Ethical Analysis of Withdrawing Total Artificial Heart Support.

Science.gov (United States)

DeMartino, Erin S; Wordingham, Sara E; Stulak, John M; Boilson, Barry A; Fuechtmann, Kayla R; Singh, Nausheen; Sulmasy, Daniel P; Pajaro, Octavio E; Mueller, Paul S

2017-05-01

To describe the characteristics of patients who undergo withdrawal of total artificial heart support and to explore the ethical aspects of withdrawing this life-sustaining treatment. We retrospectively reviewed the medical records of all adult recipients of a total artificial heart at Mayo Clinic from the program's inception in 2007 through June 30, 2015. Management of other life-sustaining therapies, approach to end-of-life decision making, engagement of ethics and palliative care consultation, and causes of death were analyzed. Of 47 total artificial heart recipients, 14 patients or their surrogates (30%) requested withdrawal of total artificial heart support. No request was denied by treatment teams. All 14 patients were supported with at least 1 other life-sustaining therapy. Only 1 patient was able to participate in decision making. It is widely held to be ethically permissible to withdraw a life-sustaining treatment when the treatment no longer meets the patient's health care-related goals (ie, the burdens outweigh the benefits). These data suggest that some patients, surrogates, physicians, and other care providers believe that this principle extends to the withdrawal of total artificial heart support. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

A Mini Axial and a Permanent Maglev Radial Heart Pump§

Science.gov (United States)

Qian, Kun-Xi; Ru, Wei-Min; Wang, Hao; Jing, Teng

2007-01-01

The implantability and durability have been for decades the focus of artificial heart R&D. A mini axial and a maglev radial pump have been developed to meet with such requirements. The mini axial pump weighing 27g (incl.5g rotor) has an outer diameter of 21mm and a length of 10mm in its largest point, but can produce a maximal blood flow of 6l/min with 50mmHg pressure increase. Therefore, it is suitable for the patients of 40-60kg body weight. For other patients of 60-80kg or 80-100kg body weight, the mini axial pumps of 23mm and 25mm outer diameter had been developed before, these devices were acknowledged to be the world smallest LVADs by Guinness World Record Center in 2004. The permanent maglev radial pump weighing 150g is a shaft-less centrifugal pump with permanent magnetic bearings developed by the author. It needs no second coil for suspension of the rotor except the motor coil, different from all other maglev pumps developed in USA, Japan, European, etc. Thus no detecting and controlling systems as well as no additional power supply for maglev are necessary. The pump can produce a blood flow up to as large as 10l/min against 100mmHg pressure. An implantable and durable blood pump will be a viable alternative to natural donor heart for transplantation. PMID:19662120

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

Science.gov (United States)

2002-09-01

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

Current state of total artificial heart therapy and introduction of the most important total artificial heart systems.

Science.gov (United States)

Spiliopoulos, Sotirios; Hergesell, Vera; Wasler, Andrae; Dapunt, Otto

2018-06-14

Due to the declining instances of organ donation, total artificial heart (TAH) therapy is of increasing importance for the management of end-stage biventricular heart failure. We introduce the currently most important established and novel TAH systems (SynCardia, CARMAT, ReinHeart, BiVACOR), report clinical outcomes and discuss technical requirements for the successful implementation of TAH therapy as an alternative to cardiac transplantation.

Mathematical problems in modeling artificial heart

Directory of Open Access Journals (Sweden)

Ahmed N. U.

1995-01-01

Full Text Available In this paper we discuss some problems arising in mathematical modeling of artificial hearts. The hydrodynamics of blood flow in an artificial heart chamber is governed by the Navier-Stokes equation, coupled with an equation of hyperbolic type subject to moving boundary conditions. The flow is induced by the motion of a diaphragm (membrane inside the heart chamber attached to a part of the boundary and driven by a compressor (pusher plate. On one side of the diaphragm is the blood and on the other side is the compressor fluid. For a complete mathematical model it is necessary to write the equation of motion of the diaphragm and all the dynamic couplings that exist between its position, velocity and the blood flow in the heart chamber. This gives rise to a system of coupled nonlinear partial differential equations; the Navier-Stokes equation being of parabolic type and the equation for the membrane being of hyperbolic type. The system is completed by introducing all the necessary static and dynamic boundary conditions. The ultimate objective is to control the flow pattern so as to minimize hemolysis (damage to red blood cells by optimal choice of geometry, and by optimal control of the membrane for a given geometry. The other clinical problems, such as compatibility of the material used in the construction of the heart chamber, and the membrane, are not considered in this paper. Also the dynamics of the valve is not considered here, though it is also an important element in the overall design of an artificial heart. We hope to model the valve dynamics in later paper.

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

Science.gov (United States)

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

2017-05-01

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

Combined heart-kidney transplantation after total artificial heart insertion.

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

Zhang, Chi; Yang, Ming

2009-11-01

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

COMPUTER MODELING IN THE DEVELOPMENT OF ARTIFICIAL VENTRICLES OF HEART

Directory of Open Access Journals (Sweden)

L. V. Belyaev

2011-01-01

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

Percutaneous dilatational tracheostomy following total artificial heart implantation.

Science.gov (United States)

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

2015-07-01

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

Nuclear-powered artificial heart system

International Nuclear Information System (INIS)

Pouchot, W.D.; Lehrfeld, D.

1976-01-01

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

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

Science.gov (United States)

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

2016-04-01

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

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

Science.gov (United States)

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

2018-06-01

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

Total artificial heart implantation in a young Marfan syndrome patient.

Science.gov (United States)

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

2018-03-01

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

Permanent complete heart block following surgical correction of ...

African Journals Online (AJOL)

Conclusion: Permanent post-operative complete heart block occurred in 1.3% of patients undergoing VSD repair and 5.5% of those undergoing repair of conotruncal anomalies (Fallot's tetralogy). The dominant anatomic risk factor was a large perimembranous VSD as an isolated defect or as part of a conotruncal anomaly.

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

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

2016-11-02

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

Perioperative Care of the Patient With the Total Artificial Heart.

Science.gov (United States)

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

2017-05-01

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

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

Science.gov (United States)

Losman, J G

1977-09-24

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

Mechanism of artificial heart

CERN Document Server

Yamane, Takashi

2016-01-01

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

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

Science.gov (United States)

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

2017-06-01

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

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

Science.gov (United States)

Villa, Chet R; Morales, David L S

2017-01-01

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

Liver failure in total artificial heart therapy.

Science.gov (United States)

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

2016-07-01

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

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

Science.gov (United States)

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

2016-10-21

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

Inspection of an artificial heart by the neutron radiography technique

International Nuclear Information System (INIS)

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

1999-01-01

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

Inspection of an artificial heart by the neutron radiography technique

CERN Document Server

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

1999-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

Hybrid Continuous-Flow Total Artificial Heart.

Science.gov (United States)

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

2018-05-01

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

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

Science.gov (United States)

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

2015-02-01

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

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

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

2018-04-01

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

Anatomy studies for an artificial heart. Final summary report

International Nuclear Information System (INIS)

Kiraly, R.J.; Nose, Y.

1977-12-01

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

Methods of stabilizing a permanent maglev rotator in heart pumps and other rotary machines

Directory of Open Access Journals (Sweden)

kun-xi qian

2014-10-01

Full Text Available Permanent maglev rotator in a rotary machine could be stabilized according to the author’s experiences, by use of a non-PM (permanent magnetic force acting together with the PM force, and a non-PM bearing functioning together with the PM bearing, or a so-called gyro-effect which can stabilize all rotators including permanent maglev rotator. This paper presents both axially and radially driven permanent maglev centrifugal heart pumps, as well as a permanent maglev turbine machine and an industrially used permanent maglev centrifugal pump. In all this devices permanent maglev rotators achieve stable equilibrium by different approaches described in detail. Finally, the principle exhibition of gyro-effect and the route chart to stabilization of permanent maglev rotator are presented.

Artificial muscle for end-stage heart failure.

Science.gov (United States)

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

2012-01-01

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

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

Science.gov (United States)

Kostrzewa, Benita; Rybak, Zbigniew

2013-01-01

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

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

Science.gov (United States)

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

2007-01-01

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

Artificial heart thermal converter component research and development

International Nuclear Information System (INIS)

Goldowsky, M.; Lehrfeld, D.

1977-01-01

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

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

International Nuclear Information System (INIS)

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

1976-08-01

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

Artificial Heart Research: An Historical Perspective

OpenAIRE

Joshi, Rayan

2001-01-01

This paper tracks the historical evolution of artificial heart technology, from its humble beginnings, to its relatively staggering current potential. While examining various milestones along this fascinating timeline, the paper attempts to shed light on some of the ethical, economic, and social dilemmas that have infused this history. In doing so, it strives to provide the reader with a sense of the various factors, some technical in nature and others purely societal, that have wielded influ...

Radionuclide power source for artificial heart autonomic apparatus

Energy Technology Data Exchange (ETDEWEB)

Lazarenko, Yu V; Gusev, V V; Pustovalov, A A

1988-02-01

Works on creating autonomous artificial heart devices with radionuclide heat source are described. Calculated and experimental parameters of /sup 238/Pu base radionuclide thermoelectric RITEG generators designed for supplying perspective blood pump electric drives are presented. RITEG structure is described and the prospects of increasing its efficiency are shown.

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

Science.gov (United States)

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

2017-09-01

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

Renal Function Recovery with Total Artificial Heart Support.

Science.gov (United States)

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

2016-01-01

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

Reliability studies for the nuclear-powered artificial heart program

International Nuclear Information System (INIS)

Horita, M.; Zeigler, R.K.

1976-04-01

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

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

Science.gov (United States)

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

2017-12-01

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

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

Science.gov (United States)

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

2017-07-01

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

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

Science.gov (United States)

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

2017-06-01

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

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

NARCIS (Netherlands)

Schneider, H.

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

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

Science.gov (United States)

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

2017-11-24

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

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

Science.gov (United States)

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

2016-01-01

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

Total Artificial Heart Implantation after Excision of Right Ventricular Angiosarcoma.

Science.gov (United States)

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

2016-06-01

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

On the feasibility of detecting flaws in artificial heart valves

NARCIS (Netherlands)

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

2000-01-01

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

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

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

2015-09-07

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

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

Science.gov (United States)

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

2017-10-01

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

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

Science.gov (United States)

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

2017-03-01

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2015-12-01

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

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

Science.gov (United States)

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

2016-01-01

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

Automatic Emboli Detection System for the Artificial Heart

Science.gov (United States)

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

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

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

International Nuclear Information System (INIS)

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

1987-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1976-09-01

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

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

International Nuclear Information System (INIS)

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

1976-09-01

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

Application of Artificial Bee Colony Algorithm and Finite Element Analysis for Optimum Design of Brushless Permanent Magnet Motor

Directory of Open Access Journals (Sweden)

Reza Ilka

2012-04-01

Full Text Available ABSTRACT: This paper develops a mathematical relationship for the purpose of designing and selecting the optimum dimensions of a brushless permanent magnet motor. The design is optimised by the use of artificial bee colony algorithm with the goal of maximizing the power density and efficiency of the motor. The required dimensions of the brushless motor are calculated based on the optimum power density and efficiency requirements. Finally, the predicted results of the optimisation are validated using a 2-D numerical program based on finite element analysis.ABSTRAK: Kajian ini mencadangkan persamaan yang menghubungkan rekabentuk dan dimensi magnet motor kekal tanpa berus. Rekabentuk optima berdasarkan algorisma koloni lebah tiruan dengan tujuan meningkatkan ketumpatan kuasa dan keberkesanan dibentangkan dalam kajian ini. Dimensi magnet motor kekal tanpa berus dihitung dengan ketumpatan kuasa optima dan keberkesanan. Akhirnya, keputusan telah disahkan dengan menggunakan program berangka 2-D berdasarkan analisis elemen finit.KEYWORDS: brushless; permanent magnet motor; power density; artificial bee colony; algorithm; finite element analysis

Physiological characterization of the SynCardia total artificial heart in a mock circulation system.

Science.gov (United States)

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

2015-01-01

The SynCardia total artificial heart (TAH) has emerged as an effective, life-saving biventricular replacement system for a wide variety of patients with end-stage heart failure. Although the clinical performance of the TAH is established, modern physiological characterization, in terms of elastance behavior and pressure-volume (PV) characterization has not been defined. Herein, we examine the TAH in terms of elastance using a nonejecting left ventricle, and then characterize the PV relation of the TAH by varying preload and afterload parameters using a Donovan Mock Circulatory System. We demonstrate that the TAH does not operate with time-varying elastance, differing from the human heart. Furthermore, we show that the TAH has a PV relation behavior that also differs from that of the human heart. The TAH does exhibit Starling-like behavior, with output increasing via preload-dependent mechanisms, without reliance on an alteration of inotropic state within the operating window of the TAH. Within our testing range, the TAH is insensitive to variations in afterload; however, this insensitivity has a limit, the limit being the maximum driving pressure of the pneumatic driver. Understanding the physiology of the TAH affords insight into the functional parameters that govern artificial heart behavior providing perspective on differences compared with the human heart.

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

Science.gov (United States)

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

2017-10-01

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

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

Science.gov (United States)

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

2013-04-01

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

Artificial heart for humanoid robot using coiled SMA actuators

Science.gov (United States)

Potnuru, Akshay; Tadesse, Yonas

2015-03-01

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

Radiological symptoms of the disfunction of artificial heart valves

Energy Technology Data Exchange (ETDEWEB)

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

1981-01-31

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

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

Science.gov (United States)

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

2011-07-01

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

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

Science.gov (United States)

Kitamura, T

1986-11-01

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

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

Science.gov (United States)

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

2017-05-01

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

Successful heart transplantation in patients with total artificial heart infections.

Science.gov (United States)

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

2018-02-01

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

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

Science.gov (United States)

Spiliopoulos, Sotirios; Koerfer, Reiner; Tenderich, Gero

2014-06-01

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

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

International Nuclear Information System (INIS)

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

1975-01-01

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

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

Science.gov (United States)

Bakanovskaya, L. N.

2016-08-01

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

Optimal design of permanent magnet flux switching generator for wind applications via artificial neural network and multi-objective particle swarm optimization hybrid approach

International Nuclear Information System (INIS)

Meo, Santolo; Zohoori, Alireza; Vahedi, Abolfazl

2016-01-01

Highlights: • A new optimal design of flux switching permanent magnet generator is developed. • A prototype is employed to validate numerical data used for optimization. • A novel hybrid multi-objective particle swarm optimization approach is proposed. • Optimization targets are weight, cost, voltage and its total harmonic distortion. • The hybrid approach preference is proved compared with other optimization methods. - Abstract: In this paper a new hybrid approach obtained combining a multi-objective particle swarm optimization and artificial neural network is proposed for the design optimization of a direct-drive permanent magnet flux switching generators for low power wind applications. The targets of the proposed multi-objective optimization are to reduce the costs and weight of the machine while maximizing the amplitude of the induced voltage as well as minimizing its total harmonic distortion. The permanent magnet width, the stator and rotor tooth width, the rotor teeth number and stator pole number of the machine define the search space for the optimization problem. Four supervised artificial neural networks are designed for modeling the complex relationships among the weight, the cost, the amplitude and the total harmonic distortion of the output voltage respect to the quantities of the search space. Finite element analysis is adopted to generate training dataset for the artificial neural networks. Finite element analysis based model is verified by experimental results with a 1.5 kW permanent magnet flux switching generator prototype suitable for renewable energy applications, having 6/19 stator poles/rotor teeth. Finally the effectiveness of the proposed hybrid procedure is compared with the results given by conventional multi-objective optimization algorithms. The obtained results show the soundness of the proposed multi objective optimization technique and its feasibility to be adopted as suitable methodology for optimal design of permanent

HEART ELECTRICAL AXIS Α ANGLE VALUES DISTRIBUTION IN PATIENTS, UNDERGOING PERMANENT PACEMAKER IMPLANTATION

Directory of Open Access Journals (Sweden)

O. S. Voronenko

2016-06-01

Full Text Available 52 patients (24 male and 28 female aged 71 ± 8 years, underwent permanent pacemaker implantation were included in the study. Analysis of heart electrical axis (HEA α angle values distribution was carried out in three dimensions in patience before and after pacemaker (PM implantation. The data processed in Microsoft Excel with calculation of the average and it’s standard deviation. Significance of differences in data before and after PM implantation was assessed using Friedman ANOVA test and Kendall concordance coefficient. It was found, that α angle values distribution in patients with implanted PM is transformed from a unimodal to bimodal on the permanent cardiac pacing background. It’s assumed, that α angle changes resulting due to right ventricular electrode positioning options during PM implantation. Clarification of the nature of this change requires a special study.

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

International Nuclear Information System (INIS)

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

1991-01-01

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

Future Prospects for the Total Artificial Heart.

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2017-02-01

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

Vicarious absolute radiometric calibration of GF-2 PMS2 sensor using permanent artificial targets in China

Science.gov (United States)

Liu, Yaokai; Li, Chuanrong; Ma, Lingling; Wang, Ning; Qian, Yonggang; Tang, Lingli

2016-10-01

GF-2, launched on August 19 2014, is one of the high-resolution land resource observing satellite of the China GF series satellites plan. The radiometric performance evaluation of the onboard optical pan and multispectral (PMS2) sensor of GF-2 satellite is very important for the further application of the data. And, the vicarious absolute radiometric calibration approach is one of the most useful way to monitor the radiometric performance of the onboard optical sensors. In this study, the traditional reflectance-based method is used to vicarious radiometrically calibrate the onboard PMS2 sensor of GF-2 satellite using three black, gray and white reflected permanent artificial targets located in the AOE Baotou site in China. Vicarious field calibration campaign were carried out in the AOE-Baotou calibration site on 22 April 2016. And, the absolute radiometric calibration coefficients were determined with in situ measured atmospheric parameters and surface reflectance of the permanent artificial calibration targets. The predicted TOA radiance of a selected desert area with our determined calibrated coefficients were compared with the official distributed calibration coefficients. Comparison results show a good consistent and the mean relative difference of the multispectral channels is less than 5%. Uncertainty analysis was also carried out and a total uncertainty with 3.87% is determined of the TOA radiance.

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

Science.gov (United States)

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

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

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

NARCIS (Netherlands)

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

1992-01-01

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

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

Science.gov (United States)

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

2015-10-17

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

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

Science.gov (United States)

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

2014-01-01

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

Increasing Prevalence of Atrial Fibrillation and Permanent Atrial Arrhythmias in Congenital Heart Disease.

Science.gov (United States)

Labombarda, Fabien; Hamilton, Robert; Shohoudi, Azadeh; Aboulhosn, Jamil; Broberg, Craig S; Chaix, Marie A; Cohen, Scott; Cook, Stephen; Dore, Annie; Fernandes, Susan M; Fournier, Anne; Kay, Joseph; Macle, Laurent; Mondésert, Blandine; Mongeon, François-Pierre; Opotowsky, Alexander R; Proietti, Anna; Rivard, Lena; Ting, Jennifer; Thibault, Bernard; Zaidi, Ali; Khairy, Paul

2017-08-15

Atrial arrhythmias are the most common complication encountered in the growing and aging population with congenital heart disease. This study sought to assess the types and patterns of atrial arrhythmias, associated factors, and age-related trends. A multicenter cohort study enrolled 482 patients with congenital heart disease and atrial arrhythmias, age 32.0 ± 18.0 years, 45.2% female, from 12 North American centers. Qualifying arrhythmias were classified by a blinded adjudicating committee. The most common presenting arrhythmia was intra-atrial re-entrant tachycardia (IART) (61.6%), followed by atrial fibrillation (28.8%), and focal atrial tachycardia (9.5%). The proportion of arrhythmias due to IART increased with congenital heart disease complexity from 47.2% to 62.1% to 67.0% in patients with simple, moderate, and complex defects, respectively (p = 0.0013). Atrial fibrillation increased with age to surpass IART as the most common arrhythmia in those ≥50 years of age (51.2% vs. 44.2%; p congenital heart disease, with a predominantly paroxysmal pattern. However, atrial fibrillation increases in prevalence and atrial arrhythmias progressively become permanent as the population ages. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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

2017-01-01

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

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

International Nuclear Information System (INIS)

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

1971-01-01

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

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

Science.gov (United States)

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

2015-09-01

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

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

NARCIS (Netherlands)

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

1996-01-01

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

Artificial heart pumps: bridging the gap between science, technology and personalized medicine by relational medicine.

Science.gov (United States)

Raia, Federica; Deng, Mario C

2017-01-01

In the US population of 300 million, 3 million have heart failure with reduced ejection fraction and 300,000 have advanced heart failure. Long-term mechanical circulatory support will, within the next decade, be recommended to 30,000 patients annually in the USA, 3000 undergo heart transplantation annually. What do these advances mean for persons suffering from advanced heart failure and their loved ones/caregivers? In this perspective article, we discuss - by exemplifying a case report of a 27-year-old man receiving a Total Artificial Heart - a practice concept of modern medicine that fully incorporates the patient's personhood perspective which we have termed Relational Medicine™. From this case study, it becomes apparent that the successful practice of modern cardiovascular medicine requires the person-person encounter as a core practice element.

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

International Nuclear Information System (INIS)

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

1982-01-01

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

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

Directory of Open Access Journals (Sweden)

S. J. Shemakin

2009-01-01

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

Stirling engine with hydraulic power output for powering artificial hearts

International Nuclear Information System (INIS)

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

1975-01-01

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

Rapid Speed Modulation of a Rotary Total Artificial Heart Impeller.

Science.gov (United States)

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

2016-09-01

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

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

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

2015-12-01

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

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

Science.gov (United States)

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

2018-01-01

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

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

Dobrova, N B; Zaretskiĭ, Iu V

1989-01-01

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

Perioperative Prophylaxis for Total Artificial Heart Transplantation.

Science.gov (United States)

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

2017-11-01

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

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

International Nuclear Information System (INIS)

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

1986-01-01

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

Making Artificial Heart Components – Selected Aspects Of Casting Technology

Directory of Open Access Journals (Sweden)

Sobczak J.J.

2015-09-01

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

[Artificial organs].

Science.gov (United States)

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

2017-01-01

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

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

International Nuclear Information System (INIS)

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

1975-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

Artificial heart system thermal insulation component development

International Nuclear Information System (INIS)

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

1975-01-01

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

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

Science.gov (United States)

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

2017-06-01

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

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

Science.gov (United States)

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

2016-10-01

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

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

Science.gov (United States)

Bramstedt, Katrina A.

2004-01-01

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

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

Science.gov (United States)

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

2009-01-01

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

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

OpenAIRE

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

2015-01-01

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

PERMANENCIA ALTERADA. LAS CIUDADES DE EXCAVACIÓN ARTIFICIAL DE PETER EISENMAN / Altered permanence: cities of artificial excavation by Peter Eisenmann

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Mayka García-Hípola

2011-05-01

Full Text Available RESUMEN Eisenman superpone y entreteje tiempos distintos en sus ciudades de arqueología artificial donde a través de distintas estrategias de escalado y superposición (scaling y overlapping se rescatan momentos pasados que se yuxtaponen con instantes futuros. Ensamblaje, montaje, collage de distintas capas dan como resultado un trastrocamiento o una nueva re-significación. En algunas de estas ciudades las arqueologías eran ficticias, pero en otras eran reales, aunque superpuestas en un proceso de una absoluta artificialidad. Todas ellas son ejemplos donde la arquitectura revela su antigua condición de permanencia a la vez que asume la alteración como posibilidad de repensar lo existente. Eisenman es el ardid que lo hace posible, pasando del uso del signo al texto, de la sintaxis a la semántica y de la gramática a la memoria. En los proyectos que se estudian en este artículo se pasa de trabajar con objetos a trabajar con las huellas que los procesos dejan a modo de palimpsestos o mapas-operativos. SUMMARY Eisenman superimposes and interweaves different times in his cities of artificial archaeology where, through different strategies of scaling and superimposition, past times are rescued and juxtaposed with future moments. The assembly, montage, and collage of different layers result in a transformation or a re-signification. In some of these cities the archaeologies were fictitious, but in others they were real but superimposed in a process of absolute artificiality. These are all examples where architecture reveals its former condition of permanence while accepting change as a chance to rethink what exists. Eisenman is the clever device that makes it possible, passing from the use of the sign to the use of text, from syntax to semantics and from grammar to memory. The projects discussed in this article pass from working with objects to working with the traces that the processes leave, such as palimpsests or operational-maps.

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

International Nuclear Information System (INIS)

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

2009-01-01

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

Noninvasive Measurement of EKG Properties of 3D Artificial Heart Muscle

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Betsy H. Salazar

2017-06-01

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

Development of a nuclear-powered artificial heart

International Nuclear Information System (INIS)

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

1972-01-01

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

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

Science.gov (United States)

Eslamizadeh, Gholamhossein; Barati, Ramin

2017-05-01

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

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

Science.gov (United States)

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

2008-12-01

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

Heart pacemaker - discharge

Science.gov (United States)

Cardiac pacemaker implantation - discharge; Artificial pacemaker - discharge; Permanent pacemaker - discharge; Internal pacemaker - discharge; Cardiac resynchronization therapy - discharge; CRT - discharge; ...

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

Science.gov (United States)

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

2018-04-26

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

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

Directory of Open Access Journals (Sweden)

Arbeiter Daniela

2017-09-01

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

Exploring the perceptions of physicians, caregivers and families towards artificial nutrition and hydration for people in permanent vegetative state: How can a photo-elicitation method help?

Directory of Open Access Journals (Sweden)

Elodie Cretin

Full Text Available The question of withdrawing artificial nutrition and hydration from people in a permanent vegetative state sparks considerable ethical and legal debate. Therefore, understanding the elements that influence such a decision is crucial. However, exploring perceptions of artificial nutrition and hydration is methodologically challenging for several reasons. First, because of the emotional state of the professionals and family members, who are facing an extremely distressing situation; second, because this question mirrors representations linked to a deep-rooted fear of dying of hunger and thirst; and third, because of taboos surrounding death. We sought to determine the best method to explore such complex situations in depth. This article aims to assess the relevance of the photo-elicitation interview method to analyze the perceptions and attitudes of health professionals and families of people in a permanent vegetative state regarding artificial nutrition and hydration. The photo-elicitation interview method consists in inserting one or more photographs into a research interview. An original set of 60 photos was built using Google Images and participants were asked to choose photos (10 maximum and talk about them. The situations of 32 patients were explored in 23 dedicated centers for people in permanent vegetative state across France. In total, 138 interviews were conducted with health professionals and family members. We found that the photo-elicitation interview method 1 was well accepted by the participants and allowed them to express their emotions constructively, 2 fostered narration, reflexivity and introspection, 3 offered a sufficient "unusual angle" to allow participants to go beyond stereotypes and habits of thinking, and 4 can be replicated in other research areas. The use of visual methods currently constitutes an expanding area of research and this study stressed that this is of special interest to enhance research among populations

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

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

2012-01-01

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

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

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

2016-12-01

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

Permanent atrial fibrillation in heart failure patients as another condition with increased reverse triiodothyronine concentration.

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Jakowczuk, Maciej; Zalas, Dominika; Owecki, Maciej

2016-09-01

To fully investigate the thyroid hormonal function in patients with the most common arrhythmia - atrial fibrillation. 120 patients (aged 55-85 yrs) with symptoms of congestive heart failure exacerbation and no other concomitant disorders (inclusion criteria: normal cardiac troponin T at admission and 12 hours after, normal renal, hepatic and respiratory function; exclusion criteria: inflammatory state, history of myocardial infarction). Depending on the presence of permanent atrial fibrillation (PAF), patients were divided into two groups: PAF (34 females, 26 males) and regular sinus heart rhythm (43 females, 17 males), the groups did not differ in terms of heart rate, blood pressure, presence of overt/subclinical thyroid dysfunction, and medical therapy used. In all subjects thyroid stimulating hormone, free thyroxine, free triiodothyronine, reverse triiodothyronine were measured; echocardiography was performed. PAF group showed higher FT4 and rT3 (1.41 vs. 1.27 ng/dl, p=0.0007; 0.61 vs. 0.32 ng/ml, p<0.0001, respectively). With ROC curve analysis the biochemical thyroid related factor of the highest prognostic value for PAF occurrence (with the highest sensitivity and specificity: 77% and 72%, respectively) was rT3 with the cut-off of above 0.3 ng/ml. Also, a positive correlation between rT3 levels and left ventricular posterior wall diameter was observed (Spearman's correlation coefficient 0.33, p=0.0093). PAF is another condition where an increase in rT3 is observed. rT3 concentration above 0.3 ng/ml may be a novel biochemical sign associated with the presence of PAF in patients with chronic heart failure.

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

International Nuclear Information System (INIS)

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

1992-01-01

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

The Eluana Englaro Case: cause of death after the withdrawal of artificial nutrition and hydration in a subject in a permanent vegetative state and with quadriplegia.

Science.gov (United States)

Moreschi, Carlo; Da Broi, Ugo; Rodriguez, Daniele; Froldi, Rino; Porzionato, Andrea; Macchi, Veronica; De Caro, Raffaele

2013-09-10

A 38-year-old woman, who had been in a permanent vegetative state with quadriplegia for 17 years following a motor vehicle accident, died 87 h after the judicially authorised suspension of artificial nutrition and hydration. Medico-legal investigations, requested by the Judicial Authorities and focusing on the evaluation of clinical and necroscopic data, aimed to explain the cause of death, to exclude any lethal cause other than one deriving from the withdrawal of artificial nutrition and hydration and to verify the level of perceived discomfort and the correctness in the application of the supportive protocol during the end of life phase. The inability of quadriplegic patients to compensate critical hyperthermic and haemodynamic disturbances induced by dehydration was considered to be the cause of a rapid demise after the withdrawal of artificial sustenance. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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

Science.gov (United States)

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

2018-03-30

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

Object permanence development in infants with motor handicaps.

Science.gov (United States)

Fetters, L

1981-03-01

This study was an investigation of the effects of a motor handicap on the development of object permanence in the young child. Motor abilities were evaluated for 12 infants aged 13 to 29 months. Based on this evaluation, the children were described as manipulators or nonmanipulators in reference to their upper extremity skills. Their stage of object permanence was assessed using traditional and nontraditional assessments. Heart rate and visual tracking were recorded during the nontraditional assessment. Heart rate did not significantly relate to visual fixation or search response. There was, however, a significant difference (p less than .02) between stage achievement with traditional testing and age-appropriate levels. There was no significant difference between the nontraditional assessment and the age-appropriate levels. In addition, there was no significant difference in the development of object permanence between infants described as manipulators and those described as nonmanipulators. The last two findings suggest that infants with motor handicaps may develop object permanence at the expected ages, according to a nontraditional assessment.

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

International Nuclear Information System (INIS)

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

1976-01-01

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

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

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

2016-07-01

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

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

Science.gov (United States)

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

2017-01-01

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

Getting a New Heart

Science.gov (United States)

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

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2014-01-01

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

Adverse effects of permanent atrial fibrillation on heart failure in patients with preserved left ventricular function and chronic right apical pacing for complete heart block.

Science.gov (United States)

Lampe, Brigitte; Hammerstingl, Christoph; Schwab, Jörg Otto; Mellert, Fritz; Stoffel-Wagner, Birgit; Grigull, Andreas; Fimmers, Rolf; Maisch, Bernhard; Nickenig, Georg; Lewalter, Thorsten; Yang, Alexander

2012-10-01

The impact of atrial fibrillation (AF) on heart failure (HF) was evaluated in patients with preserved left ventricular (LV) function and long-term right ventricular (RV) pacing for complete heart block. Clinical, echocardiographic, and laboratory parameters of HF were assessed in 35 patients with established AF who had undergone ablation of the atrioventricular node and pacemaker implantation (Group A) and 31 patients who received dual-chamber pacing for spontaneous complete heart block (Group B). During a follow-up period of 12.7 ± 7.5 years, New York Heart Association (NYHA) functional class increased from 1.3 ± 0.5 to 2.1 ± 0.6 (p Left ventricular ejection fraction (LVEF) decreased from 59.7 ± 5.1 to 53.0 ± 8.2 (p function were moderately depressed in Group A compared with those in Group B: NYHA class 2.1 ± 0.6 versus 1.6 ± 0.7, p = 0.001; LVEF 53.0 ± 8.2 versus 56.9 ± 7.0 %, p brain natriuretic peptide (NT-proBNP) 1116.8 ± 883.9 versus 622.9 ± 1059.4 pg/ml, p 10 %, increasing NYHA class ≥1, and NT-proBNP levels >1,000 pg/ml. Permanent AF was associated with adverse effects on LV function and symptoms of HF in patients with long-term RV pacing for complete heart block, and appears to play an important role in the development of HF in this specific patient cohort.

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

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

Control system for an artificial heart

Science.gov (United States)

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

1970-01-01

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

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

Science.gov (United States)

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

2016-11-01

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

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

Science.gov (United States)

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

2014-01-01

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

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

Science.gov (United States)

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

2002-01-01

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

Infection and twiddler syndrome in a dog with addison's disease, complete heart block, and wandering artificial pacemakers

International Nuclear Information System (INIS)

Hill, R.C.; Buchanan, J.W.

1990-01-01

Third degree heart block developed in an obese, 10-year-old Labrador retriever with adrenocortical failure. A permanent transthoracic pacemaker was fitted, but the pulse generator migrated 2 years later, to the ventral part of the flank, where an abscess formed. A new pacemaker was fitted, but also migrated and rotated and a syndrome analogous to Twiddler's syndrome in man developed. After a further 2 years the second pacemaker was located, encapsulated within the right pleural cavity. Culture of the brownish exudate around the pulse generator yielded Pseudomonas sp

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

Science.gov (United States)

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

2012-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-07-01

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

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

Science.gov (United States)

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

2016-10-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1976-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-05-01

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

A novel permanent maglev impeller TAH: most requirements on blood pumps have been satisfied.

Science.gov (United States)

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

2003-07-01

Based on the development of an impeller total artificial heart (TAH) (1987) and a permanent maglev (magnetic levitation) impeller pump (2002), as well as a patented magnetic bearing and magnetic spring (1996), a novel permanent maglev impeller TAH has been developed. The device consists of a rotor and a stator. The rotor is driven radially. Two impellers with different dimensions are fixed at both the ends of the rotor. The levitation of the rotor is achieved by using two permanent magnetic bearings, which have double function: radial bearing and axial spring. As the rotor rotates at a periodic changing speed, two pumps deliver the pulsatile flow synchronously. The volume balance between the two pumps is realized due to self-modulation property of the impeller pumps, without need for detection and control. Because the hemo-dynamic force acting on the left impeller is larger than that on the right impeller, and this force during systole is larger than that during diastole, the rotor reciprocates axially once a cycle. This is beneficial to prevent the thrombosis in the pump. Furthermore, a small flow via the gap between stator and rotor from left pump into right pump comes to a full washout in the motor and the pumps. Therefore, it seems neither mechanical wear nor thrombosis could occur. The previously developed prototype impeller TAH had demonstrated that it could operate in animal experiments indefinitely, if the bearing would not fail to work. Expectantly, this novel permanent magnetic levitation impeller TAH with simplicity, implantability, pulsatility, compatibility and durability has satisfied the most requirements on blood pumps and will have more extensive applications in experiments and clinics.

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

Science.gov (United States)

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

2017-07-01

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

Generality in Artificial Intelligence

Indian Academy of Sciences (India)

Home; Journals; Resonance – Journal of Science Education; Volume 19; Issue 3. Generality in Artificial Intelligence. John McCarthy. Classics Volume 19 Issue 3 March 2014 pp 283-296. Fulltext. Click here to view fulltext PDF. Permanent link: https://www.ias.ac.in/article/fulltext/reso/019/03/0283-0296. Author Affiliations.

Dronedarone in high-risk permanent atrial fibrillation

DEFF Research Database (Denmark)

Connolly, Stuart J; Camm, A John; Halperin, Jonathan L

2011-01-01

Dronedarone restores sinus rhythm and reduces hospitalization or death in intermittent atrial fibrillation. It also lowers heart rate and blood pressure and has antiadrenergic and potential ventricular antiarrhythmic effects. We hypothesized that dronedarone would reduce major vascular events...... in high-risk permanent atrial fibrillation....

Extracorporeal total artificial heart as bailout surgery.

Science.gov (United States)

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

2017-03-01

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

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

Science.gov (United States)

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

2016-03-01

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

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

International Nuclear Information System (INIS)

1977-01-01

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

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

Science.gov (United States)

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

2016-06-01

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

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

Science.gov (United States)

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

1997-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

1977-01-01

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

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

Science.gov (United States)

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

2017-12-01

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

A novel dynamic cardiac simulator utilizing pneumatic artificial muscle.

Science.gov (United States)

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

2013-01-01

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

Electromagnetic Compatibility of Transcutaneous Energy Transmission Systemfor Totally Implantable Artificial Heart

Science.gov (United States)

Shiba, Kenji; Koshiji, Kohji

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1983-02-01

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

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

Energy Technology Data Exchange (ETDEWEB)

1977-01-01

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

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

International Nuclear Information System (INIS)

1977-01-01

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

Radiochemicals used to scan the heart

International Nuclear Information System (INIS)

Anon.

1975-01-01

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

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

Science.gov (United States)

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

2016-03-01

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

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

National Research Council Canada - National Science Library

Baselli, G

2001-01-01

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

[Improved design of permanent maglev impeller assist heart].

Science.gov (United States)

Qian, Kunxi; Zeng, Pei; Ru, Weimin; Yuan, Haiyu

2002-12-01

Magnetic bearing has no mechanical contact between the rotor and stator. And a rotary pump with magnetic bearing has therefore no mechanical wear and thrombosis due to bearing. The available magnetic bearings, however, are devised with electric magnets, need complicated control and remarkable energy consumption. Resultantly, it is difficult to apply an electric magnetic bearing to rotary pump without disturbing its simplicity, implantability and reliability. The authors have developed a levitated impeller pump merely with permanent magnets. The rotor is supported by permanent magnetic forces radially. On one side of the rotor, the impeller is fixed; and on the other side of the rotor, the driven magnets are mounted. Opposite to this driven magnets, a driving motor coil with iron corn magnets is fastened to the motor axis. Thereafter, the motor drives the rotor via a rotating magnetic field. By laboratory tests with saline, if the rotor stands still or rotates under 4,000 rpm, the rotor has one-point contact axially with the driving motor coil. The contacting point is located in the center of the rotor. As the rotating speed increases gradually to more than 4,000 rpm, the rotor will detache from the stator axially. Then the rotor will be fully levitated. Since the axial levitation is produced by hydraulic force and the driven magnets have a gyro-effect, the rotor rotates very steadly during levitation. As a left ventricular assist device, the pump works in a rotating speed range of 5,000-8,000 rpm, the levitation of the impeller hence is ensured by practical use of the pump.

Artificial organs and transplantation.

Science.gov (United States)

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

2003-05-01

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

The Japanese artificial organs scene: current status.

Science.gov (United States)

Mitamura, Yoshinori; Murabayashi, Shun

2005-08-01

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

What Is Heart Surgery?

Science.gov (United States)

... kidneys, liver, and lungs. Stroke , which may cause short-term or permanent damage. Death. (Heart surgery is more likely to be life threatening in people who are very sick before the surgery.) Memory loss and other issues, such as problems concentrating or ...

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

Science.gov (United States)

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

2018-01-27

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

Effect of permanent pacemaker on mortality after transcatheter aortic valve replacement

DEFF Research Database (Denmark)

Engborg, Jonathan; Riechel-Sarup, Casper; Gerke, Oke

2017-01-01

OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is an established treatment for high-grade aortic valve stenosis in patients found unfit for open heart surgery. The method may cause cardiac conduction disorders requiring permanent pacemaker (PPM) implantation, and the long-term effect...

Chelation for Coronary Heart Disease

Science.gov (United States)

... more rare are serious and potentially fatal side effects that can include heart failure, a sudden drop in blood pressure, abnormally low calcium levels in the blood (hypocalcemia), permanent kidney damage, and bone marrow depression (blood ...

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

Science.gov (United States)

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

2010-01-01

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

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

Science.gov (United States)

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

2017-12-01

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

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

Directory of Open Access Journals (Sweden)

Sergey G. Chefranov

2013-11-01

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

Animal studies with the Carmat bioprosthetic total artificial heart.

Science.gov (United States)

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

2015-05-01

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

Modular Extended-Stay HyperGravity Facility Design Concept: An Artificial-Gravity Space-Settlement Ground Analogue

Science.gov (United States)

Dorais, Gregory A.

2015-01-01

This document defines the design concept for a ground-based, extended-stay hypergravity facility as a precursor for space-based artificial-gravity facilities that extend the permanent presence of both human and non-human life beyond Earth in artificial-gravity settlements. Since the Earth's current human population is stressing the environment and the resources off-Earth are relatively unlimited, by as soon as 2040 more than one thousand people could be living in Earthorbiting artificial-gravity habitats. Eventually, the majority of humanity may live in artificialgravity habitats throughout this solar system as well as others, but little is known about the longterm (multi-generational) effects of artificial-gravity habitats on people, animals, and plants. In order to extend life permanently beyond Earth, it would be useful to create an orbiting space facility that generates 1g as well as other gravity levels to rigorously address the numerous challenges of such an endeavor. Before doing so, developing a ground-based artificial-gravity facility is a reasonable next step. Just as the International Space Station is a microgravity research facility, at a small fraction of the cost and risk a ground-based artificial-gravity facility can begin to address a wide-variety of the artificial-gravity life-science questions and engineering challenges requiring long-term research to enable people, animals, and plants to live off-Earth indefinitely.

Aspectos ecológicos da tripanossomíase americana: VII. Permanência e mobilidade do Triatoma sordida em relação aos ecótopos artificiais Ecological aspects of South American Tripanosomiasis: VII. Permanence and mobility of Triatoma sordida with relation to artificial ecotopes

Directory of Open Access Journals (Sweden)

Oswaldo Paulo Forattini

1975-12-01

Full Text Available Nas colônias desenvolvidas espontaneamente em ecótopos artificiais, representados por galinheiros experimentais, procurou-se observar a permanência e a mobilidade de Triatoma sordida. Para tanto, procedeu-se à marcação individual de adultos e ninfas de 4.° e 5.° estádios, bem como à instalação de abrigos ao redor daqueles biótopos. Os dados obtidos permitiram observar a curta permanência dos primeiros na colônia, não ultrapassando o período de dois meses para a maioria dessas formas. A mobilidade evidenciou-se pela presença de ovos e ninfas de 1.° estádio, nos esconderijos instalados, e as evidências sugeriram ser devidas à passagem dos adultos por esses ecótopos. Concluiu-se que esta espécie é dotada de elevada capacidade de disseminação, em concordância com sua apreciável valência ecológica.Spontaneous colonies of Triatoma sordida developed in experimental fowlhouses were submitted to observations as regards permanence and mobility of this bug. During thirteen months, adults and nymphs of fourth and fifth in stars were tagged for recapture. Resting traps for atracting bugs were placed around the fowlhouses. Adults showed no more than two months of permanence inside these artificial ecotopes. Eggs and first nymphs found in the resting traps suggested activity of adults coming from the fowlhouses. It was evident that this triatomid has a dispersal capacity and an adult tendency towards leaving the colonies as soon as the first egg batches are layed. After this the female will continue the oviposition inside other ecotopes attempting to develop new colonies. This aspect agress with the high characteristic ecological valence of this bug.

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

Science.gov (United States)

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

2015-01-01

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

Selection of permanent pacing position of cardiac ventricle in patients with complete right bundle branch block

International Nuclear Information System (INIS)

Yang Minquan; Zhou Jun; Zhu Yan; Wang Jin; Rong Xin; Zhang Xiaoyi

2005-01-01

Objective: To find out the optimal pacing localization by comparing different pacing positions of the right ventricle in brady-cardiacarrhythmia patients with complete right bundle branch block. Methods: DDD type of double lumen permanent pacemaker was implanted in each of the 8 cases of sick sinus syndrome (SSS) and/or III degree atrioventricular block (III degree AVB) with complete right bundle branch block in normal heart function or class I. For each patient, four pacing positions in right ventricle were compared and the QRS pacing durations were recorded. The position with the shortest the QRS duration was chosen as the permanent pacing position. Heart function, chest X-rays and left ventricle ejection fraction (LVEF) were followed up after the operation. Results: In all the 8 cases, the posterior septum of the right ventricle were chosen as the permanent pacing position, with the shorter pacing QRS duration than that of pre-operation (P<0.05) and other pacing positions of the right ventricle. All parameters of this permanent pacing position were within the normal range. During the follow-up of 6-36 months, no abnormity was found in cardiac functions. Conclusion: In brady-cardiacarrhythmia patients with complete right bundle branch block, the implantation of permanent pacemaker should be at the junction region of inlet and outlet tracts, of the posterior septum of the right ventricle with ideal physiological function. (authors)

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

Science.gov (United States)

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

2017-08-01

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

The progression to permanent atrial fibrillation with congestive heart failure is associated with sympathetic nerve abnormality. A study with I-123 metaiodobenzylguanidine scintigraphy

International Nuclear Information System (INIS)

Kodama, Yusuke; Akutsu, Yasushi; Li, Hui-Ling; Kinohira, Yukihiko; Yamanaka, Hideyuki; Shinozuka, Akira; Katagiri, Takashi

2005-01-01

The aim of this study was to evaluate the relationship between congestive heart failure (CHF) and atrial fibrillation (AF) using iodine-123 metaiodobenzylguanidine (MIBG) scintigraphic imaging. Ninety-two AF patients (47 male and 45 female patients; mean age, 67±13 years) who did not suffer from structural heart disease or myocardial ischemia underwent MIBG scintigraphy. Global MIBG uptake was assessed by measuring the heart-to-mediastinal ratio (H/M) and washout rate (WR) on planar images, and the abnormal score (AS) was calculated on delayed MIBG single photon emission computed tomography images. Echocardiography was performed within a week after MIBG scintigraphy, to measure left ventricular ejection fraction (EF) and deceleration time (DT). The AF patients were divided into four groups: patients with permanent AF with (n=23, group A) or without (n=19, group B) a history of CHF, and patients with paroxysmal AF with (n=19, group C) or without (n=39, group D) a history of CHF. The H/M ratio was significantly lower in group A than in other groups (2.0±0.6 vs. group B: 2.7±0.6, group C: 2.3±0.5, and group D: 2.6±0.8, P<0.05), and in group C than in group D (P<0.05). Similarly, the WR was significantly higher in group A than in groups B and C (45.9±2.0 vs. group B: 38.9±1.9 and group C: 38.4±2.3, P<0.05). The AS was the highest in group A (19.7±8.2 vs. group B: 7.1±6.6, P<0.01; group C: 11.6±10.6 and group D: 13.5±9.0, P<0.05). The DT was significantly longer in group A than in groups B and D (222.0±59.4 vs. group B: 179.5±49.1, P<0.05 and group D: 177.9±37.1, P<0.01), but did not differ between groups A and C (222.0±59.4 vs. 197.4±51.1). There was no difference in EF among the groups. Although CHF with AF is associated with diastolic dysfunction, the progression to permanent AF from paroxysmal AF with CHF might be caused mainly by sympathetic nerve abnormality. (author)

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

Science.gov (United States)

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

2017-12-01

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

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

International Nuclear Information System (INIS)

1977-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

1977-01-01

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

Artificial muscle: the human chimera is the future.

Science.gov (United States)

Tozzi, P

2011-12-14

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

Knowledge representation an approach to artificial intelligence

CERN Document Server

Bench-Capon, TJM

1990-01-01

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

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

Science.gov (United States)

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

2018-01-01

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

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

Science.gov (United States)

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

2013-11-01

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

Can You Recognize a Heart Attack or Stroke? What To Do When Every Moment Counts

Science.gov (United States)

... Special Issues Subscribe August 2014 Print this issue Can You Recognize a Heart Attack or Stroke? What ... could prevent many of these deaths. Fast action can also limit permanent damage to the body. Heart ...

Clinicohemodynamic and roentgenologic correlations in patients with artificial pacemakers

International Nuclear Information System (INIS)

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

1987-01-01

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

Clinicohemodynamic and roentgenologic correlations in patients with artificial pacemakers

Energy Technology Data Exchange (ETDEWEB)

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

1987-05-01

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

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

Science.gov (United States)

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

2016-10-01

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

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

International Nuclear Information System (INIS)

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

1976-01-01

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

Restoration of heart functions using human embryonic stem cells derived heart muscle cells.

Science.gov (United States)

Gepstein, Lior; Kehat, Izhak

2005-02-01

Extract: Recent advances in molecular and cellular biology and specifically in the areas of stem cell biology and tissue engineering have paved the way for the development of a new field in biomedicine, regenerative medicine. This exciting approach seeks to develop new biological solutions, using the mobilization of endogenous stem cells or delivery of exogenous cells to replace or modify the function of diseased, absent, or malfunctioning tissue. The adult heart represents an attractive candidate for these emerging technologies, since adult cardiomyocytes have limited regenerative capacity. Thus, any significant heart cell loss or dysfunction, such as occurs during heart attack, is mostly irreversible and may lead to the development of progressive heart failure, one of the leading causes of world-wide morbidity and mortality. Similarly, dysfunction of the specialized electrical conduction system within the heart may result in inefficient rhythm initiation or impulse conduction, leading to significant slowing of the heart rate, usually requiring the implantation of a permanent electronic pacemaker. Replacement of the dysfunctional myocardium (heart muscle) by implantation of external heart muscle cells is emerging as a novel paradigm for restoration of the myocardial electromechanical properties, but has been significantly hampered by the paucity of cell sources for human heart cells and by the relatively limited evidence for functional integration between grafted and host cells. The recently described human embryonic stem cell (hESC) lines may provide a possible solution for the aforementioned cell sourcing problem.

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

Science.gov (United States)

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

2014-09-01

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

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

Science.gov (United States)

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

2006-10-01

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

Antithrombotic artificial organs

Energy Technology Data Exchange (ETDEWEB)

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

1971-07-12

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

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

Science.gov (United States)

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

2017-12-01

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

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

Science.gov (United States)

Morrissey, Megan

2012-08-01

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

Long-Term Retrievability of IVC Filters: Should We Abandon Permanent Devices?

International Nuclear Information System (INIS)

Berczi, V.; Bottomley, J. R.; Thomas, S. M.; Taneja, S.; Gaines, P. A.; Cleveland, T. J.

2007-01-01

Thromboembolic disease produces a considerable disease burden, with death from pulmonary embolism in the UK alone estimated at 30,000-40,000 per year. Whilst it is unproven whether filters actually improve longevity, the morbidity and mortality associated with thromboembolic disease in the presence of contraindications to anticoagulation is high. Thus complications associated with filter insertion, and whilst they remain in situ, must be balanced against the alternatives. Permanent filters remain in situ for the remainder of the patient's life and any complications from the filters are of significant concern. Filters that are not permanent are therefore attractive in these circumstances. Retrievable filters, to avoid or decrease long-term filter complications, appear to be a significant advance in the prevention of pulmonary embolism. In this review, we discuss the safety and effectiveness of both permanent and retrievable filters as well as the retrievability of retrievable inferior vena cava (IVC) filters, to explore whether the use of permanent IVC filters can be abandoned in favor of retrievable filters. Currently four types of retrievable filters are available: the Recovery filter (Bard Peripheral Vascular, Tempe, AZ, USA), the Guenther Tulip filter (Cook, Bloomington, IN, USA), the OptEase Filter (Cordis, Roden, The Netherlands), and the ALN filter (ALN Implants Chirurgicaux, Ghisonaccia, France). Efficacy and safety data for retrievable filters are as yet based on small series, with a total number of fewer than 1,000 insertions, and follow-up is mostly short term. Current long-term data are poor and insufficient to warrant the long-term implantation of these devices into humans. The case of fractured wire from a Recovery filter that migrated to the heart causing pericardial tamponade requiring open heart surgery is a reminder that any new endovascular device remaining in situ in the long term may produce unexpected problems. We should also bear in mind that

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

Science.gov (United States)

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

2008-06-01

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

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

International Nuclear Information System (INIS)

1977-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

1977-01-01

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

Determinants of permanent first incisor eruption in grazing Australian Angora goats.

Science.gov (United States)

McGregor, B A; Butler, K L

2011-12-01

To investigate the effects of live weight, sex and other factors on deciduous (first incisor) loss and permanent first incisor development in Angora goats. Goats were part of a pen study on the effects of energy intake in Angora does during pregnancy and lactation on kid growth and development. The design was three levels of nutrition in mid-pregnancy × two levels of postnatal nutrition in 17 randomised blocks. Conception times were calculated by using artificial insemination, with ultrasound examination 43 days after insemination. Does were fed different amounts of a formulated diet in their pens. After weaning, goats were grazed in sex groups. Deciduous first incisor loss and permanent first incisor development were recorded at 11 time points from 14 to 20 months of age. For each sex, the time for visible eruption and full development of permanent first incisor declined linearly with increased live weight by 5.9 and 5.4 days/kg live weight, respectively. The time to reach similar development stages for first permanent incisors eruption was 3 months longer for the lightest animals compared with the heaviest animals. Date of birth, birth weight, doe age, growth rates, mid-pregnancy and postnatal nutrition, parity, day of weaning and weaning weight had no detectable effect. The results explain much of the substantial range in reported first permanent incisor eruption dates for small ruminants and have application in ageing of goats, marketing of kids for meat, in the selection of animals for breeding flocks and in educational material. © 2011 The Authors. Australian Veterinary Journal © 2011 Australian Veterinary Association.

Biomaterials for artificial organs

CERN Document Server

Lysaght, Michael J

2010-01-01

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

Eruption of first permanent incisors and live weight gain in grazing yearling Angora goats.

Science.gov (United States)

McGregor, B A; Butler, K L

2013-05-01

To investigate the effects of the timing and duration of eruption of the first permanent incisors, live weight, sex and other factors on contemporaneous live weight gain in Angora goats. Goats were previously part of a pen study on the effects of energy intake of Angora does during pregnancy and lactation on kid development. The design was 3 levels of nutrition in mid-pregnancy by 2 levels of postnatal nutrition in 17 randomised blocks. Artificial insemination, ultrasound examination and feeding does in pens enabled accurate conduct of the study. After weaning, goats were grazed in sex groups. Live weight change between 14 and 20 months of age was related to deciduous first incisor loss and permanent first incisor development and other attributes assessed before the study. Live weight change was related to the elapsed time for first permanent incisors to commence eruption and to the length of time for first permanent incisors to erupt. This response was affected by sex. Over summer and autumn, entire males with short eruption intervals gained 2-3 kg more than entire males with long eruption intervals. Females that reached first permanent incisor eruption by mid-summer had a live weight gain of 3 kg more than those that reached the same development 3 months later. Live weight change in yearling Angora goats was associated with the process of first permanent incisor eruption. In females, live weight gain was greater when first permanent incisor eruption was earlier. In males, live weight gain was greater when first permanent incisor eruption was faster. © 2013 The Authors. Australian Veterinary Journal © 2013 Australian Veterinary Association.

Left atrial passive emptying function is preserved in patients with permanent atrial fibrillation--a 320-slice multidetector computed tomography study

DEFF Research Database (Denmark)

Agner, Bue Fridolin Ross; Kühl, Jørgen Tobias; Kofoed, Klaus Fuglsang

2014-01-01

OBJECTIVE: Left atrial (LA) mechanical function is thought to be virtually inexistent in patients with permanent atrial fibrillation (AF). Due to recent advances in multidetector computed tomography (MDCT) technology, it is now possible to acquire images of the entire heart in a single heartbeat....... The objective of this study was to compare individual components of LA function assessed by MDCT in patients with permanent AF and patients in sinus rhythm (SR). METHODS: 320-slice MDCT was performed in 30 patients with permanent AF. Measurements of LA volumes during the cardiac cycle were compared to 30......; 71 vs. 30 ml/m(2), p permanent AF have significantly increased LA volumes throughout the cardiac...

Dynamic cardiomyoplasty using artificial muscle.

Science.gov (United States)

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

2008-01-01

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

Artificial organs versus regenerative medicine: is it true?

Science.gov (United States)

Nosé, Yukihiko; Okubo, Hisashi

2003-09-01

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

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

Science.gov (United States)

Nishida, Masahiro

2017-09-01

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

Artificial intelligence guides system's best practices, cutting costs and improving services.

Science.gov (United States)

1999-06-01

One for the history books. Clinical care improvement initiatives guided by a sophisticated artificial intelligence program have helped a major Virginia integrated health system make dramatic improvements in the cost and quality of its health care services. Find out how the technological innovation has earned Sentara Health System a place in the permanent collection of the Smithsonian's National Museum of American History.

Fluid mechanics of heart valves.

Science.gov (United States)

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

2004-01-01

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

Pacemaker Use Following Heart Transplantation

Science.gov (United States)

Mallidi, Hari R.; Bates, Michael

2017-01-01

Background: The incidence of permanent pacemaker implantation after orthotopic heart transplantation has been reported to be 2%-24%. Transplanted hearts usually exhibit sinus rhythm in the operating room following reperfusion, and most patients do not exhibit significant arrhythmias during the postoperative period. However, among the patients who do exhibit abnormalities, pacemakers may be implanted for early sinus node dysfunction but are rarely used after 6 months. Permanent pacing is often required for atrioventricular block. A different cohort of transplant patients presents later with bradycardia requiring pacemaker implantation, reported to occur in approximately 1.5% of patients. The objectives of this study were to investigate the indications for pacemaker implantation, compare the need for pacemakers following bicaval vs biatrial anastomosis, and examine the long-term outcomes of heart transplant patients who received pacemakers. Methods: For this retrospective, case-cohort, single-institution study, patients were identified from clinical research and administrative transplant databases. Information was supplemented with review of the medical records. Standard statistical techniques were used, with chi-square testing for categorical variables and the 2-tailed t test for continuous variables. Survival was compared with the use of log-rank methods. Results: Between January 1968 and February 2008, 1,450 heart transplants were performed at Stanford University. Eighty-four patients (5.8%) were identified as having had a pacemaker implanted. Of these patients, 65.5% (55) had the device implanted within 30 days of transplantation, and 34.5% (29) had late implantation. The mean survival of patients who had an early pacemaker implant was 6.4 years compared to 7.7 years for those with a late pacemaker implant (Ppacemaker implantation. Starting in 1997, a bicaval technique was used for implantation. The incidence of pacemaker implantation by technique was 2.0% for

Artificial intelligence in medicine: the challenges ahead.

Science.gov (United States)

Coiera, E W

1996-01-01

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

Mathematical Model Analysis of Heart-Arterial Interaction in Hypertension

Science.gov (United States)

2001-10-25

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

Stirling/hydraulic artificial heart power source

International Nuclear Information System (INIS)

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

1977-01-01

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

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

Science.gov (United States)

2014-01-01

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

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

Science.gov (United States)

Hedayat, Mohammadali; Asgharzadeh, Hafez; Borazjani, Iman

2015-11-01

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

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

Science.gov (United States)

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

2017-08-01

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

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

Science.gov (United States)

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

2009-02-01

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

Prolongation of rat heart allografts by donor-specific blood transfusion treated with ultraviolet irradiation

International Nuclear Information System (INIS)

Oluwole, S.F.; Iga, C.; Lau, H.; Hardy, M.A.

1985-01-01

The effect of donor-specific blood transfusion was compared to that of UVB-irradiated donor-specific blood transfusion on heart allograft survival in inbred rats with major histocompatibility differences. In one series ACI rats received heterotopic heart grafts from Lewis rats and 1 mL transfusion of donor-type blood at 1, 2, and 3 weeks prior to the transplantation. Fifty percent of the grafts were permanently accepted (survival greater than 200 days). Following UVB-irradiated donor-specific blood transfusion, 55% of the grafts survived indefinitely. In a mixed lymphocyte reaction ACI lymphocytes are weak responders to Lewis lymphocytes. In another series, Lewis rats received ACI hearts. Donor-specific transfusions at 1, 2, and 3 weeks prior to transplantation did not significantly alter the survival of heart allografts. Lewis lymphocytes react strongly to ACI stimulator cells in a mixed lymphocyte reaction. However, when the donor blood was UVB-irradiated prior to transfusion, the ACI allograft survival was significantly prolonged in this ACI-to-Lewis strain combination. When Lewis rats received W/F hearts following either donor-specific or UVB-irradiated donor-specific transfusions, the hearts' survival was similarly and significantly prolonged, but did not become permanent. Mixed lymphocyte reaction reveals that the stimulation index of Lewis lymphocytes against W/F lymphocytes is greater than that of ACI versus Lewis, but is less than that between Lewis responder cells against ACI stimulators

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

Science.gov (United States)

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

2017-11-01

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

The permanent process

DEFF Research Database (Denmark)

Møller, Jesper; McCullagh, Peter

We extend the boson process first to a large class of Cox processes and second an even larger class of infinitely divisible point processes. Density and moment results are studied in detail. These results are obtained in closed form as weighted permanents, so the extension is called a permanent...... process. Temporal extensions and a particularly tractable case of the permanent process are also studied. Extensions of the ferminon process along similar lines, leading to so-called determinant processes, are discussed at the end. While the permanent process is attractive, the determinant process...

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

International Nuclear Information System (INIS)

Jung, Young mee; Kim, Soo Hyun

2010-01-01

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

Surgical approach to end-stage heart failure.

Science.gov (United States)

Klotz, Stefan; Scheld, Hans H

2011-02-01

End-stage heart failure is a challenging disease with growing incidence. With decreasing heart transplant rates worldwide organ preserving therapies become, again, of interest. The purpose of the present review is to examine the potential challenges of surgical therapies in patients with end-stage heart failure. The gold-standard for end-stage heart failure is and will be cardiac transplantation. However, due to organ shortage this therapy is limited to a few patients. Therefore implantation of ventricular assist devices (VADs) or long-term minimal-invasive partial support devices will increase. Improvements in device design with smaller devices, easier implantation techniques, and modified anticoagulation outcome and long-term success will likely improve. In addition, good quality of life as destination therapy is almost available. Organ conservation surgery (coronary artery bypass grafting and surgical ventricular restoration or surgical repair of mitral valve regurgitation) in end-stage heart failure patients could not prove the expected results. Transcatheter or minimal-invasive approaches of these therapies might become routine in the near future. Due to the overwhelming outcome rates, cardiac transplantation is the most established surgical therapy for end-stage heart failure. VAD therapy is increasing and minimized VADs might further open the market for destination therapy/permanent support.

The Question of Decalage Between Object Permanence and Person Permanence

Science.gov (United States)

And Others; Jackson, Elaine

1978-01-01

Presents a study of decalage between object permanence and person permanence. Decalage was influenced by environmental as well as stimulus factors with infants tested between 6- and 81/4-months/of-age. (BD)

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

International Nuclear Information System (INIS)

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

1975-01-01

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

Essure Permanent Birth Control

Science.gov (United States)

... Prosthetics Essure Permanent Birth Control Essure Permanent Birth Control Share Tweet Linkedin Pin it More sharing options ... Print Essure is a a permanently implanted birth control device for women (female sterilization). Implantation of Essure ...

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

Science.gov (United States)

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

2017-03-01

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

Thermally induced magnetic relaxation in square artificial spin ice

Science.gov (United States)

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

2016-11-01

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

Permanences GAG-EPA

CERN Document Server

GAC-EPA

2015-01-01

Le GAC organise chaque mois des permanences avec entretiens individuels. La prochaine permanence se tiendra le : Mardi 5 mai de 13 h 30 à 16 h 00 Salle de réunion de l’Association du personnel Les permanences suivantes auront lieu les mardis 2 juin, 1er septembre, 6 octobre, 3 novembre et 1er décembre 2015. Les permanences du Groupement des Anciens sont ouvertes aux bénéficiaires de la Caisse de pensions (y compris les conjoints survivants) et à tous ceux qui approchent de la retraite. Nous invitons vivement ces derniers à s’associer à notre groupement en se procurant, auprès de l’Association du personnel, les documents nécessaires.

CLINICAL AND ANGIOGRAPHIC PROFILE OF PATIENTS WITH COMPLETE HEART BLOCK

Directory of Open Access Journals (Sweden)

Kavya Pingali

2017-05-01

Full Text Available BACKGROUND The angiographic findings and prognosis of patients with Complete Heart Block (CHB remain unclear. Thus, we aimed to study the clinical profile, risk factors, angiographic distribution and in-hospital outcomes of patients with complete heart block. MATERIALS AND METHODS This was a prospective, single-centred study which included 100 patients who came to the emergency department with CHB. Routine blood investigations including serum electrolytes were done. Coronary angiogram was done and lesions were assessed. Temporary pacemaker was implanted followed by permanent pacemakers in required patients, and in-hospital complications were noted down. RESULTS Commonest age group was above 60 years (75%. The patients were predominantly males. Most common presentation was chest pain (60%; there was regional wall motion abnormality in 30% patients. Degenerative complete heart block was seen in 34% patients, diphtheric myocarditis in 15%, hypokalaemic in 15%, dilated cardiomyopathy in 2%. Of total 53 patients had AV block, 14 had bifascicular block, 23 had LBBB, 6 had RBBB, 3 had Mobitz I and 1 had Mobitz II. Inferior wall myocardial infarction (MI was pervasively present in patients. Temporary pacemakers were implanted in 6 patients and permanent pacemakers in 43 patients. In-hospital outcomes constituted of complication like cardiogenic shock (10% and death (26%. The patients who died either had 80% -90% stenosis in RCA, triple vessel disease, ostioproximal LAD occlusion or diphtheric myocarditis. CONCLUSION Complete heart block was majorly associated with advanced age and inferior wall MI, virtually caused by dominant RCA occlusion. The in-hospital mortality was significantly higher in the patients with CHB.

Acupuncture in patients with valvular heart disease and prosthetic valves.

Science.gov (United States)

Stellon, Anthony

2003-09-01

Endocarditis has been reported in patients with valvular heart disease who have undergone acupuncture treatment, although most have been associated with the use of semi-permanent needles. This has led reviewers to suggest that acupuncture may not only be contraindicated in such patients but that prophylactic antibiotics should be given. This study investigated the use of acupuncture treatment in patients with proven valvular heart disease and observed whether endocarditis developed in such patients. All patients in a single-handed GP practice with proven valvular heart disease, including those with prosthetic valves, were identified over a ten-year period. Those who had undergone acupuncture treatment underwent a clinical examination and diagnostic tests, which focused on the signs, symptoms and laboratory criteria for the diagnosis of endocarditis and included a transthoracic echocardiogram. Autopsy findings were reviewed in any patient who died. Based on these clinical and laboratory data, using the modified Duke's criteria for the diagnosis of endocarditis, patients were identified as having definite or possible endocarditis, or the diagnosis was rejected. All patients underwent brief acupuncture with no skin disinfectant and no prophylactic antibiotics were given. Semi-permanent needles were avoided. Thirty-six patients with valvular heart disease underwent a total of 479 acupuncture treatments over a ten-year period. The median number of treatments was 9 (range 1-72), with a follow-up after treatment of 5.75 years (range 0.5-10 years). Definite endocarditis was not found in any patient, but two patients had possible endocarditis, eventually discounted by both negative blood cultures and echocardiography. In conclusion, brief acupuncture was safe in this small cohort of valvular heart disease patients and no case of endocarditis was detected over a ten-year period.

Simulation of blood flow through an artificial heart

Science.gov (United States)

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

1991-01-01

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

Integra artificial skin dermal regeneration templates in burn scar surgery

International Nuclear Information System (INIS)

Rexon Ngim

1999-01-01

Integra artificial skin is a porous matrix used as a permanent dermal replacement. Developed in the 1970's, it has been used successfully in the treatment of acute bums requiring full or deep partial thickness skin replacement. Three patients with burn scars received Integra Artificial Skin to resurface various areas of burn scars and also contractures. The first was a 24-year-old woman who had two pieces of Integra to resurface a forearm/elbow/wrist defect. The second was a 28-year-old woman who had two pieces of Integra to resurface a neck contracture. The third was a 44 year-old woman who had two pieces to correct severe burn contractures/ scars of her hands. The results of these three patients, probably the first time Integra was used for bum scar and contracture revision, indicate that there is a place for Integra in Burn Scar surgery. However, the basic principle of its application must be adhered to. These include excision to remove the complete scar, recreation of original size of skin defect and meticulous application of the Artificial Skin and its care post-operatively. Details of its application will be highlighted

3-D analysis of eddy current in permanent magnet of interior permanent magnet motors

International Nuclear Information System (INIS)

Kawase, Yoshihiro; Yamaguchi, Tadashi; Fukanaga, Hiromu; Ito, Shokichi

2002-01-01

Interior permanent magnet motors are widely used in various fields. However, in high-speed operations, it is important to decrease the eddy current loss in the permanent magnet. In order to decrease the eddy current loss, we propose to divide the permanent magnet. In this paper, we clarified the effect of division of permanent magnet on the eddy current loss using the 3-D finite element method. (Author)

Comparison of torque capability of three-phase permanent magnet synchronous motors with different permanent magnet arrangement

International Nuclear Information System (INIS)

Stumberger, Bojan; Stumberger, Gorazd; Hadziselimovic, Miralem; Hamler, Anton; Gorican, Viktor; Jesenik, Marko; Trlep, Mladen

2007-01-01

The paper presents a comparison of torque capability of three-phase permanent magnet synchronous motors with different permanent magnet arrangement. Motors with the following permanent magnet topologies were accounted for in the comparison: the surface-mounted permanent magnet synchronous motor (SMPMSM), the interior permanent magnet synchronous motor (IPMSM), the permanent magnet-assisted synchronous reluctance motor (PMASRM) and the flux reversal permanent magnet motor (FRPMM). Finite element method analysis is employed to determine the performance of each motor. Calculated performance of four-pole IPMSM determined by finite element method calculation is confirmed with the measurements at nearly constant nominal output power in the range of speed 3000-10,000 rpm

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

Science.gov (United States)

Tsujimura, Shinichi; Yamagishi, Hiroto; Sankai, Yoshiyuki

2009-01-01

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

Natural and artificial intelligence misconceptions about brains and neural networks

CERN Document Server

de Callataÿ, A

1992-01-01

How does the mind work? How is data stored in the brain? How does the mental world connect with the physical world? The hybrid system developed in this book shows a radically new view on the brain. Briefly, in this model memory remains permanent by changing the homeostasis rebuilding the neuronal organelles. These transformations are approximately abstracted as all-or-none operations. Thus the computer-like neural systems become plausible biological models. This illustrated book shows how artificial animals with such brains learn invariant methods of behavior control from their repeated action

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

Science.gov (United States)

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

2010-09-01

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

Permanent quadrupole magnets

International Nuclear Information System (INIS)

Bush, E.D. Jr.

1976-01-01

A family of quadrupole magnets using a soft iron return yoke and circular cross-section permanent magnet poles were fabricated to investigate the feasibility for use in ion or electron beam focusing applications in accelerators and transport lines. Magnetic field measurements yielded promising results. In fixed-field applications, permanent magnets with sufficient gradients would be a low cost substitute for conventional electromagnets, eliminating the need for power supplies, associated wiring, and cooling. Based on preliminary tests, it was seen that permanent quadrupole magnets can offer a low cost, reliable solution in applications requiring small, fixed-field focusing devices for use in ion or electron-beam transport systems. Permanent magnets do require special considerations in design, fabrication, handling, and service that are different than encountered in conventional quadrupole magnets. If these basic conditions are satisfied, the resulting beam-focusing device would be stable, maintenance free, with virtually an indefinite lifetime

Fuzzy Expert System for Heart Attack Diagnosis

Science.gov (United States)

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

2017-08-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1975-01-01

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

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

NARCIS (Netherlands)

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

2009-01-01

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

Implant experience with an implantable hemodynamic monitor for the management of symptomatic heart failure.

Science.gov (United States)

Steinhaus, David; Reynolds, Dwight W; Gadler, Fredrik; Kay, G Neal; Hess, Mike F; Bennett, Tom

2005-08-01

Management of congestive heart failure is a serious public health problem. The use of implantable hemodynamic monitors (IHMs) may assist in this management by providing continuous ambulatory filling pressure status for optimal volume management. The Chronicle system includes an implanted monitor, a pressure sensor lead with passive fixation, an external pressure reference (EPR), and data retrieval and viewing components. The tip of the lead is placed near the right ventricular outflow tract to minimize risk of sensor tissue encapsulation. Implant technique and lead placement is similar to that of a permanent pacemaker. After the system had been successfully implanted in 148 patients, the type and frequency of implant-related adverse events were similar to a single-chamber pacemaker implant. R-wave amplitude was 15.2 +/- 6.7 mV and the pressure waveform signal was acceptable in all but two patients in whom presence of artifacts required lead repositioning. Implant procedure time was not influenced by experience, remaining constant throughout the study. Based on this evaluation, permanent placement of an IHM in symptomatic heart failure patients is technically feasible. Further investigation is warranted to evaluate the use of the continuous hemodynamic data in management of heart failure patients.

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

Energy Technology Data Exchange (ETDEWEB)

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

1971-07-01

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

Change of Exhaled Acetone Concentration in a Diabetic Patient with Acute Decompensated Heart Failure.

Science.gov (United States)

Yokokawa, Tetsuro; Ichijo, Yasuhiro; Houtsuki, Yu; Matsumoto, Yoshiyuki; Oikawa, Masayoshi; Yoshihisa, Akiomi; Sugimoto, Koichi; Nakazato, Kazuhiko; Suzuki, Hitoshi; Saitoh, Shu-Ichi; Shimouchi, Akito; Takeishi, Yasuchika

2017-10-21

In heart failure patients, exhaled acetone concentration, a noninvasive biomarker, is increased according to heart failure severity. Moreover, exhaled acetone concentration is also known to be affected by diabetes mellitus. However, there have been no reports on exhaled acetone concentration in heart failure patients with diabetes mellitus. A 77-year old man was admitted to our hospital with acute decompensated heart failure and atrioventricular block. He had controlled diabetes mellitus under insulin treatment with hemoglobin A1c of 6.5%. He underwent treatment of diuretics and permanent pacemaker implantation. His condition improved and he was discharged at Day 12. Due to the heart failure improvement, his levels of exhaled acetone concentration decreased from 1.623 ppm at admission to 0.664 ppm at discharge. This is the first report to reveal a change of exhaled acetone concentration in a diabetic patient with acute decompensated heart failure.

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

Directory of Open Access Journals (Sweden)

Miho Igarashi

2015-02-01

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

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

Directory of Open Access Journals (Sweden)

Arabia Francisco A

2010-05-01

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

Artificial Consciousness or Artificial Intelligence

OpenAIRE

Spanache Florin

2017-01-01

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

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

Science.gov (United States)

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

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

Permanent magnets including undulators and wigglers

CERN Document Server

Bahrdt, J

2010-01-01

After a few historic remarks on magnetic materials we introduce the basic definitions related to permanent magnets. The magnetic properties of the most common materials are reviewed and the production processes are described. Measurement techniques for the characterization of macroscopic and microscopic properties of permanent magnets are presented. Field simulation techniques for permanent magnet devices are discussed. Today, permanent magnets are used in many fields. This article concentrates on the applications of permanent magnets in accelerators starting from dipoles and quadrupoles on to wigglers and undulators.

Artificial heartbeat: design and fabrication of a biologically inspired pump

International Nuclear Information System (INIS)

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

2013-01-01

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

Marxism as permanent revolution

NARCIS (Netherlands)

van Ree, E.

2013-01-01

This article argues that the 'permanent revolution' represented the dominant element in Karl Marx and Friedrich Engels' political discourse, and that it tended to overrule considerations encapsulated in 'historical materialism'. In Marx and Engels's understanding, permanent revolution did not

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

Science.gov (United States)

Frazier, O H

2003-02-01

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

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

International Nuclear Information System (INIS)

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

1982-01-01

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

Hyperthyroidism: Presenting as Isolated Tricuspid Regurgitation and Right Heart Failure

OpenAIRE

Whitner, Tanya E.; Hudson, Christopher J.; Smith, Timothy D.; Littmann, Laszlo

2005-01-01

Although hyperthyroidism has many signs and symptoms, right heart failure can occasionally be the main presenting symptom. We describe the case of a previously healthy 42-year-old woman whose chief complaint was progressive bilateral lower extremity edema. The echocardiogram revealed right atrial dilatation and moderate-to-severe tricuspid regurgitation. Results of laboratory studies were consistent with hyperthyroidism. Thyroid ablation resulted in permanent resolution of symptoms and resolu...

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

Science.gov (United States)

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

2015-06-01

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

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

Science.gov (United States)

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

1994-01-01

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

Natural - synthetic - artificial!

DEFF Research Database (Denmark)

Nielsen, Peter E

2010-01-01

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

Gyro-effect stabilizes unstable permanent maglev centrifugal pump.

Science.gov (United States)

Qian, Kun-Xi

2007-03-01

According to Earnshaw's Theorem (1839), the passive maglev cannot achieve stable equilibrium and thus an extra coil is needed to make the rotor electrically levitated in a heart pump. The author had developed a permanent maglev centrifugal pump utilizing only passive magnetic bearings, to keep the advantages but to avoid the disadvantages of the electric maglev pumps. The equilibrium stability was achieved by use of so-called "gyro-effect": a rotating body with certain high speed can maintain its rotation stably. This pump consisted of a rotor (driven magnets and an impeller), and a stator with motor coil and pump housing. Two passive magnetic bearings between rotor and stator were devised to counteract the attractive force between the motor coil iron core and the rotor driven magnets. Bench testing with saline demonstrated a levitated rotor under preconditions of higher than 3,250 rpm rotation and more than 1 l/min pumping flow. Rotor levitation was demonstrated by 4 Hall sensors on the stator, with evidence of reduced maximal eccentric distance from 0.15 mm to 0.07 mm. The maximal rotor vibration amplitude was 0.06 mm in a gap of 0.15 mm between rotor and stator. It concluded that Gyro-effect can help passive maglev bearings to achieve stabilization of permanent maglev pump; and that high flow rate indicates good hydraulic property of the pump, which helps also the stability of passive maglev pump.

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

CERN Document Server

2013-01-01

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

Effects of Cement, Abutment Surface Pretreatment, and Artificial Aging on the Force Required to Detach Cantilever Fixed Dental Prostheses from Dental Implants.

Science.gov (United States)

Kappel, Stefanie; Chepura, Taras; Schmitter, Marc; Rammelsberg, Peter; Rues, Stefan

To examine the in vitro effects of different cements, abutment surface preconditioning, and artificial aging on the maximum tensile force needed to detach cantilever fixed dental prostheses (FDPs) from dental implants with titanium abutments. A total of 32 tissue-level implants were combined with standardized titanium abutments. For each test group, eight cantilever FDPs were fabricated using selective laser melting (cobalt-chromium [CoCr] alloy). The inner surfaces of the cantilever FDPs and half of the abutments were sandblasted and then joined by use of four different cements (two permanent and two semi-permanent) in two different amounts per cement. Subgroups were tested after either artificial aging (thermocycling and chewing simulation) or 3 days of water storage. Finally, axial pull off-tests were performed for each abutment separately. Cement type and surface pretreatment significantly affected decementation behavior. The highest retention forces (approximately 1,200 N) were associated with sandblasted abutments and permanent cements. With unconditioned abutments, temporary cements (Fu cement (Fu ≈ 100 N), resulted in rather low retention forces. Zinc phosphate cement guaranteed high retention forces. After aging, retention was sufficient only for cementation with zinc phosphate cement and for the combination of sandblasted abutments and glass-ionomer cement. When glass-ionomer cement is used to fix cantilever FDPs on implants, sandblasting of standard titanium abutments may help prevent loss of retention. Retention forces were still high for FDPs fixed with zinc phosphate cement, even when the abutments were not pretreated. Use of permanent cements only, however, is recommended to prevent unwanted loosening of cantilever FDPs.

Establishing a long-term permanent plot in remnant forest of Cibodas Botanic Garden, West Java

Directory of Open Access Journals (Sweden)

ZAENAL MUTAQIEN

2011-10-01

Full Text Available Mutaqien Z, Zuhri M (2011 Establishing a long-term permanent plot in remnant forest of Cibodas Botanic Garden, West Java. Biodiversitas 12: 218-224. Cibodas Botanic Garden (CBG has unique characters; almost 10% of which is forested area adjacent to the natural forest of Mt. Gede Pangrango National Park. The area is a transition between natural forest and artificial habitat which mostly consists of exotic plant species. The permanent plot in CBG was established in 2007-2009. Two hundred and eighty four units of 10x10 square meters sub-plot were established in four locations, i.e. Wornojiwo, Kompos, Jalan Akar, and Lumut forest. Vegetation analyses were conducted for trees, saplings, shrubs, and herb species. The inventory found 137 species plants consisting of 74 tree species dominated by Villebrunea rubescens (Bl. Bl. and Ostodes paniculata Bl., 30 shrub species dominated by Strobilanthes hamiltoniana (Steud., 24 herb species dominated by Cyrtandra picta Bl., 6 fern species mainly consisted of Diplazium pallidum Moore, and 3 climber species dominated by Calamus reinwardtii Mart. In comparison with the natural forest of Mt. Gede Pangrango National Park, the CBG permanent plot showed a good representative of the vegetation of lower montane forest. A regular monitoring during the successive years is needed to maintain diversity, monitor forest dynamics and anticipate the spread of invasive plant from CBG.

Application of textured YBCO bulks with artificial holes for superconducting magnetic bearing

International Nuclear Information System (INIS)

Dias, D H N; Sotelo, G G; Moysés, L A; Telles, L G T; Bernstein, P; Aburas, M; Noudem, J G; Kenfaui, D; Chaud, X

2015-01-01

The levitation force between a superconductor and a permanent magnet has been investigated for the development of superconducting magnetic bearings (SMBs). Depending on the proposed application, the SMBs can be arranged with two kinds of symmetries: rotational or linear. The SMBs present passive operation, low level of noise and no friction, but they need a cooling system for their operation. Nowadays the cooling problem may be easily solved by the use of a commercial cryocooler. The levitation force of SMBs is directly related to the quality of the superconductor material (which depends on its critical current density) and the permanent magnet arrangement. Also, research about the YBa 2 Cu 3 O x (Y123) bulk materials has shown that artificial holes enhance the superconducting properties, in particular the magnetic trapped field. In this context, this work proposes the investigation of the levitation force of a bulk Y123 sample with multiple holes and the comparison of its performances with those of conventional plain Y123 superconductors. (paper)

Permanent quadrupole magnets

International Nuclear Information System (INIS)

Bush, E.D. Jr.

1976-01-01

A family of quadrupole magnets using a soft iron return yoke and circular cross-section permanent magnet poles were fabricated to investigate the feasibility for use in ion or electron beam focusing applications in accelerators and transport lines. Magnetic field measurements yielded promising results. In fixed-field applications, permanent magnets with sufficient gradients would be a low cost substitute for conventional electromagnets, eliminating the need for power supplies, associated wiring, and cooling. (author)

Bidirectional Cardio-Respiratory Interactions in Heart Failure

Directory of Open Access Journals (Sweden)

Nikola N. Radovanović

2018-03-01

Full Text Available We investigated cardio-respiratory coupling in patients with heart failure by quantification of bidirectional interactions between cardiac (RR intervals and respiratory signals with complementary measures of time series analysis. Heart failure patients were divided into three groups of twenty, age and gender matched, subjects: with sinus rhythm (HF-Sin, with sinus rhythm and ventricular extrasystoles (HF-VES, and with permanent atrial fibrillation (HF-AF. We included patients with indication for implantation of implantable cardioverter defibrillator or cardiac resynchronization therapy device. ECG and respiratory signals were simultaneously acquired during 20 min in supine position at spontaneous breathing frequency in 20 healthy control subjects and in patients before device implantation. We used coherence, Granger causality and cross-sample entropy analysis as complementary measures of bidirectional interactions between RR intervals and respiratory rhythm. In heart failure patients with arrhythmias (HF-VES and HF-AF there is no coherence between signals (p < 0.01, while in HF-Sin it is reduced (p < 0.05, compared with control subjects. In all heart failure groups causality between signals is diminished, but with significantly stronger causality of RR signal in respiratory signal in HF-VES. Cross-sample entropy analysis revealed the strongest synchrony between respiratory and RR signal in HF-VES group. Beside respiratory sinus arrhythmia there is another type of cardio-respiratory interaction based on the synchrony between cardiac and respiratory rhythm. Both of them are altered in heart failure patients. Respiratory sinus arrhythmia is reduced in HF-Sin patients and vanished in heart failure patients with arrhythmias. Contrary, in HF-Sin and HF-VES groups, synchrony increased, probably as consequence of some dominant neural compensatory mechanisms. The coupling of cardiac and respiratory rhythm in heart failure patients varies depending on the

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

Science.gov (United States)

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

2015-01-01

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

Type of Atrial Fibrillation and Outcomes in Patients With Heart Failure and Reduced Ejection Fraction

DEFF Research Database (Denmark)

Mogensen, Ulrik M.; Jhund, Pardeep S.; Abraham, William T.

2017-01-01

Background Atrial fibrillation (AF) is common in heart failure (HF), but the outcome by type of AF is largely unknown. Objectives This study investigated outcomes related to type of AF (paroxysmal, persistent or permanent, or new onset) in 2 recent large trials in patients with HF with reduced...... risks in patients with persistent or permanent AF were not elevated. Neither type of AF was associated with higher mortality. New onset AF was associated with the greatest risk of adverse outcomes: primary endpoint (HR: 2.21; 95% CI: 1.80 to 2.71), HF hospitalization (HR: 2.11; 95% CI: 1.58 to 2.......81), stroke (HR: 2.20; 95% CI: 1.25 to 3.88), and all-cause mortality (HR: 2.26; 95% CI: 1.86 to 2.74), all p values permanent AF (71...

Bidirectional Cardio-Respiratory Interactions in Heart Failure.

Science.gov (United States)

Radovanović, Nikola N; Pavlović, Siniša U; Milašinović, Goran; Kirćanski, Bratislav; Platiša, Mirjana M

2018-01-01

We investigated cardio-respiratory coupling in patients with heart failure by quantification of bidirectional interactions between cardiac (RR intervals) and respiratory signals with complementary measures of time series analysis. Heart failure patients were divided into three groups of twenty, age and gender matched, subjects: with sinus rhythm (HF-Sin), with sinus rhythm and ventricular extrasystoles (HF-VES), and with permanent atrial fibrillation (HF-AF). We included patients with indication for implantation of implantable cardioverter defibrillator or cardiac resynchronization therapy device. ECG and respiratory signals were simultaneously acquired during 20 min in supine position at spontaneous breathing frequency in 20 healthy control subjects and in patients before device implantation. We used coherence, Granger causality and cross-sample entropy analysis as complementary measures of bidirectional interactions between RR intervals and respiratory rhythm. In heart failure patients with arrhythmias (HF-VES and HF-AF) there is no coherence between signals ( p respiratory signal in HF-VES. Cross-sample entropy analysis revealed the strongest synchrony between respiratory and RR signal in HF-VES group. Beside respiratory sinus arrhythmia there is another type of cardio-respiratory interaction based on the synchrony between cardiac and respiratory rhythm. Both of them are altered in heart failure patients. Respiratory sinus arrhythmia is reduced in HF-Sin patients and vanished in heart failure patients with arrhythmias. Contrary, in HF-Sin and HF-VES groups, synchrony increased, probably as consequence of some dominant neural compensatory mechanisms. The coupling of cardiac and respiratory rhythm in heart failure patients varies depending on the presence of atrial/ventricular arrhythmias and it could be revealed by complementary methods of time series analysis.

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

Science.gov (United States)

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

2017-10-01

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

Development of a Simple Structured Artificial Muscle Using SMA Wire

International Nuclear Information System (INIS)

Ibuki, Ryuta; Maruyama, Shigenao; Komiya, Atsuki

2006-01-01

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

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

International Nuclear Information System (INIS)

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

2003-01-01

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

31 CFR 515.335 - Permanent resident alien.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Permanent resident alien. 515.335... Definitions § 515.335 Permanent resident alien. As used in § 515.208, the term permanent resident alien means an alien lawfully admitted for permanent residence into the United States. [61 FR 37386, July 18...

Lawful Permanent Residents - Annual Report

Data.gov (United States)

Department of Homeland Security — A lawful permanent resident (LPR) or 'green card' recipient is defined by immigration law as a person who has been granted lawful permanent residence in the United...

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

Directory of Open Access Journals (Sweden)

Karla Rocha Pithon

2015-02-01

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

21 CFR 886.4445 - Permanent magnet.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Permanent magnet. 886.4445 Section 886.4445 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4445 Permanent magnet. (a) Identification. A permanent magnet is a nonelectric device that generates a magnetic field intended to find and remove metallic...

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

International Nuclear Information System (INIS)

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

1991-01-01

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

Artificial intelligence

CERN Document Server

Hunt, Earl B

1975-01-01

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

[Permanent education in health: a review].

Science.gov (United States)

Miccas, Fernanda Luppino; Batista, Sylvia Helena Souza da Silva

2014-02-01

To undertake a meta-synthesis of the literature on the main concepts and practices related to permanent education in health. A bibliographical search was conducted for original articles in the PubMed, Web of Science, LILACS, IBECS and SciELO databases, using the following search terms: "public health professional education", "permanent education", "continuing education", "permanent education health". Of the 590 articles identified, after applying inclusion and exclusion criteria, 48 were selected for further analysis, grouped according to the criteria of key elements, and then underwent meta-synthesis. The 48 original publications were classified according to four thematic units of key elements: 1) concepts, 2) strategies and difficulties, 3) public policies and 4) educational institutions. Three main conceptions of permanent education in health were found: problem-focused and team work, directly related to continuing education and education that takes place throughout life. The main strategies for executing permanent education in health are discussion, maintaining an open space for permanent education , and permanent education clusters. The most limiting factor is mainly related to directly or indirect management. Another highlight is the requirement for implementation and maintenance of public policies, and the availability of financial and human resources. The educational institutions need to combine education and service aiming to form critical-reflexive graduates. The coordination between health and education is based as much on the actions of health services as on management and educational institutions. Thus, it becomes a challenge to implement the teaching-learning processes that are supported by critical-reflexive actions. It is necessary to carry out proposals for permanent education in health involving the participation of health professionals, teachers and educational institutions. To undertake a meta-synthesis of the literature on the main concepts and

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

Science.gov (United States)

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

2010-01-01

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

Artificial Consciousness or Artificial Intelligence

Directory of Open Access Journals (Sweden)

Spanache Florin

2017-05-01

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

High speed subfractional HP-motor with permanent magnets

International Nuclear Information System (INIS)

Hanitsch, R.; Frenzel, B.

1998-01-01

During the last years an increasing demand for small permanent magnet motors can be detected, especially in the fields of medical applications. For heart assist devices there is the request to have small high speed devices operating at low voltage supply with almost no overtemperature. The design of a special hollow shaft motor for the speed range of 15000..25000 rpm and a torque of 4 to 8 mNm will be outlined. The low noise requirements and the high efficiency request lead to a design with an airgap winding. A thermal analysis is also done in order to meet the conditions given by the medical specialists. The features of the prototype will be presented and also the sensorless control strategy will be outlined. Measured and calculated data show good agreement. Focus will be on the magnetic circuit and the thermal behaviour and not on the control aspects of the motor. Specific parameters demonstrate the good quality of the drive system. (orig.)

Periodic permanent magnet focused klystron

Science.gov (United States)

Ferguson, Patrick; Read, Michael; Ives, R Lawrence

2015-04-21

A periodic permanent magnet (PPM) klystron has beam transport structures and RF cavity structures, each of which has permanent magnets placed substantially equidistant from a beam tunnel formed about the central axis, and which are also outside the extent of a cooling chamber. The RF cavity sections also have permanent magnets which are placed substantially equidistant from the beam tunnel, but which include an RF cavity coupling to the beam tunnel for enhancement of RF carried by an electron beam in the beam tunnel.

Evaluation of spontaneous space closure and development of permanent dentition after extraction of hypomineralized permanent first molars.

Science.gov (United States)

Jälevik, Birgitta; Möller, Marie

2007-09-01

The aim of this study was to evaluate spontaneous space closure, development of the permanent dentition, and need for orthodontic treatment after extraction of permanent first molars due to severe molar-incisor hypomineralization (MIH). Twenty-seven children aged 5.6-12.7 (median 8.2) years had one to four permanent first molars extracted due to severe MIH. Each case was followed up on individual indications 3.8-8.3 (median 5.7) years after extractions. The eruption of the permanent dentition, and space closure were documented by orthopantomograms, casts, photographs, and/or bitewings. Fifteen children were judged to have a favourable spontaneous development of their permanent dentition without any orthodontic intervention. Seven children were or should be subjected to orthodontic treatment for other reasons registered prior to the extraction. Five children were judged to have a treatment at least caused by the extractions, but three of them abstained because of no subjective treatment need. Extraction of permanent first molars severely affected by MIH is a good treatment alternative. Favourable spontaneous space reduction and development of the permanent dentition positioning can be expected without any intervention in the majority of cases extracted prior to the eruption of the second molar.

Modern permanent magnetic materials - preparation and properties

International Nuclear Information System (INIS)

Rodewald, W.

1989-01-01

First of all, the basic properties of the classical (steel, AlNiCo) permanent magnetic materials and the modern rare-earth (RE) permanent magnetic materials are compared. Since the properties of RE permanent magnets depend on the particular production process, the fundamentals of the main industrial processes (powder metallurgy, rapid-solidification technique) are described and the typical properties are explained. Furthermore the production processes in development such as mechanical alloying, melt spinning technique and extrusion upsetting are briefly outlined. For applying the permanent magnets, they have to be completely magnetized. The magnetization behaviour of the various RE permanent magnets is discussed by means of the internal demagnetization curve. Finally the various influences on the temperature stability of RE permanent magnets are compiled. (orig./MM) [de

Permanent scatterer InSAR processing: Forsmark

International Nuclear Information System (INIS)

Dehls, John F.

2006-04-01

It has been speculated that slow, aseismic movement may be occurring along some of the fracture zones crosscutting the Forsmark area. The purpose of this study is to determine if it is possible to measure such movement using dInSAR. Differential SAR Interferometry (DInSAR) is a technique that compares the phases of multiple radar images of an area to measure surface change. The method has the potential to detect millimetric surface deformation along the sensor - target line-of-sight. Differences in phase between two images are easily viewed by combining, or interfering, the two phase-images. In the resulting image, the waves will either reinforce or cancel one another, depending upon the relative phases. The resulting image is called an interferogram and contains concentric bands of colour, or fringes, that are related to topography and/or surface deformation. New algorithms use many images acquired over a long time period to determine the movement history of individual objects, referred to as permanent scatterers. In the current project, standard PSInSAR processing was performed on 40 ERS-1 and ERS-2 scenes. The total area processed is approximately 1,500 km 2 . Slightly less than 20,000 permanent scatterers were identified.The highest densities were obtained along the coast and on the islands, where natural outcrops are more abundant. Two main classes of objects act as permanent scatterers in this area. The first are natural reflectors, such as rocks. The second are man-made reflectors, such as parts of buildings. Numerous local movements were found in the study area, relating to building subsidence, or compaction of anthropogenic fill. The dataset was divided into three groups for analysis, based upon the location of regional lineaments provided by SKB. Both statistical and geostatistical techniques were used. The median velocity of the three blocks did not differ by more than 0.2 mm/yr. This is not considered significant, given the possible magnitude of errors

Permanent scatterer InSAR processing: Forsmark

Energy Technology Data Exchange (ETDEWEB)

Dehls, John F [Geological Survey of Norway, Trondheim (Norway)

2006-04-15

It has been speculated that slow, aseismic movement may be occurring along some of the fracture zones crosscutting the Forsmark area. The purpose of this study is to determine if it is possible to measure such movement using dInSAR. Differential SAR Interferometry (DInSAR) is a technique that compares the phases of multiple radar images of an area to measure surface change. The method has the potential to detect millimetric surface deformation along the sensor - target line-of-sight. Differences in phase between two images are easily viewed by combining, or interfering, the two phase-images. In the resulting image, the waves will either reinforce or cancel one another, depending upon the relative phases. The resulting image is called an interferogram and contains concentric bands of colour, or fringes, that are related to topography and/or surface deformation. New algorithms use many images acquired over a long time period to determine the movement history of individual objects, referred to as permanent scatterers. In the current project, standard PSInSAR processing was performed on 40 ERS-1 and ERS-2 scenes. The total area processed is approximately 1,500 km{sup 2}. Slightly less than 20,000 permanent scatterers were identified.The highest densities were obtained along the coast and on the islands, where natural outcrops are more abundant. Two main classes of objects act as permanent scatterers in this area. The first are natural reflectors, such as rocks. The second are man-made reflectors, such as parts of buildings. Numerous local movements were found in the study area, relating to building subsidence, or compaction of anthropogenic fill. The dataset was divided into three groups for analysis, based upon the location of regional lineaments provided by SKB. Both statistical and geostatistical techniques were used. The median velocity of the three blocks did not differ by more than 0.2 mm/yr. This is not considered significant, given the possible magnitude of

Lawful Permanent Residents Fiscal Year 2015 State

Data.gov (United States)

Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

Lawful Permanent Residents Fiscal Year 2014 Country

Data.gov (United States)

Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

Lawful Permanent Residents Fiscal Year 2011 State

Data.gov (United States)

Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

Lawful Permanent Residents Fiscal Year 2015 Country

Data.gov (United States)

Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

Lawful Permanent Residents Fiscal Year 2016 State

Data.gov (United States)

Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

Lawful Permanent Residents Fiscal Year 2014 State

Data.gov (United States)

Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

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

Science.gov (United States)

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

2015-09-01

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

Anesthetic management of a 2-day-old with complete congenital heart block

Directory of Open Access Journals (Sweden)

Puneet Khanna

2014-01-01

Full Text Available Maternal connective tissue disorders such as Systemic Lupus Erythematosus (most common, Sjogren′s syndrome, mixed connective tissue disorders may lead to the rare condition of complete congenital heart block in the neonate. Rare fetal syndromes such as myocarditis, 18p syndrome, mucopolysaccharidoses and mitochondrial diseases are other causes. The mortality rate of this condition is inversely propotional to the age of presentation being 6 % in the neonatal age group. As the cardiac output in the neonate is heart rate dependent, it is crucial to maintain the heart rate in these patients. Pharamacological interventions with dopamine, isoprenaline, epinephrine and atropine are known for their variable response. Although permanent pacing is the most reliable mode of management, the access to it is often not readily available, especially in the developing countries. In such cases temporary pacing methods become lifesaving. Of all the modalities of temporary pacing (transcutaneous, transesophageal and transvenous transcutaneous pacing is the most readily available and immediate mode. In this case report we present a two day old neonate with isolated complete congenital heart block and a resting heart rate of 50-55/min in immediate need of palliative surgery for trachea-esophageal fistula (TEF. With pharmacological intervention the heart rate could only be raised to 75-80/min. The surgery was successfully carried out using transcutaneous pacing to maintain a heart rate of 100/min.

Topology optimized permanent magnet systems

DEFF Research Database (Denmark)

Bjørk, Rasmus; Bahl, Christian; Insinga, Andrea Roberto

2017-01-01

Topology optimization of permanent magnet systems consisting of permanent magnets, high permeability iron and air is presented. An implementation of topology optimization for magnetostatics is discussed and three examples are considered. The Halbach cylinder is topology optimized with iron...... and an increase of 15% in magnetic efficiency is shown. A topology optimized structure to concentrate a homogeneous field is shown to increase the magnitude of the field by 111%. Finally, a permanent magnet with alternating high and low field regions is topology optimized and a ΛcoolΛcool figure of merit of 0...

Object permanence in lemurs.

Science.gov (United States)

Deppe, Anja M; Wright, Patricia C; Szelistowski, William A

2009-03-01

Object permanence, the ability to mentally represent objects that have disappeared from view, should be advantageous to animals in their interaction with the natural world. The objective of this study was to examine whether lemurs possess object permanence. Thirteen adult subjects representing four species of diurnal lemur (Eulemur fulvus rufus, Eulemur mongoz, Lemur catta and Hapalemur griseus) were presented with seven standard Piagetian visible and invisible object displacement tests, plus one single visible test where the subject had to wait predetermined times before allowed to search, and two invisible tests where each hiding place was made visually unique. In all visible tests lemurs were able to find an object that had been in clear view before being hidden. However, when lemurs were not allowed to search for up to 25-s, performance declined with increasing time-delay. Subjects did not outperform chance on any invisible displacements regardless of whether hiding places were visually uniform or unique, therefore the upper limit of object permanence observed was Stage 5b. Lemur species in this study eat stationary foods and are not subject to stalking predators, thus Stage 5 object permanence is probably sufficient to solve most problems encountered in the wild.

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

Energy Technology Data Exchange (ETDEWEB)

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

1991-11-01

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

Change of carcinogenic chrysotile fibers in the asbestos cement (eternit) to harmless waste by artificial carbonatization: Petrological and technological results

International Nuclear Information System (INIS)

Radvanec, Martin; Tuček, Ľubomír; Derco, Ján; Čechovská, Katarína; Németh, Zoltán

2013-01-01

Highlights: ► Carcinogenic chrysotile fibers in asbestos cement (eternit) are liquidated. ► Thermally modified eternit grist (at 650 °C, 1 h) reacts with CO 2 + water. ► Carbonates hydromagnesite and magnesite are the newly formed products of artificial carbonatization. ► Neutralizing of extreme pH values (around 12) at large eternit dumps. ► An alternative methodology for permanent liquidation of a part of CO 2 emissions. -- Abstract: Asbestos cement materials, mainly the eternit roof ceiling, being widely applied in the past, represent a serious environmental load. The solar radiation, rain and frost cause the deliberation of cement from the eternit roofing and consequently the wind contaminates the surrounding area by the asbestos (chrysotile) fibers. In combination with other carcinogens (e.g. smoking), or at reduced immunity of a man, they may cause serious respiratory diseases and lung cancer. The article presents the procedure and experimental results of artificial carbonatization, applied in the asbestos cement (eternit). The wet crushed and pulverized asbestos cement was thermally modified at 650 °C and then the chrysotile fibers easily and completely reacted with the mixture of CO 2 and water, producing new Mg-rich carbonates – hydromagnesite and magnesite: 2Mg 3 Si 2 O 5 (OH) 3thermally modified chrysotile +5CO 2 +nH 2 O→Mg 5 (CO 3 ) 4 (OH) 2 ⋅4H 2 O hydromagnesite +MgCO 3magnesite +4SiO 2 · nH 2 O in a morphous phase ;n=3÷9 Applying this methodology, the asbestos-bearing waste can be stabilized and environmentally friendly permanently deposited. Finding a way of neutralizing of extreme pH values (around 12) at large eternit dumps represents also an asset of presented research. Simultaneously, the artificial carbonatization of chrysotile asbestos, applying CO 2 , offers an alternative way for permanent liquidation of a part of industrial CO 2 emissions, contributing to multiple benefit of this methodology

The influx of amino acids into the heart of the rat

International Nuclear Information System (INIS)

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

1978-01-01

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

Marxism as permanent revolution

OpenAIRE

van Ree, E.

2013-01-01

This article argues that the 'permanent revolution' represented the dominant element in Karl Marx and Friedrich Engels' political discourse, and that it tended to overrule considerations encapsulated in 'historical materialism'. In Marx and Engels's understanding, permanent revolution did not represent a historical shortcut under exceptional circumstances, but the course revolutions in the modern era would normally take. Marx and Engels traced back the pattern to the sixteenth century. It is ...

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

Science.gov (United States)

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

2006-01-01

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

Tracing artificial trans fat in popular foods in Europe

DEFF Research Database (Denmark)

Stender, Steen; Astrup, Arne; Dyerberg, Jørn

2014-01-01

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

Canadian Eskimo permanent tooth emergence timing.

Science.gov (United States)

Mayhall, J T; Belier, P L; Mayhall, M F

1978-08-01

To identify the times of emergence of the permanent teeth of Canadian Eskimos (Inuit), 368 children and adolescents were examined. The presence or absence of all permanent teeth except the third molars was recorded and these data subjected to probit analysis. Female emergence times were advanced over males. Generally, the Inuit of both sexes showed statistically significant earlier emergence times than Montreal children, except for the incisors. The present results do not support hypotheses indicating that premature extraction of the deciduous teeth advances the emergence of their succedaneous counterparts. There is some indication the controls of deciduous tooth emergence continue to play some part in emergence of the permanent dentition, especially the first permanent teeth that emerge.

13 CFR 120.900 - Sources of permanent financing.

Science.gov (United States)

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Sources of permanent financing... Development Company Loan Program (504) Permanent Financing § 120.900 Sources of permanent financing. Permanent financing for each Project must come from three sources: the Borrower's contribution, Third-Party Loans, and...

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

International Nuclear Information System (INIS)

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

1989-01-01

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

Association of temporary complete AV block and junctional ectopic tachycardia after surgery for congenital heart disease

International Nuclear Information System (INIS)

Paech, Christian; Dähnert, Ingo; Kostelka, Martin; Mende, Meinhardt; Gebauer, Roman

2015-01-01

Junctional ectopic tachycardia (JET) is a postoperative complication with a mortality rate of up to 14% after surgery for congenital heart disease. This study evaluated the risk factors of JET and explored the association of postoperative temporary third degree atrioventricular (AV) block and the occurrence of JET. Data were collected retrospectively from 1158 patients who underwent surgery for congenital heart disease. The overall incidence of JET was 2.8%. Temporary third degree AV block occurred in 1.6% of cases. Permanent third degree AV block requiring pacemaker implantation occurred in 1% of cases. In all, 56% of patients with JET had temporary AV block (P < 0.001), whereas no case of postoperative JET was reported in patients with permanent AV block (P = 0.56). temporary third degree AV block did not suffer from JET. A correlation between temporary third degree AV block and postoperative JET could be observed. The risk factors identified for JET include younger age groups at the time of surgery, longer aortic cross clamping time and surgical procedures in proximity to the AV node

[The Object Permanence Fallacy.] Commentary.

Science.gov (United States)

Bradley, Ben S.

1996-01-01

Suggests that Greenberg's challenge to the centrality of object permanence in developmental thinking reveals that developmentalists' theories about childhood speak about their own self-images. Notes that developmentalists have been guilty of not only the object permanence fallacy but also the genetic fallacy, or the mistaken belief that describing…

Genes, autoimmunity and pathogenesis of rheumatic heart disease

International Nuclear Information System (INIS)

Guilherme, L; Köhler, K F; Postol, E; Kalil, J

2011-01-01

Pathogenesis of rheumatic heart disease (RHD) remains incompletely understood. Several genes associated with RHD have been described; most of these are involved with immune responses. Single nucleotide polymorphisms in a number of genes affect patients with RHD compared to controls. Molecular mimicry between streptococcal antigens and human proteins, including cardiac myosin epitopes, vimentin and other intracellular proteins is central to the pathogenesis of RHD. Autoreactive T cells migrate from the peripheral blood to the heart and proliferate in the valves in response to stimulation with specific cytokines. The types of cells involved in the inflammation as well as different cytokine profiles in these patients are being investigated. High TNF alpha, interferon gamma, and low IL4 are found in the rheumatic valve suggesting an imbalance between Th1 and Th2 cytokines and probably contributing to the progressive and permanent valve damage. Animal model of ARF in the Lewis rat may further contribute towards understanding the ARF

Topology optimized permanent magnet systems

Science.gov (United States)

Bjørk, R.; Bahl, C. R. H.; Insinga, A. R.

2017-09-01

Topology optimization of permanent magnet systems consisting of permanent magnets, high permeability iron and air is presented. An implementation of topology optimization for magnetostatics is discussed and three examples are considered. The Halbach cylinder is topology optimized with iron and an increase of 15% in magnetic efficiency is shown. A topology optimized structure to concentrate a homogeneous field is shown to increase the magnitude of the field by 111%. Finally, a permanent magnet with alternating high and low field regions is topology optimized and a Λcool figure of merit of 0.472 is reached, which is an increase of 100% compared to a previous optimized design.

Teaching Object Permanence: An Action Research Study

Science.gov (United States)

Bruce, Susan M.; Vargas, Claudia

2013-01-01

"Object permanence," also known as "object concept" in the field of visual impairment, is one of the most important early developmental milestones. The achievement of object permanence is associated with the onset of representational thought and language. Object permanence is important to orientation, including the recognition of landmarks.…

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

Science.gov (United States)

Gojo, Satoshi; Toyoda, Masashi; Umezawa, Akihiro

2011-09-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1976-01-01

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

Intrusive luxation of 60 permanent incisors

DEFF Research Database (Denmark)

Tsilingaridis, Georgios; Malmgren, Barbro; Andreasen, Jens O

2012-01-01

  Intrusive luxation in the permanent dentition is an uncommon injury but it is considered one of the most severe types of dental trauma because of the risk for damage to the periodontal ligament, pulp and alveolar bone. Management of intrusive luxation in the permanent dentition is controversial....... The purpose of this study was to evaluate pulp survival and periodontal healing in intrusive luxated permanent teeth in relation to treatment alternatives, degree of intrusion and root development....

Artificial skin and patient simulator comprising the artificial skin

NARCIS (Netherlands)

2011-01-01

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

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

International Nuclear Information System (INIS)

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

2011-01-01

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

Permanent magnet materials and their application

International Nuclear Information System (INIS)

Campbell, P.

1994-01-01

Permanent magnets are of great industrial importance in industrial drives, consumer products, computers, and automobiles. Since 1970, new classes of magnet materials have been developed. This book reviews the older and newer materials and is presented as a comprehensive design text for permanent magnets and their applications. After an initial chapter on the fundamentals of magnetism, the author discusses magnetic physics considerations specific to permanent magnets and describes the fabrications and characteristics of commercial materials: alnico, samarium-cobalt, ferrite, and neodymium-iron-boron. Thermal stability, magnet design procedures, magnetic field analysis methods, and measurement methods are discussed in subsequent chapters, followed by a concluding chapter reviewing commercial and industrial products that use permanent magnets. The chapter on thermal properties of magnet materials is of particular interest, bringing together information not readily found elsewhere. The review of applications is also deserving of attention, specifically the sections on motors and actuators. Although particle accelerator applications are discussed, the use of permanent magnet sextuples in modern ECR ion sources is not mentioned

Artificial Intelligence.

Science.gov (United States)

Information Technology Quarterly, 1985

1985-01-01

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

Selective Heart, Brain and Body Perfusion in Open Aortic Arch Replacement.

Science.gov (United States)

Maier, Sven; Kari, Fabian; Rylski, Bartosz; Siepe, Matthias; Benk, Christoph; Beyersdorf, Friedhelm

2016-09-01

Open aortic arch replacement is a complex and challenging procedure, especially in post dissection aneurysms and in redo procedures after previous surgery of the ascending aorta or aortic root. We report our experience with the simultaneous selective perfusion of heart, brain, and remaining body to ensure optimal perfusion and to minimize perfusion-related risks during these procedures. We used a specially configured heart-lung machine with a centrifugal pump as arterial pump and an additional roller pump for the selective cerebral perfusion. Initial arterial cannulation is achieved via femoral artery or right axillary artery. After lower body circulatory arrest and selective antegrade cerebral perfusion for the distal arch anastomosis, we started selective lower body perfusion simultaneously to the selective antegrade cerebral perfusion and heart perfusion. Eighteen patients were successfully treated with this perfusion strategy from October 2012 to November 2015. No complications related to the heart-lung machine and the cannulation occurred during the procedures. Mean cardiopulmonary bypass time was 239 ± 33 minutes, the simultaneous selective perfusion of brain, heart, and remaining body lasted 55 ± 23 minutes. One patient suffered temporary neurological deficit that resolved completely during intensive care unit stay. No patient experienced a permanent neurological deficit or end-organ dysfunction. These high-risk procedures require a concept with a special setup of the heart-lung machine. Our perfusion strategy for aortic arch replacement ensures a selective perfusion of heart, brain, and lower body during this complex procedure and we observed excellent outcomes in this small series. This perfusion strategy is also applicable for redo procedures.

Artificial organs: recent progress in artificial hearing and vision.

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Ifukube, Tohru

2009-01-01

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

NHLBI's program for VAD therapy for moderately advanced heart failure: the REVIVE-IT pilot trial.

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Baldwin, J Timothy; Mann, Douglas L

2010-11-01

Ventricular assist devices (VADs) are used to bridge heart failure patients to transplantation, to allow their own hearts to recover, or as permanent ("destination") therapy. To date, the use of VADs has been limited to late-stage heart failure patients because of the associated device risks. In 2008, a National Heart, Lung, and Blood Institute (NHLBI) working group met to evaluate the treatment of heart failure using VADs and to advise the institute on how therapy for heart failure may be best advanced by clinical trials involving the devices. Recognizing the improvements in VAD technology and in patient care and selection over the past decade, the working group recommended that a trial be performed to assess the use of chronic VAD therapy in patients who are less ill than those currently eligible for destination therapy. The hypothesis proposed for the trial is that VAD therapy may improve both survival and quality of life in moderately advanced heart failure patients who are neither inotrope-dependent nor exercise-intolerant and have not yet developed serious consequences such as malnourishment, end-organ damage, and immobility. Based on the group's recommendations, NHLBI issued an RFP in 2009 for the REVIVE-IT Pilot Trail, which will serve to test the hypothesis and inform the pivotal trial. Published by Elsevier Inc.

Predictors and Frequency of Conduction Disturbances After Open-Heart Surgery

Directory of Open Access Journals (Sweden)

Zahra Emkanjoo

2008-02-01

Full Text Available Introduction The risk of developing conduction disturbances after coronary bypass grafting (CABG or valvular surgery has been well established in previous studies, leading to permanent pacemaker implantation in about 2% to 3% of patients, and in 10% of patients undergoing repeat cardiac surgery.We sought to determine the incidence, features and predictors of conduction disorders in the immediate post-operative period of patients subjected to open-heart surgery, and the need for permanent pacemaker implantation.Material and Method We prospectively studied 374 consecutive patients who underwent open-heart surgery in our institution: coronary artery bypass (CABG (n=128, Mitral valve replacement(MVR(n=18, aortic valve replacement(AVR (n=21, MVR and AVR(n=56, repair of ventricular septal defect (VSD (n=51, repair of tetralogy of Fallot (TOF (n=57,CABG and valvular surgery (n=6, others (n=37.Results Among 374 patients included in our study (mean age 34.46±25.68; 146 males, 192 developed new conduction disorders: symptomatic sinus bradycardia in 8%, atrial fibrillation with slow ventricular response (AF in 4.5%, first-degree atrioventricular block (AVBin 6.4%, second-degree AVB in 0.3%, third-degree AVB in 7%, new right bundle branch block (RBBB in 33%, and new left bundle branch block (LBBB in 2.1%. In 5.6% patients, a permanent pacemaker was implanted, 47.6% of them underwent valvular surgery. In 44.1% of patients the conduction defects occurred in the first 48 hr. after surgery. In CABG group, 29.7% of patients developed new conduction disturbances; the most common of them was symptomatic sinus bradycardia. After valvular surgery 44.2% of patients developed conduction disturbances, of those the most common was atrial fibrillation with slow ventricular response . After VSD and TOF repair, the most common conduction disturbance was new RBBB. Perioperative myocardial infarction (MI occurred in 1.9% of patients. The occurrence conduction disturbance

Artificial muscle: facts and fiction.

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Schaub, Marcus C

2011-12-19

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

Hardness of enamel exposed to Coca-Cola and artificial saliva.

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Devlin, H; Bassiouny, M A; Boston, D

2006-01-01

The purpose of this study was to determine the rate of change in indentation hardness of enamel in permanent teeth exposed to Coca-Cola. In a further experiment, the ability of a commercially available artificial saliva to remineralize enamel treated with Coca-Cola was tested. Ten enamel specimens were randomly chosen to be treated with Coca-Cola (experimental groups) and seven with water (control group). The fluids were applied for 1, 2, 3 h and overnight (15 h), washed off with a few drops of water and the moist enamel indentation hardness tested after each interval. With Coca-Cola treatment, the mean enamel hardness was 92.6% (s.d. = 7.9) of the original baseline hardness after 1 h, 93.25% (s.d. = 10.15) after 2 h, 85.7% (s.d. = 12.03) after 3 h and 80.3% after 15 h. The mean indentation hardness of control specimens treated with water was 108.7% (s.d. = 16.09) of the original hardness after 1 h, 99.09% (s.d. = 18.98) after 2 h, 98.97% (s.d. =11.24) after 3 h and 98.42% (s.d. = 22.78) after 15 h. In a separate experiment, the hardness of 9 enamel specimens was tested, as previously described, before and after treatment with Coca-Cola overnight and again after application of artificial saliva for 3 min. Coca-Cola reduced the mean indentation hardness of enamel in the teeth, but the hardness was partially restored with artificial saliva (Salivart) and increased by 18% from the demineralized enamel hardness.

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

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

2017-11-01

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

Cylindrical Hall Thrusters with Permanent Magnets

International Nuclear Information System (INIS)

Raitses, Yevgeny; Merino, Enrique; Fisch, Nathaniel J.

2010-01-01

The use of permanent magnets instead of electromagnet coils for low power Hall thrusters can offer a significant reduction of both the total electric power consumption and the thruster mass. Two permanent magnet versions of the miniaturized cylindrical Hall thruster (CHT) of different overall dimensions were operated in the power range of 50W-300 W. The discharge and plasma plume measurements revealed that the CHT thrusters with permanent magnets and electromagnet coils operate rather differently. In particular, the angular ion current density distribution from the permanent magnet thrusters has an unusual halo shape, with a majority of high energy ions flowing at large angles with respect to the thruster centerline. Differences in the magnetic field topology outside the thruster channel and in the vicinity of the channel exit are likely responsible for the differences in the plume characteristics measured for the CHTs with electromagnets and permanent magnets. It is shown that the presence of the reversing-direction or cusp-type magnetic field configuration inside the thruster channel without a strong axial magnetic field outside the thruster channel does not lead to the halo plasma plume from the CHT.

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

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

2017-03-27

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

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

Directory of Open Access Journals (Sweden)

Xia Ye

2014-05-01

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

Macroscopic simulation of isotropic permanent magnets

International Nuclear Information System (INIS)

Bruckner, Florian; Abert, Claas; Vogler, Christoph; Heinrichs, Frank; Satz, Armin; Ausserlechner, Udo; Binder, Gernot; Koeck, Helmut; Suess, Dieter

2016-01-01

Accurate simulations of isotropic permanent magnets require to take the magnetization process into account and consider the anisotropic, nonlinear, and hysteretic material behaviour near the saturation configuration. An efficient method for the solution of the magnetostatic Maxwell equations including the description of isotropic permanent magnets is presented. The algorithm can easily be implemented on top of existing finite element methods and does not require a full characterization of the hysteresis of the magnetic material. Strayfield measurements of an isotropic permanent magnet and simulation results are in good agreement and highlight the importance of a proper description of the isotropic material. - Highlights: • Simulations of isotropic permanent magnets. • Accurate calculation of remanence magnetization and strayfield. • Comparison with strayfield measurements and anisotropic magnet simulations. • Efficient 3D FEM–BEM coupling for solution of Maxwell equations.

Reactor safety review of permanent changes

International Nuclear Information System (INIS)

Lam, K.F.

1997-01-01

Operational compliance engineers review all changes as part of a change control process. Each change, permanent or temporary, is required to undergo an intricate review process to ensure that the benefits associated with the change outweigh the risk. For permanent changes, it is necessary to ensure that the proposed design meets the nuclear safety requirements, conforms to the licensing requirements and complies with regulatory requirements. In addition, during installation of the permanent change and prior to in-service, a configuration management process is in place to align the change with operating and maintenance documents. (author)

Permanent multipole magnets with adjustable strength

International Nuclear Information System (INIS)

Halbach, K.

1983-01-01

Preceded by a short discussion of the motives for using permanent magnets in accelerators, a new type of permanent magnet for use in accelerators is presented. The basic design and most important properties of a quadrople will be described that uses both steel and permanent magnet material. The field gradient produced by this magnet can be adjusted without changing any other aspect of the field produced by this quadrupole. The generalization of this concept to produce other multipole fields, or combination of multipole fields, will also be presented

Nanocrystalline permanent magnets with enhanced properties

International Nuclear Information System (INIS)

Leonowicz, M.

2002-01-01

Parameters of permanent magnets result from the combination of intrinsic properties such as saturation magnetization, magnetic exchange, and magnetocrystalline energy, as well as microstructural parameters such as phase structure, grain size, and orientation. Reduction of grain size into nanocrystalline regime (∼ 50 nm) leads to the enhanced remanence which derives from ferromagnetic exchange coupling between highly refined grains. In this study the fundamental phenomena, quantities, and structure parameters, which define nanophase permanent magnets are presented and discussed. The theoretical considerations are confronted with experimental data for nanocrystalline Sm-Fe-N type permanent magnets. (author)

Permanent multipole magnets with adjustable strength

International Nuclear Information System (INIS)

Halbach, K.

1983-03-01

Preceded by a short discussion of the motives for using permanent magnets in accelerators, a new type of permanent magnet for use in accelerators is presented. The basic design and most important properties of a quadrupole will be described that uses both steel and permanent magnet material. The field gradient produced by this magnet can be adjusted without changing any other aspect of the field produced by this quadrupole. The generalization of this concept to produce other multipole fields, or combination of multipole fields, will also be presented

Hyperthyroidism presenting as isolated tricuspid regurgitation and right heart failure.

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Whitner, Tanya E; Hudson, Christopher J; Smith, Timothy D; Littmann, Laszlo

2005-01-01

Although hyperthyroidism has many signs and symptoms, right heart failure can occasionally be the main presenting symptom. We describe the case of a previously healthy 42-year-old woman whose chief complaint was progressive bilateral lower extremity edema. The echocardiogram revealed right atrial dilatation and moderate-to-severe tricuspid regurgitation. Results of laboratory studies were consistent with hyperthyroidism. Thyroid ablation resulted in permanent resolution of symptoms and resolution of tricuspid incompetence on echocardiography. In a case of isolated, unexplained tricuspid regurgitation, it is important to consider indolent hyperthyroidism in the differential diagnosis.

Sterilization of the artificial blood circulation apparatus with ozone

Energy Technology Data Exchange (ETDEWEB)

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

1982-01-01

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

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

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

2017-10-01

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

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

Science.gov (United States)

Hafizah Mokhtar, N.; Abas, Aizat

2018-05-01

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

Troponin T elevation after permanent pacemaker implantation.

Science.gov (United States)

Chen, Xueying; Yu, Ziqing; Bai, Jin; Hu, Shulan; Wang, Wei; Qin, Shengmei; Wang, Jingfeng; Sun, Zhe; Su, Yangang; Ge, Junbo

2017-08-01

The objective of the study is to study the incidence, significance, and factors associated with cardiac troponin T (CTNT) elevation after pacemaker implantation. Three hundred seventy-four patients (104 single-chamber pacemakers or ICD, 243 dual-chamber pacemakers, and 27 cardiac resynchronization therapy/cardiac resynchronization therapy defibrillator) who had normal levels of CTNT at baseline and underwent implantation of a permanent pacemaker system were included in this study. Serum levels of CTNT were measured at baseline, 6 and 24 h after the implantation procedure. The median of CTNT levels increased from 0.012 ng/mL at baseline to 0.032 and 0.019 ng/mL at 6 and 24 h after the procedure, respectively (all p 0.09 ng/mL). After 1-year follow-up, the incidence of complications including dislodgement of the lead, pocket infection, pneumothorax, hemothorax, and vein thrombus and cardiac outcomes including hospitalization of heart failure, coronary artery disease, arrhythmia, and cardiovascular mortality was not significantly different between the normal and elevated CTNT groups at 6 h after the procedure. By logistic regression analysis, gender, N-terminal pro-B type natriuretic peptide (NT-pro-BNP) at baseline, left ventricular ejection fractions (LVEF), estimated glomerular filtration rate (eGFR), and fluoroscopy time were independently associated with CTNT elevation after adjusted for age, pacemaker types, right ventricle lead location (RVA or RVOT), heart function, and left ventricular end systolic dimension. Pacemaker implantation was found to be accompanied with CTNT elevation in 55.6% of the patients at 6 h after the procedure, and its kinetics were fast, which might not be related to the complications and adverse cardiac outcomes within 1 year of follow-up. Moreover, gender, NT-pro-BNP at baseline, LVEF, eGFR, and fluoroscopy time were found to be independent predictors of CTNT elevation.

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

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

2012-06-01

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

Introduction to permanent magnets

International Nuclear Information System (INIS)

Zijlstra, H.

1985-01-01

Some general considerations concerning the application of permanent magnets are developed. The relevant magnet properties are discussed, with particular reference to Nd-Fe-B alloy. The author comes to the following conclusions; the air gap field B should be high, for high electrical efficiency; the magnet should face the air gap, for efficient use of the magnet material; the magnet material should therefore have a high remanence; and the new Nd-Fe-B magnet fits in nicely, having (potentially) the highest remanence ever reported in permanent magnets, combined with sufficient coercivity to sustain it

Complete Heart Block in a Patient Taking Trachyspermum ammi and Zingiber officinale

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Hesamoddin Hosseinjani

2018-02-01

Full Text Available Herbal products are one of the most popular medications in the world. Nevertheless, herbal medications are not always safe and several cases of side effects have been reported. A 34 years old man was referred to Tehran heart center (THC for implantation of permanent pacemaker (PPM. Recently, he had experienced several episodes of presyncope and according to the diagnosis of Complete Heart Block (CHB with accelerated junctional rhythm, a temporary pacemaker (TPM was implanted for him in another medical center. He had rheumatoid arthritis, type 2 diabetes mellitus and fatty liver in his past medical history. In his drug history, the patient took only herbal medications for the treatment of his ailments among them daily use of Trachyspermum ammi and Zingiber officinale (ginger products were the main causes of this adverse effect.

Artificial muscle for reanimation of the paralyzed face: durability and biocompatibility in a gerbil model.

Science.gov (United States)

Ledgerwood, Levi G; Tinling, Steven; Senders, Craig; Wong-Foy, Annjoe; Prahlad, Harsha; Tollefson, Travis T

2012-11-01

Current management of permanent facial paralysis centers on nerve grafting and muscle transfer; however, limitations of those procedures call for other options. To determine the durability and biocompatibility of implanted artificial muscle in a gerbil model and the degree of inflammation and fibrosis at the host tissue-artificial muscle interface. Electroactive polymer artificial muscle (EPAM) devices engineered in medical-grade silicone were implanted subcutaneously in 13 gerbils. The implanted units were stimulated with 1 kV at 1 Hz, 24 h/d via a function generator. Electrical signal input/output was recorded up to 40 days after implantation. The animals were euthanized between 23 and 65 days after implantation, and the host tissue-implant interface was evaluated histologically. The animals tolerated implantation of the EPAM devices well, with no perioperative deaths. The muscle devices created motion for a mean of 30.3 days (range, 19-40 days), with a mean of 2.6 × 106 cycles (range, 1.6 × 106 to 3.5 × 106 cycles). Histologic examination of the explanted devices revealed the development of a minimal fibrous capsule surrounding the implants, with no evidence of bacterial infection or inflammatory infiltrate. No evidence of device compromise, corrosion, or silicone breakdown was noted. Artificial muscle implanted in this short-term animal model was safe and functional in this preliminary study. We believe that EPAM devices will be a safe and viable option for restoration of facial motions in patients with irreversible facial paralysis.

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

International Nuclear Information System (INIS)

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

1997-01-01

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

Permanent education

International Nuclear Information System (INIS)

Gardien, S.; Kirsch, R.

1998-01-01

The permanent education of the IPN-Lyon inscribes itself completely in the priorities of the tri-annual plan of education of CNRS. These priorities contribute to evolution of research, evaluation of the professions, integration during the professional carriers of the personnel and form the frame for new management practice implementation

Transient or permanent fisheye views

DEFF Research Database (Denmark)

Jakobsen, Mikkel Rønne; Hornbæk, Kasper

2012-01-01

Transient use of information visualization may support specific tasks without permanently changing the user interface. Transient visualizations provide immediate and transient use of information visualization close to and in the context of the user’s focus of attention. Little is known, however......, about the benefits and limitations of transient visualizations. We describe an experiment that compares the usability of a fisheye view that participants could call up temporarily, a permanent fisheye view, and a linear view: all interfaces gave access to source code in the editor of a widespread...... programming environment. Fourteen participants performed varied tasks involving navigation and understanding of source code. Participants used the three interfaces for between four and six hours in all. Time and accuracy measures were inconclusive, but subjective data showed a preference for the permanent...

Permanent molars: Delayed development and eruption

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Arathi R

2006-05-01

Full Text Available Delayed development and eruption of all the permanent molars is a rare phenomenon, which can cause disturbance in the developing occlusion. The eruption of permanent first and second molars is very important for the coordination of facial growth and for providing sufficient occlusal support for undisturbed mastication. In the case described, the first permanent molars were delayed in their development and were seen erupting at the age of nine and a half years. Severe disparity between the left and the right side of the dentition with respect to the rate of development of molars were also present.

An Artificial Neural Networks Approach to Estimate Occupational Accident: A National Perspective for Turkey

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Hüseyin Ceylan

2014-01-01

Full Text Available Occupational accident estimation models were developed by using artificial neural networks (ANNs for Turkey. Using these models the number of occupational accidents and death and permanent incapacity numbers resulting from occupational accidents were estimated for Turkey until the year of 2025 by the three different scenarios. In the development of the models, insured workers, workplace, occupational accident, death, and permanent incapacity values were used as model parameters with data between 1970 and 2012. 2-5-1 neural network architecture was selected as the best network architecture. Sigmoid was used in hidden layers and linear function was used at output layer. The feed forward back propagation algorithm was used to train the network. In order to obtain a useful model, the network was trained between 1970 and 1999 to estimate the values of 2000 to 2012. The result was compared with the real values and it was seen that it is applicable for this aim. The performances of all developed models were evaluated using mean absolute percent errors (MAPE, mean absolute errors (MAE, and root mean square errors (RMSE.

Off-line tuning of a PI speed controller for a permanent magnet brushless DC motor using DSP

Energy Technology Data Exchange (ETDEWEB)

Demirtas, Metin, E-mail: mdtas@balikesir.edu.t [Electrical and Electronics Engineering Department, Balikesir University, Balikesir (Turkey)

2011-01-15

In this paper, a new method of tuning Proportional Integral (PI) coefficients for a permanent magnet brushless DC (PMBLDC) motor drives is proposed. Artificial neural network is used to identify the whole system using maximum overshoot and settling time obtained from the application circuit for different K{sub p}-K{sub i} pairs. Optimal values of PI controller coefficients are obtained using genetic algorithm. Motion Control Kit (MCK243) is used to carry out digital motion control applications. The MCK243 kit includes a power module and a three-phase brushless motor. TMS320F243 programs are used for PMBLDC motor speed control. Experimental results are given to show the validity of this method.

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

Science.gov (United States)

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

2012-06-01

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

Superconducting permanent magnets

International Nuclear Information System (INIS)

Wipf, S.L.; Laquer, H.L.

1989-01-01

The concept of superconducting permanent magnets with fields trapped in shells or cylinders of Type II superconductors is an old one. Unfortunately, the low values of 0.5 to 1T for the first flux jump field, which is independent of the actual current density, have frustrated its implementation with classical Type II superconductors. The fact that the flux jump fields for high temperature superconductors should be an order of magnitude larger at liquid nitrogen temperatures allows us to reconsider these options. Analysis of the hysteresis patterns, based on the critical state model, shows that, if the dimensions are chosen so that the sample is penetrated at a field B/sub p/, which is equal to or just less than the first flux jump field, B/sub fj/, a temporarily applied field of 2B/sub fj/ will trap 0.5 B/sub fj/. Thus for a 90 K superconductor with a B/sub fj/ of 6T, a permanent field of 3 T should be trapped, with an energy product of 1.8 MJ/m/sup 3/ (225 MG . Oe). This is five times as large as for the best permanent magnet materials. The authors discuss means to verify the analysis and the limitations imposed by the low critical current densities in presently available high temperature superconductors

Change of carcinogenic chrysotile fibers in the asbestos cement (eternit) to harmless waste by artificial carbonatization: Petrological and technological results

Energy Technology Data Exchange (ETDEWEB)

Radvanec, Martin; Tuček, Ľubomír; Derco, Ján; Čechovská, Katarína [State Geological Institute of Dionýz Štúr, Mlynská dolina 1, SK-817 04 Bratislava (Slovakia); Németh, Zoltán, E-mail: zoltan.nemeth@geology.sk [State Geological Institute of Dionýz Štúr, Mlynská dolina 1, SK-817 04 Bratislava (Slovakia)

2013-05-15

Highlights: ► Carcinogenic chrysotile fibers in asbestos cement (eternit) are liquidated. ► Thermally modified eternit grist (at 650 °C, 1 h) reacts with CO{sub 2} + water. ► Carbonates hydromagnesite and magnesite are the newly formed products of artificial carbonatization. ► Neutralizing of extreme pH values (around 12) at large eternit dumps. ► An alternative methodology for permanent liquidation of a part of CO{sub 2} emissions. -- Abstract: Asbestos cement materials, mainly the eternit roof ceiling, being widely applied in the past, represent a serious environmental load. The solar radiation, rain and frost cause the deliberation of cement from the eternit roofing and consequently the wind contaminates the surrounding area by the asbestos (chrysotile) fibers. In combination with other carcinogens (e.g. smoking), or at reduced immunity of a man, they may cause serious respiratory diseases and lung cancer. The article presents the procedure and experimental results of artificial carbonatization, applied in the asbestos cement (eternit). The wet crushed and pulverized asbestos cement was thermally modified at 650 °C and then the chrysotile fibers easily and completely reacted with the mixture of CO{sub 2} and water, producing new Mg-rich carbonates – hydromagnesite and magnesite: 2Mg{sub 3}Si{sub 2}O{sub 5}(OH){sub 3thermally} {sub modified} {sub chrysotile}+5CO{sub 2}+nH{sub 2}O→Mg{sub 5}(CO{sub 3}){sub 4}(OH){sub 2}⋅4H{sub 2}O{sub hydromagnesite}+MgCO{sub 3magnesite}+4SiO{sub 2} · nH{sub 2}O{sub in} a{sub morphous} {sub phase};n=3÷9 Applying this methodology, the asbestos-bearing waste can be stabilized and environmentally friendly permanently deposited. Finding a way of neutralizing of extreme pH values (around 12) at large eternit dumps represents also an asset of presented research. Simultaneously, the artificial carbonatization of chrysotile asbestos, applying CO{sub 2}, offers an alternative way for permanent liquidation of a part of

[Fistulae or catheter for elderly who start hemodialysis without permanent vascular access?].

Science.gov (United States)

García Cortés, Ma J; Viedma, G; Sánchez Perales, M C; Borrego, F J; Borrego, J; Pérez del Barrio, P; Gil Cunquero, J M; Liébana, A; Pérez Bañasco, V

2005-01-01

Autologous access is the best vascular access for dialysis also in older patients and it should be mature when patient needs hemodialysis. It is not always possible. Surgeon availability and demographic characteristics of patients (age, diabetes, vascular disease...) are factors that determine primary vascular access. To analyse outcome and vascular access complications in elderly who start hemodialysis without vascular access. All patients older than 75 years who initiated hemodialysis without vascular access between January 2000 and June 2002 were included, They were divided en two groups depending on primary vascular access. GI: arterio-venous fistulae. GIIl: Tunnelled cuffed catheter. Epidemiological and analytical data, vascular access complications related, as well as patient and first permanent vascular access survival from their inclusion in dialysis up to December 2002 were analysed and compared in both groups. 32 patients were studied. GI: n = 17 (4 men) and GIIl: n =1 5 (8 men), age: 79.9 +/- 3.8 and 81.7 +/- 4 years respectively (ns). There were no differences in sex and comorbidity (diabetes, ischemic heart disease, peripheral vascular disease and hypertension). It took GI 3 months to get a permanent vascular access suitable for using, while it took GIIl 1.3 months (p catheters was higher in GI (3.35 vs 1.87 p central venous thrombosis happen in GI (I: 25 CVT/100 patients-year) vs 30% in GIIl (I = 14.4/100 patients-year) (ns). No significant differences neither in bleeding (66.7% vs 33.3%) nor ischemia (75% vs 25%) were found. Dialysis dose (Kt/V) as well as anaemia degree were similar in both groups. Permanent vascular access survival after 2 years was 45.8% in GI and 24% in GII (ns). Patient survival was similar in GI and GII (72% vs 51% ns). Elderly who start hemodialysis without vascular access took longer to get a suitable permanent vascular access when arterio-venous fistulae is placed than with a tunnelled cuffed hemodialysis catheter. As a

Lawful Permanent Residents Fiscal Year 2011 Country

Data.gov (United States)

Department of Homeland Security — Lawful permanet residents (LPRs) are foreign nationals who have been gratned the right to reside permanently in the United States. LPRs are also known as 'permanent...

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

Science.gov (United States)

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

2017-09-01

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

Permanent magnet design for high-speed superconducting bearings

Science.gov (United States)

Hull, John R.; Uherka, Kenneth L.; Abdoud, Robert G.

1996-01-01

A high temperature superconducting bearing including a permanent magnet rotor levitated by a high temperature superconducting structure. The rotor preferably includes one or more concentric permanent magnet rings coupled to permanent magnet ring structures having substantially triangular and quadrangular cross-sections. Both alternating and single direction polarity magnet structures can be used in the bearing.

Valvular Heart Disease in Heart Failure

Directory of Open Access Journals (Sweden)

Giuseppe MC Rosano

2017-01-01

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

Permanent magnet design for high-speed superconducting bearings

International Nuclear Information System (INIS)

Hull, J.R.; Uherka, K.L.; Abdoud, R.G.

1996-01-01

A high temperature superconducting bearing including a permanent magnet rotor levitated by a high temperature superconducting structure is disclosed. The rotor preferably includes one or more concentric permanent magnet rings coupled to permanent magnet ring structures having substantially triangular and quadrangular cross-sections. Both alternating and single direction polarity magnet structures can be used in the bearing. 9 figs

NHLBI’s Program for VAD Therapy for Moderately Advanced Heart Failure: The REVIVE-IT Pilot Trial

Science.gov (United States)

Baldwin, J. Timothy; Mann, Douglas L.

2010-01-01

Background VADs are used to bridge heart failure patients to transplantation, to allow their own hearts to recover, or as permanent (“destination”) therapy. To date, the use of VADs has been limited to late-stage heart failure patients because of the associated device risks. In 2008, an NHLBI working group met to evaluate the treatment of heart failure using VADs and to advise the institute on how therapy for heart failure may be best advanced by clinical trials involving the devices. Discussion and Recommendations Recognizing the improvements in VAD technology and in patient care and selection over the past decade, the working group recommended that a trial be performed to assess the use of chronic VAD therapy in patients who are less ill than those currently eligible for destination therapy. The hypothesis proposed for the trial is that VAD therapy may improve both survival and quality of life in moderately advanced heart failure patients who are neither inotrope-dependent nor exercise-intolerant and have not yet developed serious consequences such as malnourishment, end-organ damage, and immobility. Based on the group’s recommendations, NHLBI issued an RFP in 2009 for the REVIVE-IT Pilot Trail which will serve to test the hypothesis and inform the pivotal trial. PMID:21055648

Safety effects of permanent running lights for bicycles

DEFF Research Database (Denmark)

Madsen, Jens Chr. Overgaard; Andersen, T.; Lahrmann, Harry

2013-01-01

, including all recorded bicycle accidents with personal injury to the participating cyclist, is 19% lower for cyclists with permanent running lights mounted; indicating that the permanent bicycle running light significantly improves traffic safety for cyclists. The study shows that use of permanent bicycle......Making the use of daytime running lights mandatory for motor vehicles is generally documented to have had a positive impact upon traffic safety. Improving traffic safety for bicyclists is a focal point in the road traffic safety work in Denmark. In 2004 and 2005 a controlled experiment including...... 3845 cyclists was carried out in Odense, Denmark in order to examine, if permanent running lights mounted to bicycles would improve traffic safety for cyclists. The permanent running lights were mounted to 1845 bicycles and the accident rate was recorded through 12 months for this treatment group...

40 years of electrostimulation of the heart in Slovenia 1965–2005

Directory of Open Access Journals (Sweden)

Aleš Brecelj

2005-12-01

Full Text Available Background: Permanent cardiac pacing has since the very rudimentary beginnings in 1950. evolved into an autonomous field. Miniaturization of pacemakers and electrodes paved the way toward the application of less invasive implantation techniques, implementation of computer technology, broadened the list of indications for implantation, increased reliability and longevity and finally, enabled followup and reprogramming of pacemakers to better tailor pacing to the patients’ needs. Evidently, the electrostimulation of the heart resulted in nearly physiologic functioning of the heart greatly improving the quality of life. The aim of the following review is to present the development of electrostimulation of the heart in Ljubljana from the very beginnings in 1965 till today. We present the current state-of-the-art indications for pacemaker and cardioverter-defibrillator implantations, that have widely broadened over years, the types of pacemakers, their clasification and internationally recognized coding as well as some of possible complications after implantation.Methods and results: The first permanent pacemaker implantation in Slovenia was performed by cardiac surgeon M. Košak, cardiologist A. Jagodic and colleagues on April 16th 1965 in Ljubljana. The recipient suffered from complete atrioventricular block that clinically presented with numerous syncopes. Retrospective analysis included all the patients with re/ implanted pacemaker or cardioverter-defibrillator and accompanying electrodes. Patients’ characteristics, indications and types of the devices implanted were compared in the two representative periods: early period from 1965 –74 and recent data collected from 2001 till 2005. In Slovenia, there are 450 pacemakers and 50 cardioverter-defibrillators per million annualy performed in Maribor General Hospital and Medical Centre Ljubljana.Conclusions: The current state-of-the-art and the most recent technological advances in the field of

Heart Health - Brave Heart

Science.gov (United States)

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

Artificial intelligence

CERN Document Server

Ennals, J R

1987-01-01

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

Low permanent pacemaker rates following Lotus device implantation for transcatheter aortic valve replacement due to modified implantation protocol.

Science.gov (United States)

Krackhardt, Florian; Kherad, Behrouz; Krisper, Maximilian; Pieske, Burkert; Laule, Michael; Tschöpe, Carsten

2017-01-01

Conduction disturbances requiring permanent pacemaker implantation following transcatheter aortic valve replacement (TAVR) are a common problem. Pacemaker implantation rates after TAVR appear to be higher compared to conventional aortic valve replacement. The aim of this study was to analyze whether a high annulus implantation conveys the benefit of a decreased rate of permanent pacemaker implantation while being safe and successful according to Valve Academic Research Consortium 2 (VARC2)-criteria. A total of 23 patients with symptomatic severe aortic valve stenosis, an aortic annulus of 19-27 mm and at high risk for surgery were treated with the Lotus valve. In all patients the valve was implanted in a high annulus position via femoral access. The primary device performance endpoint was VARC2-defined device success after 30 days and the primary safety endpoint was the need for permanent pacemaker implantation. The mean age was 73.23 ± 7.65 years, 46% were female, 38% were New York Heart Association class III/IV at baseline. Thirty-day follow-up data were available for all patients. The VARC2-defined device success rate after 30 days was 22/23 (96%). 2/21 (10%) patients required a newly implanted pacemaker due to 3rd degree atrioventricular block. 25% of the patients developed a new left bundle branch block after valvuloplasty or device implantation. 21 of the 23 patients (96%) had no other signs of conduction disturbances after 30 days. The approach of the modified implantation technique of Lotus TAVR device was safe and effective. The incidence of need for a permanent pacemaker following TAVR could be significantly reduced due to adopted implantation protocol.

Artificial Inductance Concept to Compensate Nonlinear Inductance Effects in the Back EMF-Based Sensorless Control Method for PMSM

DEFF Research Database (Denmark)

Lu, Kaiyuan; Lei, Xiao; Blaabjerg, Frede

2013-01-01

The back EMF-based sensorless control method is very popular for permanent magnet synchronous machines (PMSMs) in the medium- to high-speed operation range due to its simple structure. In this speed range, the accuracy of the estimated position is mainly affected by the inductance, which varies...... at different loading conditions due to saturation effects. In this paper, a new concept of using a constant artificial inductance to replace the actual varying machine inductance for position estimation is introduced. This facilitates greatly the analysis of the influence of inductance variation...

Workplace bullying a risk for permanent employees.

Science.gov (United States)

Keuskamp, Dominic; Ziersch, Anna M; Baum, Fran E; Lamontagne, Anthony D

2012-04-01

We tested the hypothesis that the risk of experiencing workplace bullying was greater for those employed on casual contracts compared to permanent or ongoing employees. A cross-sectional population-based telephone survey was conducted in South Australia in 2009. Employment arrangements were classified by self-report into four categories: permanent, casual, fixed-term and self-employed. Self-report of workplace bullying was modelled using multiple logistic regression in relation to employment arrangement, controlling for sex, age, working hours, years in job, occupational skill level, marital status and a proxy for socioeconomic status. Workplace bullying was reported by 174 respondents (15.2%). Risk of workplace bullying was higher for being in a professional occupation, having a university education and being separated, divorced or widowed, but did not vary significantly by sex, age or job tenure. In adjusted multivariate logistic regression models, casual workers were significantly less likely than workers on permanent or fixed-term contracts to report bullying. Those separated, divorced or widowed had higher odds of reporting bullying than married, de facto or never-married workers. Contrary to expectation, workplace bullying was more often reported by permanent than casual employees. It may represent an exposure pathway not previously linked with the more idealised permanent employment arrangement. A finer understanding of psycho-social hazards across all employment arrangements is needed, with equal attention to the hazards associated with permanent as well as casual employment. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

An artificial vector model for generating abnormal electrocardiographic rhythms

International Nuclear Information System (INIS)

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

2010-01-01

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

Nonuniform radiation damage in permanent magnet quadrupoles.

Science.gov (United States)

Danly, C R; Merrill, F E; Barlow, D; Mariam, F G

2014-08-01

We present data that indicate nonuniform magnetization loss due to radiation damage in neodymium-iron-boron Halbach-style permanent magnet quadrupoles. The proton radiography (pRad) facility at Los Alamos uses permanent-magnet quadrupoles for magnifying lenses, and a system recently commissioned at GSI-Darmsdadt uses permanent magnets for its primary lenses. Large fluences of spallation neutrons can be produced in close proximity to these magnets when the proton beam is, intentionally or unintentionally, directed into the tungsten beam collimators; imaging experiments at LANL's pRad have shown image degradation with these magnetic lenses at proton beam doses lower than those expected to cause damage through radiation-induced reduction of the quadrupole strength alone. We have observed preferential degradation in portions of the permanent magnet quadrupole where the field intensity is highest, resulting in increased high-order multipole components.

Nonuniform radiation damage in permanent magnet quadrupoles

International Nuclear Information System (INIS)

Danly, C. R.; Merrill, F. E.; Barlow, D.; Mariam, F. G.

2014-01-01

We present data that indicate nonuniform magnetization loss due to radiation damage in neodymium-iron-boron Halbach-style permanent magnet quadrupoles. The proton radiography (pRad) facility at Los Alamos uses permanent-magnet quadrupoles for magnifying lenses, and a system recently commissioned at GSI-Darmsdadt uses permanent magnets for its primary lenses. Large fluences of spallation neutrons can be produced in close proximity to these magnets when the proton beam is, intentionally or unintentionally, directed into the tungsten beam collimators; imaging experiments at LANL’s pRad have shown image degradation with these magnetic lenses at proton beam doses lower than those expected to cause damage through radiation-induced reduction of the quadrupole strength alone. We have observed preferential degradation in portions of the permanent magnet quadrupole where the field intensity is highest, resulting in increased high-order multipole components

Nonuniform radiation damage in permanent magnet quadrupoles

Energy Technology Data Exchange (ETDEWEB)

Danly, C. R.; Merrill, F. E.; Barlow, D.; Mariam, F. G. [Los Alamos National Laboratory, Los Alamos, New Mexico 87544 (United States)

2014-08-15

We present data that indicate nonuniform magnetization loss due to radiation damage in neodymium-iron-boron Halbach-style permanent magnet quadrupoles. The proton radiography (pRad) facility at Los Alamos uses permanent-magnet quadrupoles for magnifying lenses, and a system recently commissioned at GSI-Darmsdadt uses permanent magnets for its primary lenses. Large fluences of spallation neutrons can be produced in close proximity to these magnets when the proton beam is, intentionally or unintentionally, directed into the tungsten beam collimators; imaging experiments at LANL’s pRad have shown image degradation with these magnetic lenses at proton beam doses lower than those expected to cause damage through radiation-induced reduction of the quadrupole strength alone. We have observed preferential degradation in portions of the permanent magnet quadrupole where the field intensity is highest, resulting in increased high-order multipole components.

Case-control study of factors associated with chronic Chagas heart disease in patients over 50 years of age

Directory of Open Access Journals (Sweden)

Silvana de Araújo Silva

2007-11-01

Full Text Available A case-control study on chronic Chagas heart disease (CCHD was carried out between 1997 and 2005. Ninety patients over 50 years of age were examined for factors related to (CCHD. Fourty-six patients (51.1% with Chagas heart disease (anomalous ECG were assigned to the case group and 44 (48.9% were included in the control group as carriers of undetermined forms of chronic disease. Social, demographic (age, gender, skin color, area of origin, epidemiological (permanence within an endemic zone, family history of Chagas heart disease or sudden death, physical strain, alcoholism, and smoking, and clinical (systemic hypertension variables were analyzed. The data set was assessed through single-variable and multivariate analysis. The two factors independently associated with heart disease were age - presence of heart disease being three times higher in patients over 60 years of age (odds ratio, OR: 2.89; confidence interval of 95%: 1.09-7.61 - and family history of Chagas heart disease (OR: 2.833, CI 95%: 1.11-7.23. Systemic hypertension and gender did not prove to hold any association with heart disease, as neither did skin color, but this variable showed low statistical power due to reduced sample size.

Globally Optimal Segmentation of Permanent-Magnet Systems

DEFF Research Database (Denmark)

Insinga, Andrea Roberto; Bjørk, Rasmus; Smith, Anders

2016-01-01

Permanent-magnet systems are widely used for generation of magnetic fields with specific properties. The reciprocity theorem, an energy-equivalence principle in magnetostatics, can be employed to calculate the optimal remanent flux density of the permanent-magnet system, given any objective...... remains unsolved. We show that the problem of optimal segmentation of a two-dimensional permanent-magnet assembly with respect to a linear objective functional can be reduced to the problem of piecewise linear approximation of a plane curve by perimeter maximization. Once the problem has been cast...

Object permanence in adults : a cross-cultural perspective

OpenAIRE

Subbotski, Eugene; Trommsdorff, Gisela

1992-01-01

Soviet and German adult subjects observed the phenomenon of object non-permanence (destruction, reconstruction, or transformation of a physical object). Both samples attributed an equal degree of probability to real existence of object non-permanence. However, Soviet subjects attributed a significantly higher probability to the existence of "religion-independent" non-permanent mysterious phenomena, (e.g., "unidentified flying objects", "abominable snowman", "Loch Ness monster") while attribut...

Generation of magnetic fields for accelerators with permanent magnets

International Nuclear Information System (INIS)

Meinander, T.

1994-01-01

Commercially available permanent magnet materials and their properties are reviewed. Advantages and disadvantages of using permanent magnets as compared to electromagnets for the generation of specific magnetic fields are discussed. Basic permanent magnet configurations in multipole magnets and insertion devices are presented. (orig.)

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

Science.gov (United States)

Ronco, C; Davenport, A; Gura, V

2011-01-01

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

Entertainment Capture through Heart Rate Activity in Physical Interactive Playgrounds

DEFF Research Database (Denmark)

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

2008-01-01

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

Dovetail spoke internal permanent magnet machine

Science.gov (United States)

Alexander, James Pellegrino [Ballston Lake, NY; EL-Refaie, Ayman Mohamed Fawzi [Niskayuna, NY; Lokhandwalla, Murtuza [Clifton Park, NY; Shah, Manoj Ramprasad [Latham, NY; VanDam, Jeremy Daniel [West Coxsackie, NY

2011-08-23

An internal permanent magnet (IPM) machine is provided. The IPM machine includes a stator assembly and a stator core. The stator core also includes multiple stator teeth. The stator assembly is further configured with stator windings to generate a stator magnetic field when excited with alternating currents and extends along a longitudinal axis with an inner surface defining a cavity. The IPM machine also includes a rotor assembly and a rotor core. The rotor core is disposed inside the cavity and configured to rotate about the longitudinal axis. The rotor assembly further includes a shaft. The shaft further includes multiple protrusions alternately arranged relative to multiple bottom structures provided on the shaft. The rotor assembly also includes multiple stacks of laminations disposed on the protrusions and dovetailed circumferentially around the shaft. The rotor assembly further includes multiple pair of permanent magnets for generating a magnetic field, which magnetic field interacts with the stator magnetic field to produce a torque. The multiple pair of permanent magnets are disposed between the stacks. The rotor assembly also includes multiple middle wedges mounted between each pair of the multiple permanent magnets.

Rationale and Design of the Reduce Elevated Left Atrial Pressure in Patients With Heart Failure (Reduce LAP-HF) Trial

DEFF Research Database (Denmark)

Hasenfuss, Gerd; Gustafsson, Finn; Kaye, David

2015-01-01

OBJECTIVE: Heart failure with preserved ejection fraction (HFpEF) is characterized by elevated left atrial pressure during rest and/or exercise. The Reduce LAP-HF (Reduce Elevated Left Atrial Pressure in Patients With Heart Failure) trial will evaluate the safety and performance of the Interatrial...... Shunt Device (IASD) System II, designed to directly reduce elevated left atrial pressure, in patients with HFpEF. METHODS: The Reduce LAP-HF Trial is a prospective, nonrandomized, open-label trial to evaluate a novel device that creates a small permanent shunt at the level of the atria. A minimum of 60...... patients with ejection fraction ≥40% and New York Heart Association functional class III or IV heart failure with a pulmonary capillary wedge pressure (PCWP) ≥15 mm Hg at rest or ≥25 mm Hg during supine bike exercise will be implanted with an IASD System II, and followed for 6 months to assess the primary...

Permanent Magnet Eddy Current Loss Analysis of a Novel Motor Integrated Permanent Magnet Gear

DEFF Research Database (Denmark)

Zhang, Yuqiu; Lu, Kaiyuan; Ye, Yunyue

2012-01-01

In this paper, a new motor integrated permanent magnet gear (MIPMG) is discussed. The focus is on eddy current loss analysis associated to permanent magnets (PMs). A convenient model of MIPMG is provided based on 2-D field-motion coupled time-stepping finite element method for transient eddy...... current analysis. The model takes the eddy current effect of PMs into account in determination of the magnetic field in the air-gap and in the magnet regions. The eddy current losses generated in the magnets are properly interpreted. Design improvements for reducing the eddy current losses are suggested...

Permanent isolation surface barrier development plan

International Nuclear Information System (INIS)

Wing, N.R.

1994-01-01

The exhumation and treatment of wastes may not always be the preferred alternative in the remediation of a waste site. In-place disposal alternatives, under certain circumstances, may be the most desirable alternatives to use in the protection of human health and the environment. The implementation of an in-place disposal alternative will likely require some type of protective covering that will provide long-term isolation of the wastes from the accessible environment. Even if the wastes are exhumed and treated, a long-term barrier may still be needed to adequately dispose of the treated wastes or any remaining waste residuals. Currently, no open-quotes provenclose quotes long-term barrier is available. The Hanford Site Permanent Isolation Surface Barrier Development Program (BDP) was organized to develop the technology needed to provide a long-term surface barrier capability for the Hanford Site. The permanent isolation barrier technology also could be used at other sites. Permanent isolation barriers use engineered layers of natural materials to create an integrated structure with redundant protective features. Drawings of conceptual permanent isolation surface barriers are shown. The natural construction materials (e.g., fine soil, sand, gravel, riprap, asphalt) have been selected to optimize barrier performance and longevity. The objective of current designs is to use natural materials to develop a maintenance-free permanent isolation surface barrier that isolates wastes for a minimum of 1,000 years by limiting water drainage to near-zero amounts; reducing the likelihood of plant, animal, and human intrusion; controlling the exhalation of noxious gases; and minimizing erosion-related problems

Permanent isolation surface barrier development plan

Energy Technology Data Exchange (ETDEWEB)

Wing, N.R.

1994-01-01

The exhumation and treatment of wastes may not always be the preferred alternative in the remediation of a waste site. In-place disposal alternatives, under certain circumstances, may be the most desirable alternatives to use in the protection of human health and the environment. The implementation of an in-place disposal alternative will likely require some type of protective covering that will provide long-term isolation of the wastes from the accessible environment. Even if the wastes are exhumed and treated, a long-term barrier may still be needed to adequately dispose of the treated wastes or any remaining waste residuals. Currently, no {open_quotes}proven{close_quotes} long-term barrier is available. The Hanford Site Permanent Isolation Surface Barrier Development Program (BDP) was organized to develop the technology needed to provide a long-term surface barrier capability for the Hanford Site. The permanent isolation barrier technology also could be used at other sites. Permanent isolation barriers use engineered layers of natural materials to create an integrated structure with redundant protective features. Drawings of conceptual permanent isolation surface barriers are shown. The natural construction materials (e.g., fine soil, sand, gravel, riprap, asphalt) have been selected to optimize barrier performance and longevity. The objective of current designs is to use natural materials to develop a maintenance-free permanent isolation surface barrier that isolates wastes for a minimum of 1,000 years by limiting water drainage to near-zero amounts; reducing the likelihood of plant, animal, and human intrusion; controlling the exhalation of noxious gases; and minimizing erosion-related problems.

Adjustable permanent magnet assembly for NMR and MRI

Science.gov (United States)

Pines, Alexander; Paulsen, Jeffrey; Bouchard, Louis S; Blumich, Bernhard

2013-10-29

System and methods for designing and using single-sided magnet assemblies for magnetic resonance imaging (MRI) are disclosed. The single-sided magnet assemblies can include an array of permanent magnets disposed at selected positions. At least one of the permanent magnets can be configured to rotate about an axis of rotation in the range of at least +/-10 degrees and can include a magnetization having a vector component perpendicular to the axis of rotation. The single-sided magnet assemblies can further include a magnet frame that is configured to hold the permanent magnets in place while allowing the at least one of the permanent magnets to rotate about the axis of rotation.

Method and apparatus for assembling permanent magnet rotors

Science.gov (United States)

Hsu, J.S.; Adams, D.J.

1999-06-22

A permanent magnet assembly for assembly in large permanent magnet motors and generators includes a two-piece carrier that can be slid into a slot in the rotor and then secured in place using a set screw. The invention also provides an auxiliary carrier device with guide rails that line up with the teeth of the rotor, so that a permanent magnet assembly can be pushed first into a slot, and then down the slot to its proper location. An auxiliary tool is provided to move the permanent magnet assembly into position in the slot before it is secured in place. Methods of assembling and disassembling the magnet assemblies in the rotor are also disclosed. 2 figs.

Corporate Policies with Permanent and Transitory Shocks

NARCIS (Netherlands)

J-P. Decamps (Jean-Paul); S. Gryglewicz (Sebastian); E. Morellec (Erwan); S. Villeneuve (Stephane)

2016-01-01

textabstractWe model the financing, cash holdings, and hedging policies of a firm facing financing frictions and subject to permanent and transitory cash flow shocks. We show that permanent and transitory shocks generate distinct, sometimes opposite, effects on corporate policies and use the model

Artificial Leaf Based on Artificial Photosynthesis for Solar Fuel Production

Science.gov (United States)

2017-06-30

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

Connecting Temporary and Permanent Organizing

DEFF Research Database (Denmark)

Stjerne, Iben Sandal; Velikova, Silviya Svejenova

2016-01-01

This paper investigates the relationship between a permanent organization and a series of temporary organizations. It draws on an in-depth study of the process through which a Danish film production company, seeking to balance innovation and persistence in a troubled industry, struggles to realize...... a novel children’s film and its sequels. The study reveals tensions at different levels as well as boundary work and boundary roles that address them, bringing in shadows of past and future projects. The study extends the understanding of the dialectic between temporary and permanent organizing...

Mercury Exposure and Heart Diseases

Science.gov (United States)

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

2017-01-01

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

Mercury Exposure and Heart Diseases.

Science.gov (United States)

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

2017-01-12

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

Mercury Exposure and Heart Diseases

Directory of Open Access Journals (Sweden)

Giuseppe Genchi

2017-01-01

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

The history of permanent magnet materials

International Nuclear Information System (INIS)

Livingston, J.D.

1990-01-01

Permanent-magnet materials play a large and growing, but largely unseen, role in today's technology. Many common devices in the home and elsewhere, including appliances, computers and printers, contain permanent-magnet motors and actuators. The growth of applications for permanent magnets results in large part from the improvements in magnetic properties, which allow the engineer to design smaller, lighter and more efficient devices. The properties of the greatest technological interest are remanence, coercivity and maximum energy product. All are non-equilibrium and high structure-sensitive. Coercivity is particularly sensitive to microstructure, while remanence is sensitive to texture (crystallographic alignment). The energy product depends on both coercivity and remanence. The more than one hundredfold increase in the available energy product in this century, and the corresponding amount of magnet required for a specific application, are shown

Inhibition of Fas-associated death domain-containing protein (FADD protects against myocardial ischemia/reperfusion injury in a heart failure mouse model.

Directory of Open Access Journals (Sweden)

Qian Fan

Full Text Available As technological interventions treating acute myocardial infarction (MI improve, post-ischemic heart failure increasingly threatens patient health. The aim of the current study was to test whether FADD could be a potential target of gene therapy in the treatment of heart failure.Cardiomyocyte-specific FADD knockout mice along with non-transgenic littermates (NLC were subjected to 30 minutes myocardial ischemia followed by 7 days of reperfusion or 6 weeks of permanent myocardial ischemia via the ligation of left main descending coronary artery. Cardiac function were evaluated by echocardiography and left ventricular (LV catheterization and cardiomyocyte death was measured by Evans blue-TTC staining, TUNEL staining, and caspase-3, -8, and -9 activities. In vitro, H9C2 cells transfected with ether scramble siRNA or FADD siRNA were stressed with chelerythrin for 30 min and cleaved caspase-3 was assessed.FADD expression was significantly decreased in FADD knockout mice compared to NLC. Ischemia/reperfusion (I/R upregulated FADD expression in NLC mice, but not in FADD knockout mice at the early time. FADD deletion significantly attenuated I/R-induced cardiac dysfunction, decreased myocardial necrosis, and inhibited cardiomyocyte apoptosis. Furthermore, in 6 weeks long term permanent ischemia model, FADD deletion significantly reduced the infarct size (from 41.20 ± 3.90% in NLC to 26.83 ± 4.17% in FADD deletion, attenuated myocardial remodeling, improved cardiac function and improved survival. In vitro, FADD knockdown significantly reduced chelerythrin-induced the level of cleaved caspase-3.Taken together, our results suggest FADD plays a critical role in post-ischemic heart failure. Inhibition of FADD retards heart failure progression. Our data supports the further investigation of FADD as a potential target for genetic manipulation in the treatment of heart failure.

Effect of Popping Chocolate and Candy on Enamel Microhardness of Primary and Permanent Teeth.

Science.gov (United States)

Tabari, Mitra; Alaghemand, Homayoon; Qujeq, Durdi; Mohammadi, Elahe

2017-01-01

Dental erosion is a common disease in children. Food diets, due to high amounts of juice, soft drinks, chewing gum, and acidic chocolate, are one of the most important risk factors in erosive processes among children. The aim of this study was to evaluate the effect of candy and chocolate on the microhardness of tooth enamel. Two types of popping candy and one type of popping chocolate were used in this study. Thirty-three healthy permanent premolar teeth and 33 primary incisor teeth (A or B) were selected. Five grams of each popping chocolate or candy was dissolved with 2 ml of artificial saliva. Subsequently, their pH and titrable acidity (TA) as well as microhardness and surface roughness of enamel were examined in the laboratory. Data were analyzed and evaluated Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY through independent t -test, paired t -test, Tukey test, and ANOVA. The results of this study showed that only the pH of the candies was below the critical pH of the enamel (5.5) and their TA was B = 0.20 and C = 0.21. The most significant effect on the enamel microhardness of the permanent and primary teeth was by the following types of candy: orange flavor (C), strawberry flavor (B), and chocolate (A), respectively. This difference was significant ( P < 0.001) and the surface roughness increased after exposure. This study showed that popping chocolate and candy reduces microhardness of enamel.

Real-time optical monitoring of permanent lesion progression in radiofrequency ablated cardiac tissue (Conference Presentation)

Science.gov (United States)

Singh-Moon, Rajinder P.; Hendon, Christine P.

2016-02-01

Despite considerable advances in guidance of radiofrequency ablation (RFA) therapies for atrial fibrillation, success rates have been hampered by an inability to intraoperatively characterize the extent of permanent injury. Insufficient lesions can elusively create transient conduction blockages that eventually reconduct. Prior studies suggest significantly greater met-myoglobin (Mmb) concentrations in the lesion core than those in the healthy myocardium and may serve as a marker for irreversible tissue damage. In this work, we present real-time monitoring of permanent injury through spectroscopic assessment of Mmb concentrations at the catheter tip. Atrial wedges (n=6) were excised from four fresh swine hearts and submerged under pulsatile flow of warm (37oC) phosphate buffered saline. A commercial RFA catheter inserted into a fiber optic sheath allowed for simultaneous measurement of tissue diffuse reflectance (DR) spectra (500-650nm) during application of RF energy. Optical measurements were continuously acquired before, during, and post-ablation, in addition to healthy neighboring tissue. Met-myoglobin, oxy-myoglobin, and deoxy-myoglobin concentrations were extracted from each spectrum using an inverse Monte Carlo method. Tissue injury was validated with Masson's trichrome and hematoxylin and eosin staining. Time courses revealed a rapid increase in tissue Mmb concentrations at the onset of RFA treatment and a gradual plateauing thereafter. Extracted Mmb concentrations were significantly greater post-ablation (p<0.0001) as compared to healthy tissue and correlated well with histological assessment of severe thermal tissue destruction. On going studies are aimed at integrating these findings with prior work on near infrared spectroscopic lesion depth assessment. These results support the use of spectroscopy-facilitated guidance of RFA therapies for real-time permanent injury estimation.

6 CFR 7.29 - Documents of permanent historical value.

Science.gov (United States)

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Documents of permanent historical value. 7.29... NATIONAL SECURITY INFORMATION Classified Information § 7.29 Documents of permanent historical value. The... contained in records determined to have permanent historical value under 44 U.S.C. 2107 before they are...

Laced permanent magnet quadrupole drift tube magnets

International Nuclear Information System (INIS)

Feinberg, B.; Behrsing, G.U.; Halbach, K.; Marks, J.S.; Morrison, M.E.; Nelson, D.H.

1988-10-01

A laced permanent magnet quadrupole drift tube magnet has been constructed for a proof-of-principle test. The magnet is a conventional tape-wound quadrupole electromagnet, using iron pole- pieces, with the addition of permanent magnet material (neodymium iron) between the poles to reduce the effects of saturation. The iron is preloaded with magnetic flux generated by the permanent magnet material, resulting in an asymmetrical saturation curve. Since the polarity of the quadrupole magnets in a drift tube linac is not reversed we can take advantage of this asymmetrical saturation to provide greater focusing strength. The magnet configuration has been optimized and the vanadium permendur poles needed in a conventional quadrupole have been replaced with iron poles. The use of permanent magnet material has allowed us to increase the focusing strength of the magnet by about 20% over that of a conventional tape-wound quadrupole. Comparisons will be made between this magnet and the conventional tape-wound quadrupole. 3 refs., 5 figs

Micromagnetics of rare-earth efficient permanent magnets

Science.gov (United States)

Fischbacher, Johann; Kovacs, Alexander; Gusenbauer, Markus; Oezelt, Harald; Exl, Lukas; Bance, Simon; Schrefl, Thomas

2018-05-01

The development of permanent magnets containing less or no rare-earth elements is linked to profound knowledge of the coercivity mechanism. Prerequisites for a promising permanent magnet material are a high spontaneous magnetization and a sufficiently high magnetic anisotropy. In addition to the intrinsic magnetic properties the microstructure of the magnet plays a significant role in establishing coercivity. The influence of the microstructure on coercivity, remanence, and energy density product can be understood by using micromagnetic simulations. With advances in computer hardware and numerical methods, hysteresis curves of magnets can be computed quickly so that the simulations can readily provide guidance for the development of permanent magnets. The potential of rare-earth reduced and rare-earth free permanent magnets is investigated using micromagnetic simulations. The results show excellent hard magnetic properties can be achieved in grain boundary engineered NdFeB, rare-earth magnets with a ThMn12 structure, Co-based nano-wires, and L10-FeNi provided that the magnet’s microstructure is optimized.

[PULMONARY COMPLICATIONS IN CHILDREN, OPERATED ON FOR INBORN HEART FAILURES IN THE ARTIFICIAL BLOOD CIRCULATION ENVIRONMENT].

Science.gov (United States)

Moshkivska, L V; Nastenko, E A; Golovenko, O S; Lazoryshynets, V V

2015-11-01

The risk factors of pulmonary complications occurrence were analyzed in children, operated on for inborn heart failures in atrificial blood circulation environment. Pulmonary complications rate and the risk factors of their occurrence were analyzed.

Generative Artificial Intelligence : Philosophy and Theory of Artificial Intelligence

NARCIS (Netherlands)

van der Zant, Tijn; Kouw, Matthijs; Schomaker, Lambertus; Mueller, Vincent C.

2013-01-01

The closed systems of contemporary Artificial Intelligence do not seem to lead to intelligent machines in the near future. What is needed are open-ended systems with non-linear properties in order to create interesting properties for the scaffolding of an artificial mind. Using post-structuralistic

Improvement of Left Ventricular Function by Permanent Direct His-Bundle Pacing in a Case with Dilated Cardiomyopathy

Directory of Open Access Journals (Sweden)

Yukiko Sashida, MD

2006-01-01

Full Text Available The patient was a 67-year-old female diagnosed with dilated cardiomyopathy. She had chronic atrial fibrillation (AF with bradycardia and low left ventricular function (left ventricular ejection fraction (LVEF 40%. She was admitted for congestive heart failure. She remained New York Heart Association (NYHA functional class III due to AF bradycardia. Pacemaker implantation was necessary for treatment of heart failure and administration of dose intensive β-blockers. As she had normal His-Purkinje activation, we examined the optimal pacing sites. Hemodynamics of His-bundle pacing and biventricular pacing were compared. Pulmonary capillary wedge pressure (PCWP was significantly lower on Hisbundle pacing than right ventricular (RV apical pacing and biventricular pacing (13mmHg, 19mmHg, and 19mmHg, respectively with an almost equal cardiac index. Based on the examination we implanted a permanent pacemaker for Direct His-bundle pacing (DHBP. After the DHBP implantation, the LVEF immediately improved from 40% to 55%, and BNP level decreased from 422 pg/ml to 42 pg/ml. The number of premature ventricular complex (PVC was decreased, and non sustained ventricular tachycardia (NSVT disappeared. Pacing threshold for His-bundle pacing has remained at the same level. His-bundle pacing has been maintained during 27 months and her long-term DHBP can improve cardiac function and the NYHA functional class.

Variable Permanent Magnet Quadrupole

International Nuclear Information System (INIS)

Mihara, T.; Iwashita, Y.; Kyoto U.; Kumada, M.; NIRS, Chiba; Spencer, C.M.; SLAC

2007-01-01

A permanent magnet quadrupole (PMQ) is one of the candidates for the final focus lens in a linear collider. An over 120 T/m strong variable permanent magnet quadrupole is achieved by the introduction of saturated iron and a 'double ring structure'. A fabricated PMQ achieved 24 T integrated gradient with 20 mm bore diameter, 100 mm magnet diameter and 20 cm pole length. The strength of the PMQ is adjustable in 1.4 T steps, due to its 'double ring structure': the PMQ is split into two nested rings; the outer ring is sliced along the beam line into four parts and is rotated to change the strength. This paper describes the variable PMQ from fabrication to recent adjustments

U.S. Lawful Permanent Residents: Fiscal Year 2014

Data.gov (United States)

Department of Homeland Security — Lawful permanent residents (LPRs), also known as “green card” holders, are non-citizens who are lawfully authorized to live permanently within the United States.

Artificial life and Piaget.

Science.gov (United States)

Mueller, Ulrich; Grobman, K H.

2003-04-01

Artificial life provides important theoretical and methodological tools for the investigation of Piaget's developmental theory. This new method uses artificial neural networks to simulate living phenomena in a computer. A recent study by Parisi and Schlesinger suggests that artificial life might reinvigorate the Piagetian framework. We contrast artificial life with traditional cognitivist approaches, discuss the role of innateness in development, and examine the relation between physiological and psychological explanations of intelligent behaviour.

U.S. Lawful Permanent Residents: Fiscal Year 2013

Data.gov (United States)

Department of Homeland Security — A lawful permanent resident (LPR) or 'green card' recipient is defined by immigration law as a person who has been granted lawful permanent residence in the United...

OAS :: Authorities : Permanent Representatives to the OAS

Science.gov (United States)

Rights Actions against Corruption C Children Civil Registry Civil Society Contact Us Culture Cyber Representative of Belize Diego Pary Rodríguez Bolivia Diego Pary Rodríguez Ambassador, Permanent Representative of Bolivia José Luiz Machado Brazil José Luiz Machado e Costa Ambassador, Permanent Representative

Static devices with new permanent magnets

International Nuclear Information System (INIS)

Chavanne, J.; Laforest, J.; Pauthenet, R.

1987-01-01

The high remanence and coercivity of the new permanent magnet materials are of special interest in the static applications. High ordering temperature and are uniaxial anisotropy at the origin of their good permanent magnet properties are obtained in rare earth-transition metal compounds. Binary SmCo/sub 5/ and Sm/sub 2/Co/sub 17/ and ternary Nd/sub 2/Fe/sub 14/B compounds are the basis materials of the best permanent magnets. new concepts of calculations of static devices with these magnets can be applied: the magnetization can be considered as ridig, the density of the surface Amperian current is constant, the relative permeability is approximately 1 and the induction calculations are linear. Examples of hexapoles with Sm-Co and NdFeB magnets are described and the performances are compared. The problems of temperature behavior and corrosion resistance are underlined

U.S. Legal Permanent Residents: Fiscal Year 2007

Data.gov (United States)

Department of Homeland Security — A legal permanent resident (LPR) or “green card” recipient is defined by immigration law as a person who has been granted lawful permanent residence in the United...

U.S. Legal Permanent Residents: Fiscal Year 2010

Data.gov (United States)

Department of Homeland Security — A legal permanent resident (LPR) or “green card” recipient is defined by immigration law as a person who has been granted lawful permanent residence in the United...

U.S. Legal Permanent Residents: Fiscal Year 2008

Data.gov (United States)

Department of Homeland Security — A legal permanent resident (LPR) or “green card” recipient is defined by immigration law as a person who has been granted lawful permanent residence in the United...

U.S. Legal Permanent Residents: Fiscal Year 2012

Data.gov (United States)

Department of Homeland Security — A legal permanent resident (LPR) or “green card” recipient is defined by immigration law as a person who has been granted lawful permanent residence in the United...

Samarium-cobalt type rare earth permanent magnets

International Nuclear Information System (INIS)

Kamat, S.V.

2014-01-01

Permanent magnets are one of the oldest and largest applications of magnetic materials and form an integral part of our modern industrial society. They belong to a special class of functional materials and are characterized for remanence (flux output from the magnet), coercivity (resistance to demagnetization) and energy product (material energy density) from the second quadrant of the magnetic hysteresis loop. The reliability, stability, size, weight, cost and performance of many electro-technical devices depend mainly on the properties of permanent magnets used in them. There are three important families of permanent magnets viz., Ferrites, Alnicos and Rare Earth Permanent Magnets (REPMs) with energy product values ranging from 3 to 50 MGOe and among the front ranking high performance REPMs, SmCo 5 , Sm 2 Co 17 type and NdFeB alloys are technologically the most important materials. They are used in a wide range of applications ranging from consumer products to very specialized areas of tele-communications, microelectronics, defence, space, avionics etc. While NdFeB has the highest energy product, Sm-Co based magnets are preferred for most critical applications where temperature stability of magnetic properties is essential because of their significantly higher Curie temperatures. In this presentation some of the key challenges associated with these Sm-Co based rare earth permanent magnets will be highlighted. (author)

Magnetic resonance imaging in patients with heart valve prostheses

International Nuclear Information System (INIS)

Bachmann, R.; Juengehuelsing, M.; Schicha, H.; Deutsch, H.J.; Sechtem, U.; Hilger, H.H.

1991-01-01

Artifical valve prostheses are often regarded as a contraindication for magnetic resonance imaging (MRI), although preliminary in vitro studies suggested, that patients with these metallic implants might safely undergo MR examination. This study reports on the experience with a group of 89 patients with 100 heart valve prostheses who were examined by spin-echo MR and gradient-echo MR. MR examination was performed in all patients without complications. The spin-echo sequence showed advantages in the depiction of anatomical structures like paravalvular abcesses. Anatomical structures adjacent to the artificial valve were clearly visivle and the metal components of the valves showes no or only small artifacts. Artifacts were accentuated when using gradient-echo sequences. Gradient-echo sequences provided valuable information regarding the presence of valvular insufficiency. Physiological valvular regurgitation was easy to differentiate from pathological paravalvular or transvalvular regurgitation. These results demonstrate that patients with artificial valve prostheses can be imaged by MR without risk and that prosthesis-induced artifacts do no interfere with image interpretation. (orig.) [de

Description, evaluation and clinical decision making according to various fetal heart rate patterns. Inter-observer and regional variability

DEFF Research Database (Denmark)

Lidegaard, O; Bøttcher, L M; Weber, Tom

1992-01-01

departments, especially between departments far apart. It is concluded that we still need a scientific clarification of which specific heart rate changes are the best predictors of fetal stress. Artificial intelligence programs for interpreting fetal cardiotocograms and ECG signals constitute one promising......At 10 Danish obstetrical departments, 116 residents (42 senior and 74 junior) participated in a study to assess inter-observer and regional variability in the description and evaluation of and clinical decision regarding 11 fetal heart rate patterns. The 11 traces included normal as well...... as pathological patterns, and normal as well as clinically asphyxiated babies. Five antepartum and six intrapartum patterns were included. A total of 1,276 descriptions and evaluations were obtained. The degree of agreement in description of fetal heart rate changes was high regarding the baseline...

Artificial sweeteners

DEFF Research Database (Denmark)

Raben, Anne Birgitte; Richelsen, Bjørn

2012-01-01

Artificial sweeteners can be a helpful tool to reduce energy intake and body weight and thereby risk for diabetes and cardiovascular diseases (CVD). Considering the prevailing diabesity (obesity and diabetes) epidemic, this can, therefore, be an important alternative to natural, calorie-containin......Artificial sweeteners can be a helpful tool to reduce energy intake and body weight and thereby risk for diabetes and cardiovascular diseases (CVD). Considering the prevailing diabesity (obesity and diabetes) epidemic, this can, therefore, be an important alternative to natural, calorie......-containing sweeteners. The purpose of this review is to summarize the current evidence on the effect of artificial sweeteners on body weight, appetite, and risk markers for diabetes and CVD in humans....

Artificial cognition architectures

CERN Document Server

Crowder, James A; Friess, Shelli A

2013-01-01

The goal of this book is to establish the foundation, principles, theory, and concepts that are the backbone of real, autonomous Artificial Intelligence. Presented here are some basic human intelligence concepts framed for Artificial Intelligence systems. These include concepts like Metacognition and Metamemory, along with architectural constructs for Artificial Intelligence versions of human brain functions like the prefrontal cortex. Also presented are possible hardware and software architectures that lend themselves to learning, reasoning, and self-evolution

Milton Friedman and the Emergence of the Permanent Income Hypothesis

OpenAIRE

Hsiang-Ke Chao

2001-01-01

The purpose of this paper is to investigate the evolution of MiltonFriedman's permanent income hypothesis from the 1940s to 1960s, andhow it became the paradigm of modern consumption theory. Modellingunobservables, such as permanent income and permanent consumption, isa long-standing issue in economics and econometrics. While theconventional approach has been to set an empirical model to make"permanent income" measurable, the historical change in the meaningof that theoretical construct is al...

Hydrogen stability of SmCo5 permanent magnet

International Nuclear Information System (INIS)

Lukin, A.; Rabinovich, Y.; Bala, H.

2001-01-01

The present work has been performed with purpose to determine the level of hydrogen stability of sintered SmCo 5 permanent magnets by means of accelerated tests, to study the effect of hydrogen on the magnetic and mechanical properties of the permanent magnets and to establish the criteria of hydrogenation level and the activation energy of this process. In addition, the effect of hydrogen on the properties of sintered SmCo 5 permanent magnets in specific conditions of exploitation and storage durability of instruments was studied

Antithrombotic therapy in atrial fibrillation associated with valvular heart disease: a joint consensus document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology Working Group on Thrombosis, endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern Africa (CASSA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE).

Science.gov (United States)

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

2017-11-01

Atrial fibrillation (AF) is a major worldwide public health problem, and AF in association with valvular heart disease (VHD) is also common. However, management strategies for this group of patients have been less informed by randomized trials, which have largely focused on 'non-valvular AF' patients. Thrombo-embolic risk also varies according to valve lesion and may also be associated with CHA2DS2VASc score risk factor components, rather than only the valve disease being causal. Given marked heterogeneity in the definition of valvular and non-valvular AF and variable management strategies, including non-vitamin K antagonist oral anticoagulants (NOACs) in patients with VHD other than prosthetic heart valves or haemodynamically significant mitral valve disease, there is a need to provide expert recommendations for professionals participating in the care of patients presenting with AF and associated VHD. To address this topic, a Task Force was convened by the European Heart Rhythm Association (EHRA) and European Society of Cardiology (ESC) Working Group on Thrombosis, with representation from the ESC Working Group on Valvular Heart Disease, Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE) with the remit to comprehensively review the published evidence, and to publish a joint consensus document on the management of patients with AF and associated VHD, with up-to-date consensus recommendations for clinical practice for different forms of VHD. This consensus document proposes that the term 'valvular AF' is outdated and given that any definition ultimately relates to the evaluated practical use of oral anticoagulation (OAC) type, we propose a functional Evaluated Heartvalves, Rheumatic or Artificial (EHRA) categorization in relation to the type of OAC use in patients with AF, as follows: (i) EHRA Type 1 VHD, which refers

Artificial Disc Replacement

Science.gov (United States)

... Spondylolisthesis BLOG FIND A SPECIALIST Treatments Artificial Disc Replacement (ADR) Patient Education Committee Jamie Baisden The disc ... Disc An artificial disc (also called a disc replacement, disc prosthesis or spine arthroplasty device) is a ...

Elective extractions of first permanent molars: a review

Directory of Open Access Journals (Sweden)

Melike Kiraz

2018-05-01

Full Text Available Permanent first molar teeth possess a key role in the setting-up of the occlusion, contribute significantly to the chewing function and serve as a guide for other teeth. However, it is frequently encountered that permanent first molar teeth are extracted due to the predicted negative prognoses of caries or developmental defects. As a result of the uncontrolled extraction of the permanent first molar teeth during the growth and development period, drifting of adjacent teeth, continued eruption of the opposing teeth and displacements can be seen. Furthermore, following one-sided extraction, midline deviations, oppositional tooth eruption, skeletal and dental asymmetry, unilateral chewing habits, and temporo-mandibular joint disorders may occur. To prevent these pathological conditions and to maintain the stability of the occlusal relation, it is necessary to do compensation and balancing extractions of the permanent first molar teeth on the opposite/symmetric arc, assuming mesial drag of the permanent second and third molar teeth. With such controlled-extractions, especially in Class I cases, orthodontic or prosthetic treatments, which may require extra time, cost and effort, could be prevented and a conceivable occlusion can be established.

PENGUKURAN PERMANENT EARNINGS PADA HUBUNGAN DENGAN KEBIJAKAN DIVIDEND PERUSAHAAN : REVIEW PENELITIAN

Directory of Open Access Journals (Sweden)

Wahyu Manuhara Putra

2016-02-01

Full Text Available Corporate earnings divided into a permanent component of earnings and transitory earnings will be very useful in estimating the future value of the company, that will be useful in decision making stock return. Be more relevant for investors and financial analysts in analyzing the earnings based on the permanent and transitory earnings. On permanent earnings will be more focused to get the gain from investments. One focus of research is based on this component is to test the relationship with the earnings dividend payment policy. Based on several studies obtained different results concerning the relationship with the permanent earnings dividend policy. Research that focuses on permanent earnings using two approaches to determine the accuracy of the proxy of permanent earnings. Determination of permanent earnings through the stock price and the latter by using the accounting profit.

76 FR 78698 - Proposed Revocation of Permanent Variances

Science.gov (United States)

2011-12-19

... Administration (``OSHA'' or ``the Agency'') granted permanent variances to 24 companies engaged in the... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2011-0054] Proposed Revocation of Permanent Variances AGENCY: Occupational Safety and Health Administration (OSHA...

Permanent magnet based dipole magnets for next generation light sources

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Takahiro Watanabe

2017-07-01

Full Text Available We have developed permanent magnet based dipole magnets for the next generation light sources. Permanent magnets are advantageous over electromagnets in that they consume less power, are physically more compact, and there is a less risk of power supply failure. However, experience with electromagnets and permanent magnets in the field of accelerators shows that there are still challenges to replacing main magnets of accelerators for light sources with permanent magnets. These include the adjustability of the magnetic field, the temperature dependence of permanent magnets, and the issue of demagnetization. In this paper, we present a design for magnets for future light sources, supported by experimental and numerical results.

Preattentive processing of heart cues and the perception of heart symptoms in congenital heart disease.

Science.gov (United States)

Karsdorp, Petra A; Kindt, Merel; Everaerd, Walter; Mulder, Barbara J M

2007-08-01

The present study was aimed at clarifying whether preattentive processing of heart cues results in biased perception of heart sensations in patients with congenital heart disease (ConHD) who are also highly trait anxious. Twenty-six patients with ConHD and 22 healthy participants categorized heart-related (heart rate) or neutral sensations (constant vibration) as either heart or neutral. Both sensations were evoked using a bass speaker that was attached on the chest of the participant. Before each physical sensation, a subliminal heart-related or neutral prime was presented. Biased perception of heart-sensations would become evident by a delayed categorization of the heart-related sensations. In line with the prediction, a combination of high trait anxiety and ConHD resulted in slower responses after a heart-related sensation that was preceded by a subliminal heart cue. Preattentive processing of harmless heart cues may easily elicit overperception of heart symptoms in highly trait anxious patients with ConHD.

Design of a heart rate controller for treadmill exercise using a recurrent fuzzy neural network.

Science.gov (United States)

Lu, Chun-Hao; Wang, Wei-Cheng; Tai, Cheng-Chi; Chen, Tien-Chi

2016-05-01

In this study, we developed a computer controlled treadmill system using a recurrent fuzzy neural network heart rate controller (RFNNHRC). Treadmill speeds and inclines were controlled by corresponding control servo motors. The RFNNHRC was used to generate the control signals to automatically control treadmill speed and incline to minimize the user heart rate deviations from a preset profile. The RFNNHRC combines a fuzzy reasoning capability to accommodate uncertain information and an artificial recurrent neural network learning process that corrects for treadmill system nonlinearities and uncertainties. Treadmill speeds and inclines are controlled by the RFNNHRC to achieve minimal heart rate deviation from a pre-set profile using adjustable parameters and an on-line learning algorithm that provides robust performance against parameter variations. The on-line learning algorithm of RFNNHRC was developed and implemented using a dsPIC 30F4011 DSP. Application of the proposed control scheme to heart rate responses of runners resulted in smaller fluctuations than those produced by using proportional integra control, and treadmill speeds and inclines were smoother. The present experiments demonstrate improved heart rate tracking performance with the proposed control scheme. The RFNNHRC scheme with adjustable parameters and an on-line learning algorithm was applied to a computer controlled treadmill system with heart rate control during treadmill exercise. Novel RFNNHRC structure and controller stability analyses were introduced. The RFNNHRC were tuned using a Lyapunov function to ensure system stability. The superior heart rate control with the proposed RFNNHRC scheme was demonstrated with various pre-set heart rates. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Permanent tracheostomy: Its social impacts and their management ...

African Journals Online (AJOL)

Background: Upper respiratory tract obstruction resulting from bilateral recurrent laryngeal nerve damage is commonly managed with permanent tracheostomy in our environment. Objective: To evaluate the social impacts of permanent tracheostomy and its management in Ondo State, Southwest Nigeria. Materials and ...

Artificial life and life artificialization in Tron

Directory of Open Access Journals (Sweden)

Carolina Dantas Figueiredo

2012-12-01

Full Text Available Cinema constantly shows the struggle between the men and artificial intelligences. Fiction, and more specifically fiction films, lends itself to explore possibilities asking “what if?”. “What if”, in this case, is related to the eventual rebellion of artificial intelligences, theme explored in the movies Tron (1982 and Tron Legacy (2010 trat portray the conflict between programs and users. The present paper examines these films, observing particularly the possibility programs empowering. Finally, is briefly mentioned the concept of cyborg as a possibility of response to human concerns.

Experimental study on the effect of an artificial cardiac valve on the left ventricular flow

Science.gov (United States)

Wang, JiangSheng; Gao, Qi; Wei, RunJie; Wang, JinJun

2017-09-01

The use of artificial valves to replace diseased human heart valves is currently the main solution to address the malfunctioning of these valves. However, the effect of artificial valves on the ventricular flow still needs to be understood in flow physics. The left ventricular flow downstream of a St. Jude Medical (SJM) bileaflet mechanical heart valve (BMHV), which is a widely implanted mechanical bileaflet valve, is investigated with time-resolved particle image velocimetry in the current work. A tilting-disk valve is installed on the aortic orifice to guarantee unidirectional flow. Several post-processing tools are applied to provide combined analyses of the physics involved in the ventricular flow. The triple jet pattern that is closely related to the characteristics of the bileaflet valve is discussed in detail from both Eulerian and Lagrangian views. The effects of large-scale vortices on the transportation of blood are revealed by the combined analysis of the tracking of Lagrangian coherent structures, the Eulerian monitoring of the shear stresses, and virtual dye visualization. It is found that the utilization of the SJM BMHV complicates the ventricular flow and could reduce the efficiency of blood transportation. In addition, the kinematics of the bileaflets is presented to explore the effects of flow structures on their motion. These combined analyses could elucidate the properties of SJM BMHV. Furthermore, they could provide new insights into the understanding of other complex blood flows.

Comparison of biatrial and left atrial radiofrequency ablation in patients with heart valves diseases

Directory of Open Access Journals (Sweden)

А. В. Богачев-прокофьев

2015-10-01

Full Text Available We analysed results of left atrial and biatrial anatomic scheme of radiofrequency (RF ablation of the atria in patients with valvular heart. From 2007 to 2011, RF ablation procedure performed 283 patients with atrial fibrillation and heart valve disease. Patients were divided into two groups - group I performed a complete circuit biatrial procedure (procedure maze IV - 131 patients, in group II only ablation of the left atrium -152 patients. Most of the patients had long-term persistent AF. The main problem of early postoperative period is dysfunction of pacemaker complex, which observed in 64.9% and 50.7% patients for group I and II, respectively (p = 0.031. Permanent dysfunction of pacemaker complex required implantation of permanent pacemaker (9.2% and 4.6% of cases for group I and II, respectively, p = 0,023. Predictors of dysfunction of the pacemaker complex were biatrial execution method and duration of AF. Freedom from AF and AT during 36 months after surgery was 80.4% for patients in group I and 78.5% for patients in group II, with no statistically significant difference (log-rank test, p = 0.621. Atrial transport function has not revealed that the active fraction of the right atrium was 29.8% higher than in group II in the early postoperative phase and by 17.9% in the long term, with no difference between groups for the left atrium has been received.

Zero-fluoroscopy permanent pacemaker implantation using Ensite NavX system: Clinical viability or fanciful technique?

Science.gov (United States)

Guo, Ping; Qiu, Jie; Wang, Yan; Chen, Guangzhi; Proietti, Riccardo; Fadhle, Al-Selmi; Zhao, Chunxia; Wen Wang, Dao

2018-02-01

Fluoroscopy is the imaging modality routinely used for cardiac device implantation and electrophysiological procedures. Due to the rising concern regarding the harmful effects of radiation exposure to both the patients and operation staffs, novel 3D mapping systems have been developed and implemented in electrophysiological procedure for the navigation of catheters inside the heart chambers. Their applicability in cardiac device implantation has been rarely reported. Our aim is to evaluate the feasibility and safety of permanent pacemaker implantation without fluoroscopy. From January 2012 to June 2016, six patients (50 ± 15 years, four of six were female, one of who was at the 25th week of gestation) who underwent permanent pacemaker implantation were included (zero-fluoroscopy group). Data from 20 consecutive cases of implantation performed under fluoroscopy guidance were chosen as a control group (fluoroscopy group). Total implantation procedure time for single-chamber pacemaker was 51.3 ± 13.1 minutes in the zero-fluoroscopy group and 42.6 ± 7.4 minutes in the fluoroscopy group (P  =  0.155). The implantation procedural time for a dual-chamber pacemaker was 88.3 ± 19.6 minutes and 67.3 ± 7.6 minutes in the zero-fluoroscopy and fluoroscopy groups (P  =  0.013), respectively. No complications were observed during the procedure and the follow-up in the two groups, and all pacemakers worked with satisfactory parameters. Ensite NavX system can be used as a reliable and safe zero-fluoroscopy approach for the implantation of single- or dual-chamber permanent pacemakers in specific patients, such as pregnant women or in extreme situations when the x-ray machine is not available. © 2017 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals, Inc.

The effect of rigor mortis on the passage of erythrocytes and fluid through the myocardium of isolated dog hearts.

Science.gov (United States)

Nevalainen, T J; Gavin, J B; Seelye, R N; Whitehouse, S; Donnell, M

1978-07-01

The effect of normal and artificially induced rigor mortis on the vascular passage of erythrocytes and fluid through isolated dog hearts was studied. Increased rigidity of 6-mm thick transmural sections through the centre of the posterior papillary muscle was used as an indication of rigor. The perfusibility of the myocardium was tested by injecting 10 ml of 1% sodium fluorescein in Hanks solution into the circumflex branch of the left coronary artery. In prerigor hearts (20 minute incubation) fluorescein perfused the myocardium evenly whether or not it was preceded by an injection of 10 ml of heparinized dog blood. Rigor mortis developed in all hearts after 90 minutes incubation or within 20 minutes of perfusing the heart with 50 ml of 5 mM iodoacetate in Hanks solution. Fluorescein injected into hearts in rigor did not enter the posterior papillary muscle and adjacent subendocardium whether or not it was preceded by heparinized blood. Thus the vascular occlusion caused by rigor in the dog heart appears to be so effective that it prevents flow into the subendocardium of small soluble ions such as fluorescein.

Special-Purpose High-Torque Permanent-Magnet Motors

Science.gov (United States)

Doane, George B., III

1995-01-01

Permanent-magnet brushless motors that must provide high commanded torques and satisfy unusual heat-removal requirement are developed. Intended for use as thrust-vector-control actuators in large rocket engines. Techniques and concepts used to design improved motors for special terrestrial applications. Conceptual motor design calls for use of rotor containing latest high-energy-product rare-earth permanent magnets so that motor produces required torque while drawing smallest possible currents from power supply. Torque generated by electromagnetic interaction between stator and permanent magnets in rotor when associated electronic circuits applied appropriately temporally and spatially phased currents to stator windings. Phase relationships needed to produce commanded torque computed in response to torque command and to electronically sensed angular position of rotor relative to stator.

Modeling demagnetization effects in permanent magnet synchronous machines

NARCIS (Netherlands)

Kral, C.; Sprangers, R.L.J.; Waarma, J.; Haumer, A.; Winter, O.; Lomonova, E.

2010-01-01

This paper presents a permanent magnet model which takes temperature dependencies and demagnetization effects into account. The proposed model is integrated into a magnetic fundamental wave machine model using the model- ing language Modelica. For different rotor types permanent magnet models are

Modeling of ironless permanent magnet planar motor structures

NARCIS (Netherlands)

Boeij, de J.; Lomonova, E.A.; Vandenput, A.J.A.

2006-01-01

This paper describes an analytical model that includes end effects for ironless synchronous permanent-magnet planar actuators. Because of its flexibility, the model can be used to predict the performance of various permanent-magnet array and coil array topologies and commutation schemes. Moreover,

Artificial neural network prediction of ischemic tissue fate in acute stroke imaging

Science.gov (United States)

Huang, Shiliang; Shen, Qiang; Duong, Timothy Q

2010-01-01

Multimodal magnetic resonance imaging of acute stroke provides predictive value that can be used to guide stroke therapy. A flexible artificial neural network (ANN) algorithm was developed and applied to predict ischemic tissue fate on three stroke groups: 30-, 60-minute, and permanent middle cerebral artery occlusion in rats. Cerebral blood flow (CBF), apparent diffusion coefficient (ADC), and spin–spin relaxation time constant (T2) were acquired during the acute phase up to 3 hours and again at 24 hours followed by histology. Infarct was predicted on a pixel-by-pixel basis using only acute (30-minute) stroke data. In addition, neighboring pixel information and infarction incidence were also incorporated into the ANN model to improve prediction accuracy. Receiver-operating characteristic analysis was used to quantify prediction accuracy. The major findings were the following: (1) CBF alone poorly predicted the final infarct across three experimental groups; (2) ADC alone adequately predicted the infarct; (3) CBF+ADC improved the prediction accuracy; (4) inclusion of neighboring pixel information and infarction incidence further improved the prediction accuracy; and (5) prediction was more accurate for permanent occlusion, followed by 60- and 30-minute occlusion. The ANN predictive model could thus provide a flexible and objective framework for clinicians to evaluate stroke treatment options on an individual patient basis. PMID:20424631

Bleeding with the artificial heart: Gastrointestinal hemorrhage in CF-LVAD patients.

Science.gov (United States)

Gurvits, Grigoriy E; Fradkov, Elena

2017-06-14

Continuous-flow left ventricular assist devices (CF-LVADs) have significantly improved outcomes for patients with end-stage heart failure when used as a bridge to cardiac transplantation or, more recently, as destination therapy. However, its implantations carries a risk of complications including infection, device malfunction, arrhythmias, right ventricular failure, thromboembolic disease, postoperative and nonsurgical bleeding. A significant number of left ventricular assist devices (LVAD) recipients may experience recurrent gastrointestinal hemorrhage, mainly due to combination of antiplatelet and vitamin K antagonist therapy, activation of fibrinolytic pathway, acquired von Willebrand factor deficiency, and tendency to develop small intestinal angiodysplasias due to increased rotary speed of the pump. Gastrointestinal bleeding in LVAD patients remains a source of increased morbidity including the need for blood transfusions, extended hospital stays, multiple readmissions, and overall mortality. Management of gastrointestinal bleeding in LVAD patients involves multidisciplinary approach in stabilizing the patients, addressing risk factors and performing structured endoluminal evaluation with focus on upper gastrointestinal tract including jejunum to find and eradicate culprit lesion. Medical and procedural intervention is largely successful and universal bleeding cessation occurs in transplanted patients.

Heart transplantation in adults with congenital heart disease.

Science.gov (United States)

Houyel, Lucile; To-Dumortier, Ngoc-Tram; Lepers, Yannick; Petit, Jérôme; Roussin, Régine; Ly, Mohamed; Lebret, Emmanuel; Fadel, Elie; Hörer, Jürgen; Hascoët, Sébastien

2017-05-01

With the advances in congenital cardiac surgery and postoperative care, an increasing number of children with complex congenital heart disease now reach adulthood. There are already more adults than children living with a congenital heart defect, including patients with complex congenital heart defects. Among these adults with congenital heart disease, a significant number will develop ventricular dysfunction over time. Heart failure accounts for 26-42% of deaths in adults with congenital heart defects. Heart transplantation, or heart-lung transplantation in Eisenmenger syndrome, then becomes the ultimate therapeutic possibility for these patients. This population is deemed to be at high risk of mortality after heart transplantation, although their long-term survival is similar to that of patients transplanted for other reasons. Indeed, heart transplantation in adults with congenital heart disease is often challenging, because of several potential problems: complex cardiac and vascular anatomy, multiple previous palliative and corrective surgeries, and effects on other organs (kidney, liver, lungs) of long-standing cardiac dysfunction or cyanosis, with frequent elevation of pulmonary vascular resistance. In this review, we focus on the specific problems relating to heart and heart-lung transplantation in this population, revisit the indications/contraindications, and update the long-term outcomes. Copyright © 2017. Published by Elsevier Masson SAS.

[Object permanence in children with neurological and psychomotor disorders].

Science.gov (United States)

Pisaturo, C; Frassoni, S; Borreani, A; Battaglia, F; Meruzzi, B

1995-06-01

The aim of this research was to investigate whether the development of object permanence is an available sign of the cognitive development in infants with psychomotor handicaps. Subjects consisted of 5 males, ranging in age from 12 to 33 months, with handicaps as a result of perinatal brain injury. Four were preterm infants. All of the children received psychomotor treatment. Their stage of object permanence was assessed using traditional (B-L) and non traditional test (U-H). (The children's performances on the U-H scales have an "Intrinsic validity"). Four children achieved the first stages of the development of object permanence. The acquisition of object permanence was delayed in comparison with the age-appropriated time, but it may be considered adequate in comparison with the "developmental age" (B-L). One children with severe mental and motor disorders solved no task, the findings suggest that the children with psychomotor handicaps may gain the concept of object permanence and that psychomotor treatment may assist them in the development of the concept. This performance is not age-dependent. So the acquisition of the concept of object permanence may be considered an accurate and sensitive tool for the follow-up of the sensorimotor development in the handicapped children.

Women's Heart Disease: Heart Attack Symptoms

Science.gov (United States)

... of this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter ... most common heart attack symptom in men and women is chest pain or discomfort. However, women also ...

Permanent magnets and its production by powder metallurgy

Directory of Open Access Journals (Sweden)

Enrique Herraiz Lalana

2018-06-01

Full Text Available In this work, the historical relationship between permanent magnets and powder metallurgy is reviewed. Powder metallurgy is a manufacturing technique based on the compaction of powders that are sintered to create a solid product. This technique was used in the production of permanent magnets for the first time in the 18th century and, nowadays, most permanent magnetic materials are manufacturing by this mean. Magnetic properties are highly dependent on the microstructure of the final product, the magnetic alignment of domains and presence of porosity, to mention a few, and powder metallurgy enables fine control of these factors.

Using Artificial Intelligence to Reduce the Risk of Nonadherence in Patients on Anticoagulation Therapy.

Science.gov (United States)

Labovitz, Daniel L; Shafner, Laura; Reyes Gil, Morayma; Virmani, Deepti; Hanina, Adam

2017-05-01

This study evaluated the use of an artificial intelligence platform on mobile devices in measuring and increasing medication adherence in stroke patients on anticoagulation therapy. The introduction of direct oral anticoagulants, while reducing the need for monitoring, have also placed pressure on patients to self-manage. Suboptimal adherence goes undetected as routine laboratory tests are not reliable indicators of adherence, placing patients at increased risk of stroke and bleeding. A randomized, parallel-group, 12-week study was conducted in adults (n=28) with recently diagnosed ischemic stroke receiving any anticoagulation. Patients were randomized to daily monitoring by the artificial intelligence platform (intervention) or to no daily monitoring (control). The artificial intelligence application visually identified the patient, the medication, and the confirmed ingestion. Adherence was measured by pill counts and plasma sampling in both groups. For all patients (n=28), mean (SD) age was 57 years (13.2 years) and 53.6% were women. Mean (SD) cumulative adherence based on the artificial intelligence platform was 90.5% (7.5%). Plasma drug concentration levels indicated that adherence was 100% (15 of 15) and 50% (6 of 12) in the intervention and control groups, respectively. Patients, some with little experience using a smartphone, successfully used the technology and demonstrated a 50% improvement in adherence based on plasma drug concentration levels. For patients receiving direct oral anticoagulants, absolute improvement increased to 67%. Real-time monitoring has the potential to increase adherence and change behavior, particularly in patients on direct oral anticoagulant therapy. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02599259. © 2017 American Heart Association, Inc.

Topology optimization for design of segmented permanent magnet arrays with ferromagnetic materials

Science.gov (United States)

Lee, Jaewook; Yoon, Minho; Nomura, Tsuyoshi; Dede, Ercan M.

2018-03-01

This paper presents multi-material topology optimization for the co-design of permanent magnet segments and iron material. Specifically, a co-design methodology is proposed to find an optimal border of permanent magnet segments, a pattern of magnetization directions, and an iron shape. A material interpolation scheme is proposed for material property representation among air, permanent magnet, and iron materials. In this scheme, the permanent magnet strength and permeability are controlled by density design variables, and permanent magnet magnetization directions are controlled by angle design variables. In addition, a scheme to penalize intermediate magnetization direction is proposed to achieve segmented permanent magnet arrays with discrete magnetization directions. In this scheme, permanent magnet strength is controlled depending on magnetization direction, and consequently the final permanent magnet design converges into permanent magnet segments having target discrete directions. To validate the effectiveness of the proposed approach, three design examples are provided. The examples include the design of a dipole Halbach cylinder, magnetic system with arbitrarily-shaped cavity, and multi-objective problem resembling a magnetic refrigeration device.

Crustal deformations at permanent GPS sites in Denmark

DEFF Research Database (Denmark)

Khan, Shfaqat Abbas; Knudsen, Per; Tscherning, Carl Christian

2005-01-01

The National Survey and Cadastre (KMS) is responsible for the geodetic definition of the reference network in Denmark. Permanent GPS stations play an important role in the monitoring and maintenance of the geodetic network. During 1998 and 1999 KMS established three permanent GPS station in Denma...

Comparing superconducting and permanent magnets for magnetic refrigeration

DEFF Research Database (Denmark)

Bjørk, Rasmus; Nielsen, Kaspar Kirstein; Bahl, C. R. H.

2016-01-01

We compare the cost of a high temperature superconducting (SC) tape-based solenoidwith a permanent magnet (PM) Halbach cylinder for magnetic refrigeration.Assuming a five liter active magnetic regenerator volume, the price of each type ofmagnet is determined as a function of aspect ratio...... of the regenerator and desiredinternal magnetic field. It is shown that to produce a 1 T internal field in theregenerator a permanent magnet of hundreds of kilograms is needed or an area ofsuperconducting tape of tens of square meters. The cost of cooling the SC solenoidis shown to be a small fraction of the cost...... of the SC tape. Assuming a cost ofthe SC tape of 6000 $/m2 and a price of the permanent magnet of 100 $/kg, thesuperconducting solenoid is shown to be a factor of 0.3-3 times more expensive thanthe permanent magnet, for a desired field from 0.5-1.75 T and the geometrical aspectratio of the regenerator...

Magnetic guns with cylindrical permanent magnets

DEFF Research Database (Denmark)

Vokoun, David; Beleggia, Marco; Heller, Luděk

2012-01-01

The motion of a cylindrical permanent magnet (projectile) inside a tubular permanent magnet, with both magnets magnetized axially, illustrates nicely the physical principles behind the operation of magnetic guns. The force acting upon the projectile is expressed semi-analytically as derivative...... of the magnetostatic interaction energy. For comparison, the forces involved are also calculated numerically using finite elements methods. Based on the conservation of the magnetostatic and kinetic energies, the exit and asymptotic velocities are determined. The derived formulas can be used to optimize the generated...... forces and motion of the inner cylindrical magnet....

Design of permanent magnet synchronous motor within minimum cost

OpenAIRE

Півняк, Геннадій Григорович; Бешта, Олександр Степанович; Фурса, Сергій Григорійович; Neuberger, Nikolaus; Nolle, N.

2010-01-01

The article describes design and simulation experience of permanent magnet synchronous motor (PMSM). The design goal is to develop PMSM of the least possible cost. For that purpose the standard induction motor stator was applied as a basic solution and permanent magnets were installed in rotor. Simulation results are presented, the dependence of efficiency and total loss on magnet material mass are obtained. The optimal value of permanent magnets is estimated for the given electric motor frame.

Artificial Intelligence in Astronomy

Science.gov (United States)

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

2010-12-01

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

The M/G/1 queue with permanent customers

NARCIS (Netherlands)