. Due to its facilities, websites take part in firm positioning strategy. Accordingly this study aims to understand the innovation oriented positioning through corporate websites. The method applied in this study has been adapted from the 2QCV2Q Model developed by Mich and Franch (2000 to evaluate websites and top 30 firms with the highest Research and Development expenditures listed in Turkishtime (2015 have been analyzed. Within this context, this study presents a revised and updated method for the assessments of websites through positioning strategy framework. Findings indicate no direct relationship between website evaluation and R&D expenditure, though some common weaknesses have been put forward, such as information about management of the firms. Besides, publicly traded firms are recognized to facilitate websites more efficiently than non-publicly traded firms. Study contribute to both academia and practitioners as putting forward a new approach for 2QCV2Q Model and indicating the similarities and differences among the corporate websites through positioning perspective.

  12. The impact of right ventricular stroke work on B-type natriuretic peptide levels in patients with mitral stenosis undergoing percutaneous mitral valvuloplasty.

    Science.gov (United States)

    Esteves, William A M; Lodi-Junqueira, Lucas; Neto, Cirilo P Fonseca; Tan, Timothy C; Nascimento, Bruno R; Mehrotra, Praveen; Barbosa, Marcia M; Ribeiro, Antonio Luiz P; Nunes, Maria Carmo P

    2013-10-01

    We aimed to explore the relationship between brain natriuretic peptide (BNP) levels and right ventricular (RV) function in patients with mitral stenosis (MS), and to investigate the hemodynamic parameters that predict reduction of BNP levels after percutaneous mitral valvuloplasty (PMV). Few studies have evaluated BNP in the context of MS, specifically the impact of the RV stroke work (RVSW) on serum BNP levels has not been defined. Thirty patients with symptomatic rheumatic MS in sinus rhythm who were referred for a PMV were enrolled. Right and left heart pressures were obtained before and after valvuloplasty. RVSW index (RVSWI) was calculated by cardiac catheterization. Basal BNP levels were elevated in MS patients and correlated with several hemodynamic parameters including pulmonary pressure, pulmonary vascular resistance index, cardiac index (CI), and RVSWI. In multivariate analysis, CI and RVSWI were independent predictors of raised basal BNP levels. PMV resulted in a significant decrease in the RVSWI with a concurrent increase in CI (2.4 ± 0.43 to 2.9 ± 0.8 L/min/m(2), P = 0.010). Overall, plasma BNP levels significantly decreased from 124 (63/234) to 73 (48/148) pg/ml postvalvuloplasty. Multivariate analysis revealed that the reduction of left atrial (LA) pressure post-PMV was an independent predictor of change in BNP levels. Elevated baseline BNP level in MS patients was independently associated with CI and RVSWI. Plasma BNP levels were reduced after successful PMV, which was associated with the reduction of the LA pressure. © 2013, Wiley Periodicals, Inc.

  13. NT-proBNP, C-reactive protein and soluble uPAR in a bi-ethnic male population

    DEFF Research Database (Denmark)

    Kruger, Ruan; Schutte, Rudolph; Huisman, Hugo W

    2013-01-01

    This cross-sectional study aimed to investigate associations between a marker of cardiac strain, the N-terminal prohormone B-type natriuretic peptide (NT-proBNP), and inflammation as reflected by either a conventional or novel inflammatory marker in a bi-ethnic South African cohort....

  14. Cysteine Specific Targeting of the Functionally Distinct Peroxiredoxin and Glutaredoxin Proteins by the Investigational Disulfide BNP7787

    Directory of Open Access Journals (Sweden)

    Aulma R. Parker

    2015-03-01

    Full Text Available Glutaredoxin (Grx, peroxiredoxin (Prx, and thioredoxin (Trx are redoxin family proteins that catalyze different types of chemical reactions that impact cell growth and survival through functionally distinct intracellular pathways. Much research is focused on understanding the roles of these redoxin proteins in the development and/or progression of human diseases. Grx and Prx are overexpressed in human cancers, including human lung cancers. BNP7787 is a novel investigational agent that has been evaluated in previous clinical studies, including non-small cell lung cancer (NSCLC studies. Herein, data from activity assays, mass spectrometry analyses, and X-ray crystallographic studies indicate that BNP7787 forms mixed disulfides with select cysteine residues on Grx and Prx and modulates their function. Studies of interactions between BNP7787 and Trx have been conducted and reported separately. Despite the fact that Trx, Grx, and Prx are functionally distinct proteins that impact oxidative stress, cell proliferation and disease processes through different intracellular pathways, BNP7787 can modify each protein and appears to modulate function through mechanisms that are unique to each target protein. Tumor cells are often genomically heterogeneous containing subpopulations of cancer cells that often express different tumor-promoting proteins or that have multiple dysregulated signaling pathways modulating cell proliferation and drug resistance. A multi-targeted agent that simultaneously modulates activity of proteins important in mediating cell proliferation by functionally distinct intracellular pathways could have many potentially useful therapeutic applications.

  15. Elevated NT-proBNP is associated with unfavorably altered plasma fibrin clot properties in atrial fibrillation.

    Science.gov (United States)

    Matusik, Paweł T; Matusik, Patrycja S; Kornacewicz-Jach, Zdzisława; Małecka, Barbara; Ząbek, Andrzej; Undas, Anetta

    2017-09-15

    Dense fibrin clot formation and hypofibrinolysis have been reported in atrial fibrillation (AF). It is unclear which factors affect fibrin clot properties in AF. We investigated plasma fibrin clot permeability (K s ), clot lysis time (CLT), endogenous thrombin potential (ETP) as well as other coagulation and fibrinolysis parameters along with N-terminal pro-B-type natriuretic peptide (NT-proBNP) in 160 AF patients (median age, 70.5years). Previous stroke (n=15; 9.4%) was associated with decreased K s (P=0.04) and longer CLT (P=0.005), together with higher antiplasmin (P=0.03) and lower tissue-type plasminogen activator (P=0.01). Lower K s (P=0.04) and tendency towards longer CLT (P=0.10) were observed in patients with a left atrium diameter>40mm. Patients with a CHA 2 DS 2 -VASc score of 3 or more (82.5%) were characterized by higher thrombin-activatable fibrinolysis inhibitor antigen (P=0.009). K s was inversely correlated with log NT-proBNP (r=-0.34, PCLT was positively correlated with log NT-proBNP (R=0.61, PCLT (the top quartile,≥109min). In AF patients prothrombotic fibrin clot properties assessed ex vivo are determined by PAI-1 and NT-proBNP and this phenotype is associated with prior ischemic stroke. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Highly sensitive detection of NT-proBNP by molecular motor

    Directory of Open Access Journals (Sweden)

    Jie Zhang

    2017-03-01

    Full Text Available FoF1-ATPase is an active rotary motor, and generates three-ATP for each rotation. At saturated substrate concentration, the motor can achieve about 103 r.p.m, which means one motor can generate about 105 ATP molecules during 30 min. Here, we constituted a novel nanodevice with a molecular rotary motor and a “battery”, FoF1-ATPase and chromatophore, and presented a novel method of sandwich type rotary biosensor based on ε subunit with one target-to-one motor, in which one target corresponds 105 ATP molecules as detection signals during 30 min. The target such as NT-proBNP detection demonstrated that this novel nanodevice has potential to be developed into an ultrasensitive biosensor to detect low expressed targets.

  17. Cortex Matures Faster in Youths With Highest IQ

    Science.gov (United States)

    ... NIH Cortex Matures Faster in Youths With Highest IQ Past Issues / Summer 2006 Table of Contents For ... on. Photo: Getty image (StockDisc) Youths with superior IQ are distinguished by how fast the thinking part ...

  18. Which Kids Are at Highest Risk for Suicide?

    Science.gov (United States)

    ... Share Which Kids are at Highest Risk for Suicide? Page Content Article Body No child is immune, ... who have lost a friend or relative to suicide. Studies show that a considerable number of youth ...

  19. Relation of N-terminal pro B-type natriuretic peptide levels after symptom-limited exercise to baseline and ischemia levels.

    Science.gov (United States)

    van der Zee, P Marc; Verberne, Hein J; van Spijker, Rianne C; van Straalen, Jan P; Fischer, Johan C; Sturk, Augueste; van Eck-Smit, Berthe L F; de Winter, Robbert J

    2009-03-01

    Circulating levels of B-type natriuretic peptide (BNP) and the amino-terminal portion of the prohormone (NT-proBNP) have been reported to increase immediately after myocardial ischemia. The association between extent of exercise-induced myocardial ischemia measured using myocardial perfusion scintigraphy and the magnitude and time course of changes in NT-proBNP was studied. One hundred one patients underwent symptom-limited exercise myocardial perfusion scintigraphy. Myocardial ischemia was assessed semiquantitatively. Serum samples were obtained before the start of exercise (baseline), at maximal exercise, and every hour up to 6 hours after maximal exercise. Myocardial ischemia was present in 37 patients (37%). NT-proBNP rapidly increased during exercise (to 113%, interquartile range 104 to 144, and 118%, interquartile range 106 to 142, of baseline, respectively), with a second peak at 4 (141%, interquartile range 119 to 169) and 5 hours (136%, interquartile range 93 to 188), respectively. Absolute changes between NT-proBNP at baseline and at maximum exercise in patients with versus without ischemia were similar (median, 30 pg/ml, interquartile range 7 to 45 vs 15, interquartile range 4 to 46, respectively, p = 0.230), but absolute change between baseline and the secondary peak was higher in patients with ischemia than in patients without ischemia (median 64 pg/ml, interquartile range 32 to 172 vs 34, interquartile range 19 to 85, respectively, p = 0.024). In multivariate linear stepwise regression analysis of determinants of changes in NT-proBNP after exercise, baseline NT-proBNP was the only independent determinant of absolute changes at maximum exercise, whereas the presence of ischemia was not predictive. Baseline NT-proBNP, cystatin C, and end-systolic volume were independent determinants of the absolute increase to secondary peak levels. In conclusion, myocardial ischemia per se did not lead to additional increases in NT-proBNP within 6 hours after exercise.

  20. Lung Cancer Screening May Benefit Those at Highest Risk

    Science.gov (United States)

    People at the highest risk for lung cancer, based on a risk model, may be more likely to benefit from screening with low-dose CT, a new analysis suggests. The study authors believe the findings may better define who should undergo lung cancer screening, as this Cancer Currents blog post explains.

  1. Highest weight representations of the quantum algebra Uh(gl∞)

    International Nuclear Information System (INIS)

    Palev, T.D.; Stoilova, N.I.

    1997-04-01

    A class of highest weight irreducible representations of the quantum algebra U h (gl-∞) is constructed. Within each module a basis is introduced and the transformation relations of the basis under the action of the Chevalley generators are explicitly written. (author). 16 refs

  2. Exploring the cultural dimensions of the right to the highest ...

    African Journals Online (AJOL)

    The right to enjoying the highest attainable standard of health is incorporated in many international and regional human rights instruments. This right contains both freedoms and entitlements, including the freedom to control one's own health and body and the right to an accessible system of health care, goods and services.

  3. The highest energy cosmic rays, photons and neutrinos

    International Nuclear Information System (INIS)

    Zas, Enrique

    1998-01-01

    In these lectures I introduce and discuss aspects of currently active fields of interest related to the production, transport and detection of high energy particles from extraterrestrial sources. I have payed most attention to the highest energies and I have divided the material according to the types of particles which will be searched for with different experimental facilities in planning: hadrons, gamma rays and neutrinos. Particular attention is given to shower development, stochastic acceleration and detection techniques

  4. Kerjasama Bnp2tki Dengan Iom Dalam Menangani Human Trafficking Tenaga Kerja Indonesia Di Malaysia Periode 2011-2015

    OpenAIRE

    Ayu Wulandari, Ajeng Ria; Windiani, Reni; Putranti, Ika Riswanti

    2016-01-01

    Malaysia is one of major destination countries for Indonesian migrant workers. Thisfact has been triggering many transnational crimes, including human trafficking,Despite Indonesian government has been reduced the number of migrant workerssignificantly from 2011 to 2015, the problem of human trafficking remains occur. Inorder to combat human trafficking from Indonesia to Malaysia Indonesiangovernment through the National Agency for The Placement and Protection ofIndonesian Workers (BNP2TKI)in...

  5. Is there an additional benefit of serial NT-proBNP measurements in patients with stable chronic heart failure receiving individually optimized therapy?

    Science.gov (United States)

    Franke, Jennifer; Frankenstein, Lutz; Schellberg, Dieter; Bajrovic, Amer; Wolter, Jan Sebastian; Ehlermann, Philipp; Doesch, Andreas O; Nelles, Manfred; Katus, Hugo A; Zugck, Christian

    2011-12-01

    The role of serial NT-proBNP measurements in patients suffering from chronic systolic heart failure (CHF) who already receive individually optimized pharmacotherapy is still unresolved. NT-proBNP was assessed at baseline and at 6 months follow-up in 504 stable CHF patients treated with individually optimized pharmacotherapy. After assessment of clinical stability at 6 months, patients were followed up for at least 1 year. The combined primary endpoint was defined as death, hospitalization due to cardiac reasons or heart transplantation in 1-year follow-up. We stratified our patients according to two principles: first, a percent change of value (CV) between the first and second measurement of NT-proBNP and secondly, the transformed logarithm of NT-proBNP measured at 6 months. During the follow-up period of 1 year, 50 patients (9.9%) reached the combined primary endpoint. Stratification according to percentage CV was less accurate in predicting endpoint-free survival compared to a classification in categories of lnNT-proBNP measured at 6 months (ROC AUC = 0.615; 95% CI 0.525-0.70 vs. ROC AUC = 0.790; 95% CI 0.721-0.856, respectively). When entered into proportional hazard regression analysis, lnNT-proBNP measured at 6 months remained an independent predictor of the combined primary endpoint with an associated HR of 2.53 (95% CI 1.385-4.280). To date, this is the largest analysis of serial NT-proBNP measurements in patients with CHF receiving individually optimized medical therapy. These data suggest that a single NT-proBNP measurement after 6 months in stable clinical conditions may have higher predictive value than stratification of change in serial measurements.

  6. Diagnostic and prognostic value of N-terminal pro B-type natriuretic peptide (NT-proBNP) in patients with chronic aortic regurgitation.

    Science.gov (United States)

    Weber, Michael; Hausen, Michael; Arnold, Roman; Moellmann, Helge; Nef, Holger; Elsaesser, Albrecht; Mitrovic, Vesselin; Hamm, Christian

    2008-07-21

    BNP and its N-terminal fragment NT-proBNP have proven to be of diagnostic and prognostic value in patients with valvular aortic stenosis. Data regarding those biomarkers in patients with chronic aortic regurgitation (AR) are sparse. Thus it was the aim of the present study to evaluate the diagnostic and the long term prognostic value of NT-proBNP in patients presenting with AR. This study included 60 patients with isolated AR of varying severity (AR I mild, AR II moderate and AR III severe) and preserved left ventricular function. Patients were followed over a median period of 824 (770-921) days. NT-proBNP at baseline was related to disease severity and to functional status (161 (70-456) pg/ml in AR I, 226 (100-666) pg/ml in AR II and 1268 (522-5446) pg/ml in AR III (p=0.003)). Patients (n=6) experiencing an adverse event had higher NT-proBNP values at baseline as event free survivors (1271 (613-2992) pg/ml vs. 215 (92-534) pg/ml; p=0.034). The AUC of the ROC curve for NT-proBNP as a predictor for an adverse event was 0.76 (pvalue of 602 pg/ml. Consequently, in Kaplan-Meier analysis NT-proBNP values dichotomised at this cut-off were able to discriminate patients with an adverse outcome in the entire study group (Log rank 9.98, p=0.0016) and even better in the conservative group (Log rank 26.92, p<0.001). NT-proBNP is linked to disease severity in patients with chronic aortic regurgitation reflecting hemodynamic stress due to volume overload. It provides prognostic information for the clinical outcome and thus might be a useful biomarker for risk stratification.

  7. Detection of NT-pro BNP using fluorescent protein modified by streptavidin as a label in immunochromatographic assay

    Directory of Open Access Journals (Sweden)

    Haixia Li

    2016-12-01

    Full Text Available A novel fluorescent immunochromatographic assay for the detection of NT-proBNP in human serum has been developed. Based on a sandwich-type immunoassay format, analytes in samples were captured by one monoclonal antibody labeled with fluorescent protein and “sandwiched” by another monoclonal antibody immobilized on the nitrocellulose membrane, the fluorescence and concentration of analytes were measured and then calculated by fluoroanalyzer. The fluorescent protein is a fusion protein and was prepared through the application of Streptavidin gene SA, β subunit cpcB of Phycocyanin, lyase alr0617, and phycoerythrobilin synthetase gene ho1, pebA, pebB for covalent binding. It is characterized with higher stability, good solubility in water and it is not easy to quench fluorescence. Take the advantages of fluorescent protein, the immunochromatographic assay exhibited a wide linear range for NT-proBNP from 200 pg ml−1 to 26,000 pg ml−1, with a detection limit of 47 pg ml−1 under optimal conditions. Compared with chemiluminescence immunoassay (CLIA, 131 human serum samples were analyzed and the correlation coefficient of the developed immunoassay was 0.978. These results demonstrated that fluorescent immunochromatographic assay is a more rapid, sensitive, specific method and could be developed into a platform for more biomarkers determination in clinical practice. Keywords: NT-pro BNP, Fluorescent protein, Immunochromatographic assay

  8. Amino-Terminal proB-Type Natriuretic Peptide Levels in the Umbilical Cord Blood of Neonates Differ According to the Type of Prenatally Diagnosed Congenital Heart Disease.

    Science.gov (United States)

    Bae, Jin Young; Cha, Hyun-Hwa; Seong, Won Joon

    2015-12-01

    The aim of this study was to investigate differences in amino-terminal proB-type natriuretic peptide (NT-proBNP) levels in the cord blood of neonates according to the type of congenital heart disease (CHD) and to evaluate the usefulness of NT-proBNP as a prognostic marker. We included 76 neonates with prenatally diagnosed CHD and 45 controls without CHD. Neonates were classified into five groups based on echocardiographic findings. The levels of NT-proBNP in the cord blood were examined and analyzed according to the neonatal outcomes. The levels of NT-proBNP were significantly elevated in the cord blood of neonates with CHD compared with that in the cord blood of controls. The levels of NT-proBNP in the group with right ventricular outflow tract obstruction without a ventricular septal defect were significantly increased compared to that in the other groups. The neonates that required acute surgical correction had higher levels of NT-proBNP in the cord blood, though they were not statistically significant. Meanwhile, NT-proBNP levels in the cord blood of neonates with functional single ventricle were significantly higher than that in the cord blood of those with functional biventricles. Significant differences in the levels of NT-proBNP between survivors and nonsurvivors were observed within 1 year of birth. In this study, we found that the levels of NT-proBNP in the cord blood of neonates with CHD were higher than the levels in controls. This finding was striking in the group with right ventricular outflow tract obstruction, and it was associated with surgery for functional single ventricle and 1-year survival.

  9. A Highest Order Hypothesis Compatibility Test for Monocular SLAM

    OpenAIRE

    Edmundo Guerra; Rodrigo Munguia; Yolanda Bolea; Antoni Grau

    2013-01-01

    Simultaneous Location and Mapping (SLAM) is a key problem to solve in order to build truly autonomous mobile robots. SLAM with a unique camera, or monocular SLAM, is probably one of the most complex SLAM variants, based entirely on a bearing-only sensor working over six DOF. The monocular SLAM method developed in this work is based on the Delayed Inverse-Depth (DI-D) Feature Initialization, with the contribution of a new data association batch validation technique, the Highest Order Hyp...

  10. Robert Aymar receives one of the highest Finnish distinctions

    CERN Multimedia

    2008-01-01

    On 9 December 2008 Robert Aymar, CERN Director-General, was awarded the decoration of Commander, first class, of the Order of the Lion of Finland by the President of the Republic of Finland. This decoration, one of the highest of Finland, was presented in a ceremony by the Ambassador Hannu Himanen, Permanent Representative of Finland to the UN and other international organisations in Geneva. Robert Aymar was honoured for his service to CERN, the LHC, his role in the cooperation between Finland and CERN, as well as his contribution to science in general. In his speech the ambassador underlined CERN’s efforts in the field of education, mentioning the High school teachers programme.

  11. Z-burst scenario for the highest energy cosmic rays

    International Nuclear Information System (INIS)

    Fodor, Z.

    2002-10-01

    The origin of highest energy cosmic rays is yet unknown. An appealing possibility is the so-called Z-burst scenario, in which a large fraction of these cosmic rays are decay products of Z bosons produced in the scattering of ultrahigh energy neutrinos on cosmological relic neutrinos. The comparison between the observed and predicted spectra constrains the mass of the heaviest neutrino. The required neutrino mass is fairly robust against variations of the presently unknown quantities, such as the amount of relic neutrino clustering, the universal photon radio background and the extragalactic magnetic field. Considering different possibilities for the ordinary cosmic rays the required neutrino masses are determined. In the most plausible case that the ordinary cosmic rays are of extragalactic origin and the universal radio background is strong enough to suppress high energy photons, the required neutrino mass is 0.08 eV ≤ m ν ≤ 0.40 eV. The required ultrahigh energy neutrino flux should be detected in the near future by experiments such as AMANDA, RICE or the Pierre Auger Observatory. (orig.)

  12. Estimation of the center frequency of the highest modulation filter.

    Science.gov (United States)

    Moore, Brian C J; Füllgrabe, Christian; Sek, Aleksander

    2009-02-01

    For high-frequency sinusoidal carriers, the threshold for detecting sinusoidal amplitude modulation increases when the signal modulation frequency increases above about 120 Hz. Using the concept of a modulation filter bank, this effect might be explained by (1) a decreasing sensitivity or greater internal noise for modulation filters with center frequencies above 120 Hz; and (2) a limited span of center frequencies of the modulation filters, the top filter being tuned to about 120 Hz. The second possibility was tested by measuring modulation masking in forward masking using an 8 kHz sinusoidal carrier. The signal modulation frequency was 80, 120, or 180 Hz and the masker modulation frequencies covered a range above and below each signal frequency. Four highly trained listeners were tested. For the 80-Hz signal, the signal threshold was usually maximal when the masker frequency equaled the signal frequency. For the 180-Hz signal, the signal threshold was maximal when the masker frequency was below the signal frequency. For the 120-Hz signal, two listeners showed the former pattern, and two showed the latter pattern. The results support the idea that the highest modulation filter has a center frequency in the range 100-120 Hz.

  13. Kyle Cranmer receives the highest recognition from the US government

    CERN Multimedia

    Allen Mincer

    Kyle Cranmer with Clay Sell, Deputy Secretary of EnergyKyle Cranmer, who has worked on ATLAS as a graduate student at the University of Wisconsin-Madison, a Goldhaber Fellow at Brookhaven National Laboratory, and, most recently, an Assistant Professor at New York University, has been awarded a Presidential Early Career Award for Scientists and Engineers (PECASE). As described at the United States Department of Energy web page: "The PECASE Awards are intended to recognize some of the finest scientists and engineers who, while early in their research careers, show exceptional potential for leadership at the frontiers of scientific knowledge during the twenty-first century...The PECASE Award is the highest honor bestowed by the U.S. government on outstanding scientists and engineers beginning their independent careers." Kyle's work on ATLAS focuses on tools and strategies for data analysis, triggering, and searches for the Higgs.At the awards ceremony, which took place on Thursday Nov. 1st in Washington, D.C.,...

  14. Recreational fishing selectively captures individuals with the highest fitness potential.

    Science.gov (United States)

    Sutter, David A H; Suski, Cory D; Philipp, David P; Klefoth, Thomas; Wahl, David H; Kersten, Petra; Cooke, Steven J; Arlinghaus, Robert

    2012-12-18

    Fisheries-induced evolution and its impact on the productivity of exploited fish stocks remains a highly contested research topic in applied fish evolution and fisheries science. Although many quantitative models assume that larger, more fecund fish are preferentially removed by fishing, there is no empirical evidence describing the relationship between vulnerability to capture and individual reproductive fitness in the wild. Using males from two lines of largemouth bass (Micropterus salmoides) selectively bred over three generations for either high (HV) or low (LV) vulnerability to angling as a model system, we show that the trait "vulnerability to angling" positively correlates with aggression, intensity of parental care, and reproductive fitness. The difference in reproductive fitness between HV and LV fish was particularly evident among larger males, which are also the preferred mating partners of females. Our study constitutes experimental evidence that recreational angling selectively captures individuals with the highest potential for reproductive fitness. Our study further suggests that selective removal of the fittest individuals likely occurs in many fisheries that target species engaged in parental care. As a result, depending on the ecological context, angling-induced selection may have negative consequences for recruitment within wild populations of largemouth bass and possibly other exploited species in which behavioral patterns that determine fitness, such as aggression or parental care, also affect their vulnerability to fishing gear.

  15. Academic Training - Tevatron: studying pp collisions at the highest energy

    CERN Multimedia

    2006-01-01

    ACADEMIC TRAINING LECTURE SERIES 15, 16, 17, 18 May Main Auditorium, bldg. 500 on 15, 16, 17 May - Council Chamber on 18 May Physics at the Tevatron B. HEINEMANN, Univ. of Liverpool, FERMILAB Physics Results from the Tevatron The Tevatron proton-antiproton collider at Fermilab in the US is currently the world's highest energy collider. At the experiments CDF and D0 a broad physics programme is being pursued, ranging from flavour physics via electroweak precision measurements to searches for the Higgs boson and new particles beyond the Standard Model. In my lecture I will describe some of the highlight measurements in the flavour, electroweak and searches sectors, and the experimental techniques that are used. ENSEIGNEMENT ACADEMIQUE ACADEMIC TRAINING Françoise Benz 73127 academic.training@cern.ch If you wish to participate in one of the following courses, please tell to your supervisor and apply electronically from the course description pages that can be found on the Web at: http://www.cern.ch/...

  16. A Highest Order Hypothesis Compatibility Test for Monocular SLAM

    Directory of Open Access Journals (Sweden)

    Edmundo Guerra

    2013-08-01

    Full Text Available Simultaneous Location and Mapping (SLAM is a key problem to solve in order to build truly autonomous mobile robots. SLAM with a unique camera, or monocular SLAM, is probably one of the most complex SLAM variants, based entirely on a bearing-only sensor working over six DOF. The monocular SLAM method developed in this work is based on the Delayed Inverse-Depth (DI-D Feature Initialization, with the contribution of a new data association batch validation technique, the Highest Order Hypothesis Compatibility Test, HOHCT. The Delayed Inverse-Depth technique is used to initialize new features in the system and defines a single hypothesis for the initial depth of features with the use of a stochastic technique of triangulation. The introduced HOHCT method is based on the evaluation of statistically compatible hypotheses and a search algorithm designed to exploit the strengths of the Delayed Inverse-Depth technique to achieve good performance results. This work presents the HOHCT with a detailed formulation of the monocular DI-D SLAM problem. The performance of the proposed HOHCT is validated with experimental results, in both indoor and outdoor environments, while its costs are compared with other popular approaches.

  17. A prospective study of brain natriuretic peptide levels in three subgroups: Stroke with hypertension, stroke without hypertension, and hypertension alone

    Directory of Open Access Journals (Sweden)

    Cakir Zeynep

    2010-01-01

    Full Text Available Aim: To study brain natriuretic peptide (BNP levels in three subgroups: patients having stroke with hypertension (HT, those having stroke without HT, and those with HT alone. We also tried to identify whether BNP levels predict the length of stay in hospital and mortality. Materials and Methods: The groups were formed by patients who had been admitted to the emergency department in the first 4-12 h after the onset of symptoms. There were 30 stroke patients with a history of HT (group I, 30 stroke patients without a history of HT (group II, and 20 HT patients without stroke (group III. Patients with congestive heart failure, chronic cor pulmonale, severe valvular heart disease, chronic renal failure, liver insufficiency, diabetes mellitus, atrial fibrillation, and those with a history of stroke were excluded from the study since these diseases can affect the plasma BNP levels. Results: The demographic characteristics, except the age distribution, were similar among the groups. The mean BNP levels in the three groups were 168.8 ± 223.9 pg/ml, 85.0 ± 75.1 pg/ml, and 84.8 ± 178.3 pg/ml, respectively. The differences between the groups were statistically significant. Conclusion: The mean BNP levels were affected by HT and/or stroke. The simultaneous presence of HT and stroke results in a more significant increase BNP than the presence of either stroke or HT alone. When diseases that can affect the plasma BNP levels are excluded, the BNP levels in stroke patients without a history of HT are similar to the levels seen in patients with only HT.

  18. Novel covalent modification of human anaplastic lymphoma kinase (ALK and potentiation of crizotinib-mediated inhibition of ALK activity by BNP7787

    Directory of Open Access Journals (Sweden)

    Parker AR

    2015-02-01

    Full Text Available Aulma R Parker,1 Pavankumar N Petluru,1 Vicki L Nienaber,2 Min Zhao,1 Philippe Y Ayala,1 John Badger,2 Barbara Chie-Leon,2 Vandana Sridhar,2 Cheyenne Logan,2 Harry Kochat,1 Frederick H Hausheer1 1BioNumerik Pharmaceuticals, Inc., San Antonio, TX, USA; 2Zenobia Therapeutics, Inc., La Jolla, CA, USA Abstract: BNP7787 (Tavocept, disodium 2,2’-dithio-bis-ethanesulfonate is a novel, investigational, water-soluble disulfide that is well-tolerated and nontoxic. In separate randomized multicenter Phase II and Phase III clinical trials in non-small-cell lung cancer (NSCLC patients, treatment with BNP7787 in combination with standard chemotherapy resulted in substantial increases in the overall survival of patients with advanced adenocarcinoma of the lung in the first-line treatment setting. We hypothesized that BNP7787 might interact with and modify human anaplastic lymphoma kinase (ALK. At least seven different variants of ALK fusions with the gene encoding the echinoderm microtubule-associated protein-like 4 (EML4 are known to occur in NSCLC. EML4–ALK fusions are thought to account for approximately 3% of NSCLC cases. Herein, we report the covalent modification of the kinase domain of human ALK by a BNP7787-derived mesna moiety and the functional consequences of this modification in ALK assays evaluating kinase activity. The kinase domain of the ALK protein crystallizes as a monomer, and BNP7787-derived mesna-cysteine adducts were observed at Cys 1235 and Cys 1156. The BNP7787-derived mesna adduct at Cys 1156 is located in close proximity to the active site and results in substantial disorder of the P-loop and activation loop (A-loop. Comparison with the P-loop of apo-ALK suggests that the BNP7787-derived mesna adduct at Cys 1156 interferes with the positioning of Phe 1127 into a small pocket now occupied by mesna, resulting in a destabilization of the loop's binding orientation. Additionally, in vitro kinase activity assays indicate that BNP7787

  19. Study on plasma levels of brain natriuretic peptide, angiotensin and aldosterone in patients with congestive heart failure

    International Nuclear Information System (INIS)

    Cheng Yu; Hong Liquan; Chen Zhaojun

    2009-01-01

    Objective: To investigate the relationship between brain natriuretic peptide (BNP), angiotensin (AT-II), and aldosterone (ALD) levels in patients with congestive heart failure (CHF). Methods: Plasma levels of BNP (with CLIA) and Angiotensin II (AT-II), aldosterone (ALD) (with RIA) were measured in 98 patients with CHF, 76 cardiac patients without heart faclure, and 86 controls. Results: The plasma levels of BNP, AT-II and ALD in patients (with RIA) CHF were significantly higher than those in the controls. The levels of BNP, AT-II and ALD, CHF patients after therapy were markedly dropped and were significantly lower than those patients before therapy (P<0.01). BNP levels were positively correlated with AT-II and ALD in levels CHF (P<0.05). Conclusion: The over activity of RAA systems may be one of the mechanisms of heart failure. Dynamic observation of changes of BNP, AT-II and ALD may be very useful in assessment of severity and prognosis of patients with CHF. (authors)

  20. Hyperinsulinemia correlates with low levels of plasma B-type natriuretic peptide in Japanese men irrespective of fat distribution

    Directory of Open Access Journals (Sweden)

    Nakatsuji Hideaki

    2012-03-01

    Full Text Available Abstract Background B-type natriuretic peptide (BNP, a member of the natriuretic peptide family, is a cardiac-derived secretory hormone with natriuretic, diuretic, and vasorelaxant activities. Intraabdominal fat accumulation is associated with atherosclerotic cardiovascular diseases and cardiac dysfunction. Circulating BNP levels are relatively low (within the normal limits in obesity and the metabolic syndrome. However, the relationship between plasma BNP levels and visceral fat accumulation in general population has not been reported. The present study analyzed the relationships between plasma BNP levels and various clinical variables, including insulin, visceral and subcutaneous fat area (VFA and SFA, respectively, in normal Japanese men. Methods The study (Victor-J study subjects were consecutive 500 Japanese male workers, who underwent a health checkup and were measured VFA and SFA by computed tomography. Results Age-adjusted simple linear regression analysis showed that log-BNP correlated positively with HDL-cholesterol, and negatively with VFA, log-immunoreactive insulin (IRI, log-triglyceride, and LDL-cholesterol, but not body mass index or SFA. Stepwise multiple regression analysis identified log-IRI and HDL-cholesterol as significant determinants of log-BNP. Subjects with IRI ≥5.5 μIU/mL had lower plasma BNP levels than those with IRI 2, visceral fat accumulation (VFA, cutoff value 100 cm2 and subcutaneous fat accumulation (SFA, cutoff value 128 cm2. Conclusions Our study showed that hyperinsulinemia correlated with low levels of plasma BNP in general men, irrespective of fat distribution. Trial registration UMIN 000004318.

  1. Role of B-Type Natriuretic Peptide and N-Terminal Prohormone BNP as Predictors of Cardiovascular Morbidity and Mortality in Patients With a Recent Coronary Event and Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Wolsk, Emil; Claggett, Brian; Pfeffer, Marc A; Diaz, Rafael; Dickstein, Kenneth; Gerstein, Hertzel C; Lawson, Francesca C; Lewis, Eldrin F; Maggioni, Aldo P; McMurray, John J V; Probstfield, Jeffrey L; Riddle, Matthew C; Solomon, Scott D; Tardif, Jean-Claude; Køber, Lars

    2017-05-29

    Natriuretic peptides are recognized as important predictors of cardiovascular events in patients with heart failure, but less is known about their prognostic importance in patients with acute coronary syndrome. We sought to determine whether B-type natriuretic peptide (BNP) and N-terminal prohormone B-type natriuretic peptide (NT-proBNP) could enhance risk prediction of a broad range of cardiovascular outcomes in patients with acute coronary syndrome and type 2 diabetes mellitus. Patients with a recent acute coronary syndrome and type 2 diabetes mellitus were prospectively enrolled in the ELIXA trial (n=5525, follow-up time 26 months). Best risk models were constructed from relevant baseline variables with and without BNP/NT-proBNP. C statistics, Net Reclassification Index, and Integrated Discrimination Index were analyzed to estimate the value of adding BNP or NT-proBNP to best risk models. Overall, BNP and NT-proBNP were the most important predictors of all outcomes examined, irrespective of history of heart failure or any prior cardiovascular disease. BNP significantly improved C statistics when added to risk models for each outcome examined, the strongest increments being in death (0.77-0.82, P type 2 diabetes mellitus, BNP and NT-proBNP were powerful predictors of cardiovascular outcomes beyond heart failure and death, ie, were also predictive of MI and stroke. Natriuretic peptides added as much predictive information about death as all other conventional variables combined. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01147250. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  2. Achieving world's highest level of nuclear safety learning from overseas nuclear trouble events

    International Nuclear Information System (INIS)

    Okumoto, Masaru

    2014-01-01

    Nuclear Information Research Project of Institute of Nuclear Safety System, Incorporated (INSS) had acquired trouble information of nuclear power plants (NPPs) up to annual several thousand events issued by overseas regulatory agencies for more than 20 years since INSS established and analyzed it in details respectively after the screening. Lessons extracted from the analysis were offered as suggestions to electric utilities having PWRs in Japan. Such activities would surely contribute to maintain and improve nuclear safety with no objection. However, they could not prevent the occurrence of accident of Fukushima Daiichi NPPs. Thus the project had reviewed usefulness of past activities and how improved could be by listening sincerely to outside opinions. This report introduced outlines of recent activities. Competent suggestions to electric utilities might be made with improved reflection of lessons to needed rules, deepened information sharing within the project and raised awareness of the problem. (T. Tanaka)

  3. Combined measurement of copeptin, high-sensitivity troponin T, and N-terminal proBNP improves the identification of patients at risk of cardiovascular death

    DEFF Research Database (Denmark)

    Alehagen, Urban; Dahlström, Ulf; Carstensen, John

    2012-01-01

    and all mortality was registered. Cardiovascular mortality was evaluated using Kaplan–Meier plots and multivariate Cox proportional hazard regression analyses. Results: Copeptin, HS-TnT, and NT-proBNP measurements provided independent prognostic information in a multivariate setting over 5 years (hazard......Objectives: A multimarker strategy for the handling of patients with heart failure has been suggested in the literature. Therefore, the potential prognostic relevance of combined copeptin, high-sensitivity troponin T (HS-TnT), and N-terminal proBNP (NT-proBNP) measurement in plasma from elderly...... patients with symptoms of heart failure was evaluated. Methods: This study included 470 elderly patients (mean age 73 years) from a rural municipality with symptoms of heart failure. Clinical examination, echocardiography, and biomarker measurements were performed. All patients were followed for 13 years...

  4. Differences in Natriuretic Peptide Levels by Race/Ethnicity (From the Multi-Ethnic Study of Atherosclerosis).

    Science.gov (United States)

    Gupta, Deepak K; Daniels, Lori B; Cheng, Susan; deFilippi, Christopher R; Criqui, Michael H; Maisel, Alan S; Lima, Joao A; Bahrami, Hossein; Greenland, Philip; Cushman, Mary; Tracy, Russell; Siscovick, David; Bertoni, Alain G; Cannone, Valentina; Burnett, John C; Carr, John Jeffrey; Wang, Thomas J

    2017-09-15

    Natriuretic peptides (NP) are cardiac-derived hormones with favorable cardiometabolic actions. Low NP levels are associated with increased risks of hypertension and diabetes mellitus, conditions with variable prevalence by race and ethnicity. Heritable factors underlie a significant proportion of the interindividual variation in NP concentrations, but the specific influences of race and ancestry are unknown. In 5597 individuals (40% white, 24% black, 23% Hispanic, and 13% Chinese) without prevalent cardiovascular disease at baseline in the Multi-Ethnic Study of Atherosclerosis, multivariable linear regression and restricted cubic splines were used to estimate differences in serum N-terminal pro B-type natriuretic peptide (NT-proBNP) levels according to, ethnicity, and ancestry. Ancestry was determined using genetic ancestry informative markers. NT-proBNP concentrations differed significantly by race and ethnicity (black, median 43 pg/ml [interquartile range 17 to 94], Chinese 43 [17 to 90], Hispanic 53 [23 to 107], white 68 [34 to 136]; p = 0.0001). In multivariable models, NT-proBNP was 44% lower (95% confidence interval -48 to -40) in black and 46% lower (-50 to -41) in Chinese, compared with white individuals. Hispanic individuals had intermediate concentrations. Self-identified blacks and Hispanics were the most genetically admixed. Among self-identified black individuals, a 20% increase in genetic European ancestry was associated with 12% higher (1% to 23%) NT-proBNP. Among Hispanic individuals, genetic European and African ancestry were positively and negatively associated with NT-proBNP levels, respectively. In conclusion, NT-proBNP levels differ according to race and ethnicity, with the lowest concentrations in black and Chinese individuals. Racial and ethnic differences in NT-proBNP may have a genetic basis, with European and African ancestry associated with higher and lower NT-proBNP concentrations, respectively. Copyright © 2017 Elsevier Inc. All

  5. PONTIAC (NT-proBNP selected prevention of cardiac events in a population of diabetic patients without a history of cardiac disease): a prospective randomized controlled trial.

    Science.gov (United States)

    Huelsmann, Martin; Neuhold, Stephanie; Resl, Michael; Strunk, Guido; Brath, Helmut; Francesconi, Claudia; Adlbrecht, Christopher; Prager, Rudolf; Luger, Anton; Pacher, Richard; Clodi, Martin

    2013-10-08

    The study sought to assess the primary preventive effect of neurohumoral therapy in high-risk diabetic patients selected by N-terminal pro-B-type natriuretic peptide (NT-proBNP). Few clinical trials have successfully demonstrated the prevention of cardiac events in patients with diabetes. One reason for this might be an inaccurate selection of patients. NT-proBNP has not been assessed in this context. A total of 300 patients with type 2 diabetes, elevated NT-proBNP (>125 pg/ml) but free of cardiac disease were randomized. The "control" group was cared for at 4 diabetes care units; the "intensified" group was additionally treated at a cardiac outpatient clinic for the up-titration of renin-angiotensin system (RAS) antagonists and beta-blockers. The primary endpoint was hospitalization/death due to cardiac disease after 2 years. At baseline, the mean age of the patients was 67.5 ± 9 years, duration of diabetes was 15 ± 12 years, 37% were male, HbA1c was 7 ± 1.1%, blood pressure was 151 ± 22 mm Hg, heart rate was 72 ± 11 beats/min, median NT-proBNP was 265.5 pg/ml (interquartile range: 180.8 to 401.8 pg/ml). After 12 months there was a significant difference between the number of patients treated with a RAS antagonist/beta-blocker and the dosage reached between groups (p titration of RAS antagonists and beta-blockers to maximum tolerated dosages is an effective and safe intervention for the primary prevention of cardiac events for diabetic patients pre-selected using NT-proBNP. (Nt-proBNP Guided Primary Prevention of CV Events in Diabetic Patients [PONTIAC]; NCT00562952). Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  6. The dynamic changes of brain natriuretic peptide level in patients with hyperthyroid heart disease after 131I therapy

    International Nuclear Information System (INIS)

    Su Yingrui; Zha Jinshun; Zhou Jingxiong; Lin Xiahong; Xu Chaoxiang; Wang Yaoguo; Du Xinqing

    2012-01-01

    Objective: To investigate the application value of urine brain natriuretic peptide (BNP) level in 131 I treatment of hyperthyroid heart disease. Methods: One hundred and eleven hyperthyroidism patients who received 131 I therapy were divided into two groups, hyperthyroidism group (51 cases) and hyperthyroid heart disease group (60 cases), and 30 healthy subjects as control. Sixty patients in the hyperthyroid heart disease group all received ultrasonic cardiogram. The hyperthyroid heart disease group was divided into two subgroups according to New York Heart Association (NYHA) functional classification (hyperthyroid heart disease A subgroup and hyperthyroid heart disease B subgroup). The urine and serum BNP level and serum free triiodothyronine (FT 3 ), free thyroxine (FT 4 ) level were measured through chemiluminescence before and after therapy. Results: The urine and serum BNP level before 131 I therapy of the hyperthyroid heart disease group were significantly higher than those of hyperthyroidism group (serum: t=8.98 and 9.52, both P<0.01; urine: t=10.83 and 12.73, both P<0.01) and the control group (serum: t=8.97 and 9.52, both P<0.01; urine: t=9.21 and 5.64, both P<0.01). The urine and serum BNP level before and 6, 12 months after 131 I therapy of the hyperthyroid heart disease A subgroup were significantly higher than those of hyperthyroid heart disease B subgroup (serum: t=5.98, 5.87 and 6.35, all P<0.01; serum: t=4.33, 4.09 and 5.02, all P<0.01). The urine level of BNP was gradually increased with the severity of cardiac insufficiency and it was positively correlated with the serum level of BNP (r=0.829, P<0.01), the NYHA functional classification (r=0.751, P<0.01) and the serum level of FT 3 and FT 4 (FT 3 : r=0.635, P<0.01; FT 4 : r=0.672, P<0.01). Conclusions: The urine BNP level of hyperthyroid heart disease patient increased with the severity of cardiac insufficiency. The urine BNP level could accurately reflect cardiac function of hyperthyroid heart

  7. Comparison of Brain Natriuretic Peptide Levels to Simultaneously Obtained Right Heart Hemodynamics in Stable Outpatients with Pulmonary Arterial Hypertension.

    Science.gov (United States)

    Helgeson, Scott A; Imam, J Saadi; Moss, John E; Hodge, David O; Burger, Charles D

    2018-05-01

    Pulmonary arterial hypertension (PAH) is a progressive disease that requires validated biomarkers of disease severity. While PAH is defined hemodynamically by right heart catheterization (RHC), brain natriuretic peptide (BNP) is recommended by guidelines to assess disease status. Retrospectively collected data in 138 group 1 PAH patients were examined for the correlation of BNP levels to simultaneously obtained right heart catheterization (RHC). Patients were mostly Caucasian women, with functional class III symptoms, mean BNP of 406 ± 443 pg/mL, and an average right atrial pressure (RAP) of 9.9 ± 5.7 mm Hg and mean pulmonary artery pressure (mPAP) of 47.3 ± 14.7 mm Hg. Significant correlation was demonstrated between BNP and RAP ( p = 0.021) and mPAP ( p = 0.003). Additional correlation was seen with right heart size on echocardiography: right atrial (RAE; p = 0.04) and right ventricular enlargement ( p = 0.03). An increased BNP level was an independent predictor of mortality ( p right heart hemodynamics. The current results reinforce the use of BNP level as a continuous variable to assess disease severity in group 1 PAH.

  8. The relationship of plasma creatinine (as eGFR) and high-sensitivity cardiac troponin and NT-proBNP concentrations in a hospital and community outpatient population.

    Science.gov (United States)

    Potter, Julia M; Simpson, Aaron J; Kerrigan, Jennifer; Southcott, Emma; Salib, Marie M; Koerbin, Gus; Hickman, Peter E

    2017-10-01

    While persons with overt renal failure have a well-described rise in troponin and NT-proBNP, it is less well described what the relationship is between cardiac markers and persons with impaired renal function, not requiring dialysis. We have collected ALL samples referred to our pathology practice over a 24h period and measured hs-cTnI, hs-cTnT, NT-proBNP, calculated the eGFR, and related our measurements to clinical outcomes. For both men and women, for all of hs-cTnI, hs-cTnT and NT-proBNP, there was a graded response, as renal function worsened, the concentration of the cardiac marker increased. There is a graded inverse relationship between eGFR and the concentrations of hs-cTnI, hs-cTnT and NT-proBNP. For women only there appeared to be an increase in mortality at lowest eGFR. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  9. Diagnostic Cut-Off Levels of Plasma Brain Natriuretic Peptide to Distinguish Left Ventricular Failure in Emergency Setting

    International Nuclear Information System (INIS)

    Hussain, A.; Afridi, F. I.; Lutfi, I. A.

    2014-01-01

    Objective: To determine the diagnostic cut-off values of brain natriuretic (BNP) peptide to establish left ventricular failure in patients presenting with dyspnoea in emergency department. Study Design: Descriptive study. Place and Duration of Study: Ziauddin University Hospital, Karachi, from July to December 2011. Methodology: BNP estimation was done on Axysm analyzer with kit provided by Abbott diagnostics, while the Doppler echocardiography was done on Toshiba style (UICW-660A) using 2.5 MHz and 5.0 MHz probes. Log transformation was done to normalize the original BNP values. A receiver operating curve was plotted to determine the diagnostic cut-off value of BNP which can be used to distinguish CHF from other causes of dyspnoea. Statistical analysis was performed by SPSS version 17. Results: A total of 92 patients presenting with dyspnoea in the emergency department were studied. There were 38/92 (41.3%) males and 54/92 (58.7%) females, and the average age of the study population was 64 A +- 14.1 years. These patients had BNP levels and Doppler echocardiography done. The average BNP was found to be 1117.78 A +- 1445.74 pg/ml. In log transformation, the average was found to be 2.72 A +- 0.58. BNP value of 531 pg/ml was found to be the cut off to distinguish between cardiogenic and non-cardiogenic causes of dyspnoea. Conclusion: BNP value of 531 pg/ml can distinguish CHF from other conditions as a cause of dyspnoea in emergency. (author)

  10. Expression and purification of a novel therapeutic single-chain variable fragment antibody against BNP from inclusion bodies of Escherichia coli.

    Science.gov (United States)

    Bu, Dawei; Zhou, Yuwei; Tang, Jian; Jing, Fang; Zhang, Wei

    2013-12-01

    Abnormal brain natriuretic peptide (BNP) secretion is regarded as the dominating mechanism of cerebral salt wasting syndrome (CSW), which results from a renal loss of sodium and water during intracranial disease leading to hyponatremia. Scale preparation of therapeutic single-chain variable fragment (scFv) that can neutralize elevated circulating BNP may have potential value for clinical use. In this report, we used a recently isolated humanized anti-BNP scFv fragment (3C1) as model antibody (Ab) to evaluate the potential of scale production of this therapeutic protein. The truncated gene encoding for scFv fragment cloned in pET22b (+) was mainly overexpressed as inclusion bodies in Escherichia coli (E. coli) Rosetta (DE3) pLysS cells. The insoluble fragment was solubilized and purified by Ni-NTA agarose resin under denaturation conditions, and recovered via an effective refolding buffer containing 50 mM Tris-HCl, pH 8.0, 0.15 M NaCl, 1 mM EDTA, 0.5 M arginine, 2 mM GSH, 1 mM GSSG, and 5% glycerol. The refolded scFv fragment was concentrated by PEG20000, and dialyzed in PBS (containing 5% glycerol, pH 7.4). The final yield was approximately 10.2 mg active scFv fragment per liter of culture (3.4 g wet weight cells). The scFv fragment was more than 95% pure assessed by SDS-PAGE assay. Recombinant scFv fragment with His tag displayed its immunoreactivity with anti-His tag Ab by western blotting. ELISA showed the scFv fragment specifically bound to BNP, and it displayed similar activity as the traditional anti-BNP monoclonal Ab (mAb). Thus, the current strategy allows convenient small-scale production of this therapeutic protein. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. NT-proBNP is associated with coronary heart disease risk in healthy older women but fails to enhance prediction beyond established risk factors: results from the British Women's Heart and Health Study.

    Science.gov (United States)

    Sattar, Naveed; Welsh, Paul; Sarwar, Nadeem; Danesh, John; Di Angelantonio, Emanuele; Gudnason, Vilmundur; Davey Smith, George; Ebrahim, Shah; Lawlor, Debbie A

    2010-03-01

    Limited evidence suggests NT-proBNP improves prediction of coronary heart disease (CHD) events but further data are needed, especially in people without pre-existing CHD and in women. We measured NT-proBNP in serum from 162 women with incident CHD events and 1226 controls (60-79 years) in a case-control study nested within the prospective British Women's Heart and Health Study. All cases and controls were free from CHD at baseline. We related NT-proBNP to CHD event risk, and determined to what extent NT-proBNP enhanced CHD risk prediction beyond established risk factors. The odds ratio for CHD per 1 standard deviation increase in log(e)NT-proBNP was 1.37 (95% CI: 1.13-1.68) in analyses adjusted for established CHD risk factors, social class, CRP and insulin. However, addition of log(e)NT-proBNP did not improve the discrimination of a prediction model including age, social class, smoking, physical activity, lipids, fasting glucose, waist:hip ratio, hypertension, statin and aspirin use, nor a standard Framingham risk score model; area under the receiver operator curve for the former model increased from 0.676 to 0.687 on inclusion of NT-proBNP (p=0.3). Furthermore, adding NT-proBNP did not improve calibration of a prediction model containing established risk factors, nor did inclusion more appropriately re-classify participants in relation to their final outcome. Findings were similar (independent associations, but no prediction improvement) for fasting insulin and CRP. These results caution against use of NT-proBNP for CHD risk prediction in healthy women and suggest a need for larger studies in both genders to resolve outstanding uncertainties.

  12. [The gender gap in highest quality medical research - A scientometric analysis of the representation of female authors in highest impact medical journals].

    Science.gov (United States)

    Bendels, Michael H K; Wanke, Eileen M; Benik, Steffen; Schehadat, Marc S; Schöffel, Norman; Bauer, Jan; Gerber, Alexander; Brüggmann, Dörthe; Oremek, Gerhard M; Groneberg, David A

    2018-05-01

     The study aims to elucidate the state of gender equality in high-impact medical research, analyzing the representation of female authorships from January, 2008 to September, 2017.  133 893 male and female authorships from seven high-impact medical journals were analyzed. The key methodology was the combined analysis of the relative frequency, odds ratio and citations of female authorships. The Prestige Index measures the distribution of prestigious authorships between the two genders.  35.0 % of all authorships and 34.3 % of the first, 36.1 % of the co- and 24.2 % of the last authorships were held by women. Female authors have an odds ratio of 0.97 (KI: 0.93 - 1.01) for first, 1.36 (KI: 1.32 - 1.40) for co- und 0.57 (KI: 0.54 - 0.60) for last authorships compared to male authors. The proportion of female authorships exhibits an annual growth of 1.3 % overall, with 0.5 % for first, 1.2 % for co-, and 0.8 % for last authorships. Women are underrepresented at prestigious authorship compared to men (Prestige Index = -0.38). The underrepresentation accentuates in highly competitive articles attracting the highest citation rates, namely, articles with many authors and articles that were published in highest-impact journals. Multi-author articles with male key authors are more frequently cited than articles with female key authors. The gender-specific differences in citation rates increase the more authors contribute to an article. Women publish fewer articles compared to men (39.6 % female authors are responsible for 35.0 % of the authorships) and are underrepresented at productivity levels of more than 1 article per author. Distinct differences at the country level were revealed.  High impact medical research is characterized by few female group leaders as last authors and many female researchers being first or co-authors early in their career. It is very likely that this gender-specific career dichotomy will persistent in

  13. Correlation of plasma B-type natriuretic peptide levels with metabolic risk markers.

    Science.gov (United States)

    Ahued-Ortega, José Armando; León-García, Plácido Enrique; Hernández-Pérez, Elizabeth

    2018-04-17

    Natriuretic peptide type B (BNP) is a marker of myocardium injury. This peptide has been associated with metabolic risk markers, although controversy exists in this regard. The aim of the present study was to determine the correlation of plasma BNP levels with metabolic risk parameters. A retrospective, observational study that included 152 patients, who were classified according to their clinical diagnosis as patients with metabolic syndrome. Plasma BNP levels and clinical metabolic parameters were assessed by using Spearmańs rank correlation coefficient. A significant inverse association with weight (r=-.408; p<.0001) and BMI (r=-.443; p<.001) was obtained. While a positive significant association with systolic pressure (r=.324; p<.001) was observed. A significant decrease was found in BNP levels and components of metabolic syndrome. (p<.05). Based on the results from this study, we can conclude that BNP determination could be an adequate metabolic marker. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  14. Study on clinical value of determination of plasma brain natriuretic peptide levels in patients with chronic congestive heart failure

    International Nuclear Information System (INIS)

    Chen Jianxiong; Li Zhuocheng; Tu Hong

    2010-01-01

    Objective: To evaluate the clinical value of determination of plasma brain natriuretic peptide (BNP) levels in patients with chronic congestive heart failure(CHF). Methods: The levels of plasma BNP were measured with fluorescence immunoassay in 341 patients with chronic CHF and 55 controls. Left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD) were determined with color doppler ultrasonography in CHF patients. Results: Plasma levels of BNP were significantly increased in patients with CHF as compared with those in controls (P<0.01). There were also significant differences in plasma levels of CHF patients of different clinical stages (P<0.01). There was obvious correlation between plasma levels of BNP and the values of LVEF, LVESD and LVEDD (r was-0.62, +0.54 and +0.60 respectively, P<0.01). Conclusion: Plasma level of BNP is a sensitive indicator for assessment of ventricle function in CHF patients. (authors)

  15. BNP and NT-proBNP Test

    Science.gov (United States)

    ... shortness of breath Fatigue Swelling in the feet, ankles, legs, abdomen Testing may be done in the ... heart failure and allows for better/earlier/improved therapy. (2004 February 11) ... Manual for Healthcare Professionals. [On-line information]. Available online ...

  16. Are serial BNP measurements useful in heart failure management? Serial natriuretic peptide measurements are useful in heart failure management.

    Science.gov (United States)

    Januzzi, James L; Troughton, Richard

    2013-01-29

    To deny the fact that standard HF care has substantial opportunity for improvement is at the peril of even worse outcomes in our patients affected by the disorder. We have presented a strong rationale for the value of BNP- and NTproBNP–guided HF management. Experience gained in biomarker-guided HF trials suggests that the approach results in improvement in the quality of care without an excess of adverse events related to more aggressive management. This alone is difficult to ignore given the gaps in care that exist between RCTs and real-world practice. Beyond this fact, studies examining the strategy of biomarker-guided HF care have shown substantial improvement in outcome compared with well-managed control arms, benefits that are confirmed in meta-analysis and pooled data analyses, and justifies the imminent launch of the pivotal RCT that will lead to more widespread adoption of the approach. Compared with standard management, biomarker-guided care appears cost effective, may improve patient quality of life, and may promote reverse ventricular remodeling. Although certain subgroups such as the elderly may respond in a less vigorous manner to the approach, this may reflect the effects of age on HF therapy and how the strategy is deployed in elders rather than a weakness of the approach in older patients. A fair-minded assessment of the available data suggests that care supported by BNP/NT-proBNP–guided HF treatment—as an adjunct to standard clinical acumen—is superior to standard care. The limitation of standard care strategies is evident from the suboptimal uptake and application of proven therapies documented in HF registries. Far from being a crutch to support what we should already be doing (namely, optimally evaluating and managing our patients solely with clinical means), the inclusion of NP measurement within the HF management strategy augments the quality of monitoring and treatment. Denial of the benefits of NP monitoring potentially retards

  17. Analysis of N-terminal pro-brain natriuretic peptide levels in patients with chronic heart failure

    International Nuclear Information System (INIS)

    Fu Xiao; Zhang Xingping; Zhou Kejian

    2011-01-01

    To investigate the changes and its clinical significance of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in patients with chronic heart failure(CHF), 128 patients with decompensated CHF and 20 patients without structural heart disease were selected as CHF and control group. All subjects were evaluated heart function by New York Heart Association (NYHA) class. The serum NT-proBNP levels were assayed by electrochemiluminescence double antibody sandwich immunoassay. Left ventricular ejection fraction (LVEF) was detected by color Doppler ultrasound. The results showed that the NT-proBNP levels in CHF group were significantly higher than that of in the control group (P<0.05). Further, the NT-proBNP levels showed an increased tendency accompanied by the severity of heart failure (P<0.05) and lowering of LVEF (r=-0.595, P<0.05). The serum NT-proBNP levels can reflect the state of cardiac function in patients with decompensated DHF, and useful in the diagnosis and severity assessment of CHF. (authors)

  18. Plasma N-terminal pro-brain natriuretic peptide levels in patients with acute myocardial infarction, unstable angina pectoris and non-insulin-dependent diabetes

    International Nuclear Information System (INIS)

    Zhang Yonggang; Li Yuguang

    2004-01-01

    Objective: Determination of plasma N-terminal pro-brain natriuretic peptide [NT-proBNP (1-76)] levels is useful for the diagnosis of heart failure. Present study was to investigate the significance of changes of plasma NT-proBNP (1-76) levels in patients with acute myocardial infarction (AMI), unstable angina pectoris (UAP) and non-insulin-dependent diabetes (NIDD). Methods: Plasma NT-proBNP (1-76) levels were determined with RIA in 32 patients with AMI, 27 patients with UAP, 12 patients with NIDD and 20 controls. Moreover, 16 of the 32 AMI patients underwent percutaneous transluminal coronary angioplasty (PTCA) and plasma (1-76) levels were again determined 12hr before and 12hr after the procedure. Results: The plasma NT-proBNP (1-76) levels in controls were 360.8 ± 57.3 pg/ ml with no significant difference between the sexes. In patients with AMI, UAP and NIDD, NT-proBNP (1-76) levels were 554.1 ± 195.9 pg/ml, 525.7 ± 199.1 pg/ml and 552.6 ± 141.9 pg/ml respectively; all of them were significantly higher than those in controls (P 0.05). Conclusion: The plasma NT-proBNP (1-76) levels in patients with AMI, UAP and NIDD were increased significantly and the result suggested that NT-proBNP (1-76) might be a useful risk marker for these diseases. (authors)

  19. Right ventricular function and N-terminal pro-brain natriuretic peptide levels in adult patients with simple dextro-transposition of the great arteries.

    Science.gov (United States)

    Martínez-Quintana, Efrén; Marrero-Negrín, Natalia; Gopar-Gopar, Silvia; Rodríguez-González, Fayna

    2017-06-01

    Dextro-transposition of the great arteries (d-TGA) patients is at high risk of developing right ventricular dysfunction and tricuspid regurgitation in adulthood. Determining the relation between echocardiographic parameters, N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels and the New York Heart Association (NYHA) functional class may help determining the best time to operate them. Patients with simple d-TGA operated in infancy with an atrial switch procedure (Mustard or Senning operation) were followed up in our Adult Congenital Heart Disease Unit. Analytical, echocardiographic, and clinical parameters were determined to evaluate the correlation between right echocardiographic ventricular function, NT-pro-BNP levels, and NYHA functional class. Twenty-four patients with d-TGA were operated in infancy of whom 17 alive patients had simple d-TGA. Nine patients had NT-pro-BNP levels lower than 200 pg/mL and eight patients were above 200 pg/mL. Patients with lower hemoglobin concentration, higher right ventricular diameter or under diuretic treatment showed significant higher NT-pro-BNP levels (above 200 pg/dL). The Spearman test showed a positive correlation between basal right ventricular diameter and tricuspid regurgitation with pro NT BNP levels (correlation coefficient of .624; P=.017 and .490; P=.046, respectively) and a negative correlation with the right ventricle fractional area change (-.508, P=.045). No correlation was seen between NT-pro-BNP levels and the rest of echocardiographic parameters or the NYHA functional class. NT-pro-BNP levels showed a positive correlation with basal right ventricular diameter and tricuspid regurgitation but not with NYHA association functional class in d-TGA patients. © 2017, Wiley Periodicals, Inc.

  20. Diagnostic Value of N Terminal Pro B Type Natriuretic Peptide (NT-pro BNP in Cardiac Involvement in Patients with Beta- Thalassemia

    Directory of Open Access Journals (Sweden)

    Noor Mohammad Noori

    2017-04-01

    Full Text Available Background Heart failure is a major cause of death in thalassemia. The study aimed to determine the diagnostic value of N Terminal Pro B Type Natriuretic Peptide (NT-pro BNP, to early diagnose the cardiac involvement in beta- thalassemia major patients. Materials and Methods  80 thalassemia patients aged 7 to 18 years old (patients group, and 80 healthy age and gender matched controls were enrolled in the case-control study. Patients were selected from those attending to the clinic of Aliasghar hospital, Zahedan-Iran. They were subjected to echo-Doppler tissue and conventional examination for both right and left heart function. Data were analysis using SPSS 18.0 software. Results  NT-pro BNP increased in patients compared the controls (P

  1. The role of TNF-α, Fas/Fas ligand system and NT-proBNP in the early detection of asymptomatic left ventricular dysfunction in cancer patients treated with anthracyclines

    Directory of Open Access Journals (Sweden)

    Alexandros Kouloubinis

    2015-03-01

    Conclusion: SFas, sFas-L and NT-proBNP correlate with reductions in LVEF and could be used as sensitive biochemical indices for the detection of asymptomatic left ventricular dysfunction in cancer patients under cardiotoxic chemotherapy.

  2. Belize it or not:implied contract terms in Marks and Spencer v BNP Paribas

    OpenAIRE

    McCunn, Joanna

    2016-01-01

    In Marks and Spencer v BNP Paribas, the Supreme Court restated the law on the implication of terms in fact, rejecting the previously authoritative approach taken by Lord Hoffmann in Attorney General of Belize v Belize Telecom Ltd. This article examines two major departures from Belize in Lord Neuberger’s leading judgment: the treatment of implication as a process separate from interpretation, and a return to the ‘traditional tests’ for the implication of terms. It argues that these are retrog...

  3. Diagnostic potential of serum N-terminal pro-B-type brain natriuretic peptide level in detection of cardiac wall stress in women with polycystic ovary syndrome: a cross-sectional comparison study.

    Science.gov (United States)

    Celik, Onder; Sahin, Ibrahim; Celik, Nilufer; Hascalik, Seyma; Keskin, Lezzan; Ozcan, Hamdi; Uckan, Ahmet; Kosar, Feridun

    2007-11-01

    In addition to the negative effect on fertility, polycystic ovary syndrome (PCOS) has been associated with cardiac pathology. Brain natriuretic peptide (BNP) is a possible marker for cardiac risk, therefore we investigated whether N-terminal pro-B-type BNP (NT-proBNP) increases in women with PCOS compared with healthy women of comparable age and body mass index. Thirty women with PCOS and 30 healthy women not suffering from overt cardiac disease were involved in the study. Fasting insulin and serum NT-proBNP levels were measured, and M-Mode echocardiography was performed. Insulin resistance was calculated using the homeostasis model assessment insulin resistance index (HOMA-IR). PCOS subjects had higher NT-proBNP levels than the control subjects (P PCOS subjects (but none of the controls), including valvular heart disease in nine, diastolic dysfunction in two, right ventricular enlargement in one, right atrial enlargement in one and pulmonary hypertension in one. PCOS subjects (n = 30) showed an increased left ventricular mass (LVM) (P PCOS subjects (n = 30). The present study demonstrated that the level of NT-proBNP was increased in PCOS subjects with asymptomatic heart disease.

  4. The ability of NT-proBNP to detect chronic heart failure and predict all-cause mortality is higher in elderly Chinese coronary artery disease patients with chronic kidney disease

    OpenAIRE

    Fu, Shihui; Yi,Shuangyan; Liu,Yuan; Zhu,Bing; Wang,Liang; Tiehui Xiao,; Bai,Yongyi; Ye,Ping; Luo,Leiming

    2013-01-01

    Shihui Fu, Leiming Luo, Ping Ye, Shuangyan Yi, Yuan Liu, Bing Zhu, Liang Wang, Tiehui Xiao, Yongyi Bai Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China Objective: To analyze the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) and renal function, and compare the ability and cut-off thresholds of NT-proBNP to detect chronic heart failure (CHF) and predict mortality in elderly Chinese coronary artery disease ...

  5. Dessincronia ventricular e aumento dos níveis de BNP na estimulação apical do ventrículo direito

    Directory of Open Access Journals (Sweden)

    Cláudia Drummond Guimarães Abreu

    2011-08-01

    Full Text Available FUNDAMENTO: A estimulação apical crônica do ventrículo direito pode ocasionar dessincronia ventricular e, secundariamente, alterações neuro-humorais e aumento da morbimortalidade cardíaca. OBJETIVO: Pesquisar dessincronia ventricular e seus efeitos sobre os níveis de BNP em pacientes com marca-passo estimulados cronicamente no ápice do ventrículo direito (VD. MÉTODOS: Estudo transversal com 85 pacientes com marca-passo uni ou bicameral, em classe funcional I e II da NYHA e fração de ejeção do ventrículo esquerdo (FEVE > 35%. A avaliação de dessincronia foi realizada utilizando-se várias técnicas ecocardiográficas, incluindo o Tissue Synchronization Imaging (TSI, com análise dos 12 segmentos. O BNP foi dosado junto com o ecocardiograma, porém com o examinador cego. RESULTADOS: Quarenta e seis mulheres e 39 homens, com idade de 58 ± 12 anos, chagásicos (56% e hipertensos controlados (62%, foram incluídos. A fração de ejeção do VE foi 52 ± 8% e a duração média do QRS de 139 ms (120-180 ms. O BNP mostrou-se alterado em 36,5% da amostra (ponto de corte de 60 pg/ml. Na análise multivariada de regressão linear, o BNP correlacionou-se com a idade (p = 0,024, FEVE (p < 0,0001 e tempo pré-ejetivo do VE (p = 0,009, que é índice de dessincronia intraventricular. CONCLUSÃO: Em pacientes com estimulação cardíaca convencional, estáveis clinicamente, a dessincronia intraventricular foi um preditor independente do aumento dos níveis de BNP, após ajuste pela idade e FEVE.

  6. NT-Pro-B-Type Natriuretic Peptide Levels in Infants with Failure to Thrive due to Caloric Deprivation

    Directory of Open Access Journals (Sweden)

    L. B. Mänhardt

    2010-01-01

    Methods. In a retrospective cohort study, we compared N-BNP levels from all consecutive infants with FTT and bodyweight below the tenth percentile (caloric deprivation (CD group to infants with severe HF. Reference values from infants between 2 and 12 month were taken from the literature and healthy infants. Results. Our results show that infants with FTT (n=15 had significantly (P<.001 elevated N-BNP values compared with the healthy infants (n=23, 530 (119–3150 pg/mL versus 115 (15–1121 pg/mL. N-BNP values in this CD group are comparable to the median value of infants with severe HF (n=12 673 (408–11310 pg/mL. There is no statistical significant difference in age. Conclusion. Nutritional state has an important impact on N-BNP levels in infants with FTT. We could show comparable levels of N-BNP in infants with FTT and infants with severe HF.

  7. Oxygen pathway modeling estimates high reactive oxygen species production above the highest permanent human habitation.

    Directory of Open Access Journals (Sweden)

    Isaac Cano

    Full Text Available The production of reactive oxygen species (ROS from the inner mitochondrial membrane is one of many fundamental processes governing the balance between health and disease. It is well known that ROS are necessary signaling molecules in gene expression, yet when expressed at high levels, ROS may cause oxidative stress and cell damage. Both hypoxia and hyperoxia may alter ROS production by changing mitochondrial Po2 (PmO2. Because PmO2 depends on the balance between O2 transport and utilization, we formulated an integrative mathematical model of O2 transport and utilization in skeletal muscle to predict conditions to cause abnormally high ROS generation. Simulations using data from healthy subjects during maximal exercise at sea level reveal little mitochondrial ROS production. However, altitude triggers high mitochondrial ROS production in muscle regions with high metabolic capacity but limited O2 delivery. This altitude roughly coincides with the highest location of permanent human habitation. Above 25,000 ft., more than 90% of exercising muscle is predicted to produce abnormally high levels of ROS, corresponding to the "death zone" in mountaineering.

  8. Which Environmental Factors Have the Highest Impact on the Performance of People Experiencing Difficulties in Capacity?

    Directory of Open Access Journals (Sweden)

    Verena Loidl

    2016-04-01

    Full Text Available Disability is understood by the World Health Organization (WHO as the outcome of the interaction between a health condition and personal and environmental factors. Comprehensive data about environmental factors is therefore essential to understand and influence disability. We aimed to identify which environmental factors have the highest impact on the performance of people with mild, moderate and severe difficulties in capacity, who are at risk of experiencing disability to different extents, using data from a pilot study of the WHO Model Disability Survey in Cambodia and random forest regression. Hindering or facilitating aspects of places to socialize in community activities, transportation and natural environment as well as use and need of personal assistance and use of medication on a regular basis were the most important environmental factors across groups. Hindering or facilitating aspects of the general environment were the most relevant in persons experiencing mild levels of difficulties in capacity, while social support, attitudes of others and use of medication on a regular basis were highly relevant for the performance of persons experiencing moderate to higher levels of difficulties in capacity. Additionally, we corroborate the high importance of the use and need of assistive devices for people with severe difficulties in capacity.

  9. Multimarker Strategy for Heart Failure Prognostication. Value of Neurohormonal Biomarkers: Neprilysin vs NT-proBNP.

    Science.gov (United States)

    Bayes-Genis, Antoni; Barallat, Jaume; Galán, Amparo; de Antonio, Marta; Domingo, Mar; Zamora, Elisabet; Gastelurrutia, Paloma; Vila, Joan; Peñafiel, Judith; Gálvez-Montón, Carolina; Lupón, Josep

    2015-12-01

    Neprilysin breaks down numerous vasoactive peptides. The soluble form of neprilysin, which was recently identified in heart failure, is associated with cardiovascular outcomes. Within a multibiomarker strategy, we directly compared soluble neprilysin and N-terminal pro-B-type natriuretic peptide as risk stratifiers in a real-life cohort of heart failure patients. Soluble neprilysin, N-terminal pro-B-type natriuretic peptide, ST2, and high-sensitivity troponin T levels were measured in 797 consecutive ambulatory heart failure patients followed up for 4.7 years. Comprehensive multivariable analyses and soluble neprilysin vs N-terminal pro-B-type natriuretic peptide head-to-head assessments of performance were performed. A primary composite endpoint included cardiovascular death or heart failure hospitalization. A secondary endpoint explored cardiovascular death alone. Median soluble neprilysin and N-terminal pro-B-type natriuretic peptide concentrations were 0.64ng/mL and 1187 ng/L, respectively. Both biomarkers significantly correlated with age (P<.001) and ST2 (P<.001), but only N-terminal pro-B-type natriuretic peptide significantly correlated with estimated glomerular filtration rate (P<.001), body mass index (P<.001), left ventricular ejection fraction (P=.02) and high-sensitivity troponin T (P<.001). In multivariable Cox regression analyses, soluble neprilysin remained independently associated with the composite endpoint (hazard ratio=1.14; 95% confidence interval, 1.02-1.27; P=.03) and cardiovascular death (hazard ratio=1.15; 95% confidence interval, 1.01-1.31; P=.04), but N-terminal pro-B-type natriuretic peptide did not. The head-to-head soluble neprilysin vs N-terminal pro-B-type natriuretic peptide comparison showed good calibration and similar discrimination and reclassification for both neurohormonal biomarkers, but only soluble neprilysin improved overall goodness-of-fit. When added to a multimarker strategy, soluble neprilysin remained an independent

  10. Effect of emergency PCI combined with rh-BNP therapy on neuroendocrine indicators and cardiac function in patients with acute anterior myocardial infarction

    Directory of Open Access Journals (Sweden)

    Yang Ji

    2016-06-01

    Full Text Available Objective: To analyze the effect of emergency PCI combined with rh-BNP therapy on neuroendocrine indicators and cardiac function in patients with acute anterior myocardial infarction. Methods: A total of 70 cases with acute anterior myocardial infarction who received emergency rescue in our hospital from February 2012 to September 2014 were included for study, and all included patients were divided into control group 38 cases who received emergency PCI treatment alone and observation group 32 cases who received emergency PCI combined with rh-BNP therapy. Differences in the values of neuroendocrine indicators, ventricular collagen remodeling-related indicators, cardiac function indicators, myocardial injury-related indicators and so on were compared between two groups after treatment. Results: Serum ET, PRA, ALD, AngII, NE and E values of observation group after treatment were significantly lower than those of control group (P<0.05; serum PⅠCP and PCⅢ values of observation group after treatment were lower than those of control group, and PⅠCP/ PCⅢ and TIMP-1 values were significantly higher than those of control group (P<0.05; examination of cardiac function by color Doppler ultrasound showed that LAD, LVEDD, LVESD, LVESV and LVEDV values of observation group were lower than those of control group, and LVEF and LVFS values were significantly higher than those of control group (P<0.05; serum CD14++CD2L+, hs-cTnT, HBDH and H-FABP values of observation group after treatment were significantly lower than those of control group, and CD14+CD2L- value was significantly higher than that of control group (P<0.05. Conclusions: Emergency PCI combined with rh-BNP therapy for patients with acute anterior myocardial infarction can significantly improve cardiac function and inhibit ventricular remodeling, and it has positive clinical significance.

  11. Relação entre depressão, nível de BNP e comprometimento ventricular na insuficiência cardíaca

    Directory of Open Access Journals (Sweden)

    Vera Barretto Aguiar

    2010-12-01

    Full Text Available FUNDAMENTO: A depressão é uma comorbidade frequente na insuficiência cardíaca (IC, mas os mecanismos relacionados a pior evolução de pacientes deprimidos com IC ainda não estão esclarecidos. OBJETIVO: Avaliar o papel da depressão grave na evolução dos pacientes com IC descompensada. MÉTODOS: Estudamos consecutivamente 43 pacientes com IC avançada e FE < 40,0%, hospitalizados para compensação cardíaca. Os pacientes, após história e exame físico, foram submetidos a exames laboratoriais, incluindo a dosagem de BNP. Após o diagnóstico de depressão, aplicou-se a escala de Hamilton-D. Depressão grave foi definida por escore igual ou maior que 18. As variáveis clínico-laboratoriais, segundo a presença ou não de depressão grave, foram analisadas pela regressão logística. A curva ROC definiu o ponto de corte para o BNP. RESULTADOS: Depressão grave ou muito grave foi identificada em 24 (55,8% pacientes. Os pacientes deprimidos graves não diferiram dos não deprimidos quanto à idade, sexo e função renal, mas apresentaram menor comprometimento cardíaco (FE 23,4 ± 7,2% vs 19,5 ± 5,2%; p = 0,046 e valores mais elevados do BNP (2.582,8 ± 1.596,6 pg/ml vs 1.206,6 ± 587,0 pg/ml; p < 0,001. Entretanto, os pacientes com BNP maior que 1.100 pg/ml tiveram 12,0 (odds ratio [IC 95%] = 2,61 - 55,26 vezes mais chance de desenvolverem quadros de depressão grave. CONCLUSÃO: Os pacientes com depressão grave apresentaram maior grau de estimulação neuro-hormonal, apesar do grau de disfunção ventricular ser menor. As alterações fisiopatológicas relacionadas à depressão, aumentando a estimulação neuro-hormonal e as citocinas, provavelmente contribuíram para essa maior manifestação clínica, mesmo em presença de menor dano cardíaco.

  12. The ADHF/NT-proBNP risk score to predict 1-year mortality in hospitalized patients with advanced decompensated heart failure.

    Science.gov (United States)

    Scrutinio, Domenico; Ammirati, Enrico; Guida, Pietro; Passantino, Andrea; Raimondo, Rosa; Guida, Valentina; Sarzi Braga, Simona; Canova, Paolo; Mastropasqua, Filippo; Frigerio, Maria; Lagioia, Rocco; Oliva, Fabrizio

    2014-04-01

    The acute decompensated heart failure/N-terminal pro-B-type natriuretic peptide (ADHF/NT-proBNP) score is a validated risk scoring system that predicts mortality in hospitalized heart failure patients with a wide range of left ventricular ejection fractions (LVEFs). We sought to assess discrimination and calibration of the score when applied to patients with advanced decompensated heart failure (AHF). We studied 445 patients hospitalized for AHF, defined by the presence of severe symptoms of worsening HF at admission, severely depressed LVEF, and the need for intravenous diuretic and/or inotropic drugs. The primary outcome was cumulative (in-hospital and post-discharge) mortality and post-discharge 1-year mortality. Separate analyses were performed for patients aged ≤ 70 years. A Seattle Heart Failure Score (SHFS) was calculated for each patient discharged alive. During follow-up, 144 patients (32.4%) died, and 69 (15.5%) underwent heart transplantation (HT) or ventricular assist device (VAD) implantation. After accounting for the competing events (VAD/HT), the ADHF/NT-proBNP score's C-statistic for cumulative mortality was 0.738 in the overall cohort and 0.771 in patients aged ≤ 70 years. The C-statistic for post-discharge mortality was 0.741 and 0.751, respectively. Adding prior (≤6 months) hospitalizations for HF to the score increased the C-statistic for post-discharge mortality to 0.759 in the overall cohort and to 0.774 in patients aged ≤ 70 years. Predicted and observed mortality rates by quartiles of score were highly correlated. The SHFS demonstrated adequate discrimination but underestimated the risk. The ADHF/NT-proBNP risk calculator is available at http://www.fsm.it/fsm/file/NTproBNPscore.zip. Our data suggest that the ADHF/NT-proBNP score may efficiently predict mortality in patients hospitalized with AHF. Copyright © 2014 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  13. Worsening Renal Function during Management for Chronic Heart Failure with Reduced Ejection Fraction: Results From the Pro-BNP Outpatient Tailored Chronic Heart Failure Therapy (PROTECT) Study.

    Science.gov (United States)

    Ibrahim, Nasrien E; Gaggin, Hanna K; Rabideau, Dustin J; Gandhi, Parul U; Mallick, Aditi; Januzzi, James L

    2017-02-01

    To assess prognostic meaning of worsening renal failure (WRF) occurring during management of chronic heart failure (HF) with reduced ejection fraction. When WRF develops during titration of HF medical therapy, it commonly leads to less aggressive care. A total of 151 patients enrolled in a prospective, randomized study of standard of care (SOC) HF therapy versus SOC plus a goal N-terminal pro-B type natriuretic peptide (NT-proBNP) renal function. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Cardiac Hypertrophy and Brain Natriuretic Peptide Levels in an Ovariectomized Rat Model Fed a High-Fat Diet

    Science.gov (United States)

    Goncalves, Gleisy Kelly; de Oliveira, Thiago Henrique Caldeira; de Oliveira Belo, Najara

    2017-01-01

    Background Heart failure in women increases around the time of menopause when high-fat diets may result in obesity. The heart produces brain natriuretic peptide (BNP), also known as B-type natriuretic peptide. This aims of this study were to assess cardiac hypertrophy and BNP levels in ovariectomized rats fed a high-fat diet. Material/Methods Forty-eight female Wistar rats were divided into four groups: sham-operated rats fed a control diet (SC) (n=12); ovariectomized rats fed a control diet (OC) (n=12); sham-operated rats fed a high-fat diet (SF) (n=12); and ovariectomized rats fed a high-fat diet (OF) (n=12). Body weight and blood pressure were measured weekly for 24 weeks. Rats were then euthanized, and plasma samples and heart tissue were studied for gene expression, hydroxyproline levels, and histological examination. Results A high-fat diet and ovariectomy (group OF) increased the weight body and the systolic blood pressure after three months and five months, respectively. Cardiomyocyte hypertrophy was associated with increased expression of ventricular BNP, decreased natriuretic peptide receptor (NPR)-A and increased levels of hydroxyproline and transforming growth factor (TGF)-β. The plasma levels of BNP and estradiol were inversely correlated; expression of estrogen receptor (ER)β and ERα were reduced. Conclusions The findings of this study showed that, in the ovariectomized rats fed a high-fat diet, the BNP-NPR-A receptor complex was involved in cardiac remodeling. BNP may be a marker of cardiac hypertrophy in this animal model. PMID:29249795

  15. Relation of N-terminal pro-brain natriuretic peptide levels and their prognostic power in chronic stable heart failure to obesity status.

    Science.gov (United States)

    Frankenstein, Lutz; Remppis, Andrew; Nelles, Manfred; Schaelling, Bernd; Schellberg, Dieter; Katus, Hugo; Zugck, Christian

    2008-11-01

    To investigate the relationship between body mass index (BMI) and N-terminal pro-brain natriuretic peptide (NTproBNP) level and resultant prognostic capacity in chronic heart failure (CHF) controlled for known confounders. We formed 206 triplets of patients (n = 618) with stable systolic CHF matched with respect to age, sex, renal function (MDRD, modification of diet in renal disease formula), and NYHA class, each with a BMI >30 kg/m(2) (group 3), 20-24.9 kg/m(2) (group 1), and 25-29.9 kg/m(2) (group 2). BMI conveys a 4% drop in NTproBNP per unit increase. This influence remained significant after correction for age, sex, MDRD, NYHA, heart rate, rhythm, and ejection fraction. NTproBNP remained an independent predictor of adverse outcome after correction for age, sex, BMI, NYHA, MDRD, and ejection fraction. Despite numerical differences, prognostic power was comparable between BMI groups (log-transformed NTproBNP; group 1: hazard ratio (HR) 1.435, 95% CI 1.046-1.967, chi(2) 5.02, P = 0.03; group 2: HR 1.604, 95% CI 1.203-2.138, chi(2) 10.36, P = 0.001; group 3: HR 1.735, 95% CI 1.302-2.313, chi(2) 14.12, P = 0.0002) (P = NS, all). An NTproBNP correction factor was calculated. Even matched for NYHA, age, sex, and renal function, BMI exerts a significant and independent inverse influence on NTproBNP in patients with stable CHF. NTproBNP retained equal statistical power in all three BMI groups.

  16. NT-proBNP

    DEFF Research Database (Denmark)

    Andersen, Charlotte; Mellemkjær, Søren; Hilberg, Ole

    2016-01-01

    BACKGROUND: Pulmonary hypertension (PH) is a serious complication to interstitial lung disease (ILD) and has a poor prognosis. PH is often diagnosed by screening with echocardiography followed by right heart catheterisation. A previous study has shown that a value of NT-pro-brain natriuretic...

  17. A new derivation of the highest-weight polynomial of a unitary lie algebra

    International Nuclear Information System (INIS)

    P Chau, Huu-Tai; P Van, Isacker

    2000-01-01

    A new method is presented to derive the expression of the highest-weight polynomial used to build the basis of an irreducible representation (IR) of the unitary algebra U(2J+1). After a brief reminder of Moshinsky's method to arrive at the set of equations defining the highest-weight polynomial of U(2J+1), an alternative derivation of the polynomial from these equations is presented. The method is less general than the one proposed by Moshinsky but has the advantage that the determinantal expression of the highest-weight polynomial is arrived at in a direct way using matrix inversions. (authors)

  18. The Highest Good and the Practical Regulative Knowledge in Kant’s Critique of Practical Reason

    OpenAIRE

    Joel Thiago Klein

    2016-01-01

    In this paper I defend three different points: first, that the concept of highest good is derived from an a priori but subjective argument, namely a maxim of pure practical reason; secondly, that the theory regarding the highest good has the validity of a practical regulative knowledge; and thirdly, that the practical regulative knowledge can be understood as the same “holding something to be true” as Kant attributes to hope and believe.

  19. Choice of marker for assessment of RV dysfunction in acute pulmonary embolism : NT-proBNP, pulmonary artery systolic pressure, mean arterial pressure, or blood pressure index.

    Science.gov (United States)

    Ates, H; Ates, I; Kundi, H; Yilmaz, F M

    2017-12-01

    We aimed to examine the value of NT-proBNP, pulmonary artery systolic pressure (PASP), blood pressure index (BPI), and mean arterial pressure (MAP) in the determination of right ventricular dysfunction (RVD) in patients with acute pulmonary embolism (APE). A total of 547 patients diagnosed with APE were included in the study. Demographic characteristics and comorbid conditions of patients were recorded in patient files. For blood pressure measurement, a calibrated digital blood pressure monitor was used at regular intervals. Blood samples were taken from patients at the time of admission for hemogram, biochemical, and hemostasis blood tests. Echocardiography was performed on all patients to detect RVD and evaluate pulmonary artery pressure. PASP (p blood pressure (p blood cell (p AUC ± SE = 0.975 ± 0.006; p < 0.001) was found to be the best predictor of RVD with a higher sensitivity (92.8%) and specificity (100%). We found that BPI had a better diagnostic discrimination for RVD compared with PASP and NT-proBNP.

  20. Hormone therapy with tamoxifen reduces plasma levels of NT-B-type natriuretic peptide but does not change ventricular ejection fraction after chemotherapy in women with breast cancer

    Directory of Open Access Journals (Sweden)

    F.B. Silva

    2015-02-01

    Full Text Available The objective of this study was to evaluate the effect of tamoxifen on the plasma concentration of NT-pro-B-type natriuretic peptide (NT-proBNP in women undergoing chemotherapy for breast cancer and to correlate changes in NT-proBNP with the left ventricular ejection fraction (LVEF. Over a period of 12 months, we followed 60 women with a diagnosis of breast cancer. The patients were separated into a group that received only chemotherapy (n=23, a group that received chemotherapy + tamoxifen (n=21, and a group that received only tamoxifen (n=16. Plasma levels of NT-proBNP were assessed at 0 (T0, 6 (T6, and 12 (T12 months of treatment, and echocardiography data were assessed at T0 and T12. Plasma NT-proBNP levels were increased in the chemotherapy-only group at T6 and T12, whereas elevated NT-proBNP levels were only found at T6 in the chemotherapy + tamoxifen group. At T12, the chemotherapy + tamoxifen group exhibited a significant reduction in the peptide to levels similar to the group that received tamoxifen alone. The chemotherapy-only group exhibited a significant decrease in LVEF at T12, whereas the chemotherapy + tamoxifen and tamoxifen-only groups maintained levels similar to those at the beginning of treatment. Treatment with tamoxifen for 6 months after chemotherapy significantly reduced the plasma levels of NT-proBNP and did not change LVEF in women with breast cancer.

  1. Prognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide Levels in Heart Failure Patients With and Without Atrial Fibrillation

    DEFF Research Database (Denmark)

    Kristensen, Søren Lund; Jhund, Pardeep S; Mogensen, Ulrik M

    2017-01-01

    BACKGROUND: Patients with heart failure (HF) and atrial fibrillation (AF) have higher circulating levels of NT-proBNP (N-terminal pro-B-type natriuretic peptide) than HF patients without AF. There is uncertainty about the prognostic importance of a given concentration of NT-proBNP in HF patients...... Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) or the ATMOSPHERE trial (Aliskiren Trial to Minimize Outcomes in Patients With Heart Failure), of whom 3575 (24%) had AF on their baseline ECG. Median (Q1, Q3) levels of NT-proBNP were 1817 pg/mL (1095......-3266 pg/mL) in those with AF and 1271 pg/mL (703-2569 pg/mL) in those without (PHeart Association class (III/IV; 36% versus 24%), and experienced fewer previous HF hospitalizations (52% versus 61%) or myocardial infarction (30...

  2. Dipole model analysis of highest precision HERA data, including very low Q"2's

    International Nuclear Information System (INIS)

    Luszczak, A.; Kowalski, H.

    2016-12-01

    We analyse, within a dipole model, the final, inclusive HERA DIS cross section data in the low χ region, using fully correlated errors. We show, that these highest precision data are very well described within the dipole model framework starting from Q"2 values of 3.5 GeV"2 to the highest values of Q"2=250 GeV"2. To analyze the saturation effects we evaluated the data including also the very low 0.35< Q"2 GeV"2 region. The fits including this region show a preference of the saturation ansatz.

  3. NT-pro brain natriuretic peptide levels and the risk of death in the cooperative study of sickle cell disease.

    Science.gov (United States)

    Machado, Roberto F; Hildesheim, Mariana; Mendelsohn, Laurel; Remaley, Alan T; Kato, Gregory J; Gladwin, Mark T

    2011-08-01

    Epidemiological studies support a hypothesis that pulmonary hypertension (PH) is a common complication of sickle cell disease (SCD) that is associated with a high risk of death and evolves as a complication of haemolytic anaemia. This fundamental hypothesis has been recently challenged and remains controversial. In order to further test this hypothesis in a large and independent cohort of SCD patients we obtained plasma samples from the Cooperative Study of Sickle Cell Disease (CSSCD) for analysis of a biomarker, N-terminal-pro brain natriuretic peptide (NT-proBNP), which is elevated in the setting of pulmonary arterial and venous hypertension. A NT-pro-BNP value previously identified to predict PH in adults with SCD was used to determine the association between the risk of mortality in 758 CSSCD participants (428 children and 330 adults). An abnormally high NT-proBNP level ≥160ng/l was present in 27·6% of adult SCD patients. High levels were associated with markers of haemolytic anaemia, such as low haemoglobin level (P<0·001), high lactate dehydrogenase (P<0·001), and high total bilirubin levels (P<0·007). A NT-proBNP level ≥160ng/l was an independent predictor of mortality (RR 6·24, 95% CI 2·9-13·3, P<0·0001). These findings provide further support for an association between haemolytic anaemia and cardiovascular complications in this patient population. © 2011 Blackwell Publishing Ltd.

  4. Contribution of serum FGF21 level to the identification of left ventricular systolic dysfunction and cardiac death.

    Science.gov (United States)

    Shen, Yun; Zhang, Xueli; Pan, Xiaoping; Xu, Yiting; Xiong, Qin; Lu, Zhigang; Ma, Xiaojing; Bao, Yuqian; Jia, Weiping

    2017-08-18

    The relationship between fibroblast growth factor 21 (FGF21) and cardiovascular disease has been well established in recent studies. This study aimed to investigate the relationship between FGF21 and left ventricular systolic dysfunction and cardiac death. Two-dimensional echocardiography was used to measure the left ventricular ejection fraction (LVEF) to estimate left ventricular systolic function. The optimal cutoff of FGF21 for identifying left ventricular systolic dysfunction at baseline was analyzed via receiver operating characteristic (ROC) curves. The identification of different serum levels of FGF21 and their association with cardiac death was analyzed via Kaplan-Meier survival curves. Serum FGF21 level was measured by an enzyme-linked immunosorbent assay kit, and serum N-terminal pro-brain natriuretic peptide (NT-pro-BNP) level was determined by a chemiluminescent immunoassay. A total of 253 patients were recruited for this study at baseline. Patients were excluded if they lacked echocardiography or laboratory measurement data, and there were 218 patients enrolled in the final analysis. The average age was 66.32 ± 10.10 years. The optimal cutoff values of FGF21 and NT-pro-BNP for identifying left ventricular systolic dysfunction at baseline were 321.5 pg/mL and 131.3 ng/L, respectively, determined separately via ROC analysis. The areas under the curves were non-significant among FGF21, NT-pro-BNP and FGF21 + NT-pro-BNP as determined by pairwise comparisons. Both a higher serum level of FGF21 and a higher serum level of NT-pro-BNP were independent risk factors for left ventricular systolic dysfunction at baseline (odd ratio (OR) 3.138 [1.037-9.500], P = 0.043, OR 9.207 [2.036-41.643], P = 0.004, separately). Further Kaplan-Meier survival analysis indicated an association between both a higher serum level of FGF21 and a higher serum level of NT-pro-BNP with cardiac death in 5 years [RR 5.000 (1.326-18.861), P = 0.026; RR 9.643 (2

  5. Correlation of the highest-energy cosmic rays with the positions of nearby active galactic nuclei

    NARCIS (Netherlands)

    Abraham, J.; Abreu, P.; Aglietta, M.; Aguirre, C.; Allard, D.; Allekotte, I.; Allen, J.; Allison, P.; Alvarez-Muniz, J.; Ambrosio, M.; Anchordoqui, L.; Andringa, S.; Anzalone, A.; Aramo, C.; Argiro, S.; Arisaka, K.; Armengaud, E.; Arneodo, F.; Arqueros, F.; Asch, T.; Asorey, H.; Assis, P.; Atulugama, B. S.; Aublin, J.; Ave, M.; Avila, G.; Baecker, T.; Badagnani, D.; Barbosa, A. F.; Barnhill, D.; Barroso, S. L. C.; Bauleo, P.; Beatty, J. J.; Beau, T.; Becker, B. R.; Becker, K. H.; Bellido, J. A.; BenZvi, S.; Berat, C.; Bergmann, T.; Bernardini, P.; Bertou, X.; Biermann, P. L.; Billoir, P.; Blanch-Bigas, O.; Blanco, F.; Blasi, P.; Bleve, C.; Bluemer, H.; Bohacova, M.; Bonifazi, C.; Bonino, R.; Brack, J.; Brogueira, P.; Brown, W. C.; Buchholz, P.; Bueno, A.; Burton, R. E.; Busca, N. G.; Caballero-Mora, K. S.; Cai, B.; Camin, D. V.; Caramete, L.; Caruso, R.; Carvalho, W.; Castellina, A.; Catalano, O.; Cataldi, G.; Cazon, L.; Cester, R.; Chauvin, J.; Chiavassa, A.; Chinellato, J. A.; Chou, A.; Chye, J.; Clay, R. W.; Colombo, E.; Conceicao, R.; Connolly, B.; Contreras, F.; Coppens, J.; Cordier, A.; Cotti, U.; Coutu, S.; Covault, C. E.; Creusot, A.; Criss, A.; Cronin, J.; Curutiu, A.; Dagoret-Campagne, S.; Daumiller, K.; Dawson, B. R.; de Almeida, R. M.; De Donato, C.; Bg, S. J. de Jong; De La Vega, G.; de Mello, W. J. M.; de Mello Neto, J. R. T.; De Mitri, I.; de Souza, V.; del Peral, L.; Deligny, O.; Della Selva, A.; Delle Fratte, C.; Dembinski, H.; Di Giulio, C.; Diaz, J. C.; Diep, P. N.; Dobrigkeit, C.; D'Olivo, J. C.; Dong, P. N.; Dornic, D.; Dorofeev, A.; dos Anjos, J. C.; Dova, M. T.; D'Urso, D.; Dutan, I.; DuVernois, M. A.; Engel, R.; Epele, L.; Escobar, C. O.; Etchegoyen, A.; Luis, P. Facal San; Falcke, H.; Farrar, G.; Fauth, A. C.; Fazzini, N.; Ferrer, F.; Ferry, S.; Fick, B.; Filevich, A.; Filipcic, A.; Fleck, I.; Fracchiolla, C. E.; Fulgione, W.; Garcia, B.; Gaimez, D. Garcia; Garcia-Pinto, D.; Garrido, X.; Geenen, H.; Gelmini, G.; Gemmeke, H.; Ghia, P. L.; Giller, M.; Glass, H.; Gold, M. S.; Golup, G.; Albarracin, F. Gomez; Berisso, M. Gomez; Herrero, R. Gomez; Goncalves, P.; do Amaral, M. Goncalves; Gonzalez, D.; Gonzalezc, J. G.; Gonzalez, M.; Gora, D.; Gorgi, A.; Gouffon, P.; Grassi, V.; Grillo, A. F.; Grunfeld, C.; Guardincerri, Y.; Guarino, F.; Guedes, G. P.; Gutierrez, J.; Hague, J. D.; Hamilton, J. C.; Hansen, P.; Harari, D.; Harmsma, S.; Harton, J. L.; Haungs, A.; Hauschildt, T.; Healy, M. D.; Hebbeker, T.; Hebrero, G.; Heck, D.; Hojvat, C.; Holmes, V. C.; Homola, P.; Hoerandel, J.; Horneffer, A.; Horvat, M.; Hrabovsky, M.; Huege, T.; Hussain, M.; Larlori, M.; Insolia, A.; Ionita, F.; Italiano, A.; Kaducak, M.; Kampert, K. H.; Karova, T.; Kegl, B.; Keilhauer, B.; Kemp, E.; Kieckhafer, R. M.; Klages, H. O.; Kleifges, M.; Kleinfeller, J.; Knapik, R.; Knapp, J.; Koanga, V. -H.; Krieger, A.; Kroemer, O.; Kuempel, D.; Kunka, N.; Kusenko, A.; La Rosa, G.; Lachaud, C.; Lago, B. L.; Lebrun, D.; LeBrun, P.; Lee, J.; de Oliveira, M. A. Leigui; Lopez, R.; Letessier-Selvon, A.; Leuthold, M.; Lhenry-Yvon, I.; Aguera, A. Lopez; Bahilo, J. Lozano; Garcia, R. Luna; Maccarone, M. C.; Macolino, C.; Maldera, S.; Mancarella, G.; Mancenido, M. E.; Mandatat, D.; Mantsch, P.; Mariazzi, A. G.; Maris, I. C.; Falcon, H. R. Marquez; Martello, D.; Martinez, J.; Bravo, O. Martinez; Mathes, H. J.; Matthews, J.; Matthews, J. A. J.; Matthiae, G.; Maurizio, D.; Mazur, P. O.; McCauley, T.; McEwen, M.; McNeil, R. R.; Medina, M. C.; Medina-Tanco, G.; Meli, A.; Melo, D.; Menichetti, E.; Menschikov, A.; Meurer, Chr.; Meyhandan, R.; Micheletti, M. I.; Miele, G.; Miller, W.; Mollerach, S.; Monasor, M.; Ragaigne, D. Monnier; Montanet, F.; Morales, B.; Morello, C.; Moreno, J. C.; Morris, C.; Mostafa, M.; Muller, M. A.; Mussa, R.; Navarra, G.; Navarro, J. L.; Navas, S.; Necesal, P.; Nellen, L.; Newman-Holmes, C.; Newton, D.; Nhung, P. T.; Nierstenhoefer, N.; Nitz, D.; Nosek, D.; Nozka, L.; Oehlschlaeger, J.; Ohnuki, T.; Olinto, A.; Olmos-Gilbaja, V. M.; Ortiz, M.; Ortolani, F.; Ostapchenko, S.; Otero, L.; Pacheco, N.; Selmi-Dei, D. Pakk; Palatka, M.; Pallotta, J.; Parente, G.; Parizot, E.; Parlati, S.; Pastor, S.; Patel, M.; Paul, T.; Pavlidou, V.; Payet, K.; Pech, M.; Pekala, J.; Pelayo, R.; Pepe, I. M.; Perrone, L.; Petrera, S.; Petrinca, P.; Petrov, Y.; Pichel, A.; Piegaia, R.; Pierog, T.; Pimenta, M.; Pinto, T.; Pirronello, V.; Pisanti, O.; Platino, M.; Pochon, J.; Privitera, P.; Prouza, M.; Quel, E. J.; Rautenberg, J.; Redondo, A.; Reucroft, S.; Revenu, B.; Rezende, F. A. S.; Ridky, J.; Riggi, S.; Risse, M.; Riviere, C.; Rizi, V.; Roberts, M.; Robledo, C.; Rodriguez, G.; Martino, J. Rodriguez; Rojo, J. Rodriguez; Rodriguez-Cabo, I.; Rodriguez-Frias, M. D.; Ros, G.; Rosado, J.; Roth, M.; Rouille-d'Orfeuil, B.; Roulet, E.; Roverok, A. C.; Salamida, F.; Salazar, H.; Salina, G.; Sanchez, F.; Santander, M.; Santo, C. E.; Santos, E. M.; Sarazin, F.; Sarkar, S.; Sato, R.; Scherini, V.; Schieler, H.; Schmidt, A.; Schmidt, F.; Schmidt, T.; Scholten, O.; Schovanek, P.; Schuessler, F.; Sciutto, S. J.; Scuderi, M.; Segreto, A.; Semikoz, D.; Settimo, M.; Shellard, R. C.; Sidelnik, I.; Siffert, B. B.; Sigl, G.; De Grande, N. Smetniansky; Smialkowski, A.; Smida, R.; Smith, A. G. K.; Smith, B. E.; Snow, G. R.; Sokolsky, P.; Sommers, P.; Sorokin, J.; Spinka, H.; Squartini, R.; Strazzeri, E.; Stutz, A.; Suarez, F.; Suomijarvi, T.; Supanitsky, A. D.; Sutherland, M. S.; Swain, J.; Szadkowski, Z.; Takahashi, J.; Tamashiro, A.; Tamburro, A.; Tascau, O.; Tcaciuc, R.; Thao, N. T.; Thomas, D.; Ticona, R.; Tiffenberg, J.; Timmermans, C.; Tkaczyk, W.; Peixoto, C. J. Todero; Tome, B.; Tonachini, A.; Torres, I.; Travnicek, P.; Tripathi, A.; Tristram, G.; Tscherniakhovski, D.; Tueros, M.; Ulrich, R.; Unger, M.; Urban, M.; Galicia, J. F. Valdes; Valino, I.; Valore, L.; van den Berg, A. M.; van Elewyck, V.; Vazquez, R. A.; Veberic, D.; Veiga, A.; Velarde, A.; Venters, T.; Verzi, V.; Videla, M.; Villasenor, L.; Vorobiov, S.; Voyvodic, L.; Wahlberg, H.; Wainberg, O.; Warner, D.; Watson, A. A.; Westerhoff, S.; Wieczorek, G.; Wiencke, L.; Wilczynska, B.; Wilczynski, H.; Wileman, C.; Winnick, M. G.; Wu, H.; Wundheiler, B.; Yamamoto, T.; Younk, P.; Zas, E.; Zavrtanik, D.; Zavrtanik, M.; Zech, A.; Zepeda, A.; Ziolkowski, M.

    Data collected by the Pierre Auger Observatory provide evidence for anisotropy in the arrival directions of the cosmic rays with the highest-energies, which are correlated with the positions of relatively nearby active galactic nuclei (AGN) [Pierre Auger Collaboration, Science 318 (2007) 938]. The

  6. Alpha-1-antitrypsin deficiency in Madeira (Portugal): the highest prevalence in the world.

    Science.gov (United States)

    Spínola, Carla; Bruges-Armas, Jácome; Pereira, Conceição; Brehm, António; Spínola, Hélder

    2009-10-01

    Alpha-1-antitrypsin (AAT) deficiency is a common genetic disease which affects both lung and liver. Early diagnosis can help asymptomatic patients to adjust their lifestyle choices in order to reduce the risk of Chronic Obstructive Pulmonary Disease (COPD). The determination of this genetic deficiency prevalence in Madeira Island (Portugal) population is important to clarify susceptibility and define the relevance of performing genetic tests for AAT on individuals at risk for COPD. Two hundred samples of unrelated individuals from Madeira Island were genotyped for the two most common AAT deficiency alleles, PI*S and PI*Z, using Polymerase Chain Reaction-Mediated Site-Directed Mutagenesis. Our results show one of the highest frequencies for both mutations when compared to any already studied population in the world. In fact, PI*S mutation has the highest prevalence (18%), and PI*Z mutation (2.5%) was the third highest worldwide. The frequency of AAT deficiency genotypes in Madeira (PI*ZZ, PI*SS, and PI*SZ) is estimated to be the highest in the world: 41 per 1000. This high prevalence of AAT deficiency on Madeira Island reveals an increased genetic susceptibility to COPD and suggests a routine genetic testing for individuals at risk.

  7. Role of B-Type Natriuretic Peptide and N-Terminal Prohormone BNP as Predictors of Cardiovascular Morbidity and Mortality in Patients With a Recent Coronary Event and Type 2 Diabetes Mellitus

    DEFF Research Database (Denmark)

    Wolsk, Emil; Claggett, Brian; Pfeffer, Marc A

    2017-01-01

    -terminal prohormone B-type natriuretic peptide (NT-proBNP) could enhance risk prediction of a broad range of cardiovascular outcomes in patients with acute coronary syndrome and type 2 diabetes mellitus. METHODS AND RESULTS: Patients with a recent acute coronary syndrome and type 2 diabetes mellitus were...... being in death (0.77-0.82, Pdiabetes...

  8. Sandwich-Type Electrochemiluminescence Sensor for Detection of NT-proBNP by Using High Efficiency Quench Strategy of Fe3O4@PDA toward Ru(bpy)32+ Coordinated with Silver Oxalate.

    Science.gov (United States)

    Shi, Li; Li, Xiaojian; Zhu, Wenjuan; Wang, Yaoguang; Du, Bin; Cao, Wei; Wei, Qin; Pang, Xuehui

    2017-12-22

    Heart failure (HF) is a burgeoning public health problem trigged by a heart circulation disorder. N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been acknowledged as a prognostic biomarker for cardiac disease. Herein, a sandwich-type electrochemiluminescence (ECL) immunosensor was introduced for sensitive detection of NT-proBNP. Gold nanoparticle modified graphene oxide-Ru(bpy) 3 2+ /Ag 2 C 2 O 4 was used as a luminophore and a desirable platform for immobilization of the captured antibodies. The more stable immobilization of plentiful Ru(bpy) 3 2+ could be implemented by direct covalent bonding chelation with Ag 2 C 2 O 4 . More importantly, significant quenching can be achieved by introducing polydopamine (PDA) coated Fe 3 O 4 onto the electrode via sandwich immunoreactions. The quenching mechanism mainly showed that the excited states of Ru(bpy) 3 2+ could be annihilated by quinone units in PDA via energy transfer. The ECL quenching efficiency was logarithmically related to the concentration of the NT-proBNP in the range from 0.0005 ng/mL to 100.0 ng/mL with a detection limit of 0.28 pg/mL. Furthermore, this specific immunosensor presented good stability and repeatability as well as selectivity, which offers a guiding significance in both fundamental and clinical diagnosis of NT-proBNP.

  9. Low grade inflammation as measured by levels of YKL-40

    DEFF Research Database (Denmark)

    Rathcke, Camilla Noelle; Raymond, Ilan; Kistorp, Caroline

    2010-01-01

    , increasing YKL-40 levels independently predicted overall and CV mortality rate with hazard ratios of 1.58 (95% confidence interval (CI), 1.12-2.23, p=0.009) and 1.57 (95% CI, 1.00-2.46, p=0.049) after adjustment for age, sex, smoking, total cholesterol, hsCRP, NT-proBNP and UACR. In combined Kaplan...

  10. Highest cited papers published in Neurology India: An analysis for the years 1993-2014.

    Science.gov (United States)

    Pandey, Paritosh; Subeikshanan, V; Madhugiri, Venkatesh S

    2016-01-01

    The highest cited papers published in a journal provide a snapshot of the clinical practice and research in that specialty and/or region. The aim of this study was to determine the highest cited papers published in Neurology India and analyze their attributes. This study was a citation analysis of all papers published in Neurology India since online archiving commenced in 1993. All papers published in Neurology India between the years 1993-2014 were listed. The number of times each paper had been cited up till the time of performing this study was determined by performing a Google Scholar search. Published papers were then ranked on the basis of total times cited since publication and the annual citation rate. Statistical Techniques: Simple counts and percentages were used to report most results. The mean citations received by papers in various categories were compared using the Student's t-test or a one-way analysis of variance, as appropriate. All analyses were carried out on SAS University Edition (SAS/STAT®, SAS Institute Inc, NC, USA) and graphs were generated on MS Excel 2016. The top papers on the total citations and annual citation rate rank lists pertained to basic neuroscience research. The highest cited paper overall had received 139 citations. About a quarter of the papers published had never been cited at all. The major themes represented were vascular diseases and infections. The highest cited papers reflect the diseases that are of major concern in India. Certain domains such as trauma, allied neurosciences, and basic neuroscience research were underrepresented.

  11. ATLAS event at 13 TeV - Highest mass dijets resonance event in 2015 data

    CERN Multimedia

    ATLAS Collaboration

    2015-01-01

    The highest-mass, central dijet event passing the dijet resonance selection collected in 2015 (Event 1273922482, Run 280673) : the two central high-pT jets have an invariant mass of 6.9 TeV, the two leading jets have a pT of 3.2 TeV. The missing transverse momentum in this event is 46 GeV.

  12. ATLAS event at 13 TeV - Highest mass dijets angular event in 2015 data

    CERN Multimedia

    ATLAS Collaboration

    2015-01-01

    The highest-mass dijet event passing the angular selection collected in 2015 (Event 478442529, Run 280464): the two central high-pT jets have an invariant mass of 7.9 TeV, the three leading jets have a pT of 1.99, 1.86 and 0.74 TeV respectively. The missing transverse momentum in this event is 46 GeV

  13. Eyebrow hairs from actinic keratosis patients harbor the highest number of cutaneous human papillomaviruses.

    Science.gov (United States)

    Schneider, Ines; Lehmann, Mandy D; Kogosov, Vlada; Stockfleth, Eggert; Nindl, Ingo

    2013-04-24

    Cutaneous human papillomavirus (HPV) infections seem to be associated with the onset of actinic keratosis (AK). This study compares the presence of cutaneous HPV types in eyebrow hairs to those in tissues of normal skin and skin lesions of 75 immunocompetent AK patients. Biopsies from AK lesions, normal skin and plucked eyebrow hairs were collected from each patient. DNA from these specimens was tested for the presence of 28 cutaneous HPV (betaPV and gammaPV) by a PCR based method. The highest number of HPV prevalence was detected in 84% of the eyebrow hairs (63/75, median 6 types) compared to 47% of AK lesions (35/75, median 3 types) (pAK and 69 in normal skin. In all three specimens HPV20, HPV23 and/or HPV37 were the most prevalent types. The highest number of multiple types of HPV positive specimens was found in 76% of the eyebrow hairs compared to 60% in AK and 57% in normal skin. The concordance of at least one HPV type in virus positive specimens was 81% (three specimens) and 88-93% of all three combinations with two specimens. Thus, eyebrow hairs revealed the highest number of cutaneous HPV infections, are easy to collect and are an appropriate screening tool in order to identify a possible association of HPV and AK.

  14. Elevated NT-pro-brain natriuretic peptide level is independently associated with all-cause mortality in HIV-infected women in the early and recent HAART eras in the Women's Interagency HIV Study cohort.

    Directory of Open Access Journals (Sweden)

    Matthew R Gingo

    Full Text Available HIV-infected individuals are at increased risk of right and left heart dysfunction. N-terminal-pro-brain natriuretic peptide (NT-proBNP, a marker of cardiac ventricular strain and systolic dysfunction, may be associated with all-cause mortality in HIV-infected women. The aim of this study was to determine if elevated levels of NT-proBNP is associated with increased mortality in HIV-infected women.Prospective cohort study.We measured NT-proBNP in 936 HIV-infected and 387 age-matched HIV-uninfected women early (10/11/94 to 7/17/97 and 1082 HIV-infected and 448 HIV-uninfected women late (4/1/08 to 10/7/08 in the highly active antiretroviral therapy (HAART periods in the Women's Interagency HIV Study. An NT-proBNP >75th percentile was more likely in HIV-infected persons, but only statistically significant in the late period (27% vs. 21%, unadjusted p = 0.03. In HIV-infected participants, NT-proBNP>75th percentile was independently associated with worse 5-year survival in the early HAART period (HR 1.8, 95% CI 1.3-2.4, p<0.001 and remained a predictor of mortality in the late HAART period (HR 2.8, 95% CI 1.4-5.5, p = 0.002 independent of other established risk covariates (age, race/ethnicity, body mass index, smoking, hepatitis C serostatus, hypertension, renal function, and hemoglobin. NT-proBNP level was not associated with mortality in HIV-uninfected women.NT-proBNP is a novel independent marker of mortality in HIV-infected women both when HAART was first introduced and currently. As NT-proBNP is often associated with both pulmonary hypertension and left ventricular dysfunction, these findings suggest that these conditions may contribute significantly to adverse outcomes in this population, requiring further definition of causes and treatments of elevated NT-proBNP in HIV-infected women.

  15. Eyebrow hairs from actinic keratosis patients harbor the highest number of cutaneous human papillomaviruses

    Science.gov (United States)

    2013-01-01

    Background Cutaneous human papillomavirus (HPV) infections seem to be associated with the onset of actinic keratosis (AK). This study compares the presence of cutaneous HPV types in eyebrow hairs to those in tissues of normal skin and skin lesions of 75 immunocompetent AK patients. Methods Biopsies from AK lesions, normal skin and plucked eyebrow hairs were collected from each patient. DNA from these specimens was tested for the presence of 28 cutaneous HPV (betaPV and gammaPV) by a PCR based method. Results The highest number of HPV prevalence was detected in 84% of the eyebrow hairs (63/75, median 6 types) compared to 47% of AK lesions (35/75, median 3 types) (p< 0.001) and 37% of normal skin (28/75, median 4 types) (p< 0.001), respectively. A total of 228 HPV infections were found in eyebrow hairs compared to only 92 HPV infections in AK and 69 in normal skin. In all three specimens HPV20, HPV23 and/or HPV37 were the most prevalent types. The highest number of multiple types of HPV positive specimens was found in 76% of the eyebrow hairs compared to 60% in AK and 57% in normal skin. The concordance of at least one HPV type in virus positive specimens was 81% (three specimens) and 88-93% of all three combinations with two specimens. Conclusions Thus, eyebrow hairs revealed the highest number of cutaneous HPV infections, are easy to collect and are an appropriate screening tool in order to identify a possible association of HPV and AK. PMID:23618013

  16. Brain Natriuretic Peptide, Atrial Natriuretic Peptide and Endothelin-1 response to peak exercise in patients with coronary artery disease and correlation with myocardial perfusion scintigraphy abnormalities

    International Nuclear Information System (INIS)

    Erbas, B.; Ergun, E.; Koray, Z.; Kabakci, G.; Yildirir, A.; Kes, S.

    2002-01-01

    Aim: Plasma Brain Natriuretic Peptide (BNP) has been known as a promising marker of ventricular dysfunction in cardiac patients. There are conflicting reports about its response to exercise testing. Therefore, this study was performed to investigate the exercise induced changes in BNP, Atrial Natriuretic Peptide (ANP) and Endothelin-1 (E) levels and their correlation with perfusion abnormalities on myocardial perfusion scintigraphy (MPS). Materials and Methods: Study group consisted of 35 patients (mean age=53.9+11.8) who underwent MPS with suspicion or diagnosis of coronary artery disease. Plasma levels of BNP, ANP, and E were measured at rest and after symptom-limited ergometry. Patients were divided into two groups according to the presence of perfusion abnormality (i.e. ischemia or infarction) on MPS. Results: BNP, ANP and E levels did not change significantly with exercise, however baseline levels of BNP, ANP levels and peak-exercise level of BNP in patients with perfusion abnormalities were significantly higher. Hypertensive patients with or without perfusion abnormalities had higher baseline BNP, ANP levels, and peak-exercise BNP levels compared to normotensives. BNP levels at rest and after exercise had a significant correlation with age (r=0.57, p=0.04; r=0.58, p=0.04), as well as baseline ANP values (r=0.37, p=0.033). Highest baseline BNP, ANP and exercise BNP levels were observed in patients with infarction. Conclusion: Exercise-testing did not induce significant changes in plasma levels of BNP, ANP and E. Higher BNP levels had correlation with the presence of ischemia, infarction and hypertension, as well as, increasing age

  17. 17-Year-Old Boy with Renal Failure and the Highest Reported Creatinine in Pediatric Literature

    Directory of Open Access Journals (Sweden)

    Vimal Master Sankar Raj

    2015-01-01

    Full Text Available The prevalence of chronic kidney disease (CKD is on the rise and constitutes a major health burden across the world. Clinical presentations in early CKD are usually subtle. Awareness of the risk factors for CKD is important for early diagnosis and treatment to slow the progression of disease. We present a case report of a 17-year-old African American male who presented in a life threatening hypertensive emergency with renal failure and the highest reported serum creatinine in a pediatric patient. A brief discussion on CKD criteria, complications, and potential red flags for screening strategies is provided.

  18. Observations of the highest energy gamma-rays from gamma-ray bursts

    International Nuclear Information System (INIS)

    Dingus, Brenda L.

    2001-01-01

    EGRET has extended the highest energy observations of gamma-ray bursts to GeV gamma rays. Such high energies imply the fireball that is radiating the gamma-rays has a bulk Lorentz factor of several hundred. However, EGRET only detected a few gamma-ray bursts. GLAST will likely detect several hundred bursts and may extend the maximum energy to a few 100 GeV. Meanwhile new ground based detectors with sensitivity to gamma-ray bursts are beginning operation, and one recently reported evidence for TeV emission from a burst

  19. Addressing the Highest Risk: Environmental Programs at Los Alamos National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Forbes, Elaine E [Los Alamos National Laboratory

    2012-06-08

    Report topics: Current status of cleanup; Shift in priorities to address highest risk; Removal of above-ground waste; and Continued focus on protecting water resources. Partnership between the National Nuclear Security Administration's Los Alamos Site Office, DOE Carlsbad Field Office, New Mexico Environment Department, and contractor staff has enabled unprecedented cleanup progress. Progress on TRU campaign is well ahead of plan. To date, have completed 130 shipments vs. 104 planned; shipped 483 cubic meters of above-ground waste (vs. 277 planned); and removed 11,249 PE Ci of material at risk (vs. 9,411 planned).

  20. Effects of Oral Contraceptives on Natriuretic Peptide Levels in Women with Hypothalamic Amenorrhea: A Pilot Study

    OpenAIRE

    Lin, Eleanor; Grinspoon, Steven; Wang, Thomas; Miller, Karen K.

    2011-01-01

    Natriuretic peptides, which are important regulators of salt handling and blood pressure, are 60 – 75% higher in healthy young women than in men, consistent with a gender dimorphism. In this randomized, placebo-controlled study in women with functional hypothalamic amenorrhea, we show that administration of oral contraceptives increases natriuretic peptide levels and that end-of-study free testosterone levels are inversely associated with NT-proBNP levels, consistent with the hypothesis that ...

  1. Automatic orbital GTAW welding: Highest quality welds for tomorrow's high-performance systems

    Science.gov (United States)

    Henon, B. K.

    1985-01-01

    Automatic orbital gas tungsten arc welding (GTAW) or TIG welding is certain to play an increasingly prominent role in tomorrow's technology. The welds are of the highest quality and the repeatability of automatic weldings is vastly superior to that of manual welding. Since less heat is applied to the weld during automatic welding than manual welding, there is less change in the metallurgical properties of the parent material. The possibility of accurate control and the cleanliness of the automatic GTAW welding process make it highly suitable to the welding of the more exotic and expensive materials which are now widely used in the aerospace and hydrospace industries. Titanium, stainless steel, Inconel, and Incoloy, as well as, aluminum can all be welded to the highest quality specifications automatically. Automatic orbital GTAW equipment is available for the fusion butt welding of tube-to-tube, as well as, tube to autobuttweld fittings. The same equipment can also be used for the fusion butt welding of up to 6 inch pipe with a wall thickness of up to 0.154 inches.

  2. Optimasi Penggunaan Lahan Kosong di Kecamatan Baturiti Untuk Properti Komersial Dengan Prinsip Highest and Best Use

    Directory of Open Access Journals (Sweden)

    Made Darmawan Saputra Mahardika

    2013-09-01

    Full Text Available Kecamatan Baturiti merupakan satu-satunya kecamatan di Kabupaten Tabanan yang berkembang dalam sektor ekonomi agrowisata karena lokasinya yang strategis dekat dengan berbagai obyek wisata terkenal. Dengan lokasi yang strategis, pembangunan untuk properti komersial tentu akan memberikan potensi keuntungan tinggi bagi investor yang memiliki lahan kosong di Kecamatan Baturiti. Kondisi seperti ini menyebabkan permintaan yang tinggi akan lahan, padahal ketersediaan lahan selalu berkurang. Pembangunan properti komersial di Kecamatan Baturiti perlu dioptimalisasi agar dicapai keuntungan maksimum bagi investor. Berdasarkan hal tersebut, investor yang ingin membangun di Kecamatan Baturiti memerlukan analisa untuk mendapatkan alternatif pemanfaatan lahan kosong. Lahan yang dianalisa merupakan lahan kosong belum terbangun seluas 22.175 m2 di Kecamatan Baturiti, Kabupaten Tabanan. Metode yang digunakan untuk mengetahui alternatif pendirian bangunan komersial yang memiliki nilai pasar tertinggi adalah Highest and Best Use (HBU. Dengan metode tersebut, pemilik lahan dapat mengetahui alternatif terbaik yang memenuhi syarat-syarat diijinkan secara legal, memungkinkan secara fisik, layak secara finansial, dan memiliki produktivitas maksimum. Hasil yang diperoleh dari analisa Highest and Best Use ini adalah alternatif mixed-use berupa hotel dan toko souvenir dengan nilai lahan tertinggi dibandingkan alternatif lainnya sebesar Rp 7,950,714.60 per m2.

  3. A novel method to predict the highest hardness of plasma sprayed coating without micro-defects

    Science.gov (United States)

    Zhuo, Yukun; Ye, Fuxing; Wang, Feng

    2018-04-01

    The plasma sprayed coatings are stacked by splats, which are regarded generally as the elementary units of coating. Many researchers have focused on the morphology and formation mechanism of splat. However, a novel method to predict the highest hardness of plasma sprayed coating without micro-defects is proposed according to the nanohardness of splat in this paper. The effectiveness of this novel method was examined by experiments. Firstly, the microstructure of splats and coating, meanwhile the 3D topography of the splats were observed by SEM (SU1510) and video microscope (VHX-2000). Secondly, the nanohardness of splats was evaluated by nanoindentation (NHT) in order to be compared with microhardness of coating measured by microhardness tester (HV-1000A). The results show that the nanohardness of splats with diameter of 70 μm, 100 μm and 140 μm were in the scope of 11∼12 GPa while the microhardness of coating were in the range of 8∼9 GPa. Because the splats had not micro-defects such as pores and cracks in the nanohardness evaluated nano-zone, the nanohardness of the splats can be utilized to predict the highest hardness of coating without micro-defects. This method indicates the maximum of sprayed coating hardness and will reduce the test number to get high hardness coating for better wear resistance.

  4. Free triiodothyronine levels and short-term prognosis in chronic heart failure patients with type 2 diabetes.

    Science.gov (United States)

    Chen, Pingan; Li, Shaonan; Lei, Xiaoming; Liu, Zhen; Wu, Daihong; Luo, Yi; Xu, Dingli

    2015-08-01

    In chronic heart failure (CHF) patients with type 2 diabetes mellitus (T2DM), the role of thyroid hormone (TH) in predicting CHF severity and prognosis is unclear. The authors therefore investigated the role of TH in predicting CHF severity and prognosis in these specific patients. A total of 224 CHF patients (114 with T2DM) over a mean follow-up time of 6.56 ± 0.18 months were studied. TH, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and other parameters were measured. Free triiodothyronine (FT3) levels were lower in the T2DM group compared with the nondiabetes group (P = 0.026) and higher in the New York Heart Association (NYHA) I group than in the NYHA III and IV groups (both P < 0.05). Compared with the low NT-proBNP group, the high NT-proBNP group had lower FT3 levels (P < 0.01). NT-proBNP correlated with NYHA classes (r = 0.541, P < 0.001), and inversely correlated with left ventricular ejection fraction (r = -0.431, P < 0.001) and FT3 levels (r = -0.335, P < 0.001). In multiple linear regression analysis, NT-proBNP was significantly correlated with NYHA classes (P < 0.001), left ventricular ejection fraction (P < 0.001) and FT3 (P = 0.004). Kaplan-Meier curves showed that the low FT3 group had an increased rate of short-term adverse outcomes of CHF (log rank, χ = 9.794, P = 0.002). FT3 levels are associated with the severity of CHF and seem to reflect short-term outcomes in CHF patients with T2DM.

  5. Analisa Highest and Best Use Pada Lahan Kosong Di Jemur Gayungan II Surabaya

    Directory of Open Access Journals (Sweden)

    Finda Virgitta Faradiany

    2014-09-01

    Full Text Available Perkembangan bisnis properti di Surabaya yang semakin pesat, mengakibatkan permintaan terhadap lahan semakin tinggi. Namun fakta di lapangan menampakkan hal yang sebaliknya karena ternyata masih terdapat lahan-lahan yang dibiarkan kosong tidak dimanfaatkan oleh pemiliknya. Kondisi yang demikian memerlukan efisiensi dan optimalisasi penggunaan lahan dengan mendirikan sebuah properti komersial yang memberikan keuntungan bagi pemilik serta lingkungan sekitarnya.Lahan “X” seluas 1786 m2 berlokasi di Jl. Jemur Gayungan II merupakan lahan kosong yang terletak di dekat daerah perkantoran dan berpotensi dikembangkan menjadi properti komersial. Penentuan nilai lahan “X” bergantung pada penggunaan lahan. Metode penilaian yang digunakan adalah analisa penggunaan tertinggi dan terbaik atau Highest and Best Use (HBU yang secara legal diijinkan, secara fisik memungkinkan, layak secara finansial dan memiliki produktifitas maksimum. Dari hasil penelitian didapatkan alternatif yang menghasilkan nilai lahan tertinggi dan produktivitas maksimum adalah hotel. Nilai lahan yang didapatkan sebesar Rp 9.722.718/m2 dengan produktivitas meningkat sebesar 486%.

  6. Failure of ETV in patients with the highest ETV success scores.

    Science.gov (United States)

    Gianaris, Thomas J; Nazar, Ryan; Middlebrook, Emily; Gonda, David D; Jea, Andrew; Fulkerson, Daniel H

    2017-09-01

    OBJECTIVE Endoscopic third ventriculostomy (ETV) is a surgical alternative to placing a CSF shunt in certain patients with hydrocephalus. The ETV Success Score (ETVSS) is a reliable, simple method to estimate the success of the procedure by 6 months of postoperative follow-up. The highest score is 90, estimating a 90% chance of the ETV effectively treating hydrocephalus without requiring a shunt. Treatment with ETV fails in certain patients, despite their being the theoretically best candidates for the procedure. In this study the authors attempted to identify factors that further predicted success in patients with the highest ETVSSs. METHODS A retrospective review was performed of all patients treated with ETV at 3 institutions. Demographic, radiological, and clinical data were recorded. All patients by definition were older than 1 year, had obstructive hydrocephalus, and did not have a prior shunt. Failure of ETV was defined as the need for a shunt by 1 year. The ETV was considered a success if the patient did not require another surgery (either shunt placement or a repeat endoscopic procedure) by 1 year. A statistical analysis was performed to identify factors associated with success or failure. RESULTS Fifty-nine patients met the entry criteria for the study. Eleven patients (18.6%) required further surgery by 1 year. All of these patients received a shunt. The presenting symptom of lethargy statistically correlated with success (p = 0.0126, odds ratio [OR] = 0.072). The preoperative radiological finding of transependymal flow (p = 0.0375, OR 0.158) correlated with success. A postoperative larger maximum width of the third ventricle correlated with failure (p = 0.0265). CONCLUSIONS The preoperative findings of lethargy and transependymal flow statistically correlated with success. This suggests that the best candidates for ETV are those with a relatively acute elevation of intracranial pressure. Cases without these findings may represent the failures in this

  7. The highest velocity and the shortest duration permitting attainment of VO2max during running

    Directory of Open Access Journals (Sweden)

    Tiago Turnes

    2015-02-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2015v17n2p226   The severe-intensity domain has important applications for the prescription of running training and the elaboration of experimental designs. The objectives of this study were: 1 to investigate the validity of a previously proposed model to estimate the shortest exercise duration (TLOW and the highest velocity (VHIGH at which VO2max is reached during running, and 2 to evaluate the effects of aerobic training status on these variables. Eight runners and eight physically active subjects performed several treadmill running exercise tests to fatigue in order to mathematically estimate and to experimentally determine TLOW and VHIGH. The relationship between the time to achieve VO2max and time to exhaustion (Tlim was used to estimate TLOW. VHIGH was estimated using the critical velocity model. VHIGH was assumed to be the highest velocity at which VO2 was equal to or higher than the average VO2max minus one standard deviation. TLOW was defined as Tlim associated with VHIGH. Runners presented better aerobic fitness and higher VHIGH (22.2 ± 1.9 km.h-1 than active subjects (20.0 ± 2.1 km.h-1. However, TLOW did not differ between groups (runners: 101 ± 39 s; active subjects: 100 ± 35 s. TLOW and VHIGH were not well estimated by the model proposed, with high coefficients of variation (> 6% and a low correlation coefficient (r<0.70, a fact reducing the validity of the model. It was concluded that aerobic training status positively affected only VHIGH. Furthermore, the model proposed presented low validity to estimate the upper boundary of the severe-intensity domain (i.e., VHIGH, irrespective of the subjects’ training status.

  8. Usefulness of Serum B-Type Natriuretic Peptide Levels in Comatose Patients Resuscitated from Out-of-Hospital Cardiac Arrest to Predict Outcome

    DEFF Research Database (Denmark)

    Frydland, Martin; Kjaergaard, Jesper; Erlinge, David

    2016-01-01

    N-terminal pro-B-type natriuretic (NT-proBNP) is expressed in the heart and brain, and serum levels are elevated in acute heart and brain diseases. We aimed to assess the possible association between serum levels and neurological outcome and death in comatose patients resuscitated from out......-of-hospital cardiac arrest (OHCA). Of the 939 comatose OHCA patients enrolled and randomized in the Targeted Temperature Management (TTM) trial to TTM at 33°C or 36°C for 24 hours, 700 were included in the biomarker substudy. Of these, 647 (92%) had serum levels of NT-proBNP measured 24, 48, and 72 hours after return...... of spontaneous circulation (ROSC). Neurological outcome was evaluated by the Cerebral Performance Category (CPC) score and modified Rankin Scale (mRS) at 6 months. Six hundred thirty-eight patients (99%) had serum NT-proBNP levels ≥125 pg/ml. Patients with TTM at 33°C had significantly lower NT-proBNP serum...

  9. Higher Plasma Myostatin Levels in Cor Pulmonale Secondary to Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Ju, Chun-Rong; Chen, Miao; Zhang, Jian-Heng; Lin, Zhi-Ya; Chen, Rong-Chang

    2016-01-01

    To analyze plasma myostatin levels and investigate their relationship with right ventricular (RV) function in patients with cor pulmonale secondary to chronic obstructive pulmonary disease (COPD). The study recruited 81 patients with advanced COPD and 40 age-matched controls. The patients were divided into two groups: those with cor pulmonale and those without. Echocardiography was used to evaluate RV function and morphology, and the value of tricuspid annular plane systolic excursion (TAPSE) less than 16 mm was considered RV dysfunction. Plasma myostatin levels were analyzed by enzyme-linked immunosorbent assay, and B-type natriuretic peptide (BNP) levels were analyzed as a comparison of myostatin. The data detected cor pulmonale in 39/81 patients, with the mean value of TAPSE of 14.3 mm. Plasma myostatin levels (ng/mL) were significantly higher in patients with cor pulmonale (16.68 ± 2.95) than in those without (13.56 ± 3.09), and much higher than in controls (8.79±2.79), with each pmyostatin levels were significantly correlated with the values of TAPSE and RV myocardium performance index among the COPD patients, and that BNP levels were significantly correlated only with systolic pulmonary arterial pressure, with each pmyostatin levels are increased in COPD patients who have cor pulmonale. Stronger correlations of plasma myostatin levels with echocardiographic indexes of the right heart suggest that myostatin might be superior to BNP in the early diagnosis of cor pulmonale in COPD.

  10. Higher Plasma Myostatin Levels in Cor Pulmonale Secondary to Chronic Obstructive Pulmonary Disease.

    Directory of Open Access Journals (Sweden)

    Chun-Rong Ju

    Full Text Available To analyze plasma myostatin levels and investigate their relationship with right ventricular (RV function in patients with cor pulmonale secondary to chronic obstructive pulmonary disease (COPD.The study recruited 81 patients with advanced COPD and 40 age-matched controls. The patients were divided into two groups: those with cor pulmonale and those without. Echocardiography was used to evaluate RV function and morphology, and the value of tricuspid annular plane systolic excursion (TAPSE less than 16 mm was considered RV dysfunction. Plasma myostatin levels were analyzed by enzyme-linked immunosorbent assay, and B-type natriuretic peptide (BNP levels were analyzed as a comparison of myostatin.The data detected cor pulmonale in 39/81 patients, with the mean value of TAPSE of 14.3 mm. Plasma myostatin levels (ng/mL were significantly higher in patients with cor pulmonale (16.68 ± 2.95 than in those without (13.56 ± 3.09, and much higher than in controls (8.79±2.79, with each p<0.01. Significant differences were also found in plasma BNP levels among the three groups (p<0.05. Multivariate regression analysis suggested that myostatin levels were significantly correlated with the values of TAPSE and RV myocardium performance index among the COPD patients, and that BNP levels were significantly correlated only with systolic pulmonary arterial pressure, with each p<0.05.Plasma myostatin levels are increased in COPD patients who have cor pulmonale. Stronger correlations of plasma myostatin levels with echocardiographic indexes of the right heart suggest that myostatin might be superior to BNP in the early diagnosis of cor pulmonale in COPD.

  11. Effects of cilnidipine on sympathetic nerve activity and cardiorenal function in hypertensive patients with type 2 diabetes mellitus: association with BNP and aldosterone levels.

    Science.gov (United States)

    Tanaka, Masami; Sekioka, Risa; Nishimura, Takeshi; Ichihara, Atsuhiro; Itoh, Hiroshi

    2014-12-01

    Hypertension stimulates the sympathetic nervous system and this phenomenon is exacerbated by diabetes mellitus. We investigated the effects of cilnidipine, an N/L-type calcium channel blocker, on aspects of this system in patients with type 2 diabetes mellitus. In 33 hypertensive patients with type 2 diabetes mellitus treated with a calcium channel blocker other than cilnidipine, we evaluated the influence of switching to cilnidipine on blood pressure, heart rate, catecholamine, plasma renin and aldosterone concentration, brain natriuretic peptide, urine liver-type fatty acid binding protein, and urinary albumin excretion ratio in the same patients by a cross-over design. Other biochemical parameters were also evaluated. Switching to cilnidipine did not change blood pressure but caused reduction in catecholamine concentrations in blood and urine and plasma aldosterone concentration, accompanied by significant reduction in brain natriuretic peptide, urine liver-type fatty acid binding protein, and albumin excretion ratio. These parameters other than brain natriuretic peptide were significantly increased after cilnidipine was changed to the original calcium channel blocker. In 33 hypertensive patients with type 2 diabetes mellitus, compared to other calcium channel blockers, cilnidipine suppressed sympathetic nerve activity and aldosterone, and significantly improved markers of cardiorenal disorders. Therefore, cilnidipine may be an important calcium channel blocker for use in combination with renin-angiotensin-aldosterone system inhibitors when dealing with hypertension complicated with diabetes mellitus. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Níveis séricos de NT pro-BNP: relação com função sistólica e diastólica nas miocardiopatias e pericardiopatias

    OpenAIRE

    Mady,Charles; Fernandes,Fábio; Arteaga,Edmundo; Ramires,Felix José Alvarez; Buck,Paula de Cássia; Salemi,Vera Maria Cury; Ianni,Barbara Maria; Nastari,Luciano; Dias,Ricardo Ribeiro

    2008-01-01

    FUNDAMENTO: O NT pro-BNP é marcador de disfunção sistólica e diastólica. OBJETIVO: Determinar os níveis de NT pro-BNP em pacientes com cardiopatia chagásica, hipertrófica, restritiva e afecções pericárdicas, e sua relação com medidas ecocardiográficas de disfunção sistólica e diastólica. MÉTODOS: Cento e quarenta e cinco pacientes foram divididos nos respectivos grupos: 1) cardiopatia chagásica (CCh) - 14 pacientes; 2) miocardiopatia hipertrófica (CMH) - 71 pacientes; 3) endomiocardiofibrose ...

  13. The Mass Elevation Effect of the Central Andes and Its Implications for the Southern Hemisphere's Highest Treeline

    Directory of Open Access Journals (Sweden)

    Wenhui He

    2016-05-01

    Full Text Available One of the highest treelines in the world is at 4810 m above sea level on the Sajama Volcano in the central Andes. The climatological cause of that exceptionally high treeline position is still unclear. Although it has been suggested that the mass elevation effect (MEE explains the upward shift of treelines in the Altiplano region, the magnitude of MEE has not yet been quantified for that region. This paper defines MEE as the air temperature difference in summer at the same elevation between the inner mountains/plateaus (Altiplano and the free atmosphere above the adjacent lowlands of the Andean Cordillera. The Altiplano air temperature was obtained from the Global Historical Climatology Network-Monthly temperature database, and the air temperature above the adjacent lowlands was interpolated based on the National Center for Environmental Prediction/National Center for Atmospheric Research Reanalysis 1 data set. We analyzed the mean air temperature differences for January, July, and the warm months from October to April. The air temperature was mostly higher on the Altiplano than over the neighboring lowlands at the same altitude. The air temperature difference increased from the outer Andean east-facing slope to the interior of the Altiplano in summer, and it increased from high latitudes to low latitudes in winter. The mean air temperature in the Altiplano in summer is approximately 5 K higher than it is above the adjacent lowlands at the same mean elevation, averaging about 3700 m above sea level. This upward shift of isotherms in the inner part of the Cordillera enables the treeline to climb to 4810 m, with shrub-size trees reaching even higher. Therefore, the MEE explains the occurrence of one of the world’s highest treelines in the central Andes.

  14. ASSESSMENT OF PAHS AND SELECTED PESTICIDES IN SHALLOW GROUNDWATER IN THE HIGHEST PROTECTED AREAS IN THE OPOLE REGION, POLAND

    Directory of Open Access Journals (Sweden)

    Mariusz Głowacki

    2014-04-01

    Full Text Available The ground water quality was determined after the analyses of water samples from 18 wells. The wells were in the Groundwater Area with the Highest Protection (Triassic water, Opole region, Poland, rural build up. The water table level was low: 0.5 – 18.0 m below the ground surface level (except for one artesian well. The following parameters were determined: pH, EC, colour, ammonium, nitrite, nitrate, dissolved orthophosphate, total phosphorus, dissolved oxygen, BOD, COD-Mn, COD-Cr, humic substances, chloride, sulphate, total hardness, alkalinity, dry residue PAHs (16 compounds, pesticides (6 compounds, however, only selected data were presented in this paper. In all the analysed water samples chloro-organic pesticides were observed. The analysed water contained heptachlor in the highest concentrations of 15.97 mg/dm3. Good quality water must not include concentrations higher than 0.5 mg/dm3 of heptachlor. However, the concentration was circa 32 times higher than this value. The second pesticide determining poor water quality is dieldrin. This compound in the investigated groundwater was 1.94 mg/dm3 – 4 times higher than the limit for acceptable quality ground water. The concentration of pesticides also changed over the course of the research; the concentration in the analysed groundwater in the same well changed quite dramatically over a period of 1 year. Although PAHs and pesticides are potentially toxic for biological organisms they do exist in the environment as a product of the natural biological transformation of organic matter. The noted concentrations and compositions of PAH compounds were different to natural PAHs. It confirms the fact that agricultural activity influences groundwater quality.

  15. African American Women: Surviving Breast Cancer Mortality against the Highest Odds

    Directory of Open Access Journals (Sweden)

    Shelley White-Means

    2015-12-01

    Full Text Available Among the country’s 25 largest cities, the breast cancer mortality disparity is highest in Memphis, Tennessee, where African American women are twice as likely to die from breast cancer as White women. This qualitative study of African-American breast cancer survivors explores experiences during and post treatment that contributed to their beating the high odds of mortality. Using a semi-structured interview guide, a focus group session was held in 2012 with 10 breast cancer survivors. Thematic analysis and a deductive a priori template of codes were used to analyze the data. Five main themes were identified: family history, breast/body awareness and preparedness to manage a breast cancer event, diagnosis experience and reaction to the diagnosis, family reactions, and impact on life. Prayer and family support were central to coping, and survivors voiced a cultural acceptance of racial disparities in health outcomes. They reported lack of provider sensitivity regarding pain, financial difficulties, negative responses from family/friends, and resiliency strategies for coping with physical and mental limitations. Our research suggested that a patient-centered approach of demystifying breast cancer (both in patient-provider communication and in community settings would impact how women cope with breast cancer and respond to information about its diagnosis.

  16. THE IMPACT OF FREQUENCY STANDARDS ON COHERENCE IN VLBI AT THE HIGHEST FREQUENCIES

    Energy Technology Data Exchange (ETDEWEB)

    Rioja, M.; Dodson, R. [ICRAR, University of Western Australia, Perth (Australia); Asaki, Y. [Institute of Space and Astronautical Science, 3-1-1 Yoshinodai, Chuou, Sagamihara, Kanagawa 252-5210 (Japan); Hartnett, J. [School of Physics, University of Western Australia, Perth (Australia); Tingay, S., E-mail: maria.rioja@icrar.org [ICRAR, Curtin University, Perth (Australia)

    2012-10-01

    We have carried out full imaging simulation studies to explore the impact of frequency standards in millimeter and submillimeter very long baseline interferometry (VLBI), focusing on the coherence time and sensitivity. In particular, we compare the performance of the H-maser, traditionally used in VLBI, to that of ultra-stable cryocooled sapphire oscillators over a range of observing frequencies, weather conditions, and analysis strategies. Our simulations show that at the highest frequencies, the losses induced by H-maser instabilities are comparable to those from high-quality tropospheric conditions. We find significant benefits in replacing H-masers with cryocooled sapphire oscillator based frequency references in VLBI observations at frequencies above 175 GHz in sites which have the best weather conditions; at 350 GHz we estimate a 20%-40% increase in sensitivity over that obtained when the sites have H-masers, for coherence losses of 20%-10%, respectively. Maximum benefits are to be expected by using co-located Water Vapor Radiometers for atmospheric correction. In this case, we estimate a 60%-120% increase in sensitivity over the H-maser at 350 GHz.

  17. Exchange Interactions on the Highest-Spin Reported Molecule: the Mixed-Valence Fe42 Complex

    Science.gov (United States)

    Aravena, Daniel; Venegas-Yazigi, Diego; Ruiz, Eliseo

    2016-04-01

    The finding of high-spin molecules that could behave as conventional magnets has been one of the main challenges in Molecular Magnetism. Here, the exchange interactions, present in the highest-spin molecule published in the literature, Fe42, have been analysed using theoretical methods based on Density Functional Theory. The system with a total spin value S = 45 is formed by 42 iron centres containing 18 high-spin FeIII ferromagnetically coupled and 24 diamagnetic low-spin FeII ions. The bridging ligands between the two paramagnetic centres are two cyanide ligands coordinated to the diamagnetic FeII cations. Calculations were performed using either small Fe4 or Fe3 models or the whole Fe42 complex, showing the presence of two different ferromagnetic couplings between the paramagnetic FeIII centres. Finally, Quantum Monte Carlo simulations for the whole system were carried out in order to compare the experimental and simulated magnetic susceptibility curves from the calculated exchange coupling constants with the experimental one. This comparison allows for the evaluation of the accuracy of different exchange-correlation functionals to reproduce such magnetic properties.

  18. Analisis Highest and Best Use (HBU pada Lahan Jl. Gubeng Raya No. 54 Surabaya

    Directory of Open Access Journals (Sweden)

    Akmaluddin Akmaluddin

    2013-03-01

    Full Text Available Laju pertumbuhan penduduk dan tingkat perekonomian yang semakin meningkat di  kota-kota besar seperti Surabaya, bertolak belakang dengan  ketersediaan lahan yang terbatas. Selayaknya properti yang akan dibangun di atas suatu lahan dapat memberikan manfaat yang maksimal serta efisien agar hasilnya dapat dirasakan demi pembangunan wilayah tersebut. Oleh karena itu, perlu dilakukan perhitungan  penggunaan yang paling memungkinkan dan diizinkan dari suatu tanah kosong atau tanah yang  sudah dibangun, dimana secara fisik dimungkinkan, didukung atau dibenarkan oleh peraturan, layak secara keuangan dan menghasilkan nilai tertinggi. Dalam penelitian ini dilakukan analisis Highest and Best Use (HBU pada lahan di Jl. Gubeng Raya No. 54 Surabaya seluas 1.150 m2 yang direncanakan akan dibangun hotel. Lahan tersebut berpotensi untuk dikembangkan menjadi properti komersial seperti hotel, apartemen, perkantoran dan pertokoan. Analisis tersebut menggunakan tinjauan terhadap aspek fisik, legal, finansial dan produktivitas maksimumnya. Dari hasil penelitian ini didapatkan alternatif properti komersial hotel yang memiliki penggunaan tertinggi dan terbaik pada pemanfaatan lahan dengan nilai lahan Rp. 67.069.980,31/ m2.

  19. Analisa Alternatif Revitalisasi Pasar Gubeng Masjid Surabaya dengan Metode Highest And Best Use

    Directory of Open Access Journals (Sweden)

    Marsha Swalia Mustika

    2017-01-01

    Full Text Available Dalam era globalisasi ini banyak bermunculan pasar-pasar modern yang dibangun dengan segala kelebihan dan fasilitasnya. Munculnya pasar-pasar modern membuat keberadaan pasar tradisional tersudut, tidak terkecuali Pasar Gubeng Masjid Surabaya. Namun keberadaan pasar yang strategis yaitu dekat dengan perkantoran, hotel dan pusat perbelanjaan, serta stasiun kereta api membuat pasar tersebut memiliki potensi untuk dikembangkan menjadi properti yang memberikan nilai lahan tertinggi dan terbaik. Oleh karena itu, perlu dilakukan analisa Highest and Best Use (HBU yang dapat memberikan masukan untuk melakukan investasi terbaik. Analisa HBU ini menggunakan empat kriteria yaitu secara fisik dimungkinkan, secara legal diizinkan , secara finansial layak, dan memiliki produktivitas maksimum. Alternatif yang memiliki produktivitas maksimum tersebut dapat dijadikan sebagai nilai lahan tertinggi dan terbaik pada lahan Pasar Gubeng Masjid Surabaya. Dari hasil penelitian didapatkan alternatif yang menghasilkan nilai lahan tertinggi dan produktivitas maksimum adalah alternatif pengembangan multi use pasar dengan pusat perbelanjaan.. Nilai lahan yang didapatkan sebesar Rp 46.946.524,-/m2 dengan produktivitas meningkat sebesar 312%.

  20. Transitional care for the highest risk patients: findings of a randomised control study

    Directory of Open Access Journals (Sweden)

    Kheng Hock Lee

    2015-10-01

    Full Text Available Background: Interventions to prevent readmissions of patients at highest risk have not been rigorously evaluated. We conducted a randomised controlled trial to determine if a post-discharge transitional care programme can reduce readmissions of such patients in Singapore. Methods: We randomised 840 patients with two or more unscheduled readmissions in the prior 90 days and Length of stay, Acuity of admission, Comorbidity of patient, Emergency department utilisation score ≥10 to the intervention programme (n = 419 or control (n = 421. Patients allocated to the intervention group received post-discharge surveillance by a multidisciplinary integrated care team and early review in the clinic. The primary outcome was the proportion of patients with at least one unscheduled readmission within 30 days after discharge. Results: We found no statistically significant reduction in readmissions or emergency department visits in patients on the intervention group compared to usual care. However, patients in the intervention group reported greater patient satisfaction (p < 0.001. Conclusion: Any beneficial effect of interventions initiated after discharge is small for high-risk patients with multiple comorbidity and complex care needs. Future transitional care interventions should focus on providing the entire cycle of care for such patients starting from time of admission to final transition to the primary care setting. Trial Registration: Clinicaltrials.gov, no NCT02325752

  1. Transitional care for the highest risk patients: findings of a randomised control study

    Directory of Open Access Journals (Sweden)

    Kheng Hock Lee

    2015-10-01

    Full Text Available Background: Interventions to prevent readmissions of patients at highest risk have not been rigorously evaluated. We conducted a randomised controlled trial to determine if a post-discharge transitional care programme can reduce readmissions of such patients in Singapore.Methods: We randomised 840 patients with two or more unscheduled readmissions in the prior 90 days and Length of stay, Acuity of admission, Comorbidity of patient, Emergency department utilisation score ≥10 to the intervention programme (n = 419 or control (n = 421. Patients allocated to the intervention group received post-discharge surveillance by a multidisciplinary integrated care team and early review in the clinic. The primary outcome was the proportion of patients with at least one unscheduled readmission within 30 days after discharge.Results: We found no statistically significant reduction in readmissions or emergency department visits in patients on the intervention group compared to usual care. However, patients in the intervention group reported greater patient satisfaction (p < 0.001.Conclusion: Any beneficial effect of interventions initiated after discharge is small for high-risk patients with multiple comorbidity and complex care needs. Future transitional care interventions should focus on providing the entire cycle of care for such patients starting from time of admission to final transition to the primary care setting.Trial Registration: Clinicaltrials.gov, no NCT02325752

  2. Measurement of radon concentration in dwellings in the region of highest lung cancer incidence in India

    International Nuclear Information System (INIS)

    Zoliana, B.; Rohmingliana, P.C.; Sahoo, B.K.; Mayya, Y.S.

    2015-01-01

    Monitoring of radon exhalation from soil and its concentration in indoor is found to be helpful in many investigations such as health risk assessment and others as radiation damage to bronchial cells which eventually can be the second leading cause of lung cancer next to smoking. The fact that Aizawl District, Mizoram, India has the highest lung cancer incidence rates among males and females in Age Adjusted Rate (AAR) in India as declared by Population Based Cancer Registry Report 2008 indicates the need for quantification of radon and its anomalies attached to it. Measurement of radon concentration had been carried out inside the dwellings in Aizawl district, Mizoram. A time integrated method of measurement was employed by using a solid state nuclear track detector (SSNTD) type (LR-115 films) kept in a twin cup dosimeter for measurement of concentration of radon and thoron. The dosimeters were suspended over bed rooms or living rooms in selected dwellings. They were deployed for a period of about 120 days at a time in 63 houses which were selected according to their place of location viz. fault region, places where fossil remains were found and geologically unidentified region. After the desired period of exposure, the detectors were retrieved and chemically etched which were then counted by using a spark counter. The recorded nuclear tract densities are then converted into air concentrations of Radon and Thoron

  3. A System with a Choice of Highest-Bidder-First and FIFO Services

    Directory of Open Access Journals (Sweden)

    Tejas Bodas

    2015-02-01

    Full Text Available Service systems using a highest-bidder-first (HBF policy have been studied in queueing literature for various applications and in economics literature to model corruption. Such systems have applications in modern problems like scheduling jobs in cloud computing scenarios or placement of ads on web pages. However, using a HBF service is like using a spot market and may not be preferred by many users. For such users, it may be good to provide a simple scheduler, e.g., a FIFO service. Further, in some situations it may even be necessary that a free service queue operates alongside a HBF queue. Motivated by such a scenario, we propose and analyze a service system with a FIFO server and a HBF server in parallel. Arriving customers are from a heterogeneous population with different valuations of their delay costs. They strategically choose between FIFO and HBF service; if HBF is chosen, they also choose the bid value to optimize an individual cost. We characterize the Wardrop equilibrium in such a system and analyze the revenue to the server. We see that when the total capacity is fixed and is shared between the FIFO and HBF servers, revenue is maximised when the FIFO capacity is non zero. However, if the FIFO server is added to an HBF server, then the revenue decreases with increasing FIFO capacity. We also discuss the case when customers are allowed to balk.

  4. African American Women: Surviving Breast Cancer Mortality against the Highest Odds

    Science.gov (United States)

    White-Means, Shelley; Rice, Muriel; Dapremont, Jill; Davis, Barbara; Martin, Judy

    2015-01-01

    Among the country’s 25 largest cities, the breast cancer mortality disparity is highest in Memphis, Tennessee, where African American women are twice as likely to die from breast cancer as White women. This qualitative study of African-American breast cancer survivors explores experiences during and post treatment that contributed to their beating the high odds of mortality. Using a semi-structured interview guide, a focus group session was held in 2012 with 10 breast cancer survivors. Thematic analysis and a deductive a priori template of codes were used to analyze the data. Five main themes were identified: family history, breast/body awareness and preparedness to manage a breast cancer event, diagnosis experience and reaction to the diagnosis, family reactions, and impact on life. Prayer and family support were central to coping, and survivors voiced a cultural acceptance of racial disparities in health outcomes. They reported lack of provider sensitivity regarding pain, financial difficulties, negative responses from family/friends, and resiliency strategies for coping with physical and mental limitations. Our research suggested that a patient-centered approach of demystifying breast cancer (both in patient-provider communication and in community settings) would impact how women cope with breast cancer and respond to information about its diagnosis. PMID:26703655

  5. A cosmopolitan design of teacher education and a progressive orientation towards the highest good

    Directory of Open Access Journals (Sweden)

    Klas Roth

    2013-01-01

    Full Text Available In this paper I discuss a Kantian conception of cosmopolitan education. It suggests that we pursue the highest good – an object of morality – in the world together, and requires that we acknowledge the value of freedom, render ourselves both efficacious and autonomous in practice, cultivate our judgment, and unselfishly co-operate in the co-ordination and fulfilment of our morally permissible ends. Now, such an accomplishment is one of the most difficult challenges, and may not be achieved in our time, if ever. In the first part of the paper I show that we, according to Kant, have to interact with each other, and comply with the moral law in the quest of general happiness, not merely personal happiness. In the second part, I argue that a cosmopolitan design of teacher education in Kantian terms can establish moral character, even though good moral character is ultimately the outcome of free choice. Such a design can do so by optimizing the freedom of those concerned to set and pursue their morally permissible ends, and to cultivate their judgment through the use of examples. This requires, inter alia, that they be enabled, and take responsibility, to think for themselves, in the position of everyone else, and consistently; and to strengthen their virtue or self-mastery to comply, in practice, with the moral law.

  6. Towards highest peak intensities for ultra-short MeV-range ion bunches

    Science.gov (United States)

    Busold, Simon; Schumacher, Dennis; Brabetz, Christian; Jahn, Diana; Kroll, Florian; Deppert, Oliver; Schramm, Ulrich; Cowan, Thomas E.; Blažević, Abel; Bagnoud, Vincent; Roth, Markus

    2015-01-01

    A laser-driven, multi-MeV-range ion beamline has been installed at the GSI Helmholtz center for heavy ion research. The high-power laser PHELIX drives the very short (picosecond) ion acceleration on μm scale, with energies ranging up to 28.4 MeV for protons in a continuous spectrum. The necessary beam shaping behind the source is accomplished by applying magnetic ion lenses like solenoids and quadrupoles and a radiofrequency cavity. Based on the unique beam properties from the laser-driven source, high-current single bunches could be produced and characterized in a recent experiment: At a central energy of 7.8 MeV, up to 5 × 108 protons could be re-focused in time to a FWHM bunch length of τ = (462 ± 40) ps via phase focusing. The bunches show a moderate energy spread between 10% and 15% (ΔE/E0 at FWHM) and are available at 6 m distance to the source und thus separated from the harsh laser-matter interaction environment. These successful experiments represent the basis for developing novel laser-driven ion beamlines and accessing highest peak intensities for ultra-short MeV-range ion bunches. PMID:26212024

  7. Medical school dropout--testing at admission versus selection by highest grades as predictors.

    Science.gov (United States)

    O'Neill, Lotte; Hartvigsen, Jan; Wallstedt, Birgitta; Korsholm, Lars; Eika, Berit

    2011-11-01

    Very few studies have reported on the effect of admission tests on medical school dropout. The main aim of this study was to evaluate the predictive validity of non-grade-based admission testing versus grade-based admission relative to subsequent dropout. This prospective cohort study followed six cohorts of medical students admitted to the medical school at the University of Southern Denmark during 2002-2007 (n=1544). Half of the students were admitted based on their prior achievement of highest grades (Strategy 1) and the other half took a composite non-grade-based admission test (Strategy 2). Educational as well as social predictor variables (doctor-parent, origin, parenthood, parents living together, parent on benefit, university-educated parents) were also examined. The outcome of interest was students' dropout status at 2 years after admission. Multivariate logistic regression analysis was used to model dropout. Strategy 2 (admission test) students had a lower relative risk for dropping out of medical school within 2 years of admission (odds ratio 0.56, 95% confidence interval 0.39-0.80). Only the admission strategy, the type of qualifying examination and the priority given to the programme on the national application forms contributed significantly to the dropout model. Social variables did not predict dropout and neither did Strategy 2 admission test scores. Selection by admission testing appeared to have an independent, protective effect on dropout in this setting. © Blackwell Publishing Ltd 2011.

  8. Extreme Markup: The Fifty US Hospitals With The Highest Charge-To-Cost Ratios.

    Science.gov (United States)

    Bai, Ge; Anderson, Gerard F

    2015-06-01

    Using Medicare cost reports, we examined the fifty US hospitals with the highest charge-to-cost ratios in 2012. These hospitals have markups (ratios of charges over Medicare-allowable costs) approximately ten times their Medicare-allowable costs compared to a national average of 3.4 and a mode of 2.4. Analysis of the fifty hospitals showed that forty-nine are for profit (98 percent), forty-six are owned by for-profit hospital systems (92 percent), and twenty (40 percent) operate in Florida. One for-profit hospital system owns half of these fifty hospitals. While most public and private health insurers do not use hospital charges to set their payment rates, uninsured patients are commonly asked to pay the full charges, and out-of-network patients and casualty and workers' compensation insurers are often expected to pay a large portion of the full charges. Because it is difficult for patients to compare prices, market forces fail to constrain hospital charges. Federal and state governments may want to consider limitations on the charge-to-cost ratio, some form of all-payer rate setting, or mandated price disclosure to regulate hospital markups. Project HOPE—The People-to-People Health Foundation, Inc.

  9. Towards highest peak intensities for ultra-short MeV-range ion bunches

    Science.gov (United States)

    Busold, Simon; Schumacher, Dennis; Brabetz, Christian; Jahn, Diana; Kroll, Florian; Deppert, Oliver; Schramm, Ulrich; Cowan, Thomas E.; Blažević, Abel; Bagnoud, Vincent; Roth, Markus

    2015-07-01

    A laser-driven, multi-MeV-range ion beamline has been installed at the GSI Helmholtz center for heavy ion research. The high-power laser PHELIX drives the very short (picosecond) ion acceleration on μm scale, with energies ranging up to 28.4 MeV for protons in a continuous spectrum. The necessary beam shaping behind the source is accomplished by applying magnetic ion lenses like solenoids and quadrupoles and a radiofrequency cavity. Based on the unique beam properties from the laser-driven source, high-current single bunches could be produced and characterized in a recent experiment: At a central energy of 7.8 MeV, up to 5 × 108 protons could be re-focused in time to a FWHM bunch length of τ = (462 ± 40) ps via phase focusing. The bunches show a moderate energy spread between 10% and 15% (ΔE/E0 at FWHM) and are available at 6 m distance to the source und thus separated from the harsh laser-matter interaction environment. These successful experiments represent the basis for developing novel laser-driven ion beamlines and accessing highest peak intensities for ultra-short MeV-range ion bunches.

  10. Highest-order optical phonon-mediated relaxation in CdTe/ZnTe quantum dots

    International Nuclear Information System (INIS)

    Masumoto, Yasuaki; Nomura, Mitsuhiro; Okuno, Tsuyoshi; Terai, Yoshikazu; Kuroda, Shinji; Takita, K.

    2003-01-01

    The highest 19th-order longitudinal optical (LO) phonon-mediated relaxation was observed in photoluminescence excitation spectra of CdTe self-assembled quantum dots grown in ZnTe. Hot excitons photoexcited highly in the ZnTe barrier layer are relaxed into the wetting-layer state by emitting multiple LO phonons of the barrier layer successively. Below the wetting-layer state, the LO phonons involved in the relaxation are transformed to those of interfacial Zn x Cd 1-x Te surrounding CdTe quantum dots. The ZnTe-like and CdTe-like LO phonons of Zn x Cd 1-x Te and lastly acoustic phonons are emitted in the relaxation into the CdTe dots. The observed main relaxation is the fast relaxation directly into CdTe quantum dots and is not the relaxation through either the wetting-layer quantum well or the band bottom of the ZnTe barrier layer. This observation shows very efficient optical phonon-mediated relaxation of hot excitons excited highly in the ZnTe conduction band through not only the ZnTe extended state but also localized state in the CdTe quantum dots reflecting strong exciton-LO phonon interaction of telluride compounds

  11. Effect of salvia miltiorrhiza and ligustrazine hydrochloride injection combined with hydroxyethyl starch injection on serum BNP, Hcy, MMP-2, S100B protein and hemorheology in patients with acute cerebral watershed infarction

    Directory of Open Access Journals (Sweden)

    Dong Chen

    2017-09-01

    Full Text Available Objective: To study the effect of salvia miltiorrhiza and ligustrazine hydrochloride injection combined with hydroxyethyl starch injection on serum BNP, Hcy, MMP-2, S100B protein and hemorheology in patients with acute cerebral watershed infarction. Methods: A total of 90 patientswith acute cerebral watershed infarction in our hospital from August 2014 to December 2016 were enrolled in this study. The subjects were divided into the control group (n=45 and the treatment group (n=45 randomly. The control group was treated with hydroxyethyl starch injection, the treatment group was treated withsalvia miltiorrhiza and ligustrazine hydrochloride injection combined with hydroxyethyl starch injection, and both the two groups were treated for 2 weeks. The serum BNP, Hcy, MMP-2, S100B protein and hemorheology of the two groups before and after treatments were compared. Results: There were no significantly differences of the serum BNP, Hcy, MMP-2, S100B protein and hemorheology of the two groups before treatment. The serum BNP, Hcy, MMP-2, S100B proteinlevels of the two groups after treatment were significantly lower than before treatment, and that of the treatment group after treatment were significantly lower than the control group. The PV, Lr, Mr, Hr and RE of the two groups after treatment were significantly lower than before treatment, and that of the treatment group after treatment were significantly lower than the control group. Conclusion: Salvia miltiorrhiza and ligustrazine hydrochloride injection combined with hydroxyethyl starch injectioncan significantlyimprovetheneurological function and hemorheology, reduce inflammation of the patients with acute cerebral watershed infarction, and it was worthy clinical application.

  12. Information ranks highest: Expectations of female adolescents with a rare genital malformation towards health care services.

    Directory of Open Access Journals (Sweden)

    Elisabeth Simoes

    Full Text Available Access to highly specialized health care services and support to meet the patient's specific needs is critical for health outcome, especially during age-related transitions within the health care system such as with adolescents entering adult medicine. Being affected by an orphan disease complicates the situation in several important respects. Long distances to dedicated institutions and scarcity of knowledge, even among medical doctors, may present major obstacles for proper access to health care services and health chances. This study is part of the BMBF funded TransCareO project examining in a mixed-method design health care provisional deficits, preferences, and barriers in health care access as perceived by female adolescents affected by the Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS, a rare (orphan genital malformation.Prior to a communicative validation workshop, critical elements of MRKHS related care and support (items were identified in interviews with MRKHS patients. During the subsequent workshop, 87 persons involved in health care and support for MRKHS were asked to rate the items using a 7-point Likert scale (7, strongly agree; 1, strongly disagree as to 1 the elements' potential importance (i.e., health care expected to be "best practice", or priority and 2 the presently experienced care. A gap score between the two was computed highlighting fields of action. Items were arranged into ten separate questionnaires representing domains of care and support (e.g., online-portal, patient participation. Within each domain, several items addressed various aspects of "information" and "access". Here, we present the outcome of items' evaluation by patients (attended, NPAT = 35; respondents, NRESP = 19.Highest priority scores occurred for domains "Online-Portal", "Patient participation", and "Tailored informational offers", characterizing them as extremely important for the perception as best practice. Highest gap scores yielded domains

  13. Nonlinear Analysis to Detect if Excellent Nursing Work Environments Have Highest Well-Being.

    Science.gov (United States)

    Casalicchio, Giuseppe; Lesaffre, Emmanuel; Küchenhoff, Helmut; Bruyneel, Luk

    2017-09-01

    To detect potentially nonlinear associations between nurses' work environment and nurse staffing on the one hand and nurse burnout on the other hand. A cross-sectional multicountry study for which data collection using a survey of 33,731 registered nurses in 12 European countries took place during 2009 to 2010. A semiparametric latent variable model that describes both linear and potentially nonlinear associations between burnout (Maslach Burnout Inventory: emotional exhaustion, depersonalization, personal accomplishment) and work environment (Practice Environment Scale of the Nursing Work Index: managerial support for nursing, doctor-nurse collegial relations, promotion of care quality) and staffing (patient-to-nurse ratio). Similar conclusions are reached from linear and nonlinear models estimating the association between work environment and burnout. For staffing, an increase in the patient-to-nurse ratio is associated with an increase in emotional exhaustion. At about 15 patients per nurse, no further increase in emotional exhaustion is seen. Absence of evidence for diminishing returns of improving work environments suggests that continuous improvement and achieving excellence in nurse work environments pays off strongly in terms of lower nurse-reported burnout rates. Nurse staffing policy would benefit from a larger number of studies that identify specific minimum as well as maximum thresholds at which inputs affect nurse and patient outcomes. Nurse burnout is omnipresent and has previously been shown to be related to worse patient outcomes. Additional increments in characteristics of excellent work environments, up to the highest possible standard, correspond to lower nurse burnout. © 2017 Sigma Theta Tau International.

  14. Lost opportunities in HIV prevention: programmes miss places where exposures are highest

    Science.gov (United States)

    Sandøy, Ingvild F; Siziya, Seter; Fylkesnes, Knut

    2008-01-01

    Background Efforts at HIV prevention that focus on high risk places might be more effective and less stigmatizing than those targeting high risk groups. The objective of the present study was to assess risk behaviour patterns, signs of current preventive interventions and apparent gaps in places where the risk of HIV transmission is high and in communities with high HIV prevalence. Methods The PLACE method was used to collect data. Inhabitants of selected communities in Lusaka and Livingstone were interviewed about where people met new sexual partners. Signs of HIV preventive activities in these places were recorded. At selected venues, people were interviewed about their sexual behaviour. Peer educators and staff of NGOs were also interviewed. Results The places identified were mostly bars, restaurants or sherbeens, and fewer than 20% reported any HIV preventive activity such as meetings, pamphlets or posters. In 43% of places in Livingstone and 26% in Lusaka, condoms were never available. There were few active peer educators. Among the 432 persons in Lusaka and 676 in Livingstone who were invited for interview about sexual behaviour, consistent condom use was relatively high in Lusaka (77%) but low in Livingstone (44% of men and 34% of women). Having no condom available was the most common reason for not using one. Condom use in Livingstone was higher among individuals socializing in places where condoms always were available. Conclusion In the places studied we found a high prevalence of behaviours with a high potential for HIV transmission but few signs of HIV preventive interventions. Covering the gaps in prevention in these high exposure places should be given the highest priority. PMID:18218124

  15. How to identify the person holding the highest position in the criminal hierarchy?

    Directory of Open Access Journals (Sweden)

    Grigoryev D.A.

    2014-12-01

    Full Text Available The current version of the resolution of the RF Supreme Court Plenum of June 10, 2010 N 12, clarifying the provisions of the law on liability for crimes committed by a person holding the highest position in the criminal hierarchy (Part 4 of Article 210 of the RF Criminal Code, is criticized. Evaluative character of the considered aggravating circumstance doesn’t allow to develop clear criteria for identifying the leaders of the criminal environment. Basing on the theory provisions and court practice, the authors suggest three criteria. The first criterion is specific actions including: establishment and leadership of the criminal association (criminal organization; coordinating criminal acts; creating sustainable links between different organized groups acting independently; dividing spheres of criminal influence, sharing criminal income and other criminal activities, indicating person’s authority and leadership in a particular area or in a particular sphere of activity. The second is having money, valuables and other property obtained by criminal means, without the person’s direct participation in their acquisition; transferring money, valuables and other property to that person systematically, without legal grounds (unjust enrichment; spending that money, valuables and other property to carry out criminal activities (crimes themselves and conditions of their commission. The third is international criminal ties manifested in committing one of the crimes under Part 1 of Article 210 of the RF Criminal Code, if this crime is transnational in nature; ties with extremist and (or terrorist organizations, as well as corruption ties. The court may use one or several of these criteria.

  16. Analisa Penggunaan Tertinggi dan Terbaik (Highest and Best Use Analysis pada Lahan Pasar Turi Lama Surabaya

    Directory of Open Access Journals (Sweden)

    Maulida Herradiyanti

    2017-01-01

    Full Text Available Pasar  Turi  merupakan  pasar  yang  telah lama  menjadi  ikon  perdagangan  tidak  hanya  di Surabaya,  namun  juga  di  Indonesia  Timur.  Kebakaran hebat yang terjadi pada Juli 2007 telah menghanguskan bangunan Pasar Turi. Aktivitas perdagangan di tempat tersebut  otomatis  terhenti.  Hingga saat ini, lahan Pasar Turi  Tahap  III  atau  yang  biasa  disebut  Pasar  Turi Lama  masih  terbengkalai.  Padahal,  lahan  seluas  16281 m2tersebut terletak di wilayah sentra perdagangan dan cocok  untuk  dikembangkan  menjadi properti komersial seperti perkantoran, pertokoan, rumah toko (ruko, danpasar tradisional. Salah  satu  cara  untuk  menentukan  penggunaan lahan Pasar Turi Lama adalah dengan metode Highest and  Best  Use  (HBU.  HBU  adalah  suatu  metode  untuk menentukan  penggunaan  aset  yang  memberikan peruntukan  paling  optimal sehingga dapat memberikan nilai  lahan  tertinggi.  Kriteria  HBU  yaitu  diijinkan secara  legal,  memungkinkan  secara  fisik,  layak  secara finansial, dan memiliki produktivitas maksimum.Hasil penelitian ini didapatkan alternatif pertokoan sebagai  alternatif  penggunaan  lahan  terbaik  dengan nilai  lahan  tertinggi  yaitu  sebesar  Rp27.994.695,78/m2dengan produktivitas maksimum sebesar  124%.

  17. Risk of influenza transmission in a hospital emergency department during the week of highest incidence.

    Science.gov (United States)

    Esteve-Esteve, Miguel; Bautista-Rentero, Daniel; Zanón-Viguer, Vicente

    2018-02-01

    To estimate the risk of influenza transmission in patients coming to a hospital emergency department during the week of highest incidence and to analyze factors associated with transmission. Retrospective observational analysis of a cohort of patients treated in the emergency room during the 2014-2015 flu season. The following variables were collected from records: recorded influenza diagnosis, results of a rapid influenza confirmation test, point of exposure (emergency department, outpatient clinic, or the community), age, sex, flu vaccination or not, number of emergency visits, time spent in the waiting room, and total time in the hospital. We compiled descriptive statistics and performed bivariate and multivariate analyses by means of a Poisson regression to estimate relative risk (RR) and 95% CIs. The emergency department patients had a RR of contracting influenza 3.29 times that of the communityexposed population (95% CI, 1.53-7.08, P=.002); their risk was 2.05 times greater than that of outpatient clinic visitors (95% CI, 1.04-4.02, P=.036). Emergency patients under the age of 15 years had a 5.27 greater risk than older patients (95% CI, 1.59-17.51; P=.007). The RR of patients visiting more than once was 11.43 times greater (95% CI, 3.58-36.44; P<.001). The risk attributable to visiting the emergency department risk was 70.5%, whereas risk attributable to community exposure was 2%. The risk of contracting influenza is greater for emergency department patients than for the general population or for patients coming to the hospital for outpatient clinic visits. Patients under the age of 15 years incur greater risk.

  18. Serum brain natriuretic peptide and C-reactive protein levels in adolescent with polycystic ovary syndrome.

    Science.gov (United States)

    Deveer, Rüya; Engin-Üstün, Yaprak; Uysal, Sema; Su, Filiz Akın; Sarıaslan, Seval; Gülerman, Cavidan; Mollamahmutoğlu, Leyla

    2012-08-01

    Our primary aim was to investigate whether N-terminal pro-brain natriuretic peptide (NT-proBNP) increases in adolescent with polycystic ovary syndrome (PCOS) compared with healthy controls and secondary aim was to determine whether metabolic and hormonal differences exist between groups. In this cross-sectional study, 25 adolescent patients with PCOS and 25 normal ovulatory control not suffering from PCOS were involved in the study. Fasting serum NT-proBNP, C-reactive protein (CRP), homocystein, insulin levels and biochemical and hormonal parameters were measured. Serum NT-proBNP was not significantly different in PCOS subjects (0.62 ± 0.80 vs 1.12 ± 1.51 ng/mL, p = 0.154). The mean serum fasting insulin levels (22.64 ± 10.51 vs 13.32 ± 3.97 mIU/mL, p = 0.001) and Homeostasis Model Assessment Insulin-Resistance Index (HOMA-IR) levels (5.16 ± 1.81 vs 2.97 ± 0.89, p = 0.001) were significantly high in the study group. The median serum CRP levels were not significantly different between groups (1 [1-12] vs 1 [1-19] g/dL, p = 0.286). The present study demonstrated that the levels of BNP, CRP and homocystein were not different in PCOS subjects. Serum insulin levels and HOMA-IR were significantly higher in PCOS subjects. Possible serum markers for PCOS-related metabolic abnormalities and cardiovascular events, may not present in the adolescent years.

  19. Efavirenz Has the Highest Anti-Proliferative Effect of Non-Nucleoside Reverse Transcriptase Inhibitors against Pancreatic Cancer Cells.

    Directory of Open Access Journals (Sweden)

    Markus Hecht

    Full Text Available Cancer prevention and therapy in HIV-1-infected patients will play an important role in future. The non-nucleoside reverse transcriptase inhibitors (NNRTI Efavirenz and Nevirapine are cytotoxic against cancer cells in vitro. As other NNRTIs have not been studied so far, all clinically used NNRTIs were tested and the in vitro toxic concentrations were compared to drug levels in patients to predict possible anti-cancer effects in vivo.Cytotoxicity was studied by Annexin-V-APC/7AAD staining and flow cytometry in the pancreatic cancer cell lines BxPC-3 and Panc-1 and confirmed by colony formation assays. The 50% effective cytotoxic concentrations (EC50 were calculated and compared to the blood levels in our patients and published data.The in vitro EC50 of the different drugs in the BxPC-3 pancreatic cancer cells were: Efavirenz 31.5 μmol/l (= 9944 ng/ml, Nevirapine 239 μmol/l (= 63,786 ng/ml, Etravirine 89.0 μmol/l (= 38,740 ng/ml, Lersivirine 543 μmol/l (= 168,523 ng/ml, Delavirdine 171 μmol/l (= 78,072 ng/ml, Rilpivirine 24.4 μmol/l (= 8941 ng/ml. As Efavirenz and Rilpivirine had the highest cytotoxic potential and Nevirapine is frequently used in HIV-1 positive patients, the results of these three drugs were further studied in Panc-1 pancreatic cancer cells and confirmed with colony formation assays. 205 patient blood levels of Efavirenz, 127 of Rilpivirine and 31 of Nevirapine were analyzed. The mean blood level of Efavirenz was 3587 ng/ml (range 162-15,363 ng/ml, of Rilpivirine 144 ng/ml (range 0-572 ng/ml and of Nevirapine 4955 ng/ml (range 1856-8697 ng/ml. Blood levels from our patients and from published data had comparable Efavirenz levels to the in vitro toxic EC50 in about 1 to 5% of all patients.All studied NNRTIs were toxic against cancer cells. A low percentage of patients taking Efavirenz reached in vitro cytotoxic blood levels. It can be speculated that in HIV-1 positive patients having high Efavirenz blood levels pancreatic

  20. Genetic Variation in the Natriuretic Peptide System, Circulating Natriuretic Peptide Levels, and Blood Pressure

    DEFF Research Database (Denmark)

    Jeppesen, Jørgen L; Nielsen, Søren J; Torp-Pedersen, Christian

    2012-01-01

    -h ambulatory BP measurements (ABPMs) will influence the effect of NP gene variations on BP levels.MethodsWe used rs632793 at the NPPB (NP precursor B) locus to investigate the relationship between genetically determined serum N-terminal pro-brain NP (NT-proBNP) concentrations and BP levels...... determined by both 24-h ABPMs and OBPMs in a population consisting of 1,397 generally healthy individuals taking no BP-lowering drugs.Resultsrs632793 was significantly correlated with serum Nt-proBNP levels (r = 0.10, P = 0.0003), and participants with the A:A genotype had lower serum Nt-proBNP levels than......). Office BP decreased across the genotypes from A:A to G:G, but the differences did not reach statistical significance (P = 0.12).ConclusionsThis study suggests that 24-h ABPMs is a better method than OBPMs to detect significant differences in BP levels related to genetic variance and provides further...

  1. Assessment of a bedside test for N-terminal pro B-type natriuretic peptide (NT-proBNP) to differentiate cardiac from non-cardiac causes of pleural effusion in cats.

    Science.gov (United States)

    Wurtinger, Gabriel; Henrich, Estelle; Hildebrandt, Nicolai; Wiedemann, Nicola; Schneider, Matthias; Hassdenteufel, Esther

    2017-12-20

    Cats with pleural effusion represent common emergencies in small animal practice. The aim of this prospective study was to investigate the diagnostic ability of a point-of-care ELISA (POC-ELISA) for the measurement of N-terminal pro B-type natriuretic peptide (NT-proBNP) to differentiate cardiac from non-cardiac disease in cats with pleural effusion. The sample material for use of this rapid test was either plasma or diluted pleural effusion. Twenty cats with moderate to severe pleural effusion were prospectively recruited. The cats were grouped into two groups, with or without congestive heart failure (CHF; N-CHF), after complete work-up. Blood and effusion were collected in EDTA tubes. Plasma and pleural effusion supernatants were transferred into stabilizer tubes and frozen. POC-ELISA for NT-proBNP was performed with plasma and diluted effusion (1:1). Quantitative NT-proBNP measurement was performed in plasma and diluted and undiluted effusions. Six cats were assigned to the CHF group. Of the 14 cats in the N-CHF group, 6 had concurrent cardiac abnormalities that were not responsible for the effusion. For the detection of CHF, the test displayed respective sensitivities and specificities of 100% and 79% in plasma and 100% and 86% in diluted pleural fluid. Receiver operating characteristic (ROC) analysis for quantitative NT-proBNP measurement of plasma and diluted and undiluted pleural effusions displayed areas under the curve of 0.98, sensitivities of 100% and specificities of 86%. The optimum cut-off was calculated at 399 pmol/l in plasma and 229 pmol/l in the diluted effusion and 467 pmol/l in the undiluted effusion. POC-ELISA for NT-proBNP in both plasma and diluted pleural effusion was suitable to differentiate cardiac from non-cardiac causes of feline pleural effusion. According to our results, use of pleural effusion is feasible, but dilution of the effusion before measurement seems to improve specificity.

  2. Pleistocene climatic oscillations rather than recent human disturbance influence genetic diversity in one of the world's highest treeline species.

    Science.gov (United States)

    Peng, Yanling; Lachmuth, Susanne; Gallegos, Silvia C; Kessler, Michael; Ramsay, Paul M; Renison, Daniel; Suarez, Ricardo; Hensen, Isabell

    2015-10-01

    Biological responses to climatic change usually leave imprints on the genetic diversity and structure of plants. Information on the current genetic diversity and structure of dominant tree species has facilitated our general understanding of phylogeographical patterns. Using amplified fragment length polymorphism (AFLPs), we compared genetic diversity and structure of 384 adults of P. tarapacana with those of 384 seedlings across 32 forest sites spanning a latitudinal gradient of 600 km occurring between 4100 m and 5000 m a.s.l. in Polylepis tarapacana (Rosaceae), one of the world's highest treeline species endemic to the central Andes. Moderate to high levels of genetic diversity and low genetic differentiation were detected in both adults and seedlings, with levels of genetic diversity and differentiation being almost identical. Four slightly genetically divergent clusters were identified that accorded to differing geographical regions. Genetic diversity decreased from south to north and with increasing precipitation for adults and seedlings, but there was no relationship to elevation. Our study shows that, unlike the case for other Andean treeline species, recent human activities have not affected the genetic structure of P. tarapacana, possibly because its inhospitable habitat is unsuitable for agriculture. The current genetic pattern of P. tarapacana points to a historically more widespread distribution at lower altitudes, which allowed considerable gene flow possibly during the glacial periods of the Pleistocene epoch, and also suggests that the northern Argentinean Andes may have served as a refugium for historical populations. © 2015 Botanical Society of America.

  3. Consumer Airfare Report: Table 5 - Detailed Fare Information For Highest and Lowest Fare Markets Under 750 Miles

    Data.gov (United States)

    Department of Transportation — Provides detailed fare information for highest and lowest fare markets under 750 miles. For a more complete explanation, please read the introductory information at...

  4. WHICH MOTOR ABILITIES HAVE THE HIGHEST IMPACT ON WORKING PERFORMANCE OF SLOVENIAN SOLDIERS?

    Directory of Open Access Journals (Sweden)

    Maja Pori

    2010-09-01

    Full Text Available The objective of the research was to find a correlation between motor abilities and working efficiency of soldiers in a battle unit of Slovenia Armed Forces (SAF. The subject consisted of 115 soldiers (age = 27,1 ± 3,7 years who were serving in the first brigade of the SAF. Motor abilities were measured with 11 motor tests, assessing the level of flexibility, speed, strength and coordination. To evaluate working efficiency of soldiers a special questionnaire was used, which consisted of 19 statements. Superior officer was asked to fill a questionnaire for each inferior soldier with values from 1 to 5. The correlation between motor abilities and working efficiency was assessed with the Pearson’s correlation coefficient. We have found 5 statistically significant correlations. Motor tests correlating most with working performance were tests of arm strength.

  5. Symptomatic ventricular tachyarrhythmia is associated with delayed gadolinium enhancement in cardiac magnetic resonance imaging and with elevated plasma brain natriuretic peptide level in hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    Oka, Katsumi; Tsujino, Takeshi; Nakao, Shinji; Lee-Kawabata, Masaaki; Ezumi, Akira; Masai, Miho; Ohyanagi, Mitsumasa; Masuyama, Tohru

    2008-01-01

    Delayed gadolinium enhancement (DGE) in cardiac magnetic resonance (CMR) imaging indicates the areas with myocardial fibrosis, which are suggested to be arrhythmogenic substrate in hypertrophic cardiomyopathy (HCM). Elevated brain natriuretic peptide (BNP) is associated with cardiovascular events in HCM. We investigated the grade of DGE in CMR and plasma BNP levels in HCM patients with or without symptomatic ventricular tachycardia (VT) or ventricular fibrillation (VF). We recruited 26 consecutive untreated HCM patients without any symptoms of heart failure. They were divided into 2 groups: patients with symptomatic VT/VF [VT/VF (+) group, n=6]; patients without symptomatic VT/VF [VT/VF (-) group, n=20]. CMR was performed to evaluate left ventricular geometry and the grade of DGE. Plasma BNP levels, left ventricular mass index, and the number of segments with positive DGE were greater in the VT/VF (+) group than in the VT/VF (-) group (698.1±387.6 vs. 226.9±256.8 pg/ml, p=0.006; 152.3±49.5 vs. 89.5±24.1 g/m 2 , p=0.003; 9.7±5.7 vs. 3.5±3.3, p=0.013). On logistic regression, adjusted odds ratio for symptomatic VT/VF was 214 for log BNP (95% confidence interval [CI] 1.2-37,043, p=0.04) and 1.54 for DGE score (95% CI 1.01-2.34, p=0.04). High plasma BNP levels and the enlarged area of DGE in CMR were associated with symptomatic ventricular tachyarrhythmia. These factors may be useful markers for detecting high-risk patients of sudden cardiac death in HCM. (author)

  6. Mercury contamination from artisanal gold mining in Antioquia, Colombia: The world's highest per capita mercury pollution.

    Science.gov (United States)

    Cordy, Paul; Veiga, Marcello M; Salih, Ibrahim; Al-Saadi, Sari; Console, Stephanie; Garcia, Oseas; Mesa, Luis Alberto; Velásquez-López, Patricio C; Roeser, Monika

    2011-12-01

    The artisanal gold mining sector in Colombia has 200,000 miners officially producing 30tonnes Au/a. In the Northeast of the Department of Antioquia, there are 17 mining towns and between 15,000 and 30,000 artisanal gold miners. Guerrillas and paramilitary activities in the rural areas of Antioquia pushed miners to bring their gold ores to the towns to be processed in Processing Centers or entables. These Centers operate in the urban areas amalgamating the whole ore, i.e. without previous concentration, and later burn gold amalgam without any filtering/condensing system. Based on mercury mass balance in 15 entables, 50% of the mercury added to small ball mills (cocos) is lost: 46% with tailings and 4% when amalgam is burned. In just 5 cities of Antioquia, with a total of 150,000 inhabitants: Segovia, Remedios, Zaragoza, El Bagre, and Nechí, there are 323 entables producing 10-20tonnes Au/a. Considering the average levels of mercury consumption estimated by mass balance and interviews of entables owners, the mercury consumed (and lost) in these 5 municipalities must be around 93tonnes/a. Urban air mercury levels range from 300ng Hg/m(3) (background) to 1million ng Hg/m(3) (inside gold shops) with 10,000ng Hg/m(3) being common in residential areas. The WHO limit for public exposure is 1000ng/m(3). The total mercury release/emissions to the Colombian environment can be as high as 150tonnes/a giving this country the shameful first position as the world's largest mercury polluter per capita from artisanal gold mining. One necessary government intervention is to cut the supply of mercury to the entables. In 2009, eleven companies in Colombia legally imported 130tonnes of metallic mercury, much of it flowing to artisanal gold mines. Entables must be removed from urban centers and technical assistance is badly needed to improve their technology and reduce emissions. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. Assessment of natural background radiation in one of the highest regions of Ecuador

    Science.gov (United States)

    Pérez, Mario; Chávez, Estefanía; Echeverría, Magdy; Córdova, Rafael; Recalde, Celso

    2018-05-01

    Natural background radiation was measured in the province of Chimborazo (Ecuador) with the following reference coordinates 1°40'00''S 78°39'00''W, where the furthest point to the center of the planet is located. Natural background radiation measurements were performed at 130 randomly selected sites using a Geiger Müller GCA-07W portable detector; these measurements were run at 6 m away from buildings or walls and 1 m above the ground. The global average natural background radiation established by UNSCEAR is 2.4 mSv y-1. In the study area measurements ranged from 0.57 mSv y-1 to 3.09 mSv y-1 with a mean value of 1.57 mSv y-1, the maximum value was recorded in the north of the study area at 5073 metres above sea level (m.a.s.l.), and the minimum value was recorded in the southwestern area at 297 m.a.s.l. An isodose map was plotted to represent the equivalent dose rate due to natural background radiation. An analysis of variance (ANOVA) between the data of the high and low regions of the study area showed a significant difference (p < α), in addition a linear correlation coefficient of 0.92 was obtained, supporting the hypothesis that in high altitude zones extraterrestrial radiation contributes significantly to natural background radiation.

  8. Recent unprecedented tree-ring growth in bristlecone pine at the highest elevations and possible causes

    Science.gov (United States)

    Salzer, Matthew W.; Hughes, Malcolm K.; Bunn, Andrew G.; Kipfmueller, Kurt F.

    2009-01-01

    Great Basin bristlecone pine (Pinus longaeva) at 3 sites in western North America near the upper elevation limit of tree growth showed ring growth in the second half of the 20th century that was greater than during any other 50-year period in the last 3,700 years. The accelerated growth is suggestive of an environmental change unprecedented in millennia. The high growth is not overestimated because of standardization techniques, and it is unlikely that it is a result of a change in tree growth form or that it is predominantly caused by CO2 fertilization. The growth surge has occurred only in a limited elevational band within ≈150 m of upper treeline, regardless of treeline elevation. Both an independent proxy record of temperature and high-elevation meteorological temperature data are positively and significantly correlated with upper-treeline ring width both before and during the high-growth interval. Increasing temperature at high elevations is likely a prominent factor in the modern unprecedented level of growth for Pinus longaeva at these sites. PMID:19918054

  9. THE HIGHEST-ENERGY COSMIC RAYS CANNOT BE DOMINANTLY PROTONS FROM STEADY SOURCES

    Energy Technology Data Exchange (ETDEWEB)

    Fang, Ke [Department of Astronomy, University of Maryland, College Park, MD 20742-2421 (United States); Kotera, Kumiko [Sorbonne Universités, UPMC Univ. Paris 6 et CNRS, UMR 7095, Institut d’Astrophysique de Paris, 98 bis bd Arago, F-75014 Paris (France)

    2016-11-20

    The bulk of observed ultrahigh-energy cosmic rays could be light or heavier elements and originate from an either steady or transient population of sources. This leaves us with four general categories of sources. Energetic requirements set a lower limit on single-source luminosities, while the distribution of particle arrival directions in the sky sets a lower limit on the source number density. The latter constraint depends on the angular smearing in the skymap due to the magnetic deflections of the charged particles during their propagation from the source to the Earth. We contrast these limits with the luminosity functions from surveys of existing luminous steady objects in the nearby universe and strongly constrain one of the four categories of source models, namely, steady proton sources. The possibility that cosmic rays with energy >8 × 10{sup 19} eV are dominantly pure protons coming from steady sources is excluded at 95% confidence level, under the safe assumption that protons experience less than 30° magnetic deflection on flight.

  10. Density functional theory, comparative vibrational spectroscopic studies, highest occupied molecular orbital and lowest unoccupied molecular orbital analysis of Linezolid

    Science.gov (United States)

    Rajalakshmi, K.; Gunasekaran, S.; Kumaresan, S.

    2015-06-01

    The Fourier transform infrared spectra and Fourier transform Raman spectra of Linezolid have been recorded in the regions 4,000-400 and 4,000-100 cm-1, respectively. Utilizing the observed Fourier transform infrared spectra and Fourier transform Raman spectra data, a complete vibrational assignment and analysis of the fundamental modes of the compound have been carried out. The optimum molecular geometry, harmonic vibrational frequencies, infrared intensities and Raman scattering activities, have been calculated by density functional theory with 6-31G(d,p), 6-311G(d,p) and M06-2X/6-31G(d,p) levels. The difference between the observed and scaled wavenumber values of most of the fundamentals is very small. A detailed interpretation of the infrared and Raman spectra of Linezolid is reported. Mulliken's net charges have also been calculated. Ultraviolet-visible spectrum of the title molecule has also been calculated using time-dependent density functional method. Besides, molecular electrostatic potential, highest occupied molecular orbital and lowest unoccupied molecular orbital analysis and several thermodynamic properties have been performed by the density functional theoretical method.

  11. The Root-Associated Microbial Community of the World's Highest Growing Vascular Plants.

    Science.gov (United States)

    Angel, Roey; Conrad, Ralf; Dvorsky, Miroslav; Kopecky, Martin; Kotilínek, Milan; Hiiesalu, Inga; Schweingruber, Fritz; Doležal, Jiří

    2016-08-01

    Upward migration of plants to barren subnival areas is occurring worldwide due to raising ambient temperatures and glacial recession. In summer 2012, the presence of six vascular plants, growing in a single patch, was recorded at an unprecedented elevation of 6150 m.a.s.l. close to the summit of Mount Shukule II in the Western Himalayas (Ladakh, India). Whilst showing multiple signs of stress, all plants have managed to establish stable growth and persist for several years. To learn about the role of microbes in the process of plant upward migration, we analysed the root-associated microbial community of the plants (three individuals from each) using microscopy and tagged amplicon sequencing. No mycorrhizae were found on the roots, implying they are of little importance to the establishment and early growth of the plants. However, all roots were associated with a complex bacterial community, with richness and diversity estimates similar or even higher than the surrounding bare soil. Both soil and root-associated communities were dominated by members of the orders Sphingomonadales and Sphingobacteriales, which are typical for hot desert soils, but were different from communities of temperate subnival soils and typical rhizosphere communities. Despite taxonomic similarity on the order level, the plants harboured a unique set of highly dominant operational taxonomic units which were not found in the bare soil. These bacteria have been likely transported with the dispersing seeds and became part of the root-associated community following germination. The results indicate that developing soils act not only as a source of inoculation to plant roots but also possibly as a sink for plant-associated bacteria.

  12. A profile of women at the highest risk of maternal death in Pakistan.

    Science.gov (United States)

    Agha, Sohail

    2015-09-01

    Traditionally, health interventions implemented in Pakistan have been designed to increase the supply of maternal health services, but have not focused on reaching the poorest women or on providing high-quality services. Demand-side barriers to the utilization of health services are substantial in Pakistan, as are supply-side constraints to the provision of quality health care. This study uses data from the Pakistan Demographic and Health Survey 2006-07 to develop a profile of the poorest women in Pakistan in order to understand demand-side barriers to accessing maternal health care. The study shows stark differences in human capital, material and demographic resources between the poorest women and other women. It illustrates how these differences translate into low levels of service utilization among the poorest women. The purpose of the study is to stimulate a discussion of both the difficulty and the importance of reaching the poorest women with high-quality maternal health interventions. The findings from several pilot projects in Pakistan suggest that the poorest women can be reached at disproportionately higher rates than non-poor women through targeted, community-based, interventions. There is little demonstrable evidence, however, that high-quality care has been provided through these interventions. Evidence-based approaches, which have the potential to overcome financial and sociocultural barriers to service utilization, should be scaled up as soon as possible. However, measures should be taken to ensure that the quality of care provided through these interventions is adequate and able to lead to significant reductions in mortality. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  13. Accessory pathway location affects brain natriuretic peptide level in patients with Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Nakatani, Yosuke; Kumagai, Koji; Naito, Shigeto; Nakamura, Kohki; Minami, Kentaro; Nakano, Masahiro; Sasaki, Takehito; Kinugawa, Koichiro; Oshima, Shigeru

    2017-01-01

    The purpose of this study was to investigate the relationship between the accessory pathway location and brain natriuretic peptide (BNP) level in patients with Wolff-Parkinson-White (WPW) syndrome. We divided 102 WPW syndrome patients with normal left ventricular systolic function into four groups: those with manifest right (MR, n = 14), manifest septal (MS, n = 11), manifest left (ML, n = 30), and concealed (C, n = 47) accessory pathways. BNP level and electrophysiological properties, including difference in timing of the ventricular electrogram between the His bundle area and the distal coronary sinus area (His-CS delay), which indicate intraventricular dyssynchrony, were compared. BNP levels (pg/dl) were higher in the MR and MS groups than in the ML and C groups (MR, 64 ± 58; MS, 55 ± 45; ML, 17 ± 15; C, 25 ± 21; P syndrome patients with normal cardiac function.

  14. Serotonin-promoted elevation of ROS levels may lead to cardiac pathologies in diabetic rat

    Directory of Open Access Journals (Sweden)

    Ali Tahir

    2015-01-01

    Full Text Available Patients with diabetes mellitus (DM develop tendencies toward heart disease. Hyperglycemia induces the release of serotonin from enterochromaffin cells (EC. Serotonin was observed to elevate reactive oxygen species (ROS and downregulate antioxidant enzymes. As a result, elevated levels of serotonin could contribute to diabetic complications, including cardiac hypertrophy. In the present study, diabetes mellitus was induced in rats by alloxan administration; this was followed by the administration of serotonin to experimental animals. ROS, catalase (CAT, superoxide dismutase (SOD, B-type natriuretic peptide (BNP expression, and histopathological assessments were performed. Elevated ROS concentrations and decreased antioxidant enzyme activities were detected. Further, we observed an increase in cell surface area and elevated BNP expression which suggests that events associated with cardiac hypertrophy were increased in serotonin-administered diabetic rats. We conclude that serotonin secretion in diabetes could contribute to diabetic complications, including cardiac hypertrophy, through enhanced ROS production.

  15. Relative Importance of History of Heart Failure Hospitalization and N-Terminal Pro-B-Type Natriuretic Peptide Level as Predictors of Outcomes in Patients With Heart Failure and Preserved Ejection Fraction

    DEFF Research Database (Denmark)

    Kristensen, Søren L; Jhund, Pardeep S; Køber, Lars

    2015-01-01

    of NT-proBNP (n = 1468) (HR: 3.19; 95% CI: 2.68 to 3.80). In patients with no recent HF hospitalization and NT-proBNP ≤360 pg/ml (n = 1,187), the event rate was 2.43 (95% CI: 2.03 to 2.90) compared with 17.79 (95% CI: 15.77 to 20.07) per 100 person-years when both risk predictors were present (n = 523......; HR: 6.18; 95% CI: 4.96 to 7.69). CONCLUSIONS: Recent hospitalization for HF or an elevated level of NT-proBNP identified patients at higher risk for cardiovascular events, and this risk was increased further when both factors were present.......OBJECTIVES: The aim of this study was to investigate N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and recent heart failure (HF) hospitalization as predictors of future events in heart failure - preserved ejection fraction (HF-PEF). BACKGROUND: Recently, doubt has been expressed...

  16. Highest weight generating functions for hyperKähler T{sup ⋆}(G/H) spaces

    Energy Technology Data Exchange (ETDEWEB)

    Hanany, Amihay [Theoretical Physics Group, Imperial College London,Prince Consort Road, London, SW7 2AZ (United Kingdom); Ramgoolam, Sanjaye [Centre for Research in String Theory,School of Physics and Astronomy, Queen Mary University of London,Mile End Road, London E1 4NS (United Kingdom); Rodriguez-Gomez, Diego [Department of Physics, Universidad de Oviedo,Avda. Calvo Sotelo 18, 33007, Oviedo (Spain)

    2016-10-05

    We develop an efficient procedure for counting holomorphic functions on a hyperKahler cone that has a resolution as a cotangent bundle of a homogeneous space by providing a formula for computing the corresponding Highest Weight Generating function.

  17. Influence of sports games classes in specialized sections on formation of healthy lifestyle at students of the highest educational institutions

    OpenAIRE

    Kudryavtsev, M.; Galimova, A.; Alshuvayli, Kh.; Altuvayni, A.

    2018-01-01

    In modern society, the problem of formation of healthy lifestyle at youth, in particular, at students of the highest educational institutions is very relevant. Sport is a good mean for motivation, in this case – sports games. Purpose: to reveal consequences of participation in sports games and influence of these actions on healthy lifestyle of students of the highest educational institutions, to designate a role of classes in the sections, specializing in preparation for sports games in this ...

  18. Investigation of Behçet's Disease and Recurrent Aphthous Stomatitis Frequency: The Highest Prevalence in Turkey

    Directory of Open Access Journals (Sweden)

    Yalçın Baş

    2016-08-01

    Full Text Available Background: The Recurrent Aphthous Stomatitis (RAS is the most frequently observed painful pathology of the oral mucosa in the society. It appears mostly in idiopathic form; however, it may also be related with systemic diseases like Behçet’s Disease (BD. Aims: Determining the prevalence of RAS and BD in the Northern Anatolian Region, which is one of the important routes on the Antique Silk Road. Study Design: Cross-sectional study. Methods: Overall, 85 separate exemplification groups were formed to reflect the population density, and the demographic data of the region they represent. In the first stage, the individuals, who were selected in random order, were invited to a Family Physician Unit at a certain date and time. The dermatological examinations of the volunteering individuals were performed by only 3 dermatology specialists. In the second stage, those individuals who had symptoms of BD were invited to our hospital, and the Pathergy Test and eye examinations were performed. Results: The annual prevalence of RAS was determined as 10.84%. The annual prevalence was determined to be higher in women than in men (p=0.000. It was observed that the prevalence was at the peak level in the 3rd decade, and then decreased proportionally in the following decades (p=0.000. It was also observed that the aphtha recurrence decreased in the following decades (p=0.048. The Behçet’s prevalence was found to be 0.60%. The prevalence in women was found to be higher than in men (0.86% female, 0.14% male; p=0.022. Conclusion: While the RAS prevalence ratio was at an average value when compared with the other societies; the BD prevalence was found as the highest ratio in the world according to the literature.

  19. The additive value of N-terminal pro-B-type natriuretic peptide testing at the emergency department in patients with acute dyspnoea.

    Science.gov (United States)

    van der Burg-de Graauw, N; Cobbaert, C M; Middelhoff, C J F M; Bantje, T A; van Guldener, C

    2009-05-01

    B-type natriuretic peptide (BNP) and its inactive counterpart NT-proBNP can help to identify or rule out heart failure in patients presenting with acute dyspnoea. It is not well known whether measurement of these peptides can be omitted in certain patient groups. We conducted a prospective observational study of 221 patients presenting with acute dyspnoea at the emergency department. The attending physicians estimated the probability of heart failure by clinical judgement. NT-proBNP was measured, but not reported. An independent panel made a final diagnosis of all available data including NT-proBNP level and judged whether and how NT-proBNP would have altered patient management. NT-proBNP levels were highest in patients with heart failure, alone or in combination with pulmonary failure. Additive value of NT-proBNP was present in 40 of 221 (18%) of the patients, and it mostly indicated that a more intensive treatment for heart failure would have been needed. Clinical judgement was an independent predictor of additive value of NT-proBNP with a maximum at a clinical probability of heart failure of 36%. NT-proBNP measurement has additive value in a substantial number of patients presenting with acute dyspnoea, but can possibly be omitted in patients with a clinical probability of heart failure of >70%.

  20. Inclusion of Highest Glasgow Coma Scale Motor Component Score in Mortality Risk Adjustment for Benchmarking of Trauma Center Performance.

    Science.gov (United States)

    Gomez, David; Byrne, James P; Alali, Aziz S; Xiong, Wei; Hoeft, Chris; Neal, Melanie; Subacius, Harris; Nathens, Avery B

    2017-12-01

    The Glasgow Coma Scale (GCS) is the most widely used measure of traumatic brain injury (TBI) severity. Currently, the arrival GCS motor component (mGCS) score is used in risk-adjustment models for external benchmarking of mortality. However, there is evidence that the highest mGCS score in the first 24 hours after injury might be a better predictor of death. Our objective was to evaluate the impact of including the highest mGCS score on the performance of risk-adjustment models and subsequent external benchmarking results. Data were derived from the Trauma Quality Improvement Program analytic dataset (January 2014 through March 2015) and were limited to the severe TBI cohort (16 years or older, isolated head injury, GCS ≤8). Risk-adjustment models were created that varied in the mGCS covariates only (initial score, highest score, or both initial and highest mGCS scores). Model performance and fit, as well as external benchmarking results, were compared. There were 6,553 patients with severe TBI across 231 trauma centers included. Initial and highest mGCS scores were different in 47% of patients (n = 3,097). Model performance and fit improved when both initial and highest mGCS scores were included, as evidenced by improved C-statistic, Akaike Information Criterion, and adjusted R-squared values. Three-quarters of centers changed their adjusted odds ratio decile, 2.6% of centers changed outlier status, and 45% of centers exhibited a ≥0.5-SD change in the odds ratio of death after including highest mGCS score in the model. This study supports the concept that additional clinical information has the potential to not only improve the performance of current risk-adjustment models, but can also have a meaningful impact on external benchmarking strategies. Highest mGCS score is a good potential candidate for inclusion in additional models. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Assessment of cardiotoxicity during haemopoietic stem cell transplantation with plasma brain natriuretic peptide.

    Science.gov (United States)

    Snowden, J A; Hill, G R; Hunt, P; Carnoutsos, S; Spearing, R L; Espiner, E; Hart, D N

    2000-08-01

    Cardiac failure is a known complication of haemopoietic stem cell transplantation (HSCT) and is often difficult to diagnose as patients may have multiple medical problems. Since brain natriuretic peptide (BNP) is largely a hormone of cardiac ventricular origin and is released early in the course of ventricular dysfunction, we have examined the value of serial plasma BNP levels for detecting cardiac failure in patients undergoing cytotoxic conditioning for HSCT. Fifteen patients undergoing HSCT were evaluated (10 undergoing autologous HSCT; five undergoing allogeneic HSCT). BNP was measured by radioimmunoassay prior to therapy and weekly for 5 weeks. Seven patients had a significant rise in BNP level (above a previously established threshold of 43 pmol/l associated with cardiac failure), occurring 1-4 weeks post commencement of conditioning. In three of these patients, cardiac failure was subsequently diagnosed clinically 3, 9 and 23 days after a BNP level of 43 pmol/l had been detected. These three patients had the highest peak BNP levels for the group and in each case elevation in BNP level occurred for a period exceeding 1 week. Although numbers were relatively small, a BNP >43 pmol/l was significantly associated with the inclusion of high-dose cyclophosphamide in the preparative regimen (P = 0.02). BNP levels showed no relationship to febrile episodes. In conclusion, these results show that plasma BNP may be used as a marker for early detection of cardiac dysfunction in patients undergoing HSCT, particularly if levels are increased for periods exceeding 1 week. Measurement of BNP during HSCT may be helpful in patients at risk of cardiac failure, in complex clinical situations and in monitoring the cardiotoxicity of preparative regimens.

  2. Haematopoietic depletion in vaccine-induced neonatal pancytopenia depends on both the titre and specificity of alloantibody and levels of MHC I expression.

    Science.gov (United States)

    Bell, Charlotte R; MacHugh, Niall D; Connelley, Timothy K; Degnan, Kathryn; Morrison, W Ivan

    2015-07-09

    Bovine Neonatal Pancytopenia (BNP) is a disease of calves characterised by haematopoietic depletion, mediated by ingestion of alloantibodies in colostrum. It has been linked epidemiologically to vaccination of the dams of affected calves with a particular vaccine (Pregsure) containing a novel adjuvant. Evidence suggests that BNP-alloantibodies are directed against MHC I molecules, induced by contaminant bovine cellular material from Madin-Darby Bovine Kidney (MDBK) cells used in the vaccine's production. We aimed to investigate the specificity of BNP-alloantibody for bovine MHC I alleles, particularly those expressed by MDBK cells, and whether depletion of particular cell types is due to differential MHC I expression levels. A complement-mediated cytotoxicity assay was used to assess functional serum alloantibody titres in BNP-dams, Pregsure-vaccinated dams with healthy calves, cows vaccinated with an alternative product and unvaccinated controls. Alloantibody specificity was investigated using transfected mouse lines expressing the individual MHC I alleles identified from MDBK cells and MHC I-defined bovine leukocyte lines. All BNP-dams and 50% of Pregsure-vaccinated cows were shown to have MDBK-MHC I specific alloantibodies, which cross-reacted to varying degrees with other MHC I genotypes. MHC I expression levels on different blood cell types, assessed by flow cytometry, were found to correlate with levels of alloantibody-mediated damage in vitro and in vivo. Alloantibody-killed bone marrow cells were shown to express higher levels of MHC I than undamaged cells. The results provide evidence that MHC I-specific alloantibodies play a dominant role in the pathogenesis of BNP. Haematopoietic depletion was shown to be dependent on the titre and specificity of alloantibody produced by individual cows and the density of surface MHC I expression by different cell types. Collectively, the results support the hypothesis that MHC I molecules originating from MDBK cells

  3. Development of an Interferometric Phased Array Trigger for Balloon-Borne Detection of the Highest Energy Cosmic Particles

    Science.gov (United States)

    Vieregg, Abigail

    Through high energy neutrino astrophysics, we explore the structure and evolution of the universe in a unique way and learn about the physics inside of astrophysical sources that drives the acceleration of the highest energy particles. Neutrinos travel virtually unimpeded through the universe, making them unique messenger particles for cosmic sources and carrying information about very distant sources that would otherwise be unavailable. The highest energy neutrinos (E>10^{18} eV), created as a by-product of the interaction of the highest energy cosmic rays with the cosmic microwave background, are an important tool for determining the origin of the highest energy cosmic rays and still await discovery. Balloon-borne and ground-based experiments are poised to discover these ultra-high energy (UHE) cosmogenic neutrinos by looking for radio emission from two different types of neutrino interactions: particle cascades induced by neutrinos in glacial ice, and extensive air showers in the atmosphere induced by the charged-particle by-product of tau neutrinos interacting in the earth. These impulsive radio detectors are also sensitive to radio emission from extensive air showers induced directly by UHE cosmic rays. Balloon-borne experiments are especially well-suited for discovering the highest energy neutrinos, and are the only way to probe the high energy cutoff of the sources themselves to reveal the astrophysics that drives the central engines inside the most energetic accelerators in the universe. Balloon platforms offer the chance to monitor extremely large volumes of ice and atmosphere, but with a higher energy threshold compared to ground-based observatories, since the neutrino interaction happens farther from the detector. This tradeoff means that the sensitivity of balloon-borne experiments, such as the Antarctic Impulsive Transient Antenna (ANITA) or the ExaVolt Antenna, is optimized for discovery of the highest energy neutrinos. We are developing an

  4. Ground-state energies and highest occupied eigenvalues of atoms in exchange-only density-functional theory

    Science.gov (United States)

    Li, Yan; Harbola, Manoj K.; Krieger, J. B.; Sahni, Viraht

    1989-11-01

    The exchange-correlation potential of the Kohn-Sham density-functional theory has recently been interpreted as the work required to move an electron against the electric field of its Fermi-Coulomb hole charge distribution. In this paper we present self-consistent results for ground-state total energies and highest occupied eigenvalues of closed subshell atoms as obtained by this formalism in the exchange-only approximation. The total energies, which are an upper bound, lie within 50 ppm of Hartree-Fock theory for atoms heavier than Be. The highest occupied eigenvalues, as a consequence of this interpretation, approximate well the experimental ionization potentials. In addition, the self-consistently calculated exchange potentials are very close to those of Talman and co-workers [J. D. Talman and W. F. Shadwick, Phys. Rev. A 14, 36 (1976); K. Aashamar, T. M. Luke, and J. D. Talman, At. Data Nucl. Data Tables 22, 443 (1978)].

  5. Serum potassium decline during hospitalization for acute decompensated heart failure is a predictor of 6-month mortality, independent of N-terminal pro-B-type natriuretic peptide levels: An individual patient data analysis.

    Science.gov (United States)

    Salah, Khibar; Pinto, Yigal M; Eurlings, Luc W; Metra, Marco; Stienen, Susan; Lombardi, Carlo; Tijssen, Jan G; Kok, Wouter E

    2015-09-01

    Limited data exist for the role of serum potassium changes during hospitalization for acute decompensated heart failure (ADHF). The present study investigated the long-term prognostic value of potassium changes during hospitalization in patients admitted for ADHF. Our study is a pooled individual patient data analysis assembled from 3 prospective cohorts comprising 754 patients hospitalized for ADHF. The endpoint was all-cause mortality within 180 days after discharge. Serum potassium levels and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured at admission and at discharge. A percentage decrease >15% in serum potassium levels occurred in 96 (13%) patients, and an absolute decrease of >0.7 mmol/L in serum potassium levels occurred in 85 (12%) patients; and both were predictors of poor outcome independent of admission or discharge serum potassium. After the addition of other strong predictors of mortality-a 30% change in NT-proBNP during hospitalization, discharge levels of NT-proBNP, renal markers, and other relevant clinical variables-the multivariate hazard ratio of serum potassium percentage reduction of >15% remained an independent predictor of 180-day mortality (hazard ratio 2.06, 95% CI 1.14-3.73). A percentage serum potassium decline of >15% is an independent predictor of 180-day all-cause mortality on top of baseline potassium levels, NT-proBNP levels, renal variables, and other relevant clinical variables. This suggest that patients hospitalized for ADHF with a decline of >15% in serum potassium levels are at risk and thus monitoring and regulating of serum potassium level during hospitalization are needed in these patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Adiponectin through its biphasic serum level is a useful biomarker during transition from diastolic dysfunction to systolic dysfunction - an experimental study.

    Science.gov (United States)

    Fu, Mingqiang; Zhou, Jingmin; Qian, Juying; Jin, Xuejuan; Zhu, Hongmin; Zhong, Chunlin; Fu, Michael; Zou, Yunzeng; Ge, Junbo

    2012-08-30

    Adiponectin is reported to relate with cardiovascular diseases, we sought to examine whether adiponectin is associated with disease progression of heart failure from hypertension in rats in comparison with other known biomarkers and echocardiographic parameters. Spontaneously hypertensive rats (SHR, n = 35), aged 1 month, were used and followed up to 18 months. High frequency echocardiography was performed both at baseline and every 3 months thereafter. Moreover, serum levels of N-terminal pro-natriuretic peptide (NT-proBNP) and interleukin-6 (IL-6) as well as serum level and tissue expression of adiponectin were determined at the same time as echocardiography. The results clearly demonstrated time-dependent progression of hypertension and heart dysfunction as evidenced by gradually increased left ventricular mass index, NT-proBNP, IL-6 as well as gradually decreased cardiac function as assessed by echocardiography. Meanwhile, tissue and serum adiponectin decreased from 3 months and reached plateau until 12 months in parallel with decreasing of cardiac diastolic function. Thereafter, adiponectin levels increased prior to occurrence of systolic dysfunction. Adiponectin concentration is inversely related with NT-proBNP, IL-6 and E/E' (correlation coefficient (r) = -0.756 for NT-proBNP, p A and E'/A' (r = 0.683 for E/A, p = 0.001, 0.671 for E'/A', p = 0.001, respectively). No difference for adiponectin distribution among visceral adipose tissues was found. Adiponectin through its biphasic serum level is a useful biomarker during transition from diastolic dysfunction to systolic dysfunction.

  7. Sporothrix brasiliensis produces the highest levels of oxidative stress in a murine model among the species of the Sporothrix schenckii complex

    Directory of Open Access Journals (Sweden)

    Débora Nunes Mario

    Full Text Available Abstract INTRODUCTION: We compared indicators of oxidative stress in the tissue of mice infected with strains from Sporothrix schenckii complex. METHODS: Mice were inoculated with Sporothrix brasiliensis, Sporothrix schenckii sensu stricto, Sporothrix globosa, Sporothrix mexicana or Sporothrix albicans. The activity of catalase and glutathione were accessed in the liver and spleen. RESULTS: Animals infected with S. brasiliensis exhibited splenomegaly and significant decrease in catalase activity, and protein and non-protein thiol content compared to animals infected with the other species. CONCLUSIONS: Sporothrix brasiliensis exhibits higher pathogenicity compared to other species of the Sporothrix schenckii complex by increasing oxidative stress in animal tissue.

  8. The practice of euthanasia at the highest level of society: the Lords Dawson (1864-1945) and Horder (1871-1955).

    Science.gov (United States)

    Cook, G C

    2006-05-01

    The intimate involvement of Lord Dawson of Penn in the terminal illness of King George V in 1936 was highlighted 50 years later when his personal papers were released for perusal in the public arena. A popular jingle of the time relating to Dawson was recalled in a leading article in The Times newspaper in 1986. Knowing that a similar rhyme was in circulation involving Lord Horder of Ashford, I wrote to his son in order to verify exactly what this was; his reply is reproduced in this article.

  9. Solving The Long-Standing Problem Of Low-Energy Nuclear Reactions At The Highest Microscopic Level. Annual Continuation And Progress Report, August 15, 2014 -- August 14, 2015

    Energy Technology Data Exchange (ETDEWEB)

    Quaglioni, Sofia [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-03-19

    The aim of this project is to develop a comprehensive framework that will lead to a fundamental description of both structural properties and reactions of light nuclei in terms of constituent protons and neutrons interacting through nucleon-nucleon (NN) and three-nucleon (3N) forces. This project will provide the research community with the theoretical and computational tools what will enable: an accurate prediction for fusion reactions that power stars and Earth-based fusion facilities; an improved description of the spectroscopy of exotic nuclei, including light Borromean systems; and, a fundamental understanding of the three-nucleon force in nuclear reaction and nuclei at the drip line.

  10. The Experience Elicited by Hallucinogens Presents the Highest Similarity to Dreaming within a Large Database of Psychoactive Substance Reports

    Science.gov (United States)

    Sanz, Camila; Zamberlan, Federico; Erowid, Earth; Erowid, Fire; Tagliazucchi, Enzo

    2018-01-01

    Ever since the modern rediscovery of psychedelic substances by Western society, several authors have independently proposed that their effects bear a high resemblance to the dreams and dreamlike experiences occurring naturally during the sleep-wake cycle. Recent studies in humans have provided neurophysiological evidence supporting this hypothesis. However, a rigorous comparative analysis of the phenomenology (“what it feels like” to experience these states) is currently lacking. We investigated the semantic similarity between a large number of subjective reports of psychoactive substances and reports of high/low lucidity dreams, and found that the highest-ranking substance in terms of the similarity to high lucidity dreams was the serotonergic psychedelic lysergic acid diethylamide (LSD), whereas the highest-ranking in terms of the similarity to dreams of low lucidity were plants of the Datura genus, rich in deliriant tropane alkaloids. Conversely, sedatives, stimulants, antipsychotics, and antidepressants comprised most of the lowest-ranking substances. An analysis of the most frequent words in the subjective reports of dreams and hallucinogens revealed that terms associated with perception (“see,” “visual,” “face,” “reality,” “color”), emotion (“fear”), setting (“outside,” “inside,” “street,” “front,” “behind”) and relatives (“mom,” “dad,” “brother,” “parent,” “family”) were the most prevalent across both experiences. In summary, we applied novel quantitative analyses to a large volume of empirical data to confirm the hypothesis that, among all psychoactive substances, hallucinogen drugs elicit experiences with the highest semantic similarity to those of dreams. Our results and the associated methodological developments open the way to study the comparative phenomenology of different altered states of consciousness and its relationship with non-invasive measurements of brain physiology. PMID

  11. Relation of average and highest solvent vapor concentrations in workplaces in small to medium enterprises and large enterprises.

    Science.gov (United States)

    Ukai, Hirohiko; Ohashi, Fumiko; Samoto, Hajime; Fukui, Yoshinari; Okamoto, Satoru; Moriguchi, Jiro; Ezaki, Takafumi; Takada, Shiro; Ikeda, Masayuki

    2006-04-01

    The present study was initiated to examine the relationship between the workplace concentrations and the estimated highest concentrations in solvent workplaces (SWPs), with special references to enterprise size and types of solvent work. Results of survey conducted in 1010 SWPs in 156 enterprises were taken as a database. Workplace air was sampled at > or = 5 crosses in each SWP following a grid sampling strategy. An additional air was grab-sampled at the site where the worker's exposure was estimated to be highest (estimated highest concentration or EHC). The samples were analyzed for 47 solvents designated by regulation, and solvent concentrations in each sample were summed up by use of additiveness formula. From the workplace concentrations at > or = 5 points, geometric mean and geometric standard deviations were calculated as the representative workplace concentration (RWC) and the indicator of variation in workplace concentration (VWC). Comparison between RWC and EHC in the total of 1010 SWPs showed that EHC was 1.2 (in large enterprises with>300 employees) to 1.7 times [in small to medium (SM) enterprises with enterprises and large enterprises, both RWC and EHC were significantly higher in SM enterprises than in large enterprises. Further comparison by types of solvent work showed that the difference was more marked in printing, surface coating and degreasing/cleaning/wiping SWPs, whereas it was less remarkable in painting SWPs and essentially nil in testing/research laboratories. In conclusion, the present observation as discussed in reference to previous publications suggests that RWC, EHC and the ratio of EHC/WRC varies substantially among different types of solvent work as well as enterprise size, and are typically higher in printing SWPs in SM enterprises.

  12. The Experience Elicited by Hallucinogens Presents the Highest Similarity to Dreaming within a Large Database of Psychoactive Substance Reports

    Directory of Open Access Journals (Sweden)

    Camila Sanz

    2018-01-01

    Full Text Available Ever since the modern rediscovery of psychedelic substances by Western society, several authors have independently proposed that their effects bear a high resemblance to the dreams and dreamlike experiences occurring naturally during the sleep-wake cycle. Recent studies in humans have provided neurophysiological evidence supporting this hypothesis. However, a rigorous comparative analysis of the phenomenology (“what it feels like” to experience these states is currently lacking. We investigated the semantic similarity between a large number of subjective reports of psychoactive substances and reports of high/low lucidity dreams, and found that the highest-ranking substance in terms of the similarity to high lucidity dreams was the serotonergic psychedelic lysergic acid diethylamide (LSD, whereas the highest-ranking in terms of the similarity to dreams of low lucidity were plants of the Datura genus, rich in deliriant tropane alkaloids. Conversely, sedatives, stimulants, antipsychotics, and antidepressants comprised most of the lowest-ranking substances. An analysis of the most frequent words in the subjective reports of dreams and hallucinogens revealed that terms associated with perception (“see,” “visual,” “face,” “reality,” “color”, emotion (“fear”, setting (“outside,” “inside,” “street,” “front,” “behind” and relatives (“mom,” “dad,” “brother,” “parent,” “family” were the most prevalent across both experiences. In summary, we applied novel quantitative analyses to a large volume of empirical data to confirm the hypothesis that, among all psychoactive substances, hallucinogen drugs elicit experiences with the highest semantic similarity to those of dreams. Our results and the associated methodological developments open the way to study the comparative phenomenology of different altered states of consciousness and its relationship with non-invasive measurements of brain

  13. Communication: The highest frequency hydrogen bond vibration and an experimental value for the dissociation energy of formic acid dimer

    DEFF Research Database (Denmark)

    Kollipost, F.; Larsen, René Wugt; Domanskaya, A.V.

    2012-01-01

    The highest frequency hydrogen bond fundamental of formic acid dimer, ν24 (Bu), is experimentally located at 264 cm−1. FTIR spectra of this in-plane bending mode of (HCOOH)2 and band centers of its symmetric D isotopologues (isotopomers) recorded in a supersonic slit jet expansion are presented...... thermodynamics treatment of the dimerization process up to room temperature. We obtain D0 = 59.5(5) kJ/mol as the best experimental estimate for the dimer dissociation energy at 0 K. Further improvements have to wait for a more consistent determination of the room temperature equilibrium constant....

  14. The Physikalisch-Technische Bundesanstalt PTB (physical-technical Federal institution) - research institute and highest technical authority

    International Nuclear Information System (INIS)

    Klages, H.

    1976-01-01

    The PTB Braunschweig and Berlin is a Federal institution for the natural sciences and engineering and the highest technical authority for measurements. It is subject to the directions of the Federal Ministry for Economic Affairs. Its main tasks are representation, maintenance and development of physical units and, in connection with this, research, examinations, and granting permissions for calibration measuring equipment, as well as examinations of building types and permissions. The types of measuring equipment are represented. Many examinations are carried out on a voluntary basis. The advisory activities and the PTB's publications are also reported on. An organizational plan informs of the structure of the PTB. (orig.) [de

  15. The Licancabur Project: Exploring the Limits of Life in the Highest Lake on Earth as an Analog to Martian Paleolakes

    Science.gov (United States)

    Cabrol, N. A.; Grin, E. A.; McKay, C. P.; Friedmann, I.; Diaz, G. Chong; Demergasso, C.; Kisse, K.; Grigorszky, I.; Friedmann, R. Ocampo; Hock, A.

    2003-01-01

    The Licancabur volcano (6017 m) hosts the highest and one of the least explored lakes in the world in its summit crater. It is located 22 deg.50 min. South / 67 deg.53 min. West at the boundary of Chile and Bolivia in the High-Andes. In a freezing environment, the lake located in volcano-tectonic environment combines low-oxygen, low atmospheric pressure due to altitude, and high-UV radiation (see table). However, its bottom water temperature remains above 0 C year-round. These conditions make Licancabur a unique analog to Martian paleolakes considered high-priority sites for the search for life on Mars.

  16. Potential need for re-definition of the highest priority recovery action in the Krsko SAG-1

    International Nuclear Information System (INIS)

    Bilic Zabric, T.; Basic, I.

    2005-01-01

    Replacement of old SG (Steam Generators) [7] and the characteristic of new ones throws the question of proper accident management strategy, which leans on philosophy that repair and recovery actions have first priority. In the current NPP Krsko SAMGs (Severe Accident Management Guidelines), water supply to the SG has priority over re-injection water into the core. NPP Krsko reconsidered the highest priority of SAG-1 (inject water to the SG), against the WOG (Westinghouse Owners Group) generic approach (inject water into the core) and potential revision of Severe Accident Phenomenology Evaluations using MAAP (Modular accident Analysis Program) 4.0.5 code. (author)

  17. Derivation and validation of a simple clinical risk-model in heart failure based on 6 minute walk test performance and NT-proBNP status--do we need specificity for sex and beta-blockers?

    Science.gov (United States)

    Frankenstein, L; Goode, K; Ingle, L; Remppis, A; Schellberg, D; Nelles, M; Katus, H A; Clark, A L; Cleland, J G F; Zugck, C

    2011-02-17

    It is unclear whether risk prediction strategies in chronic heart failure (CHF) need to be specific for sex or beta-blockers. We examined this problem and developed and validated the consequent risk models based on 6-minute-walk-test and NT-proBNP. The derivation cohort comprised 636 German patients with systolic dysfunction. They were validated against 676 British patients with similar aetiology. ROC-curves for 1-year mortality identified cut-off values separately for specificity (none, sex, beta-blocker, both). Patients were grouped according to number of cut-offs met (group I/II/III - 0/1/2 cut-offs). Widest separation between groups was achieved with sex- and beta-blocker-specific cut offs. In the derivation population, 1-year mortality was 0%, 8%, 31% for group I, II and III, respectively. In the validation population, 1-year rates in the three risk groups were 2%, 7%, 14%, respectively, after application of the same cut-offs. Risk stratification for CHF should perhaps take sex and beta-blocker usage into account. We derived and independently validated relevant risk models based on 6-minute-walk-tests and NT-proBNP. Specifying sex and use of beta-blockers identified three distinct sub-groups with widely differing prognosis. In clinical practice, it may be appropriate to tailor the intensity of follow-up and/or the treatment strategy according to the risk-group. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  18. A cost effectiveness study establishing the impact and accuracy of implementing the NICE guidelines lowering plasma NTproBNP threshold in patients with clinically suspected heart failure at our institution.

    Science.gov (United States)

    Webb, Jessica; Draper, Jane; Rua, Tiago; Yiu, Yee; Piper, Susan; Teall, Thomas; Fovargue, Lauren; Bolca, Elena; Jackson, Tom; Claridge, Simon; Sieniewicz, Ben; Porter, Bradley; McDiarmid, Adam; Rajani, Ronak; Kapetanakis, Stamatis; Rinaldi, Christopher A; Razavi, Reza; McDonagh, Theresa A; Carr-White, Gerald

    2018-04-15

    The 2014 National Institute of Clinical Excellence (NICE) guidelines on the management of acute heart failure recommended using a plasma NT-proBNP threshold of 300pg/ml to assist in ruling out the diagnosis of heart failure (HF), updating previous guidelines recommending using a threshold of 400pg/ml. NICE based their recommendations on 6 studies performed in other countries. This study sought to determine the diagnostic and economic implications of using these thresholds in a large unselected UK population. Patient and clinical demographics were recorded for all consecutive suspected HF patients over 12months, as well as clinical outcomes including time to HF hospitalisation and time to death (follow up 15.8months). Of 1995 unselected patients admitted with clinically suspected HF, 1683 (84%) had a NTproBNP over the current NICE recommended threshold, of which 35% received a final diagnosis of HF. Lowering the threshold from 400 to 300pg/ml would have involved screening an additional 61 patients and only would have identified one new patient with HF (sensitivity 0.985, NPV 0.976, area under the curve (AUC) at 300pg/ml 0.67; sensitivity 0.983, NPV 0.977, AUC 0.65 at 400pg/ml). The economic implications of lowering the threshold would have involved additional costs of £42,842.04 (£702.33 per patient screened, or £ 42,824.04 per new HF patient). Applying the recent updated NICE guidelines to an unselected real world population increases the AUC but would have a significant economic impact and only identified one new patient with heart failure. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Highest recorded electrical conductivity and microstructure in polypropylene-carbon nanotubes composites and the effect of carbon nanofibers addition

    Science.gov (United States)

    Ramírez-Herrera, C. A.; Pérez-González, J.; Solorza-Feria, O.; Romero-Partida, N.; Flores-Vela, A.; Cabañas-Moreno, J. G.

    2018-04-01

    In the last decade, numerous investigations have been devoted to the preparation of polypropylene-multiwalled carbon nanotubes (PP/MWCNT) nanocomposites having enhanced properties, and in particular, high electrical conductivities (> 1 S cm-1). The present work establishes that the highest electrical conductivity in PP/MWCNT nanocomposites is limited by the amount of nanofiller content which can be incorporated in the polymer matrix, namely, about 20 wt%. This concentration of MWCNT in PP leads to a maximum electrical conductivity slightly lower than 8 S cm-1, but only by assuring an adequate combination of dispersion and spatial distribution of the carbon nanotubes. The realization of such an optimal microstructure depends on the characteristics of the production process of the PP/MWCNT nanocomposites; in our experiments, involving composite fabrication by melt mixing and hot pressing, a second re-processing cycle is shown to increase the electrical conductivity values by up to two orders of magnitude, depending on the MWCNT content of the nanocomposite. A modest increase of the highest electrical conductivity obtained in nanocomposites with 21.5 wt% MWCNT content has been produced by the combined use of carbon nanofibers (CNF) and MWCNT, so that the total nanofiller content was increased to 30 wt% in the nanocomposite with PP—15 wt% MWCNT—15 wt%CNF.

  20. Presentation and verification of a simple mathematical model foridentification of the areas behind noise barrierwith the highest performance

    Directory of Open Access Journals (Sweden)

    M. Monazzam

    2009-07-01

    Full Text Available Background and aims   Traffic noise barriers are the most important measure to control the environmental noise pollution. Diffraction from top edge of noise barriers is the most important path of indirect sound wave moves towards receiver.Therefore, most studies are focused on  improvement of this kind.   Methods   T-shape profile barriers are one of the most successful barrier among many different profiles. In this investigation the theory of destructive effect of diffracted waves from real edge of barrier and the wave diffracted from image of the barrier with phase difference of radians is used. Firstly a simple mathematical representation of the zones behind rigid and absorbent T- shape barriers with the highest insertion loss using the destructive effect of indirect path via barrier  image is introduced and then two different profile reflective and absorption barrier is used for  verification of the introduced model   Results   The results are then compared with the results of a verified two dimensional boundary element method at 1/3 octave band frequencies and in a wide field behind those barriers. Avery good agreement between the results has been achieved. In this method effective height is used for any different profile barriers.   Conclusion   The introduced model is very simple, flexible and fast and could be used for choosing the best location of profile rigid and absorptive barriers to achieve the highest  performance.  

  1. The Idea of a Highest Divine Principle — Founding Reason and Spirituality. A Necessary Concept of a Comparative Philosophy?

    Directory of Open Access Journals (Sweden)

    Claudia Bickmann

    2012-10-01

    Full Text Available By reference to the Platonic, Aristotelian, and Neo-Platonic philosophical traditions (and then to German Idealism, including Husserl and Heidegger, I will indicate the way in which the concept of reason—on the one side—depends on the horizon of spirituality (by searching for the ultimate ground within us and the striving for the highest good; and inversely—how far the idea of the divine or our spiritual self may be deepened, understood and transmitted by reference to reason and rationality. But whereas philosophical analysis aims at the universal dimensions of spirituality or the divine (as in Plato's idea of the 'highest good', the Aristotelian 'Absolute substance', the 'Oneness of the One' (Plotinus and the Neo-Platonists or the Hegelian 'Absolute spirit',—Comparative Theology may preserve the dimension of spirituality or divinity in its individuality and specifity. Comparative Theology mediates between the universality of the philosophical discourse and the uniqueness of our individual experience (symbolized by a sacred person—such as Jesus, Brahman, Buddha or Mohammed by reflecting and analyzing our religious experiences and practices. Religion may lose its specificity by comparative conceptual analysis within the field of philosophy, but Comparative Theology may enhance the vital dimensions of the very same spiritual experience by placing them in a comparative perspective.

  2. N-terminal pro B-type natriuretic peptide predicts mortality in patients with left ventricular hypertrophy.

    Science.gov (United States)

    Garcia, Santiago; Akbar, Muhammad S; Ali, Syed S; Kamdar, Forum; Tsai, Michael Y; Duprez, Daniel A

    2010-09-03

    Left ventricular hypertrophy adversely affects outcomes in patients with hypertension. Whether N-terminal pro B-type natriuretic peptide (NT-proBNP) adds incremental prognostic information in patients with hypertension and left ventricular hypertrophy (LVH) is not well established. We aimed to study the prognostic value of NT-proBNP in hypertensive patients with LVH. Echocardiography was performed in 232 patients (mean age 61±15, 102 males, 130 females) for the diagnosis of left ventricular hypertrophy. Left ventricular mass was measured according to The American Society of Echocardiography guidelines. A blood sample was taken for NT-proBNP determination. NT-proBNP levels were analyzed in quartiles after log transformation. Long term survival was established by review of electronic medical records. Arterial hypertension was present in 130 patients (56%) and left ventricular hypertrophy was present in 105 patients (45%). In patients with left ventricular hypertrophy, NT-proBNP levels predicted long term survival (Chi-square=10, p=0.01). After adjusting by age, presence of coronary artery disease, ejection fraction, diabetes status, and hypertension; patients in highest NT pro-BNP quartile were twice as likely to die when compared to patients in the lowest NT-ptoBNP quartile (OR=2.2, 95% CI=1.0-4.6, p=0.03). NT-proBNP is an independent predictor of survival in patients with hypertension and increased left ventricular mass. Copyright © 2009 Elsevier B.V. All rights reserved.

  3. Who jumps the highest? Anthropometric and physiological correlations of vertical jump in youth elite female volleyball players.

    Science.gov (United States)

    Nikolaidis, Pantelis T; Gkoudas, Konstantinos; Afonso, José; Clemente-Suarez, Vicente J; Knechtle, Beat; Kasabalis, Stavros; Kasabalis, Athanasios; Douda, Helen; Tokmakidis, Savvas; Torres-Luque, Gema

    2017-06-01

    The aim of the present study was to examine the relationship of vertical jump (Abalakov jump [AJ]) with anthropometric and physiological parameters in youth elite female volleyball players. Seventy-two selected volleyball players from the region of Athens (age 13.3±0.7 years, body mass 62.0±7.2 kg, height 171.5±5.7 cm, body fat 21.2±4.5%), classified into quartiles according to AJ performance (group A, 21.4-26.5 cm; group B, 26.8-29.9 cm; group C, 30.5-33.7 cm; group D, 33.8-45.9 cm), performed a series of physical fitness tests. AJ was correlated with anthropometric (age at peak height velocity [APHV]: r=0.38, Pvolleyball players that jumped the highest were those who matured later than others.

  4. Repeated Radionuclide therapy in metastatic paraganglioma leading to the highest reported cumulative activity of 131I-MIBG

    International Nuclear Information System (INIS)

    Ezziddin, Samer; Sabet, Amir; Ko, Yon-Dschun; Xun, Sunny; Matthies, Alexander; Biersack, Hans-Jürgen

    2012-01-01

    131 I-MIBG therapy for neuroendocrine tumours may be dose limited. The common range of applied cumulative activities is 10-40 GBq. We report the uneventful cumulative administration of 111 GBq (= 3 Ci) 131 I-MIBG in a patient with metastatic paraganglioma. Ten courses of 131 I-MIBG therapy were given within six years, accomplishing symptomatic, hormonal and tumour responses with no serious adverse effects. Chemotherapy with cisplatin/vinblastine/dacarbazine was the final treatment modality with temporary control of disease, but eventually the patient died of progression. The observed cumulative activity of 131 I-MIBG represents the highest value reported to our knowledge, and even though 12.6 GBq of 90 Y-DOTATOC were added intermediately, no associated relevant bone marrow, hepatic or other toxicity were observed. In an individual attempt to palliate metastatic disease high cumulative activity alone should not preclude the patient from repeat treatment

  5. Impact of thermal frequency drift on highest precision force microscopy using quartz-based force sensors at low temperatures

    Directory of Open Access Journals (Sweden)

    Florian Pielmeier

    2014-04-01

    Full Text Available In frequency modulation atomic force microscopy (FM-AFM the stability of the eigenfrequency of the force sensor is of key importance for highest precision force measurements. Here, we study the influence of temperature changes on the resonance frequency of force sensors made of quartz, in a temperature range from 4.8–48 K. The sensors are based on the qPlus and length extensional principle. The frequency variation with temperature T for all sensors is negative up to 30 K and on the order of 1 ppm/K, up to 13 K, where a distinct kink appears, it is linear. Furthermore, we characterize a new type of miniaturized qPlus sensor and confirm the theoretically predicted reduction in detector noise.

  6. Analysis of the highest transverse energy events seen in the UAl detector at the Spp-barS collider

    International Nuclear Information System (INIS)

    1987-06-01

    The first full solid angle analysis is presented of large transverse energy events in pp-bar collisions at the CERN collider. Events with transverse energies in excess of 200 GeV at √s = 630 GeV are studied for any non-standard physics and quantitatively compared with expectations from perturbative QCD Monte Carlo models. A corrected differential cross section is presented. A detailed examination is made of jet profiles, event jet multiplicities and the fraction of the transverse energy carried by the two jets with the highest transverse jet energies. There is good agreement with standard theory for events with transverse energies up to the largest observed values (approx. √s/2) and the analysis shows no evidence for any non-QCD mechanism to account for the event characteristics. (author)

  7. A common founder mutation in FANCA underlies the world's highest prevalence of Fanconi anemia in Gypsy families from Spain.

    Science.gov (United States)

    Callén, Elsa; Casado, José A; Tischkowitz, Marc D; Bueren, Juan A; Creus, Amadeu; Marcos, Ricard; Dasí, Angeles; Estella, Jesús M; Muñoz, Arturo; Ortega, Juan J; de Winter, Johan; Joenje, Hans; Schindler, Detlev; Hanenberg, Helmut; Hodgson, Shirley V; Mathew, Christopher G; Surrallés, Jordi

    2005-03-01

    Fanconi anemia (FA) is a genetic disease characterized by bone marrow failure and cancer predisposition. Here we have identified Spanish Gypsies as the ethnic group with the world's highest prevalence of FA (carrier frequency of 1/64-1/70). DNA sequencing of the FANCA gene in 8 unrelated Spanish Gypsy FA families after retroviral subtyping revealed a homozygous FANCA mutation (295C>T) leading to FANCA truncation and FA pathway disruption. This mutation appeared specific for Spanish Gypsies as it is not found in other Gypsy patients with FA from Hungary, Germany, Slovakia, and Ireland. Haplotype analysis showed that Spanish Gypsy patients all share the same haplotype. Our data thus suggest that the high incidence of FA among Spanish Gypsies is due to an ancestral founder mutation in FANCA that originated in Spain less than 600 years ago. The high carrier frequency makes the Spanish Gypsies a population model to study FA heterozygote mutations in cancer.

  8. Analysis of the highest transverse energy events seen in the UA1 detector at the Spanti pS collider

    International Nuclear Information System (INIS)

    Albajar, C.; Bezaguet, A.; Cennini, P.

    1987-01-01

    This is the first full solid angle analysis of large transverse energy events in panti p collisions at the CERN collider. Events with transverse energies in excess of 200 GeV at √s=630 GeV are studied for any non-standard physics and quantitatively compared with expectations from perturbative QCD Monte Carlo models. A corrected differential cross section is presented. A detailed examination is made of jet profiles, event jet multiplicities and the fraction of the transverse energy carried by the two jets with the highest transverse jet energies. There is good agreement with standard theory for events with transverse energies up to the largest observed values (≅ √s/2) and the analysis shows no evidence for any non-QCD mechanism to account for the event characteristics. (orig.)

  9. Contact with HIV prevention services highest in gay and bisexual men at greatest risk: cross-sectional survey in Scotland

    Directory of Open Access Journals (Sweden)

    Hart Graham J

    2010-12-01

    Full Text Available Abstract Background Men who have sex with men (MSM remain the group most at risk of acquiring HIV in the UK and new HIV prevention strategies are needed. In this paper, we examine what contact MSM currently have with HIV prevention activities and assess the extent to which these could be utilised further. Methods Anonymous, self-complete questionnaires and Orasure™ oral fluid collection kits were distributed to men visiting the commercial gay scenes in Glasgow and Edinburgh in April/May 2008. 1508 men completed questionnaires (70.5% response rate and 1277 provided oral fluid samples (59.7% response rate; 1318 men were eligible for inclusion in the analyses. Results 82.5% reported some contact with HIV prevention activities in the past 12 months, 73.1% obtained free condoms from a gay venue or the Internet, 51.1% reported accessing sexual health information (from either leaflets in gay venues or via the Internet, 13.5% reported talking to an outreach worker and 8.0% reported participating in counselling on sexual health or HIV prevention. Contact with HIV prevention activities was associated with frequency of gay scene use and either HIV or other STI testing in the past 12 months, but not with sexual risk behaviours. Utilising counselling was also more likely among men who reported having had an STI in the past 12 months and HIV-positive men. Conclusions Men at highest risk, and those likely to be in contact with sexual health services, are those who report most contact with a range of current HIV prevention activities. Offering combination prevention, including outreach by peer health workers, increased uptake of sexual health services delivering behavioural and biomedical interventions, and supported by social marketing to ensure continued community engagement and support, could be the way forward. Focused investment in the needs of those at highest risk, including those diagnosed HIV-positive, may generate a prevention dividend in the long

  10. Influence of atrial fibrillation on plasma von willebrand factor, soluble E-selectin, and N-terminal pro B-type natriuretic peptide levels in systolic heart failure.

    Science.gov (United States)

    Freestone, Bethan; Gustafsson, Finn; Chong, Aun Yeong; Corell, Pernille; Kistorp, Caroline; Hildebrandt, Per; Lip, Gregory Y H

    2008-05-01

    Endothelial dysfunction is present in patients with heart failure (HF) due to left ventricular systolic dysfunction, as well as in patients with atrial fibrillation (AF) who have normal cardiac function. It is unknown whether AF influences the degree of endothelial dysfunction in patients with systolic HF. We measured levels of plasma von Willebrand factor (vWF) and E-selectin (as indexes of endothelial damage/dysfunction and endothelial activation, respectively; both enzyme-linked immunosorbent assay) in patients with AF and HF (AF-HF), who were compared to patients with sinus rhythm and HF (SR-HF), as well as in age-matched, healthy, control subjects. We also assessed the relationship of vWF and E-selectin to plasma N-terminal pro B-type natriuretic peptide (NTpro-BNP), a marker for HF severity and prognosis. One hundred ninety patients (73% men; mean age, 69.0 +/- 10.1 years [+/- SD]) with systolic HF were studied, who were compared to 117 healthy control subjects: 52 subjects (27%) were in AF, while 138 subjects (73%) were in sinus rhythm. AF-HF patients were older than SR-HF patients (p = 0.046), but left ventricular ejection fraction and New York Heart Association class were similar. There were significant differences in NT-proBNP (p NT-proBNP (p NT-proBNP levels (Spearman r = 0.139; p = 0.017). There is evidence of greater endothelial damage/dysfunction in AF-HF patients when compared to SR-HF patients. The clinical significance of this is unclear but may have prognostic value.

  11. New hybrid magnet system for structure research at highest magnetic fields and temperatures in the millikelvin region

    International Nuclear Information System (INIS)

    Smeibidl, Peter; Ehmler, Hartmut; Tennant, Alan; Bird, Mark

    2012-01-01

    The Helmholtz Centre Berlin (HZB) is a user facility for the study of structure and dynamics with neutrons and synchrotron radiation with special emphasis on experiments under extreme conditions. Neutron scattering is uniquely suited to study magnetic properties on a microscopic length scale, because neutrons have comparable wavelengths and, due to their magnetic moment, they interact with the atomic magnetic moments. At HZB a dedicated instrument for neutron scattering at extreme magnetic fields and low temperatures is under construction, the Extreme Environment Diffractometer ExED. It is projected according to the time-of-flight principle for elastic and inelastic neutron scattering and for the special geometric constraints of analysing samples in a high field magnet. The new hybrid magnet will not only allow for novel experiments, it will be at the forefront of development in magnet technology itself. With a set of superconducting and resistive coils a maximum field above 30 T will be possible. To compromise between the needs of the magnet design for highest fields and the concept of the neutron instrument, the magnetic field will be generated by means of a coned, resistive inner solenoid and a superconducting outer solenoid with horizontal field orientation. To allow for experiments down to Millikelvin Temperatures the installation of a 3 He or a dilution cryostat with a closed cycle precooling stage is foreseen.

  12. A Systematic Study to Optimize SiPM Photo-Detectors for Highest Time Resolution in PET

    CERN Document Server

    Gundacker, S.; Frisch, B.; Hillemanns, H.; Jarron, P.; Meyer, T.; Pauwels, K.; Lecoq, P.

    2012-01-01

    We report on a systematic study of time resolution made with three different commercial silicon photomultipliers (SiPMs) (Hamamatsu MPPC S10931-025P, S10931-050P, and S10931-100P) and two LSO scintillating crystals. This study aimed to determine the optimum detector conditions for highest time resolution in a prospective time-of-flight positron emission tomography (TOF-PET) system. Measurements were based on the time over threshold method in a coincidence setup using the ultrafast amplifier-discriminator NINO and a fast oscilloscope. Our tests with the three SiPMs of the same area but of different SPAD sizes and fill factors led to best results with the Hamamatsu type of 50×50×μm2 single-pixel size. For this type of SiPM and under realistic geometrical PET scanner conditions, i.e., with 2×2×10×mm3 LSO crystals, a coincidence time resolution of 220 ±4 ps FWHM could be achieved. The results are interpreted in terms of SiPM photon detection efficiency (PDE), dark noise, and photon yield.

  13. Site characterization of the highest-priority geologic formations for CO2 storage in Wyoming

    Energy Technology Data Exchange (ETDEWEB)

    Surdam, Ronald C. [Univ. of Wyoming, Laramie, WY (United States); Bentley, Ramsey [Univ. of Wyoming, Laramie, WY (United States); Campbell-Stone, Erin [Univ. of Wyoming, Laramie, WY (United States); Dahl, Shanna [Univ. of Wyoming, Laramie, WY (United States); Deiss, Allory [Univ. of Wyoming, Laramie, WY (United States); Ganshin, Yuri [Univ. of Wyoming, Laramie, WY (United States); Jiao, Zunsheng [Univ. of Wyoming, Laramie, WY (United States); Kaszuba, John [Univ. of Wyoming, Laramie, WY (United States); Mallick, Subhashis [Univ. of Wyoming, Laramie, WY (United States); McLaughlin, Fred [Univ. of Wyoming, Laramie, WY (United States); Myers, James [Univ. of Wyoming, Laramie, WY (United States); Quillinan, Scott [Univ. of Wyoming, Laramie, WY (United States)

    2013-12-07

    This study, funded by U.S. Department of Energy National Energy Technology Laboratory award DE-FE0002142 along with the state of Wyoming, uses outcrop and core observations, a diverse electric log suite, a VSP survey, in-bore testing (DST, injection tests, and fluid sampling), a variety of rock/fluid analyses, and a wide range of seismic attributes derived from a 3-D seismic survey to thoroughly characterize the highest-potential storage reservoirs and confining layers at the premier CO2 geological storage site in Wyoming. An accurate site characterization was essential to assessing the following critical aspects of the storage site: (1) more accurately estimate the CO2 reservoir storage capacity (Madison Limestone and Weber Sandstone at the Rock Springs Uplift (RSU)), (2) evaluate the distribution, long-term integrity, and permanence of the confining layers, (3) manage CO2 injection pressures by removing formation fluids (brine production/treatment), and (4) evaluate potential utilization of the stored CO2

  14. Compressive sensing-based wideband capacitance measurement with a fixed sampling rate lower than the highest exciting frequency

    International Nuclear Information System (INIS)

    Xu, Lijun; Ren, Ying; Sun, Shijie; Cao, Zhang

    2016-01-01

    In this paper, an under-sampling method for wideband capacitance measurement was proposed by using the compressive sensing strategy. As the excitation signal is sparse in the frequency domain, the compressed sampling method that uses a random demodulator was adopted, which could greatly decrease the sampling rate. Besides, four switches were used to replace the multiplier in the random demodulator. As a result, not only the sampling rate can be much smaller than the signal excitation frequency, but also the circuit’s structure is simpler and its power consumption is lower. A hardware prototype was constructed to validate the method. In the prototype, an excitation voltage with a frequency up to 200 kHz was applied to a capacitance-to-voltage converter. The output signal of the converter was randomly modulated by a pseudo-random sequence through four switches. After a low-pass filter, the signal was sampled by an analog-to-digital converter at a sampling rate of 50 kHz, which was three times lower than the highest exciting frequency. The frequency and amplitude of the signal were then reconstructed to obtain the measured capacitance. Both theoretical analysis and experiments were carried out to show the feasibility of the proposed method and to evaluate the performance of the prototype, including its linearity, sensitivity, repeatability, accuracy and stability within a given measurement range. (paper)

  15. [Archivos de Bronconeumología: among the 3 Spanish medical journals with the highest national impact factors].

    Science.gov (United States)

    Aleixandre Benavent, R; Valderrama Zurián, J C; Castellano Gómez, M; Simó Meléndez, R; Navarro Molina, C

    2004-12-01

    Citation analysis elucidates patterns of information consumption within professional communities. The aim of this study was to analyze the citations of 87 Spanish medical journals by calculating their impact factors and immediacy indices for 2001, and to estimate the importance of Archivos de Bronconeumología within the framework of Spanish medicine. Eighty-seven Spanish medical journals were included. All were listed in the Spanish Medical Index (Indice Medico Español) and in at least one of the following databases: MEDLINE, BIOSIS, EMBASE, or Science Citation Index. References to articles from 1999 through 2001 in citable articles from 2001 were analyzed. Using the method of the Institute for Scientific Information, we calculated the national impact factor and immediacy index for each journal. The journals with the highest national impact factors were Revista Española de Quimioterapia (0.894), Medicina Clínica (0.89), and Archivos de Bronconeumología (0.732). The self-citation percentage of Archivos de Bronconeumología was 18.3% and the immediacy index was 0.033. The impact factor obtained by Archivos de Bronconeumología confirms its importance in Spanish medicine and validates its inclusion as a source journal in Science Citation Index and Journal Citation Report.

  16. The Risk of Reported Cryptosporidiosis in Children Aged <5 Years in Australia is Highest in Very Remote Regions.

    Science.gov (United States)

    Lal, Aparna; Fearnley, Emily; Kirk, Martyn

    2015-09-18

    The incidence of cryptosporidiosis is highest in children <5 years, yet little is known about disease patterns across urban and rural areas of Australia. In this study, we examine whether the risk of reported cryptosporidiosis in children <5 years varies across an urban-rural gradient, after controlling for season and gender. Using Australian data on reported cryptosporidiosis from 2001 to 2012, we spatially linked disease data to an index of geographic remoteness to examine the geographic variation in cryptosporidiosis risk using negative binomial regression. The Incidence Risk Ratio (IRR) of reported cryptosporidiosis was higher in inner regional (IRR 1.4 95% CI 1.2-1.7, p < 0.001), and outer regional areas (IRR 2.4 95% CI 2.2-2.9, p < 0.001), and in remote (IRR 5.2 95% CI 4.3-6.2, p < 0.001) and very remote (IRR 8.2 95% CI 6.9-9.8, p < 0.001) areas, compared to major cities. A linear test for trend showed a statistically significant trend with increasing remoteness. Remote communities need to be a priority for future targeted health promotion and disease prevention interventions to reduce cryptosporidiosis in children <5 years.

  17. The Risk of Reported Cryptosporidiosis in Children Aged <5 Years in Australia is Highest in Very Remote Regions

    Directory of Open Access Journals (Sweden)

    Aparna Lal

    2015-09-01

    Full Text Available The incidence of cryptosporidiosis is highest in children <5 years, yet little is known about disease patterns across urban and rural areas of Australia. In this study, we examine whether the risk of reported cryptosporidiosis in children <5 years varies across an urban-rural gradient, after controlling for season and gender. Using Australian data on reported cryptosporidiosis from 2001 to 2012, we spatially linked disease data to an index of geographic remoteness to examine the geographic variation in cryptosporidiosis risk using negative binomial regression. The Incidence Risk Ratio (IRR of reported cryptosporidiosis was higher in inner regional (IRR 1.4 95% CI 1.2–1.7, p < 0.001, and outer regional areas (IRR 2.4 95% CI 2.2–2.9, p < 0.001, and in remote (IRR 5.2 95% CI 4.3–6.2, p < 0.001 and very remote (IRR 8.2 95% CI 6.9–9.8, p < 0.001 areas, compared to major cities. A linear test for trend showed a statistically significant trend with increasing remoteness. Remote communities need to be a priority for future targeted health promotion and disease prevention interventions to reduce cryptosporidiosis in children <5 years.

  18. Two Clock Transitions in Neutral Yb for the Highest Sensitivity to Variations of the Fine-Structure Constant

    Science.gov (United States)

    Safronova, Marianna S.; Porsev, Sergey G.; Sanner, Christian; Ye, Jun

    2018-04-01

    We propose a new frequency standard based on a 4 f146 s 6 p P0 3 -4 f136 s25 d (J =2 ) transition in neutral Yb. This transition has a potential for high stability and accuracy and the advantage of the highest sensitivity among atomic clocks to variation of the fine-structure constant α . We find its dimensionless α -variation enhancement factor to be K =-15 , in comparison to the most sensitive current clock (Yb+ E 3 , K =-6 ), and it is 18 times larger than in any neutral-atomic clocks (Hg, K =0.8 ). Combined with the unprecedented stability of an optical lattice clock for neutral atoms, this high sensitivity opens new perspectives for searches for ultralight dark matter and for tests of theories beyond the standard model of elementary particles. Moreover, together with the well-established 1S0-3P0 transition, one will have two clock transitions operating in neutral Yb, whose interleaved interrogations may further reduce systematic uncertainties of such clock-comparison experiments.

  19. Impacts of informal trails on vegetation and soils in the highest protected area in the Southern Hemisphere.

    Science.gov (United States)

    Barros, Agustina; Gonnet, Jorge; Pickering, Catherine

    2013-09-30

    There is limited recreation ecology research in South America, especially studies looking at informal trails. Impacts of informal trails formed by hikers and pack animals on vegetation and soils were assessed for the highest protected area in the Southern Hemisphere, Aconcagua Provincial Park. The number of braided trails, their width and depth were surveyed at 30 sites along the main access route to Mt Aconcagua (6962 m a.s.l.). Species composition, richness and cover were also measured on control and trail transects. A total of 3.3 ha of alpine meadows and 13.4 ha of alpine steppe were disturbed by trails. Trails through meadows resulted in greater soil loss, more exposed soil and rock and less vegetation than trails through steppe vegetation. Trampling also affected the composition of meadow and steppe vegetation with declines in sedges, herbs, grasses and shrubs on trails. These results highlight how visitor use can result in substantial cumulative damage to areas of high conservation value in the Andes. With unregulated use of trails and increasing visitation, park agencies need to limit the further spread of informal trails and improve the conservation of plant communities in Aconcagua Provincial Park and other popular parks in the region. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. A story about the discovery of the largest glacier and the highest peak in heart of the Pamirs

    Directory of Open Access Journals (Sweden)

    V. M. Kotlyakov

    2014-01-01

    Full Text Available The paper tells a story how the “blank spot” at the Pamirs center was puzzled out. In 1878, a small party of explorers headed by V.D. Oshanin had found here a big glacier about 30–40 km long and named it for Fedchenko. In 1884–85, known investigator G.E. Grumm-Grzhimailo made his important proposal about orographic structure of the Pamirs central part. In 1890, expedition headed by topographer N.I. Kosinenko investigated the lower part of the Fedchenko Glacier and, for the first time, saw a separate high peak. In 1916, astronomer Ya.I. Belyaev had put on a map a great pyramidal summit but he had mistaken it for the Garmo Peak well known to local Tadzhiks (Fig. 2.In 1927, N.L. Korzhenevsky published a chart of arrangement of ridges near sources of the river Muksu (Fig. 3 that became a basis for work of the Tadzhik-Pamir expedition of 1928–1932. In 1928, Ya.I. Belyaev determined a true length of the Fechenko Glacier that was 70 km, and geodesist I.G. Dorofeevmapped the whole basin of this glacier (Fig. 4 including also a high irregular truncated pyramid of 7495 m in height (as he believed. But earlier this summit was identified as known the Garmo Peak. And only in 1932, it was established that definitions made by Dorofeev in 1928 were related to this highest peak of the Pamirs and also of the whole Soviet Union. The chart of real Central Pamir orography constructed by I.G. Dorofeev is presented in the paper together with his letter addressed to the author (Fig. 5.Thus, the “Garmo peaks” which were observed by the above mentioned explorers were actually three different summits. One of them does tower on the north of the “knot being puzzled out” and reaches 7495 m, and namely this “one-tooth” peak was repeatedly seen by N.V. Krylenko from valleys Gando and Garmo. It was named then the Stalin peak, and later – the peak of Communism. Another one is located in 18 km southward, and this peak is actually the true Garmo Peak 6595 m

  1. Binding of higher alcohols onto Mn(12) single-molecule magnets (SMMs): access to the highest barrier Mn(12) SMM.

    Science.gov (United States)

    Lampropoulos, Christos; Redler, Gage; Data, Saiti; Abboud, Khalil A; Hill, Stephen; Christou, George

    2010-02-15

    Two new members of the Mn(12) family of single-molecule magnets (SMMs), [Mn(12)O(12)(O(2)CCH(2)Bu(t))(16)(Bu(t)OH)(H(2)O)(3)].2Bu(t)OH (3.2Bu(t)OH) and [Mn(12)O(12)(O(2)CCH(2)Bu(t))(16)(C(5)H(11)OH)(4)] (4) (C(5)H(11)OH is 1-pentanol), are reported. They were synthesized from [Mn(12)O(12)(O(2)CMe)(16)(H(2)O)(4)].2MeCO(2)H.4H(2)O (1) by carboxylate substitution and crystallization from the appropriate alcohol-containing solvent. Complexes 3 and 4 are new members of the recently established [Mn(12)O(12)(O(2)CCH(2)Bu(t))(16)(solv)(4)] (solv = H(2)O, alcohols) family of SMMs. Only one bulky Bu(t)OH can be accommodated into 3, and even this causes significant distortion of the [Mn(12)O(12)] core. Variable-temperature, solid-state alternating current (AC) magnetization studies were carried out on complexes 3 and 4, and they established that both possess an S = 10 ground state spin and are SMMs. However, the magnetic behavior of the two compounds was found to be significantly different, with 4 showing out-of-phase AC peaks at higher temperatures than 3. High-frequency electron paramagnetic resonance (HFEPR) studies were carried out on single crystals of 3.2Bu(t)OH and 4, and these revealed that the axial zero-field splitting constant, D, is very different for the two compounds. Furthermore, it was established that 4 is the Mn(12) SMM with the highest kinetic barrier (U(eff)) to date. The results reveal alcohol substitution as an additional and convenient means to affect the magnetization relaxation barrier of the Mn(12) SMMs without major change to the ligation or oxidation state.

  2. Where do the highest energy CR's come from? and How does the Milky Way affect their arrival directions?

    Directory of Open Access Journals (Sweden)

    Kronberg Philipp

    2013-06-01

    Full Text Available A “grand magnetic design” for the Milky Way disk clearly emerges within ~1.5 kpc of the Galactic mid-plane near the Sun [1], and reveals a pitch angle of −5.5°. directed inward from the Solar tangential. This pitch angle can be expected to differ for Galactic disc locations other than ours. Above ~1.5 kpc, the field geometry is completely different, and its 3-D structure is not yet completely specified. However it appears that the UHECR (> 5 · 1019 eV propagation to us is not much affected by the halo field, at least for protons. I discuss new multi-parameter analyses of UHECR deflections which provide a conceptual “template” for future interpretations of energy-species-direction data from AUGER, HiRes etc., and their successors [2]. I show how the strength and structure of the cosmologically nearby intergalactic magnetic field, BIGM, is now well-estimated out to D ~5 Mpc from the Milky Way: − 20nG. These are the first VHECR data-based estimates of BIGM on nearby supragalactic scales, and are also important for understanding and modeling CR propagation in the more distant Universe. CR Acceleration to the highest energies is probably a natural accompanying phenomenon of Supermassive Black Hole (SMBH-associated jets and lobes [3]. I briefly describe what we know about magnetic configurations in these candidate sites for UHECR acceleration, and the first direct estimate of an extragalactic Poynting flux current, ~3 · 1018 Amperes [4, 5]. This number connects directly to SMBH accretion disk physics, and leads directly to ideas of how VHECR acceleration in jets and lobes, possibly involving magnetic reconnection, is likely to be common in the Universe. It remains to be fully understood.

  3. Identification of multiple sclerosis patients at highest risk of cognitive impairment using an integrated brain magnetic resonance imaging assessment approach.

    Science.gov (United States)

    Uher, T; Vaneckova, M; Sormani, M P; Krasensky, J; Sobisek, L; Dusankova, J Blahova; Seidl, Z; Havrdova, E; Kalincik, T; Benedict, R H B; Horakova, D

    2017-02-01

    While impaired cognitive performance is common in multiple sclerosis (MS), it has been largely underdiagnosed. Here a magnetic resonance imaging (MRI) screening algorithm is proposed to identify patients at highest risk of cognitive impairment. The objective was to examine whether assessment of lesion burden together with whole brain atrophy on MRI improves our ability to identify cognitively impaired MS patients. Of the 1253 patients enrolled in the study, 1052 patients with all cognitive, volumetric MRI and clinical data available were included in the analysis. Brain MRI and neuropsychological assessment with the Brief International Cognitive Assessment for Multiple Sclerosis were performed. Multivariable logistic regression and individual prediction analysis were used to investigate the associations between MRI markers and cognitive impairment. The results of the primary analysis were validated at two subsequent time points (months 12 and 24). The prevalence of cognitive impairment was greater in patients with low brain parenchymal fraction (BPF) (3.5 ml) than in patients with high BPF (>0.85) and low T2-LV (patients predicted cognitive impairment with 83% specificity, 82% negative predictive value, 51% sensitivity and 75% overall accuracy. The risk of confirmed cognitive decline over the follow-up was greater in patients with high T2-LV (OR 2.1; 95% CI 1.1-3.8) and low BPF (OR 2.6; 95% CI 1.4-4.7). The integrated MRI assessment of lesion burden and brain atrophy may improve the stratification of MS patients who may benefit from cognitive assessment. © 2016 EAN.

  4. Lyman alpha emission in nearby star-forming galaxies with the lowest metallicities and the highest [OIII]/[OII] ratios

    Science.gov (United States)

    Izotov, Yuri

    2017-08-01

    The Lyman alpha line of hydrogen is the strongest emission line in galaxies and the tool of predilection for identifying and studying star-forming galaxies over a wide range of redshifts, especially in the early universe. However, it has become clear over the years that not all of the Lyman alpha radiation escapes, due to its resonant scattering on the interstellar and intergalactic medium, and absorption by dust. Although our knowledge of the high-z universe depends crucially on that line, we still do not have a complete understanding of the mechanisms behind the production, radiative transfer and escape of Lyman alpha in galaxies. We wish here to investigate these mechanisms by studying the properties of the ISM in a unique sample of 8 extreme star-forming galaxies (SFGs) that have the highest excitation in the SDSS spectral data base. These dwarf SFGs have considerably lower stellar masses and metallicities, and higher equivalent widths and [OIII]5007/[OII]3727 ratios compared to all nearby SFGs with Lyman alpha emission studied so far with COS. They are, however, very similar to the dwarf Lyman alpha emitters at redshifts 3-6, which are thought to be the main sources of reionization in the early Universe. By combining the HST/COS UV data with data in the optical range, and using photoionization and radiative transfer codes, we will be able to study the properties of the Lyman alpha in these unique objects, derive column densities of the neutral hydrogen N(HI) and compare them with N(HI) obtained from the HeI emission-line ratios in the optical spectra. We will derive Lyman alpha escape fractions and indirectly Lyman continuum escape fractions.

  5. Can All Doctors Be Like This? Seven Stories of Communication Transformation Told by Physicians Rated Highest by Patients.

    Science.gov (United States)

    Janisse, Tom; Tallman, Karen

    2017-01-01

    The top predictors of patient satisfaction with clinical visits are the quality of the physician-patient relationship and the communications contributing to their relationship. How do physicians improve their communication, and what effect does it have on them? This article presents the verbatim stories of seven high-performing physicians describing their transformative change in the areas of communication, connection, and well-being. Data for this study are based on interviews from a previous study in which a 6-question set was posed, in semistructured 60-minute interviews, to 77 of the highest-performing Permanente Medical Group physicians in 4 Regions on the "Art of Medicine" patient survey. Transformation stories emerged spontaneously during the interviews, and so it was an incidental finding when some physicians identified that they were not always high performing in their communication with patients. Seven different modes of transformation in communication were described by these physicians: a listening tool, an awareness course, finding new meaning in clinical practice, a technologic tool, a sudden insight, a mentor observation, and a physician-as-patient experience. These stories illustrate how communication skills can be learned through various activities and experiences that transform physicians into those who are highly successful communicators. All modes result in a change of state-a new way of seeing, of being-and are not just a new tool or a new practice, but a change in state of mind. This state resulted in a marked change of behavior, and a substantial improvement of communication and relationship.

  6. A New Orally Active, Aminothiol Radioprotector-Free of Nausea and Hypotension Side Effects at Its Highest Radioprotective Doses

    Energy Technology Data Exchange (ETDEWEB)

    Soref, Cheryl M. [ProCertus BioPharm, Inc., Madison, WI (United States); Hacker, Timothy A. [Department of Medicine, Cardiovascular Physiology Core, University of Wisconsin-Madison, Madison, WI (United States); Fahl, William E., E-mail: fahl@oncology.wisc.edu [ProCertus BioPharm, Inc., Madison, WI (United States); McArdle Laboratory for Cancer Research, University of Wisconsin Carbone Cancer Center, Madison, WI (United States)

    2012-04-01

    Purpose: A new aminothiol, PrC-210, was tested for orally conferred radioprotection (rats, mice; 9.0 Gy whole-body, which was otherwise lethal to 100% of the animals) and presence of the debilitating side effects (nausea/vomiting, hypotension/fainting) that restrict use of the current aminothiol, amifostine (Ethyol, WR-2721). Methods and Materials: PrC-210 in water was administered to rats and mice at times before irradiation, and percent-survival was recorded for 60 days. Subcutaneous (SC) amifostine (positive control) or SC PrC-210 was administered to ferrets (Mustela putorius furo) and retching/emesis responses were recorded. Intraperitoneal amifostine (positive control) or PrC-210 was administered to arterial cannulated rats to score drug-induced hypotension. Results: Oral PrC-210 conferred 100% survival in rat and mouse models against an otherwise 100% lethal whole-body radiation dose (9.0 Gy). Oral PrC-210, administered by gavage 30-90 min before irradiation, conferred a broad window of radioprotection. The comparison of PrC-210 and amifostine side effects was striking because there was no retching or emesis in 10 ferrets treated with PrC-210 and no induced hypotension in arterial cannulated rats treated with PrC-210. The tested PrC-210 doses were the ferret and rat equivalent doses of the 0.5 maximum tolerated dose (MTD) PrC-210 dose in mice. The human equivalent of this mouse 0.5 MTD PrC-210 dose would likely be the highest PrC-210 dose used in humans. By comparison, the mouse 0.5 MTD amifostine dose, 400 {mu}g/g body weight (equivalent to the human amifostine dose of 910 mg/m{sup 2}), when tested at equivalent ferret and rat doses in the above models produced 100% retching/vomiting in ferrets and 100% incidence of significant, progressive hypotension in rats. Conclusions: The PrC-210 aminothiol, with no detectable nausea/vomiting or hypotension side effects in these preclinical models, is a logical candidate for human drug development to use in healthy

  7. Time of highest tuberculosis death risk and associated factors: an observation of 12 years in Northern Thailand

    Directory of Open Access Journals (Sweden)

    Saiyud Moolphate

    2011-02-01

    Full Text Available Saiyud Moolphate1,2, Myo Nyein Aung1,3, Oranuch Nampaisan1, Supalert Nedsuwan4, Pacharee Kantipong5, Narin Suriyon6, Chamnarn Hansudewechakul6, Hideki Yanai7, Norio Yamada2, Nobukatsu Ishikawa21TB/HIV Research Foundation, Chiang Rai, Thailand; 2Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association (RIT-JATA, Tokyo, Japan; 3Department of Pharmacology, University of Medicine, Mandalay, Myanmar; 4Department of Preventive and Social Medicine, Chiang Rai Regional Hospital, Chiang Rai, Thailand; 5Department of Health Service System Development, Chiang Rai Regional Hospital, Chiang Rai, Thailand; 6Provincial Health Office, Chiang Rai, Thailand; 7Department of Clinical Laboratory, Fukujuji Hospital, Tokyo, JapanPurpose: Northern Thailand is a tuberculosis (TB endemic area with a high TB death rate. We aimed to establish the time of highest death risk during TB treatment, and to identify the risk factors taking place during that period of high risk.Patients and methods: We explored the TB surveillance data of the Chiang Rai province, Northern Thailand, retrospectively for 12 years. A total of 19,174 TB patients (including 5,009 deaths were investigated from 1997 to 2008, and the proportion of deaths in each month of TB treatment was compared. Furthermore, multiple logistic regression analysis was performed to identify the characteristics of patients who died in the first month of TB treatment. A total of 5,626 TB patients from 2005 to 2008 were included in this regression analysis.Result: The numbers of deaths in the first month of TB treatment were 38%, 39%, and 46% in the years 1997–2000, 2001–2004, and 2005–2008, respectively. The first month of TB treatment is the time of the maximum number of deaths. Moreover, advancing age, HIV infection, and being a Thai citizen were significant factors contributing to these earlier deaths in the course of TB treatment.Conclusion: Our findings have pointed to the specific time period and

  8. The part of the solar spectrum with the highest influence on the formation of SOA in the continental boundary layer

    Directory of Open Access Journals (Sweden)

    M. Boy

    2002-01-01

    Full Text Available The relationship between nucleation events and spectral solar irradiance was analysed using two years of data collected at the Station for Measuring Forest Ecosystem-Atmosphere Relations (SMEAR II in Hyytiälä, Finland. We analysed the data in two different ways. In the first step we calculated ten nanometer average values from the irradiance measurements between 280 and 580 nm and explored if any special wavelengths groups showed higher values on event days compared to a spectral reference curve for all the days for 2 years or to reference curves for every month. The results indicated that short wavelength irradiance between 300 and 340 nm is higher on event days in winter (February and March compared to the monthly reference graph but quantitative much smaller than in spring or summer. By building the ratio between the average values of different event classes and the yearly reference graph we obtained peaks between 1.17 and 1.6 in the short wavelength range (300--340 nm. In the next step we included number concentrations of particles between 3 and 10 nm and calculated correlation coefficients between the different wavelengths groups and the particles. The results were quite similar to those obtained previously; the highest correlation coefficients were reached for the spectral irradiance groups 3--5 (300--330 nm with average values for the single event classes around 0.6 and a nearly linear decrease towards higher wavelengths groups by 30%. Both analyses indicate quite clearly that short wavelength irradiance between 300 and 330 or 340 nm is the most important solar spectral radiation for the formation of newly formed aerosols. In the end we introduce a photochemical mechanism as one possible pathway how short wavelength irradiance can influence the formation of SOA by calculating the production rate of excited oxygen. This mechanism shows in which way short wavelength irradiance can influence the formation of new particles even though the

  9. Elevated N-terminal pro-brain natriuretic peptide levels predict an enhanced anti-hypertensive and anti-proteinuric benefit of dietary sodium restriction and diuretics, but not angiotensin receptor blockade, in proteinuric renal patients.

    Science.gov (United States)

    Slagman, Maartje C J; Waanders, Femke; Vogt, Liffert; Damman, Kevin; Hemmelder, Marc; Navis, Gerjan; Laverman, Gozewijn D

    2012-03-01

    Renin-angiotensin aldosterone system (RAAS) blockade only partly reduces blood pressure, proteinuria and renal and cardiovascular risk in chronic kidney disease (CKD) but often requires sodium targeting [i.e. low sodium diet (LS) and/or diuretics] for optimal efficacy. However, both under- and overtitration of sodium targeting can easily occur. We evaluated whether N-terminal pro-brain natriuretic peptide (NT-proBNP), a biomarker of volume expansion, predicts the benefits of sodium targeting in CKD patients. In a cross-over randomized controlled trial, 33 non-diabetic CKD patients (proteinuria 3.8 ± 0.4 g/24 h, blood pressure 143/86 ± 3/2 mmHg, creatinine clearance 89 ± 5 mL/min) were treated during 6-week periods with placebo, angiotensin receptor blockade (ARB; losartan 100 mg/day) and ARB plus diuretics (losartan 100 mg/day plus hydrochlorothiazide 25 mg/day), combined with LS (93 ± 52 mmol Na(+)/24 h) and regular sodium diet (RS; 193 ± 62 mmol Na(+)/24 h, P diuretics and was normalized by ARB + diuretic + LS [39 (26-59) pg/mL, P = 0.65 versus controls]. NT-proBNP levels above the upper limit of normal (>125 pg/mL) predicted a larger reduction of blood pressure and proteinuria by LS and diuretics but not by ARB, during all steps of the titration regimen. Elevated NT-proBNP levels predict an enhanced anti-hypertensive and anti-proteinuric benefit of sodium targeting, but not RAAS blockade, in proteinuric CKD patients. Importantly, this applies to the untreated condition, as well as to the subsequent treatment steps, consisting of RAAS blockade and even RAAS blockade combined with diuretics. NT-proBNP can be a useful tool to identify CKD patients in whom sodium targeting can improve blood pressure and proteinuria.

  10. [The highest proportion of tobacco materials in the blend analysis using PPF projection method for the near-infrared spectrum and Monte Carlo method].

    Science.gov (United States)

    Mi, Jin-Rui; Ma, Xiang; Zhang, Ya-Juan; Wang, Yi; Wen, Ya-Dong; Zhao, Long-Lian; Li, Jun-Hui; Zhang, Lu-Da

    2011-04-01

    The present paper builds a model based on Monte Carlo method in the projection of the blending tobacco. This model is made up of two parts: the projecting points of tobacco materials, whose coordinates are calculated by means of the PPF (projection based on principal component and Fisher criterion) projection method for the tobacco near-infrared spectrum; and the point of tobacco blend, which is produced by linear additive to the projecting point coordinates of tobacco materials. In order to analyze the projection points deviation from initial state levels, Monte Carlo method is introduced to simulate the differences and changes of raw material projection. The results indicate that there are two major factors affecting the relative deviation: the highest proportion of tobacco materials in the blend, which is too high to make the deviation under control; and the quantity of materials, which is so small to control the deviation. The conclusion is close to the principle of actual formulating designing, particularly, the more in the quantity while the lower in proportion of each. Finally the paper figures out the upper limit of the proportions in the different quantity of materials by theory. It also has important reference value for other agricultural products blend.

  11. The Preoperative Level of B-Type Natriuretic Peptides and the Results of Clinical and Functional Studies of Cardiosurgical Patients

    Directory of Open Access Journals (Sweden)

    I. A. Kozlov

    2009-01-01

    Full Text Available Objective: to study the plasma content of B-type natriuretic peptides in coronary heart disease patients prepared for surgery under extracorporeal circulation and to assess the association of the level of these biomarkers with the data of clinical and functional studies. Material and methods. The levels of active B-type natriuretic peptide were determined by immunofluoresence assay in the blood of 52 patients aged 57.8±1 years. The patients’ baseline clinical condition was in New York Heart Association (NYHA Functional Class I—IV. The left ventricular ejection fraction was 59.6±1.2%. The plasma concentration of the inactive N-terminal fragment of the BNP prohormone (NT-proBNP was estimated by electric chemiluminescence technique in 61 patients aged 54.6±1.18 years. The patients’ clinical condition was in NYHA Functional Class II—IV. The left ventricular ejection fraction was 51.5±1.6%. Results. The plasma content of B-type natriuretic peptide in the examinees was 48.5±5.9 pg/ml. The level of the biomarker correlated with the NYHA functional class (r=0.4; p=0.005, the electrocardiographic signs of postinfarct cardiosclerosis (r=0.29; p=0.04, and left ventricular ejection fraction (r=-0.41; p=0.003, and end-systolic volume (r=0.32; p=0.03. The plasma concentration of inactive NT-proBNP was 659.4±91.6 pg/ml. The level of the biomarker correlated with the NYHA functional class (r=0.4; p=0.002, the stage of circulatory insufficiency as described by I. D. Strazhesko and V. Kh. Vasilenko (r=0.49; p=0.001, and left ventricular ejection fraction (r=-0.45; p=0.001, and end-diastolic (r=0.39; p=0.002 and end-systolic (r=0.42; p=0.001 volumes. In patients with the values of the biomarker of less than 1000 pg/ml, the latter was related to age (r=0.3; p=0.047. Conclusion. The study of the level of B-type natriuretic peptides in cardiosurgical patients with coronary heart disease, prepared for surgery under extracorporeal circulation, suggests

  12. Exploring nuclear magnetic resonance at the highest pressure. Closing the pseudogap under pressure in a high temperature superconductor

    International Nuclear Information System (INIS)

    Meissner, Thomas

    2013-01-01

    In the present work, a novel probe design for high pressure NMR experiments in gem anvil cells (GAC) was used which places a small microcoil inside the high pressure volume as the detection coil. Based on tests carried out at ambient pressure and high pressure of 42 kbar it is demonstrated that this approach is indeed feasible and results in an increase of sensitivity by two orders of magnitude compared to previous GAC-NMR designs. The design was then successfully employed in the investigation of the electronic properties of metallic aluminum and the high temperature superconductor YBa 2 Cu 4 O 8 at pressures of up to 101 kbar. Because of its improved sensitivity and the potential to achieve even higher pressures, the microcoil GAC-NMR setup should prove useful in the investigation of materials under high pressure conditions in the future. In the case of metallic aluminum, the effect of pressure on the electronic density of states at the Fermi level was probed via the Knight-shift K and the spin-lattice relaxation time T 1 at room temperature up to a pressure of 101 kbar, extending the pressure range of previous NMR measurements by a factor of 14 [72]. Most notably, a decrease of K(p) by 11% is detected in the investigated pressure range that is inconsistent with a free electron behavior of the density of states. Numerical band structure calculations that are in excellent agreement with the experimental data suggest that the observed changes of K and T 1 are due to a kink in the electronic states at a Lifshitz-transition at about 75 kbar which has not been observed previously. A further decrease of K by a factor of 2 is predicted to occur in the pressure range up to 300 kbar. In addition, an increase of the NMR linewidths of the metallic aluminum signal was observed above about 42 kbar that is inconsistent with a pure dipolar linewidth. Based on an analysis of the field dependence of this effect it was ascribed to a small additional quadrupolar broadening which is

  13. Exploring nuclear magnetic resonance at the highest pressure. Closing the pseudogap under pressure in a high temperature superconductor

    Energy Technology Data Exchange (ETDEWEB)

    Meissner, Thomas

    2013-05-13

    In the present work, a novel probe design for high pressure NMR experiments in gem anvil cells (GAC) was used which places a small microcoil inside the high pressure volume as the detection coil. Based on tests carried out at ambient pressure and high pressure of 42 kbar it is demonstrated that this approach is indeed feasible and results in an increase of sensitivity by two orders of magnitude compared to previous GAC-NMR designs. The design was then successfully employed in the investigation of the electronic properties of metallic aluminum and the high temperature superconductor YBa{sub 2}Cu{sub 4}O{sub 8} at pressures of up to 101 kbar. Because of its improved sensitivity and the potential to achieve even higher pressures, the microcoil GAC-NMR setup should prove useful in the investigation of materials under high pressure conditions in the future. In the case of metallic aluminum, the effect of pressure on the electronic density of states at the Fermi level was probed via the Knight-shift K and the spin-lattice relaxation time T{sub 1} at room temperature up to a pressure of 101 kbar, extending the pressure range of previous NMR measurements by a factor of 14 [72]. Most notably, a decrease of K(p) by 11% is detected in the investigated pressure range that is inconsistent with a free electron behavior of the density of states. Numerical band structure calculations that are in excellent agreement with the experimental data suggest that the observed changes of K and T{sub 1} are due to a kink in the electronic states at a Lifshitz-transition at about 75 kbar which has not been observed previously. A further decrease of K by a factor of 2 is predicted to occur in the pressure range up to 300 kbar. In addition, an increase of the NMR linewidths of the metallic aluminum signal was observed above about 42 kbar that is inconsistent with a pure dipolar linewidth. Based on an analysis of the field dependence of this effect it was ascribed to a small additional

  14. Effects of Sacubitril/Valsartan (LCZ696) on Natriuresis, Diuresis, Blood Pressures, and NT-proBNP in Salt-Sensitive Hypertension.

    Science.gov (United States)

    Wang, Tzung-Dau; Tan, Ru-San; Lee, Hae-Young; Ihm, Sang-Hyun; Rhee, Moo-Yong; Tomlinson, Brian; Pal, Parasar; Yang, Fan; Hirschhorn, Elizabeth; Prescott, Margaret F; Hinder, Markus; Langenickel, Thomas H

    2017-01-01

    Salt-sensitive hypertension (SSH) is characterized by impaired sodium excretion and subnormal vasodilatory response to salt loading. Sacubitril/valsartan (LCZ696) was hypothesized to increase natriuresis and diuresis and result in superior blood pressure control compared with valsartan in Asian patients with SSH. In this randomized, double-blind, crossover study, 72 patients with SSH received sacubitril/valsartan 400 mg and valsartan 320 mg once daily for 4 weeks each. SSH was diagnosed if the mean arterial pressure increased by ≥10% when patients switched from low (50 mmol/d) to high (320 mmol/d) sodium diet. The primary outcome was cumulative 6- and 24-hour sodium excretion after first dose administration. Compared with valsartan, sacubitril/valsartan was associated with a significant increase in natriuresis (adjusted treatment difference: 24.5 mmol/6 hours, 50.3 mmol/24 hours, both Psacubitril/valsartan significantly reduced N-terminal pro B-type natriuretic peptide levels on day 28 (adjusted treatment difference: -20%; P=0.001). Sacubitril/valsartan and valsartan were safe and well tolerated with no significant changes in body weight or serum sodium and potassium levels with either treatments. In conclusion, sacubitril/valsartan compared with valsartan was associated with short-term increases in natriuresis and diuresis, superior office and ambulatory blood pressure control, and significantly reduced N-terminal pro B-type natriuretic peptide levels in Asian patients with SSH. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01681576. © 2016 American Heart Association, Inc.

  15. Relative Importance of History of Heart Failure Hospitalization and N-Terminal Pro-B-Type Natriuretic Peptide Level as Predictors of Outcomes in Patients With Heart Failure and Preserved Ejection Fraction.

    Science.gov (United States)

    Kristensen, Søren L; Jhund, Pardeep S; Køber, Lars; McKelvie, Robert S; Zile, Michael R; Anand, Inder S; Komajda, Michel; Cleland, John G F; Carson, Peter E; McMurray, John J V

    2015-06-01

    The aim of this study was to investigate N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and recent heart failure (HF) hospitalization as predictors of future events in heart failure - preserved ejection fraction (HF-PEF). Recently, doubt has been expressed about the value of a history of HF hospitalization as a predictor of adverse cardiovascular outcomes in patients with HF and HF-PEF. We estimated rates and adjusted hazard ratios (HRs) for the composite endpoint of cardiovascular death or HF hospitalization, according to history of recent HF hospitalization and baseline NT-proBNP level in the I-PRESERVE (Irbesartan in Heart Failure with Preserved systolic function) trial. Rates of composite endpoints in patients with (n = 804) and without (n = 1,963) a recent HF hospitalization were 12.78 (95% confidence interval [CI]: 11.47 to 14.24) and 4.49 (95% CI: 4.04 to 4.99) per 100 person-years, respectively (HR: 2.71; 95% CI: 2.33 to 3.16). For patients with NT-proBNP concentrations >360 pg/ml (n = 1,299), the event rate was 11.51 (95% CI: 10.54 to 12.58) compared to 3.04 (95% CI: 2.63 to 3.52) per 100 person-years in those with a lower level of NT-proBNP (n = 1468) (HR: 3.19; 95% CI: 2.68 to 3.80). In patients with no recent HF hospitalization and NT-proBNP ≤360 pg/ml (n = 1,187), the event rate was 2.43 (95% CI: 2.03 to 2.90) compared with 17.79 (95% CI: 15.77 to 20.07) per 100 person-years when both risk predictors were present (n = 523; HR: 6.18; 95% CI: 4.96 to 7.69). Recent hospitalization for HF or an elevated level of NT-proBNP identified patients at higher risk for cardiovascular events, and this risk was increased further when both factors were present. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  16. Benefits & risks of statin therapy for primary prevention of cardiovascular disease in Asian Indians – A population with the highest risk of premature coronary artery disease & diabetes

    Science.gov (United States)

    Enas, Enas A.; Kuruvila, Arun; Khanna, Pravien; Pitchumoni, C.S.; Mohan, Viswanathan

    2013-01-01

    Several reviews and meta-analyses have demonstrated the incontrovertible benefits of statin therapy in patients with cardiovascular disease (CVD). But the role for statins in primary prevention remained unclear. The updated 2013 Cochrane review has put to rest all lingering doubts about the overwhelming benefits of long-term statin therapy in primary prevention by conclusively demonstrating highly significant reductions in all-cause mortality, major adverse cardiovascular events (MACE) and the need for coronary artery revascularization procedures (CARPs). More importantly, these benefits of statin therapy are similar at all levels of CVD risk, including subjects at low (statins is also highly effective in delaying and avoiding expensive CARPs such as angioplasties, stents, and bypass surgeries. There is no evidence of any serious harm or threat to life caused by statin therapy, though several adverse effects that affect the quality of life, especially diabetes mellitus (DM) have been reported. Asian Indians have the highest risk of premature coronary artery disease (CAD) and diabetes. When compared with Whites, Asian Indians have double the risk of CAD and triple the risk of DM, when adjusted for traditional risk factors for these diseases. Available evidence supports the use of statin therapy for primary prevention in Asian Indians at a younger age and with lower targets for low-density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein (non-HDL-C), than those currently recommended for Americans and Europeans. Early and aggressive statin therapy offers the greatest potential for reducing the continuing epidemic of CAD among Indians. PMID:24434254

  17. Electrodynamics at the highest energies

    International Nuclear Information System (INIS)

    Klein, Spencer R.

    2002-01-01

    At very high energies, the bremsstrahlung and pair production cross sections exhibit complex behavior due to the material in which the interactions occur. The cross sections in dense media can be dramatically different than for isolated atoms. This writeup discusses these in-medium effects, emphasizing how the cross section has different energy and target density dependencies in different regimes. Data from SLAC experiment E-146 will be presented to confirm the energy and density scaling. Finally, QCD analogs of the electrodynamics effects will be discussed

  18. Vermont Highest Priority Connectivity Blocks

    Data.gov (United States)

    Vermont Center for Geographic Information — Act 174 requires plans to identify potential areas for the development and siting of renewable energy resources and areas that are unsuitable for siting those...

  19. On the possibility of highest energy cosmic rays bursts and their correlation with gamma rays bursts e.g. March 5th, 1979 event

    International Nuclear Information System (INIS)

    Drukier, K.

    1982-01-01

    The avalanche production of magnetic monopoles is possible in neutron stars. Big part of the magnetic field energy can be used to accelerate a pulse of 10 30 monopoles to the energy E > approximately 10 17 eV. Thus the neutron stars may be ''point'' sources of bursts of highest energy Cosmic Rays. The emission of brehmsstrahlung photons by these highly relativistic monopoles would be seen as X and gamma bursts. This ''exotic'' model for March 5th, 1979 event, predicts that it has been followed by burst of highest energy Cosmic Rays coming from the direction of LMC supernovae remanent N49

  20. Relation between N-terminal pro-brain natriuretic peptide levels and response to enhanced external counterpulsation in chronic angina pectoris.

    Science.gov (United States)

    Sahlén, Anders; Wu, Eline; Rück, Andreas; Hagerman, Inger; Förstedt, Gunilla; Sylvén, Christer; Berglund, Margareta; Jernberg, Tomas

    2014-01-01

    Although enhanced external counterpulsation (EECP) provides symptom reduction in many patients with severe angina pectoris, one-quarter of patients fail to respond. Earlier reports have not clearly established whether and how EECP responders may be identified pre-hoc. We hypothesized that clinical and biochemical data may be used to predict EECP response. We explored a database of n=53 patients who had undergone clinically indicated EECP during 35 1-h sessions in our unit (65±7 years; 49 male), and sought to clarify which factors are predictive of response. Efficiency of counterpulsation was measured as the diastolic augmentation (DA) ratio, and was recorded both at beginning and end of the EECP treatment course. An increase in 6-min walk (6MW) distance of 5% was indicative of clinical response. Response occurred in 28 patients (53%; nonresponse in n=25, 47%). Responders had shorter baseline 6MW distance (377±81 vs. 445±62 m; P<0.01), lower left ventricular ejection fraction (48±9 vs. 54±8%; P<0.05), frequently had an increase in DA ratio during the EECP treatment course (23/28 vs. 5/28 with unchanged or decreased DA ratio; P<0.05), and higher levels of N-terminal pro-brain natriuretic peptide [NT-proBNP; 256 (123-547) vs. 62 (26-444) ng/l, P<0.01]. In multivariate logistic regression, response was independently predicted by baseline 6MW distance and baseline NT-proBNP levels (P<0.05 for both; model sensitivity: 82%, specificity: 72%, accuracy: 79%). There is larger clinical benefit of EECP in patients with greater functional impairment and higher levels of NT-proBNP.

  1. On the Derivation of Highest-Order Compact Finite Difference Schemes for the One- and Two-Dimensional Poisson Equation with Dirichlet Boundary Conditions

    KAUST Repository

    Settle, Sean O.; Douglas, Craig C.; Kim, Imbunm; Sheen, Dongwoo

    2013-01-01

    - and two-dimensional Poisson equation on uniform, quasi-uniform, and nonuniform face-to-face hyperrectangular grids and directly prove the existence or nonexistence of their highest-order local accuracies. Our derivations are unique in that we do not make

  2. How to reliably deliver narrow individual-patient error bars for optimization of pacemaker AV or VV delay using a "pick-the-highest" strategy with haemodynamic measurements.

    Science.gov (United States)

    Francis, Darrel P

    2013-03-10

    Intuitive and easily-described, "pick-the-highest" is often recommended for quantitative optimization of AV and especially VV delay settings of biventricular pacemakers (BVP; cardiac resynchronization therapy, CRT). But reliable selection of the optimum setting is challenged by beat-to-beat physiological variation, which "pick-the-highest" combats by averaging multiple heartbeats. Optimization is not optimization unless the optimum is identified confidently. This document shows how to calculate how many heartbeats must be averaged to optimize reliably by pick-the-highest. Any reader, by conducting a few measurements, can calculate for locally-available methods (i) biological scatter between replicate measurements, and (ii) curvature of the biological response. With these, for any clinically-desired precision of optimization, the necessary number of heartbeats can be calculated. To achieve 95% confidence of getting within ±∆x of the true optimum, the number of heartbeats needed is 2(scatter/curvature)(2)/∆x(4) per setting. Applying published scatter/curvature values (which readers should re-evaluate locally) indicates that optimizing AV, even coarsely with a 40ms-wide band of precision, requires many thousand beats. For VV delay, the number approaches a million. Moreover, identifying the optimum twice as precisely requires 30-fold more beats. "Pick the highest" is quick to say but slow to do. We must not expect staff to do the impossible; nor criticise them for not doing so. Nor should we assume recommendations and published protocols are well-designed. Reliable AV or VV optimization, using "pick-the-highest" on commonly-recommended manual measurements, is unrealistic. Improving time-efficiency of the optimization process to become clinically realistic may need a curve-fitting strategy instead, with all acquired data marshalled conjointly. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. [Study of personal best value of peak expiratory flow in patients with asthma--comparison of the highest value of daily PEF under good control and the highest value of daily PEF obtained after using repeated inhaled beta2-agonist during high-dose inhaled steroid treatment].

    Science.gov (United States)

    Watanabe, Naoto; Makino, Sohei; Kihara, Norio; Fukuda, Takeshi

    2008-12-01

    In the guideline for asthma management, it is important to find the personal best value of peak expiratory flow (best PEF). Recently, we have substituted the highest value of PEF in daily life under good control (daily highest PEF) for the best PEF. In the present study, we considered whether the daily highest PEF could be used as the best PEF or not. Subjects were 30 asthmatics who were well controlled but whose baseline PEF values were less than 80 percent of predicted values. We compared the daily highest PEF and the highest of PEF obtained after repeated inhaled beta2-agonist (salbutamol MDI every 20 minutes three times). All subjects then received 1600 microg/day of beclomethasone dipropionate (BDP) for 4 to 8 weeks. We studied the effect of high-dose inhaled steroid treatment on each PEF value and compared the daily highest PEF and the highest PEF obtained after using repeated salbutamol MDI during high dose inhaled steroid therapy on the examination day again. The baseline PEF, daily highest PEF and the highest PEF obtained after salbutamol MDI were significantly less than the each values obtained after high-dose BDP. The best PEF value of them was the value obtained after repeated salbutamol MDI during high dose BDP. We suggest that the daily highest PEF under good control is not a substitute for best PEF because it changes according to the degree of improvement of airway inflammation. We recommend that a course of high dose inhaled steroid is effective in finding the best value of PEF for each individual with moderate asthma.

  4. Effect of milrinone on the cardiac function and N-terminal pro-brain natriuretic peptide levels in patients with senile refractory heart failure

    Directory of Open Access Journals (Sweden)

    Jiao-Na Wei1

    2017-06-01

    Full Text Available Objective: To study the effect of milrinone on the cardiac function and N-terminal probrain natriuretic peptide (NT-proBNP levels in patients with senile refractory heart failure. Methods: 90 patients with senile refractory heart failure who were treated in our hospital between August 2013 and August 2016 were collected and divided into control group (n=45 and observation group (n=45 according to the random number table. The control group received regular clinical treatment, and the observation group received regular + milrinone treatment. The cardiac function and serum NT-proBN contents were compared between two groups of patients before and after treatment. Results: Before treatment, the differences in ultrasound and serum cardiac function indexes and serum NT-proBN levels were not statistically significant between two groups of patients. After treatment, ultrasound serum cardiac function parameter LVEDD level in observation group was lower than that in control group while CI and SV levels were higher than those in control group; serum cardiac function indexes Cys-C, GDF-15, sST2 and H-FABP contents were lower than those in control group; serum NT-proBNP content was lower than that in control group. Conclusion: Milrinone therapy can optimize the cardiac function and reduce the serum NT-proBN levels in patients with senile refractory heart failure.

  5. Bi-level positive airway pressure ventilation for treating heart failure with central sleep apnea that is unresponsive to continuous positive airway pressure.

    Science.gov (United States)

    Dohi, Tomotaka; Kasai, Takatoshi; Narui, Koji; Ishiwata, Sugao; Ohno, Minoru; Yamaguchi, Tetsu; Momomura, Shin-Ichi

    2008-07-01

    Cheyne-Stokes respiration with central sleep apnea (CSR-CSA) is associated with a poor prognosis in patients with heart failure (HF). However, some patients do not respond to continuous positive airway pressure (CPAP), so other therapeutic modalities should be considered, such as bi-level positive airway pressure (PAP), which also assists respiration and might be effective for such patients. The 20 patients with HF because of left ventricular systolic dysfunction were assessed: 8 had ischemic etiology, and all had severe CSA according to the apnea - hypopnea index (AHI) determined by polysomnography. All diagnosed patients underwent repeat polysomnography using CPAP. The AHI improved significantly in 11 (AHI or=15). Bi-level PAP titration significantly improved the AHI in the latter group. Those who were unresponsive to CPAP had significantly lower PaCO(2), higher plasma brain natriuretic peptide (BNP), longer mean duration of CSR and fewer obstructive episodes than CPAP responders. After 6 months of positive airway support with either CPAP (n=9) or bi-level PAP (n=7), BNP levels significantly decreased and left ventricular ejection fraction significantly increased. Bi-level PAP could be an effective alternative for patients with HF and pure CSR-CSA who are unresponsive to CPAP.

  6. Simplifying consent for HIV testing is associated with an increase in HIV testing and case detection in highest risk groups, San Francisco January 2003-June 2007.

    Directory of Open Access Journals (Sweden)

    Nicola M Zetola

    2008-07-01

    Full Text Available Populations at highest risk for HIV infection face multiple barriers to HIV testing. To facilitate HIV testing procedures, the San Francisco General Hospital Medical Center eliminated required written patient consent for HIV testing in its medical settings in May 2006. To describe the change in HIV testing rates in different hospital settings and populations after the change in HIV testing policy in the SFDH medical center, we performed an observational study using interrupted time series analysis.Data from all patients aged 18 years and older seen from January 2003 through June 2007 at the San Francisco Department of Public Health (SFDPH medical care system were included in the analysis. The monthly HIV testing rate per 1000 had patient-visits was calculated for the overall population and stratified by hospital setting, age, sex, race/ethnicity, homelessness status, insurance status and primary language.By June 2007, the average monthly rate of HIV tests per 1000 patient-visits increased 4.38 (CI, 2.17-6.60, p<0.001 over the number predicted if the policy change had not occurred (representing a 44% increase. The monthly average number of new positive HIV tests increased from 8.9 (CI, 6.3-11.5 to 14.9 (CI, 10.6-19.2, p<0.001, representing a 67% increase. Although increases in HIV testing were seen in all populations, populations at highest risk for HIV infection, particularly men, the homeless, and the uninsured experienced the highest increases in monthly HIV testing rates after the policy change.The elimination of the requirement for written consent in May 2006 was associated with a significant and sustained increase in HIV testing rates and HIV case detection in the SFDPH medical center. Populations facing the higher barriers to HIV testing had the highest increases in HIV testing rates and case detection in response to the policy change.

  7. Application of trajectory clustering and source attribution methods for investigating regional CO2 and CH4 concentrations at Germany's highest mountain site

    Science.gov (United States)

    Giemsa, Esther; Jacobeit, Jucundus; Ries, Ludwig; Frank, Gabriele; Hachinger, Stephan; Meyer-Arnek, Julian

    2017-04-01

    Carbon dioxide (CO2) and methane (CH4) represent the most important contributors to increased radiative forcing enhancing it together by contemporary 2.65 W/m2 on the global average (IPCC 2013). The unbroken increase of atmospheric greenhouse gases (GHG) has been unequivocally attributed to human emissions mainly coming from fossil fuel burning and land-use changes, while the oceans and terrestrial ecosystems slightly attenuate this rise with seasonally varying strength. Short-term fluctuations in the GHG concentrations that superimpose the seasonal cycle and the climate change driven trend reflect the presence of regional sources and sinks. A perfect place for investigating the comprehensive influence of these regional emissions is provided by the Environmental Research Station Schneefernerhaus (47.42°N, 10.98°E, 2.650m a.s.l.) situated in the eastern Alps at the southern side of Zugspitze mountain. Located just 300m below the highest peak of the German Alps, the exposed site is one of the currently 30 global core sites of the World Meteorological Organisation (WMO) Global Atmosphere Watch (GAW) programme and thus provides ideal conditions to study source-receptor relationships for greenhouse gases. We propose a stepwise statistical methodology for examining the relationship between synoptic-scale atmospheric transport patterns and climate gas mole fractions to finally receive a characterization of the sampling site with regard to the key processes driving CO2 and CH4 concentration levels. The first step entails a reliable radon-based filtering approach to subdivide the detected air masses according to their regional or 'background' origin. Simultaneously, a large number of ten-day back-trajectories from Schneefernerhaus every two hours over the entire study period 2011 - 2015 is calculated with the Lagrangian transport and dispersion model FLEXPART (Stohl et al. 2005) and subjected to cluster analysis. The weather- and emission strength-related (short

  8. Supported rhodium catalysts for ammonia-borane hydrolysis. Dependence of the catalytic activity on the highest occupied state of the single rhodium atoms

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Liangbing; Li, Hongliang; Zhang, Wenbo; Zhao, Xiao; Qiu, Jianxiang; Li, Aowen; Zheng, Xusheng; Zeng, Jie [Hefei National Lab. for Physical Sciences at the Microscale, Key Lab. of Strongly-Coupled Quantum Matter Physics, Chinese Academy of Sciences, Hefei, Anhui(China); Department of Chemical Physics, University of Science and Technology of China, Hefei, Anhui (China); Hu, Zhenpeng [School of Physics, Nankai University, Tianjin (China); Si, Rui [Shanghai Synchrotron Radiation Facility, Shanghai Institute of Applied Physics, Chinese Academy of Sciences (China)

    2017-04-18

    Supported metal nanocrystals have exhibited remarkable catalytic performance in hydrogen generation reactions, which is influenced and even determined by their supports. Accordingly, it is of fundamental importance to determine the direct relationship between catalytic performance and metal-support interactions. Herein, we provide a quantitative profile for exploring metal-support interactions by considering the highest occupied state in single-atom catalysts. The catalyst studied consisted of isolated Rh atoms dispersed on the surface of VO{sub 2} nanorods. It was observed that the activation energy of ammonia-borane hydrolysis changed when the substrate underwent a phase transition. Mechanistic studies indicate that the catalytic performance depended directly on the highest occupied state of the single Rh atoms, which was determined by the band structure of the substrates. Other metal catalysts, even with non-noble metals, that exhibited significant catalytic activity towards NH{sub 3}BH{sub 3} hydrolysis were rationally designed by adjusting their highest occupied states. (copyright 2017 Wiley-VCH Verlag GmbH and Co. KGaA, Weinheim)

  9. The impact of B-type natriuretic peptide levels on the suppression of accompanying atrial fibrillation in Wolff-Parkinson-White syndrome patients after accessory pathway ablation.

    Science.gov (United States)

    Kawabata, Mihoko; Goya, Masahiko; Takagi, Takamitsu; Yamashita, Shu; Iwai, Shinsuke; Suzuki, Masahito; Takamiya, Tomomasa; Nakamura, Tomofumi; Hayashi, Tatsuya; Yagishita, Atsuhiko; Sasaki, Takeshi; Takahashi, Yoshihide; Ono, Yuhichi; Hachiya, Hitoshi; Yamauchi, Yasuteru; Otomo, Kenichiro; Nitta, Junichi; Okishige, Kaoru; Nishizaki, Mitsuhiro; Iesaka, Yoshito; Isobe, Mitsuaki; Hirao, Kenzo

    2016-12-01

    Atrial fibrillation (AF) often coexists with Wolff-Parkinson-White (WPW) syndrome. We compared the efficacy of Kent bundle ablation alone and additional AF ablation on accompanying AF, and examined which patients would still have a risk of AF after successful Kent bundle ablation. This retrospective multicenter study included 96 patients (56±15 years, 72 male) with WPW syndrome and AF undergoing Kent bundle ablation. Some patients underwent simultaneous pulmonary vein isolation (PVI) for AF. The incidence of post-procedural AF was examined. Sixty-four patients underwent only Kent bundle ablation (Kent-only group) and 32 also underwent PVI (+PVI group). There was no significant difference in the basic patient characteristics between the groups. Additional PVI did not improve the freedom from residual AF compared to Kent bundle ablation alone (p=0.53). In the Kent-only group, AF episodes remained in 25.0% during the follow-up (709 days). A univariate analysis showed that age ≥60 years, left atrial dimension ≥38mm, B-type natriuretic peptide (BNP) ≥40pg/ml, and concomitant hypertension were predictive factors for residual AF. However, in the multivariate analysis, only BNP ≥40pg/ml remained as an independent predictive factor (HR=17.1 and CI: 2.3-128.2; p=0.006). Among patients with WPW syndrome and AF, Kent bundle ablation alone may have a sufficient clinical impact of preventing recurrence of AF in select patients. Screening the BNP level would help decide the strategy to manage those patients. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  10. Adult Cigarette Smokers at Highest Risk for Concurrent Alternative Tobacco Product Use Among a Racially/Ethnically and Socioeconomically Diverse Sample.

    Science.gov (United States)

    Nollen, Nicole L; Ahluwalia, Jasjit S; Lei, Yang; Yu, Qing; Scheuermann, Taneisha S; Mayo, Matthew S

    2016-04-01

    Rates of alternative tobacco product use (ATPs; eg, cigars, cigarillos, pipes) among cigarette smokers are on the rise but little is known about the subgroups at highest risk. This study explored interactions between demographic, tobacco, and psychosocial factors to identify cigarette smokers at highest risk for ATP use from a racially/ethnically and socioeconomically diverse sample of adult smokers across the full smoking spectrum (nondaily, daily light, daily heavy). Two-thousand three-hundred seventy-six adult cigarette smokers participated in an online cross-sectional survey. Quotas ensured equal recruitment of African American (AA), white (W), Hispanic/Latino (H) as well as daily and nondaily smokers. Classification and Regression Tree modeling was used to identify subgroups of cigarette smokers at highest risk for ATP use. 51.3% were Cig+ATP smokers. Alcohol for men and age, race/ethnicity, and discrimination for women increased the probability of ATP use. Strikingly, 73.5% of men screening positive for moderate to heavy drinking and 62.2% of younger (≤45 years) African American/Hispanic/Latino women who experienced regular discrimination were Cig+ATP smokers. Screening for concurrent ATP use is necessary for the continued success of tobacco cessation efforts especially among male alcohol users and racial/ethnic minority women who are at greatest risk for ATP use. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. A at single nucleotide polymorphism-358 is required for G at -420 to confer the highest plasma resistin in the general Japanese population.

    Directory of Open Access Journals (Sweden)

    Hiroshi Onuma

    Full Text Available Insulin resistance is a feature of type 2 diabetes. Resistin, secreted from adipocytes, causes insulin resistance in mice. We previously reported that the G/G genotype of single nucleotide polymorphism (SNP at -420 (rs1862513 in the human resistin gene (RETN increased susceptibility to type 2 diabetes by enhancing its promoter activity. Plasma resistin was highest in Japanese subjects with G/G genotype, followed by C/G, and C/C. In this study, we cross-sectionally analyzed plasma resistin and SNPs in the RETN region in 2,019 community-dwelling Japanese subjects. Plasma resistin was associated with SNP-638 (rs34861192, SNP-537 (rs34124816, SNP-420, SNP-358 (rs3219175, SNP+299 (rs3745367, and SNP+1263 (rs3745369 (P<10(-13 in all cases. SNP-638, SNP -420, SNP-358, and SNP+157 were in the same linkage disequilibrium (LD block. SNP-358 and SNP-638 were nearly in complete LD (r(2 = 0.98, and were tightly correlated with SNP-420 (r(2 = 0.50, and 0.51, respectively. The correlation between either SNP-358 (or SNP-638 or SNP-420 and plasma resistin appeared to be strong (risk alleles for high plasma resistin; A at SNP-358, r(2 = 0.5224, P = 4.94x10(-324; G at SNP-420, r(2 = 0.2616, P = 1.71x10(-133. In haplotypes determined by SNP-420 and SNP-358, the estimated frequencies for C-G, G-A, and G-G were 0.6700, 0.2005, and 0.1284, respectively, and C-A was rare (0.0011, suggesting that subjects with A at -358, generally had G at -420. This G-A haplotype conferred the highest plasma resistin (8.24 ng/ml difference/allele compared to C-G, P<0.0001. In THP-1 cells, the RETN promoter with the G-A haplotype showed the highest activity. Nuclear proteins specifically recognized one base difference at SNP-358, but not at SNP-638. Therefore, A at -358 is required for G at -420 to confer the highest plasma resistin in the general Japanese population. In Caucasians, the association between SNP-420 and plasma resistin is not strong, and A at -358 may not exist

  12. The first cytogenetic description of Euleptes europaea (Gené, 1839 from Northern Sardinia reveals the highest diploid chromosome number among sphaerodactylid geckos (Sphaerodactylidae, Squamata

    Directory of Open Access Journals (Sweden)

    Ekaterina Gornung

    2013-06-01

    Full Text Available The karyotype of a sphaerodactylid gecko Euleptes europaea (Gené, 1839 was assembled for the first time in this species. It is made of 2n = 42 gradually decreasing in size chromosomes, the highest chromosome number so far acknowledged in the family Sphaerodactylidae. The second chromosome pair of the karyotype appears slightly heteromorphic in the male individual. Accordingly, FISH with a telomeric probe revealed an uneven distribution of telomeric repeats on the two homologues of this pair, which may be indicative of an XY sex-determination system in the species, to be further investigated.

  13. Evaluating the consistency of location of the most severe acute skin reaction and highest skin dose measured by thermoluminescent dosimeter during radiotherapy for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Li-Min, E-mail: limin.sun@yahoo.com [Department of Radiation Oncology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung City, Taiwan (China); Huang, Chih-Jen [Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan (China); Department of Faculty of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan (China); Department of College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan (China); Chen, Hsiao-Yun [Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan (China); Chang, Gia-Hsin [Department of Radiation Oncology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung City, Taiwan (China); Tsao, Min-Jen [Department of General Surgery, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung City, Taiwan (China)

    2016-10-01

    We conducted this prospective study to evaluate whether the location of the most severe acute skin reaction matches the highest skin dose measured by thermoluminescent dosimeter (TLD) during adjuvant radiotherapy (RT) for patients with breast cancer after breast conservative surgery. To determine whether TLD measurement can reflect the location of the most severe acute skin reaction, 80 consecutive patients were enrolled in this prospective study. We divided the irradiated field into breast, axillary, inframammary fold, and areola/nipple areas. In 1 treatment session when obvious skin reaction occurred, we placed the TLD chips onto the 4 areas and measured the skin dose. We determined whether the highest measured skin dose area is consistent with the location of the most severe skin reaction. The McNemar test revealed that the clinical skin reaction and TLD measurement are more consistent when the most severe skin reaction occurred at the axillary area, and the p = 0.0108. On the contrary, TLD measurement of skin dose is less likely consistent with clinical observation when the most severe skin reaction occurred at the inframammary fold, breast, and areola/nipple areas (all the p > 0.05). Considering the common site of severe skin reaction over the axillary area, TLD measurement may be an appropriate way to predict skin reaction during RT.

  14. On the Derivation of Highest-Order Compact Finite Difference Schemes for the One- and Two-Dimensional Poisson Equation with Dirichlet Boundary Conditions

    KAUST Repository

    Settle, Sean O.

    2013-01-01

    The primary aim of this paper is to answer the question, What are the highest-order five- or nine-point compact finite difference schemes? To answer this question, we present several simple derivations of finite difference schemes for the one- and two-dimensional Poisson equation on uniform, quasi-uniform, and nonuniform face-to-face hyperrectangular grids and directly prove the existence or nonexistence of their highest-order local accuracies. Our derivations are unique in that we do not make any initial assumptions on stencil symmetries or weights. For the one-dimensional problem, the derivation using the three-point stencil on both uniform and nonuniform grids yields a scheme with arbitrarily high-order local accuracy. However, for the two-dimensional problem, the derivation using the corresponding five-point stencil on uniform and quasi-uniform grids yields a scheme with at most second-order local accuracy, and on nonuniform grids yields at most first-order local accuracy. When expanding the five-point stencil to the nine-point stencil, the derivation using the nine-point stencil on uniform grids yields at most sixth-order local accuracy, but on quasi- and nonuniform grids yields at most fourth- and third-order local accuracy, respectively. © 2013 Society for Industrial and Applied Mathematics.

  15. [Impact of plasma pro-B-type natriuretic peptide amino-terminal and galectin-3 levels on the predictive capacity of the LIPID Clinical Risk Scale in stable coronary disease].

    Science.gov (United States)

    Higueras, Javier; Martín-Ventura, José Luis; Blanco-Colio, Luis; Cristóbal, Carmen; Tarín, Nieves; Huelmos, Ana; Alonso, Joaquín; Pello, Ana; Aceña, Álvaro; Carda, Rocío; Lorenzo, Óscar; Mahíllo-Fernández, Ignacio; Asensio, Dolores; Almeida, Pedro; Rodríguez-Artalejo, Fernando; Farré, Jerónimo; López Bescós, Lorenzo; Egido, Jesús; Tuñón, José

    2015-01-01

    At present, there is no tool validated by scientific societies for risk stratification of patients with stable coronary artery disease (SCAD). It has been shown that plasma levels of monocyte chemoattractant protein-1 (MCP-1), galectin-3 and pro-B-type natriuretic peptide amino-terminal (NT-proBNP) have prognostic value in this population. To analyze the prognostic value of a clinical risk scale published in Long-term Intervention with Pravastatin in Ischemic Disease (LIPID) study and determining its predictive capacity when combined with plasma levels of MCP-1, galectin-3 and NT-proBNP in patients with SCAD. A total of 706 patients with SCAD and a history of acute coronary syndrome (ACS) were analyzed over a follow up period of 2.2 ± 0.99 years. The primary endpoint was the occurrence of an ischemic event (any SCA, stroke or transient ischemic attack), heart failure, or death. A clinical risk scale derived from the LIPID study significantly predicted the development of the primary endpoint, with an area under the ROC curve (Receiver Operating Characteristic) of 0.642 (0.579 to 0.705); Pvalue improved with an area under the curve of 0.744 (0.684 to 0.805); P<0.001 (P=0.022 for comparison). A score greater than 21.5 had a sensitivity of 74% and a specificity of 61% for the development of the primary endpoint (P<0.001, log -rank test). Plasma levels of MCP-1, galectin -3 and NT-proBNP improve the ability of the LIPID clinical scale to predict the prognosis of patients with SCAD. Copyright © 2014 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  16. Two-dimensional thermal simulations of aluminum and carbon ion strippers for experiments at SPIRAL2 using the highest beam intensities

    International Nuclear Information System (INIS)

    Tahir, N.A.; Kim, V.; Lamour, E.; Lomonosov, I.V.; Piriz, A.R.; Rozet, J.P.; Stöhlker, Th.; Sultanov, V.; Vernhet, D.

    2012-01-01

    In this paper we report on two-dimensional numerical simulations of heating of a rotating, wheel shaped target impacted by the full intensity of the ion beam that will be delivered by the SPIRAL2 facility at Caen, France. The purpose of this work is to study heating of solid targets that will be used to strip the fast ions of SPIRAL2 to the required high charge state for the FISIC (Fast Ion–Slow Ion Collision) experiments. Strippers of aluminum with different emissivities and of carbon are exposed to high beam current of different ion species as oxygen, neon and argon. These studies show that carbon, due to its much higher sublimation temperature and much higher emissivity, is more favorable compared to aluminum. For the highest beam intensities, an aluminum stripper does not survive. However, problem of the induced thermal stresses and long term material fatigue needs to be investigated before a final conclusion can be drawn.

  17. Trends in AIDS Deaths, New Infections and ART Coverage in the Top 30 Countries with the Highest AIDS Mortality Burden; 1990–2013

    Science.gov (United States)

    Granich, Reuben; Gupta, Somya; Hersh, Bradley; Williams, Brian; Montaner, Julio; Young, Benjamin; Zuniga, José M.

    2015-01-01

    Background Antiretroviral therapy (ART) prevents human immunodeficiency virus (HIV) disease progression, mortality and transmission. We assess the impact of expanded HIV treatment for the prevention of Acquired Immunodeficiency Syndrome (AIDS)-related deaths and simulate four treatment scenarios for Nigeria and South Africa. Methods For 1990–2013, we used the Joint United Nations Programme on HIV/AIDS (UNAIDS) database to examine trends in AIDS deaths, HIV incidence and prevalence, ART coverage, annual AIDS death rate, AIDS death-to-treatment and HIV infections to treatment ratios for the top 30 countries with the highest AIDS mortality burden and compare them with data from high-income countries. We projected the 1990–2020 AIDS deaths for Nigeria and South Africa using four treatment scenarios: 1) no ART; 2) maintaining current ART coverage; 3) 90% ART coverage based on 2013 World Health Organization (WHO) ART guidelines by 2020; and 4) reaching the United Nations 90-90-90 Target by 2020. Findings In 2013, there were 1.3 million (1.1 million–1.6 million) AIDS deaths in the top 30 countries representing 87% of global AIDS deaths. Eight countries accounted for 58% of the global AIDS deaths; Nigeria and South Africa accounted for 27% of global AIDS deaths. The highest death rates per 1000 people living with HIV were in Central African Republic (91), South Sudan (82), Côte d’Ivoire (75), Cameroon (72) and Chad (71), nearly 8–10 times higher than the high-income countries. ART access in 2013 has averted as estimated 1,051,354 and 422,448 deaths in South Africa and Nigeria, respectively. Increasing ART coverage in these two countries to meet the proposed UN 90-90-90 Target by 2020 could avert 2.2 and 1.2 million deaths, respectively. Interpretation Over the past decade the expansion of access to ART averted millions of deaths. Reaching the proposed UN 90-90-90 Target by 2020 will prevent additional morbidity, mortality and HIV transmission. Despite progress

  18. Highest performance in 3D metal cutting at smallest footprint: benchmark of a robot based system vs. parameters of gantry systems

    Science.gov (United States)

    Scheller, Torsten; Bastick, André; Michel-Triller, Robert; Manzella, Christon

    2014-02-01

    In the automotive industry as well as in other industries ecological aspects regarding energy savings are driving new technologies and materials, e.g. lightweight materials as aluminium or press hardened steels. Processing such parts especially complex 3D shaped parts laser manufacturing has become the key process offering highest efficiency. The most established systems for 3D cutting applications are based on gantry systems. The disadvantage of those systems is their huge footprint to realize the required stability and work envelope. Alternatively a robot based system might be of advantage if accuracy, speed and overall performance would be capable processing automotive parts. With the BIM "beam in motion" system, JENOPTIK Automatisierungstechnik GmbH has developed a modular robot based laser processing machine, which meets all OEM specs processing press hardened steel parts. A benchmark of the BIM versus a gantry system was done regarding all required parameters to fulfil OEM specifications for press hardened steel parts. As a result a highly productive, accurate and efficient system can be described based on one or multiple robot modules working simultaneously together. The paper presents the improvements on the robot machine concept BIM addressed in 2012 [1] leading to an industrial proven system approach for the automotive industry. It further compares the performance and the parameters for 3D cutting applications of the BIM system versus a gantry system by samples of applied parts. Finally an overview of suitable applications for processing complex 3D parts with high productivity at small footprint is given.

  19. Non-apical positive surgical margins after radical prostatectomy for pT2 prostate cancer is associated with the highest risk of recurrence

    DEFF Research Database (Denmark)

    Roder, Martin Andreas; Kawa, Sandra; Scheike, Thomas

    2014-01-01

    BACKGROUND AND OBJECTIVE: To investigate how location of positive surgical margins (PSM) in pT2 tumors affect the risk of biochemical recurrence (BR). METHODS: The study includes 1,133 consecutive patients from 1995 until end of 2011, who had organ-confined disease (pT2) following RP. The location...... a 3.1-fold increased risk of BR compared to margin negative patients. Patients with pT2 apical and non-apical PSM had a 5-year biochemical recurrence-free survival of 84.9% (95% CI: 77.6-92.2%) and 78.6% (95% CI: 71.3-85.9%), respectively. In multivariate analysis, pT2 apical and non-apical PSM...... was individually associated with a 2.2- and 3.8-fold increased risk of BR compared to margin negative patients. CONCLUSION: In our cohort the location of pT2 PSM was associated with time to BR, that is, patients with non-apical pT2 PSM endured the highest risk of BR compared to apical PSM. This may indicate...

  20. Investigations to the potential of the high temperature reactor for steam power processes with highest steam conditions and comparison with according conventional power plants

    International Nuclear Information System (INIS)

    Mondry, M.

    1988-04-01

    Already in the fifties conventional power plants with high parameters of the live steam were built to improve the total efficiency. The power plant with the highest steam conditions in the Federal Republic of Germany has 300 bar pressure and 600deg C temperature. Because of high material costs and other problems power plants with such high conditions were not continued to be built. Standard conditions of today's power plants are in the order of 180-250 bar pressure and 535deg C temperature. As the high temperature reactor is partly built up in another way than a conventional power plant, the results regarding the high steam parameters are not transferable. Possibilities for the technical realization of determined HTR-specific components are introduced and discussed. Then different HTR-power plants with steam conditions up to 350 bar pressure and 650deg C temperature are projected. Economical considerations show that an HTR with higher steam parameters brings financial profits. Further efficiency increase, which is possible by the high steam conditions, is shortly presented. The work ends with a technical and economical comparison of corresponding conventional power plants. (orig./UA) [de

  1. Flagellar region 3b supports strong expression of integrated DNA and the highest chromosomal integration efficiency of the Escherichia coli flagellar regions.

    Science.gov (United States)

    Juhas, Mario; Ajioka, James W

    2015-07-01

    The Gram-negative bacterium Escherichia coli is routinely used as the chassis for a variety of biotechnology and synthetic biology applications. Identification and analysis of reliable chromosomal integration and expression target loci is crucial for E. coli engineering. Chromosomal loci differ significantly in their ability to support integration and expression of the integrated genetic circuits. In this study, we investigate E. coli K12 MG1655 flagellar regions 2 and 3b. Integration of the genetic circuit into seven and nine highly conserved genes of the flagellar regions 2 (motA, motB, flhD, flhE, cheW, cheY and cheZ) and 3b (fliE, F, G, J, K, L, M, P, R), respectively, showed significant variation in their ability to support chromosomal integration and expression of the integrated genetic circuit. While not reducing the growth of the engineered strains, the integrations into all 16 target sites led to the loss of motility. In addition to high expression, the flagellar region 3b supports the highest efficiency of integration of all E. coli K12 MG1655 flagellar regions and is therefore potentially the most suitable for the integration of synthetic genetic circuits. © 2015 The Authors. Microbial Biotechnology published by John Wiley & Sons Ltd and Society for Applied Microbiology.

  2. Proposed stratotype for the base of the highest Cambrian stage at the first appearance datum of Cordylodus andresi, Lawson Cove section, Utah, USA

    Science.gov (United States)

    Miller, J.F.; Ethington, Raymond L.; Evans, K.R.; Holmer, L.E.; Loch, James D.; Popov, L.E.; Repetski, J.E.; Ripperdan, R.L.; Taylor, John F.

    2006-01-01

    We propose a candidate for the Global Standard Stratotype-section and Point (GSSP) for the base of the highest stage of the Furongian Series of the Cambrian System. The section is at Lawson Cove in the Ibex area of Millard County, Utah, USA. The marker horizon is the first appearance datum (FAD) of the conodont Cordylodus andresi Viira et Sergeyeva in Kaljo et al. [Kaljo, D., Borovko, N., Heinsalu, H., Khazanovich, K., Mens, K., Popov, L., Sergeyeva, S., Sobolevskaya, R., Viira, V., 1986. The Cambrian-Ordovician boundary in the Baltic-Ladoga clint area (North Estonia and Leningrad Region, USSR). Eesti NSV Teaduste Akadeemia Toimetised. Geologia 35, 97-108]. At this section and elsewhere this horizon also is the FAD of the trilobite Eurekia apopsis (Winston et Nicholls, 1967). This conodont characterizes the base of the Cordylodus proavus Zone, which has been recognized in many parts of the world. This trilobite characterizes the base of the Eurekia apopsis Zone, which has been recognized in many parts of North America. The proposed boundary is 46.7 m above the base of the Lava Dam Member of the Notch Peak Formation at the Lawson Cove section. Brachiopods, sequence stratigraphy, and carbon-isotope geochemistry are other tools that characterize this horizon and allow it to be recognized in other areas. ?? 2006 Nanjing Institute of Geology and Palaeontology, CAS.

  3. Study on energy efficient mushroom business in 2010. Highest feasible level of energy conservation and energy efficiency; Onderzoek naar het energiezuinig paddenstoelenbedrijf anno 2010. Hoogst haalbare niveau van energiereductie en energie-efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Suurmeijer, J.M.; Mikkers, E. [Grontmij, Amersfoort (Netherlands); Hilkens, J. [AdVisie, Herkenbosch (Netherlands)

    2010-06-15

    Targets of Dutch mushroom cultivation businesses include an energy efficiency improvement of 2.5% annually, implementation of sustainable energy options, and climate-neutral and economically viable cultivation by new mushroom cultivation businesses that are to be built in 2020. This report describes the measures that could be implemented in support of these targets [Dutch] De doelstellingen voor paddestoelenbedrijven zijn een energie-efficientie verbetering van 2,5% per jaar, implementatie van duurzame energieopties, en klimaatneutrale en economisch rendabele teelt van de in 2020 nieuw te bouwen paddenstoelenbedrijven. In dit rapport staan de maatregelen beschreven die genomen kunnen worden ter ondersteuning van de doelstellingen.

  4. Far ahead of the times. Measurements demonstrate: solar thermal heating systems save money at the highest level of domestic comfort; Der Zeit weit voraus. Messungen beweisen: solarthermische Heizsysteme sparen bares Geld bei hoechstem Wohnkomfort

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2012-12-15

    If someone wants to build or renovate its own home at present, is well advised to decide for a sustainable and cost saving energy concept. Already at the beginning of this year, the oil and gas prices amount to more than 90 cent per litre. Tendency: increasing. Many households look back on one of the most expensive heating periods of the past five years, although the winter 2011/2012 brought average temperatures statistically. If someone wants to become independent from the development of the energy prices, needs a building and heating concept which meets the heat requirement from renewable energy resources as wide-ranging as possible.

  5. New low pressure exhaust modules for the MAN steam turbine product line. High performance bladings for highest efficiency levels; Neue Niederdruck-Module fuer die MAN-Dampfturbinenproduktlinie. Hochentwickelte Beschaufelungen fuer hoechste Leistungsdichten und Wirkungsgrade

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, M.A.; Behnke, K.; Klemm, H. [MAN TURBO AG, Oberhausen (Germany)

    2008-07-01

    Currently it can be observed that in the case of generator drives as well as 'mechanical drives' smaller units are demanded with a steam turbine capacity of up to 150 MW and clearly higher efficiencies. MAN TURBO is meeting the challenge through realisation of a comprehensive development project aiming at the extension of the application range of the current steam turbine series.

  6. Infrared, diode laser spectroscopy of the Ar--N2O complex: Observation of the intermolecular bending mode in combination with the highest frequency intramolecular stretching mode

    International Nuclear Information System (INIS)

    Hu, T.A.; Chappell, E.L.; Sharpe, S.W.

    1993-01-01

    Rotationally resolved vibrational spectra consisting of a-type transitions have been observed for the low-frequency, intermolecular bending mode in combination with the highest frequency, intramolecular stretching mode of Ar--N 2 O. Analysis of the spectral data places the origin of the combination band at 2256.1 cm -1 while the origin of the intramolecular stretching fundamental is at 2223.9 cm -1 . The difference between these two origins is approximately 32.2 cm -1 and agrees well with our calculated frequency of 31.5 cm -1 for the intermolecular bending mode, which was obtained by analysis of the centrifugal distortion constants. In addition, argon--nitrous oxide exhibits an anomalously large inertial defect of 10.96 amu A 2 in the combination state. This indicates a breakdown in the assumption of separation between vibration and rotation. While much of the inertial defect in the ground state can be accounted for by including Coriolis interactions, that occurring in the combination state is only partially accounted for by a similar analysis. Small, but significant changes, are observed in both the radial and angular parameters for Ar--N 2 O when going from the ground to the combination state, indicating large amplitude motion. The combination band is approximately 200 times less intense than the high-frequency, stretching fundamental of Ar--N 2 O. In addition, over 400 new rovibrational transitions are assigned to the previously observed 1 0 1 intramolecular stretching fundamental of the complex, and the subsequent rotational analysis is found to be in close agreement with earlier studies. Data were taken on a newly built, rapid-scan, diode laser spectrometer that incorporates a 12 cmx200 μm pulsed slit-expansion nozzle

  7. Harnessing Omics Big Data in Nine Vertebrate Species by Genome-Wide Prioritization of Sequence Variants with the Highest Predicted Deleterious Effect on Protein Function.

    Science.gov (United States)

    Rozman, Vita; Kunej, Tanja

    2018-05-10

    Harnessing the genomics big data requires innovation in how we extract and interpret biologically relevant variants. Currently, there is no established catalog of prioritized missense variants associated with deleterious protein function phenotypes. We report in this study, to the best of our knowledge, the first genome-wide prioritization of sequence variants with the most deleterious effect on protein function (potentially deleterious variants [pDelVars]) in nine vertebrate species: human, cattle, horse, sheep, pig, dog, rat, mouse, and zebrafish. The analysis was conducted using the Ensembl/BioMart tool. Genes comprising pDelVars in the highest number of examined species were identified using a Python script. Multiple genomic alignments of the selected genes were built to identify interspecies orthologous potentially deleterious variants, which we defined as the "ortho-pDelVars." Genome-wide prioritization revealed that in humans, 0.12% of the known variants are predicted to be deleterious. In seven out of nine examined vertebrate species, the genes encoding the multiple PDZ domain crumbs cell polarity complex component (MPDZ) and the transforming acidic coiled-coil containing protein 2 (TACC2) comprise pDelVars. Five interspecies ortho-pDelVars were identified in three genes. These findings offer new ways to harness genomics big data by facilitating the identification of functional polymorphisms in humans and animal models and thus provide a future basis for optimization of protocols for whole genome prioritization of pDelVars and screening of orthologous sequence variants. The approach presented here can inform various postgenomic applications such as personalized medicine and multiomics study of health interventions (iatromics).

  8. Changes in Plasma Copeptin Levels during Hemodialysis: Are the Physiological Stimuli Active in Hemodialysis Patients?

    Directory of Open Access Journals (Sweden)

    Esmée M Ettema

    Full Text Available Plasma levels of copeptin, a surrogate marker for the vasoconstrictor hormone arginine vasopressin (AVP, are increased in hemodialysis patients. Presently, it is unknown what drives copeptin levels in hemodialysis patients. We investigated whether the established physiological stimuli for copeptin release, i.e. plasma osmolality, blood volume and mean arterial pressure (MAP, are operational in hemodialysis patients.One hundred and eight prevalent, stable hemodialysis patients on a thrice-weekly dialysis schedule were studied during hemodialysis with constant ultrafiltration rate and dialysate conductivity in this observational study. Plasma levels of copeptin, sodium, MAP, and blood volume were measured before, during and after hemodialysis. Multivariate analysis was used to determine the association between copeptin (dependent variable and the physiological stimuli plasma sodium, MAP, excess weight as well as NT-pro-BNP immediately prior to dialysis and between copeptin and changes of plasma sodium, MAP and blood volume with correction for age, sex and diabetes during dialysis treatment.Patients were 63 ± 15.6 years old and 65% were male. Median dialysis vintage was 1.6 years (IQR 0.7-4.0. Twenty-three percent of the patients had diabetes and 82% had hypertension. Median predialysis copeptin levels were 141.5 pmol/L (IQR 91.0-244.8 pmol/L. Neither predialysis plasma sodium levels, nor NT-proBNP levels, nor MAP were associated with predialysis copeptin levels. During hemodialysis, copeptin levels rose significantly (p<0.01 to 163.0 pmol/L (96.0-296.0 pmol/L. Decreases in blood volume and MAP were associated with increases in copeptin levels during dialysis, whereas there was no significant association between the change in plasma sodium levels and the change in copeptin levels.Plasma copeptin levels are elevated predialysis and increase further during hemodialysis. Volume stimuli, i.e. decreases in MAP and blood volume, rather than osmotic

  9. Females, younger patients and patients with high BMI have the highest pre-operative knee awareness measured using the Forgotten Joint Score

    DEFF Research Database (Denmark)

    Li, Dana; Troelsen, A; Ingelsrud, L

    2018-01-01

    PURPOSE: The Forgotten Joint Score (FJS) is a novel measurement for patients' awareness of their knee in daily life. By identifying factors that could explain pre-operative FJS levels, the clinician could better prioritize and single out patients who would benefit most from TKA. The aim of this s...

  10. The voltage optimization of a four-element lens used on a hemispherical spectrograph with virtual entry for highest energy resolution

    International Nuclear Information System (INIS)

    Sise, O.; Martínez, G.; Madesis, I.; Laoutaris, A.; Dimitriou, A.; Fernández-Martín, M.; Zouros, T.J.M.

    2016-01-01

    Highlights: • We investigate the voltage settings for the four-element injection lens of an HDA. • The two well-known approaches, BEM and FDM, in charged particle optics were used. • We tested optimal lens voltages from simulation on the actual experimental setup. • The measured FWHM were well modeled using realistic source parameters. • The results are helpful to experimenters. - Abstract: The methodology and results of a detailed four-element lens optimization analysis based on electron trajectory numerical simulations are presented for a hemispherical deflector analyzer (HDA), whose entry aperture size is determined by the injection lens itself and is therefore virtual. Trajectory calculations were performed using both the boundary-element method (BEM) and the finite-difference method (FDM) and results from these two different approaches were benchmarked against each other, to probe and confirm the accuracy of our results. Since the first and last electrode are held at fixed potentials, the two intermediate adjustable lens electrode voltages were varied over the entire available voltage space in a direct, systematic, brute-force approach, while minima in beam spot size on the 2-D position sensitive detector (PSD) at the exit of the HDA were investigated using a beam shaping approach. Lens voltages demonstrating improved energy resolution for the combined lens/HDA/PSD spectrograph system were sought with and without pre-retardation. The optimal voltages were then tested experimentally on the modeled HDA system using a hot-wire electron gun. The measured energy resolution was found to be in good overall agreement with our simulations, particularly at the highest resolution (∼0.05%) working conditions. These simulations also provide a detailed insight to the distinctive trajectory optics and positions of the first and second image planes, when the PSD has to be placed some distance away from the HDA exit plane, and is therefore not at the ideal optics

  11. The voltage optimization of a four-element lens used on a hemispherical spectrograph with virtual entry for highest energy resolution

    Energy Technology Data Exchange (ETDEWEB)

    Sise, O., E-mail: omersise@sdu.edu.tr [Department of Science Education, Faculty of Education, Suleyman Demirel University, 32260 Isparta (Turkey); Martínez, G. [Departamento de Física Aplicada III, Facultad de Física, UCM, 28040 Madrid (Spain); Madesis, I. [Department of Physics, University of Crete, P.O. Box 2208, GR, 71003 Heraklion (Greece); Tandem Accelerator Laboratory, INPP, NCSR Demokritos, GR, 15310 Ag Paraskevi (Greece); Laoutaris, A. [Tandem Accelerator Laboratory, INPP, NCSR Demokritos, GR, 15310 Ag Paraskevi (Greece); Department of Applied Physics, National Technical University of Athens, GR, 15780 Athens (Greece); Dimitriou, A. [Department of Physics, University of Crete, P.O. Box 2208, GR, 71003 Heraklion (Greece); Tandem Accelerator Laboratory, INPP, NCSR Demokritos, GR, 15310 Ag Paraskevi (Greece); Fernández-Martín, M. [Departamento de Física Aplicada III, Facultad de Física, UCM, 28040 Madrid (Spain); Zouros, T.J.M. [Department of Physics, University of Crete, P.O. Box 2208, GR, 71003 Heraklion (Greece); Tandem Accelerator Laboratory, INPP, NCSR Demokritos, GR, 15310 Ag Paraskevi (Greece)

    2016-08-15

    Highlights: • We investigate the voltage settings for the four-element injection lens of an HDA. • The two well-known approaches, BEM and FDM, in charged particle optics were used. • We tested optimal lens voltages from simulation on the actual experimental setup. • The measured FWHM were well modeled using realistic source parameters. • The results are helpful to experimenters. - Abstract: The methodology and results of a detailed four-element lens optimization analysis based on electron trajectory numerical simulations are presented for a hemispherical deflector analyzer (HDA), whose entry aperture size is determined by the injection lens itself and is therefore virtual. Trajectory calculations were performed using both the boundary-element method (BEM) and the finite-difference method (FDM) and results from these two different approaches were benchmarked against each other, to probe and confirm the accuracy of our results. Since the first and last electrode are held at fixed potentials, the two intermediate adjustable lens electrode voltages were varied over the entire available voltage space in a direct, systematic, brute-force approach, while minima in beam spot size on the 2-D position sensitive detector (PSD) at the exit of the HDA were investigated using a beam shaping approach. Lens voltages demonstrating improved energy resolution for the combined lens/HDA/PSD spectrograph system were sought with and without pre-retardation. The optimal voltages were then tested experimentally on the modeled HDA system using a hot-wire electron gun. The measured energy resolution was found to be in good overall agreement with our simulations, particularly at the highest resolution (∼0.05%) working conditions. These simulations also provide a detailed insight to the distinctive trajectory optics and positions of the first and second image planes, when the PSD has to be placed some distance away from the HDA exit plane, and is therefore not at the ideal optics

  12. Comparison of usefulness of N-terminal pro-brain natriuretic peptide as an independent predictor of cardiac function among admission cardiac serum biomarkers in patients with anterior wall versus nonanterior wall ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.

    Science.gov (United States)

    Haeck, Joost D E; Verouden, Niels J W; Kuijt, Wichert J; Koch, Karel T; Van Straalen, Jan P; Fischer, Johan; Groenink, Maarten; Bilodeau, Luc; Tijssen, Jan G P; Krucoff, Mitchell W; De Winter, Robbert J

    2010-04-15

    The purpose of the present study was to determine the prognostic value of N-terminal pro-brain natriuretic peptide (NT-pro-BNP), among other serum biomarkers, on cardiac magnetic resonance (CMR) imaging parameters of cardiac function and infarct size in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. We measured NT-pro-BNP, cardiac troponin T, creatinine kinase-MB fraction, high-sensitivity C-reactive protein, and creatinine on the patients' arrival at the catheterization laboratory in 206 patients with ST-segment elevation myocardial infarction. The NT-pro-BNP levels were divided into quartiles and correlated with left ventricular function and infarct size measured by CMR imaging at 4 to 6 months. Compared to the lower quartiles, patients with nonanterior wall myocardial infarction in the highest quartile of NT-pro-BNP (> or = 260 pg/ml) more often had a greater left ventricular end-systolic volume (68 vs 39 ml/m(2), p pro-BNP level of > or = 260 pg/ml was the strongest independent predictor of left ventricular ejection fraction in patients with nonanterior wall myocardial infarction compared to the other serum biomarkers (beta = -5.8; p = 0.019). In conclusion, in patients with nonanterior wall myocardial infarction undergoing primary percutaneous coronary intervention, an admission NT-pro-BNP level of > or = 260 pg/ml was a strong, independent predictor of left ventricular function assessed by CMR imaging at follow-up. Our findings suggest that NT-pro-BNP, a widely available biomarker, might be helpful in the early risk stratification of patients with nonanterior wall myocardial infarction. Copyright 2010 Elsevier Inc. All rights reserved.

  13. Clinical significance of detection of plasma natriuretic peptide in the diagnosis of patients with heart failure

    International Nuclear Information System (INIS)

    Song Chunli; Liu Haihong; Zhao Ning; Li Jie; Huang Jianmin

    2009-01-01

    To explore the clinical significance of plasma natriuretic peptide in the diagnosis of patients with heart failure (HF), the plasma atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), NT-pro brain natriuretic peptide (NT-proBNP) levels in 129 patients with heart failure and 30 healthy controls were detected by RIA and ELISA. The results showed that the plasma ANP, BNP, NT-proBNP levels in patients with heart failure were significantly higher than the healthy controls. As the cardiac function deteriorated from NYHA I to IV, the BNP and NT-proBNP levels increased consecutively with significant differences from each other. There was a negative correlation between the plasma ANP and NT-proBNP levels and LVEF. The determination of plasma ANP, BNP and NT-proBNP levels in patients with HF were helpful to the study of the severity and diagnosis of disease. (authors)

  14. Clinical implications of B-type natriuretic peptide and N-terminal pro--B-type natriuretic peptide in the care of the vascular surgery patient.

    Science.gov (United States)

    Wayne Causey, Marlin; Singh, Niten

    2014-12-01

    B-type natriuretic peptide (also known as brain natriuretic peptide or BNP) is a physiologic marker that is often used to assess a patient's global cardiovascular health. BNP is secreted from the ventricular cardiac myocytes in response to stretch that occurs due to increased intravascular volume. PreproBNP is cleaved into BNP and N-terminal proBNP (NT proBNP) to cause diuresis, natriuresis, and vasodilation, and can be measured with a blood laboratory assay test or point-of-care testing. BNP/NT proBNP has been most extensively studied in the diagnosis and management of heart failure, but within the past 5 years, interest has carried over to vascular surgery patients. Studies have demonstrated that elevated levels of BNP/NT-proBNP (typically >100 pg/mL/>300 pg/mL) are associated with major adverse cardiac events at 30 and 180 days. Additional analysis of BNP/NT-proBNP has demonstrated that patients can be classified as very low risk (400 pg/mL). BNP/NT-proBNP in the low- and very-low-risk groups suggests patients are unlikely to have a major adverse cardiac event. An elevated BNP/NT-proBNP, excluding those with reasons for abnormal values, suggests the need for additional risk stratification and medical risk factor optimization. A preoperative measure of BNP or NT-proBNP affords an easy and rapid opportunity to individually and objectively quantify perioperative cardiovascular risk. Recent studies have also identified other biomarkers, none superior to BNP or NT-proBNP, but that, when used concomitantly, aid in further stratifying perioperative risk and will likely be the focus of future investigations. Published by Elsevier Inc.

  15. Looking at the roots of the highest mountains: the lithospheric structure of the Himalaya-Tibet and the Zagros orogens. Results from a geophysical-petrological study

    Science.gov (United States)

    Tunini, L.; Jimenez-Munt, I.; Fernandez, M.; Villasenor, A.; Afonso, J. C.; Verges, J.

    2013-12-01

    The Himalaya-Tibet and Zagros orogens are the two most prominent mountain belts built by continental collision. They are part of a huge belt of Cenozoic age which runs from the Pyrenees to Burma. In its central sector, the collision with the southern margin of the Eurasian plate has resulted not only in the building of mountain ranges over the north-eastern edges of the Arabian and Indian plates but also in widespread deformation 1000-3000 km from the suture zones. Zagros and Himalaya-Tibet orogens share many geodynamic processes but at different rates, amount of convergence and stage of development. The study of their present-day structures provides new insights into their quasi coeval collisional event pointing out differences and similarities in the mountain building processes. We present 2D crust and upper mantle cross-sections down to 400 km depth, along four SW-NE trending profiles. Two profiles cross the Zagros Mountains, running from the Mesopotamian Foreland Basin up to the Alborz and Central Iran. Two other profiles run through the Himalaya-Tibetan orogen: the western transect crosses the western Himalaya, Tarim Basin, Tian Shan Mountains and Junggar Basin; the eastern transect runs from the Indian shield to the Beishan Basin, crossing the eastern Himalaya, Tibetan Plateau, Qaidam Basin and Qilian Mountains. We apply the LitMod-2D code which integrates potential fields (gravity and geoid), isostasy (elevation) and thermal (heat flow and temperature distribution) equations, and mantle petrology. The resulting crust and upper mantle structure is constrained by available data on elevation, Bouguer anomaly, geoid height, surface heat flow and seismic data including P- and S-wave tomography models. Our results show distinct deformation patterns between the crust and the lithospheric mantle beneath the Zagros and Himalaya-Tibetan orogens, indicating a strong strain partitioning in both areas. At crustal level, we found a thickening beneath the Zagros and the

  16. Aprotinina não influencia troponina I, NTproBNP e função renal em crianças operadas com circulação extracorpórea High-dose aprotinin does not affect troponin I, N-Terminal pro-B-type natriuretic peptid and renal function in children submitted to surgical correction with extracorporeal circulation

    Directory of Open Access Journals (Sweden)

    Cesar Augusto Ferreira

    2009-12-01

    glutamic-oxaloacetic transaminase (SGOT and the aminoterminal fraction of natriuretic peptide type B (NT-proBNP did not differ significantly between groups. Post-ECC blood lactate concentration and metabolic acidosis was more intense in the Aprotinin Group. There were no complications with the use of aprotinin. CONCLUSION: High-dose aprotinin did not significant influence in serum markers troponin I, NT-proBNP and renal function, but did associated with hemodilution, blood lactate concentration and metabolic acidosis more intense.

  17. Serum Pentraxin 3 and hs-CRP Levels in Children with Severe Pulmonary Hypertension

    Directory of Open Access Journals (Sweden)

    Cemşit Karakurt

    2014-09-01

    Full Text Available Background: Pulmonary arterial hypertension secondary to untreated left-to-right shunt defects leads to increased pulmonary blood flow, endothelial dysfunction, increased pulmonary vascular resistance, vascular remodelling, neointimal and plexiform lesions. Some recent studies have shown that inflammation has an important role in the pathophysiology of pulmonary arterial hypertension. Aims: The aim of this study is to evaluate serum pentraxin 3 and high sensitive (hs-C reactive protein (hs-CRP levels in children with severe pulmonary arterial hypertension (PAH secondary to untreated congenital heart defects and evaluate the role of inflammation in pulmonary hypertension. Study Design: Cross sectional study. Methods: After ethics committee approval and receiving consent from parents, there were 31 children were selected for the study with severe PAH, mostly with a left-to-right shunt, who had been assessed by cardiac catheterisation and were taking specific pulmonary vasodilators. The control group consisted of 39 age and gender matched healthy children. After recording data about all the patients including age, gender, weight, haemodynamic studies and vasodilator testing, a physical examination was done for all subjects. Blood was taken from patients and the control group using peripheral veins to analyse serum Pentraxin 3, N-terminal pro-Brain Natriuretic Peptide (NT-ProBNP and hs-CRP levels. Serum Pentraxin-3 levels were measured by enzyme linked immunosorbent assay (ELISA and expressed as ng/mL. Serum hs-CRP levels were measured with an immunonephelometric method and expressed as mg/dL. The serum concentration of NT-proBNP was determined by a chemiluminescent immunumetric assay and expressed as pg/mL. Results: Serum Pentraxin- 3 levels were determined to be 1.28±2.12 (0.12-11.43 in the PAH group (group 1 and 0.40±0.72 (0.07-3.45 in group 2. There was a statistically significant difference between the two groups (p<0.01. Serum hs-CRP levels

  18. Differences in polysubstance use among youth in the child welfare system: toward a better understanding of the highest-risk teens.

    Science.gov (United States)

    Traube, Dorian E; Yarnell, Lisa M; Schrager, Sheree M

    2016-02-01

    The current study extended limited prior work on polysubstance use among youth in the child welfare system (CWS) by addressing their potentially greater risk of engaging in polysubstance use, the causes of interpersonal variation in use, and changes in use over time, particularly at later points of involvement in the CWS. Using longitudinal data from the National Survey of Child and Adolescent Well-Being (n=1,178), a series of time-invariant and time-varying demographic and contextual factors were explored to assess their role both overall and at unique points of involvement in the CWS. A series of unconditional and conditional curve-of-factor models were estimated and results indicated that time-invariant characteristics of ethnicity and gender were not related to polysubstance use. Time-variant characteristics of age and placement were associated with polysubstance use and highlighted the dynamic nature of age as a risk factor. Out-of-home placement was protective against later substance use for youth who had been removed from contexts with their original caretaker where there were higher levels of reported violence. Our results suggest that in the child welfare population, the modeling of multiple substances rather than a single substance in isolation is more informative because it yields information on the confluence of behaviors that tend to occur and evolve together. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Determination of levels of some nutrients and anti nutrients in five ...

    African Journals Online (AJOL)

    It was observed that spinach had the highest level of moisture, Sodium and Phosphorus (90.55%, 82.55mg and 18.6mg respectively). Bitter leaf recorded the highest level of fiber (3.72%), soybean had the highest level of protein, carbohydrate and calcium (8.35%, 20.45% and 480mg), respectively. Okra was high in ...

  20. Optimization of Aqueous Extraction from Kalanchoe pinnata Leaves to Obtain the Highest Content of an Anti-inflammatory Flavonoid using a Response Surface Model.

    Science.gov (United States)

    Dos Santos Nascimento, Luana Beatriz; de Aguiar, Paula Fernandes; Leal-Costa, Marcos Vinicius; Coutinho, Marcela Araújo Soares; Borsodi, Maria Paula Gonçalves; Rossi-Bergmann, Bartira; Tavares, Eliana Schwartz; Costa, Sônia Soares

    2018-05-01

    The medicinal plant Kalanchoe pinnata is a phenolic-rich species used worldwide. The reports on its pharmacological uses have increased by 70% in the last 10 years. The leaves of this plant are the main source of an unusual quercetin-diglycosyl flavonoid (QAR, quercetin arabinopyranosyl rhamnopyranoside), which can be easily extracted using water. QAR possess a strong in vivo anti-inflammatory activity. To optimize the aqueous extraction of QAR from K. pinnata leaves using a three-level full factorial design. After a previous screening design, time (x 1 ) and temperature (x 2 ) were chosen as the two independent variables for optimization. Freeze-dried leaves were extracted with water (20% w/v), at 30°C, 40°C or 50°C for 5, 18 or 30 min. QAR content (determined by HPLC-DAD) and yield of extracts were analyzed. The optimized extracts were also evaluated for cytotoxicity. The optimal heating times for extract yield and QAR content were similar in two-dimensional (2D) surface responses (between 12.8 and 30 min), but their optimal extraction temperatures were ranged between 40°C and 50°C for QAR content and 30°C and 38°C for extract yield. A compromise region for both parameters was at the mean points that were 40°C for the extraction temperature and 18 min for the total time. The optimized process is faster and spends less energy than the previous one (water; 30 min at 55°C); therefore is greener and more attractive for industrial purposes. This is the first report of extraction optimization of this bioactive flavonoid. Copyright © 2018 John Wiley & Sons, Ltd. Copyright © 2018 John Wiley & Sons, Ltd.

  1. Lathe leveler

    Energy Technology Data Exchange (ETDEWEB)

    Lovelady, III, Michael W.J.

    2018-03-06

    A lathe leveler for centering a cutting tool in relation to a cylindrical work piece includes a first leveling arm having a first contact point disposed adjacent a distal end of the first leveling arm, a second leveling arm having a second contact point disposed adjacent a distal end of the second leveling arm, a leveling gage, and a leveling plate having a cutting tool receiving surface positioned parallel to a horizontal axis of the leveling gage and on a same plane as a midpoint of the first contact point and the second contact point. The leveling arms and leveling plate are dimensioned and configured such that the cutting tool receiving surface is centered in relation to the work piece when the first and second contact points are in contact with one of the inner surface and outer surface of the cylindrical work piece and the leveling gage is centered.

  2. Studies of the electron density in the highest occupied molecular orbitals of PH 3, PF 3 and P(CH 3) 3 by electron momentum spectroscopy and Hartree-Fock, MRSD-CI and DFT calculations

    Science.gov (United States)

    Rolke, J.; Brion, C. E.

    1996-06-01

    The spherically averaged momentum profiles for the highest occupied molecular orbitals of PF 3 and P(CH 3) 3 have been obtained by electron momentum spectroscopy. The measurements provide a stringent test of basis set effects and the quality of ab-initio methods in the description of these larger molecular systems. As in previous work on the methyl-substituted amines, intuitive arguments fail to predict the correct amount of s- and p-type contributions to the momentum profile while delocalized molecular orbital concepts provide a more adequate description of the HOMOs. The experimental momentum profiles have been compared with theoretical momentum profiles calculated at the level of the target Hartree-Fock approximation with a range of basis sets. New Hartree-Fock calculations are also presented for the HOMO of PH 3 and compared to previously published experimental and theoretical momentum profiles. The experimental momentum profiles have further been compared to calculations at the level of the target Kohn-Sham approximation using density functional theory with the local density approximation and also with gradient corrected (non-local) exchange correlation potentials. In addition, total energies and dipole moments have been calculated for all three molecules by the various theoretical methods and compared to experimental values. Calculated 'density difference maps' show the regions where the HOMO momentum and position electron densities of PF 3 and P(CH 3) 3 change relative to the corresponding HOMO density of PH 3. The results suggest that methyl groups have an electron-attracting effect (relative to H) on the HOMO charge density in trimethyl phosphines. These conclusions are supported by a consideration of dipole moments and the 31P NMR chemical shifts for PH 3, PF 3 and P(CH 3) 3.

  3. Changes in Serum Natriuretic Peptide Levels after Percutaneous Closure of Small to Moderate Ventricular Septal Defects

    Directory of Open Access Journals (Sweden)

    Yuksel Kaya

    2012-01-01

    Full Text Available Background. B-type natriuretic peptide has been shown to be a very sensitive and specific marker of heart failure. In this study, we aimed to investigate the effect of percutaneous closure of ventricular septal defects with Amplatzer septal occluders on brain natriuretic peptide levels. Methods. Between 2008 and 2011, 23 patients underwent successfully percutaneous ventricular septal defect closure in 4 cardiology centers. Brain natriuretic peptide levels were measured in nine patients (4 male, mean ages were 25.3±14.3 who underwent percutaneous closure with Amplatzer occluders for membranous or muscular ventricular septal defects were enrolled in the study. Brain natriuretic peptide levels were measured one day before and one month after the closure. Patients were evaluated clinically and by echocardiography one month after the procedure. Results. Percutaneous closures of ventricular septal defects were successfully performed in all patients. There was not any significant adverse event in patients group during followup. Decrease in brain natriuretic peptide levels after closure were statistically significant (97.3±78.6 versus 26.8±15.6, =0.013. Conclusion. Brain Natriuretic Peptide levels are elevated in patients with ventricular septal defects as compared to controls. Percutaneous closure of Ventricular Septal Defect with Amplatzer occluders decreases the BNP levels.

  4. Analysis of brain natriuretic peptide in 30 patients with atrial fibrillation

    International Nuclear Information System (INIS)

    Jin Qiang; Lu Jianghui; Li Weipeng; Yuan Yuan; Sun Weili

    2009-01-01

    To investigate the relationship between atrial fibrillation and brain natriuretic peptide (BNP), plasma levels of BNP in 30 patients with atrial fibrillation and 30 health controls were assayed and compared. The results showed that plasma levels of BNP in patients with atrial fibrillation were significantly higher than those of health controls (P<0.05). When the patients with atrial fibrillation were restored sinus rhythm, the concentration of BNP decreased significantly (P<0.05). BNP was a sensitive marker of cardiac dysfunction, and BNP was positively correlated with atrial fibrillation. (authors)

  5. Cortisol level

    Science.gov (United States)

    ... enable JavaScript. The cortisol blood test measures the level of cortisol in the blood. Cortisol is a ... in the morning. This is important, because cortisol level varies throughout the day. You may be asked ...

  6. Triglyceride level

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003493.htm Triglyceride level To use the sharing features on this page, please enable JavaScript. The triglyceride level is a blood test to measure the amount ...

  7. Potential prognostic significance of decreased serum levels of TRAIL after acute myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Paola Secchiero

    Full Text Available BACKGROUND: Since soluble TRAIL exhibits anti-inflammatory and anti-atherosclerotic activities both in vitro and in animal models, this study was designed to assess the relationship between the serum levels of TRAIL and clinical outcomes in patients with acute myocardial infarction (AMI. METHODOLOGY/PRINCIPAL FINDINGS: Levels of TRAIL were measured by ELISA in serial serum samples obtained from 60 patients admitted for AMI, both during hospitalization and in a follow-up of 12 months, as well as in 60 healthy control subjects. Serum levels of TRAIL were significantly decreased in patients with AMI at baseline (within 24 hours from admission, compared with healthy controls, and showed a significant inverse correlation with a series of negative prognostic markers, such as CK, CK-MB and BNP. TRAIL serum levels progressively increased at discharge, but normalized only at 6-12 months after AMI. Of note, low TRAIL levels at the patient discharge were associated with increased incidence of cardiac death and heart failure in the 12-month follow-up, even after adjustment for demographic and clinical risk parameters (hazard ratio [HR] of 0.93 [95% CI, 0.89 to 0.97]; p = 0.001. CONCLUSIONS/SIGNIFICANCE: Although the number of patients studied was limited, our findings indicate for the first time that circulating TRAIL might represent an important predictor of cardiovascular events, independent of conventional risk markers.

  8. Level 1 - level 2 interface

    International Nuclear Information System (INIS)

    Boneham, P.

    2003-01-01

    The Plant Damage States (PDS) are the starting point for the level 2 analysis. A PDS is group of core damage sequences that are expected to have similar severe accident progressions. In this paper an overview of Level 1/Level 2 interface, example PDS parameters, example PDS definitions using codes and example Bridge Tree are presented. PDS frequency calculation (identification of sequences for each PDS in level 1,split some CD sequences which have different level 2 progressions), code calculations providing support for grouping decisions and timings as well as PDS frequencies and definitions input to level 2 are also discussed

  9. Vermont Highest Priority Interior Forest Blocks

    Data.gov (United States)

    Vermont Center for Geographic Information — Act 174 requires plans to identify potential areas for the development and siting of renewable energy resources and areas that are unsuitable for siting those...

  10. Challenges for highest energy circular colliders

    CERN Document Server

    Benedikt, M; Wenninger, J; Zimmermann, F

    2014-01-01

    A new tunnel of 80–100 km circumference could host a 100 TeV centre-of-mass energy-frontier proton collider (FCC-hh/VHE-LHC), with a circular lepton collider (FCCee/TLEP) as potential intermediate step, and a leptonhadron collider (FCC-he) as additional option. FCC-ee, operating at four different energies for precision physics of the Z, W, and Higgs boson and the top quark, represents a significant push in terms of technology and design parameters. Pertinent R&D efforts include the RF system, topup injection scheme, optics design for arcs and final focus, effects of beamstrahlung, beam polarization, energy calibration, and power consumption. FCC-hh faces other challenges, such as high-field magnet design, machine protection and effective handling of large synchrotron radiation power in a superconducting machine. All these issues are being addressed by a global FCC collaboration. A parallel design study in China prepares for a similar, but smaller collider, called CepC/SppC.

  11. The Gull Sees Farthest Who Flies Highest

    Science.gov (United States)

    Pirri, Anthony N.

    2005-04-01

    The proverb from Richard Bach's book Jonathan Livingston Seagull expresses the theme that he in life who thinks and acts ahead of the flock lives live to the fullest and enjoys the freedom that is the very nature of being. This keynote address will give examples of three noted professionals who were not content to make small improvements in technology but strove to make giant leaps. Their work became the driving force for those of us who became their followers in seeking fulfillment from our professional lives.

  12. High and highest spin states in nuclei

    International Nuclear Information System (INIS)

    Ploszajczak, M.

    1977-06-01

    A study of the following phenomena in rotating nuclei is presented, namely: 1) the destruction of the pair-correlation between the protons and the neutrons as well as decoupling and orientation of the particles along the rotation axis; 2) the formation of a nucleus with axial symmetry rotating around the symmetry axis, caused by the strong centrifugal and Coriolis forces; 3) the shell effects at low angular momentum, which led in some Pb, Hg and Pt isotopes to the formation of a prolate nucleus, rotating around the symmetry axis; 4) the formation of longliving states at very high angular momenta ('Yrast-traps'). At low angular momenta the nucleus is described by the Cranking-Hartree-Fock-Bogolyubov theory (CHFB) with the pair-(P), quadrupole-(QQ) and hexade coupole force (HH) as residual interaction. (orig.) [de

  13. MiR-190b, the highest up-regulated miRNA in ERα-positive compared to ERα-negative breast tumors, a new biomarker in breast cancers?

    International Nuclear Information System (INIS)

    Cizeron-Clairac, Geraldine; Lallemand, François; Vacher, Sophie; Lidereau, Rosette; Bieche, Ivan; Callens, Celine

    2015-01-01

    MicroRNAs (miRNAs) show differential expression across breast cancer subtypes and have both oncogenic and tumor-suppressive roles. Numerous microarray studies reported different expression patterns of miRNAs in breast cancers and found clinical interest for several miRNAs but often with contradictory results. Aim of this study is to identify miRNAs that are differentially expressed in estrogen receptor positive (ER + ) and negative (ER − ) breast primary tumors to better understand the molecular basis for the phenotypic differences between these two sub-types of carcinomas and to find potential clinically relevant miRNAs. We used the robust and reproductive tool of quantitative RT-PCR in a large cohort of well-annotated 153 breast cancers with long-term follow-up to identify miRNAs specifically differentially expressed between ER + and ER − breast cancers. Cytotoxicity tests and transfection experiments were then used to examine the role and the regulation mechanisms of selected miRNAs. We identified a robust collection of 20 miRNAs significantly deregulated in ER + compared to ER − breast cancers : 12 up-regulated and eight down-regulated miRNAs. MiR-190b retained our attention as it was the miRNA the most strongly over-expressed in ER + compared to ER − with a fold change upper to 23. It was also significantly up-regulated in ER + /Normal breast tissue and down-regulated in ER − /Normal breast tissue. Functional experiments showed that miR-190b expression is not directly regulated by estradiol and that miR-190b does not affect breast cancer cell lines proliferation. Expression level of miR-190b impacts metastasis-free and event-free survival independently of ER status. This study reveals miR-190b as the highest up-regulated miRNA in hormone-dependent breast cancers. Due to its specificity and high expression level, miR-190b could therefore represent a new biomarker in hormone-dependent breast cancers but its exact role carcinogenesis remains to

  14. Biomarkers in Trypanosoma cruzi-infected and uninfected individuals with varying severity of cardiomyopathy in Santa Cruz, Bolivia.

    Science.gov (United States)

    Okamoto, Emi E; Sherbuk, Jacqueline E; Clark, Eva H; Marks, Morgan A; Gandarilla, Omar; Galdos-Cardenas, Gerson; Vasquez-Villar, Angel; Choi, Jeong; Crawford, Thomas C; Do, Rose Q; Q, Rose; Fernandez, Antonio B; Colanzi, Rony; Flores-Franco, Jorge Luis; Gilman, Robert H; Bern, Caryn

    2014-10-01

    Twenty to thirty percent of persons with Trypanosoma cruzi infection eventually develop cardiomyopathy. If an early indicator were to be identified and validated in longitudinal studies, this could enable treatment to be prioritized for those at highest risk. We evaluated cardiac and extracellular matrix remodeling markers across cardiac stages in T. cruzi infected (Tc+) and uninfected (Tc-) individuals. Participants were recruited in a public hospital in Santa Cruz, Bolivia and assigned cardiac severity stages by electrocardiogram and echocardiogram. BNP, NTproBNP, CKMB, troponin I, MMP-2, MMP-9, TIMP-1, TIMP-2, TGFb1, and TGFb2 were measured in specimens from 265 individuals using multiplex bead systems. Biomarker levels were compared between Tc+ and Tc- groups, and across cardiac stages. Receivers operating characteristic (ROC) curves were created; for markers with area under curve>0.60, logistic regression was performed. Analyses stratified by cardiac stage showed no significant differences in biomarker levels by Tc infection status. Among Tc+ individuals, those with cardiac insufficiency had higher levels of BNP, NTproBNP, troponin I, MMP-2, TIMP-1, and TIMP-2 than those with normal ejection fraction and left ventricular diameter. No individual marker distinguished between the two earliest Tc+ stages, but in ROC-based analyses, MMP-2/MMP-9 ratio was significantly higher in those with than those without ECG abnormalities. BNP, NTproBNP, troponin I, MMP-2, TIMP-1, and TIMP-2 levels rose with increasing severity stage but did not distinguish between Chagas cardiomyopathy and other cardiomyopathies. Among Tc+ individuals without cardiac insufficiency, only the MMP-2/MMP-9 ratio differed between those with and without ECG changes.

  15. Level densities

    International Nuclear Information System (INIS)

    Ignatyuk, A.V.

    1998-01-01

    For any applications of the statistical theory of nuclear reactions it is very important to obtain the parameters of the level density description from the reliable experimental data. The cumulative numbers of low-lying levels and the average spacings between neutron resonances are usually used as such data. The level density parameters fitted to such data are compiled in the RIPL Starter File for the tree models most frequently used in practical calculations: i) For the Gilber-Cameron model the parameters of the Beijing group, based on a rather recent compilations of the neutron resonance and low-lying level densities and included into the beijing-gc.dat file, are chosen as recommended. As alternative versions the parameters provided by other groups are given into the files: jaeri-gc.dat, bombay-gc.dat, obninsk-gc.dat. Additionally the iljinov-gc.dat, and mengoni-gc.dat files include sets of the level density parameters that take into account the damping of shell effects at high energies. ii) For the backed-shifted Fermi gas model the beijing-bs.dat file is selected as the recommended one. Alternative parameters of the Obninsk group are given in the obninsk-bs.dat file and those of Bombay in bombay-bs.dat. iii) For the generalized superfluid model the Obninsk group parameters included into the obninsk-bcs.dat file are chosen as recommended ones and the beijing-bcs.dat file is included as an alternative set of parameters. iv) For the microscopic approach to the level densities the files are: obninsk-micro.for -FORTRAN 77 source for the microscopical statistical level density code developed in Obninsk by Ignatyuk and coworkers, moller-levels.gz - Moeller single-particle level and ground state deformation data base, moller-levels.for -retrieval code for Moeller single-particle level scheme. (author)

  16. Amino-terminal pro-brain natriuretic peptide as a predictor of outcome in patients admitted to intensive care. A prospective observational study.

    Science.gov (United States)

    De Geer, Lina; Fredrikson, Mats; Oscarsson, Anna

    2012-06-01

    Amino-terminal pro-brain-type natriuretic peptide is known to predict outcome in patients with heart failure, but its role in an intensive care setting is not yet fully established. To assess the incidence of elevated amino-terminal pro-brain natriuretic peptide (NT-pro-BNP) on admission to intensive care and its relation to death in the ICU and within 30 days. Prospective, observational cohort study. A mixed non-cardiothoracic tertiary ICU in Sweden. NT-pro-BNP was collected from 481 consecutive patients on admission to intensive care, in addition to data on patient characteristics and outcome. A receiver-operating characteristic curve was used to identify a discriminatory level of significance, a stepwise logistic regression analysis to correct for other clinical factors and a Kaplan-Meier analysis to assess survival. The correlation between Simplified Acute Physiology Score (SAPS) 3, Sequential Organ Failure Assessment score (SOFA) and NT-pro-BNP was analysed using Spearman's correlation test. Quartiles of NT-pro-BNP elevation were compared for baseline data and outcome using a logistic regression model. An NT-pro-BNP more than 1380 ng -l on admission was an independent predictor of death in the ICU and within 30 days [odds ratio (OR) 2.6; 95% confidence interval (CI), 1.5 to 4.4] and was present in 44% of patients. Thirty-three percent of patients with NT-pro-BNP more than 1380 ng -1, and 14.6% of patients below that threshold died within 30 days (log rank P=0.005). NT-pro-BNP correlated moderately with SAPS 3 and with SOFA on admission (Spearman's ρ 0.5552 and 0.5129, respectively). In quartiles of NT-pro-BNP elevation on admission, severity of illness and mortality increased significantly (30-day mortality 36.1%; OR 3.9; 95% CI, 2.0 to 7.3 in the quartile with the highest values, vs. 12.8% in the lowest quartile). We conclude that NT-pro-BNP is commonly elevated on admission to intensive care, that it increases with severity of illness and that it is an

  17. Projecting future sea level

    Science.gov (United States)

    Cayan, Daniel R.; Bromirski, Peter; Hayhoe, Katharine; Tyree, Mary; Dettinger, Mike; Flick, Reinhard

    2006-01-01

    California’s coastal observations and global model projections indicate that California’s open coast and estuaries will experience increasing sea levels over the next century. Sea level rise has affected much of the coast of California, including the Southern California coast, the Central California open coast, and the San Francisco Bay and upper estuary. These trends, quantified from a small set of California tide gages, have ranged from 10–20 centimeters (cm) (3.9–7.9 inches) per century, quite similar to that estimated for global mean sea level. So far, there is little evidence that the rate of rise has accelerated, and the rate of rise at California tide gages has actually flattened since 1980, but projections suggest substantial sea level rise may occur over the next century. Climate change simulations project a substantial rate of global sea level rise over the next century due to thermal expansion as the oceans warm and runoff from melting land-based snow and ice accelerates. Sea level rise projected from the models increases with the amount of warming. Relative to sea levels in 2000, by the 2070–2099 period, sea level rise projections range from 11–54 cm (4.3–21 in) for simulations following the lower (B1) greenhouse gas (GHG) emissions scenario, from 14–61 cm (5.5–24 in) for the middle-upper (A2) emission scenario, and from 17–72 cm (6.7–28 in) for the highest (A1fi) scenario. In addition to relatively steady secular trends, sea levels along the California coast undergo shorter period variability above or below predicted tide levels and changes associated with long-term trends. These variations are caused by weather events and by seasonal to decadal climate fluctuations over the Pacific Ocean that in turn affect the Pacific coast. Highest coastal sea levels have occurred when winter storms and Pacific climate disturbances, such as El Niño, have coincided with high astronomical tides. This study considers a range of projected future

  18. The value of use of amino-terminal brain naturitic peptide as marker in cases of pleural effusion of different etiologies

    Directory of Open Access Journals (Sweden)

    Laila A. Banawan

    2013-10-01

    Conclusion: The results support the feasibility of using the pleural fluid amino terminal proBNP measurement in thoracentesis that would enhance discrimination among the different causes of pleural effusion especially for heart failure patients. Serum and pleural fluid levels of NT-pro BNP were closely correlated and measurement of NT-pro BNP in serum showed equally good diagnostic properties.

  19. A proposal of the diagnosis-dynamic characteristic (DDC) model describing the relation between search time and confidence levels for a dichotomous judgment, and its application to ROC curve generation

    Science.gov (United States)

    Matsumoto, Toru; Fukuda, Nobuo; Furukawa, Akira; Suwa, Koji; Wada, Shinichi; Matsumoto, Mitsuomi; Sone, Shusuke

    2006-03-01

    When physicians inspect an image, they make up a certain degree of confidence that the image are abnormal; p(t), or normal; n(t)[n(t)=1-p(t)]. After infinite time of the inspection, they reach the equilibrium levels of the confidence of p*=p(∞) and n*=n(∞). There are psychological conflicts between the decisions of normal and abnormal. We assume that the decision of "normal" is distracted by the decision of "abnormal" by a factor of k(1 + ap), and in an inverse direction by a factor of k(1 + bn), where k ( > 0) is a parameter that relates with image quality and skill of the physicians, and a and b are unknown constants. After the infinite time of inspection, the conflict reaches the equilibrium, which satisfies the equation, k(1 + ap*)n* = k(1 + bn*)p*. Here we define a parameter C, which is 2p*/[p*(1 - p*)]. After the infinite time of inspection, the conflict reaches the equilibrium, which satisfies t that changes in the confidence level with the time (dp/dt) is proportional to [k(1+ap)n - k(1+bn)p], i.e. k[-cp2 + (c - 2)p + 1]. Solving the differential equation, we derived the equation; t(p) and p(t) depending with the parameters; k, c, S. S (0-1) is the value arbitrary selected and related with probability of "abnormal" before the image inspection (S = p(0)). Image reading studies were executed for CT images. ROC curves were generated both by the traditional 4-step score-based method and by the confidence level; p estimated from the equation t(p) of the DDC model using observed judgment time. It was concluded that ROC curves could be generated by measuring time for dichotomous judgment without the subjective scores of diagnostic confidence and applying the DDC model.

  20. DIAGNOSTIC VALUE OF GALECTIN-3 LEVEL IN PATIENTS WITH CHRONIC HEART FAILURE AND TYPE 2 DIABETES

    Directory of Open Access Journals (Sweden)

    A. A. Snetkova

    2015-09-01

    Full Text Available Currently, a greater emphasis is placed on the search for additional biomarkers of chronic heart failure (CHF. Galectin-3, a marker of fibrosis and inflammation, has shown himself as a biomarker of CHF in many studies, but the dynamics of its levels in patients with concomitant diabetes mellitus (DM type 2 is not well-studied.Aim. To identify diagnostic significance of galectin-3 plasma level evaluation and its correlations with echocardiographic criteria for patients with CHF and DM type 2.Material and methods. The study included 33 patients with ischemic CHF (all patients had a history of myocardial infarction and DM type 2. The patients were divided into two groups according to the left ventricle (LV ejection fraction (EF: a group with CHF and preserved ejection fraction (PEF (EF≥50% and with CHF and reduced ejection fraction (EF<50%. Patients underwent clinical laboratory tests and Doppler echocardiography; moreover, the levels of brain natriuretic peptide (BNP and galeсtin-3 were measured.Results. The mean level of galectin-3 in blood plasma in the group with CHF and PEF was significantly higher than in the group with CHF and reduced EF (p=0.007. In the group with CHF and PEF a positive correlation between the level of galectin-3 and diastolic LV function E/E' was found (r=0.620, p=0.01. A significant correlation between galectin-3 level and LV systolic function was stated in the group with reduced EF (r=0.53; p<0.05, while in the group with PEF, the correlation was not significant (p=0.225. In the group of patients with reduced EF a negative correlation between galectin-3 and the volume of left atrium was revealed (r=-0.53; p<0.05.Conclusion. Galectin-3 can be used as a diagnostic biomarker primarily in patients with CHF and PEF.

  1. Localization of Brain Natriuretic Peptide Immunoreactivity in Rat Spinal Cord

    Directory of Open Access Journals (Sweden)

    Essam M Abdelalim

    2016-12-01

    Full Text Available Brain natriuretic peptide (BNP exerts its functions through natriuretic peptide receptors. Recently, BNP has been shown to be involved in a wide range of functions. Previous studies reported BNP expression in the sensory afferent fibers in the dorsal horn of the spinal cord. However, BNP expression and function in the neurons of the central nervous system are still controversial. Therefore, in this study, we investigated BNP expression in the rat spinal cord in detail using RT-PCR and immunohistochemistry. RT-PCR analysis showed that BNP mRNA was present in the spinal cord and DRG. BNP immunoreactivity was observed in different structures of the spinal cord, including the neuronal cell bodies and neuronal processes. BNP immunoreactivity was observed in the dorsal horn of the spinal cord and in the neurons of the intermediate column and ventral horn. Double-immunolabeling showed a high level of BNP expression in the afferent fibers (laminae I-II labeled with calcitonin gene-related peptide (CGRP, suggesting BNP involvement in sensory function. In addition, BNP was co-localized with CGRP and choline acetyltransferase in the motor neurons of the ventral horn. Together, these results indicate that BNP is expressed in sensory and motor systems of the spinal cord, suggesting its involvement in several biological actions on sensory and motor neurons via its binding to NPR-A and/or NPR-B in the DRG and spinal cord.

  2. Occupational exposure levels of bioaerosol components are associated with serum levels of the acute phase protein Serum Amyloid A in greenhouse workers

    DEFF Research Database (Denmark)

    Madsen, Anne Mette; Thilsing, Trine; Bælum, Jesper

    2016-01-01

    to elevated levels of bioaerosols. The objective of this study is to assess whether greenhouse workers personal exposure to bioaerosol components was associated with serum levels of the acute phase proteins Serum Amyloid A (SAA) and C-reactive protein (CRP). METHODS: SAA and CRP levels were determined......-glucan. RESULTS: Serum levels of SAA and CRP were not significantly different in greenhouse workers and a reference group, or on the two work days. In a mixed model, SAA levels were positively associated with endotoxin exposure levels (p = 0.0007). Results for fungi were not clear. CRP levels were positively...... associated with endotoxin exposures (p = 0.022). Furthermore, when workers were categorized into three groups based on SAA and CRP serum levels endotoxin exposure was highest in the group with the highest SAA levels and in the group with middle and highest CRP levels. SAA and CRP levels were elevated...

  3. Arg156 in the AP2-domain exhibits the highest binding activity among the 20 individuals to the GCC box in BnaERF-B3-hy15, a mutant ERF transcription factor from Brassica napus

    Directory of Open Access Journals (Sweden)

    Jing Zhuang

    2016-10-01

    Full Text Available To develop mutants of the ERF factor with more binding activities to the GCC box, we performed in vitro directed evolution by using DNA shuffling and screened mutants through yeast one-hybrid assay. Here, a series of mutants were obtained and used to reveal key amino acids that induce changes in the DNA binding activity of the BnaERF-B3 protein. With the BnaERF-B3-hy15 as the template, we produced 12 mutants which host individual mutation of potential key residues. We found that amino acid 156 is the key site, and the other 18 mutants host the 18 corresponding individual amino acid residues at site 156. Among the 20 individuals comprising WT (Gly156, Mu3 (Arg156, and 18 mutants with other 18 amino acid residues, Arg156 in the AP2-domain is the amino acid residue with the highest binding activity to the GCC box. The structure of the α-helix in the AP2-domain affects the binding activity. Other residues within AP2-domain modulated binding activity of ERF protein, suggesting that these positions are important for binding activity. Comparison of the mutant and wild-type transcription factors revealed the relationship of protein function and sequence modification. Our result provides a potential useful resource for understanding the trans-activation of ERF proteins.

  4. The Human Mind As General Problem Solver, Is Observed To Find ``Best'' Solutions, That Correspond To Highest Mental Coherence: Will Discuss ``sing Glass Type Theory'' of Princeton Physicist J J Hopfield, Points To How Best Use Our Own Human Mind!!

    Science.gov (United States)

    Gurr, Henry

    2014-03-01

    Princeton Physicist J. J. Hopfield's Mathematical Model of the Mammalian Brain, (Similar To Ising Glass Model of a crystal of magnetic spin particles) says our Brain-Work for Memory, Perception, Language, Thinking, etc, (Even the AHA-EUREKA-Flash Of Insight Type Problem Solving), is achieved by our massively inter-connected CNS Neurons ... working together ... MINIMIZING an analog of physical energy ... thus yielding Optimal Solutions: These ``best'' answers, correspond to highest mental coherence, for most facets organism response, beit mental (eg: perception, memory, ideas, thinking, etc) or physical-muscular-actions (eg speaking, tool using, trail following, etc). Our brain is this way, because living creature, MUST be evolved, so they will find & use the best actions, for survival!!! Our human heritage, is to instantly compute near optimal future plans, (mental & physical-muscular), and be able to accomplish plans reliably & efficiently. If you know of book or articles in these topic areas, please email to HenryG--USCA.edu How to work well, with your own ``self'', called mind-body, will follow!! Conjectures: Who is the ``I'' that appears to make decisions? Am ``I'' the master of my domain? Is there an ``I'' or am ``I'' merely an illusion of reality.

  5. Combined use of brain natriuretic peptide and C-reactive protein for predicting cardiovascular risk in outpatients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Toshihiro Tsuruda

    2007-09-01

    Full Text Available Toshihiro Tsuruda1, Johji Kato2, Takahiro Sumi1, Kazuya Mishima1, Hiroyuki Masuyama1, Hiroyuki Nakao3, Takuroh Imamura1, Tanenao Eto1, Kazuo Kitamura11Department of Internal Medicine, Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan; 2Frontier Research Center, University of Miyazaki, Miyazaki, Japan; 3Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan Abstract: Appropriate tools are necessary for predicting cardiovascular events in patients with diabetes mellitus because of their high incidence. In this study, we assessed whether a combination of brain natriuretic peptide (BNP and C-reactive protein (CRP measurement were useful prognosticators in patients with type 2 diabetes mellitus. One hundred and nine patients with type 2 diabetes mellitus, aged 52 to 93 years, were examined at outpatient clinics for blood, urinary samples, and echocardiography. They were then followed prospectively. During the average follow-up period of 30 months (range, 3 to 37, 15 patients (14% had cardiovascular events: This was the first event in 5 patients and a recurrence in 10. Cox regression analysis showed that the past event (hazard ratio [HR] 4.819 [95% confidence interval (CI: 1.299–17.881]; p = 0.019 and plasma BNP level (HR 1.007 [95% CI: 1.002–1.012]; p = 0.010] were independently significant factors for the cardiovascular events during the follow-up period. Patients with plasma BNP ≥53 pg/mL and CRP ≥0.95 mg/dL demonstrated the highest incidence in cardiovascular event, compared to those categorized into either or both low levels of BNP and CRP. This study suggests that combination of plasma BNP and CRP measurement provides the additive prognostic information of cardiovascular events in patients with type 2 diabetes mellitus.Keywords: diabetes mellitus; natriuretic peptide; inflammation; mortality and morbidity

  6. Toll/Interleukin-1 receptor member ST2 exhibits higher soluble levels in type 2 diabetes, especially when accompanied with left ventricular diastolic dysfunction

    Directory of Open Access Journals (Sweden)

    Fousteris Evangelos

    2011-11-01

    Full Text Available Abstract Background Soluble ST2, a member of the of the Toll/IL-1 superfamily, is a novel biomarker with exceptional predictive value in heart failure and myocardial infarction- related mortality as well as in acute dyspneic states. Soluble ST2 is considered a decoy receptor of IL 33 that blocks the protective effects of the cytokine in atherosclerosis and cardiac remodeling. In the present study we investigated the differences in the levels of soluble ST2, BNP and hs-CRP between healthy controls and patients with type 2 diabetes with and without left ventricular diastolic dysfunction. A secondary aim was to investigate correlations between sST2 and other biomarkers of type 2 diabetes, such as HbA1c. Methods 158 volunteers were recruited and underwent a complete Doppler-echocardiographic evaluation of both systolic & diastolic cardiac function. All subjects with ejection fraction Results Patients with type 2 diabetes with (p Conclusions Patients with type 2 diabetes exhibit higher sST2 levels compared to healthy controls. The presence of LVDD in patients with type 2 diabetes is associated with even higher sST2 levels. A significant correlation between glycemic control and sST2 levels was also revealed.

  7. Postoperative B-Type Natriuretic Peptide as Predictor for Postoperative Outcomes in Patients Implanted With Left Ventricular Assist Devices.

    Science.gov (United States)

    Yost, Gardner; Bhat, Geetha; Pappas, Patroklos; Tatooles, Antone

    2018-04-18

    Brain natriuretic peptide (BNP) is a cardiac neurohormone known to correlate with left ventricular (LV) dilation, decreased contractility, and increased stiffness. Consequently, BNP has been used as a prognostic tool to assess the degree of LV unloading for patients supported by continuous-flow LV assist devices (LVADs). We assessed the prognostic value of changes in BNP in the 2 weeks after LVAD implantation. This retrospective study analyzed laboratory findings and outcomes of 189 LVAD patients. Patients were separated into two groups based on whether serum BNP levels had improved from preoperative levels by postoperative day 14. Group 1 had improvement in BNP levels, whereas group 2 had no improvement or worsening in BNP. There were no significant differences between the groups in age, gender, race, body mass index, or comorbidities. Group 1 had preoperative BNP 1,125 ± 1,078.3 pg/dl and postoperative BNP 440.2 ± 267.7 pg/dl (ΔBNP = -693.09 ± 942.4 pg/dl), whereas group 2 had preoperative BNP 346.0 ± 309.1 pg/dl and postoperative BNP 631.57 ± 483.4 pg/dl (ΔBNP = 289.32 ± 329.7 pg/dl). Postoperative survival in group 2 was significantly worse than in group 1. Rates of right ventricular failure (RVF) were significantly higher in group 2 (group 1: 39%, group 2: 52.7%; p = 0.01). In most patients implanted with a LVAD, BNP improves significantly in the postoperative period as the LV is unloaded. Our results indicate that lack of improvement in postoperative BNP is associated with longer length of stay, increased rates of RVF, and is an independent risk factor for reduced postoperative survival.

  8. The learning organization and the level of consciousness

    OpenAIRE

    Chiva Gómez, Ricardo

    2017-01-01

    Purpose – The purpose of this paper is to analyze learning organization by comparing with other types of organizations. This typology is based on the levels of consciousness and relates each type of organization with a level of learning and an organizational structure. Design/methodology/approach – This is a conceptual paper based on the concept of levels of consciousness. Findings – The paper proposes that learning organization requires the highest level of consciousness. O...

  9. Relationship of plasma proadrenomedullin and cortisol levels with systemic inflammatory response and target organ damage in children with sepsis after burn

    Directory of Open Access Journals (Sweden)

    Xing Wei

    2017-08-01

    Full Text Available Objective: To study the relationship of plasma proadrenomedullin (pro-ADM and cortisol (Cor levels with systemic inflammatory response and target organ damage in children with sepsis after burn. Methods: A total of 30 children with sepsis after burn who were treated in the hospital between August 2014 and August 2016 were collected as observation group, and 30 normal children who received vaccination in the hospital during the same period were collected as normal control group. The pro-ADM and Cor levels in plasma as well as the levels of inflammatory factors, myocardial injury markers and intestinal barrier function indexes in serum of the two groups were determined. Pearson test was used to assess the correlation of plasma pro-ADM and Cor levels with systemic inflammatory response and target organ damage in patients with sepsis after burn. Results: Plasma pro-ADM and Cor levels in observation group were higher than those in normal control group. Serum inflammatory cytokines IL-1, IL-6, IL-10 and TNF-α levels in observation group were higher than those in normal control group; serum myocardial injury markers CK-MB, cTnⅠ and NT-proBNP levels were higher than those in normal control group; serum intestinal barrier function indexes ET, DAO and D-L levels were higher than those in normal control group. Conclusion: Plasma pro-ADM and Cor levels increase in patients with sepsis after burn, and are highly consistent with systemic inflammatory response and target organ injury.

  10. Sea level change

    Digital Repository Service at National Institute of Oceanography (India)

    Church, J.A.; Clark, P.U.; Cazenave, A.; Gregory, J.M.; Jevrejeva, S.; Levermann, A.; Merrifield, M.A.; Milne, G.A.; Nerem, R.S.; Nunn, P.D.; Payne, A.J.; Pfeffer, W.T.; Stammer, D.; Unnikrishnan, A.S.

    This chapter considers changes in global mean sea level, regional sea level, sea level extremes, and waves. Confidence in projections of global mean sea level rise has increased since the Fourth Assessment Report (AR4) because of the improved...

  11. Sea level trends in Southeast Asian seas

    Science.gov (United States)

    Strassburg, M. W.; Hamlington, B. D.; Leben, R. R.; Manurung, P.; Lumban Gaol, J.; Nababan, B.; Vignudelli, S.; Kim, K.-Y.

    2015-05-01

    Southeast Asian seas span the largest archipelago in the global ocean and provide a complex oceanic pathway connecting the Pacific and Indian oceans. The Southeast Asian sea regional sea level trends are some of the highest observed in the modern satellite altimeter record that now spans almost 2 decades. Initial comparisons of global sea level reconstructions find that 17-year sea level trends over the past 60 years exhibit good agreement with decadal variability associated with the Pacific Decadal Oscillation and related fluctuations of trade winds in the region. The Southeast Asian sea region exhibits sea level trends that vary dramatically over the studied time period. This historical variation suggests that the strong regional sea level trends observed during the modern satellite altimeter record will abate as trade winds fluctuate on decadal and longer timescales. Furthermore, after removing the contribution of the Pacific Decadal Oscillation (PDO) to sea level trends in the past 20 years, the rate of sea level rise is greatly reduced in the Southeast Asian sea region. As a result of the influence of the PDO, the Southeast Asian sea regional sea level trends during the 2010s and 2020s are likely to be less than the global mean sea level (GMSL) trend if the observed oscillations in wind forcing and sea level persist. Nevertheless, long-term sea level trends in the Southeast Asian seas will continue to be affected by GMSL rise occurring now and in the future.

  12. Ecological concerns following Superstorm Sandy: stressor level and recreational activity levels affect perceptions of ecosystem.

    Science.gov (United States)

    Burger, Joanna

    2015-06-01

    Coastal habitats are vulnerable to storms, and with increasing urbanization, sea level rise, and storm frequency, some urban populations are at risk. This study examined perceptions of respondents in coastal and central New Jersey to Superstorm Sandy , including: 1) concerns about ecological resources and effects (open-ended question), 2) information sources for ecology of the coast (open-ended), and 3) ratings of a list of ecological services as a function of demographics, location (coastal, central Jersey), stressor level (power outages, high winds, flooding) and recreational rates. "Wildlife" and "fish" were the ecological concerns mentioned most often, while beaches and dunes were most often mentioned for environmental concerns. Television, radio, and web/internet were sources trusted for ecological information. The data indicate 1) stressor level was a better predictor of ratings of ecological services than geographical location, but days engaged in recreation contributed the most to variations in ratings, 2) ecological services were rated the highest by respondents with the highest stressor levels, and by those from the coast, compared to others, 3) Caucasians rated ecological services higher than all others, and 4) recreational rates were highest for coastal respondents, and ratings for ecological services increased with recreational rates. Only 20 % of respondents listed specific ecological services as one of their three most important environmental concerns. These data will be useful for increasing preparedness, enhancing educational strategies for shore protection, and providing managers and public policy makers with data essential to developing resiliency strategies.

  13. Accuracy of chest radiographs in the emergency diagnosis of heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Studler, Ueli; Kretzschmar, Martin; Steinbrich, Wolfgang [University Hospital Basel, Department of Radiology, Basel (Switzerland); Christ, Michael; Breidthardt, Tobias; Noveanu, Markus; Perruchoud, Andre P.; Mueller, Christian [University Hospital Basel, Department of Internal Medicine, Basel (Switzerland); Schoetzau, Andreas [Institute of Biostatistics, Basel (Switzerland)

    2008-08-15

    The purpose of this study was to determine the diagnostic accuracy of chest radiographic findings of heart failure (HF) in current patients presenting with dyspnea in the emergency department. In a secondary analysis of the BASEL study, initial chest radiographs of 277 patients with acute dyspnea were evaluated by two radiologists blinded to the adjudicated diagnosis (56% had the final diagnosis of HF). Predefined radiographic criteria of HF were used. Statistical analysis included receiver-operating characteristic (ROC) analysis and calculation of a logistic regression model including B-type natriuretic peptide (BNP) levels. The reader's overall impression showed the highest area under the ROC curve for the diagnosis of HF in both supine and erect patient positions (0.855 and 0.857). Among individual radiographic findings, peribronchial cuffing in the supine position (0.829) showed the highest accuracies. The lowest accuracy was found for the vascular pedicle width in the supine position (0.461). Logistic regression analysis showed no significant differences between the reader's overall impression, the radiographic model, and BNP testing. In our study, the combination of radiographic features provided valuable information and was of comparable accuracy as BNP-testing for the diagnosis of HF. (orig.)

  14. A theoretical study of the atmospherically important radical-radical reaction BrO + HO2; the product channel O2(a1Δg) + HOBr is formed with the highest rate.

    Science.gov (United States)

    Chow, Ronald; Mok, Daniel K W; Lee, Edmond P F; Dyke, John M

    2016-11-09

    A theoretical study has been made of the BrO + HO 2 reaction, a radical-radical reaction which contributes to ozone depletion in the atmosphere via production of HOBr. Reaction enthalpies, activation energies and mechanisms have been determined for five reaction channels. Also rate coefficients have been calculated, in the atmospherically important temperature range 200-400 K, for the two channels with the lowest activation energies, both of which produce HOBr: (R1a) HOBr(X 1 A') + O 2 (X 3 Σ) and (R1b) HOBr(X 1 A') + O 2 (a 1 Δ g ). The other channels considered are: (R2) BrO + HO 2 → HBr + O 3 , (R3) BrO + HO 2 → OBrO + OH and (R4) BrO + HO 2 → BrOO + OH. For all channels, geometry optimization and frequency calculations were carried out at the M06-2X/AVDZ level, while relative energies of the stationary points on the reaction surface were improved at a higher level (BD(TQ)/CBS or CCSD(T)/CBS). The computed standard reaction enthalpies (ΔH) for channels (R1a), (R1b), (R2), (R3) and (R4) are -47.5, -25.0, -4.3, 14.9 and 5.9 kcal mol -1 , and the corresponding computed activation energies (ΔE) are 2.53, -3.07, 11.83, 35.0 and 37.81 kcal mol -1 . These values differ significantly from those obtained in earlier work by Kaltsoyannis and Rowley (Phys. Chem. Chem. Phys., 2002, 4, 419-427), particularly for channel (R1b), and reasons for this are discussed. In particular, the importance of obtaining an open-shell singlet wavefunction, rather than a closed-shell singlet wavefunction, for the transition state of this channel is emphasized. Rate coefficient calculations from computed potential energy surfaces were made for BrO + HO 2 for the first time. Although channel (R1a) is the most exothermic, channel (R1b) has the lowest barrier height, which is negative (at -3.07 kcal mol -1 ). Most rate coefficient calculations were therefore made for (R1b). A two transition state model has been used, involving an outer and an inner transition state. The inner transition

  15. In-hospital and long-term outcomes of congestive heart failure: Predictive value of B-type and amino-terminal pro-B-type natriuretic peptides and their ratio.

    Science.gov (United States)

    Dai, Yuxiang; Yang, Jun; Takagi, Atsutoshi; Konishi, Hakuoh; Miyazaki, Tetsuro; Masuda, Hiroshi; Shimada, Kazunori; Miyauchi, Katsumi; Daida, Hiroyuki

    2017-08-01

    Relative changes in B-type natriuretic peptide (BNP) and amino terminal pro-BNP (NT-proBNP) levels may help to assess the risk of congestive heart failure (CHF). However, whether these levels at the time of admission enable the prediction of outcomes with acute exacerbation remains unknown. The current study determined the abilities of BNP, NT-proBNP and their ratio to predict in-hospital and long-term outcomes of patients with CHF. Patients who were admitted to the cardiac care unit of Juntendo University Hospital (Tokyo, Japan) with acute CHF onset were consecutively enrolled into the present observational study. Serum levels of BNP and NT-proBNP were immediately measured on admission, and other biomarkers and clinical data were also investigated. Of 195 enrolled patients, 16 (8.2%) succumbed to CHF in hospital and 124 (69.3%) reached the endpoint of mortality or readmission following a median follow-up of 14 months. Multiple linear regression analysis revealed body mass index, low density lipoprotein cholesterol, hemoglobin, estimated glomerular filtration rate and C-reactive protein as independent predictors of the NT-proBNP/BNP ratio. BNP, NT-proBNP and their ratio were significantly higher among those who succumbed to CHF than in those who remained alive in hospital (P<0.05). Logistic regression analysis indicated that the ratio was an independent predictor for in-hospital mortality and long-term outcomes. In conclusion, the ratio of NT-proBNP to BNP more effectively predicts in-hospital outcomes than either factor alone and it may also help to predict outcomes among patients with acute exacerbation of HF.

  16. Measurement of Urinary Amino-Terminal Pro-Brain Natriuretic Peptide in Childhood Lower Respiratory Tract Infections: An Indicator of Clinical Severity?

    Directory of Open Access Journals (Sweden)

    Nisa Eda Çullas İlarslan

    2017-12-01

    Full Text Available Aim: Prompt diagnosis and determination of the clinical severity and intervention of lower respiratory tract infections (LRTI is essential for the prevention and management of life-threatening complications. Laboratory tests do not serve as accurate indicators of clinical severity. Our aim was to evaluate the contribution of urinary amino-terminal pro-brain natriuretic peptide (NT-ProBNP concentrations in children with LRTI to clinical assessment in terms of determining clinical severity and the necessity of hospitalization. Materials and Methods: This prospective non-randomised study included a total of 160 patients, aged 0-6 years, diagnosed with LRTI [(group 1=outpatient group (n=108, and (group 2=hospitalized patients (n=52]. The control group (group 3 was comprised of 46 healthy children. Urinary NT-ProBNP level of each participant was measured by ELISA method. Results: Although not significant, the mean urinary NT-ProBNP level of all patients was higher than that of the control group (p=0.322. When we compared the three groups separately, the highest levels belonged to outpatients whereas hospitalized patients showed slightly lower levels than the control group without any statistical significance (p=0.128. As for newborns (n=16, patients showed higher levels than the controls (p=0.041. P value <0.05 was considered significant. Conclusion: Although urinary NT-ProBNP level tends to increase to some extent in childhood LRTI, this alteration does not seem to be valuable in the prediction of the severity of the disease. We believe that the establishment of further studies including larger series of patients, especially neonates, is warranted.

  17. Alarming levels of carboxyhemoglobin in banked blood.

    Science.gov (United States)

    Ehlers, Melissa; Labaze, Georges; Hanakova, Marcela; McCloskey, David; Wilner, George

    2009-06-01

    To determine the level of carboxyhemoglobin found in banked blood in the Albany, NY region. A retrospective descriptive analysis of carboxyhemoglobin (COHb) levels in a series of packed red blood cell (PRBC) units. The blood bank of a university tertiary care hospital in Albany, NY. All PRBC units considered for possible use in pediatric cardiac surgery were first analyzed for levels of COHb. Only those units with COHb levels of <1.5% were deemed acceptable for use during pediatric cardiac surgery. A sample of blood drawn from the sample side arm of each PRBC unit was analyzed on a Chiron 855 Blood Gas Analyzer (Chiron Inc, Emeryville, CA, now Siemens/Bayer RapidLab 865) to determine the level of COHb. The average COHb level was 0.78% (standard deviation +/- 1.48%), and out of the 468 units tested, 48 (10.3%) had COHb levels of 1.5% or greater. The highest recorded COHb level was 12%. The transfusion of PRBC units may artificially elevate readings of COHb and cause confusion over possible causes. Certain high-risk populations (eg, cyanotic neonates undergoing cardiopulmonary bypass) may be especially at risk. Although levels of COHb in the US blood supply are dropping, institutions may want to consider analyzing COHb levels in their PRBC units before transfusion in these high-risk populations.

  18. Late Pleistocene leopards across Europe - northernmost European German population, highest elevated records in the Swiss Alps, complete skeletons in the Bosnia Herzegowina Dinarids and comparison to the Ice Age cave art

    Science.gov (United States)

    Diedrich, Cajus G.

    2013-09-01

    European leopard sites in Europe demonstrate Early/Middle Pleistocene out of Africa lowland, and Late Pleistocene Asian alpine migrations being driven by climatic changes. Four different European Pleistocene subspecies are known. The final European Late Pleistocene “Ice Age leopard” Panthera pardus spelaea (Bächler, 1936) is validated taxonomically. The skull shows heavy signs of sexual dimorphism with closest cranial characters to the Caucasian Panthera pardus ciscaucasica (Persian leopard). Late Pleistocene leopards were distributed northernmost, up to S-England with the youngest stratigraphic records by skeletons and cave art in the MIS 2/3 (about 32,000-26,000 BP). The oldest leopard painting left by Late Palaeolithics (Aurignacians/Gravettians) in the Chauvet Cave (S-France) allows the reconstruction of the Ice Age leopard fur spot pattern being close to the snow or Caucasian leopards. The last Ice Age glacial leopard habitat was the mountain/alpine boreal forest (not mammoth steppe lowland), where those hunted even larger prey such as alpine game (Ibex, Chamois). Into some lairs, those imported their prey by short-term cave dwelling (e.g. Baumann's Cave, Harz Mountains, Germany). Only Eurasian Ice Age leopards specialized, similar as other Late Pleistocene large felids (steppe lions), on cave bear predation/scavenging partly very deep in caves. In Vjetrenica Cave (Dinarid Mountains, Bosnia Herzegovina), four adult leopards (two males/two females) of the MIS 3 were found about two km deep from the entrance in a cave bear den, near to one cave bear skeleton, that remained articulated in its nest. Leopards died there, partly being trapped by raising water levels of an active ponor stream, but seem to have been killed possibly either, similar as for lions known, in battles with cave bears in several cave bear den sites of Europe (e.g. Baumann's Cave, Wildkirchli Cave, Vjetrenica Cave). At other large cave sites, with overlap of hyena, wolf and dhole dens at

  19. Serial measurements of N-terminal pro-brain natriuretic peptide after acute ischemic stroke

    DEFF Research Database (Denmark)

    Jensen, J.K.; Mickley, H.; Bak, S.

    2006-01-01

    consecutive patients with acute ischemic stroke. RESULTS: NT-proBNP peaked the day after onset of symptoms (p = 0.007) followed by a decrease until day 5 (p = 0.001, ANOVA). At 6-month follow-up the difference in the level of NT-proBNP was unchanged compared to day 5 (p = 0.42). NT-proBNP levels > or =615 pg...

  20. Time-dependent changes in B-type natriuretic peptide after heart transplantation: correlation with allograft rejection and function.

    Science.gov (United States)

    Bader, Feras M; Rogers, R Kevin; Kfoury, Abdallah G; Gilbert, Edward M; Horne, Ben D; Stehlik, Josef; Renlund, Dale G

    2009-01-01

    Endomyocardial biopsy is the gold standard to diagnose cardiac allograft rejection, although a noninvasive modality such as brain natriuretic peptide (BNP) is attractive. The authors examined the correlation of BNP levels with rejection patterns and allograft function in cardiac allograft recipients followed up to 8 years. One hundred forty-four consecutive patients underwent endomyocardial biopsy, right heart catheterization, and blood sampling. BNP levels decreased during the first 6 months after transplant but then reached a plateau. Time-dependent correlations were made between BNP levels and allograft rejection, left ventricular ejection fraction, pulmonary capillary wedge pressure, right atrial pressure, and serum creatinine. BNP levels were not different between patients with any rejection pattern and no rejection prior to or after 6 months following transplant. BNP levels did not correlate with ejection fraction, pulmonary capillary wedge pressure, right atrial pressure, or creatinine in the first 6 months after transplant. Statistically significant correlations existed between BNP and these parameters after 6 months following transplant. In cardiac transplant recipients, BNP levels decrease in the first 6 months following transplant and then reach a plateau regardless of the presence, type, or severity of allograft rejection. BNP levels do predict allograft rejection but correlate with allograft function after 6 months following transplant.

  1. Dynamic detection of N-terminal pro-B-type natriuretic peptide helps to predict the outcome of patients with major trauma.

    Science.gov (United States)

    Qian, A; Zhang, M; Zhao, G

    2015-02-01

    NT-proBNP and BNP have been demonstrated to be prognostic markers in cardiac disease and sepsis. However, the prognostic value and the dynamic changes of BNP or NT-proBNP in trauma patients remain unclear. The present study was conducted to investigate the dynamic changes of NT-proBNP in patients with major trauma (injury severity score ≥16), determine whether NT-proBNP could be used as a simple index to predict mortality in major trauma patients. This prospective observational study included 60 patients with major trauma. Serum NT-proBNP levels were measured on the 1st, 3rd and 7th day after injury The NT-proBNP levels in survivors were compared with those in non-survivors. The efficacy of NT-proBNP to predict survival was analyzed using receiver operating characteristic curves. An analysis of correlations between NT-proBNP and various factors, including injury severity score, Glasgow coma score, acute physiology and chronic health evaluation II, central venous pressure, creatine kinase-MB, cardiac troponin I and procalcitonin (PCT) was performed. NT-proBNP levels in patients with traumatic brain injury were compared with those in patients without traumatic brain injury. A comparison of NT-proBNP levels between patients with and without sepsis was also performed at each time point. NT-proBNP levels in non-survivors were significantly higher than those in survivors at all the indicated time points. In the group of non-survivors, NT-proBNP levels on the 7th day were markedly higher than those on the 1st day. In contrast, NT-proBNP levels in survivors showed a reduction over time. The efficacy of NT-proBNP to predict survival was analyzed using ROC curves, and there was no difference in the area under the ROC between NT-proBNP and APACHE II/ISS at the three time points. A significant correlation was found between NT-proBNP and ISS on the 1st day, NT-proBNP and CK-MB, Tn-I and APACHE II on the 3rd day, NT-proBNP and PCT on the 7th day. There were no significant

  2. Prognostic value of N-terminal pro-B-type natriuretic peptide in patients with acute coronary syndromes undergoing left main percutaneous coronary intervention.

    Science.gov (United States)

    Jaberg, Laurenz; Toggweiler, Stefan; Puck, Marietta; Frank, Michelle; Rufibach, Kaspar; Lüscher, Thomas F; Corti, Roberto

    2011-01-01

    Patients undergoing acute left main (LM) coronary artery revascularization have a high mortality and natriuretic peptides such as N-terminal pro-B-type (NT-proBNP) have been shown to have prognostic value in patients with acute coronary syndromes. The present study looked at the prognostic value of NT-proBNP in these patients. We studied all consecutive patients undergoing acute LM coronary artery percutaneous coronary intervention between January 2005 and December 2008 in whom NT-proBNP was measured (n=71). We analyzed the clinical characteristics and the short- and long-term outcomes in relation to NT-proBNP level at admission. Median NT-proBNP was 1,364 ng/L, ranging from 46 to 70,000 ng/L. NT-proBNP was elevated in 63 (89%) patients and was ≥1,000ng/L in 42 (59%). Log NT-proBNP (hazard ratio [HR] 3.51, 95% confidence interval [CI] 1.55-7.97, P=0.003) and left ventricular ejection fraction (HR 0.95, 95%CI 0.91-0.99, P=0.007) were predictors for all-cause mortality. Log NT-proBNP was the only independent significant predictor of cardiovascular mortality. In-hospital mortality was 0% for patients with NT-proBNP value for NT-proBNP in patients undergoing acute LM coronary artery intervention.

  3. Effect of eplerenone on parathyroid hormone levels in patients with primary hyperparathyroidism: a randomized, double-blind, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Tomaschitz Andreas

    2012-09-01

    Full Text Available Abstract Background Increasing evidence suggests the bidirectional interplay between parathyroid hormone and aldosterone as an important mechanism behind the increased risk of cardiovascular damage and bone disease observed in primary hyperparathyroidism. Our primary object is to assess the efficacy of the mineralocorticoid receptor-blocker eplerenone to reduce parathyroid hormone secretion in patients with parathyroid hormone excess. Methods/design Overall, 110 adult male and female patients with primary hyperparathyroidism will be randomly assigned to eplerenone (25 mg once daily for 4 weeks and 4 weeks with 50 mg once daily after dose titration] or placebo, over eight weeks. Each participant will undergo detailed clinical assessment, including anthropometric evaluation, 24-h ambulatory arterial blood pressure monitoring, echocardiography, kidney function and detailed laboratory determination of biomarkers of bone metabolism and cardiovascular disease. The study comprises the following exploratory endpoints: mean change from baseline to week eight in (1 parathyroid hormone(1–84 as the primary endpoint and (2 24-h systolic and diastolic ambulatory blood pressure levels, NT-pro-BNP, biomarkers of bone metabolism, 24-h urinary protein/albumin excretion and echocardiographic parameters reflecting systolic and diastolic function as well as cardiac dimensions, as secondary endpoints. Discussion In view of the reciprocal interaction between aldosterone and parathyroid hormone and the potentially ensuing target organ damage, the EPATH trial is designed to determine whether eplerenone, compared to placebo, will effectively impact on parathyroid hormone secretion and improve cardiovascular, renal and bone health in patients with primary hyperparathyroidism. Trial registration ISRCTN33941607

  4. Guidance levels, achievable doses and expectation levels

    International Nuclear Information System (INIS)

    Li, Lianbo; Meng, Bing

    2002-01-01

    The National Radiological Protection Board (NRPB), the International Atomic Energy Agency (IAEA) and the Commission of the European Communities (CEC) published their guidance levels and reference doses for typical X-ray examination and nuclear medicine in their documents in 1993, 1994 and 1996 respectively. From then on, the concept of guidance levels or reference doses have been applied to different examinations in the field of radiology and proved to be effective for reduction of patient doses. But the guidance levels or reference doses are likely to have some shortcomings and can do little to make further reduction of patient dose in the radiology departments where patient dose are already below them. For this reason, the National Radiological Protection Board (NRPB) proposed a concept named achievable doses which are based on the mean dose observed for a selected sample of radiology departments. This paper will review and discuss the concept of guidance levels and achievable doses, and propose a new concept referred to as Expectation Levels that will encourage the radiology departments where patient dose are already below the guidance levels to keep patient dose as low as reasonably achievable. Some examples of the expectation levels based on the data published by a few countries are also illustrated in this paper

  5. Levels of toxaphene congeners in fish from Danish waters

    DEFF Research Database (Denmark)

    Fromberg, Arvid; Cederberg, Tommy Licht; Hilbert, G.

    2000-01-01

    The levels of toxaphene congeners, in addition to PCB congeners and organochlorine pesticides, were determined in various fish samples from different Danish waters. While PCB-153 and p,p'-DDE show different levels depending on the fishing area, with highest levels in fish from the Western Baltic...... Sea, toxaphene was detected in all the samples investigated at a more constant level. The distribution of the three toxaphene congeners Parlar #26, #50 and #62 depends on the fishing area, with the Western Baltic Sea being different from the other waters by having almost equal levels of toxaphene...

  6. ACOS GOSAT/TANSO-FTS Level 2 Full Physics Standard Product V2.9

    Data.gov (United States)

    National Aeronautics and Space Administration — This data set contains Carbon Dioxide (CO2) column averaged dry air mole fraction for all soundings for which retrieval was attempted. These are the highest-level...

  7. Jupiter's Multi-level Clouds

    Science.gov (United States)

    1997-01-01

    Clouds and hazes at various altitudes within the dynamic Jovian atmosphere are revealed by multi-color imaging taken by the Near-Infrared Mapping Spectrometer (NIMS) onboard the Galileo spacecraft. These images were taken during the second orbit (G2) on September 5, 1996 from an early-morning vantage point 2.1 million kilometers (1.3 million miles) above Jupiter. They show the planet's appearance as viewed at various near-infrared wavelengths, with distinct differences due primarily to variations in the altitudes and opacities of the cloud systems. The top left and right images, taken at 1.61 microns and 2.73 microns respectively, show relatively clear views of the deep atmosphere, with clouds down to a level about three times the atmospheric pressure at the Earth's surface.By contrast, the middle image in top row, taken at 2.17 microns, shows only the highest altitude clouds and hazes. This wavelength is severely affected by the absorption of light by hydrogen gas, the main constituent of Jupiter's atmosphere. Therefore, only the Great Red Spot, the highest equatorial clouds, a small feature at mid-northern latitudes, and thin, high photochemical polar hazes can be seen. In the lower left image, at 3.01 microns, deeper clouds can be seen dimly against gaseous ammonia and methane absorption. In the lower middle image, at 4.99 microns, the light observed is the planet's own indigenous heat from the deep, warm atmosphere.The false color image (lower right) succinctly shows various cloud and haze levels seen in the Jovian atmosphere. This image indicates the temperature and altitude at which the light being observed is produced. Thermally-rich red areas denote high temperatures from photons in the deep atmosphere leaking through minimal cloud cover; green denotes cool temperatures of the tropospheric clouds; blue denotes cold of the upper troposphere and lower stratosphere. The polar regions appear purplish, because small-particle hazes allow leakage and reflectivity

  8. Baseline Response Levels Are a Nuisance in Infant Contingency Learning

    Science.gov (United States)

    Millar, W. S.; Weir, Catherine

    2015-01-01

    The impact of differences in level of baseline responding on contingency learning in the first year was examined by considering the response acquisition of infants classified into baseline response quartiles. Whereas the three lower baseline groups showed the predicted increment in responding to a contingency, the highest baseline responders did…

  9. High-level waste-form-product performance evaluation

    International Nuclear Information System (INIS)

    Bernadzikowski, T.A.; Allender, J.S.; Stone, J.A.; Gordon, D.E.; Gould, T.H. Jr.; Westberry, C.F. III.

    1982-01-01

    Seven candidate waste forms were evaluated for immobilization and geologic disposal of high-level radioactive wastes. The waste forms were compared on the basis of leach resistance, mechanical stability, and waste loading. All forms performed well at leaching temperatures of 40, 90, and 150 0 C. Ceramic forms ranked highest, followed by glasses, a metal matrix form, and concrete. 11 tables

  10. Physico-chemical characteristics and Heavy metal levels in Drinking ...

    African Journals Online (AJOL)

    Physico-chemical characteristics and Heavy metal levels in Drinking Water sources in Sokoto metropolis in North-western Nigeria. ... Tap water samples had similar conductivity values (180 -190μS/m), sachet water samples had conductivity values ranging from 80μS/m to 260μS/m while well water samples had highest ...

  11. Readability versus Leveling.

    Science.gov (United States)

    Fry, Edward

    2002-01-01

    Shows some similarities and differences between readability formulas and leveling procedures and reports some current large-scale uses of readability formulas. Presents a dictionary definition of readability and leveling, and a history and background of readability and leveling. Discusses what goes into determining readability and leveling scores.…

  12. Their Highest Vocation: Social Justice and the Millennial Generation

    Science.gov (United States)

    Fox, Helen

    2012-01-01

    According to polls, today's "Millennial" college students are the most politically progressive generation in U.S. history. They are deeply concerned about social and economic inequality, they support egalitarian relationships among nations and peoples, and they believe that the government should do whatever it takes to protect the environment.…

  13. Highest national honour for CSIR President - (SABC Morning Live Interview)

    CSIR Research Space (South Africa)

    Sibisi, S

    2007-09-26

    Full Text Available . This is the tenth time that our free people have had occasion to salute in humble gratitude such distinguished men and women who are, indeed, the stars on our firmament. Today, they are admitted into the ranks of those who belong to the esteemed National Orders...

  14. MOC's Highest Resolution View of Mars Pathfinder Landing Site

    Science.gov (United States)

    2000-01-01

    [figure removed for brevity, see original site] (A) Mars Pathfinder site, left: April 1998; right: January 2000. [figure removed for brevity, see original site] (B) top: April 1998; bottom: January 2000.Can Mars Global Surveyor's 1.5 meter (5 ft) per pixel camera be used to find any evidence as to the fate of the Mars Polar Lander that was lost on December 3, 1999? One way to find out is to look for one of the other Mars landers and determine what, if anything, can be seen. There have been three successful Mars lander missions: Viking 1 (July 1976), Viking 2 (September 1976), and Mars Pathfinder (July 1997). Of these, the location of Mars Pathfinder is known the best because there are several distinct landmarks visible in the lander's images that help in locating the spacecraft. The MGS MOC Operations Team at Malin Space Science Systems has been tasked since mid-December 1999 with looking for the lost Polar Lander. Part of this effort has been to test the capabilities of MOC by taking a picture of the landing site of Mars Pathfinder.An attempt to photograph the Pathfinder site was made once before, in April 1998, by turning the entire MGS spacecraft so that the camera could point at the known location of the Mars Pathfinder lander. Turning the MGS spacecraft like this is not a normal operation--it takes considerable planning, and disrupts the on-going, normal acquisition of science data. It took 3 attempts to succeed, but on April 22, 1998, MOC acquired the picture seen on the left side of Figure A, above. The three near-by major landmarks that were visible to the Pathfinder's cameras are labeled here (North Peak, Big Crater, Twin Peaks). It was known at the time that this image was not adequate to see the Pathfinder lander because the camera was not in focus and had a resolution of only 3.3 meters (11 ft) per pixel. In this and all other images shown here, north is up. All views of the 1998 MOC image are illuminated from the lower right, all views of the 2000 MOC image are illuminated from the lower left.As part of the Polar Lander search effort, the Mars Pathfinder site was targeted again in December 1999 and January 2000. Like the 1998 attempt, the spacecraft had to be pointed off of its normal, nadir (straight-down) view. Like history repeating itself, it once again took 3 tries before the Pathfinder landing site was hit. The picture on the right side of Figure A, above, shows the new image that was acquired on January 16, 2000. The white box indicates the location shown in Figure B (above, right). The 1000 m scale bar equals 0.62 miles.Figure B (above) shows a subsection of both the 1998 image (top, labeled SPO-1-25603) and the 2000 image (bottom, labeled m11-2414) projected at a scale of 3 meters (10 ft) per pixel. At this scale, the differences in camera focus and sunlight illumination angle are apparent, with the January 2000 image being both in focus and having better lighting conditions. In addition, the MGS spacecraft took the 2000 image from a lower altitude than in 1998, thus the image has better spatial resolution overall. The 500 m scale bar is equal to about 547 yards. The white box shows the location of images in Figure C, below. [figure removed for brevity, see original site] (C) higher-resolution view; left: April 1998; right: January 2000. [figure removed for brevity, see original site] D) Erroneous, preliminary identification of Mars Pathfinder location in January 2000 image. Subsequent analysis (Figures E & F, below) identified the correct spot.The third figure (C, above) again shows portions of the April 1998 image (C, left) and January 2000 image (C, right), only this time they have been enlarged to a resolution of 0.75 meters (2.5 ft) per pixel. The intrinsic resolution of the January 2000 image is 1.5 meters (5 ft), so this is a 200% expanded view of the actual M11-02414 image. The circular features in this and the previous images are impact craters in various states of erosion. Some boulders (dark dots) can be seen near the crater in the lower left corner. The texture that runs diagonally across the scene from upper left toward lower right consists of ridges created by the giant floods that washed through the Pathfinder site from Ares and/or Tiu Vallis many hundreds of millions of years ago. These ridges and the troughs between them were also seen by the Pathfinder lander; their crests often covered with boulders and cobbles (which cannot be seen at the resolution of the MOC image). The 100 m scale bar is equal to 109 yards (which can be compared with a 100 yard U.S. football field). The Mars Pathfinder landing site is located near the center of this view.The fourth picture, Figure D (above), shows a feature that was initially thought to be the Mars Pathfinder lander by MOC investigators. This and the following figures point out just how difficult it is to find a lander on the martian surface using the MGS MOC. Figure D was prepared early in the week following receipt of the new MOC image on January 17, 2000, and for several days it was believed that the lander had been found. As the subsequent two figures will show (E, and F, below), this location appears to be in error. How the features were misidentified is discussed below. Both Figure D and Figure F, showing possible locations of the Pathfinder lander in the MOC image, are enlarged by a factor of three over the intrinsic resolution of that image (that is, to a scale of 0.5 meters or about 1 ft, 7 inch per pixel). The right picture in Figure D shows sight-lines to the large horizon features--Big Crater, Twin Peaks, and North Peak--that were derived by the MOC team by looking at the images taken by the lander in 1997. After placing these lines on the overall image, there appeared to be two features close to the intersection of the sight-lines. Based upon the consistency of the size and shape of the lander as illuminated by sunlight in this image, the northern of the two candidate features (the small 'hump' at the center of both left and right pictures) was considered, at the time, to be the most likely. HOWEVER... [figure removed for brevity, see original site] (E) Photoclinometry, Topography, and Revised Landing Site Location. [figure removed for brevity, see original site] (F) Mars Pathfinder Landing Site; lander not resolved by MOC. Later in the week following acquisition of the January 16, 2000, image (and over the following weekend), there was time for additional analysis to determine whether the rounded hump identified earlier in the week (Figure D, above) was, in fact, the Mars Pathfinder lander. A computer program that estimates relative topography in a MOC image from knowledge of the illumination (called 'shape-from-shading' or photoclinometry) was run to determine which parts of the landing site image are depressions, which are hills, and which are flat surfaces. The picture at the left in Figure E (above) shows the photoclinometry results for the area around the Pathfinder lander. The picture at the center of Figure E shows the same photoclinometry results overlain by an inset of a topographic map of the Pathfinder landing site derived by the U.S. Geological Survey Astrogeology Branch (Flagstaff, Arizona) from photogrammetry (parallax measurements) using images from Pathfinder's own stereo camera. By matching the features seen by MOC with those seen by the Pathfinder (the large arrows are examples of the matching), the location of the lander was refined and is now indicated in the picture on the right side of Figure E. The large, rounded hump previously identified as Pathfinder in Figure D (above), is more likely a large boulder that was seen in Pathfinder's images and named 'Couch' by the Pathfinder science team in 1997.Figure F is summary of the results of this effort to find Mars Pathfinder: it shows that while the landing site of Mars Pathfinder can be identified, the lander itself cannot be seen. It is too small to be resolved in an image where each pixel acquired by the MOC covers a square of 1.5 meters (5 feet) to a side, given the contrast conditions on Mars and the MOC's ability to discriminate contrast. At this scale, Pathfinder is not much larger than two pixels, and the same is true of the lost Polar Lander.No evidence has been found in the January 2000 MOC image of the aft portion of Mars Pathfinder's aeroshell or its parachute, either. If the aeroshell is laying on its side, as interpreted from Mars Pathfinder's images, then it would be very difficult to see this from orbit. Because Pathfinder did not image the parachute, it is not known how it may be configured on the surface--it could be wrapped around the aeroshell or a boulder, for example.This effort to photograph the Mars Pathfinder lander demonstrates that it is extremely difficult to find a lander on the surface of Mars using the Mars Orbiter Camera aboard the MGS spacecraft. This analysis suggests that it is not very likely that the December 1999 Polar Lander will be found by MOC.

  15. Zooxanthellae Densities are Highest in Summer Months in ...

    African Journals Online (AJOL)

    Abstract—Coral bleaching (loss of zooxathellae) is an increasing problem for the health and persistence of corals, but the phenomenon can not be fully comprehended without understanding seasonal fluctuations in the field. Seasonal dynamics of coral zooxanthellae (population density and mitotic indices) of eleven ...

  16. Golden mean energy equals highest atomic electron orbital energy

    Energy Technology Data Exchange (ETDEWEB)

    Malinowski, Leonard J. [Interdisciplinary Research Club, P.O. Box 371, Monroeville, PA 15146 (United States)], E-mail: LJMalinowski@gmail.com

    2009-12-15

    The golden mean numerical value {phi} = 0.5({radical}5 - 1) has been given a physical manifestation through E infinity theory. This short paper relates the golden mean energy 0.618034 MeV to atomic electron orbitals.

  17. Golden mean energy equals highest atomic electron orbital energy

    International Nuclear Information System (INIS)

    Malinowski, Leonard J.

    2009-01-01

    The golden mean numerical value φ = 0.5(√5 - 1) has been given a physical manifestation through E infinity theory. This short paper relates the golden mean energy 0.618034 MeV to atomic electron orbitals.

  18. SiPM Photodetectors for Highest Time Resolution in PET

    CERN Document Server

    Gundacker, S; Meyer, T; Lecoq, P; Jarron, P; Frisch, B

    2012-01-01

    Mesh anode Vacuum Phototriodes (VPTs) are radiation resistant, single gain-stage photomultipliers which are designed to operate in a strong quasi-axial magnetic field. These VPTs are used in the endcap electromagnetic calorimeter of the CMS experiment at the CERN LHC to detect scintillation light from lead tungstate crystals. Short term dynamic response changes occur because of pulse rate variations during normal LHC operation cycles. Over the longer term the effect of increasing integrated charge taken from the photocathode causes an overall degradation of response. We have investigated these effects over time periods exceeding two years of simulated operation and discuss the implications for the long term performance of the VPTs in CMS.

  19. Drivers of flood damage on event level

    DEFF Research Database (Denmark)

    Kreibich, H.; Aerts, J. C. J. H.; Apel, H.

    2016-01-01

    example are the 2002 and 2013 floods in the Elbe and Danube catchments in Germany. The 2002 flood caused the highest economic damage (EUR 11600 million) due to a natural hazard event in Germany. Damage was so high due to extreme flood hazard triggered by extreme precipitation and a high number......-level mitigation measures, 3) more effective early warning and improved coordination of disaster response and 4) a more targeted maintenance of flood defence systems and their deliberate relocation. Thus, despite higher hydrological severity damage due to the 2013 flood was significantly lower than in 2002. In our...

  20. Developing State Level Approaches under the State Level Concept

    International Nuclear Information System (INIS)

    Budlong Sylvester, K.; Murphy, C.L.; Boyer, B.; Pilat, J.F.

    2015-01-01

    With the pursuit of the State-Level Concept (SLC), the IAEA has sought to further evolve the international safeguards system in a manner which maintains (or improves) the effectiveness of the system in an environment of expanding demands and limited resources. The IAEA must not remain static and should continuously examine its practices to ensure it can capture opportunities for cost reductions while adapting to, and staying ahead of, emerging proliferation challenges. Contemporary safeguards have been focused on assessing the nuclear programme of the State as a whole, rather than on the basis of individual facilities. Since the IAEA's integrated safeguards program, State-level Approaches (SLAs) have been developed that seek to optimally combine the measures provided for by the Additional Protocol with those of traditional safeguards. This process resulted in facility specific approaches that, while making use of a State's broader conclusion, were nonetheless prescriptive. Designing SLAs on a State-by-State basis would avoid the shortcomings of a one-size-fits-all system. It would also enable the effective use of the Agency's information analysis and State evaluation efforts by linking this analysis to safeguards planning efforts. Acquisition Path Analysis (APA), along with the State Evaluation process, can be used to prioritize paths in a State in terms of their attractiveness for proliferation. While taking advantage of all safeguards relevant information, and tailoring safeguards to individual characteristics of the State, paths of the highest priority in all States will necessarily meet the same standard of coverage. Similarly, lower priority paths will have lower performance targets, thereby promoting nondiscrimination. Such an approach would improve understanding of safeguards implementation under the SLC and the rational for safeguards resource allocation. The potential roles for APA and performance targets in SLA development will be reviewed

  1. Data analysis at Level-1 Trigger level

    CERN Document Server

    Wittmann, Johannes; Aradi, Gregor; Bergauer, Herbert; Jeitler, Manfred; Wulz, Claudia; Apanasevich, Leonard; Winer, Brian; Puigh, Darren Michael

    2017-01-01

    With ever increasing luminosity at the LHC, optimum online data selection is getting more and more important. While in the case of some experiments (LHCb and ALICE) this task is being completely transferred to computer farms, the others - ATLAS and CMS - will not be able to do this in the medium-term future for technological, detector-related reasons. Therefore, these experiments pursue the complementary approach of migrating more and more of the offline and High-Level Trigger intelligence into the trigger electronics. This paper illustrates how the Level-1 Trigger of the CMS experiment and in particular its concluding stage, the Global Trigger, take up this challenge.

  2. Low magnesium level

    Science.gov (United States)

    Low magnesium level is a condition in which the amount of magnesium in the blood is lower than normal. The medical ... that convert or use energy ( metabolism ). When the level of magnesium in the body drops below normal, ...

  3. Coupling of sea level and tidal range changes, with implications for future water levels.

    Science.gov (United States)

    Devlin, Adam T; Jay, David A; Talke, Stefan A; Zaron, Edward D; Pan, Jiayi; Lin, Hui

    2017-12-05

    Are perturbations to ocean tides correlated with changing sea-level and climate, and how will this affect high water levels? Here, we survey 152 tide gauges in the Pacific Ocean and South China Sea and statistically evaluate how the sum of the four largest tidal constituents, a proxy for the highest astronomical tide (HAT), changes over seasonal and interannual time scales. We find that the variability in HAT is significantly correlated with sea-level variability; approximately 35% of stations exhibit a greater than ±50 mm tidal change per meter sea-level fluctuation. Focusing on a subset of three stations with long records, probability density function (PDF) analyses of the 95% percentile exceedance of total sea level (TSL) show long-term changes of this high-water metric. At Hong Kong, the increase in tides significantly amplifies the risk caused by sea-level rise. Regions of tidal decrease and/or amplification highlight the non-linear response to sea-level variations, with the potential to amplify or mitigate against the increased flood risk caused by sea-level rise. Overall, our analysis suggests that in many regions, local flood level determinations should consider the joint effects of non-stationary tides and mean sea level (MSL) at multiple time scales.

  4. Beyond level planarity

    NARCIS (Netherlands)

    Angelini, P.; Da Lozzo, G.; Di Battista, G.; Frati, F.; Patrignani, M.; Rutter, I.; Hu, Y.; Nöllenburg, M.

    2016-01-01

    In this paper we settle the computational complexity of two open problems related to the extension of the notion of level planarity to surfaces different from the plane. Namely, we show that the problems of testing the existence of a level embedding of a level graph on the surface of the rolling

  5. Liquid metal level measurement

    International Nuclear Information System (INIS)

    Hale, J.C.; Leyland, K.S.

    1982-01-01

    A liquid metal level indicator is described which can be used to measure, in a stainless steel tank, the level of a nuclear reactor coolant such as sodium. The instrument, which is based on the eddy current induction effect, gives readings over substantially the full depth of the tank and indicates the sense of change of level. (U.K.)

  6. Risk stratification in stable coronary artery disease is possible at cardiac troponin levels below conventional detection and is improved by use of N-terminal pro-B-type natriuretic peptide

    DEFF Research Database (Denmark)

    Lyngbæk, Stig; Winkel, Per; Gøtze, Jens P

    2014-01-01

    AIMS: Low prevalence of detectable cardiac troponin in healthy people and low-risk patients previously curtailed its use. With a new high-sensitive cardiac troponin assay (hs-cTnT), concentrations below conventional detection may have prognostic value, notably in combination with N-terminal pro......-B-type natriuretic peptide (NT-pro-BNP). METHODS AND RESULTS: Biomarker concentrations were determined from serum obtained at enrolment in the CLARICOR trial involving 4197 patients with stable coronary artery disease (CAD) followed for 2.6 years. Serum hs-cTnT was detectable (above 3 ng/l) in 78% and above...... the conventional 99th percentile (13.5 ng/l) in 23%. Across all levels of hs-cTnT there was a graded increase in the risk of cardiovascular death after adjustment for known prognostic indicators: hazard ratio (HR) per unit increase in the natural logarithm of the hs-cTnT level, 1.49; 95% confidence interval (CI...

  7. Pulmonary hypertension in patients with advanced heart failure is associated with increased levels of interleukin-6.

    Science.gov (United States)

    Dolenc, Jure; Šebeštjen, Miran; Vrtovec, Bojan; Koželj, Mirta; Haddad, François

    2014-08-01

    Inflammatory, endothelial and neurohormonal biomarkers are involved in heart failure (HF) and pulmonary hypertension (PH) pathogenesis. To study these biomarkers in PH due to advanced HF. Thirty adults with HF were included. Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hsCRP), endothelin-1 and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) were measured in peripheral vein and pulmonary artery during right heart catheterisation. IL-6, TNF-α, hsCRP and NT-proBNP correlated with pulmonary pressures independent of ventricular function, HF etiology and vascular bed. IL-6 was independent predictor of systolic pulmonary artery pressure (sPAP). Inflammatory biomarkers correlate to PH severity. IL-6 predicts sPAP in advanced HF.

  8. Precision contact level gauge

    International Nuclear Information System (INIS)

    Krejci, M.; Pilat, M.; Stulik, P.

    1977-01-01

    Equipment was developed measuring the heavy water level in the TR-0 reactor core within an accuracy of several hundredths of a millimeter in a range of around 3.5 m and at a temperatu