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Sample records for pivot bi-leaflet heart

  1. Platelet activation through a Bi-leaflet mechanical heart valve

    Science.gov (United States)

    Hedayat, Mohammadali; Borazjani, Iman

    2016-11-01

    Platelet activation is one of the major drawbacks of the Mechanical Heart Valves (MHVs) which can increase the risk of thrombus formation in patients. The platelet activation in MHVs can be due to the abnormal shear stress during the systole, the backward leakage flow during the diastole, and the flow through the hinge region. We investigate the contribution of each of the above mechanism to the activation of platelets in MHVs by performing simulations of the flow through the MHV and in the hinge region. The large scale heart valve simulations are performed in a straight aorta using a sharp interface curvilinear immersed boundary method along with a strong-coupling algorithm under physiological flow conditions. In addition, in order to perform the simulation of hinge region the flow field boundary conditions are obtained from the largescale simulations during a whole cardiac cycle. In order to investigate the role of hinge flow on platelet activation in MHVs, a 23mm St. Jude Medical Regent valve hinge with three different gap sizes is tested along with different platelet activation models to ensure the consistency of our results with different activation models. We compare the platelet activation of the hinge region against the bulk of the flow during one cardiac cycle. This work is supported by the American Heart Association Grant 13SDG17220022, and the computational resources were partly provided by Center for Computational Research (CCR) at University at Buffalo.

  2. Laser Doppler anemometry measurements of steady flow through two bi-leaflet prosthetic heart valves

    Directory of Open Access Journals (Sweden)

    Ovandir Bazan

    2013-12-01

    Full Text Available INTRODUCTION: In vitro hydrodynamic characterization of prosthetic heart valves provides important information regarding their operation, especially if performed by noninvasive techniques of anemometry. Once velocity profiles for each valve are provided, it is possible to compare them in terms of hydrodynamic performance. In this first experimental study using laser doppler anemometry with mechanical valves, the simulations were performed at a steady flow workbench. OBJECTIVE: To compare unidimensional velocity profiles at the central plane of two bi-leaflet aortic prosthesis from St. Jude (AGN 21 - 751 and 21 AJ - 501 models exposed to a steady flow regime, on four distinct sections, three downstream and one upstream. METHODS: To provide similar conditions for the flow through each prosthesis by a steady flow workbench (water, flow rate of 17L/min. and, for the same sections and sweeps, to obtain the velocity profiles of each heart valve by unidimensional measurements. RESULTS: It was found that higher velocities correspond to the prosthesis with smaller inner diameter and instabilities of flow are larger as the section of interest is closer to the valve. Regions of recirculation, stagnation of flow, low pressure, and flow peak velocities were also found. CONCLUSIONS: Considering the hydrodynamic aspect and for every section measured, it could be concluded that the prosthesis model AGN 21 - 751 (RegentTM is superior to the 21 AJ - 501 model (Master Series. Based on the results, future studies can choose to focus on specific regions of the these valves.

  3. High-resolution fluid-structure interaction simulations of flow through a bi-leaflet mechanical heart valve in an anatomic aorta.

    Science.gov (United States)

    Borazjani, Iman; Ge, Liang; Sotiropoulos, Fotis

    2010-02-01

    We have performed high-resolution fluid-structure interaction simulations of physiologic pulsatile flow through a bi-leaflet mechanical heart valve (BMHV) in an anatomically realistic aorta. The results are compared with numerical simulations of the flow through an identical BMHV implanted in a straight aorta. The comparisons show that although some of the salient features of the flow remain the same, the aorta geometry can have a major effect on both the flow patterns and the motion of the valve leaflets. For the studied configuration, for instance, the BMHV leaflets in the anatomic aorta open much faster and undergo a greater rebound during closing than the same valve in the straight axisymmetric aorta. Even though the characteristic triple-jet structure does emerge downstream of the leaflets for both cases, for the anatomic case the leaflet jets spread laterally and diffuse much faster than in the straight aorta due to the aortic curvature and complex shape of the anatomic sinus. Consequently the leaflet shear layers in the anatomic case remain laminar and organized for a larger portion of the accelerating phase as compared to the shear layers in the straight aorta, which begin to undergo laminar instabilities well before peak systole is reached. For both cases, however, the flow undergoes a very similar explosive transition to the small-scale, turbulent-like state just prior to reaching peak systole. The local maximum shear stress is used as a metric to characterize the mechanical environment experienced by blood cells. Pockets of high local maximum shear are found to be significantly more widespread in the anatomic aorta than in the straight aorta throughout the cardiac cycle. Pockets of high local maximum shear were located near the leaflets and in the aortic arc region. This work clearly demonstrates the importance of the aortic geometry on the flow phenomena in a BMHV and demonstrates the potential of our computational method to carry out image

  4. A biomimetic bi-leaflet mitral prosthesis with enhanced physiological left ventricular swirl restorative capability

    Science.gov (United States)

    Tan, Sean Guo-Dong; Kim, Sangho; Leo, Hwa Liang

    2016-06-01

    Mechanical heart valve prostheses are often implanted in young patients due to their durability and long-term reliability. However, existing designs are known to induce elevated levels of blood damage and blood platelet activation. As a result, there is a need for patients to undergo chronic anti-coagulation treatment to prevent thrombosis, often resulting in bleeding complications. Furthermore, recent studies have suggested that the implantation of a mechanical prosthetic valve at the mitral position results in a significant alteration of the left ventricular flow field which may contribute to flow turbulence. This study proposes a bi-leaflet mechanical heart valve design (Bio-MHV) that mimics the geometry of a human mitral valve, with the aim of reducing turbulence levels in the left ventricle by replicating physiological flow patterns. An in vitro three-dimensional particle velocimetry imaging experiment was carried out to compare the hemodynamic performance of the Bio-MHV with that of the clinically established ATS valve. The Bio-MHV was found to replicate physiological left ventricular flow patterns and produced lower turbulence levels.

  5. Time-Resolved Micro PIV in the Pivoting Area of the Triflo Mechanical Heart Valve.

    Science.gov (United States)

    Vennemann, Bernhard M; Rösgen, Thomas; Carrel, Thierry P; Obrist, Dominik

    2016-09-01

    The Lapeyre-Triflo FURTIVA valve aims at combining the favorable hemodynamics of bioprosthetic heart valves with the durability of mechanical heart valves (MHVs). The pivoting region of MHVs is hemodynamically of special interest as it may be a region of high shear stresses, combined with areas of flow stagnation. Here, platelets can be activated and may form a thrombus which in the most severe case can compromise leaflet mobility. In this study we set up an experiment to replicate the pulsatile flow in the aortic root and to study the flow in the pivoting region under physiological hemodynamic conditions (CO = 4.5 L/min / CO = 3.0 L/min, f = 60 BPM). It was found that the flow velocity in the pivoting region could reach values close to that of the bulk flow during systole. At the onset of diastole the three valve leaflets closed in a very synchronous manner within an average closing time of 55 ms which is much slower than what has been measured for traditional bileaflet MHVs. Hot spots for elevated viscous shear stresses were found at the flanges of the housing and the tips of the leaflet ears. Systolic VSS was maximal during mid-systole and reached levels of up to 40 Pa.

  6. Twenty-year single-center experience with the medtronic open pivot mechanical heart valve.

    Science.gov (United States)

    Van Nooten, Guido J; Bové, Thierry; Van Belleghem, Yves; François, Katrien; Caes, Frank; Vandenplas, Guy; De Pauw, Michel; Taeymans, Yves

    2014-04-01

    Since May 1992 the Medtronic Open Pivot mechanical heart valve has been implanted routinely at the authors' institution. The study aim was to analyze, retrospectively, the 20-year clinical results of the valve. Between May 1992 and December 2011 a total of 1,520 valves was inserted into 1,382 consecutive patients (1,012 aortic, 473 mitral, 26 tricuspid, 9 pulmonary). The mean age of the patients was 61±13.2 years. Preoperatively, 65% of the patients were in New York Heart Association (NYHA) class III or greater. Frequent comorbidities included atrial fibrillation (n=419), coronary disease (n=357), and diabetes (n=255). The 99% complete follow-up totaled 10,527 patient-years (range 12 to 244 months). Ninety-day mortality was 5.2% (n=73, 8 valve related). Of the 550 total deaths, 240 were cardiac and 56 valve related. Multivariate analysis selected age, NYHA III or greater, concomitant coronary revascularization, and respiratory insufficiency as risk factors for death. Renal failure was considered a risk factor in the aortic and atrial fibrillation in the mitral subgroup. Erratic international normalized ratio (INR), NYHA class III or greater, and non-sinus rhythm were risk factors for thromboembolism; likewise redo operations in the aortic subgroup. Erratic INR and age were risk factors for bleeding as were over-coagulation and coronary revascularization in the aortic subgroup and redo operations and renal failure in mitral patients. This 20-year experience demonstrated excellent clinical outcomes with no structural valve failure. Odds ratio defined aortic patients as the lowest risk for adverse events. By contrast atrial fibrillation and elderly age, in combination with instable anticoagulation, yielded the worst long-term results. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Hypoxia-driven glycolytic and fructolytic metabolic programs: Pivotal to hypertrophic heart disease.

    Science.gov (United States)

    Mirtschink, Peter; Krek, Wilhelm

    2016-07-01

    Pathologic cardiac growth is an adaptive response of the myocardium to various forms of systemic (e.g. pressure overload) or genetically-based (e. g. mutations in genes encoding sarcomeric proteins) stress. It represents a key aspect of different types of heart disease including aortic stenosis (AS) and hypertrophic cardiomyopathy (HCM). While many of the pathophysiological and hemodynamical aspects of pathologic cardiac hypertrophy have been uncovered during the last decades, its underlying metabolic determinants are only beginning to come into focus. Here, we review the epidemiological evidence and pathological features of hypertrophic heart disease in AS and HCM and consider in this context the development of microenvironmental tissue hypoxia as a key component of the heart's growth response to pathologic stress. We particularly reflect on recent evidence illustrating how activation of hypoxia-inducible factor (HIF) drives glycolytic and fructolytic metabolic programs to maintain ATP generation and support anabolic growth of the pathologically-stressed heart. Finally we discuss how this metabolic programs, when protracted, deprive the heart of energy leading ultimately to heart failure. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel.

  8. Pivotal effects of phosphodiesterase inhibitors on myocyte contractility and viability in normal and ischemic hearts

    Institute of Scientific and Technical Information of China (English)

    Yuan James RAO; Lei XI

    2009-01-01

    Phosphodiesterases (PDEs) are enzymes that degrade cellular cAMP and cGMP and are thus essential for regulating the cyclic nucleotides. At least 11 families of PDEs have been identified, each with a distinctive structure, activity, expression, and tissue distribution. The PDE type-3, -4, and -5 (PDE3, PDE4, PDE5) are localized to specific regions of the cardiomyo-cyte, such as the sarcoplasmic reticulum and Z-disc, where they are likely to influence cAMP/cGMP signaling to the end effectors of contractility. Several PDE inhibitors exhibit remarkable hemodynamic and inotropic properties that may be valuable to clinical practice. In particular, PDE3 inhibitors have potent cardiotonic effects that can be used for short-term inotropic support, especially in situations where adrenergic stimulation is insufficient. Most relevant to this review, PDE in-hibitors have also been found to have cytoprotective effects in the heart. For example, PDE3 inhibitors have been shown to be cardioprotective when given before ischemic attack, whereas PDE5 inhibitors, which include three widely used erectile dysfunction drugs (sildenafil, vardenafil and tadalafil), can induce remarkable cardioprotection when administered either prior to ischemia or upon reperfusion. This article provides an overview of the current laboratory and clinical evidence, as well as the cellular mechanisms by which the inhibitors of PDE3, PDE4 and PDE5 exert their beneficial effects on normal and ischemic hearts. It seems that PDE inhibitors hold great promise as clinically applicable agents that can improve car-diac performance and cell survival under critical situations, such as ischemic heart attack, cardiopulmonary bypass surgery, and heart failure.

  9. Pivotal importance of STAT3 in protecting the heart from acute and chronic stress: new advancement and unresolved issues

    Directory of Open Access Journals (Sweden)

    Foaud A. Zouein

    2015-11-01

    Full Text Available The transcription factor Signal Transducer and Activator of Transcription 3 (STAT3 has been implicated in protecting the heart from acute ischemic injury under both basal conditions and as a crucial component of pre- and post-conditioning protocols. A number of anti-oxidant and antiapoptotic genes are upregulated by STAT3 via canonical means involving phosphorylation on Y705 and S727, although other incompletely defined posttranslational modifications are involved. In addition, STAT3 is now known to be present in cardiac mitochondria and to exert actions that regulate the electron transport chain, reactive oxygen species (ROS production, and mitochondrial permeability transition pore (mPTP opening. These non-canonical actions of STAT3 are enhanced by S727 phosphorylation. The molecular basis for the mitochondrial actions of STAT3 are poorly understood, but STAT3 is known to interact with a critical subunit of complex I and to regulate complex I function. Dysfunctional complex I has been implicated in ischemic injury, heart failure, and the aging process. Evidence also indicates that STAT3 is protective to the heart under chronic stress conditions, including hypertension, pregnancy, and advanced age. Paradoxically, the accumulation of unphosphorylated STAT3 (U-STAT3 in the nucleus has been suggested to drive pathological cardiac hypertrophy and inflammation via noncanonical gene expression, perhaps involving a distinct acetylation profile. U-STAT3 may also regulate chromatin stability. Our understanding of how the noncanonical genomic and mitochondrial actions of STAT3 in the heart are regulated and coordinated with the canonical actions of STAT3 is rudimentary. Here we present an overview of what is currently known about the pleotropic actions of STAT3 in the heart in order to highlight controversies and unresolved issues.

  10. Mid- to long-term outcome comparison of the Medtronic Hancock II and bi-leaflet mechanical aortic valve replacement in patients younger than 60 years of age: a propensity-matched analysis.

    Science.gov (United States)

    Wang, Yin; Chen, Si; Shi, Jiawei; Li, Geng; Dong, Nianguo

    2016-03-01

    This study aims to compare mid-long-term clinical outcomes between patients younger than 60 years of age undergoing bioprosthetic and mechanical aortic valve replacement. From January 2002 to December 2009, patients younger than 60 years of age who received Medtronic Hancock II porcine bioprostheses were selected and compared with those who received mechanical bi-leaflet valves in the aortic position. A stepwise logistic regression propensity score identified a subset of 112 evenly matched patient-pairs. Mid-long-term outcomes of survival, valve-related reoperations, thromboembolic events and bleeding events were assessed. The follow-up was only 95.1% complete. Fourteen measurable variables were statistically similar for the matched cohort. Postoperative in-hospital mortality was 3.6% (bioprosthetic valves) and 2.7% (mechanical valves) (P = 0.700). Survival at 5 and 10 years was 96.3 and 88.7% for patients receiving bioprosthetic valve replacement versus 96.3 and 87.9% for patients receiving mechanical valve replacement (P = 0.860), respectively. At 5 and 10 years after operations, freedom from valve-related reoperation was 97.2 and 94.8% for patients receiving mechanical valve replacement, and 96.3 and 90.2% for patients receiving bioprosthetic valve replacement (P = 0.296), respectively. There was no difference between freedom from thromboembolic events (P = 0.528) and bleeding events (P = 0.128) between the matched groups during the postoperative 10 years. In patients younger than 60 years of age undergoing aortic valve replacement, mid-long-term survival rate was similar for patients receiving bioprosthetic versus mechanical valve replacement. Bioprosthetic valves were associated with a trend for a lower risk of anticoagulation treatment and did not have significantly greater likelihood of a reoperation. These findings suggest that a bioprosthetic valve may be a reasonable choice for AVR in patients younger than 60 years of age. © The Author 2015. Published by

  11. Comprender: propuesta de pivotes

    Directory of Open Access Journals (Sweden)

    Santiago Alonso

    2011-06-01

    Full Text Available How do we understand? A pivot proposalThe basic question is what it is needed to understand. The proposal is that understanding requires pivots, a useful word to integrate findings in different areas. In that sense, a pivot can be understood as a mental model. It can also be the body, an idea based on embodied cognition. But more fundamentally, our biology and brain are the central pivots for understanding. Therefore, this essay can be seen as a brief travel through three different subjects: Mental Models, Embodied Cognition and Cognitive Neuroscience, all of which are necessary to understand how a person understands.

  12. Two-dimensional FSI simulation of closing dynamics of a tilting disc mechanical heart valve.

    Science.gov (United States)

    Govindarajan, V; Udaykumar, H S; Herbertson, L H; Deutsch, S; Manning, K B; Chandran, K B

    2010-03-01

    The fluid dynamics during valve closure resulting in high shear flows and large residence times of particles has been implicated in platelet activation and thrombus formation in mechanical heart valves. Our previous studies with bi-leaflet valves have shown that large shear stresses induced in the gap between the leaflet edge and the valve housing results in relatively high platelet activation levels whereas flow between the leaflets results in shed vortices not conducive to platelet damage. In this study we compare the result of closing dynamics of a tilting disc valve with that of a bi-leaflet valve. The two-dimensional fluid-structure interaction analysis of a tilting disc valve closure mechanics is performed with a fixed grid Cartesian mesh flow solver with local mesh refinement, and a Lagrangian particle dynamic analysis for computation of potential for platelet activation. Throughout the simulation the flow remains in the laminar regime and the flow through the gap width is marked by the development of a shear layer which separates from the leaflet downstream of the valve. Zones of re-circulation are observed in the gap between the leaflet edge and the valve housing on the major orifice region of the tilting disc valve and are seen to be migrating towards the minor orifice region. Jet flow is observed at the minor orifice region and a vortex is formed which sheds in the direction of fluid motion as observed in experiments using PIV measurements. The activation parameter computed for the tilting disc valve, at the time of closure was found to be 2.7 times greater than that of the bi-leaflet mechanical valve and was found to be in the vicinity of the minor orifice region mainly due to the migration of vortical structures from the major to the minor orifice region during the leaflet rebound of the closing phase.

  13. en los pivotes centrales

    Directory of Open Access Journals (Sweden)

    Reynaldo Roque Rodés

    2005-01-01

    Full Text Available Se hace una revisión y comentarios sobre las ventajas y limitantes del empleo del LEPA (Low Enery Precision Aplication en los sistemas de riego de pivotes centrales. Estos sistemas o filosofía de manejo del agua para condiciones de escasez o mala calidad del líquido es una alternativa viable para la producción de alimentos. Introducida en la década del 80 en las planicies del sur de Texas, donde la alta evaporación del agua y la necesidad de regar grandes áreas con pivotes centrales obligaba a la búsqueda de una alternativa para incrementar al máximo la eficiencia de aplicación del riego. Aún en fase de estudio e introducción en Cuba para áreas específicas, puede ser una solución de incremento de los rendimientos de los cultivos, empleando menos agua y aguas con calidad limitada

  14. Analysis of Pivot Sampling in Dual-Pivot Quicksort

    DEFF Research Database (Denmark)

    Nebel, Markus E.; Wild, Sebastian; Martinez, Conrado

    2016-01-01

    The new dual-pivot Quicksort by Vladimir Yaroslavskiy—used in Oracle’s Java runtime library since version 7—features intriguing asymmetries. They make a basic variant of this algorithm use less comparisons than classic single-pivot Quicksort. In this paper, we extend the analysis to the case where...

  15. How Good Is Multi-Pivot Quicksort?

    DEFF Research Database (Denmark)

    Aumüller, Martin; Dietzfelbinger, Martin; Klaue, Pascal

    2016-01-01

    Multi-Pivot Quicksort refers to variants of classical quicksort where in the partitioning step k pivots are used to split the input into k + 1 segments. For many years, multi-pivot quicksort was regarded as impractical, but in 2009 a two-pivot approach by Yaroslavskiy, Bentley, and Bloch was chosen...... for multi-pivot quicksort are devised and analyzed. The analysis shows that the benefits of using multiple pivots with respect to the average comparison count are marginal and these strategies are inferior to simpler strategies such as the well-known median-of-k approach. A substantial part...

  16. HPC s Pivot to Data

    Energy Technology Data Exchange (ETDEWEB)

    Parete-Koon, Suzanne [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility (OLCF); Caldwell, Blake A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility (OLCF); Canon, Richard Shane [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). National Energy Research Scientific Computing Center (NERSC); Dart, Eli [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Sciences Network (ESnet); Hick, Jason [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). National Energy Research Scientific Computing Center (NERSC); Hill, Jason J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility (OLCF); Layton, Chris [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility (OLCF); Pelfrey, Daniel S. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility (OLCF); Shipman, Galen M [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility (OLCF); Skinner, David [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). National Energy Research Scientific Computing Center (NERSC); Nam, Hai Ah [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility (OLCF); Wells, Jack C. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Oak Ridge Leadership Computing Facility (OLCF); Zurawski, Jason [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Energy Sciences Network (ESnet)

    2014-05-03

    Computer centers such as NERSC and OLCF have traditionally focused on delivering computational capability that enables breakthrough innovation in a wide range of science domains. Accessing that computational power has required services and tools to move the data from input and output to computation and storage. A ''pivot to data'' is occurring in HPC. Data transfer tools and services that were previously peripheral are becoming integral to scientific workflows. Emerging requirements from high-bandwidth detectors, high-throughput screening techniques, highly concur- rent simulations, increased focus on uncertainty quantification, and an emerging open-data policy posture toward published research are among the data-drivers shaping the networks, file systems, databases, and overall compute and data environment. In this paper we explain the pivot to data in HPC through user requirements and the changing resources provided by HPC with particular focus on data movement. For WAN data transfers we present the results of a study of network performance between centers.

  17. Pivotal Response Treatment: Case Reports.

    Science.gov (United States)

    Ventola, Pamela; Friedman, Hannah; Oosting, Devon

    2015-01-01

    The current paper provides an overview of an evidence-based treatment, Pivotal Response Treatment (PRT), for autism spectrum disorder (ASD). The paper describes PRT principles and then illustrates the approach using two case reports. The children are preschool-aged children with high-functioning ASD. They were participating in a four-month clinical trial of PRT. At the start of treatment, they presented with significant social communication impairments, including a minimal understanding of reciprocity, limited play skills, and repetitive behaviors and speech. The paper outlines how behavioral treatment goals were identified and then how activities were designed, using principles of PRT, to target skill acquisition. Following the treatment course, both children made substantial and meaningful gains in social communication skill development.

  18. Extending Teach and Repeat to Pivoting Wheelchairs

    Directory of Open Access Journals (Sweden)

    Guillermo Del Castillo

    2003-02-01

    Full Text Available The paper extends the teach-and-repeat paradigm that has been successful for the control of holonomic robots to nonholonomic wheelchairs which may undergo pivoting action over the course of their taught movement. Due to the nonholonomic nature of the vehicle kinematics, estimation is required -- in the example given herein, based upon video detection of wall-mounted cues -- both in the teaching and the tracking events. In order to accommodate motion that approaches pivoting action as well as motion that approaches straight-line action, the estimation equations of the Extended Kalman Filter and the control equations are formulated using two different definitions of a nontemporal independent variable. The paper motivates the need for pivoting action in real-life settings by reporting extensively on the abilities and limitations of estimation-based teach-and-repeat action where pivoting and near-pivoting action is disallowed. Following formulation of the equations in the near-pivot mode, the paper reports upon experiments where taught trajectories which entail a seamless mix of near-straight and near-pivot action are tracked.

  19. The Akt-mTOR axis is a pivotal regulator of eccentric hypertrophy during volume overload

    OpenAIRE

    Masataka Ikeda; Tomomi Ide; Takeo Fujino; Yuka Matsuo; Shinobu Arai; Keita Saku; Takamori Kakino; Yasuhiro Oga; Akiko Nishizaki; Kenji Sunagawa

    2015-01-01

    The heart has two major modalities of hypertrophy in response to hemodynamic loads: concentric and eccentric hypertrophy caused by pressure and volume overload (VO), respectively. However, the molecular mechanism of eccentric hypertrophy remains poorly understood. Here we demonstrate that the Akt-mammalian target of rapamycin (mTOR) axis is a pivotal regulator of eccentric hypertrophy during VO. While mTOR in the heart was activated in a left ventricular end-diastolic pressure (LVEDP)-depende...

  20. Learning to Pivot with Adversarial Networks

    CERN Document Server

    Louppe, Gilles; Cranmer, Kyle

    2016-01-01

    Many inference problems involve data generation processes that are not uniquely specified or are uncertain in some way. In a scientific context, the presence of several plausible data generation processes is often associated to the presence of systematic uncertainties. Robust inference is possible if it is based on a pivot -- a quantity whose distribution is invariant to the unknown value of the (categorical or continuous) nuisance parameters that parametrizes this family of generation processes. In this work, we introduce a flexible training procedure based on adversarial networks for enforcing the pivotal property on a predictive model. We derive theoretical results showing that the proposed algorithm tends towards a minimax solution corresponding to a predictive model that is both optimal and independent of the nuisance parameters (if that models exists) or for which one can tune the trade-off between power and robustness. Finally, we demonstrate the effectiveness of this approach with a toy example and an...

  1. Multi-Pivot Quicksort: an Experiment with Single, Dual, Triple, Quad, and Penta-Pivot Quicksort Algorithms in Python

    Science.gov (United States)

    Budiman, M. A.; Zamzami, E. M.; Rachmawati, D.

    2017-03-01

    Dual-pivot quicksort, which was proposed by Yaroslavsky, has been experimentally proven to be more efficient than the classical single-pivot quicksort under the Java Virtual Machine [6]. Moreover, Kushagara, López-Ortiz, and Munro [4] has shown that triple-pivot quicksort runs 7-8% faster than dual-pivot quicksort in C, mutatis mutandis. In this research, we implement and experiment with single, dual, triple, quad, and penta-pivot quicksort algorithms in Python. Our experimental results are as follows. Firstly, the quicksort with single pivot is the slowest among the five variants. Secondly, at least until five (penta) pivots are being used, it is proven that the more pivots are used in a quicksort algorithm, the faster its performance becomes. Thirdly, the increase of speed resulted by adding more pivots tends to decrease gradually.

  2. 76 FR 53425 - Pivotal LNG, Inc.; Notice of Application

    Science.gov (United States)

    2011-08-26

    ... Energy Regulatory Commission Pivotal LNG, Inc.; Notice of Application Take notice that on August 8, 2011, Pivotal LNG, Inc. (Pivotal), Ten Peachtree Place, Suite 1000, Atlanta, Georgia 30309, filed with the... transportation of natural gas as a by-product of the operation of non-jurisdictional liquefied natural gas...

  3. Sequential pivotal mechanisms for public project problems

    CERN Document Server

    Apt, Krzysztof R

    2008-01-01

    It is well-known that for several natural decision problems no budget balanced Groves mechanisms exist. This motivated recent research on designing variants of feasible Groves mechanisms (termed as `redistribution of VCG (Vickrey-Clarke-Groves) payments') that generate reduced deficit. With this in mind, we study sequential Groves mechanisms and consider optimal strategies that can lower the taxes that the players would have to pay under the simultaneous mechanism. We show that in the sequential pivotal mechanism for several variants of public project problems such strategies do exist. These strategies differ from truth-telling. In particular we exhibit an optimal strategy with the property that when each player follows it a maximal social welfare is generated.

  4. Intervention patterns of pivot nurses in oncology.

    Science.gov (United States)

    Skrutkowski, Myriam; Saucier, Andréanne; Ritchie, Judith A; Tran, Ngoc; Smith, Kevin

    2011-01-01

    The Pivot Nurse in Oncology (PNO) is a health care professional dedicated to providing patients with cancer and their families with continuing and consistent supportive care throughout the care trajectory. The purpose of this paper is to describe the variation and frequency of nursing interventions delivered by 12 PNOs at our health centre. An administrative analysis over a three-year period revealed a total of 43,906 interventions that were grouped into 10 categories. This analysis provided a description of the intervention frequency and these interventions were further collapsed into the four role functions of the PNO. Coordination/continuity of care and the assessment of needs and symptoms were identified as the dominant practice domains of the PNO in the professional cancer navigator role.

  5. Excel PivotTables and PivotCharts Your Visual Blueprint for Creating Dynamic Spreadsheets

    CERN Document Server

    McFedries, Paul

    2010-01-01

    Master two of the most powerful features of Excel. Even if you use Excel all the time, you may not be up to speed on two of Excel's most useful features. PivotTable and PivotChart turn long lists of unreadable data into dynamic, easy-to-read tables and charts that highlight the information you need most; you can tweak results with a click or easily fuse data from several sources into one document. Now you can learn how to tap these powerful Excel tools with this practical guide. Using a series of step-by-step tutorials and easy-to-follow screenshots, this book shows you in a visual way how to

  6. In Vitro Durability - Pivot bearing with Diamond Like Carbon for Ventricular Assist Devices

    CERN Document Server

    de Sá, Rosa Corrêa Leoncio; Leão, Tarcísio Fernandes; da Silva, Evandro Drigo; da Fonseca, Jeison Willian Gomes; da Silva, Bruno Utiyama; Leal, Edir Branzoni; Moro, João Roberto; de Andrade, Aron José Pazin; Bock, Eduardo Guy Perpétuo

    2015-01-01

    Institute Dante Pazzanese of Cardiology (IDPC) develops Ventricular Assist Devices (VAD) that can stabilize the hemodynamics of patients with severe heart failure before, during and/or after the medical practice; can be temporary or permanent. The ADV's centrifugal basically consist of a rotor suspended for system pivoting bearing; the PIVOT is the axis with movement of rotational and the bearing is the bearing surface. As a whole system of an implantable VAD should be made of long-life biomaterial so that there is no degradation or deformation during application time; surface modification techniques have been widely studied and implemented to improve properties such as biocompatibility and durability of applicable materials. The Chemical Vapour Deposition technique allows substrates having melting point higher than 300 {\\deg}C to be coated, encapsulated, with a diamond like carbon film (DLC); The test simulated the actual conditions in which the system of support remains while applying a ADV. The results hav...

  7. Pivotal Response Training. What Works Clearinghouse Intervention Report

    Science.gov (United States)

    What Works Clearinghouse, 2016

    2016-01-01

    This intervention report presents findings from a systematic review of "pivotal response training" conducted using the What Works Clearinghouse Procedures and Standards Handbook (version 3.0) and the Children and Students with an Autism Spectrum Disorder review protocol (version 3.0). "Pivotal response training"…

  8. The Discharge Coefficient of a Centre-Pivot Roof Window

    DEFF Research Database (Denmark)

    Iqbal, Ahsan; Afshari, Alireza; Nielsen, Peter V.

    2012-01-01

    value of discharge coefficient is used. The constant value of discharge coefficient leads to deceptive airflow estimation in the cases of centre-pivot roof windows. The object of this paper is to study and evaluate the discharge coefficient of the centre pivot roof window. Focus is given...

  9. Evaluating a Pivot-Based Approach for Bilingual Lexicon Extraction

    Directory of Open Access Journals (Sweden)

    Jae-Hoon Kim

    2015-01-01

    Full Text Available A pivot-based approach for bilingual lexicon extraction is based on the similarity of context vectors represented by words in a pivot language like English. In this paper, in order to show validity and usability of the pivot-based approach, we evaluate the approach in company with two different methods for estimating context vectors: one estimates them from two parallel corpora based on word association between source words (resp., target words and pivot words and the other estimates them from two parallel corpora based on word alignment tools for statistical machine translation. Empirical results on two language pairs (e.g., Korean-Spanish and Korean-French have shown that the pivot-based approach is very promising for resource-poor languages and this approach observes its validity and usability. Furthermore, for words with low frequency, our method is also well performed.

  10. Fiducial inference in the pivotal family of distributions

    Institute of Scientific and Technical Information of China (English)

    XU; Xingzhong; LI; Guoying

    2006-01-01

    In this paper a family, called the pivotal family, of distributions is considered.A pivotal family is determined by a generalized pivotal model. Analytical results show that a great many parametric families of distributions are pivotal. In a pivotal family of distributions a general method of deriving fiducial distributions of parameters is proposed. In the method a fiducial model plays an important role. A fiducial model is a function of a random variable with a known distribution, called the pivotal random element, when the observation of a statistic is given.The method of this paper includes some other methods of deriving fiducial distributions. Specially the first fiducial distribution given by Fisher can be derived by the method. For the monotone likelihood ratio family of distributions, which is a pivotal family, the fiducial distributions have a frequentist property in the Neyman-Pearson view. Fiducial distributions of regular parametric functions also have the above frequentist property. Some advantages of the fiducial inference are exhibited in four applications of the fiducial distribution. Many examples are given, in which the fiducial distributions cannot be derived by the existing methods.

  11. TIPOLOGI GRAMATIKAL DAN SISTEM PIVOT BAHASA PAKPAK-DAIRI

    Directory of Open Access Journals (Sweden)

    Ida Basaria

    2013-07-01

    The pivot testing shows that the deletion of a nominal phrase in PDL can be directly made if it functions as a subject or adverbial. If a nominal phrase functions as a predicate, the deletion cannot be directly made; one of the clauses must be made passive or topicalized first. Based on such a pattern, in can be concluded that PDL belongs to the accusative language typology with a pivot pattern of S/A.

  12. A NEW PRINCIPAL PIVOTING SCHEME FOR BOX LINEAR COMPLEMENTARITY PROBLEMS

    Institute of Scientific and Technical Information of China (English)

    WANGZHEMIN

    1997-01-01

    Judice and Pires developed in recent years principal pivoting methods for the solving ofthe so-called box linear complementarity problems (BLCPs) where the constraint matrices are restrictedly supposed to be of P-matrices. This paper aims at presenting a new principal pivoting scheme for BLCPs where the constraint matrices are loosely supposed to be row sufficient. This scheme can be applied to the solving of convex quadratic programs subject to linear constraints and arbitrary upper and lower bound constraints on variables.

  13. Topic-aware pivot language approach for statistical machine translation

    Institute of Scientific and Technical Information of China (English)

    Jin-song SU; Xiao-dong SHI; Yan-zhou HUANG; Yang LIU; Qing-qiang WU; Yi-dong CHEN; Huai-lin DONG

    2014-01-01

    The pivot language approach for statistical machine translation (SMT) is a good method to break the resource bottleneck for certain language pairs. However, in the implementation of conventional approaches, pivot-side context information is far from fully utilized, resulting in erroneous estimations of translation probabilities. In this study, we propose two topic-aware pivot language approaches to use different levels of pivot-side context. The fi rst method takes advantage of document-level context by assuming that the bridged phrase pairs should be similar in the document-level topic distributions. The second method focuses on the effect of local context. Central to this approach are that the phrase sense can be refl ected by local context in the form of probabilistic topics, and that bridged phrase pairs should be compatible in the latent sense distributions. Then, we build an interpolated model bringing the above methods together to further enhance the system performance. Experimental results on French-Spanish and French-German translations using English as the pivot language demonstrate the effectiveness of topic-based context in pivot-based SMT.

  14. 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 ...

  15. PowerPivot for advanced reporting and dashboards

    CERN Document Server

    Bosco, Robert

    2013-01-01

    A step-by-step tutorial with focused examples that builds progressively from basic to advanced topics and helps you create business intelligence reports and dashboards quickly and efficiently using the PowerPivot add-in.This book is ideal for data analysts, reporting and MIS professionals, business analysts, managers, dashboard makers, business intelligence professionals, self-service business intelligence personnel, and students. It is assumed that you have basic data analysis skills and intermediate level Excel skills. Familiarity with Pivot Tables as well as basic knowledge of VBA scripting

  16. Determination of kinetic energy applied by center pivot sprinklers

    Science.gov (United States)

    The kinetic energy of discrete drops impacting a bare soil surface is generally observed to lead to a drastic reduction in water infiltration rate due to soil surface seal formation. Under center pivot sprinkler irrigation, kinetic energy transferred to the soil prior to crop canopy development can...

  17. Droplet Kinetic Energy from Center-Pivot Sprinklers

    Science.gov (United States)

    The kinetic energy of discrete water drops impacting a bare soil surface is generally observed to lead to a drastic reduction in water infiltration rate due to soil surface seal formation. Under center-pivot sprinkler irrigation, kinetic energy transferred to the soil prior to crop canopy developmen...

  18. Classroom Pivotal Response Teaching for Children with Autism

    Science.gov (United States)

    Stahmer, Aubyn C.; Suhrheinrich, Jessica; Reed, Sarah; Schreibman, Laura; Bolduc, Cynthia

    2011-01-01

    This practical manual and accompanying DVD-ROM present a research-supported behavioral intervention for children with autism that teachers can easily integrate into their existing classroom curriculum. Classroom Pivotal Response Teaching (CPRT) enhances children's motivation and participation in learning; increases the number of learning…

  19. Pivotal Teaching Moments in Technology-Intensive Secondary Geometry Classrooms

    Science.gov (United States)

    Cayton, Charity; Hollebrands, Karen; Okumus, Samet; Boehm, Ethan

    2017-01-01

    This study investigates three teachers' uses of a dynamic geometry program (The Geometer's Sketchpad) in their high school geometry classes over a 2-year period. The researchers examine teachers' actions and questions during pivotal teaching moments to characterize mathematics instruction that utilizes technology. Findings support an association…

  20. Performance evaluation of a center pivot variable rate irrigation system

    Science.gov (United States)

    Variable Rate Irrigation (VRI) for center pivots offers potential to match specific application rates to non-uniform soil conditions along the length of the lateral. The benefit of such systems is influenced by the areal extent of these variations and the smallest scale to which the irrigation syste...

  1. Distraction osteogenesis with pivot plate in the treatment of scaphocephaly.

    Science.gov (United States)

    Nam, Seung Min; Kim, Yong Bae; Shin, Ho Seong; Park, Eun Soo; Jung, Sung Gyun

    2011-01-01

    In scaphocephaly, traditional distraction osteogenesis increases only the bitemporal width. We describe distraction osteogenesis with a pivot plate for scaphocephaly, which not only increases the bitemporal width but also decreases the anteroposterior length. Three patients with scaphocephaly were treated using distraction osteogenesis with a pivot plate between January 2005 and June 2006. These children underwent cranial reshaping by gradual distraction using an external distraction device and pivot plate. The distraction rate was 1 mm/d, and the latency period was 5 days. The follow-up period after distraction osteogenesis ranged from 16 to 24 months. No specific complications, such as accidental removal of the distraction devices, infection, or neurologic problems in any patient, occurred. The mean distraction was 45 mm. The mean cranial index was 73.6. Distraction osteogenesis for scaphocephaly is still in the development stage, but it is becoming accepted as a useful method because of its many advantages. Distraction osteogenesis with a pivot plate for scaphocephaly is better than other distraction osteogenesis techniques because it induces increased bitemporal width and decreased anteroposterior length synchronously.

  2. Recent advances in treatment of heart failure

    OpenAIRE

    Kitai, Takeshi; Tang, WH Wilson

    2015-01-01

    With the total cases and economic burden of heart failure continuing to rise, there is an overwhelming need for novel therapies. Several drugs for heart failure have succeeded in preclinical and early-phase clinical trials, but most of them failed to show the real benefit in pivotal clinical trials. Meanwhile, the US Food and Drug Administration recently approved two promising new drugs to treat heart failure: ivabradine and sacubitril/valsartan. Furthermore, some of the newer agents in testi...

  3. Remote pivot decoupler pylon: Wing/store flutter suppressor

    Science.gov (United States)

    Hassler, J. M., Jr. (Inventor)

    1986-01-01

    A device for suspending a store from an aerodynamic support surface, such an an aircraft wing, and more specifically, for improving upon singlet pivot decoupler pylons by reducing both frequency of active store, alignment, and alignment system space and power requirements. Two links suspend a lower pylon/rack section and releasable attached store from an upper pylon section mounted under the wing. The links allow the lower pylon section to rotate in pitch about a remote pivot point. A leaf spring connected between the lower section and electrical alignment system servomechanism provides pitch alignment of the lower section/store combination. The servomechanism utilizes an electric servomotor to drive the gear train and reversibly move the leaf spring, thereby maintaining the pitch attitude of the store within acceptable limits. The damper strokes when the lower section rotates to damp large oscillations of store.

  4. An Analysis and Implementation of a Parallel Ball Pivoting Algorithm

    Directory of Open Access Journals (Sweden)

    Julie Digne

    2014-07-01

    Full Text Available The problem of surface reconstruction from a set of 3D points given by their coordinates andoriented normals is a difficult problem, which has been tackled with many different approaches.In 1999, Bernardini and colleagues introduced a very elegant and efficient reconstruction methodthat uses a ball pivoting around triangle edges and adds new triangles if the ball is incidentto three points and contains no other points. This paper details an implementation and parallelization of this algorithm.

  5. Towards a pivotal-based approach for business process alignment

    OpenAIRE

    Ulmer, Jean-Stéphane; Belaud, Jean-Pierre; Le Lann, Jean-Marc

    2011-01-01

    This article focuses on business process engineering, especially on alignment between business analysis and implementation. Through a business process management approach, different transformations interfere with process models in order to make them executable. To keep the consistency of process model from business model to IT model, we propose a pivotal metamodel-centric methodology. It aims at keeping or giving all requisite structural and semantic data needed to perform such transformation...

  6. Gyroscope Pivot Bearing Dimension and Surface Defect Detection

    OpenAIRE

    2011-01-01

    Because of the perceived lack of systematic analysis in illumination system design processes and a lack of criteria for design methods in vision detection a method for the design of a task-oriented illumination system is proposed. After detecting the micro-defects of a gyroscope pivot bearing with a high curvature glabrous surface and analyzing the characteristics of the surface detection and reflection model, a complex illumination system with coaxial and ring lights is proposed. The illumin...

  7. New insights into muscle function during pivot feeding in seahorses.

    Directory of Open Access Journals (Sweden)

    Sam Van Wassenbergh

    Full Text Available Seahorses, pipefish and their syngnathiform relatives are considered unique amongst fishes in using elastic recoil of post-cranial tendons to pivot the head extremely quickly towards small crustacean prey. It is known that pipefish activate the epaxial muscles for a considerable time before striking, at which rotations of the head and the hyoid are temporarily prevented to allow energy storage in the epaxial tendons. Here, we studied the motor control of this system in seahorses using electromyographic recordings of the epaxial muscles and the sternohyoideus-hypaxial muscles with simultaneous high-speed video recordings of prey capture. In addition we present the results from a stimulation experiment including the muscle hypothesised to be responsible for the locking and triggering of pivot feeding in seahorses (m. adductor arcus palatini. Our data confirmed that the epaxial pre-activation pattern observed previously for pipefish also occurs in seahorses. Similar to the epaxials, the sternohyoideus-hypaxial muscle complex shows prolonged anticipatory activity. Although a considerable variation in displacements of the mouth via head rotation could be observed, it could not be demonstrated that seahorses have control over strike distance. In addition, we could not identify the source of the kinematic variability in the activation patterns of the associated muscles. Finally, the stimulation experiment supported the previously hypothesized role of the m. adductor arcus palatini as the trigger in this elastic recoil system. Our results show that pre-stressing of both the head elevators and the hyoid retractors is taking place. As pre-activation of the main muscles involved in pivot feeding has now been demonstrated for both seahorses and pipefish, this is probably a generalized trait of Syngnathidae.

  8. Long-term outcomes following Medtronic Open Pivot valved conduit.

    Science.gov (United States)

    Naidoo, Rishendran; Pearse, Bronwyn; Tesar, Peter J; Yap, Su-Ann; Barnett, Adrian G; Fayers, Trevor

    2014-01-01

    Aortic root replacement is a complex procedure, though subsequent modifications of the original Bentall procedure have made surgery more reproducible. The study aim was to examine the outcomes of a modified Bentall procedure, using the Medtronic Open PivotTM valved conduit. Whilst short-term data on the conduit and long-term data on the valve itself are available, little is known of the long-term results with the valved conduit. Patients undergoing aortic root replacement between February 1999 and February 2010, using the Medtronic Open Pivot valved conduit were identified from the prospectively collected Cardiothoracic Register at The Prince Charles Hospital, Brisbane, Australia. All patients were followed up echocardiographically and clinically. The primary end-point was death, and a Cox proportional model was used to identify factors associated.with survival. Secondary end-points were valve-related morbidity (as defined by STS guidelines) and postoperative morbidity. Predictors of morbidity were identified using logistic regression. A total of 246 patients (mean age 50 years) was included in the study. The overall mortality was 12%, with actuarial 10-year survival 79% and a 10-year estimate of valve-related death of 0.04 (95% CI: 0.004, 0.07). Preoperative myocardial infarction (p = 0.004, HR 4.74), urgency of operation (p = 0.038, HR 2.8) and 10% incremental decreases in ejection fraction (p = 0.046, HR 0.69) were predictive of mortality. Survival was also affected by the valve gradients, with a unit increase in peak gradient reducing mortality (p = 0.021, HR 0.93). Valve-related morbidity occurred in 11 patients. Urgent surgery (p Medtronic Open Pivot valved conduit is a safe and durable option for aortic root replacement, and is associated with low morbidity and 10-year survival of 79%. However, further studies are required to determine the effect of valve gradient on survival.

  9. Pivotal Technology Research of Grid Based on Mobile Agent

    Institute of Scientific and Technical Information of China (English)

    CHEN Hong-wei; WANG Ru-chuan

    2004-01-01

    Grid Based on Mobile Agent is a new grid scheme. The purpose of the paper is to solve the pivotal technology of Grid Based on Mobile Agent ( GBMA) combined with thought of Virtual Organization ( VO). In GBMA, virtual organization is viewed as the basic management unit of the grid, and mobile agent is regarded as an important interactive means. Grid architecture, grid resource management and grid task management are the core technology problem of GBMA. The simulation results show that Inter- VO pattern has the obvious advantage because it can make full use of resources from other virtual organizations in GBMA environment.

  10. Gyroscope Pivot Bearing Dimension and Surface Defect Detection

    Directory of Open Access Journals (Sweden)

    Xudong Li

    2011-03-01

    Full Text Available Because of the perceived lack of systematic analysis in illumination system design processes and a lack of criteria for design methods in vision detection a method for the design of a task-oriented illumination system is proposed. After detecting the micro-defects of a gyroscope pivot bearing with a high curvature glabrous surface and analyzing the characteristics of the surface detection and reflection model, a complex illumination system with coaxial and ring lights is proposed. The illumination system is then optimized based on the analysis of illuminance uniformity of target regions by simulation and grey scale uniformity and articulation that are calculated from grey imagery. Currently, in order to apply the Pulse Coupled Neural Network (PCNN method, structural parameters must be tested and adjusted repeatedly. Therefore, this paper proposes the use of a particle swarm optimization (PSO algorithm, in which the maximum between cluster variance rules is used as fitness function with a linearily reduced inertia factor. This algorithm is used to adaptively set PCNN connection coefficients and dynamic threshold, which avoids algorithmic precocity and local oscillations. The proposed method is used for pivot bearing defect image processing. The segmentation results of the maximum entropy and minimum error method and the one described in this paper are compared using buffer region matching, and the experimental results show that the method of this paper is effective.

  11. Gyroscope pivot bearing dimension and surface defect detection.

    Science.gov (United States)

    Ge, Wenqian; Zhao, Huijie; Li, Xudong

    2011-01-01

    Because of the perceived lack of systematic analysis in illumination system design processes and a lack of criteria for design methods in vision detection a method for the design of a task-oriented illumination system is proposed. After detecting the micro-defects of a gyroscope pivot bearing with a high curvature glabrous surface and analyzing the characteristics of the surface detection and reflection model, a complex illumination system with coaxial and ring lights is proposed. The illumination system is then optimized based on the analysis of illuminance uniformity of target regions by simulation and grey scale uniformity and articulation that are calculated from grey imagery. Currently, in order to apply the Pulse Coupled Neural Network (PCNN) method, structural parameters must be tested and adjusted repeatedly. Therefore, this paper proposes the use of a particle swarm optimization (PSO) algorithm, in which the maximum between cluster variance rules is used as fitness function with a linearily reduced inertia factor. This algorithm is used to adaptively set PCNN connection coefficients and dynamic threshold, which avoids algorithmic precocity and local oscillations. The proposed method is used for pivot bearing defect image processing. The segmentation results of the maximum entropy and minimum error method and the one described in this paper are compared using buffer region matching, and the experimental results show that the method of this paper is effective.

  12. Wave Energy, Lever Operated Pivoting Float LOPF Study

    DEFF Research Database (Denmark)

    Margheritini, Lucia

    University in Denmark. The model size was 60cm W x 90cm L x 21cm H. The 60 cm width pointed towards the wave front. The LOPF buoy is characterized by a simple mechanical design with few moving parts and direct electrical output and it is taut moored to the sea bed, so all forces are referenced to the seabed......The fully instrumented Resen Waves Lever Operated Pivoting Float LOPF wave energy buoy model has gone through the first stage of testing in regular waves in scale 1:25 of the North Sea wave conditions, in the 3D deep wave basin at the Hydraulic and Coastal Engineering Laboratory of Aalborg...... for maximum energy output in regular as well as irregular waves. During storms the buoy pivots and streamlines itself to minimize loads on the mooring line. A conservative estimate shows that a full scale system for North Sea conditions has a float size width of 15 m that will, with 60% generator efficiency...

  13. Gene transfer for congestive heart failure: update 2013.

    Science.gov (United States)

    Tang, Tong; Hammond, H Kirk

    2013-04-01

    Congestive heart failure is a major cause of morbidity and mortality with increasing social and economic costs. There have been no new high impact therapeutic agents for this devastating disease for more than a decade. However, many pivotal regulators of cardiac function have been identified using cardiac-directed transgene expression and gene deletion in preclinical studies. Some of these increase function of the failing heart. Altering the expression of these pivotal regulators using gene transfer is now either being tested in clinical gene transfer trials, or soon will be. In this review, we summarize recent progress in cardiac gene transfer for clinical congestive heart failure.

  14. Heart Disease

    Science.gov (United States)

    ... type of heart disease you have. Symptoms of heart disease in your blood vessels (atherosclerotic disease) Cardiovascular disease ... can sometimes be found early with regular evaluations. Heart disease symptoms caused by abnormal heartbeats (heart arrhythmias) A ...

  15. Perturb and Observe Control for an Embedded Point Pivoted Absorber

    Directory of Open Access Journals (Sweden)

    Gianluca Brando

    2016-11-01

    Full Text Available Marine energy sources represent an attractive and inexhaustible reservoir able to contribute to the fulfillment of the world energy demand in accordance with climate/energy regulatory frameworks. Wave energy converter (WEC integration into the main grid requires both the maximization of the harvested energy and the proper management of the generation variability. The present paper focuses on both these mentioned issues. More specifically, it presents an embedded point pivoted absorber (PPA and its related control strategy aimed at maximizing the harvested energy. Experimental and numerical investigations have been carried out in a wave/towing tank facility in order to derive the design characteristics of the full-scale model and demonstrate the validity and effectiveness of the proposed control strategy.

  16. Astrocyte glutamine synthetase: pivotal in health and disease.

    Science.gov (United States)

    Rose, Christopher F; Verkhratsky, Alexei; Parpura, Vladimir

    2013-12-01

    The multifunctional properties of astrocytes signify their importance in brain physiology and neurological function. In addition to defining the brain architecture, astrocytes are primary elements of brain ion, pH and neurotransmitter homoeostasis. GS (glutamine synthetase), which catalyses the ATP-dependent condensation of ammonia and glutamate to form glutamine, is an enzyme particularly found in astrocytes. GS plays a pivotal role in glutamate and glutamine homoeostasis, orchestrating astrocyte glutamate uptake/release and the glutamate-glutamine cycle. Furthermore, astrocytes bear the brunt of clearing ammonia in the brain, preventing neurotoxicity. The present review depicts the central function of astrocytes, concentrating on the importance of GS in glutamate/glutamine metabolism and ammonia detoxification in health and disease.

  17. Characteristics of pivotal trials and FDA review of innovative devices.

    Science.gov (United States)

    Rising, Joshua P; Moscovitch, Ben

    2015-01-01

    When patients lack sufficient treatment options for serious medical conditions, they rely on the prompt approval and development of new therapeutic alternatives, such as medical devices. Understanding the development of innovative medical devices, including the characteristics of premarket clinical trials and length of Food and Drug Administration (FDA) review, can help identify ways to expedite patient access to novel technologies and inform recent efforts by FDA to more quickly get these products to patients and physicians. We analyzed publicly available information on clinical trials and premarket FDA review for innovative medical devices that fill an unmet medical need. In this first-of-its-kind study focusing on these products, we extracted data on the length of the pivotal trials, primary study endpoint and FDA review; number of patients enrolled in trials; and in what country the device was available first. We identified 27 approved priority review devices from January 2006 through August 2013. The median duration of pivotal clinical trials was 3 years, ranging from 3 months to approximately 7 years. Trials had a median primary outcome measure evaluation time of one year and a median enrollment of 297 patients. The median FDA review time was 1 year and 3 months. Most priority review devices were available abroad before they were approved in the United States. Our study indicates that addressing the length of clinical studies--and contributing factors, such as primary outcome measures and enrollment--could expedite patient access to innovative medical devices. FDA, manufacturers, Congress and other stakeholders should identify the contributing factors to the length of clinical development, and implement appropriate reforms to address those issues.

  18. Characteristics of pivotal trials and FDA review of innovative devices.

    Directory of Open Access Journals (Sweden)

    Joshua P Rising

    Full Text Available When patients lack sufficient treatment options for serious medical conditions, they rely on the prompt approval and development of new therapeutic alternatives, such as medical devices. Understanding the development of innovative medical devices, including the characteristics of premarket clinical trials and length of Food and Drug Administration (FDA review, can help identify ways to expedite patient access to novel technologies and inform recent efforts by FDA to more quickly get these products to patients and physicians. We analyzed publicly available information on clinical trials and premarket FDA review for innovative medical devices that fill an unmet medical need. In this first-of-its-kind study focusing on these products, we extracted data on the length of the pivotal trials, primary study endpoint and FDA review; number of patients enrolled in trials; and in what country the device was available first. We identified 27 approved priority review devices from January 2006 through August 2013. The median duration of pivotal clinical trials was 3 years, ranging from 3 months to approximately 7 years. Trials had a median primary outcome measure evaluation time of one year and a median enrollment of 297 patients. The median FDA review time was 1 year and 3 months. Most priority review devices were available abroad before they were approved in the United States. Our study indicates that addressing the length of clinical studies--and contributing factors, such as primary outcome measures and enrollment--could expedite patient access to innovative medical devices. FDA, manufacturers, Congress and other stakeholders should identify the contributing factors to the length of clinical development, and implement appropriate reforms to address those issues.

  19. Wave energy, lever operated pivoting float LOPF study

    Energy Technology Data Exchange (ETDEWEB)

    Margheritini, L.

    2012-11-01

    The fully instrumented Resen Waves Lever Operated Pivoting Float LOPF wave energy buoy model has gone through the first stage of testing in regular waves in scale 1:25 of the North Sea wave conditions, in the 3D deep wave basin at the Hydraulic and Coastal Engineering Laboratory of Aalborg University in Denmark. The model size was 60cm W x 90cm L x 21cm H. The 60 cm width pointed towards the wave front. The LOPF buoy is characterized by a simple mechanical design with few moving parts and direct electrical output and it is taut moored to the sea bed, so all forces are referenced to the seabed for maximum energy output in regular as well as irregular waves. During storms the buoy pivots and streamlines itself to minimize loads on the mooring line. A conservative estimate shows that a full scale system for North Sea conditions has a float size width of 15 m that will, with 60% generator efficiency, produce 610 MWh/y (609.497 kWh/y) with an average power output of 69.6 kW, which requires a generator capacity of 700 kW. It is expected the generator efficiency can be increased to 90% in the future. More specific calculations (from EnergiNet) show that with one generator of 695 kW the expected power production is 585 MWh/y; with a generator of 250 kW and 100 kW, the expected power production is 481 MWh/y and 182 MWh/y respectively. In addition there are several areas for future improvements for increased power production. (Author)

  20. Laboratory evaluation of the pivot-shift phenomenon with use of kinetic analysis: a preliminary study.

    Science.gov (United States)

    Sanchis-Alfonso, Vicente; Baydal-Bertomeu, José-María; Castelli, Andrea; Montesinos-Berry, Erik; Marín-Roca, Susana; Garrido-Jaén, José-David

    2011-07-06

    Currently, a suitable and reliable noninvasive method to evaluate rotational stability in vivo in anterior cruciate ligament-deficient knees, particularly during sports movements, does not exist. We speculated that if there is a rotational instability, the patient would avoid reaching a high pivoting moment during pivoting activities as a defense mechanism, and that the ground reaction moment, as registered by dynamometric platforms, would be reduced. On the basis of this hypothesis, we developed a study using kinetic analysis to evaluate rotational stability under dynamic loading. Thirty recreationally active athletes, including fifteen healthy subjects and fifteen with an anterior cruciate ligament-deficient knee, were recruited for this study. Patients performed jumping with pivoting with internal tibial rotation and external tibial rotation on the dynamometric platform with both the healthy and the injured limb. The quantitative results were graphically plotted, and the following parameters were evaluated: loading moment, pivoting moment, torque amplitude, loading slope, pivoting slope, percentage of pivoting with load, loading impulse, pivoting impulse, and maximum body rotation angle. There were no significant differences between the dominant and nondominant knees in the control group during the jumping with pivoting and external tibial rotation test with regard to the pivoting moment (p = 0.805), pivoting slope (p = 0.716), pivoting impulse 2 (p = 0.858), and pivoting impulse 3 (p = 0.873). In patients with a chronic tear of the anterior cruciate ligament, there was a significant decrease of the pivoting moment (p = 0.02), pivoting slope (p = 0.005), pivoting impulse 2 (p = 0.006), and pivoting impulse 3 (p = 0.035) during the jumping with pivoting and external tibial rotation test in the anterior cruciate ligament-deficient knee compared with the healthy, contralateral knee. Kinetic analysis with use of a dynamic platform can objectively detect alterations

  1. Plant hormone cross-talk: the pivot of root growth.

    Science.gov (United States)

    Pacifici, Elena; Polverari, Laura; Sabatini, Sabrina

    2015-02-01

    Root indeterminate growth and its outstanding ability to produce new tissues continuously make this organ a highly dynamic structure able to respond promptly to external environmental stimuli. Developmental processes therefore need to be finely tuned, and hormonal cross-talk plays a pivotal role in the regulation of root growth. In contrast to what happens in animals, plant development is a post-embryonic process. A pool of stem cells, placed in a niche at the apex of the meristem, is a source of self-renewing cells that provides cells for tissue formation. During the first days post-germination, the meristem reaches its final size as a result of a balance between cell division and cell differentiation. A complex network of interactions between hormonal pathways co-ordinates such developmental inputs. In recent years, by means of molecular and computational approaches, many efforts have been made aiming to define the molecular components of these networks. In this review, we focus our attention on the molecular mechanisms at the basis of hormone cross-talk during root meristem size determination. © The Author 2015. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  2. Pivot and cluster strategy: a preventive measure against diagnostic errors

    Directory of Open Access Journals (Sweden)

    Shimizu T

    2012-11-01

    Full Text Available Taro Shimizu,1 Yasuharu Tokuda21Rollins School of Public Health, Emory University, Atlanta, GA, USA; 2Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, JapanAbstract: Diagnostic errors constitute a substantial portion of preventable medical errors. The accumulation of evidence shows that most errors result from one or more cognitive biases and a variety of debiasing strategies have been introduced. In this article, we introduce a new diagnostic strategy, the pivot and cluster strategy (PCS, encompassing both of the two mental processes in making diagnosis referred to as the intuitive process (System 1 and analytical process (System 2 in one strategy. With PCS, physicians can recall a set of most likely differential diagnoses (System 2 of an initial diagnosis made by the physicians’ intuitive process (System 1, thereby enabling physicians to double check their diagnosis with two consecutive diagnostic processes. PCS is expected to reduce cognitive errors and enhance their diagnostic accuracy and validity, thereby realizing better patient outcomes and cost- and time-effective health care management.Keywords: diagnosis, diagnostic errors, debiasing

  3. Graph reductions, binary rank, and pivots in gene assembly

    CERN Document Server

    Pflueger, Nathan

    2011-01-01

    In this paper, we describe a graph reduction operation, generalizing three combinatorial graph reduction rules related to gene assembly in ciliates. We study these reductions and their relation to the binary rank of a graph, which is the rank of the adjacency matrix over the finite field with two elements, and relate them to the graph pivot operation. We use these methods to solve two open problems posed by Harju, Li, and Petre regarding a graph formalization of gene assembly in ciliates. The graph formalization of gene assembly considers three reduction rules, called the positive, double, and negative rule, each of which removes one or two vertices from the graph. The graph reductions we define consist precisely of all compositions of these rules. We give algebraic criteria describing those subsets of vertices that can be removed by graph reductions, characterize the number of times the negative rule is applied to remove a given set of vertices, and show that such reductions are path invariant, in the sense ...

  4. Heart Disease

    Science.gov (United States)

    ... daily aspirin to prevent heart attack? Does taking birth control pills increase my risk for heart disease? Does using ... tells you to. Return to top Does taking birth control pills increase my risk for heart disease? Taking birth ...

  5. Pivotal response treatment for autism spectrum disorder: current perspectives

    Directory of Open Access Journals (Sweden)

    Lei J

    2017-06-01

    Full Text Available Jiedi Lei, Pamela Ventola Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA Abstract: Pivotal response treatment (PRT is an evidence-based behavioral intervention based on applied behavior analysis principles aimed to improve social communication skills in individuals with autism spectrum disorder (ASD. PRT adopts a more naturalistic approach and focuses on using a number of strategies to help increase children’s motivation during intervention. Since its conceptualization, PRT has received much empirical support for eliciting therapeutic gains in greater use of functional social communication skills in individuals with ASD. Building upon the empirical evidence supporting PRT, recent advancements have increasingly turned to using interdisciplinary research integrating neuroimaging techniques and behavioral measures to help identify objective biomarkers of treatment, which have two primary purposes. First, neuroimaging results can help characterize how PRT may elicit change, and facilitate partitioning of the heterogeneous profiles of neural mechanisms underlying similar profile of behavioral changes observed over PRT. Second, neuroimaging provides an objective means to both map and track how biomarkers may serve as reliable and sensitive predictors of responder profiles to PRT, assisting clinicians to identify who will most likely benefit from PRT. Together, a better understanding of both mechanisms of change and predictors of responder profile will help PRT to serve as a more precise and targeted intervention for individuals with ASD, thus moving towards the goal of precision medicine and improving quality of care. This review focuses on the recent emerging neuroimaging evidences supporting PRT, offering current perspectives on the importance of interdisciplinary research to help clinicians better understand how PRT works and predict who will respond to PRT. Keywords: PRT, ASD, biomarkers, neuroimaging

  6. Heart Transplantation

    Science.gov (United States)

    A heart transplant removes a damaged or diseased heart and replaces it with a healthy one. The healthy heart comes from a donor who has died. It is the last resort for people with heart failure when all other treatments have failed. The ...

  7. Heart Diseases

    Science.gov (United States)

    ... you're like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the U.S. ... of disability. There are many different forms of heart disease. The most common cause of heart disease is ...

  8. Automation of a center pivot using the temperature-time-threshold method of irriation scheduling

    Science.gov (United States)

    A center pivot was completely automated using the temperature-time-threshold (TTT) method of irrigation scheduling. An array of infrared thermometers was mounted on the center pivot and these were used to remotely determine the crop leaf temperature as an indicator of crop water stress. We describ...

  9. Pivotal behavior as the mediator of the relationship between parental responsiveness and children's symbolic behavior.

    Science.gov (United States)

    Chiu, Chun-Hao; Lin, Chu-Sui; Mahoney, Gerald; Cheng, Shu-Fen; Chang, Shu-Hui

    2017-08-01

    Previous research with parents and children with developmental disabilities indicated that the relationship between mothers' responsive style of interaction and children's rate of development was mediated by the simultaneous relationship between mothers' responsiveness and children's social engagement, or pivotal behavior. In this study, we attempted to determine whether children's pivotal behavior might also mediate the relationship between responsiveness and child development in a sample of 165 typically developing toddlers and their Taiwanese parents. Child development was assessed with a parent report measure of children's symbolic behavior. Parental responsiveness and children's pivotal behavior were assessed from observations of parent-child play. Results indicated that parental responsiveness was correlated with children's pivotal behavior, and that both of these variables were correlated with children's symbolic behavior. Structural equation models indicated that the relationship between responsiveness and children's symbolic behavior was fully mediated by children's pivotal behavior. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Hevin plays a pivotal role in corneal wound healing.

    Directory of Open Access Journals (Sweden)

    Shyam S Chaurasia

    with exogenous administration of rhHevin. Thus, hevin plays a pivotal role in the corneal wound healing.

  11. Heart Failure

    Science.gov (United States)

    ... heart failure due to systolic dysfunction. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ... patient with heart failure or cardiomyopathy. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ...

  12. Heart palpitations

    Science.gov (United States)

    ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  13. Heart pacemaker

    Science.gov (United States)

    ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  14. Heart Attack

    Science.gov (United States)

    ... a million people in the U.S. have a heart attack. About half of them die. Many people have permanent heart damage or die because they don't get ... It's important to know the symptoms of a heart attack and call 9-1-1 if someone ...

  15. Pivotal response treatment for children with autism spectrum disorders: A systematic review

    NARCIS (Netherlands)

    Verschuur, R.; Didden, H.C.M.; Lang, R.; Sigafoos, J.; Huskens, B.E.B.M.

    2014-01-01

    Intervention studies evaluating pivotal response treatment (PRT) were systematically identified and analyzed. Forty-three studies were summarized in terms of (a) participant characteristics, (b) dependent variables, (c) intervention procedures, (d) intervention outcomes, and (e) certainty of evidenc

  16. 78 FR 66941 - Design Considerations for Pivotal Clinical Investigations for Medical Devices; Guidance for...

    Science.gov (United States)

    2013-11-07

    ... for Medical Devices; Guidance for Industry, Clinical Investigators, Institutional Review Boards and... entitled ``Design Considerations for Pivotal Clinical Investigations for Medical Devices.'' This document... premarket submissions for medical devices and for FDA staff who review those submissions. This...

  17. A study of shallow water’s effect on a ship’s pivot point

    Directory of Open Access Journals (Sweden)

    Jorge Enrique Carreño

    2012-12-01

    Full Text Available Information regarding a turning ship’s pivot point has been collected, taking practical notes and ship maneuvering manuals into account as well as experimental data and simulated results, together revealing consistent behaviour when varying water depth or some ship’s particulars. Results from studies already carried out using the Colombian Navy’s River Support Patrol Vessel (RSPV are included here to estimate the pivot point and contrast results with theory and available observations. Linear manoeuvrability theory was tested and the results revealed poor agreement with kinematic equations. As to the depth variation effect, full-scale experiments confirmed that the pivot point’s position, when in shallow water, always varied in the same way, thereby agreeing with available pivot point information.

  18. The Polynomial Pivots as Initial Values for a New Root-Finding Iterative Method

    Directory of Open Access Journals (Sweden)

    Mario Lázaro

    2015-01-01

    Full Text Available A new iterative method for polynomial root-finding based on the development of two novel recursive functions is proposed. In addition, the concept of polynomial pivots associated with these functions is introduced. The pivots present the property of lying close to some of the roots under certain conditions; this closeness leads us to propose them as efficient starting points for the proposed iterative sequences. Conditions for local convergence are studied demonstrating that the new recursive sequences converge with linear velocity. Furthermore, an a priori checkable global convergence test inside pivots-centered balls is proposed. In order to accelerate the convergence from linear to quadratic velocity, new recursive functions together with their associated sequences are constructed. Both the recursive functions (linear and the corrected (quadratic convergence are validated with two nontrivial numerical examples. In them, the efficiency of the pivots as starting points, the quadratic convergence of the proposed functions, and the validity of the theoretical results are visualized.

  19. ChIP-seq Identification of Weakly Conserved Heart Enhancers

    Energy Technology Data Exchange (ETDEWEB)

    Blow, Matthew J.; McCulley, David J.; Li, Zirong; Zhang, Tao; Akiyama, Jennifer A.; Holt, Amy; Plajzer-Frick, Ingrid; Shoukry, Malak; Wright, Crystal; Chen, Feng; Afzal, Veena; Bristow, James; Ren, Bing; Black, Brian L.; Rubin, Edward M.; Visel, Axel; Pennacchio, Len A.

    2010-07-01

    Accurate control of tissue-specific gene expression plays a pivotal role in heart development, but few cardiac transcriptional enhancers have thus far been identified. Extreme non-coding sequence conservation successfully predicts enhancers active in many tissues, but fails to identify substantial numbers of heart enhancers. Here we used ChIP-seq with the enhancer-associated protein p300 from mouse embryonic day 11.5 heart tissue to identify over three thousand candidate heart enhancers genome-wide. Compared to other tissues studied at this time-point, most candidate heart enhancers are less deeply conserved in vertebrate evolution. Nevertheless, the testing of 130 candidate regions in a transgenic mouse assay revealed that most of them reproducibly function as enhancers active in the heart, irrespective of their degree of evolutionary constraint. These results provide evidence for a large population of poorly conserved heart enhancers and suggest that the evolutionary constraint of embryonic enhancers can vary depending on tissue type.

  20. A sustainable model for training teachers to use pivotal response training.

    Science.gov (United States)

    Suhrheinrich, Jessica

    2015-08-01

    The increase in the rate of autism diagnoses has created a growing demand for teachers who are trained to use effective interventions. The train-the-trainer model, which involves training supervisors to train others, may be ideal for providing cost-effective training and ongoing support to teachers. Although research supports interventions, such as pivotal response training, as evidence-based, dissemination to school environments has been problematic. This study assessed the benefits of using the train-the-trainer model to disseminate pivotal response training to school settings. A multiple-baseline design was conducted across three training groups, each consisting of one school staff member (trainer), three special education teachers, and six students. Trainers conducted the teacher-training workshop with high adherence to training protocol and met mastery criteria in their ability to implement pivotal response training, assess implementation of pivotal response training, and provide feedback to teachers. Six of the nine teachers mastered all components of pivotal response training. The remaining three teachers implemented 89% of the pivotal response training components correctly. The majority of trainers and teachers maintained their abilities at follow-up. These results support the use of the train-the-trainer model as an effective method of disseminating evidence-based practices in school settings. © The Author(s) 2014.

  1. Efficient Execution Methods of Pivoting for Bulk Extraction of Entity-Attribute-Value-Modeled Data.

    Science.gov (United States)

    Luo, Gang; Frey, Lewis J

    2016-03-01

    Entity-attribute-value (EAV) tables are widely used to store data in electronic medical records and clinical study data management systems. Before they can be used by various analytical (e.g., data mining and machine learning) programs, EAV-modeled data usually must be transformed into conventional relational table format through pivot operations. This time-consuming and resource-intensive process is often performed repeatedly on a regular basis, e.g., to provide a daily refresh of the content in a clinical data warehouse. Thus, it would be beneficial to make pivot operations as efficient as possible. In this paper, we present three techniques for improving the efficiency of pivot operations: 1) filtering out EAV tuples related to unneeded clinical parameters early on; 2) supporting pivoting across multiple EAV tables; and 3) conducting multi-query optimization. We demonstrate the effectiveness of our techniques through implementation. We show that our optimized execution method of pivoting using these techniques significantly outperforms the current basic execution method of pivoting. Our techniques can be used to build a data extraction tool to simplify the specification of and improve the efficiency of extracting data from the EAV tables in electronic medical records and clinical study data management systems.

  2. Stress optimization of leaf-spring crossed flexure pivots for an active Gurney flap mechanism

    Science.gov (United States)

    Freire Gómez, Jon; Booker, Julian D.; Mellor, Phil H.

    2015-04-01

    The EU's Green Rotorcraft programme is pursuing the development of a functional and airworthy Active Gurney Flap (AGF) for a full-scale helicopter rotor blade. Interest in the development of this `smart adaptive rotor blade' technology lies in its potential to provide a number of aerodynamic benefits, which would in turn translate into a reduction in fuel consumption and noise levels. The AGF mechanism selected employs leaf-spring crossed flexure pivots. These provide important advantages over bearings as they are not susceptible to seizing and do not require maintenance (i.e. lubrication or cleaning). A baseline design of this mechanism was successfully tested both in a fatigue rig and in a 2D wind tunnel environment at flight-representative deployment schedules. For full validation, a flight test would also be required. However, the severity of the in-flight loading conditions would likely compromise the mechanical integrity of the pivots' leaf-springs in their current form. This paper investigates the scope for stress reduction through three-dimensional shape optimization of the leaf-springs of a generic crossed flexure pivot. To this end, a procedure combining a linear strain energy formulation, a parametric leaf-spring profile definition and a series of optimization algorithms is employed. The resulting optimized leaf-springs are proven to be not only independent of the angular rotation at which the pivot operates, but also linearly scalable to leaf-springs of any length, minimum thickness and width. Validated using non-linear finite element analysis, the results show very significant stress reductions relative to pivots with constant cross section leaf-springs, of up to as much as 30% for the specific pivot configuration employed in the AGF mechanism. It is concluded that shape optimization offers great potential for reducing stress in crossed flexure pivots and, consequently, for extending their fatigue life and/or rotational range.

  3. Hypoplastic left heart syndrome

    Science.gov (United States)

    HLHS; Congenital heart - hypoplastic left heart; Cyanotic heart disease - hypoplastic left heart ... Hypoplastic left heart is a rare type of congenital heart disease. It is more common in males than in ...

  4. Heart transplantation

    OpenAIRE

    Cheng, Allen; Slaughter, Mark S.

    2014-01-01

    Heart failure remains a major global problem with approximately 6 million individuals suffering from heart failure in the United States alone. The surgical technique of heart transplantation, popularized by Dr. Norman Shumway, has led to its success and currently remains the best treatment options for patients with end-stage. However, with the continued limitation of donor organs and the rapid development of ventricular assist device technology, the number of patients bridged to transplant wi...

  5. Recent advances in treatment of heart failure [version 1; referees: 2 approved

    OpenAIRE

    Takeshi Kitai; WH Wilson Tang

    2015-01-01

    With the total cases and economic burden of heart failure continuing to rise, there is an overwhelming need for novel therapies. Several drugs for heart failure have succeeded in preclinical and early-phase clinical trials, but most of them failed to show the real benefit in pivotal clinical trials. Meanwhile, the US Food and Drug Administration recently approved two promising new drugs to treat heart failure: ivabradine and sacubitril/valsartan. Furthermore, some of the newer agents in testi...

  6. Heart attack

    Science.gov (United States)

    ... Saunders; 2014:chap 51. Read More Arrhythmias Cardiogenic shock Diabetes Hardening of the arteries Heart failure - overview High blood pressure Implantable cardioverter-defibrillator Lipoprotein- ...

  7. Heart transplant

    Science.gov (United States)

    ... factors include the type and severity of your heart disease, and how sick you are at the time you are listed. The amount of time you spend on a waiting list is usually NOT a factor for how soon you get a heart, except in the case of children. Most, but ...

  8. Heart failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970284 Effects of enalapril on heart rate variabilityin patients with congestive heart failure. ZHANGYouhua(章友华), et a1. Dept Cardiol, Cardiovasc Instit& Fuwai Hosp, CAMS & PUMC, Beijing, 100037. ChinCir J 1996; 11(2): 729-732.

  9. Heart Anatomy

    Science.gov (United States)

    ... from the left ventricle into the aorta, your body's largest artery. See also on this site: The Heartbeat The Conduction System (illustration) Electrical impulses from your heart muscle (the myocardium) cause your heart to contract. This electrical signal begins in the sinoatrial (SA) node, located at ...

  10. Identifying and locating land irrigated by center-pivot irrigation systems using satellite imagery

    Science.gov (United States)

    Hoffman, R. O.

    1980-01-01

    A methodology for using Landsat imagery for the identification and location of land irrigated by center-pivot irrigation systems is presented. The procedure involves the use of sets of Landsat band 5 imagery taken separated in time by about three weeks during the irrigation season, a zoom transfer scope and mylar base maps to record the locations of center pivots. Further computer processing of the data has been used to obtain plots of center-pivot irrigation systems and tables indicating the distribution and growth of systems by county for the state of Nebraska, and has been found to be in 95% agreement with current high-altitude IR photography. The information obtainable can be used for models of ground-water aquifers or resource planning.

  11. Pivotal surfaces in inverse hexagonal and cubic phases of phospholipids and glycolipids.

    Science.gov (United States)

    Marsh, Derek

    2011-03-01

    Data on the location and dimensions of the pivotal surfaces in inverse hexagonal (H(II)) and inverse cubic (Q(II)) phases of phospholipids and glycolipids are reviewed. This includes the H(II) phases of dioleoyl phosphatidylethanolamine, 2:1 mol/mol mixtures of saturated fatty acids with the corresponding diacyl phosphatidylcholine, and glucosyl didodecylglycerol, and also the Q(II)(230/G) gyroid inverse cubic phases of monooleoylglycerol and glucosyl didodecylglycerol. Data from the inverse cubic phases are largely compatible with those from inverse hexagonal H(II)-phases. The pivotal plane is located in the hydrophobic region, relatively close to the polar-apolar interface. The area per lipid at the pivotal plane is similar in size to lipid cross-sectional areas found in the fluid lamellar phase (L(α)) of lipid bilayers. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  12. Single-sided natural ventilation through a centre-pivot roof window

    DEFF Research Database (Denmark)

    Iqbal, Ahsan; Nielsen, Peter V.; Gunner, Amalie

    2014-01-01

    The characteristics of centre pivot roof windows for wind driven single-sided ventilation has not been studied before. These types of windows are dominating roof windows in Europe. Knowledge of flow characteristics of this kind of window is essential for accurate designing of natural ventilation...... systems. In this study, numerical methods were used to characterise a centre-pivot roof window for wind-driven single-sided ventilation. A 1:20 scale model house of the Energy Flex House (Denmark) was used in this study. The roof slope was 36o. It was found that the single-sided ventilation through...... the centre-pivot roof window can be characterised by a factor called the flow factor. The flow factor was a function of the sash opening-angle and wind direction. The flow factor increased with increase in opening-angle and decreased with increase in wind direction....

  13. Steps towards commercialization of new power buoy with pivoting arm LOPF

    DEFF Research Database (Denmark)

    2013-01-01

    direct measurements from the model device are: voltage output, the torque on the generator, the arm bending moment produced by the mooring line and the absolute angle of the pivoting float. These allowed to follow the conversion of power in the power train from mechanic to electric power......The fully instrumented Lever Operated Pivoting Float LOPF wave energy buoy model has gone through the first stage of testing in regular waves in scale 1:25 of the North Sea wave conditions, in the 3D deep wave basin at the Hydraulic and Coastal Engineering Laboratory of Aalborg University. Some...

  14. Developing a Simple Unique Head-Discharge Equation for Pivot Weirs with Different Side Contractions

    Directory of Open Access Journals (Sweden)

    neda Sheikh Rezazadeh Nikou

    2016-10-01

    Full Text Available Introduction: Pivot weirs (sharp crested inclined weirs, Fig. 1-a is frequently used for discharge measurement, controlling water surface and flow diversion. Some typical features of pivot weirs are: (a overshot design for better water level control, (b Their application as head gates, turnout or check structure which requiring low head loss and high accuracy, (c ease of removing sediment deposit behind the weir, and (d ability to manage and monitor on-site or operating remotely when connected to a supervisory control and data acquisition (SCADA network. Kindsvater and Carter (8 derived a weir discharge equation based on energy and continuity equations. Hulsing (4 determined head-discharge relationship of inclined suppressed sharp crested weir with the slope of 3:3, 2:3 and 1:3 toward downstream and compared them with the equivalent normal sharp crested weir. In the USBR report on pivot weirs (regarding The Boulder Canyon Project,1948 the head discharge data of the suppressed pivot weir were presented in a channel with 5.5m length, 2.9m depth and 0.61m width. Some field experiments were also carried out in the IID (Imperial Irrigation District on a trapezoidal cross-section (0.61 m bottom width channel with pivot weir of 1.7m length, and two different widths of 1.63m. The flow rate (350-880 lit/s was held constant and different angles (15-50° calibrated instead of holding the angle constant and varying the flow rate. Some other laboratory tests were performed with Wahlin and Replogle (1994 on two pivot weirs with 1.2 m and 1.14 m width for the 0.61 m and 0.46 m length of blade and contraction factor of 0.925. RUBICON Company established an extensive operation on the application and automation of pivot weirs in irrigation channels in Australia (Www.rubicon.com. All previous studies concentrated on modifying the normal rectangular weir head-discharge equation so that it can be used for the pivot weirs. In this study, it is trying to derive a

  15. Excel Data Analysis your visual blueprint for creating and analyzing data, charts and PivotTables

    CERN Document Server

    Etheridge, Denise

    2010-01-01

    Advanced techniques for Excel power users. Crunch and analyze Excel data the way the professionals do with this clean, uncluttered, visual guide to advanced Excel techniques. Using numerous screenshots and easy-to-follow numbered steps, this book clearly shows you how to perform professional-level modeling, charting, data access, data slicing, and other functions. You'll find super techniques for getting the most out of Excel's statistical and financial functions, Excel PivotTables and PivotCharts, Excel Solver and BackSolver, and more.: Provides a clear look at power-using Excel, the world's

  16. Improvement of effective solid angle using virtual-pivot holder and large EDS detector.

    Science.gov (United States)

    Koshiya, Shogo; Kimoto, Koji

    2017-02-01

    This paper describes the effective solid angle improvement achieved using a large-area silicon drift detector together with a virtual-pivot double-tilt specimen holder. The virtual-pivot mechanism enables various designs of specimen-retaining and can reduce the shadowing effect. Energy-dispersive X-ray spectra were measured and converted into effective solid angles using different types of specimen holders and specimens. The investigated shadowing-free mechanical system yielded effective solid angles approaching the nominal solid angle of 0.464sr. In addition, we have demonstrated the availability of the plastic (polyetheretherketone) specimen holder for low system noise.

  17. Experimental Evaluation of the Discharge Coefficient of a Centre-Pivot Roof Window

    DEFF Research Database (Denmark)

    Iqbal, Ahsan; Afshari, Alireza; Heiselberg, Per

    2013-01-01

    Windows are a component of naturally ventilated buildings. The scientific knowledge of how to estimate of airflow rates through windows is limited, especially in the case of centre-pivot roof windows. The flow through this type of windows is traditionally characterized by the orifice plate flow...... equation. This equation involves a discharge coefficient of the window. The value of the discharge coefficient is the major cause of erroneous estimation of airflow rates. This paper focuses on the experimental study of the discharge coefficient (CD) of a centre-pivot roof window. The measurements were...

  18. Simple, heart-smart substitutions

    Science.gov (United States)

    Coronary artery disease - heart smart substitutions; Atherosclerosis - heart smart substitutions; Cholesterol - heart smart substitutions; Coronary heart disease - heart smart substitutions; Healthy diet - heart ...

  19. Using Pivotal Response Training and Technology to Engage Preschoolers with Autism in Conversations

    Science.gov (United States)

    Stockall, Nancy; Dennis, Lindsay R.

    2014-01-01

    It is well known that children with autism spectrum disorder (ASD) demonstrate a significant delay in language development that impacts their ability to engage in robust conversations. In this article the authors discuss two specific elements of pivotal response training--motivation and self-initiations--for children with ASD. Specific…

  20. Improving Question-Asking Initiations in Young Children with Autism Using Pivotal Response Treatment

    Science.gov (United States)

    Koegel, Robert L.; Bradshaw, Jessica L.; Ashbaugh, Kristen; Koegel, Lynn Kern

    2014-01-01

    Social initiations make up a core deficit for children with autism spectrum disorder (ASD). In particular, initiated questions during social interactions are often minimal or absent in this population. In the context of a multiple baseline design, the efficacy of using the motivational procedures of Pivotal Response Treatment to increase social…

  1. Pivotal Response Treatment for Children with Autism: Core Principles and Applications for School Psychologists

    Science.gov (United States)

    Renshaw, Tyler L.; Kuriakose, Sarah

    2011-01-01

    During the past 2 decades, pivotal response treatment (PRT) has emerged as an evidence-based methodology for intervening with the behavioral, communicative, social, and academic impairments of children with autism. Unlike other highly structured behavioral interventions for autism, PRT emphasizes principles over procedures and focuses on enhancing…

  2. Peer-Mediated Pivotal Response Treatment for Young Children with Autism Spectrum Disorders: A Systematic Review

    Science.gov (United States)

    Boudreau, Ainsley M.; Corkum, Penny; Meko, Katelyn; Smith, Isabel M.

    2015-01-01

    This review examined the effectiveness of peer-mediated pivotal response treatment (PM-PRT) to increase social-communication skills for children with autism spectrum disorders (ASD). A systematic review was conducted of all published studies examining PM-PRT in school-aged children with ASD, based on an established rubric. Five PM-PRT studies…

  3. Evaluation of water distribution under pivot irrigation systems using remote sensing imagery in eastern Nile delta

    Directory of Open Access Journals (Sweden)

    E. Farg

    2017-04-01

    Full Text Available Traditional methods for center pivot evaluation depend on the water depth distribution along the pivot arm. Estimation and mapping the water depth under pivot irrigation systems using remote sensing data is essential for calculating the coefficient of uniformity (CU of water distribution. This study focuses on estimating and mapping water depth using Landsat OLI 8 satellite data integrated with Heerman and Hein (1968 modified equation for center pivot evaluation. Landsat OLI 8 image was geometrically and radiometrically corrected to calculate the vegetation and water indices (NDVI and NDWI in addition to land surface temperature. Results of the statistical analysis showed that the collected water depth in catchment cans is also highly correlated negatively with NDVI. On the other hand water, depth was positively correlated with NDWI and LST. Multi-linear regression analysis using stepwise selection method was applied to estimate and map the water depth distribution. The results showed R2 and adjusted R2 0.93 and 0.88 respectively. Study area or field level verification was applied for estimation equation with correlation 0.93 between the collected water depth and estimated values.

  4. From Pivot to Symmetry Integrating Africa in the Rebalance to Asia

    Science.gov (United States)

    2014-02-13

    could be worse than any kind of pivot. Notes 1 Aaron Friedberg , "The Future of U.S.-China Relations: Is Conflict Inevitable... Friedberg , p. 7. 3 Stephen M. Walt, “Dealing With a Chinese Monroe Doctrine,” New York Times, 26 August 2013, http://www.nytimes.com/roomfordebate/2012/05

  5. Droplet kinetic energy of moving spray-plate center-pivot irrigation sprinklers

    Science.gov (United States)

    The kinetic energy of discrete water drops impacting a bare soil surface generally leads to a drastic reduction in water infiltration rate due to formation of a seal on the soil surface. Under center-pivot sprinkler irrigation, kinetic energy transferred to the soil prior to crop canopy development ...

  6. Characterizing droplet kinetic energy applied by moving spray-plate center pivot irrigation sprinklers

    Science.gov (United States)

    The kinetic energy of discrete drops impacting a bare soil surface is generally observed to lead to a drastic reduction in water infiltration rate due to soil surface seal formation. Under center pivot sprinkler irrigation, kinetic energy transferred to the soil prior to crop canopy development can...

  7. Effect of Opening the Sash of a Centre-Pivot Roof Window on Wind Pressure Coefficients

    DEFF Research Database (Denmark)

    Iqbal, Ahsan; Wigö, Hans; Heiselberg, Per

    2014-01-01

    This paper describes the effect of outward opening the sash of a window on local and overall wind pressures. Wind tunnel experiments were used for the purpose of evaluation. A centre-pivot roof window on a pitched roof in a modelled scaled building was used in the analysis of wind pressures...

  8. Neural Mechanisms of Improvements in Social Motivation after Pivotal Response Treatment: Two Case Studies

    Science.gov (United States)

    Voos, Avery C.; Pelphrey, Kevin A.; Tirrell, Jonathan; Bolling, Danielle Z.; Vander Wyk, Brent; Kaiser, Martha D.; McPartland, James C.; Volkmar, Fred R.; Ventola, Pamela

    2013-01-01

    Pivotal response treatment (PRT) is an empirically validated behavioral treatment that has widespread positive effects on communication, behavior, and social skills in young children with autism spectrum disorder (ASD). For the first time, functional magnetic resonance imaging was used to identify the neural correlates of successful response to…

  9. Subexponential lower bounds for randomized pivoting rules for the simplex algorithm

    DEFF Research Database (Denmark)

    Friedmann, Oliver; Hansen, Thomas Dueholm; Zwick, Uri

    2011-01-01

    The simplex algorithm is among the most widely used algorithms for solving linear programs in practice. With essentially all deterministic pivoting rules it is known, however, to require an exponential number of steps to solve some linear programs. No non-polynomial lower bounds were known, prior...

  10. Integration of wireless sensor networks into automatic irrigation scheduling of a center pivot

    Science.gov (United States)

    A six-span center pivot system was used as a platform for testing two wireless sensor networks (WSN) of infrared thermometers. The cropped field was a semi-circle, divided into six pie shaped sections of which three were irrigated manually and three were irrigated automatically based on the time tem...

  11. Wine and heart health

    Science.gov (United States)

    Health and wine; Wine and heart disease; Preventing heart disease - wine; Preventing heart disease - alcohol ... more often just to lower your risk of heart disease. Heavier drinking can harm the heart and ...

  12. How the Heart Works

    Science.gov (United States)

    ... Works Explore How the Heart Works What Is... Anatomy Contraction Circulation Electrical System Heart Disease Related Topics Arrhythmia Congenital Heart Defects Coronary Heart Disease Heart Valve Disease How the Lungs Work Send a link to NHLBI to someone ...

  13. Heart Disease (For Kids)

    Science.gov (United States)

    ... CPR: A Real Lifesaver Kids Talk About: Coaches Heart Disease KidsHealth > For Kids > Heart Disease Print A A ... chest pain, heart attacks, and strokes . What Is Heart Disease? The heart is the center of the cardiovascular ...

  14. Men and Heart Disease

    Science.gov (United States)

    ... Pressure Salt Cholesterol Million Hearts® WISEWOMAN Men and Heart Disease Fact Sheet Recommend on Facebook Tweet Share Compartir Source: Interactive Atlas of Heart Disease and Stroke Heart Disease Facts in Men Heart disease is the leading ...

  15. About Heart Failure

    Science.gov (United States)

    ... talk about your health and the medicines About Heart Failure Heart failure is a disease where the heart cannot do ... very important for your health. common causes of heart failure are diseases or conditions that damage the heart. ...

  16. What Is Heart Failure?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Is Heart Failure? Heart failure is a condition in which the heart can' ... force. Some people have both problems. The term "heart failure" doesn't mean that your heart has stopped ...

  17. Heart Disease

    Science.gov (United States)

    ... Atherosclerosis is also the most common cause of cardiovascular disease. It can be caused by correctable problems, such as an unhealthy diet, lack of exercise, being overweight and smoking. Causes of heart arrhythmia ...

  18. Heart Attack

    Science.gov (United States)

    ... tear in the heart artery (spontaneous coronary artery dissection). Certain factors contribute to the unwanted buildup of ... logo are trademarks of Mayo Foundation for Medical Education and Research. © 1998-2017 Mayo Foundation for Medical ...

  19. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008275 Relationship of calcineure in mRNA level in peripheral blood and cardiac muscle of patients with heart failure.WANG Mengmeng(王萌萌),et al.Dept Cardiol,Shandong Prov Hosp,Shandong Univ,Jinan 250021.Chin Cir J 2008;23(2):113-116.Objective To study the relationship of calcineurin mRNA level between peripheral lymphocytes and cardiac muscles of patients with chronic heart failure.Methods

  20. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008037 Factors associated with efficacy of cardiac resynchronization therapy for patients with congestive heart failure. SHI Haoying(史浩颖), et al. Dept Cardiol, Zhongshan Hosp Fudan Univ, Shanghai 200032. Chin J Cardiol 2007;35(12):1099-1163. Objective The efficacy of cardiac resynchronization therapy (CRT) in patients with congestive heart failure and the potential factors associated with responder or nonresponder were investigated. Methods Fifty

  1. Efficient Storage and Querying of Horizontal Tables Using a PIVOT Operation in Commercial Relational DBMSs

    Science.gov (United States)

    Shin, Sung-Hyun; Moon, Yang-Sae; Kim, Jinho; Kim, Sang-Wook

    In recent years, a horizontal table with a large number of attributes is widely used in OLAP or e-business applications to analyze multidimensional data efficiently. For efficient storing and querying of horizontal tables, recent works have tried to transform a horizontal table to a traditional vertical table. Existing works, however, have the drawback of not considering an optimized PIVOT operation provided (or to be provided) in recent commercial RDBMSs. In this paper we propose a formal approach that exploits the optimized PIVOT operation of commercial RDBMSs for storing and querying of horizontal tables. To achieve this goal, we first provide an overall framework that stores and queries a horizontal table using an equivalent vertical table. Under the proposed framework, we then formally define 1) a method that stores a horizontal table in an equivalent vertical table and 2) a PIVOT operation that converts a stored vertical table to an equivalent horizontal view. Next, we propose a novel method that transforms a user-specified query on horizontal tables to an equivalent PIVOT-included query on vertical tables. In particular, by providing transformation rules for all five elementary operations in relational algebra as theorems, we prove our method is theoretically applicable to commercial RDBMSs. Experimental results show that, compared with the earlier work, our method reduces storage space significantly and also improves average performance by several orders of magnitude. These results indicate that our method provides an excellent framework to maximize performance in handling horizontal tables by exploiting the optimized PIVOT operation in commercial RDBMSs.

  2. The Pivot to Asia: Can It Serve as the Foundation for American Grand Strategy in the 21st Century

    Science.gov (United States)

    noting the growing importance of India and Chinas efforts to expand their influence into Central Asia, Europe, Africa , and Latin America. Dr. Stuart...complicated its efforts to keep its focus on the pivot strategy in the IAP region . He concludes with some lessons for strategists, derived from the Obama teams experience with the pivot.

  3. Two independent pivotal statistics that test location and misspecification and add-up to the Anderson-Rubin statistic

    NARCIS (Netherlands)

    Kleibergen, F.R.

    2002-01-01

    We extend the novel pivotal statistics for testing the parameters in the instrumental variables regression model. We show that these statistics result from a decomposition of the Anderson-Rubin statistic into two independent pivotal statistics. The first statistic is a score statistic that tests loc

  4. Acid-base balance in heart failure.

    Science.gov (United States)

    Frangiosa, A; De Santo, L S; Anastasio, P; De Santo, N G

    2006-01-01

    In end-stage heart failure, various acid-base disorders can be discovered due to the renal loss of hydrogen ions and hydrogen ion movements into cells, the reduction of the effective circulating volume, hypoxemia and renal failure. This justifies the occurrence of metabolic alkalosis, metabolic acidosis, respiratory alkalosis, as well as respiratory acidosis alone or in combination. Several studies have been published on the acid-base state in heart failure. In a 1951 study, Squires et al analyzed the distribution of body fluid in congestive heart failure by taking into consideration the abnormalities in serum electrolyte concentration and in acid-base equilibrium. A recent study by Milionis et al, analyzed 86 patients with congestive heart failure receiving conventional treatment; the majority of these patients exhibited hypokalemia, hyponatremia, hypocalcemia and hypophosphatemia. Disorders in acid-base balance were noted in 37.2% of patients. In a recent study, 70 patients with severe congestive heart failure before heart transplantation showed high-normal pH, slightly reduced pCO 2 and a slight loss of hydrogen ions. After heart transplantation, stability of blood pH and hydrogen ion concentrations was found. In contrast, bicarbonate and pCO 2 increased significantly. The data led us to formulate the diagnosis of a mixed acid-base disorder that includes respiratory alkalosis and metabolic alkalosis before heart transplantation. In heart failure, the presence of acid-base imbalance associated with the activation of mechanisms that lead to salt and water retention reveals evidence concerning the pivotal role of the kidney in determining the outcome of these patients.

  5. Heart failure - tests

    Science.gov (United States)

    CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... the best test to: Identify which type of heart failure (systolic versus diastolic, valvular) Monitor your heart failure ...

  6. Problem: Heart Valve Stenosis

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  7. Healthy Heart Quizzes

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  8. Problem: Heart Valve Regurgitation

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  9. Travel and Heart Disease

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  10. Pivotal temperature and sexual dimorphism of Podocnemis expansa hatchlings (Testudines: Podocnemididae from Bananal Island, Brazil

    Directory of Open Access Journals (Sweden)

    Adélio Lubiana

    2009-09-01

    Full Text Available A common problem when trying to identify the sex of hatchling turtles is that juveniles are not obviously externally dimorphic and current techniques to identify sex are often invasive. In this paper, 300 eggs of Podocnemis expansa from Bananal Island, state of Tocantins (Brazil, were incubated at constant temperatures. The carapaces of the hatchlings were photographed and subjected to geometric morphometric analysis. The hatchlings were subsequently euthanized and had their gonads removed for sex determination. The pivotal temperature of P. expansa was 33.5ºC, confirming that this species has the highest pivotal temperature among reptiles. Geometric morphometric analysis of the shape of the carapace proved efficient in differentiating the sex of the hatchlings and confirmed that this methodology can be efficient for studies that need to ascertain the sex ratio in P. expansa hatchlings.

  11. Safer and More Efficient Ship Handling with the Pivot Point Concept

    Directory of Open Access Journals (Sweden)

    Seong-Gi Seo

    2016-12-01

    Full Text Available The concept of the pivot point of a turning ship has been in existence for more than two centuries. It was not, however, properly understood from the beginning, and thus some misconceptions developed. This in turn caused it to be viewed as something mystical, thus preventing ship handling from scientific approach. The concept is expounded in a fresh light, deriving an equation for the definition and others for the calculation of the pivot point location both in general and for specific examples in an idealized condition. The implications of the derived equations are discussed. The results of a verification experiment are presented, which proved centuries’ of teachings and learnings to have been incorrect. A number of exercises for both steady and unsteady cases have been suggested for the training of the practitioners in the light of these new findings.

  12. U.S.“Pivot to Asia" Faces Numerous Problems Ahead

    Institute of Scientific and Technical Information of China (English)

    Hong; Yuan

    2014-01-01

    <正>It is generally believed that U.S.pivot to Asia or the rebalancing in Asia-Pacific derives from its psychology,which is more fear of China’s rise than China’s wish to challenge America.So far there is no effective evidence showing that China is challenging the United States,but fear of China can be seen everywhere in the United States.Therefore,the biggest global objective of the United States is

  13. Plant responses, climate pivot points, and trade-offs in water-limited ecosystems

    Science.gov (United States)

    Munson, Seth M.

    2013-01-01

    Plant species in dryland ecosystems are limited by water availability and may be vulnerable to increases in aridity. Methods are needed to monitor and assess the rate of change in plant abundance and composition in relation to climate, understand the potential for degradation in dryland ecosystems, and forecast future changes in plant species assemblages. I employ nearly a century of vegetation monitoring data from three North American deserts to demonstrate an approach to determine plant species responses to climate and critical points over a range of climatic conditions at which plant species shift from increases to decreases in abundance (climate pivot points). I assess these metrics from a site to regional scale and highlight how these indicators of plant performance can be modified by the physical and biotic environment. For example, shrubs were more responsive to drought and high temperatures on shallow soils with limited capacity to store water and fine-textured soils with slow percolation rates, whereas perennial grasses were more responsive to precipitation in sparse shrublands than in relatively dense grasslands and shrublands, where competition for water is likely more intense. The responses and associated climate pivot points of plant species aligned with their lifespan and structural characteristics, and the relationship between responses and climate pivot points provides evidence of the trade-off between the capacity of a plant species to increase in abundance when water is available and its drought resistance.

  14. Optimal irrigation water allocation for a center pivot using remotely sensed data

    Science.gov (United States)

    Hassan Esfahani, L.; McKee, M.

    2013-12-01

    Efficient irrigation can help avoid crop water stress, undesirable leaching of nutrients, and yield reduction due to water shortage, and runoff and soil erosion due to over irrigation. Gains in water use efficiency can be achieved when water application is precisely matched to the spatially distributed crop water demand. This is important to produce high quality crops and otherwise conserve water for greatest efficiency of use. Irrigation efficiency is a term which defines irrigation performance based on indicators such as irrigation uniformity, crop production, economic return and water resources sustainability. The present paper introduces a modeling approach for optimal water allocation to a center pivot irrigation unit in consideration of these types of indicators. Landsat images, weather data and field measurements were used to develop a soil water balance model using Artificial Neural Networks (ANN). The model includes two main modules, one for soil water forecasting and one for optimization of water allocation. The optimization module uses Genetic Algorithms (GA) to identify optimal crop water application rates based on the crop type, growing stage and sensitivity to water stress. The forecasting module allocates water through time across the area covered by the center pivot considering the results from the previous period of irrigation and the operational limitations of the center pivot irrigation system. The model was tested for a farm equipped with a modern sprinkler irrigation system in Scipio, Utah. The solution obtained from the model used up to 30 percent less water without reducing the benefits realized by the irrigator than traditional operating procedures.

  15. Advances in the understanding and management of heart transplantation

    OpenAIRE

    Singh, Dhssraj; Taylor, David O.

    2015-01-01

    Cardiac transplantation represents one of the great triumphs in modern medicine and remains the cornerstone in the treatment of advanced heart failure. In this review, we contextualize pivotal developments in our understanding and management of cardiac transplant immunology, histopathology, rejection surveillance, drug development and surgery. We also discuss current limitations in their application and the impact of the left ventricular assist devices in bridging this gap.

  16. Heart Health: The Heart Truth Campaign 2009

    Science.gov (United States)

    ... Past Issues Cover Story Heart Health The Heart Truth Campaign 2009 Past Issues / Winter 2009 Table of ... of the celebrities supporting this year's The Heart Truth campaign. Both R&B singer Ashanti (center) and ...

  17. Women's Heart Disease: Heart Attack Symptoms

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter 2014 Table ... NHLBI has uncovered some of the causes of heart diseases and conditions, as well as ways to prevent ...

  18. Women's Heart Disease: Heart Disease Risk Factors

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Disease Risk Factors Past Issues / Winter 2014 Table of ... or habits may raise your risk for coronary heart disease (CHD). These conditions are known as risk factors. ...

  19. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    2009170 Curcumin attenuates left ventricular dysfunction and remodeling in rabbits with chronic heart failure. TANG Yanhong(唐艳红),et al.Dept Cardiol,Renmin Hosp,Wuhan Univ,Wuhan 430060.Chin J Cardiol,2009;37(3):262-267.

  20. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008411 Expression of S100B during heart failure in rats. JIANG Zhenni(蒋珍妮), et al. Dept Cardiol, 2nd Affili Hosp, Zhejiang Univ, Coll Med Hangzhou 310009. Chin J Emerg Med 2008;17(5):475-478. Objective To evaluate the value of S100B gene on cardiovascular remodeling in rats with abdominal aorta coarctation.

  1. Heart attack first aid

    Science.gov (United States)

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle ...

  2. Pediatric heart surgery

    Science.gov (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... the type of defect, and the type of surgery that was done. Many children recover completely and lead normal, active lives.

  3. Diabetic Heart Disease

    Science.gov (United States)

    ... be coronary heart disease (CHD), heart failure, and diabetic cardiomyopathy. Diabetes by itself puts you at risk for heart disease. Other risk factors include Family history of heart disease Carrying extra ...

  4. Coronary heart disease

    Science.gov (United States)

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... slow down or stop. A risk factor for heart disease is something that increases your chance of getting ...

  5. Heart Diseases and Disorders

    Science.gov (United States)

    ... Resources Heart Diseases & Disorders Back to Patient Resources Heart Diseases & Disorders Millions of people experience irregular heartbeats, called ... harmless and happen in healthy people free of heart disease. However, some abnormal heart rhythms can be serious ...

  6. Overview of Heart Tumors

    Science.gov (United States)

    ... develop in the sac that surrounds the heart (pericardium). Tumors in the pericardium may squeeze (constrict) the heart, preventing it from ... Heart wall Fibroma Hemangioma Rhabdomyoma Outside surface Lipoma Pericardium (outer sac covering heart) Pericardial cyst Base of ...

  7. Classes of Heart Failure

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Classes of Heart Failure Updated:Sep 28,2016 Doctors usually classify patients' ... Blood Pressure Tracker Find additional helpful resources here Heart Failure • Home • About Heart Failure Introduction Types of Heart ...

  8. Heart valve surgery

    Science.gov (United States)

    ... Tricuspid valve stenosis Risks The risks of having cardiac surgery include: Death Heart attack Heart failure Bleeding requiring ... and the A.D.A.M. Editorial team. Heart Surgery Read more Heart Valve Diseases Read more Latest ...

  9. Current Evidence on Treatment of Patients With Chronic Systolic Heart Failure and Renal Insufficiency

    NARCIS (Netherlands)

    Damman, Kevin; Tang, W. H. Wilson; Felker, G. Michael; Lassus, Johan; Zannad, Faiez; Krum, Henry; McMurray, John J. V.

    2014-01-01

    Chronic kidney disease (CKD) is increasingly prevalent in patients with chronic systolic heart failure. Therefore, evidence-based therapies are more and more being used in patients with some degree of renal dysfunction. However, most pivotal randomized clinical trials specifically excluded patients

  10. Predictive Role of Diastolic Echocardiographic Findings in the Outcome of Heart Failure with Preserved Ejection Fraction

    Directory of Open Access Journals (Sweden)

    Farveh Vakilian

    2016-01-01

    According to the results of this review, Doppler echocardiography plays a pivotal role in the assessment of diastolic left ventricular filling dynamics. However, this technique is restricted by the confounding effects of the changes in the heart rate and loading conditions.

  11. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005186 The diagnostic application of bedside measurement of plasma brain natriuretic in patients with heart failure. SHAO Le-wen (邵乐文) , Advanced Ward Dept, 1st Hosp, Med Sch, Zhejiang Univ, Hangzhou 310003. Chin J Intern Med, 2005;44(2): 99-101. Objective: To investigate differential diagnosis value of ultra-rapid bedside measurement of brain na-triuretic peptide (BNP) in patients with dyspnea.

  12. Heart failure

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    2010316 Tissue doppler imaging observation on effect of long-term use of gingko biloba tabtet on left ventricular function in patients with chronic heart failure. ZHANG Hui(张辉),et al. Dept Cardiovasc Med, 2nd Hosp, Hebei Med Univ,Shijiazhuang 050000. Chin J Integr Tradit & West Med 2010;30(5):478-481. Objective To quantitatively observe the effect of long-term

  13. Kalman Filter-based Single-baseline GNSS Data Processing without Pivot Satellite Changing

    Directory of Open Access Journals (Sweden)

    ZHANG Baocheng

    2015-09-01

    Full Text Available Single-baseline global navigation satellite system (GNSS data are able to be processed into a batch of parameters such as positions, timing information as well as atmospheric delays. The applications of relevance, therefore, consist of relative positioning, time and frequency transfer and so forth. To achieve real-time capability, these parameters are usually estimated by means of Kalman-filter. Moreover, the reliability of these parameters can be further strengthened by forming and then successfully fixing a set of independent double-differenced (DD integer ambiguities. For this purpose, the filter function model is commonly set up based on the DD observation equations (DD filter model. In order to preserve the continuity of the filter, DD filter model needs to explicitly refer to another pivot satellite once the previous one becomes invisible. This thereby implies that, before being predicted to the next epoch, the former filtered DD ambiguity vector has to be “mapped” with respect to the newly-defined pivot satellite. In addition to that, the estimated receiver phase clocks using DD filter model may soak up distinct between-receiver single-differenced (SD ambiguities belonging to different pivot satellites and would thereby be subject to apparent “integer jumps”. In this contribution, SD observation equations involving estimable DD ambiguity parameters are alternatively selected as the filter function model (SD filter model. Our analyses suggest that, both DD and SD filter models are equivalent in theory, but differ from each other as far as their implementations are concerned. Typically, for SD filter model, no effort should be made to map DD ambiguities, thus implying less intensive computational burden and better flexibility than DD filter model. At the same time, receiver phase clocks determined by SD filter model are free from “integer jumps” and thus are particularly beneficial for frequency transfer.

  14. Motion within the unstable cervical spine during patient maneuvering: the neck pivot-shift phenomenon.

    Science.gov (United States)

    Lador, Ran; Ben-Galim, Peleg; Hipp, John A

    2011-01-01

    Cervical extrication collars are applied to millions of blunt trauma victims despite the lack of any evidence that a collar can protect against secondary injuries to the cervical spine. Cadaver studies support that in the presence of a dissociative injury, substantial motion can occur within the occipitocervical spine with collar application or during patient transfers. Little is known about the biomechanics of cervical stabilization; hence, it is difficult to develop and test improved immobilization strategies. Severe unstable injuries were created in seven fresh whole human cadavers. Rigid collars were applied with the body in a neutral position. Computed tomographic examinations were obtained before and after tilting the body or backboard as would be done during patient transport or to inspect the back. Relative displacements between vertebrae at the site of the injury were measured from the Computed tomographic examinations. The overall relative alignment between body and collar was assessed to understand the mechanisms that may facilitate motion at the injury site. Intervertebral motion averaged 7.7 mm±6.8 mm in the axial plain and 2.9 mm±2.5 mm in the cranial-caudal direction. The rigid collars appeared to create pivot points where the collar contacts the head in the region under the ear and where the collar contacts the shoulders. Rigid cervical collars appear to create pivot points that shift the center of rotation lateral to the spine and contribute to the intervertebral motions that were measured. Immobilization strategies that avoid these neck pivot-shift phenomena may help to reduce secondary injuries to the cervical spine. The whole cadaver model with simulation of patient maneuvers may provide an effective test method for cervical immobilization.

  15. Experimental analysis of single sided ventilation through a centre pivot roof window

    DEFF Research Database (Denmark)

    Iqbal, Ahsan; Afshari, Alireza; Heiselberg, Per

    2015-01-01

    In the present study bidirectional airflow characteristics of a centre-pivot roof window were analysed in-situ. Both wind and temperature differences were present at the time of measurements. Tracer gas technique using N2O gas was used to estimate the air change rates in the experimental space....... Leakages through the experimental space were estimated using the blower door tests. Air-change rates increased with increase in the window sash opening angle. When the window was open all the way, with an average wind speed of 4 m/s, the average air-change rate was 2. Flow factor was used to characterise...

  16. Clusters and pivots for evaluating a large numberof alternatives in AHP

    Directory of Open Access Journals (Sweden)

    Alessio Ishizaka

    2012-04-01

    Full Text Available AHP has been successful in many cases but it has a major limitation: a larger number of alternatives requires a high number of judgements in the comparison matrices. In order to reduce this problem,we present a method with clusters and pivots. This method also helps with a further four problems of the Analytic Hierarchy Process. It enlarges the comparison scale, facilitates the construction of a consistent or near consistent matrix, eliminates the problem of the choice of the priorities derivation method and allows the use of incomparable alternatives.

  17. Tropical grasslands: A pivotal place for a more multi-functional agriculture.

    Science.gov (United States)

    Boval, Maryline; Angeon, Valérie; Rudel, Tom

    2017-02-01

    Tropical grasslands represent a pivotal arena for the sustainable intensification of agriculture in the coming decades. The abundant ecosystem services provided by the grasslands, coupled with the aversion to further forest destruction, makes sustainable intensification of tropical grasslands a high policy priority. In this article, we provide an inventory of agricultural initiatives that would contribute to the sustainable intensification of the tropical grassland agro-ecosystem, and we recommend a shift in the scientific priorities of animal scientists that would contribute to realization of a more agro-ecological and multi-functional agriculture in the world's tropical grasslands.

  18. Pivotal connection for articulated column of sea-bed working structure. Leddforbindelse for en soeyle for arbeide paa havbunnen

    Energy Technology Data Exchange (ETDEWEB)

    Tuson, S.; Chilardi, J.P.

    1984-08-20

    The invention relates to a pivotal connecting device of the kind forming a universal Cardan joint coupling in particular for a compliant or articulated column of a sea-bed working structure, said column being pivotally connected to a base member, wherein said universal Cardan joint coupling is associated with one or more rigid connecting ducts for conveying the flow of at least one fluid between said base member and said column. 4 drawings.

  19. Effect of Opening the Sash of a Centre-Pivot Roof Window on Wind Pressure Coefficients

    DEFF Research Database (Denmark)

    Iqbal, Ahsan; Wigö, Hans; Heiselberg, Per

    2014-01-01

    This paper describes the effect of outward opening the sash of a window on local and overall wind pressures. Wind tunnel experiments were used for the purpose of evaluation. A centre-pivot roof window on a pitched roof in a modelled scaled building was used in the analysis of wind pressures. The ...... pressure distribution nearby the window. The use of wind pressure coefficients from the analysis of sealed plain surface may lead to erroneous estimation of airflow rate.......This paper describes the effect of outward opening the sash of a window on local and overall wind pressures. Wind tunnel experiments were used for the purpose of evaluation. A centre-pivot roof window on a pitched roof in a modelled scaled building was used in the analysis of wind pressures....... The wind pressures were defined in terms of wind pressure coefficients. Traditionally wind pressure coefficients are extracted from the analysis of sealed plain surface. These wind pressure coefficients are used to estimate the natural ventilation rate through windows/openings due to wind effect. Surface...

  20. Resilience Pivots: Stability and Identity in a Social-Ecological-Cultural System

    Directory of Open Access Journals (Sweden)

    Stephanie J. Rotarangi

    2014-03-01

    Full Text Available How is cultural resilience achieved in the face of significant social and ecological change? Is resilience compatible with changed structures, functions, and feedbacks as long as identity is maintained? The concept of cultural resilience has been less explored than its older siblings ecological resilience, social resilience, and social-ecological resilience. We seek to redress the balance, drawing from resilience thinking to examine how a New Zealand Māori tribal group of landowners retained strong cultural identity and connectedness to their land despite enduring significant changes in land use, economy, tenure, and governance. The landowners negotiated radical transformations in the ecology and land use of their home lands on terms that supported matters of cultural importance. The key resilience concepts of adaptation and transformation were helpful in analyzing the trajectory of change, but fell short of representing the elements of stability that supported the cultural resilience of the landowners. The concept of resilience pivots was designed to address this conceptual gap, and to offer another heuristic to resilience thinking by focusing on stability rather than change. Resilience pivots are those elements of a resilient system that remain stable despite adaptation or even transformation of other elements of that system, and in doing so support the maintenance of the system's distinctive identity.

  1. Types of Heart Failure

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Types of Heart Failure Updated:Feb 9,2017 Left-sided heart failure ... making. This content was last reviewed April 2015. Heart Failure • Home • About Heart Failure Introduction Types of Heart ...

  2. Fluid therapy in critically ill patients: perspectives from the right heart.

    Science.gov (United States)

    Elbers, Paul; Rodrigus, Tim; Nossent, Esther; Malbrain, Manu L N G; Vonk-Noordegraaf, Anton

    2015-01-01

    As right heart function can affect outcome in the critically ill patient, a thorough understanding of factors determining right heart performance in health and disease is pivotal for the critical care physician. This review focuses on fluid therapy, which remains controversial in the setting of impending or overt right heart failure. In this context, we will attempt to elucidate which patients are likely to benefit from fluid administration and for which patients fluid therapy would likely be harmful. Following a general discussion of right heart function and failure, we specifically focus on important causes of right heart failure in the critically ill, i.e. sepsis induced myocardial dysfunction, the acute respiratory distress syndrome, acute pulmonary embolism and the effects of positive pressure ventilation. It is argued that fluid therapy should always be cautiously administered with the right heart in mind, which calls for close multimodal monitoring.

  3. Acid-base and electrolyte abnormalities in heart failure: pathophysiology and implications.

    Science.gov (United States)

    Urso, Caterina; Brucculeri, Salvatore; Caimi, Gregorio

    2015-07-01

    Electrolyte and acid-base abnormalities are a frequent and potentially dangerous complication in subjects with congestive heart failure. This may be due either to the pathophysiological alterations present in the heart failure state leading to neurohumoral activation (stimulation of the renin-angiotensin-aldosterone system, sympathoadrenergic stimulation), or to the adverse events of therapy with diuretics, cardiac glycosides, and ACE inhibitors. Subjects with heart failure may show hyponatremia, magnesium, and potassium deficiencies; the latter two play a pivotal role in the development of cardiac arrhythmias. The early identification of these alterations and the knowledge of the pathophysiological mechanisms are very useful for the management of these patients.

  4. Left heart catheterization

    Science.gov (United States)

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye will be injected into your ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  5. Heart-Healthy Exercise

    Science.gov (United States)

    ... American Heart Association Cardiology Patient Page Heart-Healthy Exercise Lauren Healey Mellett , Gisele Bousquet Download PDF https:// ... if you already have heart disease. How Can Exercise Help? There are many modifiable risk factors for ...

  6. Heart pacemaker - discharge

    Science.gov (United States)

    ... pacemaker can be used for patients with heart failure. It has three leads to help the heart beat in a more coordinated manner. Some pacemakers also can deliver electric shocks to the heart that can stop life-threatening ...

  7. Honolulu Heart Program

    Science.gov (United States)

    2016-04-13

    Cardiovascular Diseases; Coronary Disease; Cerebrovascular Accident; Heart Diseases; Heart Failure, Congestive; Myocardial Infarction; Asthma; Emphysema; Lung Diseases, Obstructive; Aortic Aneurysm, Abdominal; Bronchitis; Dementia; Hypertension; Chronic Obstructive Pulmonary Disease; Heart Failure

  8. Heart Health Tests

    Science.gov (United States)

    ... is easier to treat. Blood tests and heart health tests can help find heart diseases or identify ... diseases. There are several different types of heart health tests. Your doctor will decide which test or ...

  9. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  10. Heart and Down Syndrome

    Science.gov (United States)

    ... Associated Conditions » The Heart & Down Syndrome The Heart & Down Syndrome Abnormalities of the cardiovascular system are common in ... the Most Common Heart Defects in Children With Down Syndrome? The most common defects are Atrioventricular Septal Defect ( ...

  11. Congenital heart disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/001114.htm Congenital heart disease To use the sharing features on this page, please enable JavaScript. Congenital heart disease (CHD) is a problem with the heart's structure ...

  12. Cyanotic heart disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/001104.htm Cyanotic heart disease To use the sharing features on this page, please enable JavaScript. Cyanotic heart disease refers to a group of many different heart ...

  13. Heart Disease Risk Factors

    Science.gov (United States)

    ... Hearts® WISEWOMAN Program Other Chronic Disease Topics Diabetes Nutrition Obesity Physical Activity Stroke Heart Disease Risk Factors Recommend ... Hearts® WISEWOMAN Program Other Chronic Disease Topics Diabetes Nutrition Obesity Physical Activity Stroke File Formats Help: How do ...

  14. Heart disease and depression

    Science.gov (United States)

    ... gov/ency/patientinstructions/000790.htm Heart disease and depression To use the sharing features on this page, ... a heart attack or heart surgery Signs of Depression It is pretty common to feel down or ...

  15. Living with Heart Failure

    Science.gov (United States)

    ... page from the NHLBI on Twitter. Living With Heart Failure Currently, heart failure has no cure. You'll ... avoid harmful side effects. Take Steps To Prevent Heart Failure From Getting Worse Certain actions can worsen your ...

  16. Who Needs Heart Surgery?

    Science.gov (United States)

    ... this page from the NHLBI on Twitter. Who Needs Heart Surgery? Heart surgery is used to treat ... will work with you to decide whether you need heart surgery. A cardiologist specializes in diagnosing and ...

  17. Revealing Hearts

    DEFF Research Database (Denmark)

    Saghaug, Kristin Falck; Pattison, George; Lindgren, Peter

    2014-01-01

    Some small business owners want to balance personal values as well as economic values. “I have to follow my heart” or “it must be meaningful” some of them say. But how might they be able to know what gives meaning to the heart? The philosophical theologian Paul Tillich finds that the problem...... with reference to Tillich’s account of the meaning of revelation through culture and art, summed up in the statement that “(...) revelation is the manifestation of the ground of being for human knowledge” (Tillich, 1951, p.94), which, we argue, can be extended to everyday experiences, for example, in business...... life. In Tillich’s own terms, even preliminary concerns may point at an ultimate concern (Tillich, 1964), which can also be understood as ‘knowledge of the heart’. Our account is also connected to wider discussions concerning the nature of intuition....

  18. Pivotal Role of Regulator of G-protein Signaling 12 in Pathological Cardiac Hypertrophy.

    Science.gov (United States)

    Huang, Jia; Chen, Lijuan; Yao, Yuyu; Tang, Chengchun; Ding, Jiandong; Fu, Cong; Li, Hongliang; Ma, Genshan

    2016-06-01

    Cardiac hypertrophy is a major predictor of heart failure and is regulated by diverse signaling pathways. As a typical multi-domain member of the regulator of G-protein signaling (RGS) family, RGS12 plays a regulatory role in various signaling pathways. However, the precise effect of RGS12 on cardiac hypertrophy remains largely unknown. In this study, we observed increased expression of RGS12 in the development of pathological cardiac hypertrophy and heart failure. We then generated genetically engineered mice and neonatal rat cardiomyocytes to investigate the effects of RGS12 during this pathological process. Four weeks after aortic banding, RGS12-deficient hearts showed decreased cardiomyocyte cross area (374.7±43.2 μm(2) versus 487.1±47.9 μm(2) in controls; Phypertrophy in isolated cardiomyocytes. Mechanistically, our data indicated that the activation of MEK1/2-ERK1/2 signaling may be responsible for the prohypertrophic action of RGS12. In addition, the requirement of the MEK1/2-ERK1/2 signaling for RGS12-mediated cardiac hypertrophy was confirmed in rescue experiments using the MEK1/2-specific inhibitor U0126. In conclusion, our findings provide a novel diagnostic and therapeutic target for pathological cardiac hypertrophy and heart failure. © 2016 American Heart Association, Inc.

  19. Understanding chronic heart failure

    OpenAIRE

    Fenton, Matthew; Burch, Michael

    2007-01-01

    The key principles of chronic heart failure and the development of clinical management strategies are described. The physiological changes in chronic heart failure and the clinical management of children with heart failure are considered, but the treatment of heart failure related to congenital heart disease or the intensive care management of heart failure are not mentioned as both topics require consideration in their own right. A greater understanding of the maladaptive responses to chroni...

  20. Off-design performance loss model for radial turbines with pivoting, variable-area stators

    Science.gov (United States)

    Meitner, P. L.; Glassman, A. J.

    1980-01-01

    An off-design performance loss model was developed for variable stator (pivoted vane), radial turbines through analytical modeling and experimental data analysis. Stator loss is determined by a viscous loss model; stator vane end-clearance leakage effects are determined by a clearance flow model. Rotor loss coefficient were obtained by analyzing the experimental data from a turbine rotor previously tested with six stators having throat areas from 20 to 144 percent of design area and were correlated with stator-to-rotor throat area ratio. An incidence loss model was selected to obtain best agreement with experimental results. Predicted turbine performance is compared with experimental results for the design rotor as well as with results for extended and cutback versions of the rotor. Sample calculations were made to show the effects of stator vane end-clearance leakage.

  1. Impact of Functional Electrical Stimulation of Lower Limbs during Sitting Pivot Transfer Motion for Paraplegic People

    Directory of Open Access Journals (Sweden)

    Jovana Jovic

    2013-01-01

    Full Text Available Individuals with Spinal Cord Injury (SCI, perform Sitting Pivot Transfer (SPT motion around fifteen times a day using upper extremities. It can lead to upper limbs pain and often shoulder complications. In this paper, we investigate the influence of Functional Electrical Stimulation (FES on SPT motion of a paraplegic person. First, we proposed to develop a dynamic optimization method in order to predict SPT motion of an able‐bodied subject. This approach has been validated by comparing the computed SPT trajectories with the ones measured during the experiment with an able‐bodied subject. Then, we used the optimization tool to analyze the influence of FES on the SPT maneuver of paraplegic persons. Our results suggest that FES can decrease arm participation during the transfer motion of a paraplegic person.

  2. Frequency domain wave equation forward modeling using gaussian elimination with static pivoting

    Science.gov (United States)

    Jian-Yong, Song; Xiao-Dong, Zheng; Yan, Zhang; Ji-Xiang, Xu; Zhen, Qin; Xue-Juan, Song

    2011-03-01

    Frequency domain wave equation forward modeling is a problem of solving large scale linear sparse systems which is often subject to the limits of computational efficiency and memory storage. Conventional Gaussian elimination cannot resolve the parallel computation of huge data. Therefore, we use the Gaussian elimination with static pivoting (GESP) method for sparse matrix decomposition and multi-source finite-difference modeling. The GESP method does not only improve the computational efficiency but also benefit the distributed parallel computation of matrix decomposition within a single frequency point. We test the proposed method using the classic Marmousi model. Both the single-frequency wave field and time domain seismic section show that the proposed method improves the simulation accuracy and computational efficiency and saves and makes full use of memory. This method can lay the basis for waveform inversion.

  3. Impact of Functional Electrical Stimulation of Lower Limbs during Sitting Pivot Transfer Motion for Paraplegic People

    Directory of Open Access Journals (Sweden)

    Jovana Jovic

    2013-01-01

    Full Text Available Individuals with Spinal Cord Injury (SCI, perform Sitting Pivot Transfer (SPT motion around fifteen times a day using upper extremities. It can lead to upper limbs pain and often shoulder complications. In this paper, we investigate the influence of Functional Electrical Stimulation (FES on SPT motion of a paraplegic person. First, we proposed to develop a dynamic optimization method in order to predict SPT motion of an able-bodied subject. This approach has been validated by comparing the computed SPT trajectories with the ones measured during the experiment with an able-bodied subject. Then, we used the optimization tool to analyze the influence of FES on the SPT maneuver of paraplegic persons. Our results suggest that FES can decrease arm participation during the transfer motion of a paraplegic person.

  4. Achieving numerical accuracy and high performance using recursive tile LU factorization with partial pivoting

    KAUST Repository

    Dongarra, Jack

    2013-09-18

    The LU factorization is an important numerical algorithm for solving systems of linear equations in science and engineering and is a characteristic of many dense linear algebra computations. For example, it has become the de facto numerical algorithm implemented within the LINPACK benchmark to rank the most powerful supercomputers in the world, collected by the TOP500 website. Multicore processors continue to present challenges to the development of fast and robust numerical software due to the increasing levels of hardware parallelism and widening gap between core and memory speeds. In this context, the difficulty in developing new algorithms for the scientific community resides in the combination of two goals: achieving high performance while maintaining the accuracy of the numerical algorithm. This paper proposes a new approach for computing the LU factorization in parallel on multicore architectures, which not only improves the overall performance but also sustains the numerical quality of the standard LU factorization algorithm with partial pivoting. While the update of the trailing submatrix is computationally intensive and highly parallel, the inherently problematic portion of the LU factorization is the panel factorization due to its memory-bound characteristic as well as the atomicity of selecting the appropriate pivots. Our approach uses a parallel fine-grained recursive formulation of the panel factorization step and implements the update of the trailing submatrix with the tile algorithm. Based on conflict-free partitioning of the data and lockless synchronization mechanisms, our implementation lets the overall computation flow naturally without contention. The dynamic runtime system called QUARK is then able to schedule tasks with heterogeneous granularities and to transparently introduce algorithmic lookahead. The performance results of our implementation are competitive compared to the currently available software packages and libraries. For example

  5. Pivotal response treatment for preschoolers with autism spectrum disorder: Defining a predictor profile.

    Science.gov (United States)

    Fossum, Kristin-Lee; Williams, Loriann; Garon, Nancy; Bryson, Susan E; Smith, Isabel M

    2017-08-31

    Behavioral characteristics of children with autism spectrum disorder (ASD) who respond positively to Pivotal Response Treatment (PRT) have been described previously, based on single-subject design research. The present study examined several such characteristics, as well as positive affect, as predictors of expressive language (EL) gains in a representative sample of preschoolers with ASD (n = 57) enrolled in a PRT-based community early intervention program. Children's cognitive ability, positive affect, and levels of appropriate toy contact measured at the start of intervention each contributed significantly to the prediction of EL outcomes. Together these variables accounted for 40% of the total outcome variance. In addition, a profile of increased EL ability, positive affect and appropriate toy contact, and decreased social avoidance and stereotyped and repetitive vocalizations was associated with greater gains during intervention. Results are discussed in relation to their implications for understanding both the variable treatment response documented in children with ASD and how to tailor treatment to optimize individual benefit. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. The study examined behavior of 57 preschoolers who made the greatest and least gains from 1 year of a community Pivotal Response Treatment program. Using pre-treatment videos, we saw that children who made the most progress showed more language, positive affect, and appropriate interactions with toys, also less avoidance of people and fewer repetitive vocalizations. Behavior profiles can be used to match treatment to individual children's needs. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

  6. Heart failure - home monitoring

    Science.gov (United States)

    ... failure - discharge Heart failure - fluids and diuretics Heart failure - what to ask ... Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, ...

  7. ChIP-Seq identification of weakly conserved heart enhancers.

    Science.gov (United States)

    Blow, Matthew J; McCulley, David J; Li, Zirong; Zhang, Tao; Akiyama, Jennifer A; Holt, Amy; Plajzer-Frick, Ingrid; Shoukry, Malak; Wright, Crystal; Chen, Feng; Afzal, Veena; Bristow, James; Ren, Bing; Black, Brian L; Rubin, Edward M; Visel, Axel; Pennacchio, Len A

    2010-09-01

    Accurate control of tissue-specific gene expression plays a pivotal role in heart development, but few cardiac transcriptional enhancers have thus far been identified. Extreme noncoding-sequence conservation has successfully predicted enhancers that are active in many tissues but has failed to identify substantial numbers of heart-specific enhancers. Here, we used ChIP-Seq with the enhancer-associated protein p300 from mouse embryonic day 11.5 heart tissue to identify over 3,000 candidate heart enhancers genome wide. Compared to enhancers active in other tissues we studied at this time point, most candidate heart enhancers were less deeply conserved in vertebrate evolution. Nevertheless, transgenic mouse assays of 130 candidate regions revealed that most function reproducibly as enhancers active in the heart, irrespective of their degree of evolutionary constraint. These results provide evidence for a large population of poorly conserved heart enhancers and suggest that the evolutionary conservation of embryonic enhancers can vary depending on tissue type.

  8. Mesenchymal Stem Cells as a Biological Drug for Heart Disease: Where Are We With Cardiac Cell-Based Therapy?

    Science.gov (United States)

    Sanina, Cristina; Hare, Joshua M

    2015-07-17

    Cell-based treatment represents a new generation in the evolution of biological therapeutics. A prototypic cell-based therapy, the mesenchymal stem cell, has successfully entered phase III pivotal trials for heart failure, signifying adequate enabling safety and efficacy data from phase I and II trials. Successful phase III trials can lead to approval of a new biological therapy for regenerative medicine.

  9. Take heart!

    CERN Multimedia

    Alizée Dauvergne

    2010-01-01

    Recently, ten new semi-automatic defibrillators were installed at various locations around CERN. This is a preventive measure intended to provide cardiac arrest victims with the best possible response. The first responder could be you!   The Director-General has welcomed the initiative of the Medical Service and Fire Brigade for the installation of ten new semi-automatic defibrillators. You have probably seen them on your way to the restaurant, for example:  brand new semi-automatic defibrillators, ready for an emergency. Housed in a white wall-mounted case, the bright red defibrillators are marked with a white heart symbol crossed by a lightning bolt (see photo). The defibrillator is designed so that anyone can use it. “Anyone can use it, you don’t need to be a health professional,” says Dr Reymond from CERN's Medical Service. Together with the CERN Fire Brigade, he is behind the initiative to have these units put in place. And with good reason, as the unit...

  10. Imaging in the context of replacement heart valve development: use of the Visible Heart(®) methodologies.

    Science.gov (United States)

    Bateman, Michael G; Iaizzo, Paul A

    2012-09-01

    In recent years huge strides have been made in the fields of interventional cardiology and cardiac surgery which now allow physicians and surgeons to repair or replace cardiac valves with greater success in a larger demographic of patients. Pivotal to these advances has been significant improvements in cardiac imaging and improved fundamental understanding of valvular anatomies and morphologies. We describe here a novel series of techniques utilized within the Visible Heart(®) laboratory by engineers, scientists, and/or anatomists to visualize and analyze the form and function of the four cardiac valves and to assess potential repair or replacement therapies. The study of reanimated large mammalian hearts (including human hearts) using various imaging modalities, as well as specially prepared anatomical specimens, has enhanced the design, development, and testing of novel cardiac therapies.

  11. The Competency Pivot: Introducing a Revised Approach to the Business Communication Curriculum

    Science.gov (United States)

    Lucas, Kristen; Rawlins, Jacob D.

    2015-01-01

    In this article, we outline a competency-based approach to teaching business communication. At the heart of this approach, classroom instruction, assignments, and evaluation center on a goals-oriented and receiver-centric understanding of communication in which students are taught strategies for meeting five core competencies of business…

  12. The Competency Pivot: Introducing a Revised Approach to the Business Communication Curriculum

    Science.gov (United States)

    Lucas, Kristen; Rawlins, Jacob D.

    2015-01-01

    In this article, we outline a competency-based approach to teaching business communication. At the heart of this approach, classroom instruction, assignments, and evaluation center on a goals-oriented and receiver-centric understanding of communication in which students are taught strategies for meeting five core competencies of business…

  13. Hypoplastic left heart syndrome (image)

    Science.gov (United States)

    Hypoplastic left heart syndrome is a congenital heart condition that occurs during the development of the heart in the ... womb. During the heart's development, parts of the left side of the heart (mitral valve, left ventricle ...

  14. On the Controllability and Observability of Actively Lubricated Journal Bearings with Pads Featuring Different Nozzle-Pivot Configurations

    DEFF Research Database (Denmark)

    Salazar, Jorge Andrés González; Santos, Ilmar

    2017-01-01

    and/or actively high pressurized oil into the rotor-pad gap through, commonly, a single radial nozzle. For the work goal, a four degrees-of-freedom (DOFs) ALB system linking the mechanical with the hydraulic dynamics is presented and studied, comprising: (i) the vertical journal movement, (ii) the pad...... tilt angle, (iii) the vertical pad movement-due to the pivot flexibility, and (iv) the controllable force as the hydraulic DOF. The test rig consists of a rigid rotor supported by a single rocker-pivoted rigid pad. A thorough parametric study is carried out by investigating the effects of: (a) nozzle...

  15. What Causes Heart Disease?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Causes Heart Disease? Research suggests that coronary heart disease (CHD) begins with damage to the lining and ... causing coronary microvascular disease (MVD). Coronary MVD is heart disease that affects the heart's tiny arteries. The cause ...

  16. Heart Disease in Women

    Science.gov (United States)

    ... United States, 1 in 4 women dies from heart disease. The most common cause of heart disease in both men and women is narrowing or ... It's the major reason people have heart attacks. Heart diseases that affect women more than men include Coronary ...

  17. Pivot method for global optimization: A study of structures and phase changes in water clusters

    Science.gov (United States)

    Nigra, Pablo Fernando

    In this thesis, we have carried out a study of water clusters. The research work has been developed in two stages. In the first stage, we have investigated the properties of water clusters at zero temperature by means of global optimization. The clusters were modeled by using two well known pairwise potentials having distinct characteristics. One is the Matsuoka-Clementi-Yoshimine potential (MCY) that is an ab initio fitted function based on a rigid-molecule model, the other is the Sillinger-Rahman potential (SR) which is an empirical function based on a flexible-molecule model. The algorithm used for the global optimization of the clusters was the pivot method, which was developed in our group. The results have shown that, under certain conditions, the pivot method may yield optimized structures which are related to one another in such a way that they seem to form structural families. The structures in a family can be thought of as formed from the aggregation of single units. The particular types of structures we have found are quasi-one dimensional tubes built from stacking cyclic units such as tetramers, pentamers, and hexamers. The binding energies of these tubes form sequences that span smooth curves with clear asymptotic behavior; therefore, we have also studied the sequences applying the Bulirsch-Stoer (BST) algorithm to accelerate convergence. In the second stage of the research work, we have studied the thermodynamic properties of a typical water cluster at finite temperatures. The selected cluster was the water octamer which exhibits a definite solid-liquid phase change. The water octamer also has several low lying energy cubic structures with large energetic barriers that cause ergodicity breaking in regular Monte Carlo simulations. For that reason we have simulated the octamer using paralell tempering Monte Carlo combined with the multihistogram method. This has permited us to calculate the heat capacity from very low temperatures up to T = 230 K. We

  18. Pivotal results for the Medtronic Valiant Thoracic Stent Graft System in the VALOR II trial.

    Science.gov (United States)

    Fairman, Ronald M; Tuchek, J Michael; Lee, W Anthony; Kasirajan, Karthikeshwar; White, Rodney; Mehta, Manish; Lyden, Sean; Mukherjee, Dipankar; Bavaria, Joseph

    2012-11-01

    We report 30-day and 12-month results of endovascular treatment with the Valiant Thoracic Stent Graft System (Medtronic Vascular, Santa Rosa, Calif) in patients with descending thoracic aortic aneurysms of degenerative etiology. The Valiant stent graft is an evolution of the Talent thoracic stent graft (Medtronic Vascular). The VALOR II (Evaluation of the Clinical Performance of the Valiant Thoracic Stent Graft System in the Treatment of Descending Thoracic Aneurysms of Degenerative Etiology in Subjects Who Are Candidates for Endovascular Repair) was a prospective, nonrandomized, pivotal trial conducted at 24 U.S. sites with enrollment between December 2006 and September 2009. Standard follow-up examinations, including physical examination, computed tomography, and chest radiography, were at 1, 6, and 12 months, and annually through 5 years. VALOR II outcomes were compared with those from the pivotal VALOR (Evaluation of the Medtronic Vascular Talent Thoracic Stent Graft System for the Treatment of Thoracic Aortic Aneurysms) trial of the Talent stent graft, which enrolled 195 patients with similar enrollment criteria. VALOR II enrolled 160 patients. Compared with VALOR patients, VALOR II patients had similar age and sex distribution but higher rates of cardiovascular risk factors and significantly more severe modified Society for Vascular Surgery/American Association for Vascular Surgery risk scores. Stent graft delivery and deployment were successful in 154 patients (96.3%). Outcomes at 30 days in VALOR II were perioperative mortality, 3.1%; major adverse events, 38.1%; paraplegia, 0.6%; paraparesis, 1.9%; and stroke, 2.5%. At 12 months, after the minimum sample size was reached, 151 patients were evaluated: aneurysm-related mortality was 4.0%, stent graft migration was 2.9%, and endoleak was 13.0%. Through 12 months, there were no ruptures, conversions to open surgery, secondary procedures due to endoleak >30 days, or loss of stent graft patency. The Valiant

  19. Heart rate variability in isolated rabbit hearts.

    Science.gov (United States)

    Frey, B; Heger, G; Mayer, C; Kiegler, B; Stöhr, H; Steurer, G

    1996-11-01

    The presence of heart rate variability (HRV) in patients with cardiac denervation after heart transplantation raised our interest in HRV of isolated, denervated hearts. Hearts from seven adult white ELCO rabbits were transferred to a perfusion apparatus. All hearts were perfused in the working mode and in the Langendorff mode for 20 minutes each. HRV was analyzed in the frequency domain. A computer simulated test ECG at a constant rate of 2 Hz was used for error estimation of the system. In the isolated, denervated heart, HRV was of random, broadband fluctuations, different from the well-characterized oscillations at specific frequencies in intact animals. Mean NN was 423 +/- 51 ms in the Langendorff mode, 406 +/- 33 ms in the working heart mode, and 500 ms in the test ECG. Total power was 663 +/- 207 ms2, 817 +/- 318 ms2, and 3.7 ms2, respectively. There was no significant difference in any measure of HRV between Langendorff and working heart modes. The data provide evidence for the presence of HRV in isolated, denervated rabbit hearts. Left atrial and ventricular filling, i.e., the working heart mode, did not alter HRV, indicating that left atrial or ventricular stretch did not influence the sinus nodal discharge rate.

  20. Small ruminant macrophage polarization may play a pivotal role on lentiviral infection.

    Science.gov (United States)

    Crespo, Helena; Bertolotti, Luigi; Juganaru, Magda; Glaria, Idoia; de Andrés, Damián; Amorena, Beatriz; Rosati, Sergio; Reina, Ramsés

    2013-09-26

    Small ruminant lentiviruses (SRLV) infect the monocyte/macrophage lineage inducing a long-lasting infection affecting body condition, production and welfare of sheep and goats all over the world. Macrophages play a pivotal role on the host's innate and adaptative immune responses against parasites by becoming differentially activated. Macrophage heterogeneity can tentatively be classified into classically differentiated macrophages (M1) through stimulation with IFN-γ displaying an inflammatory profile, or can be alternatively differentiated by stimulation with IL-4/IL-13 into M2 macrophages with homeostatic functions. Since infection by SRLV can modulate macrophage functions we explored here whether ovine and caprine macrophages can be segregated into M1 and M2 populations and whether this differential polarization represents differential susceptibility to SRLV infection. We found that like in human and mouse systems, ovine and caprine macrophages can be differentiated with particular stimuli into M1/M2 subpopulations displaying specific markers. In addition, small ruminant macrophages are plastic since M1 differentiated macrophages can express M2 markers when the stimulus changes from IFN-γ to IL-4. SRLV replication was restricted in M1 macrophages and increased in M2 differentiated macrophages respectively according to viral production. Identification of the infection pathways in macrophage populations may provide new targets for eliciting appropriate immune responses against SRLV infection.

  1. Dichromatic state sum models for four-manifolds from pivotal functors

    CERN Document Server

    Bärenz, Manuel

    2016-01-01

    A family of invariants of smooth, oriented four-dimensional manifolds is defined via handle decompositions and Kirby calculus. It is shown that some of them are stronger than the signature and Euler invariant. The invariants are parameterised by a pivotal functor from a spherical fusion category into a ribbon fusion category. A state sum formula for the invariant is constructed via a chain mail procedure, so a large class of topological state sum models can be phrased in terms of it. Most prominently, the Crane-Yetter state sum over an arbitrary ribbon fusion category is recovered, including the nonmodular case. Another example is the four-dimensional Dijkgraaf-Witten model. Derivations of state space dimensions of some TQFTs as special cases agree with recent calculations of ground state degeneracies in Walker-Wang models. It is also shown that the Crane-Yetter invariant for nonmodular categories is stronger than signature and Euler invariant. Relations to different approaches to quantum gravity such as Cart...

  2. Pivotal role of median eminence tanycytes for hypothalamic function and neurogenesis.

    Science.gov (United States)

    Rizzoti, Karine; Lovell-Badge, Robin

    2017-04-15

    Along with the sub-ventricular zone of the forebrain lateral ventricles and the sub-granular zone of the dentate gyrus in the hippocampus, the hypothalamus has recently emerged as a third gliogenic and neurogenic niche in the central nervous system. The hypothalamus is the main regulator of body homeostasis because it centralizes peripheral information to regulate crucial physiological functions through the pituitary gland and the autonomic nervous system. Its ability to sense signals originating outside the brain relies on its exposure to blood-born molecules through the median eminence, which is localized outside the blood brain barrier. Within the hypothalamus, a population of specialized radial glial cells, the tanycytes, control exposure to blood-born signals by acting both as sensors and regulators of the hypothalamic input and output. In addition, lineage-tracing experiments have recently revealed that tanycytes represent a population of hypothalamic stem cells, defining them as a pivotal cell type within the hypothalamus. Hypothalamic neurogenesis has moreover been shown to have an important role in feeding control and energy metabolism, which challenges previous knowledge and offers new therapeutic options.

  3. Tlx3 Function in the Dorsal Root Ganglion is Pivotal to Itch and Pain Sensations

    Directory of Open Access Journals (Sweden)

    Chengcheng Huang

    2017-06-01

    Full Text Available Itch, a sensation eliciting a desire to scratch, is distinct from but not completely independent of pain. Inspiring achievements have been made in the characterization of itch-related receptors and neurotransmitters, but the molecular mechanisms controlling the development of pruriceptors remain poorly understood. Here, our RNAseq and in situ hybridization data show that the transcription factor Tlx3 is required for the expression of a majority of itch-related molecules in the dorsal root ganglion (DRG. As a result, Tlx3F/F;Nav1.8-cre mice exhibit significantly attenuated acute and dry skin-induced chronic itch. Furthermore, our study indicates that TRPV1 plays a pivotal role in the chronic itch evoked by dry skin and allergic contact dermatitis (ACD. The mutants also display impaired response to cold and inflammatory pain and elevated response to capsaicin, whereas the responses to acute mechanical, thermal stimuli and neuropathic pain remain normal. In Tlx3F/F;Nav1.8-cre mice, TRPV1 is derepressed and expands predominantly into IB4+ non-peptidergic (NP neurons. Collectively, our data reveal a molecular mechanism in regulating the development of pruriceptors and controlling itch and pain sensations.

  4. Pivotal role of innate and adaptive immunity in anthracycline chemotherapy of established tumors.

    Science.gov (United States)

    Mattarollo, Stephen R; Loi, Sherene; Duret, Helene; Ma, Yuting; Zitvogel, Laurence; Smyth, Mark J

    2011-07-15

    We show, in a series of established experimental breast adenocarcinomas and fibrosarcomas induced by carcinogen de novo in mice, that the therapeutic efficacy of doxorubicin treatment is dependent on CD8 T cells and IFN-γ production. Doxorubicin treatment enhances tumor antigen-specific proliferation of CD8 T cells in tumor-draining lymph nodes and promotes tumor infiltration of activated, IFN-γ-producing CD8 T cells. Optimal doxorubicin treatment outcome also requires both interleukin (IL)-1β and IL-17 cytokines, as blockade of IL-1β/IL-1R or IL-17A/IL-17Rα signaling abrogated the therapeutic effect. IL-23p19 had no observed role. The presence of γδ T cells, but not Jα18(+) natural killer T cells, at the time of doxorubicin treatment was also important. In tumor samples taken from breast cancer patients prior to treatment with anthracycline chemotherapy, a correlation between CD8α, CD8β, and IFN-γ gene expression levels and clinical response was observed, supporting their role in the therapeutic efficacy of anthracyclines in humans. Overall, these data strongly support the pivotal contribution of both innate and adaptive immunity in treatment outcomes of anthracycline chemotherapy. ©2011 AACR.

  5. Effect of pivot location and passive heave on propulsion from a pitching airfoil

    Science.gov (United States)

    Mackowski, A. W.; Williamson, C. H. K.

    2017-01-01

    We experimentally investigate the propulsive characteristics of a pitching NACA 0012 airfoil section, with emphasis on thrust and propulsive efficiency, at a Reynolds number of 1.7 ×104 . For the sake of mechanical simplicity, we consider an airfoil restricted to a single actuator in the pitching direction. We examine the effect of changing the airfoil's axis of rotation, finding that contrary to Garrick's linear theory, there exists a pitching axis near the airfoil that maximizes propulsive efficiency. Next, we examine the effect of placing passive springs on the airfoil in the heave (transverse) direction using our Cyber-Physical Fluid Dynamics technique. This elastic heaving motion allows the airfoil to combine pitching and heaving modes while being actuated only in the pitching direction. Two sets of dynamics are considered: one case where the airfoil is weighted unevenly and pitched about its center of mass (so that the resulting heaving motion is independent of inertial forces), and another case where the airfoil's center of mass is fixed at its centroid. For pitching at an amplitude of 8∘ and a reduced frequency k of two, we find that elastic heave produces a maximum propulsive efficiency of 35%, compared to 25% without any heave motion. Further, while operating at the same efficiency as the static-pivot case, we find that passive heaving greatly increases the magnitude of the airfoil's thrust. The airfoil configurations with highest propulsive efficiency generally involve pitching near or ahead of the airfoil's leading edge.

  6. Pivoting between calmodulin lobes triggered by calcium in the Kv7.2/calmodulin complex.

    Science.gov (United States)

    Alaimo, Alessandro; Alberdi, Araitz; Gomis-Perez, Carolina; Fernández-Orth, Juncal; Bernardo-Seisdedos, Ganeko; Malo, Covadonga; Millet, Oscar; Areso, Pilar; Villarroel, Alvaro

    2014-01-01

    Kv7.2 (KCNQ2) is the principal molecular component of the slow voltage gated M-channel, which strongly influences neuronal excitability. Calmodulin (CaM) binds to two intracellular C-terminal segments of Kv7.2 channels, helices A and B, and it is required for exit from the endoplasmic reticulum. However, the molecular mechanisms by which CaM controls channel trafficking are currently unknown. Here we used two complementary approaches to explore the molecular events underlying the association between CaM and Kv7.2 and their regulation by Ca(2+). First, we performed a fluorometric assay using dansylated calmodulin (D-CaM) to characterize the interaction of its individual lobes to the Kv7.2 CaM binding site (Q2AB). Second, we explored the association of Q2AB with CaM by NMR spectroscopy, using (15)N-labeled CaM as a reporter. The combined data highlight the interdependency of the N- and C-lobes of CaM in the interaction with Q2AB, suggesting that when CaM binds Ca(2+) the binding interface pivots between the N-lobe whose interactions are dominated by helix B and the C-lobe where the predominant interaction is with helix A. In addition, Ca(2+) makes CaM binding to Q2AB more difficult and, reciprocally, the channel weakens the association of CaM with Ca(2+).

  7. Pivoting between calmodulin lobes triggered by calcium in the Kv7.2/calmodulin complex.

    Directory of Open Access Journals (Sweden)

    Alessandro Alaimo

    Full Text Available Kv7.2 (KCNQ2 is the principal molecular component of the slow voltage gated M-channel, which strongly influences neuronal excitability. Calmodulin (CaM binds to two intracellular C-terminal segments of Kv7.2 channels, helices A and B, and it is required for exit from the endoplasmic reticulum. However, the molecular mechanisms by which CaM controls channel trafficking are currently unknown. Here we used two complementary approaches to explore the molecular events underlying the association between CaM and Kv7.2 and their regulation by Ca(2+. First, we performed a fluorometric assay using dansylated calmodulin (D-CaM to characterize the interaction of its individual lobes to the Kv7.2 CaM binding site (Q2AB. Second, we explored the association of Q2AB with CaM by NMR spectroscopy, using (15N-labeled CaM as a reporter. The combined data highlight the interdependency of the N- and C-lobes of CaM in the interaction with Q2AB, suggesting that when CaM binds Ca(2+ the binding interface pivots between the N-lobe whose interactions are dominated by helix B and the C-lobe where the predominant interaction is with helix A. In addition, Ca(2+ makes CaM binding to Q2AB more difficult and, reciprocally, the channel weakens the association of CaM with Ca(2+.

  8. Minimal clinically important difference in Parkinson's disease as assessed in pivotal trials of pramipexole extended release.

    Science.gov (United States)

    Hauser, Robert A; Gordon, Mark Forrest; Mizuno, Yoshikuni; Poewe, Werner; Barone, Paolo; Schapira, Anthony H; Rascol, Olivier; Debieuvre, Catherine; Fräßdorf, Mandy

    2014-01-01

    Background. The minimal clinically important difference (MCID) is the smallest change in an outcome measure that is meaningful for patients. Objectives. To calculate the MCID for Unified Parkinson's Disease Rating Scale (UPDRS) scores in early Parkinson's disease (EPD) and for UPDRS scores and "OFF" time in advanced Parkinson's disease (APD). Methods. We analyzed data from two pivotal, double-blind, parallel-group trials of pramipexole ER that included pramipexole immediate release (IR) as an active comparator. We calculated MCID as the mean change in subjects who received active treatment and rated themselves "a little better" on patient global impression of improvement (PGI-I) minus the mean change in subjects who received placebo and rated themselves unchanged. Results. MCIDs in EPD (pramipexole ER, pramipexole IR) for UPDRS II were -1.8 and -2.0, for UPDRS III -6.2 and -6.1, and for UPDRS II + III -8.0 and -8.1. MCIDs in APD for UPDRS II were -1.8 and -2.3, for UPDRS III -5.2 and -6.5, and for UPDRS II + III -7.1 and -8.8. MCID for "OFF" time (pramipexole ER, pramipexole IR) was -1.0 and -1.3 hours. Conclusions. A range of MCIDs is emerging in the PD literature that provides the basis for power calculations and interpretation of clinical trials.

  9. Square-Root Lasso: Pivotal Recovery of Sparse Signals via Conic Programming

    CERN Document Server

    Belloni, Alexandre; Wang, Lie

    2010-01-01

    We propose a pivotal method for estimating high-dimensional sparse linear regression models, where the overall number of regressors $p$ is large, possibly much larger than $n$, but only $s$ regressors are significant. The method is a modification of LASSO, called square-root LASSO. The method neither relies on the knowledge of the standard deviation $\\sigma$ of the regression errors nor does it need to pre-estimate $\\sigma$. Despite not knowing $\\sigma$, square-root LASSO achieves near-oracle performance, attaining the convergence rate $\\sigma \\sqrt{(s/n)\\log p}$, and thus matching the performance of the standard LASSO that knows $\\sigma$. Moreover, we show that these results are valid for both Gaussian and non-Gaussian errors, under some mild moment restrictions, using moderate deviation theory. Finally, we formulate the square-root LASSO as a solution to a convex conic programming problem, which allows us to use efficient computational methods, such as interior point methods, to implement the estimator.

  10. A long term clinical outcome of the Medial Pivot Knee Arthroplasty System.

    Science.gov (United States)

    Macheras, George A; Galanakos, Spyridon P; Lepetsos, Panagiotis; Anastasopoulos, Panagiotis P; Papadakis, Stamatios A

    2017-03-01

    The ideal total knee arthroplasty (TKA) should provide maximum range of motion and functional stability for all desired daily activities and, if possible, to replicate normal knee kinematics and function. The ADVANCE® Medial Pivot (AMP) Knee System was designed with a highly congruent medial compartment and a less conforming lateral compartment to more closely mimic the kinematics of the normal knee and to offer more stability through out of range of motion (ROM). The purpose of this study was to evaluate the long-term clinical and radiographic outcomes of this TKA system. Three hundred and twenty-five (325) patients (347 knees) with knee osteoarthritis underwent a TKA using the AMP prosthesis in our Department. For evaluation, objective and subjective clinical rating systems along with radiograph series were used. The average follow-up was 15.2years. All patients showed a statistically significant improvement (p<0.0005) in the Knee Society clinical rating system, Western Ontario and McMaster Universities Osteoarthritis Index questionnaire, SF-12® questionnaire, and Oxford knee score. The majority of patients (94%) were able to perform age-appropriate activities with a mean knee flexion of 120° (range, 105°-135°) at final follow-up. Survival analysis showed a cumulative success rate of 98.8% at 17years. The obtained results demonstrate excellent long-term clinical outcome for this knee design. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  11. Ryanodine receptors as pharmacological targets for heart disease

    Institute of Scientific and Technical Information of China (English)

    Marco SANTONASTASI; Xander H T WEHRENS

    2007-01-01

    Calcium release from intracellular stores plays an important role in the regulationof muscle contraction and electrical signals that determine the heart rhythm. Theryanodine receptor (RyR) is the major calcium (Ca2+) release channel required forexcitation-contraction coupling in the heart. Recent studies have demonstratedthat RyR are macromolecular complexes comprising of 4 pore-forming channelsubunits, each of which is associated with regulatory subunits. Clinical andexperimental studies over the past 5 years have provided compelling evidencethat intracellular Ca2+release channels play a pivotal role in the development ofcardiac arrhythmias and heart failure. Changes in the channel regulation andsubunit composition are believed to cause diastolic calcium leakage from thesarcoplasmic reticulum, which could trigger arrhythmias and weaken cardiaccontractility. Therefore, cardiac RyR have emerged as potential therapeutic tar-gets for the treatment of heart disease. Consequently, there is a strong desire toidentify and/or develop novel pharmacological agents that may target these Ca2+signaling pathways. Pharmacological agents known to modulate RyR in the heart,and their potential application towards the treatment of heart disease are dis-cussed in this review.

  12. "Anatomic" single-bundle anterior cruciate ligament reconstruction reduces both anterior translation and internal rotation during the pivot shift.

    Science.gov (United States)

    Porter, Mark D; Shadbolt, Bruce

    2014-12-01

    The ability of single-bundle anterior cruciate ligament (ACL) reconstruction to restore rotational control has been questioned by proponents of the double-bundle technique. The term anatomic positioning has become popularized in recognition of the incorrect positioning sometimes used in the past, which may have contributed to the lack of rotation control. The pivot-shift test remains the most clinically useful measure of ACL deficiency, and it is now possible to measure it both accurately and objectively using computer navigation. Single-bundle ACL reconstruction will reduce anterior translation and internal rotation of the tibia during the pivot-shift test when compared with the contralateral uninjured knee. Descriptive laboratory study. A total of 20 patients with an acute isolated ACL rupture underwent reconstruction with a single-bundle autologous hamstring graft. Computer navigation was used intraoperatively to plot the pivot shift before and after reconstruction. The opposite uninjured knee was used as a control. Statistical analysis was used to compare the pivot shifts before and after surgery. Single-bundle ACL reconstruction produced a significant reduction in anterior translation, from a mean ± SD of 17.4 ± 3.80 mm to 6.4 ± 1.95 mm (P operated knee both before and after surgery. It is possible to reduce both anterior translation and internal rotation, which occur during the pivot-shift test in the ACL-deficient knee, using single-bundle ACL reconstruction, when measured at the time of surgery. However, normal motion is not fully restored. © 2014 The Author(s).

  13. All about Heart Rate (Pulse)

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  14. The glial scar-monocyte interplay: a pivotal resolution phase in spinal cord repair.

    Directory of Open Access Journals (Sweden)

    Ravid Shechter

    Full Text Available The inflammatory response in the injured spinal cord, an immune privileged site, has been mainly associated with the poor prognosis. However, recent data demonstrated that, in fact, some leukocytes, namely monocytes, are pivotal for repair due to their alternative anti-inflammatory phenotype. Given the pro-inflammatory milieu within the traumatized spinal cord, known to skew monocytes towards a classical phenotype, a pertinent question is how parenchymal-invading monocytes acquire resolving properties essential for healing, under such unfavorable conditions. In light of the spatial association between resolving (interleukin (IL-10 producing monocytes and the glial scar matrix chondroitin sulfate proteoglycan (CSPG, in this study we examined the mutual relationship between these two components. By inhibiting the de novo production of CSPG following spinal cord injury, we demonstrated that this extracellular matrix, mainly known for its ability to inhibit axonal growth, serves as a critical template skewing the entering monocytes towards the resolving phenotype. In vitro cell culture studies demonstrated that this matrix alone is sufficient to induce such monocyte polarization. Reciprocal conditional ablation of the monocyte-derived macrophages concentrated at the lesion margins, using diphtheria toxin, revealed that these cells have scar matrix-resolving properties. Replenishment of monocytic cell populations to the ablated mice demonstrated that this extracellular remodeling ability of the infiltrating monocytes requires their expression of the matrix-degrading enzyme, matrix metalloproteinase 13 (MMP-13, a property that was found here to be crucial for functional recovery. Altogether, this study demonstrates that the glial scar-matrix, a known obstacle to regeneration, is a critical component skewing the encountering monocytes towards a resolving phenotype. In an apparent feedback loop, monocytes were found to regulate scar resolution. This

  15. The pivotal role of semantic memory in remembering the past and imagining the future

    Directory of Open Access Journals (Sweden)

    Muireann eIrish

    2013-04-01

    Full Text Available Episodic memory refers to a complex and multifaceted process which enables the retrieval of richly detailed evocative memories from the past. In contrast, semantic memory is conceptualised as the retrieval of general conceptual knowledge divested of a specific spatiotemporal context. The neural substrates of the episodic and semantic memory systems have been dissociated in healthy individuals during functional imaging studies, and in clinical cohorts, leading to the prevailing view that episodic and semantic memory represent functionally distinct systems subtended by discrete neurobiological substrates. Importantly, however, converging evidence focusing on widespread neural networks now points to significant overlap between those regions essential for retrieval of autobiographical memories, episodic learning, and semantic processing. Here we review recent advances in episodic memory research focusing on neurodegenerative populations which has proved revelatory for our understanding of the complex interplay between episodic and semantic memory. Whereas episodic memory research has traditionally focused on retrieval of autobiographical events from the past, we also include evidence from the recent paradigm shift in which episodic memory is viewed as an adaptive and constructive process which facilitates the imagining of possible events in the future. We examine the available evidence which converges to highlight the pivotal role of semantic memory in providing schemas and meaning whether one is engaged in autobiographical retrieval for the past, or indeed, is endeavouring to construct a plausible scenario of an event in the future. It therefore seems plausible to contend that semantic processing may underlie most, if not all, forms of episodic memory, irrespective of temporal condition.

  16. COSTRUIRE TESTI, STRUTTURARE CONVERSAZIONI: LA DIDATTICA DEI SEGNALI DISCORSIVI COME ELEMENTI PIVOT DELL'INTERAZIONE VERBALE

    Directory of Open Access Journals (Sweden)

    Paloma Pernas

    2011-07-01

    Full Text Available Questo articolo intende analizzare un aspetto importante ma spesso trascurato della didattica dell’italiano come L2/LS: i segnali discorsivi (SD nell’interazione orale spontanea. La prima parte dell’articolo riporta i risultati di uno studio sull’acquisizione dei segnali discorsivi da parte di apprendenti ispanofoni in contesto formale. Questi dati, raccolti nell’ambito di una ricerca corpus-based, sono risultati utili per migliorare la didattica di questi importanti meccanismi dell’interazione orale. La seconda parte dell’articolo passa in rassegna i manuali di italiano più usati nelle scuole spagnole che insegnano lingue straniere agli adulti, con particolare riferimento alla dimensione testuale e ai SD in particolare. Come risultato di questa rassegna critica, si propone una selezione delle attività didattiche maggiormente coerenti, da un lato, con un effettivo approccio comunicativo e, dall’altro, con i nostri risultati acquisizionali.     Constructing texts, structuring conversations: didactics of discourse markers as pivotal elements in verbal interaction   This paper aims to shed light on an important yet neglected aspect of Italian in L2/FL teaching: discourse markers in oral interaction. The first part reports the outcomes of Italian DM acquisition by Spanish learners in formal contexts, gathered  from corpus-based research, which can be useful for improving Italian DM teaching and learning. The second part is a review of the most commonly used Italian textbooks in Spanish language schools for adult learners, focusing on the oral textual dimension and specially DM. The result of this review is a selection of the DM learning activities most suited to a communicative approach and our acquisitional findings.

  17. Smoking Thickens Heart Wall, Leading to Heart Failure: Study

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_160932.html Smoking Thickens Heart Wall, Leading to Heart Failure: Study ... 13, 2016 TUESDAY, Sept. 13, 2016 (HealthDay News) -- Smoking leads to heart failure by causing thickened heart ...

  18. Heart Disease Affects Far More Than the Heart

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_163584.html Heart Disease Affects Far More Than the Heart Blocked arteries ... 14, 2017 TUESDAY, Feb. 14, 2017 (HealthDay News) -- Heart disease affects more than just the heart. It also ...

  19. Texas Heart Institute

    Science.gov (United States)

    ... Cardiovascular Regenerative Medicine today with a keynote from Texas State Senator Paul Bettencourt Dr. Taylor received the ... in cardiovascular discovery is happening here at the Texas Heart Institute. Visit www.thenextfirst.org . Your Heart ...

  20. Heart Diseases--Prevention

    Science.gov (United States)

    ... you have a close family member who had heart disease at an early age. Fortunately, there are many things you can do reduce your chances of getting heart disease. You should Know your blood pressure and keep ...

  1. Heart failure - discharge

    Science.gov (United States)

    ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  2. Heart and Stroke Encyclopedia

    Science.gov (United States)

    ... Venous Thromboembolism Aortic Aneurysm More The Heart and Stroke Encyclopedia Click a letter below to get a ... dozens of cardiovascular terms from our Heart and Stroke Encyclopedia and get links to in-depth information. ...

  3. Open heart surgery

    Science.gov (United States)

    Heart surgery - open ... lung machine is used in most cases during open heart surgery. While the surgeon works on the ... with these procedures, the surgeon may have to open the chest to do the surgery.

  4. Valvular heart disease

    OpenAIRE

    Gelson, E; Gatzoulis, M; Johnson, M.

    2007-01-01

    Valvular disease may be unmasked in pregnancy when physiological changes increase demands on the heart. Women with valvular heart disease require close follow-up during pregnancy, delivery, and postpartum

  5. Hypothyroidism and Heart Disease

    Science.gov (United States)

    ... in Balance › Hypothyroidism and Heart Disease Fact Sheet Hypothyroidism and Heart Disease January 2014 Download PDFs English ... nervous system, body temperature, and weight. What is hypothyroidism and what are its symptoms? Hypothyroidism, also called ...

  6. Heart disease - risk factors

    Science.gov (United States)

    Heart disease - prevention; CVD - risk factors; Cardiovascular disease - risk factors; Coronary artery disease - risk factors; CAD - risk ... a certain health condition. Some risk factors for heart disease you cannot change, but some you can. ...

  7. Anatomy of the Heart

    Science.gov (United States)

    ... Share this page from the NHLBI on Twitter. Anatomy of the Heart Your heart is located under your ribcage in the center of your chest between your right and left lungs. Its muscular walls beat, or contract, pumping blood ...

  8. Heart Health for Women

    Science.gov (United States)

    ... it Email Print En Español In Chinese - In Korean - In Vietnamese - In French Creole You may think ... Download and Share: Social Media Toolkit (PDF 481KB) Learn More About Heart Disease: The Heart Truth Campaign ...

  9. Heart Attack Payment - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – provider data. This data set includes provider data for payments associated with a 30-day episode of care for heart...

  10. Inflammation and Heart Disease

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Inflammation and Heart Disease Updated:Oct 12,2016 Understand the risks of ... inflammation causes cardiovascular disease, inflammation is common for heart disease and stroke patients and is thought to be ...

  11. Meditation and Heart Health

    Science.gov (United States)

    ... Check Meal Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering the Menu Ordering Your Meal Eating Fast ...

  12. Alcohol and Heart Health

    Science.gov (United States)

    ... Check Meal Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering the Menu Ordering Your Meal Eating Fast ...

  13. Heart disease and women

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007188.htm Heart disease and women To use the sharing features on ... please enable JavaScript. People often DO NOT consider heart disease a woman's disease. Yet cardiovascular disease is the ...

  14. Aspirin and heart disease

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000092.htm Aspirin and heart disease To use the sharing features on this page, ... healthy people who are at low risk for heart disease. You provider will consider your overall medical condition ...

  15. [Understanding heart failure].

    Science.gov (United States)

    Boo, José Fernando Guadalajara

    2006-01-01

    Heart failure is a disease with several definitions. The term "heart failure" is used by has brougth about confusion in the terminology. For this reason, the value of the ejection fraction (< 0.40 or < 0.35) is used in most meganalyses on the treatment of heart failure, avoiding the term "heart failure" that is a confounding concept. In this paper we carefully analyze the meaning of contractility, ventricular function or performance, preload, afterload, heart failure, compensation mechanisms in heart failure, myocardial oxygen consumption, inadequate, adequate and inappropriate hypertrophy, systole, diastole, compliance, problems of relaxation, and diastolic dysfunction. Their definitions are supported by the original scientific descriptions in an attempt to clarify the concepts about ventricular function and heart failure and, in this way, use the same scientific language about the meaning of ventricular function, heart failure, and diastolic dysfunction.

  16. Pericarditis - after heart attack

    Science.gov (United States)

    ... and swelling of the covering of the heart (pericardium). It can occur in the days or weeks ... Symptoms include: Anxiety Chest pain from the swollen pericardium rubbing on the heart. The pain may be ...

  17. Heart failure - medicines

    Science.gov (United States)

    ... are working and to measure your potassium levels. Beta Blockers Beta blockers slow your heart rate and decrease the strength ... muscle contracts in the short term. Long term beta blockers help keep your heart failure from becoming worse. ...

  18. Know Your Heart's Numbers

    Science.gov (United States)

    ... of body fat based on height and weight), waist circumference, blood sugar and weight. The telephone survey of ... for heart health. Just 36 percent knew that waist circumference is important measure of heart disease risk. The ...

  19. Heart Attack Payment - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – state data. This data set includes state-level data for payments associated with a 30-day episode of care for heart...

  20. Heart Attack Payment - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – national data. This data set includes national-level data for payments associated with a 30-day episode of care for heart...

  1. DenHeart

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Rasmussen, Trine Bernholdt; Thrysøe, Lars

    2017-01-01

    differences were found in all patient reported outcomes across diagnostic groups. Listed from worst to best outcomes were heart failure, heart valve disease, ischemic heart disease, infectious heart disease, arrhythmia, congenital heart disease and heart transplant. Also “observation for cardiac disease...... reported outcomes. Methods A national cross-sectional survey combined with national register data. From April 2013 to April 2014 all patients (n = 34,564) discharged or transferred from one of five Danish Heart Centres were invited to participate. 16,712 patients (51%) responded; 67% male and mean age 64...... years. All diagnostic groups were represented similar to real life proportions. Patient reported outcome measures included: SF-12, Hospital Anxiety and Depression Scale, EQ-5D, Brief Illness Perception Questionnaire, HeartQoL and Edmonton Symptom Assessment Scale. Results Statistically significant...

  2. Right heart ventriculography

    Science.gov (United States)

    Angiography - right heart ... The catheter will be moved forward into the right side of the heart. As the catheter is advanced, the doctor can record pressures from the right atrium and right ventricle. Contrast material ("dye") is ...

  3. Menopause and Heart Disease

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Menopause and Heart Disease Updated:Jun 23,2017 Heart ... can become more evident after the onset of menopause. Menopause does not cause cardiovascular diseases . However, certain ...

  4. Heart-lung transplantation

    OpenAIRE

    Griffith, Bartley P.; Magliato, Kathy E.

    2014-01-01

    Heart-lung transplantation itself is not a particularly difficult operation technically. It is the setting in which this procedure is performed which is difficult. The three issues of importance in a successful outcome are appropriate harvest of the heart-lung bloc from the donor, careful explant of the heart and lungs of the recipient, and finally the implant of the heart-lung bloc into the recipient. None of this requires extraordinary technical skill, but does require careful coordination ...

  5. DMPD: Pivotal role of PGE2 and IL-10 in the cross-regulation of dendritic cell-derivedinflammatory mediators. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available 16978535 Pivotal role of PGE2 and IL-10 in the cross-regulation of dendritic cell-derivedinflammatory media...l) (.csml) Show Pivotal role of PGE2 and IL-10 in the cross-regulation of dendritic cell-derivedinflammatory media...egulation of dendritic cell-derivedinflammatory mediators. Authors Harizi H, Gualde N. Publication Cell Mol

  6. Heart Valve Diseases

    Science.gov (United States)

    Your heart has four valves. Normally, these valves open to let blood flow through or out of your heart, and then shut to keep it from flowing ... close tightly. It's one of the most common heart valve conditions. Sometimes it causes regurgitation. Stenosis - when ...

  7. Heart failure overview

    Science.gov (United States)

    ... symptoms) You feel a severe crushing chest pain Prevention Most cases of heart failure can be prevented by living a healthy lifestyle and taking steps aimed at reducing your risk for heart disease . . Alternative Names CHF; Congestive heart failure; Left-sided ...

  8. The Danish Heart Registry

    DEFF Research Database (Denmark)

    Özcan, Cengiz; Juel, Knud; Lassen, Jens Flensted

    2016-01-01

    AIM: The Danish Heart Registry (DHR) seeks to monitor nationwide activity and quality of invasive diagnostic and treatment strategies in patients with ischemic heart disease as well as valvular heart disease and to provide data for research. STUDY POPULATION: All adult (≥15 years) patients...

  9. Heart valve surgery - discharge

    Science.gov (United States)

    ... ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College ... Editorial team. Related MedlinePlus Health Topics Heart Surgery Heart Valve Diseases Browse the Encyclopedia A.D.A.M., Inc. ...

  10. The Heart of Coaching

    Science.gov (United States)

    Docheff, Dennis M.; Gerdes, Dan

    2015-01-01

    This article challenges coaches to address the more personal, human elements of coaching--the HEART of coaching. While there is much research on numerous aspects of coaching, this article provides ideas that make a lasting impact on the hearts of athletes. Using HEART as an acronym, five elements of effective coaching are presented: Humility,…

  11. Heart Truth for Latinas

    Science.gov (United States)

    ... That’s a man’s disease.” But here’s The Heart Truth : Heart disease is the #1 killer of Latinas ... TAKING ACTION Now that you know The Heart Truth , what should you do? First, find out your ...

  12. The Heart of Coaching

    Science.gov (United States)

    Docheff, Dennis M.; Gerdes, Dan

    2015-01-01

    This article challenges coaches to address the more personal, human elements of coaching--the HEART of coaching. While there is much research on numerous aspects of coaching, this article provides ideas that make a lasting impact on the hearts of athletes. Using HEART as an acronym, five elements of effective coaching are presented: Humility,…

  13. Living with Heart Disease

    Science.gov (United States)

    ... page from the NHLBI on Twitter. Living With Heart Disease If you have coronary heart disease (CHD), you can take steps to control its ... the section of this article titled "How Is Heart Disease Treated?" You also can visit the Health Topics ...

  14. Women and Heart Disease

    Institute of Scientific and Technical Information of China (English)

    邹国如

    2005-01-01

    Heart disease is the leading killer of Americans. But it kills more women than men. The American Heart Association says heart disease and other cardiovascular (心血管的) disorders kill about five hundred thousand women a year. That is more than the next seven causes of death combined.

  15. Implantable Heart Aid

    Science.gov (United States)

    1984-01-01

    CPI's human-implantable automatic implantable defibrillator (AID) is a heart assist system, derived from NASA's space circuitry technology, that can prevent erratic heart action known as arrhythmias. Implanted AID, consisting of microcomputer power source and two electrodes for sensing heart activity, recognizes onset of ventricular fibrillation (VF) and delivers corrective electrical countershock to restore rhythmic heartbeat.

  16. Tachycardia | Fast Heart Rate

    Science.gov (United States)

    ... SA) node --- the heart's natural pacemaker - sends out electrical signals faster than usual. The heart rate is fast, but the heart beats properly. Causes of sinus tachycardia A rapid heartbeat may be your body's response to common conditions such as: Fever Anxiety ...

  17. Congenital Heart Disease in Adults

    Science.gov (United States)

    ... and genetics may play a role. Why congenital heart disease resurfaces in adulthood Some adults may find that ... in following adults with congenital heart disease. Congenital heart disease and pregnancy Women with congenital heart disease who ...

  18. Managing Feelings about Heart Failure

    Science.gov (United States)

    ... About Heart Failure Module 6: Managing Feelings About Heart Failure Download Module Order Hardcopy Heart failure can cause ... professional help for emotional problems. Common Feelings About Heart Failure It is common for people to feel depressed ...

  19. Illegal Drugs and Heart Disease

    Science.gov (United States)

    ... Venous Thromboembolism Aortic Aneurysm More Illegal Drugs and Heart Disease Updated:May 17,2017 Most illegal drugs can ... www.dea.gov/druginfo/factsheets.shtml Alcohol and Heart Disease Caffeine and Heart Disease Tobacco and Heart Disease ...

  20. What Are Congenital Heart Defects?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Are Congenital Heart Defects? Congenital (kon-JEN-ih-tal) heart defects are problems ... carry blood to the heart or the body Congenital heart defects change the normal flow of blood through the ...

  1. A perspective on sympathetic renal denervation in chronic congestive heart failure.

    Science.gov (United States)

    Madanieh, Raef; El-Hunjul, Mohammed; Alkhawam, Hassan; Kosmas, Constantine E; Madanieh, Abed; Vittorio, Timothy J

    2016-01-01

    Medical therapy has indisputably been the mainstay of management for chronic congestive heart failure. However, a significant percentage of patients continue to experience worsening heart failure (HF) symptoms despite treatment with multiple therapeutic agents. Recently, catheter-based interventional strategies that interrupt the renal sympathetic nervous system have shown promising results in providing better symptom control in patients with HF. In this article, we will review the pathophysiology of HF for better understanding of the interplay between the cardiovascular system and the kidney. Subsequently, we will briefly discuss pivotal renal denervation (RDN) therapy trials in patients with resistant hypertension and then present the available evidence on the role of RDN in HF therapy.

  2. Materializing Heart Regeneration: Biomimicry of Key Observations in Cell Transplantation Therapies and Natural Cardiac Regeneration

    Science.gov (United States)

    Kong, Yen P.; Jongpaiboonkit, Leena

    2016-07-01

    New regenerative paradigms are needed to address the growing global problem of heart failure as existing interventions are unsatisfactory. Outcomes from the current paradigm of cell transplantation have not been stellar but the mechanistic knowledge learned from them is instructive in the development of future paradigms. An emerging biomaterial-based approach incorporating key mechanisms and additional ones scrutinized from the process of natural heart regeneration in zebrafish may become the next evolution in cardiac repair. We highlight, with examples, tested key concepts and pivotal ones that may be integrated into a successful therapy.

  3. Stroke Prevention in Atrial Fibrillation and Valvular Heart Disease.

    Science.gov (United States)

    Ahmad, Saad; Wilt, Heath

    2016-01-01

    There is a clinically staggering burden of disease stemming from cerebrovascular events, of which a majority are ischemic in nature and many are precipitated by atrial fibrillation (AF). AF can occur in isolation or in association with myocardial or structural heart disease. In the latter case, and when considering health at an international level, congenital and acquired valve-related diseases are frequent contributors to the current pandemic of AF and its clinical impact. Guidelines crafted by the American Heart Association, American College of Cardiology, European Society of Cardiology and Heart Rhythm Society underscore the use of vitamin K antagonists (VKAs) among patients with valvular heart disease, particularly in the presence of concomitant AF, to reduce the risk of ischemic stroke of cardioembolic origin; however, the non-VKAs, also referred to as direct, target-specific or new oral anticoagulants (NOACs), have not been actively studied in this particular population. In fact, each of the new agents is approved in patients with AF not caused by a valve problem. The aim of our review is to carefully examine the available evidence from pivotal phase 3 clinical trials of NOACs and determine how they might perform in patients with AF and concomitant valvular heart disease.

  4. Pivotal results of the Medtronic Vascular Talent Thoracic Stent Graft System: the VALOR trial.

    Science.gov (United States)

    Fairman, Ronald M; Criado, Frank; Farber, Mark; Kwolek, Christopher; Mehta, Manish; White, Rodney; Lee, Anthony; Tuchek, J Michael

    2008-09-01

    This report summarizes the 30-day and 12-month results of endovascular treatment using the Medtronic Vascular Talent Thoracic Stent Graft System (Medtronic Vascular, Santa Rosa, Calif) for patients with thoracic aortic aneurysms (TAA) who are considered candidates for open surgical repair. The study was a prospective, nonrandomized, multicenter, pivotal trial conducted at 38 sites. Enrollment occurred between December 2003 and June 2005. Standard follow-up interval examinations were prescribed at 1 month, 6 months, 1 year, and annually thereafter. These endovascular results were compared with retrospective open surgical data from three centers of excellence. The Evaluation of the Medtronic Vascular Talent Thoracic Stent Graft System for the Treatment of Thoracic Aortic Aneurysms (VALOR) trial enrolled 195 patients, and 189 were identified as retrospective open surgical subjects. Compared with the open surgery group, the VALOR test group had similar age and sex distributions, but had a smaller TAA size. Patients received a mean number of 2.7 +/- 1.3 stent graft components. The diameters of 25% of the proximal stent graft components implanted were 40 mm. Left subclavian artery revascularization was performed before the initial stent graft procedure in 5.2% of patients. Iliac conduits were used in 21.1% of patients. In 33.5% of patients, the bare spring segment of the most proximally implanted device was in zones 1 or 2 of the aortic arch. In 194 patients (99.5%), vessel access and stent graft deployment were successful at the intended site. The 30-day VALOR results included perioperative mortality, 2.1%; major adverse advents, 41%; incidence of paraplegia, 1.5%; paraparesis, 7.2%; and stroke, 3.6%. The 12-month VALOR results included all-cause mortality, 16.1%; aneurysm-related mortality, 3.1%; conversion to open surgery, 0.5%; target aneurysm rupture, 0.5%; stent graft migration >10 mm, 3.9%; endoleak (12.2%), stent graft patency, 100%; stable or decreasing aneurysm

  5. Renal sympathetic denervation for treatment of patients with heart failure: summary of the available evidence.

    Science.gov (United States)

    Nammas, Wail; Koistinen, Juhani; Paana, Tuomas; Karjalainen, Pasi P

    2017-02-10

    Heart failure syndrome results from compensatory mechanisms that operate to restore - back to normal - the systemic perfusion pressure. Sympathetic overactivity plays a pivotal role in heart failure; norepinephrine contributes to maintenance of the systemic blood pressure and increasing preload. Cardiac norepinephrine spillover increases in patients with heart failure; norepinephrine exerts direct toxicity on cardiac myocytes resulting in a decrease of synthetic activity and/or viability. Importantly, cardiac norepinephrine spillover is a powerful predictor of mortality in patients with moderate to severe HF. This provided the rationale for trials that demonstrated survival benefit associated with the use of beta adrenergic blockers in heart failure with reduced ejection fraction. Nevertheless, the MOXCON trial demonstrated that rapid uptitration of moxonidine (inhibitor of central sympathetic outflow) in patients with heart failure was associated with excess mortality and morbidity, despite reduction of plasma norepinephrine. Interestingly, renal norepinephrine spillover was the only independent predictor of adverse outcome in patients with heart failure, in multivariable analysis. Recently, renal sympathetic denervation has emerged as a novel approach for control of blood pressure in patients with treatment-resistant hypertension. This article summarizes the available evidence for the effect of renal sympathetic denervation in the setting of heart failure. Key messages Experimental studies supported a beneficial effect of renal sympathetic denervation in heart failure with reduced ejection fraction. Clinical studies demonstrated improvement of symptoms, and left ventricular function. In heart failure and preserved ejection fraction, renal sympathetic denervation is associated with improvement of surrogate endpoints.

  6. The Danish Heart Registry

    DEFF Research Database (Denmark)

    Özcan, Cengiz; Juel, Knud; Flensted Lassen, Jens;

    2016-01-01

    AIM: The Danish Heart Registry (DHR) seeks to monitor nationwide activity and quality of invasive diagnostic and treatment strategies in patients with ischemic heart disease as well as valvular heart disease and to provide data for research. STUDY POPULATION: All adult (≥15 years) patients...... undergoing coronary angiography (CAG), percutaneous coronary intervention (PCI), coronary artery bypass grafting, and heart valve surgery performed across all Danish hospitals were included. MAIN VARIABLES: The DHR contains a subset of the data stored in the Eastern and Western Denmark Heart Registries (EDHR...

  7. Heart Age PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2015-09-01

    This 60 second public service announcement is based on the September 2015 CDC Vital Signs report. Your heart age is the age of your heart and blood vessels as a result of your risk factors for heart attack and stroke. If you smoke or have high blood pressure, your heart age will be much higher than your actual age. Learn what you can do to lower your heart age and keep it low.  Created: 9/1/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 9/1/2015.

  8. New design of care: Assessment of an interdisciplinary orthopaedic clinic with a pivot nurse in the province of Quebec.

    Science.gov (United States)

    Poder, Thomas G; Bellemare, Christian; Bédard, Suzanne K; He, Jie; Lemieux, Renald

    2010-01-01

    New designs of care in orthopaedic clinics are needed to cope with the shortage of orthopaedic surgeons and the lengthening of waiting times. To assess the effectiveness of an interdisciplinary orthopaedic clinic with a pivot nurse in the Canadian province of Quebec with regard to accessibility, quality of care, efficacy and efficiency of the clinic, and patient's quality of life. Two strategies were developed: (1) a selected cohort of new patients attending an orthopaedic service from February to September 2008 were entered into a database recording patient details, source of referral, diagnosis, satisfaction, and quality of life (36-Item Short Form Health Survey version 2). In this setting, 2 sets of questionnaires were administered to the patients: the first one during the first visit and the second one, 2 months later. A total of 243 patients from the case control were compared with 89 patients of the case study, where an interdisciplinary orthopaedic clinic with a pivot nurse has been developed; (2) costs per patient were calculated using the staff timesheets provided by the two orthopaedic clinics. The results showed a significant reduction in the waiting-list duration (accessibility) in the case study clinic owing to a strong decrease in the inappropriate consultations with the orthopaedic consultant. The quality of care remained high, and the target surgeries for total hip and knee replacement were reached, despite a strong shortage of orthopaedic doctors. Interdisciplinary orthopaedic clinic with a pivot nurse is a new approach in the province of Quebec and first results are encouraging.

  9. Development of computer tablet software for clinical quantification of lateral knee compartment translation during the pivot shift test.

    Science.gov (United States)

    Muller, Bart; Hofbauer, Marcus; Rahnemai-Azar, Amir Ata; Wolf, Megan; Araki, Daisuke; Hoshino, Yuichi; Araujo, Paulo; Debski, Richard E; Irrgang, James J; Fu, Freddie H; Musahl, Volker

    2016-01-01

    The pivot shift test is a commonly used clinical examination by orthopedic surgeons to evaluate knee function following injury. However, the test can only be graded subjectively by the examiner. Therefore, the purpose of this study is to develop software for a computer tablet to quantify anterior translation of the lateral knee compartment during the pivot shift test. Based on the simple image analysis method, software for a computer tablet was developed with the following primary design constraint - the software should be easy to use in a clinical setting and it should not slow down an outpatient visit. Translation of the lateral compartment of the intact knee was 2.0 ± 0.2 mm and for the anterior cruciate ligament-deficient knee was 8.9 ± 0.9 mm (p software provides reliable, objective, and quantitative data on translation of the lateral knee compartment during the pivot shift test and meets the design constraints posed by the clinical setting.

  10. The pivotal role of cholesterol absorption inhibitors in the management of dyslipidemia

    Directory of Open Access Journals (Sweden)

    Suleiman Ehab S

    2004-10-01

    Full Text Available Abstract Elevated low-density lipoprotein (LDL-cholesterol is associated with a significantly increased risk of coronary heart disease. Ezetimibe is the first member of a new class of selective cholesterol absorption inhibitors. It impairs the intestinal reabsorption of both dietary and hepatically excreted biliary cholesterol. Ezetimibe is an effective and safe agent for lowering LDL-C and non HDL-C. Short term clinical trials have established the role of ezetimibe monotherapy and its use in combination with statins. Furthermore, ezetimibe and statin combination therapy increased the percentage of patients who achieved their LDL-C treatment goal. Studies using surrogate markers of atherosclerosis have suggested a possible role of ezetimibe in combating atherosclerosis. Ezetimibe provides an effective therapeutic strategy for the management of homozygous familial hypercholesterolemia (HoFH and sitosterolemia. The lack of outcomes and long term safety data is attributed to the relatively recent introduction of this medication.

  11. Recent advances in treatment of heart failure [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Takeshi Kitai

    2015-12-01

    Full Text Available With the total cases and economic burden of heart failure continuing to rise, there is an overwhelming need for novel therapies. Several drugs for heart failure have succeeded in preclinical and early-phase clinical trials, but most of them failed to show the real benefit in pivotal clinical trials. Meanwhile, the US Food and Drug Administration recently approved two promising new drugs to treat heart failure: ivabradine and sacubitril/valsartan. Furthermore, some of the newer agents in testing offer the potential for significant progress in addition to these drugs. Patiromer and zirconium cyclosilicate are attractive agents that are expected to prevent hyperkalemia during renin-angiotensin-aldosterone system inhibition, and serelaxin and urodilatin are promising drugs in the treatment of acute heart failure. Future clinical trials with more appropriate study designs, optimal clinical endpoints, and proper patient selection are mandatory to assess the true efficacy of these attractive compounds in clinical practice.

  12. Heart transplantation in adult congenital heart disease.

    Science.gov (United States)

    Burchill, Luke J

    2016-12-01

    Heart failure (HF) in adult congenital heart disease (ACHD) is vastly different to that observed in acquired heart disease. Unlike acquired HF in which pharmacological strategies are the cornerstone for protecting and improving ventricular function, ACHD-related HF relies heavily upon structural and other interventions to achieve these aims. patients with ACHD constitute a small percentage of the total adult heart transplant population (∼3%), although the number of ACHD heart transplant recipients is growing rapidly with a 40% increase over the last two decades. The worldwide experience to date has confirmed heart transplantation as an effective life-extending treatment option in carefully selected patients with ACHD with end-stage cardiac disease. Opportunities for improving outcomes in patients with ACHD-related HF include (i) earlier recognition and referral to centres with combined expertise in ACHD and HF, (ii) increased awareness of arrhythmia and sudden cardiac death risk in this population, (iii) greater collaboration between HF and ACHD specialists at the time of heart transplant assessment, (iv) expert surgical planning to reduce ischaemic time and bleeding risk at the time of transplant, (v) tailored immunosuppression in the post-transplant period and (vi) development and validation of ACHD-specific risk scores to predict mortality and guide patient selection. The purpose of this article is to review current approaches to diagnosing and treating advanced HF in patients with ACHD including indications, contraindications and clinical outcomes after heart transplantation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. VERTICAL PROJECTION EFFICIENCY OF PIVOT POINTS USING ELECTRONIC TACHEOMETER DURING CONSTRUCTION OF BUILDINGS AND STRUCTURES

    Directory of Open Access Journals (Sweden)

    M. S. Nesterenok

    2014-01-01

    Full Text Available The paper shows that functional limitation of zenith devices and introduction of modern high-accuracy electronic tacheometers should lead to substitution of the mentioned devices for tacheometers in geodesic works concerning vertical projection of pivot points of the constructed buildings and structures. However the electronic tacheometer has not been considered in the function of a zenith device in ТКП 45-1.03-26-2006.Special experiemnts and practical works executed by UE “Geokart” has proved that in accordance with its design the electronic tacheometer equipped with a compensator for small inclinations and zenith prism attachment for ocular can be applied as a vertical projection device while setting sighting line of a telescope in a fixed vertical position. Corresponding experiments have been carried out for multi-storied building of business centre located in the M. Tank Street in Minsk in order to obtain comparative characteristics of vertical projection accuracy with the help of tacheometer TOPCON GPT 7501 and zenith device PZL-100. An initial point of the staked grid has been situated at the elevation ±0,0 м, standard graph elevation has been equal to +49,5 м (concrete slab of the 14th floor, projection height referred to the device has been equal to Н = 47,8 м. Both devices have been set on the same stand using a purpose made adaptive device in order to exclude centering errors. Deviation in position of final projection points on the standard graph which were obtained with the help of two devices has been equal to 1.2 mm, that testifies practical equal accuracy of the zenith device and tacheometer for vertical projection function.Additional advantage of the electronic tacheometer in comparison with special vertical projection devi ces lies in the fact that in the case of a certain misalignment of geodesic openings in intermediate floors ta- cheometer deviating from the vertical makes it possible to carry out initial point

  14. One-year pivotal trial outcomes of the Nellix system for endovascular aneurysm sealing.

    Science.gov (United States)

    Carpenter, Jeffrey P; Cuff, Robert; Buckley, Clifford; Healey, Christopher; Hussain, Sajjad; Reijnen, Michel M P J; Trani, Jose; Böckler, Dittmar

    2017-02-01

    The Nellix EndoVascular Aneurysm Sealing (EVAS) System (Endologix, Inc, Irvine, Calif) is a novel approach to abdominal aortic aneurysm (AAA) treatment whereby polymer is used to fill the AAA sac. We report 1-year results of the investigational device exemption pivotal trial. Eligible patients were treated at 30 sites in the United States and Europe. Inclusion criteria required an asymptomatic infrarenal AAA, with a neck length ≥10 mm and ≤60° angle, iliac artery blood lumen diameter 9 to 35 mm, access artery diameter ≥6 mm, and serum creatinine ≤2 mg/dL. Follow-up included computed tomography angiography scans at 30 days, 6 months, and 1 year that were evaluated by a core laboratory. The primary safety end point was 30-day major adverse events (MAEs), which were compared with a performance goal of year, which was compared with a performance goal of >80%. Treatment success required procedural technical success and absence of AAA rupture during follow-up, conversion to open surgical repair, endoleak (type I or III) at 1 year, migration >10 mm causing complications or requiring secondary intervention, aneurysm enlargement, or secondary procedures through 1 year for resolution of endoleak, device obstruction or occlusion, or device defect. Of 150 treated patients, 149 (99.3%) completed 1-year follow-up. The MAEs rate at 30 days was 2.7% (95% confidence interval, 0.7%-6.7%), satisfying the primary safety end point (year treatment success was 94% (95% confidence interval, 88.6%-97.4%), achieving the primary effectiveness end point (>80%). At 1 year, key secondary outcomes included 6.7% MAEs, 4.7% serious device-related events, 1.3% AAA-related mortality, 3.7% secondary interventions, and 0.7% surgical conversions. MAEs through 1 year included death (n = 6), stroke (n = 3), bowel ischemia (n = 2), renal failure (n = 2), respiratory failure (n = 2), and myocardial infarction (n =1). One iatrogenic AAA rupture occurred and one AAA rupture

  15. Investigation of the crossed flexure pivot and the dynamics of the momentum management system spacecraft control component and the dynamically tuned gyroscope

    Science.gov (United States)

    Cain, Jeffrey Stuart

    1999-11-01

    The Momentum Management System (MMS) is a novel concept which incorporates the rate sensing capabilities of the Dynamically Tuned Gyro (DTG) and the actuation ability of a gimballed momentum wheel. The mechanical components of the MMS and DTG consist of a rotor, gimbal and shaft which are connected using crossed flexure pivots. This document presents a static and vibration analysis of the crossed flexure pivot and a kinematic and dynamic analysis of the Dynamically Tuned Gyroscope and the Momentum Management System. Hamilton's principle of minimum energy is used to develop static and vibrational models of the crossed flexure pivot. These models were used to design the pivots used in the MMS. Comparisons are made between the static model results and those found in the literature. A discussion of the effects of large angle deflections and wide pivot strips is also included. In order to provide additional experimental validation of the static equations, a pivot was designed and tested and the results compared to the theoretical model. The static model showed that the torsional stiffness of the crossed flexure pivot is dependent on the applied loads and that the buckling load is lower than previously thought. The vibration analysis was used to find the unforced, fundamental frequencies of the crossed flexure pivots used in the MMS. A two body stability analysis of the DTG and MMS involving the gimbal and rotor was performed using small angle equations. This included a study of the effect of using bearings instead of the crossed flexure pivots. The DTG and MMS were found to be unstable only in extreme cases. The dynamic equations were derived using Lagrange's Equations and Hamilton's Canonical Equations. The dynamic equations are used in a numerical simulation which allows the MMS to be modelled. The results show that the three body analysis involving the rotor, gimbal and shaft is more accurate than the standard two body analysis seen in the literature, especially when

  16. Heart rate index

    DEFF Research Database (Denmark)

    Haedersdal, C; Pedersen, F H; Svendsen, J H

    1992-01-01

    The present study compares the variables assessed by standard exercise test with the left ventricular ejection fraction (LVEF) measured by multigated radionuclide angiocardiography (MUGA) in 77 patients early after myocardial infarction. The exercise test and MUGA were performed within two weeks...... after the myocardial infarction. A significant correlation (Spearman's correlation coefficient rs, p less than 0.05) was found between LVEF at rest and the following variables assessed at exercise test: 1) the heart rate at rest, 2) rise in heart rate, 3) ratio between maximal heart rate and heart rate...... at rest, 4) rise in systolic blood pressure, 5) rate pressure product at rest, 6) rise in rate pressure product, 7) ratio (rHR) between maximal rate pressure product and rate pressure product at rest, 8) total exercise time. The heart rate was corrected for effects caused by age (heart index (HR...

  17. Patterns of Heart Attacks

    Science.gov (United States)

    2010-06-01

    Hypertension (high blood pressure), smoking, family history of heart disease, and diabetes mellitus (both types 1 and 2) are also factors that increase the risk...breath 16% 19% Hyperlipidemia 2% Asthma 23% Coronary Artery Disease 15% Chest Pain 4% Pneumonia 24% 38% Diabetes 7% Congestive Heart Failure 9% 6...Pain Diabetes Congestive Heart Failure Hypertension Asthma Table 5.7: Diagnoses that distinguish cluster 8 from the cost bucket 2 population average. The

  18. Music and the heart

    OpenAIRE

    Koelsch, Stefan; Jäncke, Lutz

    2017-01-01

    Music can powerfully evoke and modulate emotions and moods, along with changes in heart activity, blood pressure (BP), and breathing. Although there is great heterogeneity in methods and quality among previous studies on effects of music on the heart, the following findings emerge from the literature: Heart rate (HR) and respiratory rate (RR) are higher in response to exciting music compared with tranquilizing music. During musical frissons (involving shivers and piloerection), both HR and RR...

  19. Heart Rate Monitors

    Science.gov (United States)

    1990-01-01

    Under a NASA grant, Dr. Robert M. Davis and Dr. William M. Portnoy came up with a new type of electrocardiographic electrode that would enable long term use on astronauts. Their invention was an insulated capacitive electrode constructed of a thin dielectric film. NASA subsequently licensed the electrode technology to Richard Charnitski, inventor of the VersaClimber, who founded Heart Rate, Inc., to further develop and manufacture personal heart monitors and to produce exercise machines using the technology for the physical fitness, medical and home markets. Same technology is on both the Home and Institutional Model VersaClimbers. On the Home Model an infrared heart beat transmitter is worn under exercise clothing. Transmitted heart rate is used to control the work intensity on the VersaClimber using the heart rate as the speedometer of the exercise. This offers advantages to a full range of users from the cardiac rehab patient to the high level physical conditioning of elite athletes. The company manufactures and markets five models of the 1*2*3 HEART RATE monitors that are used wherever people exercise to accurately monitor their heart rate. Company is developing a talking heart rate monitor that works with portable headset radios. A version of the heart beat transmitter will be available to the manufacturers of other aerobic exercise machines.

  20. Anesthesia for Heart Transplantation.

    Science.gov (United States)

    Ramsingh, Davinder; Harvey, Reed; Runyon, Alec; Benggon, Michael

    2017-09-01

    This article seeks to evaluate current practices in heart transplantation. The goals of this article were to review current practices for heart transplantation and its anesthesia management. The article reviews current demographics and discusses the current criteria for candidacy for heart transplantation. The process for donor and receipt selection is reviewed. This is followed by a review of mechanical circulatory support devices as they pertain to heart transplantation. The preanesthesia and intraoperative considerations are also discussed. Finally, management after transplantation is also reviewed. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. [Heart transplantation and infection].

    Science.gov (United States)

    Ozábalová, Eva; Krejčí, Jan; Hude, Petr; Godava, Julius; Honek, Tomáš; Špinarová, Lenka; Pavlík, Petr; Bedáňová, Helena; Němec, Petr

    2017-01-01

    Heart transplantation (HTx) is a method of treatment for patients with end-stage heart failure with severe symptoms despite complex therapy. Post-transplant difficulties include acute rejection and infectious complications, which are the most common reason of morbidity and mortality in the first year after heart transplant. It requires the patient to remain on immunosuppressive medication to avoid the possibility of graft rejection. Therefore the range of infection is much larger. The diagnosis and treatment of viral, bacterial and fungal infections is often difficult.Key words: heart transplantation - immunosuppression - infection.

  2. All about Heart Rate (Pulse)

    Science.gov (United States)

    ... get a picture of your health. Learn more: Blood Pressure Vs. Heart Rate Target Heart Rate Arrhythmias (abnormal heart rhythms) This ... Healthy 6 What are the Symptoms of High Blood Pressure? 7 All About Heart Rate (Pulse) 8 Warning Signs of a Heart Attack ...

  3. Mucosal mast cells are pivotal elements in inflammatory bowel disease that connect the dots: Stress, intestinal hyperpermeability and inflammation

    Institute of Scientific and Technical Information of China (English)

    Ashkan Farhadi; Jeremy Z Fields; Ali Keshavarzian

    2007-01-01

    Mast cells (MC) are pivotal elements in several physiological and immunological functions of the gastrointestinal (GI) tract. MC translate the stress signals that has been transmitted through brain gut axis into release of proinflammatory mediators that can cause stimulation of nerve endings that could affect afferent nerve terminals and change their perception, affect intestinal motility, increase intestinal hyperpermeability and, in susceptible individuals, modulate the inflammation. Thus, it is not surprising that MC are an important element in the pathogenesis of inflammatory bowel disease and non inflammatory GI disorders such as IBS and mast cell enterocolitis.

  4. HTML5 PivotViewer: high-throughput visualization and querying of image data on the web.

    Science.gov (United States)

    Taylor, Stephen; Noble, Roger

    2014-09-15

    Visualization and analysis of large numbers of biological images has generated a bottle neck in research. We present HTML5 PivotViewer, a novel, open source, platform-independent viewer making use of the latest web technologies that allows seamless access to images and associated metadata for each image. This provides a powerful method to allow end users to mine their data. Documentation, examples and links to the software are available from http://www.cbrg.ox.ac.uk/data/pivotviewer/. The software is licensed under GPLv2. © The Author 2014. Published by Oxford University Press.

  5. Dimensional analysis of heart rate variability in heart transplant recipients

    Energy Technology Data Exchange (ETDEWEB)

    Zbilut, J.P.; Mayer-Kress, G.; Geist, K.

    1987-01-01

    We discuss periodicities in the heart rate in normal and transplanted hearts. We then consider the possibility of dimensional analysis of these periodicities in transplanted hearts and problems associated with the record.

  6. Women's Heart Disease: Join the Heart Truth Community

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Join The Heart Truth Community Past Issues / Winter ... introduced as the national symbol for women and heart disease awareness in 2002 by the NHLBI. The Red ...

  7. Women and Heart Disease: Sharing Advice from the Heart

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Women and Heart Disease Sharing Advice From The Heart Past Issues / Spring ... gowns in an effort to raise awareness that heart disease is the leading cause of death among women. ...

  8. Three-dimensional kinematic and kinetic analysis of knee rotational stability in ACL-deficient patients during walking, running and pivoting

    DEFF Research Database (Denmark)

    Bohn, Marie Bagger; Petersen, Annemette Krintel; Nielsen, Dennis Brandborg

    2016-01-01

    and kinetic data were collected from both legs of 44 ACLD patients and 16 healthy controls during walking, running and a pivoting maneuver (descending a staircase and immediately pivoting 90° on the landing leg). Motion data were captured using 8 high-speed cameras and a force-plate. Reflective markers were...... intact knees (ACLI) and a knee healthy control group during walking, running and 90° pivoting. We hypothesized a larger tibial internal rotation, a smaller knee joint external moment and a lower rotational stiffness in the ACLD group compared to the ACLI and the control group. METHODS: Kinematic......: The tibial internal rotation of the ACLD knee was not significantly different from the ACLI knee during all three tasks. During walking and running, the tibial rotation of the control group was significantly different from both legs of the ACL-injured patient. For pivoting, no difference in tibial rotation...

  9. Mapping the Heart

    Science.gov (United States)

    Hulse, Grace

    2012-01-01

    In this article, the author describes how her fourth graders made ceramic heart maps. The impetus for this project came from reading "My Map Book" by Sara Fanelli. This book is a collection of quirky, hand-drawn and collaged maps that diagram a child's world. There are maps of her stomach, her day, her family, and her heart, among others. The…

  10. Chronic heart failure

    African Journals Online (AJOL)

    population, and up to 10% in people aged 75 years and older. It is also estimated that ... The first step in the development of heart failure is an injury to the myocardium ... treatment of heart failure by blocking the compensatory mechanisms with ... pulmonary disease, cognitive dysfunction, depression, chronic kidney disease ...

  11. Heart Surgery Terms

    Science.gov (United States)

    ... CABG) The surgical procedure to treat narrowing or " stenosis " of the coronary arteries is called coronary artery bypass, or CABG ( ... blood flow to the heart. Coronary artery disease Coronary artery disease is characterized by a narrowing or " stenosis " of the blood vessels to the heart resulting ...

  12. The total artificial heart.

    Science.gov (United States)

    Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

    2015-12-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

  13. Heart failure in COPD

    NARCIS (Netherlands)

    Rutten, Frans Hendrik

    2005-01-01

    The main aim of the thesis was to assess the prevalence of heart failure in patients with a diagnosis of chronic obstructive pulmonary disease (COPD). Furthermore, to explore diagnostic strategies (including natriuretic peptides and cardiovascular magnetic resonance imaging (CMR)) to identify heart

  14. Mapping the Heart

    Science.gov (United States)

    Hulse, Grace

    2012-01-01

    In this article, the author describes how her fourth graders made ceramic heart maps. The impetus for this project came from reading "My Map Book" by Sara Fanelli. This book is a collection of quirky, hand-drawn and collaged maps that diagram a child's world. There are maps of her stomach, her day, her family, and her heart, among others. The…

  15. Music and the heart.

    Science.gov (United States)

    Koelsch, Stefan; Jäncke, Lutz

    2015-11-21

    Music can powerfully evoke and modulate emotions and moods, along with changes in heart activity, blood pressure (BP), and breathing. Although there is great heterogeneity in methods and quality among previous studies on effects of music on the heart, the following findings emerge from the literature: Heart rate (HR) and respiratory rate (RR) are higher in response to exciting music compared with tranquilizing music. During musical frissons (involving shivers and piloerection), both HR and RR increase. Moreover, HR and RR tend to increase in response to music compared with silence, and HR appears to decrease in response to unpleasant music compared with pleasant music. We found no studies that would provide evidence for entrainment of HR to musical beats. Corresponding to the increase in HR, listening to exciting music (compared with tranquilizing music) is associated with a reduction of heart rate variability (HRV), including reductions of both low-frequency and high-frequency power of the HRV. Recent findings also suggest effects of music-evoked emotions on regional activity of the heart, as reflected in electrocardiogram amplitude patterns. In patients with heart disease (similar to other patient groups), music can reduce pain and anxiety, associated with lower HR and lower BP. In general, effects of music on the heart are small, and there is great inhomogeneity among studies with regard to methods, findings, and quality. Therefore, there is urgent need for systematic high-quality research on the effects of music on the heart, and on the beneficial effects of music in clinical settings.

  16. Heart imaging method

    Science.gov (United States)

    Collins, H. Dale; Gribble, R. Parks; Busse, Lawrence J.

    1991-01-01

    A method for providing an image of the human heart's electrical system derives time-of-flight data from an array of EKG electrodes and this data is transformed into phase information. The phase information, treated as a hologram, is reconstructed to provide an image in one or two dimensions of the electrical system of the functioning heart.

  17. Guidelines for heart transplantation

    OpenAIRE

    de Jonge, N; Kirkels, J.H.; Klöpping, C.; Lahpor, J.R.; Caliskan, K.; Maat, A.P.W.M.; Brügemann, J; Erasmus, M.E.; Klautz, R. J. M.; Verwey, H.F; Oomen, A.; Peels, C.H.; Golüke, A.E.J.; Nicastia, D.; Koole, M.A.C.

    2008-01-01

    Based on the changes in the field of heart transplantation and the treatment and prognosis of patients with heart failure, these updated guidelines were composed by a committee under the supervision of both the Netherlands Society of Cardiology and the Netherlands Association for Cardiothoracic surgery (NVVC and NVT).

  18. Guidelines for heart transplantation

    NARCIS (Netherlands)

    Kirkels, J. H.; Klopping, C.; Lahpor, J. R.; Caliskan, K.; Maat, A. P. W. M.; Brugemann, J.; Erasmus, M. E.; Klautz, R. J. M.; Verwey, H. F.; Oomen, A.; Peels, C. H.; Goluke, A. E. J.; Nicastia, D. M.; Koole, M. A. C.; Balk, A. H. M. M.; de Jonge, N.

    Based on the changes in the field of heart transplantation and the treatment and prognosis of patients with heart failure, these updated guidelines were composed by a committee under the supervision of both the Netherlands Society of Cardiology and the Netherlands Association for Cardiothoracic

  19. World Heart Day

    Centers for Disease Control (CDC) Podcasts

    2009-09-01

    For World Heart Day, learn more about what heart-healthy steps you can take in the workplace.  Created: 9/1/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 9/9/2009.

  20. The effects of pressure and temperature on the energetics and pivotal surface in a monoacylglycerol/water gyroid inverse bicontinuous cubic phase.

    Science.gov (United States)

    Tang, T-Y Dora; Seddon, Annela M; Jeworrek, Christoph; Winter, Roland; Ces, Oscar; Seddon, John M; Templer, Richard H

    2014-05-07

    We have studied the effect of pressure and temperature on the location of the pivotal surface in a lipid inverse bicontinuous gyroid cubic phase (Q(G)(II)), described by the area at the pivotal surface (An), the volume between the pivotal surface and the bilayer midplane (Vn), and the molecular volume of the lipid (V). Small angle X-ray scattering (SAXS) was used to measure the swelling behaviour of the lipid, monolinolein, as a function of pressure and temperature, and the data were fitted to two different geometric models: the parallel interface model (PIM), and the constant mean curvature model (CMCM). The results show that an increase in temperature leads to a shift in the location of the pivotal surface towards the bilayer midplane, whilst an increase in pressure causes the pivotal surface to move towards the interfacial region. In addition, we describe the relevance of An, Vn and V for modeling the energetics of curved mesophases with specific reference to the mean curvature at the pivotal surface and discuss the significance of this parameter for modelling the energetics of curved mesophases.

  1. "The Heart Game"

    DEFF Research Database (Denmark)

    Dithmer, Marcus; Rasmussen, Jack Ord; Grönvall, Erik

    2016-01-01

    Objective: The aim of this article is to describe the development and testing of a prototype application (“The Heart Game”) using gamification principles to assist heart patients in their telerehabilitation process in the Teledialog project. Materials and Methods: A prototype game was developed via...... tool as a part of their telerehabilitation process in everyday life. Gamification and gameful design principles such as leaderboards, relationships, and achievements engaged the patients and relatives. The inclusion of a close relative in the game motivated the patients to perform rehabilitation...... activities. Conclusions: “The Heart Game” concept presents a new way to motivate heart patients by using technology as a social and active approach to telerehabilitation. The findings show the potential of using gamification for heart patients as part of a telerehabilitation program. The evaluation indicated...

  2. Theory of heart

    Energy Technology Data Exchange (ETDEWEB)

    Glass, L. (ed.) (McGill Univ., Montreal (Canada). Dept. of Physiology); Hunter, P. (ed.) (Auckland Univ., Auckland (New Zealand). Dept. of Engineering Science); McCulloch, A. (ed.) (California Univ., San Diego (United States))

    1991-01-01

    In recent years there has been a growth in interest in studying the heart from the perspective of the physical sciences: mechanics, fluid flow, electromechanics. This volume is the result of a workshop held in July 1989 at the Institute for Nonlinear Sciences at the University of California at San Diego that brought together scientists and clinicians with graduate students and postdoctoral fellows who share an interest in the heart. The chapters were prepared by the invited speakers as didactic reviews of their subjects but also include up-to-date results in their fields. Topics covered include the structure, mechanical properties, and function of the heart and the myocardium, electrical activity of the heart and myocardium, and mathematical models of heart function. Individual chapters are abstracted separately.

  3. Types of Congenital Heart Defects

    Science.gov (United States)

    ... heart develops. Examples of Simple Congenital Heart Defects Holes in the Heart (Septal Defects) The septum is ... Google+ SITE INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA NO FEAR ACT OIG CONTACT US National Institutes of Health ...

  4. Can Pregnancy Harm Your Heart?

    Science.gov (United States)

    ... and women's heart health, said Dr. Mary Ann Bauman, a spokeswoman for the American Heart Association. "We ... of the mechanisms of women and heart disease," Bauman said. "Women aren't just men with ovaries. ...

  5. Heart Disease and African Americans

    Science.gov (United States)

    ... Minority Population Profiles > Black/African American > Heart Disease Heart Disease and African Americans Although African American adults are ... were 30 percent more likely to die from heart disease than non-Hispanic whites. African American women are ...

  6. Heart Disease and Stroke Prevention

    Science.gov (United States)

    ... Heart Health and Stroke Heart disease and stroke prevention Related information Learn more about healthy eating and ... top More information on Heart disease and stroke prevention Read more from womenshealth.gov A Lifetime of ...

  7. Living with Coronary Heart Disease

    Science.gov (United States)

    ... from the NHLBI on Twitter. Living With Coronary Heart Disease Coronary heart disease (CHD) can cause serious complications. However, if you ... changes and medicines, go to "How Is Coronary Heart Disease Treated?" Work closely with your doctor to control ...

  8. Living with Diabetic Heart Disease

    Science.gov (United States)

    ... from the NHLBI on Twitter. Living With Diabetic Heart Disease Diabetic heart disease (DHD) increases the likelihood of earlier and more ... also tend to have less success from certain heart disease treatments, such as coronary artery bypass grafting and ...

  9. About the Operation: Heart Transplant

    Science.gov (United States)

    ... There are two very different surgical approaches to heart transplantation: the orthotopic and the heterotopic approach. Because the ... begins. Heterotopic Approach. Heterotopic transplantation, also called ... by leaving the recipient's heart in place and connecting the donor heart to ...

  10. Heart Disease and Stroke Statistics

    Science.gov (United States)

    ... Media for Heart.org Heart and Stroke Association Statistics Banner 1 - Stats white banner Each year, the ... health and disease in the population. Heart & Stroke Statistics FAQs What is Prevalence? Prevalence is an estimate ...

  11. What Causes Heart Valve Disease?

    Science.gov (United States)

    ... a heart attack or injury to the heart. Rheumatic Fever Untreated strep throat or other infections with strep bacteria that progress to rheumatic fever can cause heart valve disease. When the body ...

  12. Effects of two types of sprinklers and height in the irrigation of sugar beet with a centre pivot

    Energy Technology Data Exchange (ETDEWEB)

    Ortiz, J. N.; Tarjuelo, J. M.; Juan, J. A. de

    2012-11-01

    The main objective of this paper is to analyse the effects of sprinkler type and height above the ground on soil water uniformity (CUs) and sugar beet yield. Irrigation was performed with a centre pivot operating under field conditions with two types of sprinklers, one with a stationary plate (SPS) and the other with a moving plate (MPS), at two heights (1 and 2.5 m). The average coefficient of uniformity (CU) of water application of individual irrigation events with SPS ranged from 74 to 81%, compared to nearly 90% from MPS. The value of the cumulative coefficient of uniformity for the set of irrigation events (CUa) for all sprinkler-height combinations exceeded 90%, a value similar to that obtained for CUS. Results do not show a clear advantage in the final crop response by using sprinklers with MPS or SPS. However, MPS, and especially those located at 1 m in height with a spacing of 1.5 m, have higher water application uniformity, achieving higher yield and yield indexes, as well as higher water use efficiency. The final yield of sugar beet was more influenced by the amount of soil water available for the crop than the small differences in soil water uniformity obtained with the centre pivot. (Author) 62 refs.

  13. A study on the effectiveness of investment strategy based on the concept of pivot points levels using Matthews criterion

    Directory of Open Access Journals (Sweden)

    Antoni Wiliński

    2013-04-01

    Full Text Available In this work, the possibility of assessing traditional investment strategy based on the pivot points for using with other than the commonly used criterion is examined. The authors attempted to apply the Matthews Correlation Coefficient (further reffered as MCC criterion based on a confusion matrix when assessing the strategy to include more factors than the traditional criteria (such as profit, profit vs. Risk, Sharpe ratio, Calmar ratio and to express these factors by one number. The criterion based on a confusion matrix is, in authors beliefs, unique in this application and gives a fairly valuable estimation of trading strategy. An example of several strategies tested on EURUSD 1h time series in selected intervals in the years 2012-2013 is considered. Among these strategies there is a simple strategy based on the concept of pivot points levels and more complex derivative strategies, based on the vector of optimized values of certain parameters. These strategies are evaluated using both traditional criteria and modification of MCC proposed by the authors.

  14. Development of offset pivot guide%偏摆式纠偏机构的研究与设计

    Institute of Scientific and Technical Information of China (English)

    张杰; 裴全喜

    2015-01-01

    重点介绍了偏摆式纠偏机构中纠偏框架和驱动装置的工作原理及结构设计,利用辊筒支架上3个支点的直线运动实现纠偏框架的摆动,驱动装置采用扭轮摩擦传动方式. 由于采用了特殊的工作原理和方法,使纠偏装置具有了更好的适用性和经济性.%It focus on the working principle and structure design of guiding frame and driving device for the offset pivot guide , using linear motion of three pivots of roller bracket to realize swing of the guiding frame , designs the driving device for adopting twist -roller friction drive .Because of adopting especial working principle and means, the guiding system has more applicability and economy .

  15. TLR4-mediated expression of Mac-1 in monocytes plays a pivotal role in monocyte adhesion to vascular endothelium.

    Science.gov (United States)

    Lee, Seung Jin; Choi, Eun Kyoung; Seo, Kyo Won; Bae, Jin Ung; Park, So Youn; Kim, Chi Dae

    2014-01-01

    Toll-like receptor 4 (TLR4) is known to mediate monocyte adhesion to endothelial cells, however, its role on the expression of monocyte adhesion molecules is unclear. In the present study, we investigated the role of TLR4 on the expression of monocyte adhesion molecules, and determined the functional role of TLR4-induced adhesion molecules on monocyte adhesion to endothelial cells. When THP-1 monocytes were stimulated with Kdo2-Lipid A (KLA), a specific TLR4 agonist, Mac-1 expression was markedly increased in association with an increased adhesion of monocytes to endothelial cells. These were attenuated by anti-Mac-1 antibody, suggesting a functional role of TLR4-induced Mac-1 on monocyte adhesion to endothelial cells. In monocytes treated with MK886, a 5-lipoxygenase (LO) inhibitor, both Mac-1 expression and monocyte adhesion to endothelial cells induced by KLA were markedly attenuated. Moreover, KLA increased the expression of mRNA and protein of 5-LO, suggesting a pivotal role of 5-LO on these processes. In in vivo studies, KLA increased monocyte adhesion to aortic endothelium of wild-type (WT) mice, which was attenuated in WT mice treated with anti-Mac-1 antibody as well as in TLR4-deficient mice. Taken together, TLR4-mediated expression of Mac-1 in monocytes plays a pivotal role on monocyte adhesion to vascular endothelium, leading to increased foam cell formation in the development of atherosclerosis.

  16. Angioplasty and stent placement - heart

    Science.gov (United States)

    ... angioplasty; Coronary artery angioplasty; Percutaneous transluminal coronary angioplasty; Heart artery dilatation ... to carefully guide the catheter up into your heart and arteries. Dye will be injected into your ...

  17. Lungs in Heart Failure

    Directory of Open Access Journals (Sweden)

    Anna Apostolo

    2012-01-01

    Full Text Available Lung function abnormalities both at rest and during exercise are frequently observed in patients with chronic heart failure, also in the absence of respiratory disease. Alterations of respiratory mechanics and of gas exchange capacity are strictly related to heart failure. Severe heart failure patients often show a restrictive respiratory pattern, secondary to heart enlargement and increased lung fluids, and impairment of alveolar-capillary gas diffusion, mainly due to an increased resistance to molecular diffusion across the alveolar capillary membrane. Reduced gas diffusion contributes to exercise intolerance and to a worse prognosis. Cardiopulmonary exercise test is considered the “gold standard” when studying the cardiovascular, pulmonary, and metabolic adaptations to exercise in cardiac patients. During exercise, hyperventilation and consequent reduction of ventilation efficiency are often observed in heart failure patients, resulting in an increased slope of ventilation/carbon dioxide (VE/VCO2 relationship. Ventilatory efficiency is as strong prognostic and an important stratification marker. This paper describes the pulmonary abnormalities at rest and during exercise in the patients with heart failure, highlighting the principal diagnostic tools for evaluation of lungs function, the possible pharmacological interventions, and the parameters that could be useful in prognostic assessment of heart failure patients.

  18. Heart rate turbulence.

    Science.gov (United States)

    Cygankiewicz, Iwona

    2013-01-01

    Heart rate turbulence (HRT) is a baroreflex-mediated biphasic reaction of heart rate in response to premature ventricular beats. Heart rate turbulence is quantified by: turbulence onset (TO) reflecting the initial acceleration of heart rate following premature beat and turbulence slope (TS) describing subsequent deceleration of heart rate. Abnormal HRT identifies patients with autonomic dysfunction or impaired baroreflex sensitivity due to variety of disorders, but also may reflect changes in autonomic nervous system induced by different therapeutic modalities such as drugs, revascularization, or cardiac resynchronization therapy. More importantly, impaired HRT has been shown to identify patients at high risk of all-cause mortality and sudden death, particularly in postinfarction and congestive heart failure patients. It should be emphasized that abnormal HRT has a well-established role in stratification of postinfarction and heart failure patients with relatively preserved left ventricular ejection fraction. The ongoing clinical trials will document whether HRT can be used to guide implantation of cardioverter-defibrillators in this subset of patients, not covered yet by ICD guidelines. This review focuses on the current state-of-the-art knowledge regarding clinical significance of HRT in detection of autonomic dysfunction and regarding the prognostic significance of this parameter in predicting all-cause mortality and sudden death. © 2013.

  19. The coronary heart team.

    Science.gov (United States)

    Yanagawa, Bobby; Puskas, John D; Bhatt, Deepak L; Verma, Subodh

    2017-09-01

    The concept of a Coronary Heart Team has generated increased interest, including support from major practice guidelines. Here, we review the rationale and the published experience of Coronary Heart Teams. A Coronary Heart Team should be led by both cardiology and cardiac surgery with a shared decision-making approach. The team should incorporate data from anatomic and clinical risk prediction models to offer individualized care. Most teams focus on management of complex patients and those with indications for both coronary artery bypass graft and percutaneous coronary intervention. The potential benefits of a Coronary Heart Team include balanced decision-making, greater adherence to evidence-based practice guidelines, as well as promoting greater collegiality and exchange of knowledge between specialties. Single-center series have demonstrated consistency in decision-making by Coronary Heart Teams but prospective data demonstrating improved patient outcomes and/or cost effectiveness are necessary. The concept of a Coronary Heart Team is gaining traction for patients with complex coronary artery disease. There is a growing literature in support of Coronary Heart Teams but comparative and prospective data demonstrating improved patient outcomes are needed.

  20. [Ischemic heart disease].

    Science.gov (United States)

    Yamamuro, Megumi; Ogawa, Hisao

    2009-04-01

    It has been reported that antihypertensive therapy reduces the risk of ischemic heart disease. Except for the antihypertensive effects, the angiotensin converting enzyme (ACE) inhibitors are proved to be very effective in primary and secondary event onset prophylaxis by many clinical trials. The angiotensin II receptor antagonists (ARBs) used briskly in recent years inhibits angiotensin II type 1 receptor alternatively. Although ARBs protect organs, especially blood vessel, heart, brain and kidney in sites of pharmacology, ARBs are still not much as effective results as ACE inhibitors for the patients with ischemic heart disease, by many clinical trials.

  1. Thyroid and the Heart

    Directory of Open Access Journals (Sweden)

    A Karas

    2009-09-01

    Full Text Available The cardiovascular signs and symptoms of thyroid disease are some of the most clinically relevant findings that accompany both hyperthyroidism and hypothyroidism. On the basis of the understanding of the mechanisms of thyroid hormone action on the heart and cardiovascular system, it is possible to explain the changes in cardiac output, cardiac contractility, blood pressure and rhythm disturbances that result from thyroid dysfunction. In the present review will integrate what is known about the mechanisms of thyroid hormone action on the heart and the alterations in thyroid hormone metabolism that accompany chronic congestive heart failure.

  2. Heart to Heart Art: Empowering Homeless Children and Youth

    Science.gov (United States)

    Shepard, Jerri; Booth, Deborah

    2009-01-01

    This article describes Heart to Heart Art, an after-school program developed for homeless children and youth at the YWCA in Spokane, Washington. Pre-service teacher candidates from a local university create meaningful activities that engage homeless students in visual art, music, drama, cooking, and community service. Heart to Heart Art was…

  3. Development of an automated method to detect sitting pivot transfer phases using biomechanical variables: toward a standardized method

    Directory of Open Access Journals (Sweden)

    Desroches Guillaume

    2012-02-01

    Full Text Available Abstract Background Sitting pivot transfer (SPT is one of the most important, but at the same time strenuous at the upper extremity, functional task for spinal cord injured individuals. In order to better teach this task to those individuals and to improve performance, a better biomechanical understanding during the different SPT phases is a prerequisite. However, no consensus has yet been reached on how to depict the different phases of the SPT. The definition of the phases of the SPT, along with the events characterizing these phases, will facilitate the interpretation of biomechanical outcome measures related to the performance of SPTs as well as strengthen the evidence generated across studies. Methods Thirty-five individuals with a spinal cord injury performed two SPTs between seats of similar height using their usual SPT technique. Kinematics and kinetics were recorded using an instrumented transfer assessment system. Based on kinetic and kinematic measurements, a relative threshold-based algorithm was developed to identify four distinct phases: pre-lift, upper arm loading, lift-pivot and post-lift phases. To determine the stability of the algorithm between the two SPTs, Student t-tests for dependent samples were performed on the absolute duration of each phase. Results The mean total duration of the SPT was 2.00 ± 0.49 s. The mean duration of the pre-lift, upper arm loading, lift-pivot and post-lift phases were 0.74 ± 0.29 s, 0.28 ± 0.13 s, 0.72 ± 0.24 s, 0.27 ± 0.14 s whereas their relative contributions represented approximately 35%, 15%, 35% and 15% of the overall SPT cycle, respectively. No significant differences were found between the trials (p = 0.480-0.891. Conclusion The relative threshold-based algorithm used to automatically detect the four distinct phases of the SPT, is rapid, accurate and repeatable. A quantitative and thorough description of the precise phases of the SPT is prerequisite to better interpret biomechanical

  4. Data and Statistics: Women and Heart Disease

    Science.gov (United States)

    ... Pressure Salt Cholesterol Million Hearts® WISEWOMAN Women and Heart Disease Fact Sheet Recommend on Facebook Tweet Share Compartir ... Atlas of Heart Disease Facts on Women and Heart Disease Heart disease is the leading cause of death ...

  5. Caffeine and Heart Disease

    Science.gov (United States)

    ... dehydration. Caffeine is in coffee, tea, soft drinks, chocolate and some nuts. Whether high caffeine intake increases ... and Heart Disease Healthy Eating • Healthy Eating Home • Nutrition AHA Diet and Lifestyle Recommendations Making Healthy Choices ...

  6. Heart disease. Third edition

    Energy Technology Data Exchange (ETDEWEB)

    Braunwald, E.

    1988-01-01

    This book contains 62 chapters. Some of the chapter titles are: Radiological and Angiographic Examination of the Heart; Newer Cardiac Imaging Techniques: Digital Subtraction Angiography, Computerized Tomography, Magnetic Resonance Imaging; Nuclear Cardiology; and Genetics and Cardiovascular Disease.

  7. Heart attack - discharge

    Science.gov (United States)

    ... nih.gov/pubmed/23166211 . Giugliano RP, Cannon CP, Braunwald E. Non-ST elevation acute coronary syndromes. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  8. Advanced Heart Failure

    Science.gov (United States)

    ... patients and their doctors, making good decisions requires teamwork. Through shared decision making, doctors and patients consider ... Heart Failure and Knowing Your Options Planning Ahead Communicating With Your Healthcare Provider Overcoming Barriers to Shared ...

  9. Heart and vascular services

    Science.gov (United States)

    ... CT angiography (CTA) and magnetic resonance angiography (MRA) Echocardiogram PET scan of the heart Stress tests (many ... most cases, such procedures do not need general anesthesia . Patients often do not need to stay in ...

  10. Heart disease and diet

    Science.gov (United States)

    ... liver, and prepared meats such as sausage, hot dogs, and high-fat lunch meats. Adults should eat ... risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. ...

  11. Hyperkalemia in Heart Failure.

    Science.gov (United States)

    Sarwar, Chaudhry M S; Papadimitriou, Lampros; Pitt, Bertram; Piña, Ileana; Zannad, Faiez; Anker, Stefan D; Gheorghiade, Mihai; Butler, Javed

    2016-10-01

    Disorders of potassium homeostasis can potentiate the already elevated risk of arrhythmia in heart failure. Heart failure patients have a high prevalence of chronic kidney disease, which further heightens the risk of hyperkalemia, especially when renin-angiotensin-aldosterone system inhibitors are used. Acute treatment for hyperkalemia may not be tolerated in the long term. Recent data for patiromer and sodium zirconium cyclosilicate, used to treat and prevent high serum potassium levels on a more chronic basis, have sparked interest in the treatment of hyperkalemia, as well as the potential use of renin-angiotensin-aldosterone system inhibitors in patients who were previously unable to take these drugs or tolerated only low doses. This review discusses the epidemiology, pathophysiology, and outcomes of hyperkalemia in heart failure; provides an overview of traditional and novel ways to approach management of hyperkalemia; and discusses the need for further research to optimally treat heart failure.

  12. Picturing the Heart

    Science.gov (United States)

    ... Links for Students Glossary Picturing the Heart SCIENCE EDUCATION Science Topics Resource Links for General Public Resource Links for Parents/Teachers Resource Links for Students Glossary Government Resources Kids.gov – Science Information and services on the web ...

  13. A heart for interaction

    DEFF Research Database (Denmark)

    Fusaroli, Riccardo; Roepstorff, Andreas; Tylén, Kristian

    2016-01-01

    Interpersonally shared physiological dynamics are increasingly argued to underlie rapport, empathy, and even team performance. Inspired by the model of interpersonal synergy, we critically investigate the presence, temporal development, possible mechanisms and impact of shared interpersonal heart...

  14. Heart CT scan

    Science.gov (United States)

    ... stored, viewed on a monitor, or printed on film. 3D or three-dimensional models of the heart ... Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, ...

  15. Protein and Heart Health

    Science.gov (United States)

    ... It Works Healthy Workplace Food and Beverage Toolkit Protein and Heart Health Updated:May 5,2015 Protein ... said. What’s the harm in getting too much protein? The main problem is that often the extra ...

  16. Stress and your heart

    Science.gov (United States)

    ... Newly Reported Coronary Heart Disease Among US Active Duty and Reserve Forces. Circulation . 2014;129(18):1813- ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  17. Types of Heart Surgery

    Science.gov (United States)

    ... from the NHLBI on Twitter. Types of Heart Surgery Coronary Artery Bypass Grafting Coronary artery bypass grafting ( ... TAHs) might be used to treat these patients. Surgery To Place Ventricular Assist Devices or Total Artificial ...

  18. Acute heart failure syndrome

    African Journals Online (AJOL)

    tandfonline.com/ ... When heart failure develops gradually, there is time for the compensatory ... of this can be seen in acute brain injury, some forms of takotsubo syndrome or .... reduce blood pressure in cases presenting with elevated blood pressure.

  19. Heart Healthy Eating

    Science.gov (United States)

    ... of heart disease and stroke? You should limit: Saturated fats. Saturated fat is usually in pizza, ice cream, fried chicken, ... and hamburgers. Check the Nutrition Facts label for saturated fat. Less than 10% of your daily calories should ...

  20. Heart PET scan

    Science.gov (United States)

    ... nuclear medicine scan; Heart positron emission tomography; Myocardial PET scan ... A PET scan requires a small amount of radioactive material (tracer). This tracer is given through a vein (IV), ...

  1. Target Heart Rates

    Science.gov (United States)

    ... morning after you’ve had a good night’s sleep and before you get out of bed. According to the National Institute of Health, the average resting heart rate: for children 10 years and older, and adults ( ...

  2. Loss model for off-design performance analysis of radial turbines with pivoting-vane, variable-area stators

    Science.gov (United States)

    Meitner, P. L.; Glassman, A. J.

    1980-01-01

    An off-design performance loss model for a radial turbine with pivoting, variable-area stators is developed through a combination of analytical modeling and experimental data analysis. A viscous loss model is used for the variation in stator loss with setting angle, and stator vane end-clearance leakage effects are predicted by a clearance flow model. The variation of rotor loss coefficient with stator setting angle is obtained by means of an analytical matching of experimental data for a rotor that was tested with six stators, having throat areas from 20 to 144% of the design area. An incidence loss model is selected to obtain best agreement with experimental data. The stator vane end-clearance leakage model predicts increasing mass flow and decreasing efficiency as a result of end-clearances, with changes becoming significantly larger with decreasing stator area.

  3. Potential for Photovoltaic Solar Installation in Non-Irrigated Corners of Center Pivot Irrigation Fields in the State of Colorado

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, B.

    2011-07-01

    The State of Colorado expressed an interest in assessing the potential for photovoltaic (PV) solar installations on non-irrigated corners of center-pivot irrigation (CPI) fields throughout the state. Using aerial imagery and irrigated land data available from the Colorado Water Conservation Board, an assessment of potentially suitable sites was produced. Productivity estimates were calculated from that assessment. The total area of non-irrigated corners of CPI fields in Colorado was estimated to be 314,674 acres, which could yield 223,418 acres of installed PV panels assuming 71% coverage in triangular plots. The total potential annual electricity production for the state was estimated to be 56,821 gigawatt hours (GWH), with an average of 1.3 GWH per available plot.

  4. The possible pivotal role of the eastward dust transport from Central Asia in the global temperature decrease

    Institute of Scientific and Technical Information of China (English)

    LIU Mingzhe; WEI Wenshou

    2006-01-01

    It is generally considered that the occurrence of glacial-interglacial gyrations can be explained with the Milankovitch theory. However, the solutions of some problems in the theory are currently not derived yet. After researching the eastward dust transport from Central Asia, we have found that there is a positive feedback mechanism between the eastward dust transport and the global temperature decrease. This magnifies the effect of solar radiation change in the high-latitude area of the Northern Hemisphere, and results in the occurrence of the global glacial epoch. The positive feedback mechanism starts with the reduction of solar radiation in the high-latitude area of the Northern Hemisphere. Subsequently, the global temperature decreases and global glacial epoch occurs, in which the pivotal factor is the eastward dust transport from Central Asia.With the theory of the positive feedback mechanism,some problems in the Milankovitch theory can be solved well.

  5. Loss model for off-design performance analysis of radial turbines with pivoting-vane, variable-area stators

    Science.gov (United States)

    Meitner, P. L.; Glassman, A. J.

    1980-01-01

    An off-design performance loss model for a radial turbine with pivoting, variable-area stators is developed through a combination of analytical modeling and experimental data analysis. A viscous loss model is used for the variation in stator loss with setting angle, and stator vane end-clearance leakage effects are predicted by a clearance flow model. The variation of rotor loss coefficient with stator setting angle is obtained by means of an analytical matching of experimental data for a rotor that was tested with six stators, having throat areas from 20 to 144% of the design area. An incidence loss model is selected to obtain best agreement with experimental data. The stator vane end-clearance leakage model predicts increasing mass flow and decreasing efficiency as a result of end-clearances, with changes becoming significantly larger with decreasing stator area.

  6. Pathophysiology of heart failure.

    Science.gov (United States)

    Chiariello, M; Perrone-Filardi, P

    1999-01-01

    Heart failure is a leading cause of mortality and morbidity in Western countries. Common etiology is mostly represented by ischemic and hypertensive heart disease. Clinically, heart failure can be defined as an impaired cardiac performance, unable to meet the energy requirements of the periphery. Pathophysiologically, the clinical onset of heart failure symptoms already represents an advanced stage of disease when compensatory mechanisms triggered by the underlying decrease in contractility are no longer capable of maintaining adequate cardiac performance during exercise and, subsequently, under resting conditions. Independent of its underlying etiology, cardiac failure is always characterized by an impairment in the intrinsic contractility of myocytes. As a consequence of reduced contractility, a number of central and peripheral compensatory mechanisms take place that are capable of effectively counteracting reduced intravascular intrinsic performance for a long period of time. Among them, recruitment of preload reserve, enhanced neurohormonal stimulation and cardiac hypertrophy are the most important. All of them, however, also carry unfavorable effects that contribute to further deterioration of cardiac function. In fact, increased end-diastolic volume determines increased wall stress that further reduces systolic performance; sympathetic and angiotensin stimulation increases peripheral resistance and contributes to increase volume expansion; hypertrophic myocytes demonstrate impaired intrinsic contractility and relaxation, and hypertrophy causes a clinically relevant deterioration of ventricular relaxation and compliance that substantially participates in increased end-diastolic pressure, and, therefore, to limited exercise performance. Diastolic dysfunction usually accompanies systolic dysfunction, although in some cases it may represent the prevalent mechanism of congestive heart failure in patients in whom systolic performance is preserved. Biological causes

  7. Life After a Heart Attack

    Science.gov (United States)

    ... symptoms of a heart attack. It presents one woman's real-life experience with heart attack symptoms, which started during her pregnancy. The video also explains how a heart attack occurs and encourages women to seek care right away for heart attack symptoms. For more information, ...

  8. What Is a Heart Attack?

    Science.gov (United States)

    ... symptoms of a heart attack. It presents one woman's real-life experience with heart attack symptoms, which started during her pregnancy. The video also explains how a heart attack occurs and encourages women to seek care right away for heart attack symptoms. For more information, ...

  9. What Causes a Heart Attack?

    Science.gov (United States)

    ... symptoms of a heart attack. It presents one woman's real-life experience with heart attack symptoms, which started during her pregnancy. The video also explains how a heart attack occurs and encourages women to seek care right away for heart attack symptoms. For more information, ...

  10. Risks for Heart Disease & Stroke

    Science.gov (United States)

    ... for Heart Disease & Stroke Risks for Heart Disease & Stroke About 1.5 million heart attacks and strokes happen every year in the United States. You ... some of your risks for heart disease and stroke, but you can manage many of your risks ...

  11. How Is Heart Disease Diagnosed?

    Science.gov (United States)

    ... heart tests are done. If you can't exercise, you may be given medicines to increase your heart rate. When your heart is working hard and beating fast, it needs more blood and oxygen. Plaque-narrowed coronary (heart) arteries can' ...

  12. Novel therapies in heart failure

    NARCIS (Netherlands)

    Liu, Licette Cécile Yang

    2016-01-01

    Heart failure is a clinical condition that is characterized by the inability of the heart to meet the oxygen requirements of peripheral tissues and organs, despite normal filling pressures. Despite recent developments in the treatment of heart failure, the prognosis of heart failure patients remains

  13. Predicting Outcome of Heart Transplantation

    NARCIS (Netherlands)

    Tjang, Y.S.

    2008-01-01

    Heart transplantation has become the treatment of choice for patients with end-stage heart diseases. Originally, strict recipient and donor selection criteria were developed to minimize morbidity and mortality after heart transplantation. However, the increasing demand for heart transplantation has

  14. Congenital Heart Defects (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Congenital Heart Defects KidsHealth > For Parents > Congenital Heart Defects A A A What's in this article? How ... a Problem en español Anomalías cardíacas congénitas A congenital heart defect is a problem in the heart's structure that ...

  15. Novel therapies in heart failure

    NARCIS (Netherlands)

    Liu, Licette Cécile Yang

    2016-01-01

    Heart failure is a clinical condition that is characterized by the inability of the heart to meet the oxygen requirements of peripheral tissues and organs, despite normal filling pressures. Despite recent developments in the treatment of heart failure, the prognosis of heart failure patients remains

  16. What is Broken Heart Syndrome

    Science.gov (United States)

    ... having a heart attack , a more common medical emergency caused by a blocked coronary (heart) artery. The two conditions have similar symptoms, ... after exposure to the unexpected stress. Many seek emergency care, concerned they are having a heart attack. Often, patients who have broken heart syndrome ...

  17. Comprehensive characterization of a theophylline riboswitch reveals two pivotal features of Shine-Dalgarno influencing activated translation property.

    Science.gov (United States)

    Cui, Wenjing; Cheng, Jintao; Miao, Shengnan; Zhou, Li; Liu, Zhongmei; Guo, Junling; Zhou, Zhemin

    2017-03-01

    Tuneable gene expression controlled by synthetic biological elements is of great importance to biotechnology and synthetic biology. The synthetic riboswitch is a pivotal type of elements that can easily control the heterologous gene expression in diverse bacteria. In this study, the theophylline-dependent synthetic riboswitch and the corresponding variants with varied spacings between Shine-Dalgarno (SD) sequence and start codon were employed to comprehensively characterize the induction and regulation properties through combining a strong promoter aprE in Bacillus subtilis. Amongst the sets of newly constructed expression elements, the expression element with 9-bp spacing exhibited the higher expression level, a superior induction fold performance, and a considerably lower leaky expression than those with longer or shorter spacings. The riboswitch expression element with 9-bp spacing showed an approximately linear dose dependence from 0 to 8 mM of theophylline. Modification of the SD sequence through the insertion of a single A base prior to the native sequence enables the increase of the expression level post induction while decreasing the induction fold as a result of the elevated leaky level. The riboswitch elements with the engineered SD and the optimal 9-bp spacing exhibit an altered dose dependency in which the approximately linear range shifts to 0-4 mM, although it has a similar profile to the induction process. These results not only provide comprehensive data for the induced expression by a theophylline riboswitch combined with a strong native promoter from B. subtilis but also provide the two pivotal features of SD essential to the modular design of other synthetic riboswitches.

  18. Carcinoid heart disease.

    Science.gov (United States)

    Hassan, Saamir A; Banchs, Jose; Iliescu, Cezar; Dasari, Arvind; Lopez-Mattei, Juan; Yusuf, Syed Wamique

    2017-10-01

    Rare neuroendocrine tumours (NETs) that most commonly arise in the gastrointestinal tract can lead to carcinoid syndrome and carcinoid heart disease. Patients with carcinoid syndrome present with vasomotor changes, hypermotility of the gastrointestinal system, hypotension and bronchospasm. Medical therapy for carcinoid syndrome, typically with somatostatin analogues, can help control symptoms, inhibit tumour progression and prolong survival. Carcinoid heart disease occurs in more than 50% of these patients and is the initial presentation of carcinoid syndrome in up to 20% of patients. Carcinoid heart disease has characteristic findings of plaque-like deposits composed of smooth muscle cells, myofibroblasts, extracellular matrix and an overlying endothelial layer which can lead to valve dysfunction. Valvular dysfunction can lead to oedema, ascites and right-sided heart failure. Medical therapy of carcinoid heart disease is limited to symptom control and palliation. Valve surgery for carcinoid heart disease should be considered for symptomatic patients with controlled metastatic carcinoid syndrome. A multidisciplinary approach is needed to guide optimal management. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. [Heart failure and comorbidities].

    Science.gov (United States)

    Boully, Clémence; Hanon, Olivier

    2015-03-01

    Heart failure is a frequent disease in the elderly. Its clinical presentation is less typical and the prognosis more severe than in younger subjects because heart failure occurs in patients with multiple comorbidities. A comprehensive geriatric assessment should therefore be performed to detect the vulnerabilities and manage the comorbidities. The main diseases associated with heart failure are dementia, depression, malnutrition, atrial fibrillation, coronary artery disease, orthostatic hypotension, renal failure, anemia and iron deficiency. Comorbidities worsen heart failure and makes its treatment more difficult. The identification and treatment of comorbidities improve the prognosis in terms of mortality but especially in terms of quality of life. Caution with drugs is necessary because of pharmacokinetic or pharmacodynamic changes related to aging and the comorbidities. In this context, clinical and laboratory monitoring should be increased, mostly during an acute event (acute heart failure, infection, dehydration, fall, new therapy…). Therefore, the follow-up of elderly patients with heart failure requires a multidisciplinary approach that involves close cooperation between cardiologists, geriatricians, general practitioners, nurses, and pharmacists.

  20. Novel and successful free comments method for sensory characterization of chocolate ice cream: A comparative study between pivot profile and comment analysis.

    Science.gov (United States)

    Fonseca, Fernando G A; Esmerino, Erick A; Filho, Elson R Tavares; Ferraz, Juliana P; da Cruz, Adriano G; Bolini, Helena M A

    2016-05-01

    Rapid sensory profiling methods have gained space in the sensory evaluation field. Techniques using direct analysis of the terms generated by consumers are considered easy to perform, without specific training requirements, thus improving knowledge about consumer perceptions on various products. This study aimed to determine the sensory profile of different commercial samples of chocolate ice cream, labeled as conventional and light or diet, using the "comment analysis" and "pivot profile" methods, based on consumers' perceptions. In the comment analysis task, consumers responded to 2 separate open questions describing the sensory attributes they liked or disliked in each sample. In the pivot profile method, samples were served in pairs (consisting of a coded sample and pivot), and consumers indicated the higher and lower intensity attributes in the target sample compared with the pivot. We observed that both methods were able to characterize the different chocolate ice cream samples using consumer perception, with high correlation results and configurational similarity (regression vector coefficient=0.917) between them. However, it is worth emphasizing that comment analysis is performed intuitively by consumers, whereas the pivot profile method showed high analytical and discriminative power even using consumers, proving to be a promising technique for routine application when classical descriptive methods cannot be used.

  1. COMBINED HEART-KIDNEY TRANSPLANTATION

    OpenAIRE

    V. N. Poptsov

    2016-01-01

    Combined heart-kidney transplantation may be performed in carefully selected patients with end-stage heart disease and renal failure. There are two types of combined transplantation of heart and kidney: 1) simultaneous heart-kidney transplantation (SHKT) from the same donor; 2) staged transplantation of heart and kidneys from two genetically different donors. The ISHLT registry in 2014 reported an increase in the number of SHKT over the years: from 22 in 1994 to 97 in 2012. World experience d...

  2. Prevalence and importance of comorbidities in patients with heart failure.

    Science.gov (United States)

    Triposkiadis, Filippos K; Skoularigis, John

    2012-12-01

    Heart failure (HF), being a disease of the elderly, is associated with several noncardiac comorbidities, defined as chronic conditions coexisting with HF that play an integral role in its development, progression, and response to treatment. These include pulmonary dysfunction, sleep-disordered breathing, renal dysfunction, liver dysfunction, anaemia, thyroid disorders, diabetes mellitus, skeletal myopathy, depression, and cognitive impairment. The noncardiac comorbidity burden is higher and associated with higher non-HF hospitalizations in patients with HF and preserved, as compared with those with HF and reduced, left-ventricular ejection fraction. Since chronic inflammation is a characteristic feature of both HF and the coexisting morbidities, it may play a pivotal role in their development, progression, and interactions.

  3. Stress-induced cardiomyopathy (Takotsubo)--broken heart and mind?

    Science.gov (United States)

    Redfors, Björn; Shao, Yangzhen; Omerovic, Elmir

    2013-01-01

    Stress-induced cardiomyopathy (SIC), also known as Takotsubo cardiomyopathy, is characterized by severe but potentially reversible regional left ventricular wall motion abnormalities, ie, akinesia, in the absence of explanatory angiographic evidence of a coronary occlusion. The typical pattern is that of an akinetic apex with preserved contractions in the base, but other variants are also common, including basal or midmyocardial akinesia with preserved apical function. The pathophysiology of SIC remains largely unknown but catecholamines are believed to play a pivotal role. The diverse array of triggering events that have been linked to SIC are arbitrarily categorized as either emotional or somatic stressors. These categories can be considered as different elements of a continuous spectrum, linked through the interface of neurology and psychiatry. This paper reviews our current knowledge of SIC, with focus on the intimate relationship between the brain and the heart.

  4. Targeting the autonomic nervous system: measuring autonomic function and novel devices for heart failure management.

    Science.gov (United States)

    Patel, Hitesh C; Rosen, Stuart D; Lindsay, Alistair; Hayward, Carl; Lyon, Alexander R; di Mario, Carlo

    2013-12-10

    Neurohumoral activation, in which enhanced activity of the autonomic nervous system (ANS) is a key component, plays a pivotal role in heart failure. The neurohumoral system affects several organs and currently our knowledge of the molecular and systemic pathways involved in the neurohumoral activation is incomplete. All the methods of assessing the degree of activation of the autonomic system have limitations and they are not interchangeable. The methods considered include noradrenaline spillover, microneurography, radiotracer imaging and analysis of heart rate and blood pressure (heart rate variability, baroreceptor sensitivity, heart rate turbulence). Despite the difficulties, medications that affect the ANS have been shown to improve mortality in heart failure and the mechanism is related to attenuation of the sympathetic nervous system (SNS) and stimulation of the parasympathetic nervous system. However, limitations of compliance with medication, side effects and inadequate SNS attenuation are issues of concern with the pharmacological approach. The newer device based therapies for sympathetic modulation are showing encouraging results. As they directly influence the autonomic nervous system, more mechanistic information can be gleaned if appropriate investigations are performed at the time of the outcome trials. However, clinicians should be reminded that the ANS is an evolutionary survival mechanism and therefore there is a need to proceed with caution when trying to completely attenuate its effects. So our enthusiasm for the application of these devices in heart failure should be controlled, especially as none of the devices have trial data powered to assess effects on mortality or cardiovascular events. © 2013.

  5. [Mechanobiology and the Heart].

    Science.gov (United States)

    Ishiguro, Yoshiki

    2016-05-01

    Mechanobiology has been focusing on biological research regarding mechanisms of muscle force generation, or recently sensing and response to the force applied to the tissue or each cell. Therefore, the heart has been one of the target organs and studied extensively for a long time since late 19th century. Its force-length relationship was demonstrated as the Starling's law of the heart, which is one of the most important findings in mechanobiology. In late 20th century, excitation-contraction coupling in the muscle was demonstrated and then, molecular mechanisms are gradually elucidated including calcium homeostasis and signal transductions in various situations: under the effects of catecholamines, other vasoactive agents, or ischemia. Among them, recent findings suggest possible involvement of titin, the giant elastic protein connected with both actin and myosin, with basic mechanism of the Starling's law of the heart Pathological proliferation of the heart as hypertrophic remodeling has also been extensively studied in recent years, and its signal transduction from pressure overload and volume overload to respective morphological changes of the heart chamber are partially clarified.

  6. [Heart failure and anemia].

    Science.gov (United States)

    Reda, S; Motloch, L J; Hoppe, U C

    2013-09-01

    Chronic heart failure has an age-dependent prevalence of 2% and is therefore one of the most frequent diseases in western societies. A reduced hemoglobin concentration according to the definition of the World Health Organization is a common comorbidity affecting more than half of all heart failure patients. Elderly patients, patients suffering from renal impairment and women are more likely to develop anemia but a definitive etiology of anemia is only identified in the minority of cases. Anemia is associated with a poor clinical status and a greater risk of hospitalization and is a predictive factor for increased mortality. The incidence of anemia appears to increase with a poorer functional class. Intravenous iron therapy improves the exercise capacity in patients with systolic heart failure and iron deficiency and is currently being recommended for patients with persistent symptoms despite optimal medical and device therapy. However, erythropoietin-stimulating agents as a treatment for anemia in chronic heart failure have failed to improve clinical outcome in a large randomized trial. In patients with heart failure but with maintained ejection fraction, anemia is also associated with a poor prognosis. Specific therapeutic recommendations for these patients are still not available.

  7. The application of the instantaneous states reduction to the orbital monitoring of pivotal arcs of the Chang’E-1 satellite

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    In the Chinese lunar exploration project,the Chang’E-1 (CE-1) satellite was jointly monitored by the United S-band range and Doppler and the VLBI technique. A real-time reduction of the tracking data is realized to deduce the time series of the instantaneous state vectors (ISV) (position and velocity vec-tors) of the CE-1 satellite,and is applied to the orbital monitoring of pivotal arcs. This paper introduces this real-time data reduction method and its application to the orbital monitoring of pivotal arcs of the CE-1 satellite in order to serve as a source of criticism and reference.

  8. 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

    2017-02-22

    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.

  9. Race By Hearts

    DEFF Research Database (Denmark)

    Sonne, Tobias; Jensen, Mads Møller

    2014-01-01

    In this paper, we explore the qualities of sharing biometric data in re- al-time between athletes, in order to increase two motivational factors for gym- goers: Enjoyment and social interaction. We present a novel smartphone appli- cation, called Race By Hearts, which enables competition based...... on heart rate data sharing between users in real-time. Through an empirical study conducted in the gym, we show that sharing biometric data in real-time can strengthen so- cial relations between participants, increase motivation, and improve the en- joyment of the fitness activity. Nevertheless, we found...

  10. Protect Your Heart in the Heat

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  11. When a Heart Murmur Signals Valve Disease

    Science.gov (United States)

    ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  12. 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.

  13. Heart Truth for Women: If You Have Heart Disease

    Science.gov (United States)

    ... of physical activity • Unhealthy diet • Diabetes and prediabetes • Metabolic syndrome Other conditions and factors also may contribute to ... The Heart Truth is a way of informing women about what they can do to prevent heart ...

  14. Towards defining heart failure in adults with congenital heart disease.

    Science.gov (United States)

    Bolger, Aidan P; Gatzoulis, Michael A

    2004-12-01

    Injury to the myocardium disrupts geometric integrity and results in changes to intracardiac pressure, wall stress and tension, and the pattern of blood flow through the heart. Significant disruption to pump function results in heart failure which is defined in terms of symptoms: breathlessness and fatigue, signs of salt and water retention, and neurohormonal activation. This syndrome most commonly occurs in the context of injury due to ischaemic heart disease and dilated cardiomyopathy but because patients with congenital heart disease (CHD) are born with sometimes gross distortions of cardiac anatomy they too are subject to the forces that drive heart failure. This paper explores the available data relating to the clinical and neurohormonal manifestations of heart failure in patients with congenital heart disease and describes how, by additionally exploring events at a cellular level, we may be able to arrive at a definition of heart failure relevant to this population.

  15. Transmissible endoplasmic reticulum stress from myocardiocytes to macrophages is pivotal for the pathogenesis of CVB3-induced viral myocarditis

    Science.gov (United States)

    Zhang, Hui; Yue, Yan; Sun, Tianle; Wu, Xuejie; Xiong, Sidong

    2017-01-01

    Infiltrating macrophages have been proven as a pivotal pathological inflammatory cell subset in coxsackievirus B3 (CVB3) induced viral myocarditis. However, the mechanisms underlying the initiation and promotion of macrophage pro-inflammatory responses are still blur. We previously reported that cardiac ER stress contributed to CVB3-induced myocarditis by augmenting inflammation. In this study, we focused on the influence of ER stress on the macrophage inflammatory responses in the viral myocarditis. We found that ER stress was robustly induced in the cardiac infiltrating macrophages from CVB3-infected mice, and robustly facilitated the production of pro-inflammatory cytokines (IL-6, IL-12, MCP-1 and IP-10). Consistently, adoptive transfer of ER stressed macrophages significantly worsened the viral myocarditis; while transfer of ER stress-inhibited macrophages obviously alleviated the myocarditis. To our surprise, this significantly activated ER stress was not directly caused by the virus stimulation, but was transferred from the CVB3-infected, ER stressed myocardiocytes via soluble molecules in a TLR2, 4-independent way. In the present study, we reported that the transmissible ER stress from the infected myocardiocytes to macrophages could augment the pro-inflammatory responses and promoted the pathogenesis of viral myocarditis. Blocking ER stress transmission, instead of inhibiting its initiation, may represent novel therapeutic strategies against viral myocarditis. PMID:28176833

  16. ATF4 plays a pivotal role in the development of functional hematopoietic stem cells in mouse fetal liver.

    Science.gov (United States)

    Zhao, Yunze; Zhou, Jie; Liu, Dan; Dong, Fang; Cheng, Hui; Wang, Weili; Pang, Yakun; Wang, Yajie; Mu, Xiaohuan; Ni, Yanli; Li, Zhuan; Xu, Huiyu; Hao, Sha; Wang, Xiaochen; Ma, Shihui; Wang, Qian-fei; Xiao, Guozhi; Yuan, Weiping; Liu, Bing; Cheng, Tao

    2015-11-19

    The fetal liver (FL) serves as a predominant site for expansion of functional hematopoietic stem cells (HSCs) during mouse embryogenesis. However, the mechanisms for HSC development in FL remain poorly understood. In this study, we demonstrate that deletion of activating transcription factor 4 (ATF4) significantly impaired hematopoietic development and reduced HSC self-renewal in FL. In contrast, generation of the first HSC population in the aorta-gonad-mesonephros region was not affected. The migration activity of ATF4(-/-) HSCs was moderately reduced. Interestingly, the HSC-supporting ability of both endothelial and stromal cells in FL was significantly compromised in the absence of ATF4. Gene profiling using RNA-seq revealed downregulated expression of a panel of cytokines in ATF4(-/-) stromal cells, including angiopoietin-like protein 3 (Angptl3) and vascular endothelial growth factor A (VEGFA). Addition of Angptl3, but not VEGFA, partially rescued the repopulating defect of ATF4(-/-) HSCs in the culture. Furthermore, chromatin immunoprecipitation assay in conjunction with silencing RNA-mediated silencing and complementary DNA overexpression showed transcriptional control of Angptl3 by ATF4. To summarize, ATF4 plays a pivotal role in functional expansion and repopulating efficiency of HSCs in developing FL, and it acts through upregulating transcription of cytokines such as Angptl3 in the microenvironment.

  17. Simultaneous Five-axis Motion for Identifying Geometric Deviations Through Simulation in Machining Centers with a Double Pivot Head

    Science.gov (United States)

    Dassanayake, Muditha; Yamamoto, Ken; Tsutsumi, Masaomi; Saito, Akinori; Mikami, Shigetaka

    In this paper, simultaneous five-axis control motions were newly proposed to identify the ten inherent deviations to double pivot head type five-axis machines. This motion was designed for the application of a ball bar to the measurements. The ball bar can be applied to the motion by changing the ball bar's sensitive direction in the axial, radial and tangential directions in relation to the A-axis rotation. All the three ball bar settings can be changed in a single arrangement, with a magnetic clamp fixed onto the main spindle. This leads to reduce the setting errors and setting time as well. The ten deviations are identified by using three measurements, two of which are taken in the axial direction motion while the third is extracted using the tangential or radial direction motion. From the axial direction motion, seven deviations are estimated; four of these estimations are made using the observation equation while the other three are made using simple geometric relations. The remaining three of the ten deviations are determined by using tangential or radial motion. The validity of the proposed method is confirmed by simulations.

  18. Ultrasensitive colorimetric detection of circulating tumor DNA using hybridization chain reaction and the pivot of triplex DNA

    Science.gov (United States)

    Li, Ruimin; Zou, Li; Luo, Yanwei; Zhang, Manjun; Ling, Liansheng

    2017-03-01

    This work presents an amplified colorimetric biosensor for circulating tumor DNA (ctDNA), which associates the hybridization chain reaction (HCR) amplification with G-Quadruplex DNAzymes activity through triplex DNA formation. In the presence of ctDNA, HCR occurs. The resulting HCR products are specially recognized by one sequence to include one GGG repeat and the other containing three GGG repeats, through the synergetic effect of triplex DNA and asymmetrically split G-Quadruplex forming. Such design takes advantage of the amplification property of HCR and the high peroxidase-like catalytic activity of asymmetrically split G-Quadruplex DNAzymes by means of triplex DNA formation, which produces color signals in the presence of ctDNA. Nevertheless, in the absence of ctDNA, no HCR happens. Thus, no triplex DNA and G-Quadruplex structure is formed, producing a negligible background. The colorimetric sensing platform is successfully applied in complex biological environments such as human blood plasma for ctDNA detection, with a detection limit corresponding to 0.1 pM. This study unambiguously uses triplex DNA forming as the pivot to integrate nucleic acid amplification and DNAzymes for producing a highly sensitive signal with low background.

  19. A new type of microglia gene targeting shows TAK1 to be pivotal in CNS autoimmune inflammation.

    Science.gov (United States)

    Goldmann, Tobias; Wieghofer, Peter; Müller, Philippe F; Wolf, Yochai; Varol, Diana; Yona, Simon; Brendecke, Stefanie M; Kierdorf, Katrin; Staszewski, Ori; Datta, Moumita; Luedde, Tom; Heikenwalder, Mathias; Jung, Steffen; Prinz, Marco

    2013-11-01

    Microglia are brain macrophages and, as such, key immune-competent cells that can respond to environmental changes. Understanding the mechanisms of microglia-specific responses during pathologies is hence vital for reducing disease burden. The definition of microglial functions has so far been hampered by the lack of genetic in vivo approaches that allow discrimination of microglia from closely related peripheral macrophage populations in the body. Here we introduce a mouse experimental system that specifically targets microglia to examine the role of a mitogen-associated protein kinase kinase kinase (MAP3K), transforming growth factor (TGF)-β-activated kinase 1 (TAK1), during autoimmune inflammation. Conditional depletion of TAK1 in microglia only, not in neuroectodermal cells, suppressed disease, significantly reduced CNS inflammation and diminished axonal and myelin damage by cell-autonomous inhibition of the NF-κB, JNK and ERK1/2 pathways. Thus, we found TAK1 to be pivotal in CNS autoimmunity, and we present a tool for future investigations of microglial function in the CNS.

  20. Infection by Toxoplasma gondii Specifically Induces Host c-Myc and the Genes This Pivotal Transcription Factor Regulates

    Science.gov (United States)

    Franco, Magdalena; Shastri, Anjali J.

    2014-01-01

    Toxoplasma gondii infection has previously been described to cause dramatic changes in the host transcriptome by manipulating key regulators, including STATs, NF-κB, and microRNAs. Here, we report that Toxoplasma tachyzoites also mediate rapid and sustained induction of another pivotal regulator of host cell transcription, c-Myc. This induction is seen in cells infected with all three canonical types of Toxoplasma but not the closely related apicomplexan parasite Neospora caninum. Coinfection of cells with both Toxoplasma and Neospora still results in an increase in the level of host c-Myc, showing that c-Myc is actively upregulated by Toxoplasma infection (rather than repressed by Neospora). We further demonstrate that this upregulation may be mediated through c-Jun N-terminal protein kinase (JNK) and is unlikely to be a nonspecific host response, as heat-killed Toxoplasma parasites do not induce this increase and neither do nonviable parasites inside the host cell. Finally, we show that the induced c-Myc is active and that transcripts dependent on its function are upregulated, as predicted. Hence, c-Myc represents an additional way in which Toxoplasma tachyzoites have evolved to specifically alter host cell functions during intracellular growth. PMID:24532536

  1. Heart Health: Learn the Truth About Your Heart

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Learn the Truth About Your Heart Past Issues / Winter 2009 Table of Contents For ... turn Javascript on. Photo: iStock February is American Heart Month. Now is the time to make sure ...

  2. The Effect of Pivotal Response Treatment in Children with Autism Spectrum Disorders: A Non-Randomized Study with a Blinded Outcome Measure

    Science.gov (United States)

    Duifhuis, E. A.; den Boer, J. C.; Doornbos, A.; Buitelaar, J. K.; Oosterling, I. J.; Klip, H.

    2017-01-01

    Purpose of this quasi-experimental trial was to investigate the effect of Pivotal response treatment (PRT) versus treatment as usual (TAU) on autism symptoms. Children with autism spectrum disorder (ASD), aged 3-8 years, received either PRT (n = 11) or TAU (n = 13). Primary outcome measure was the total score on the Autism Diagnostic Observation…

  3. Increasing Opportunities for Question-Asking in School-Aged Children with Autism Spectrum Disorder: Effectiveness of Staff Training in Pivotal Response Treatment

    Science.gov (United States)

    Verschuur, Rianne; Huskens, Bibi; Verhoeven, Ludo; Didden, Robert

    2017-01-01

    Deficits in question-asking are common in children with autism spectrum disorder (ASD). Furthermore, their opportunities to self-initiate questions are often hindered by directive behavior of their conversation partners. This study assessed the effectiveness of staff training in pivotal response treatment (PRT) on staff member-created…

  4. A Randomized Clinical Trial Comparison between Pivotal Response Treatment (PRT) and Adult-Driven Applied Behavior Analysis (ABA) Intervention on Disruptive Behaviors in Public School Children with Autism

    Science.gov (United States)

    Mohammadzaheri, Fereshteh; Koegel, Lynn Kern; Rezaei, Mohammad; Bakhshi, Enayatolah

    2015-01-01

    Children with autism often demonstrate disruptive behaviors during demanding teaching tasks. Language intervention can be particularly difficult as it involves social and communicative areas, which are challenging for this population. The purpose of this study was to compare two intervention conditions, a naturalistic approach, Pivotal Response…

  5. Sweet & Simple Clay Hearts

    Science.gov (United States)

    White, Heather

    2010-01-01

    Nothing pleases parents more than receiving handmade gifts from their children, especially if the gift is in the shape of a heart. Nothing pleases an art teacher more than having a lesson that is easy to follow, teaches basic skills, and enables students to be successful with the activity. In this article, the author describes how to create a…

  6. Copeptin in Heart Failure

    DEFF Research Database (Denmark)

    Balling, Louise; Gustafsson, Finn

    2016-01-01

    Heart failure (HF) is one of the most common causes of hospitalization and mortality in the modern Western world and an increasing proportion of the population will be affected by HF in the future. Although HF management has improved quality of life and prognosis, mortality remains very high...

  7. Diabetic Heart Disease

    Science.gov (United States)

    ... develop DHD. The higher a person's blood sugar level is, the higher his or her risk of DHD. Diabetes affects heart disease risk in three major ways. ... is that many lifestyle changes help control multiple risk factors. For example, ... treatment plan for diabetes and see your doctor for ongoing care. If ...

  8. Hypertensive Heart Disease

    DEFF Research Database (Denmark)

    Wachtell, Kristian

    2011-01-01

    Abstract Hypertensive heart disease is prevalent and during the last decade it has been determined that patients with left ventricular (LV) hypertrophy have increased cardiovascular morbidity and mortality. However, many have doubted the effectiveness of LV mass assessment because it is difficult...

  9. Congenital Heart Information Network

    Science.gov (United States)

    ... and Uwe Baemayr for The Congenital Heart Information Network Exempt organization under Section 501(c)3. Copyright ©1996 - 2016 C.H.I.N. All rights reserved TX4-390-685 Original site design and HTML by Panoptic Communications

  10. Heart Disease and Stroke

    Centers for Disease Control (CDC) Podcasts

    2013-09-03

    In this podcast, Dr. Tom Frieden, CDC Director, discusses the number one killer in the United States - heart disease and stroke.  Created: 9/3/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/6/2014.

  11. Congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970296 Evaluating the degree of pulmonary vascularlesions in congenital heart disease with selective pul-monary angiography. PAN Shiwei(潘世伟), et al.Fuwai Hosp, CAMS & PUMC, Beijing, 100037. Chin JCardiol 1997; 25(1): 39-41. Objective: To evaluate the degree of pulmonary vas-

  12. [Echinococcosis of the heart].

    Science.gov (United States)

    Rein, R; Niggemann, B; Runge, M

    1996-06-01

    Human disease caused by echinococcus granulosus is rare in Northern Europe, but is seen increasingly due to migration of labour and of tourism to endemic areas e. g. Southern Europe and the Middle East. Echinococcosis of the heart occurs in only 0.5 to 2% of cases of echinococcosis. Diagnosis is difficult because of the long latency between infection and manifestation of disease, and also because symptoms are unspecific. It is a diagnosis "to think of". Apart from a thorough history serological tests and medical imaging (ultrasound, X-rays, computed tomography) are used in the diagnosis of echinococcosis. Surgery is the preferred therapy, if not feasible medical treatment with benzimidazoles (Albendazole and Mebendazole) is effective. We describe a case of echinococcosis of the heart as the only manifestation of the disease: a 34-year-old male Turkish patient came in severe cardiac shock due to cardiac tamponade to the emergency department. Immediate heart surgery revealed a pericardium filled with cysts of echinococcus granulosus, infiltrating the left ventricle of the heart (Figure 1). The cysts were removed and the patient was put on a 2-year course of Mebendazole. The patient is free of relapse for more than 6 years now and he is considered to be cured.

  13. Feedback on heart attack.

    Science.gov (United States)

    Pearce, Lynne

    2016-04-13

    The Royal Brompton & Harefield NHS Foundation Trust in London is the largest heart and lung centre in the UK. This article explores a project carried out by nurses at the trust looking at the experiences of having an acute myocardial infarction, and how patients felt about taking part in a research study.

  14. The Danish heart register

    DEFF Research Database (Denmark)

    Abildstrøm, Steen Z; Madsen, Mette

    2011-01-01

    Introduction: The Danish Heart Register (DHR) is a clinical database of invasive procedures within cardiology. Content: All providers of these procedures have been obliged to report to DHR since 2000. DHR is used to monitor the activity and quality of the procedures and serves as a data source...

  15. Educating the Heart

    Science.gov (United States)

    Schwartz, Sherry

    2007-01-01

    Japan's elementary and junior high schools have a formal, nationally mandated moral curriculum called Kokoro-no-kyoiku--education of the heart. Japanese educators include moral growth as an integral part of one's intellectual growth and believe that democratic societies must promote virtuous decision making. Moral education in Japan nurtures the…

  16. Unlock Their Lonely Hearts.

    Science.gov (United States)

    Fu, Danling

    1998-01-01

    Argues that, for new immigrant children, literacy education that challenges students to speak and engage in meaningful work (not worksheets and handwriting practice) is the key to initiating them into American culture, to helping them feel this country is their home, and to unlocking their lonely hearts. Focuses on the special problems of Chinese…

  17. Types of Heart Block

    Science.gov (United States)

    ... P wave as it normally would. If an electrical signal is blocked before it reaches the ventricles, they won't contract and pump blood to the lungs and the rest of the body. Second-degree heart block is divided into two ...

  18. Stress and Heart Health

    Science.gov (United States)

    ... also zap your energy, wreak havoc on your sleep and make you feel cranky, forgetful and out of control. A stressful situation sets off a chain of events. Your body releases adrenaline, a hormone that temporarily causes your breathing and heart rate to speed up and your blood pressure to ...

  19. Exercise and Your Heart.

    Science.gov (United States)

    National Heart and Lung Inst. (DHHS/NIH), Bethesda, MD.

    This pamphlet presents information on the effects of physical activity on the heart and practical guidelines for starting and staying on an exercise program. The following topics are discussed: (1) the benefits of getting sufficient exercise; (2) possible risks in exercising compared to benefits; (3) when to seek doctor's advice and prevention of…

  20. Mental Health and Heart Health

    Science.gov (United States)

    ... Recognition & Awards Healthy Workplace Food and Beverage Toolkit Mental Health and Heart Health Updated:Nov 10,2015 For years, doctors thought the connection between mental health and heart health was strictly behavioral – such as ...

  1. What Is a Heart Murmur?

    Science.gov (United States)

    ... Holes in the Heart How the Heart Works Patent Ductus Arteriosus Stress Testing Tetralogy of Fallot Rate This Content: Updated: December 9, 2016 Twitter Facebook YouTube Google+ SITE INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA OIG CONTACT ...

  2. Hispanics and Heart Disease, Stroke

    Science.gov (United States)

    ... Thromboembolism Aortic Aneurysm More Hispanics and Heart Disease, Stroke Updated:Aug 30,2016 Heart disease is the No. 1 killer for all Americans and stroke is the fifth leading cause of death. Hispanics ...

  3. Diabetes, Heart Disease, and Stroke

    Science.gov (United States)

    ... Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Diabetes, Heart Disease, and Stroke Having diabetes means that ... help to stop. What is the link between diabetes, heart disease, and stroke? Over time, high blood ...

  4. How Is Heart Failure Diagnosed?

    Science.gov (United States)

    ... your heart pumps blood when it beats. Doppler Ultrasound A Doppler ultrasound uses sound waves to measure ... when your heart is working hard and beating fast. During stress testing , you exercise to make your ...

  5. Dental Health and Heart Health

    Science.gov (United States)

    ... Check Meal Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering the Menu Ordering Your Meal Eating Fast ...

  6. FastStats: Heart Disease

    Science.gov (United States)

    ... this? Submit What's this? Submit Button NCHS Home Heart Disease Recommend on Facebook Tweet Share Compartir Data are ... the U.S. Morbidity Number of adults with diagnosed heart disease: 28.4 million Percent of adults with diagnosed ...

  7. Adults with Congenital Heart Defects

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Web Booklet: Adults With Congenital Heart Defects Updated:Aug 29,2017 ... the list below to learn more. Web Booklet: Adults With Congenital Heart Defects Introduction Introduction: Adults with ...

  8. Heart Disease: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 Table of Contents ... to view a larger version of the image Symptoms It is very important to learn the signs ...

  9. Hypoplastic left heart syndrome

    Directory of Open Access Journals (Sweden)

    Thiagarajan Ravi

    2007-05-01

    Full Text Available Abstract Hypoplastic left heart syndrome(HLHS refers to the abnormal development of the left-sided cardiac structures, resulting in obstruction to blood flow from the left ventricular outflow tract. In addition, the syndrome includes underdevelopment of the left ventricle, aorta, and aortic arch, as well as mitral atresia or stenosis. HLHS has been reported to occur in approximately 0.016 to 0.036% of all live births. Newborn infants with the condition generally are born at full term and initially appear healthy. As the arterial duct closes, the systemic perfusion becomes decreased, resulting in hypoxemia, acidosis, and shock. Usually, no heart murmur, or a non-specific heart murmur, may be detected. The second heart sound is loud and single because of aortic atresia. Often the liver is enlarged secondary to congestive heart failure. The embryologic cause of the disease, as in the case of most congenital cardiac defects, is not fully known. The most useful diagnostic modality is the echocardiogram. The syndrome can be diagnosed by fetal echocardiography between 18 and 22 weeks of gestation. Differential diagnosis includes other left-sided obstructive lesions where the systemic circulation is dependent on ductal flow (critical aortic stenosis, coarctation of the aorta, interrupted aortic arch. Children with the syndrome require surgery as neonates, as they have duct-dependent systemic circulation. Currently, there are two major modalities, primary cardiac transplantation or a series of staged functionally univentricular palliations. The treatment chosen is dependent on the preference of the institution, its experience, and also preference. Although survival following initial surgical intervention has improved significantly over the last 20 years, significant mortality and morbidity are present for both surgical strategies. As a result pediatric cardiologists continue to be challenged by discussions with families regarding initial decision

  10. Modelling heart rate kinetics.

    Science.gov (United States)

    Zakynthinaki, Maria S

    2015-01-01

    The objective of the present study was to formulate a simple and at the same time effective mathematical model of heart rate kinetics in response to movement (exercise). Based on an existing model, a system of two coupled differential equations which give the rate of change of heart rate and the rate of change of exercise intensity is used. The modifications introduced to the existing model are justified and discussed in detail, while models of blood lactate accumulation in respect to time and exercise intensity are also presented. The main modification is that the proposed model has now only one parameter which reflects the overall cardiovascular condition of the individual. The time elapsed after the beginning of the exercise, the intensity of the exercise, as well as blood lactate are also taken into account. Application of the model provides information regarding the individual's cardiovascular condition and is able to detect possible changes in it, across the data recording periods. To demonstrate examples of successful numerical fit of the model, constant intensity experimental heart rate data sets of two individuals have been selected and numerical optimization was implemented. In addition, numerical simulations provided predictions for various exercise intensities and various cardiovascular condition levels. The proposed model can serve as a powerful tool for a complete means of heart rate analysis, not only in exercise physiology (for efficiently designing training sessions for healthy subjects) but also in the areas of cardiovascular health and rehabilitation (including application in population groups for which direct heart rate recordings at intense exercises are not possible or not allowed, such as elderly or pregnant women).

  11. Modelling heart rate kinetics.

    Directory of Open Access Journals (Sweden)

    Maria S Zakynthinaki

    Full Text Available The objective of the present study was to formulate a simple and at the same time effective mathematical model of heart rate kinetics in response to movement (exercise. Based on an existing model, a system of two coupled differential equations which give the rate of change of heart rate and the rate of change of exercise intensity is used. The modifications introduced to the existing model are justified and discussed in detail, while models of blood lactate accumulation in respect to time and exercise intensity are also presented. The main modification is that the proposed model has now only one parameter which reflects the overall cardiovascular condition of the individual. The time elapsed after the beginning of the exercise, the intensity of the exercise, as well as blood lactate are also taken into account. Application of the model provides information regarding the individual's cardiovascular condition and is able to detect possible changes in it, across the data recording periods. To demonstrate examples of successful numerical fit of the model, constant intensity experimental heart rate data sets of two individuals have been selected and numerical optimization was implemented. In addition, numerical simulations provided predictions for various exercise intensities and various cardiovascular condition levels. The proposed model can serve as a powerful tool for a complete means of heart rate analysis, not only in exercise physiology (for efficiently designing training sessions for healthy subjects but also in the areas of cardiovascular health and rehabilitation (including application in population groups for which direct heart rate recordings at intense exercises are not possible or not allowed, such as elderly or pregnant women.

  12. Modelling Heart Rate Kinetics

    Science.gov (United States)

    Zakynthinaki, Maria S.

    2015-01-01

    The objective of the present study was to formulate a simple and at the same time effective mathematical model of heart rate kinetics in response to movement (exercise). Based on an existing model, a system of two coupled differential equations which give the rate of change of heart rate and the rate of change of exercise intensity is used. The modifications introduced to the existing model are justified and discussed in detail, while models of blood lactate accumulation in respect to time and exercise intensity are also presented. The main modification is that the proposed model has now only one parameter which reflects the overall cardiovascular condition of the individual. The time elapsed after the beginning of the exercise, the intensity of the exercise, as well as blood lactate are also taken into account. Application of the model provides information regarding the individual’s cardiovascular condition and is able to detect possible changes in it, across the data recording periods. To demonstrate examples of successful numerical fit of the model, constant intensity experimental heart rate data sets of two individuals have been selected and numerical optimization was implemented. In addition, numerical simulations provided predictions for various exercise intensities and various cardiovascular condition levels. The proposed model can serve as a powerful tool for a complete means of heart rate analysis, not only in exercise physiology (for efficiently designing training sessions for healthy subjects) but also in the areas of cardiovascular health and rehabilitation (including application in population groups for which direct heart rate recordings at intense exercises are not possible or not allowed, such as elderly or pregnant women). PMID:25876164

  13. Give your heart a workout

    Science.gov (United States)

    ... to your health care provider before starting an exercise program. The Benefits of Exercise Exercise helps your heart in several ways. Burns ... is the best type for your heart. Aerobic exercise is any activity that uses ... faster. To benefit your heart, experts recommend getting at least 30 ...

  14. Heart murmurs and other sounds

    Science.gov (United States)

    ... ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College ... team. Related MedlinePlus Health Topics Congenital Heart Defects Heart Valve Diseases Browse the Encyclopedia A.D.A.M., Inc. ...

  15. Chelation for Coronary Heart Disease

    Science.gov (United States)

    ... V W X Y Z Chelation for Coronary Heart Disease Share: © AHA Coronary heart disease is a leading cause of death among both ... health approach . The use of disodium EDTA for heart disease has not been approved by the U.S. Food ...

  16. What Is Coronary Heart Disease?

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Is Coronary Heart Disease? Español Coronary heart disease (CHD) is a disease in which a waxy ... medical procedures can help prevent or treat coronary heart disease. These treatments may reduce the risk of related ...

  17. Ejection Fraction Heart Failure Measurement

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Ejection Fraction Heart Failure Measurement Updated:Feb 15,2017 The ejection fraction ( ... failure This content was last reviewed April 2015. Heart Failure • Home • About Heart Failure • Causes and Risks for ...

  18. Aging, telomeres and heart failure

    NARCIS (Netherlands)

    Wong, Liza S. M.; van der Harst, Pim; de Boer, Rudolf A.; Huzen, Jardi; van Gilst, Wiek H.; van Veldhuisen, Dirk J.

    2010-01-01

    During normal aging, the heart undergoes functional, morphological and cellular changes. Although aging per se does not lead to the expression of heart failure, it is likely that age-associated changes lower the threshold for the manifestation of signs and symptoms of heart failure. In patients, the

  19. Heart failure - fluids and diuretics

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000112.htm Heart failure - fluids and diuretics To use the sharing features on ... at Home When you have heart failure, your heart does not pump out enough blood. This causes fluids to build up in your body. If you ...

  20. What Is a Total Artificial Heart?

    Science.gov (United States)

    ... the NHLBI on Twitter. What Is a Total Artificial Heart? A total artificial heart (TAH) is a device ... outside power source. Normal Heart and CardioWest Total Artificial Heart Figure A shows the normal structure and location ...

  1. Heart Surgery: MedlinePlus Health Topic

    Science.gov (United States)

    ... Is a Pediatric Heart Surgeon? (American Academy of Pediatrics) Also in Spanish Patient Handouts Aortic valve surgery - open (Medical Encyclopedia) ... Spanish Open heart surgery (Medical Encyclopedia) Also in Spanish ... heart surgery Pediatric heart surgery - discharge Sternal exploration or closure Related ...

  2. Heart Failure in Children and Adolescents

    Science.gov (United States)

    ... the heart to beat too slow or too fast. Sometimes one of the heart valves does not open properly causing pressure to back up inside the heart chambers. Rarely, severe chest trauma may damage the heart. Children with muscular dystrophy ...

  3. What Is a Pediatric Heart Surgeon?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Heart Surgeon? Page Content Article Body If your ... require heart surgery. What Kind of Training Do Pediatric Heart Surgeons Have? Pediatric heart surgeons are medical ...

  4. Heart Disease Affects Women of All Ages

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Heart Disease Affects Women of All Ages Past Issues / Winter ... weeks of a heart attack. For Women with Heart Disease: About 6 million American women have coronary heart ...

  5. Association of heart rate variability and inflammatory response in patients with cardiovascular diseases: current strengths and limitations.

    Science.gov (United States)

    Papaioannou, Vasilios; Pneumatikos, Ioannis; Maglaveras, Nikos

    2013-01-01

    Many experimental and clinical studies have confirmed a continuous cross-talk between both sympathetic and parasympathetic branches of autonomic nervous system and inflammatory response, in different clinical scenarios. In cardiovascular diseases, inflammation has been proven to play a pivotal role in disease progression, pathogenesis and resolution. A few clinical studies have assessed the possible inter-relation between neuro-autonomic output, estimated with heart rate variability analysis, which is the variability of R-R in the electrocardiogram, and different inflammatory biomarkers, in patients suffering from stable or unstable coronary artery disease (CAD) and heart failure. Moreover, different indices derived from heart rate signals' processing, have been proven to correlate strongly with severity of heart disease and predict final outcome. In this review article we will summarize major findings from different investigators, evaluating neuro-immunological interactions through heart rate variability analysis, in different groups of cardiovascular patients. We suggest that markers originating from variability analysis of heart rate signals seem to be related to inflammatory biomarkers. However, a lot of open questions remain to be addressed, regarding the existence of a true association between heart rate variability and autonomic nervous system output or its adoption for risk stratification and therapeutic monitoring at the bedside. Finally, potential therapeutic implications will be discussed, leading to autonomic balance restoration in relation with inflammatory control.

  6. Saffron (Crocus sativus) pretreatment confers cardioprotection against ischemia-reperfusion injuries in isolated rabbit heart.

    Science.gov (United States)

    Nader, Moni; Chahine, Nathalie; Salem, Charelle; Chahine, Ramez

    2016-12-01

    Restoration of blood flow to the ischemic myocardium is imperative to avoid demise of cardiomyocytes, but is paradoxically associated with irreversible damage to cardiac tissues due to the excessive generation of reactive oxygen species (ROS). We have previously reported that saffron, a natural antioxidant, attenuated ischemia-reperfusion (IR) injuries in vitro; however, its role in a meaningful cardiac recovery remains unknown. Here, we show that saffron supplement (oral administration for 6 weeks) reduced myocardial damage and restored cardiac function in an IR model of rabbit hearts. This was evidenced by improved left ventricle pressure, heart rate and coronary flow, and left ventricle end diastolic pressure (LVEDP) in IR hearts (isolated from rabbits pre-exposed to saffron (S/IR)). Electrophysiological recordings revealed a significant decline in both premature ventricle contraction and ventricle tachycardia/fibrillation in S/IR compared to IR hearts. This was paralleled by increased expression of the contractile proteins α-actinin and Troponin C in the myocardium of S/IR hearts. Histological examination combined to biochemical analysis indicated that hearts pre-exposed to saffron exhibited reduced infarct size, lower lipid peroxidation, with increased glutathione peroxidase activity, and oxidation of nitro blue tetrazolium (by reactive oxygen species). Furthermore, in contrast with IR hearts, saffron pretreatment induced restoration of the phosphorylation level of the survival proteins Akt and 4EBP1 and reduced activity of p38. Collectively, our data demonstrate that the natural antioxidant saffron plays a pivotal role in halting IR-associated cardiac injuries and emerges as a novel preventive tool for ischemic heart disease.

  7. Heart rate reduction in coronary artery disease and heart failure.

    Science.gov (United States)

    Ferrari, Roberto; Fox, Kim

    2016-08-01

    Elevated heart rate is known to induce myocardial ischaemia in patients with coronary artery disease (CAD), and heart rate reduction is a recognized strategy to prevent ischaemic episodes. In addition, clinical evidence shows that slowing the heart rate reduces the symptoms of angina by improving microcirculation and coronary flow. Elevated heart rate is an established risk factor for cardiovascular events in patients with CAD and in those with chronic heart failure (HF). Accordingly, reducing heart rate improves prognosis in patients with HF, as demonstrated in SHIFT. By contrast, data from SIGNIFY indicate that heart rate is not a modifiable risk factor in patients with CAD who do not also have HF. Heart rate is also an important determinant of cardiac arrhythmias; low heart rate can be associated with atrial fibrillation, and high heart rate after exercise can be associated with sudden cardiac death. In this Review, we critically assess these clinical findings, and propose hypotheses for the variable effect of heart rate reduction in cardiovascular disease.

  8. Cancer Therapy Targeting the HER2-PI3K Pathway: Potential Impact on the Heart

    Directory of Open Access Journals (Sweden)

    Giannoula Lakka Klement

    2012-06-01

    Full Text Available The HER2-PI3K pathway is the one of the most mutated pathways in cancer. Several drugs targeting the major kinases of this pathway have been approved by the Food and Drug Administration and many are being tested in clinical trials for the treatment of various cancers. However, the HER2-PI3K pathway is also pivotal for maintaining the physiological function of the heart, especially in the presence of cardiac stress. Clinical studies have shown that in patients treated with doxorubicin concurrently with Trastuzumab, a monoclonal antibody that blocks the HER2 receptor, the New York Heart Association class III/IV heart failure was significantly increased compared to those who were treated with doxorubicin alone (16 vs. 3%. Studies in transgenic mice have also shown that other key kinases of this pathway, such as PI3Kα, PDK1, Akt and mTOR, are important for protecting the heart from ischemia-reperfusion and aortic stenosis induced cardiac dysfunction. Studies, however, have also shown that inhibition of PI3Kγ improve cardiac function of a failing heart. In addition, results from transgenic mouse models are not always consistent with the outcome of the pharmacological inhibition of this pathway. Here, we will review these findings and discuss how we can address the cardiac side-effects caused by inhibition of this important pathway in both cancer and cardiac biology.

  9. Aldosterone receptor antagonists--how cardiovascular actions may explain their beneficial effects in heart failure.

    Science.gov (United States)

    Ovaert, P; Elliott, J; Bernay, F; Guillot, E; Bardon, T

    2010-04-01

    Historically, aldosterone receptor antagonists (ARA) have been classified as 'potassium sparing diuretics'. However, the positive effect of spironolactone, the most extensively studied ARA, on morbidity and mortality observed in humans suffering cardiac insufficiency could not be explained by the renal effect of the drug alone, and a pivotal clinical study has led to extensive research. Many experimental studies have demonstrated that ARA have previously unexpected beneficial effects on the cardiovascular system including reduction in remodelling of the vascular smooth muscle cells and myocytes and improvement of endothelial cell dysfunction in heart failure. These effects improve vascular compliance and slow down the progression of left ventricular dysfunction and end-organ damage. Furthermore, aldosterone receptor blockade also restores the baroreceptor reflex, improving heart rate variability in heart failure in humans. Some of these effects have been demonstrated in dog models of cardiac disease and so justified further investigation of the potential benefit of ARA in dogs with congestive heart failure (CHF). Positive effects of spironolactone on morbidity and mortality appear to have been seen in studies conducted in dogs suffering from naturally occurring CHF. In addition, eplerenone has been shown to have benefits in canine models of heart failure. The precise mechanisms by which ARA produce these beneficial effects in dogs remain to be determined but this group of drugs clearly provide therapeutic actions out-with their diuretic effects.

  10. Toll-Like Receptor 9 Promotes Cardiac Inflammation and Heart Failure during Polymicrobial Sepsis

    Directory of Open Access Journals (Sweden)

    Ralph Lohner

    2013-01-01

    Full Text Available Background. Aim was to elucidate the role of toll-like receptor 9 (TLR9 in cardiac inflammation and septic heart failure in a murine model of polymicrobial sepsis. Methods. Sepsis was induced via colon ascendens stent peritonitis (CASP in C57BL/6 wild-type (WT and TLR9-deficient (TLR9-D mice. Bacterial load in the peritoneal cavity and cardiac expression of inflammatory mediators were determined at 6, 12, 18, 24, and 36 h. Eighteen hours after CASP cardiac function was monitored in vivo. Sarcomere length of isolated cardiomyocytes was measured at 0.5 to 10 Hz after incubation with heat-inactivated bacteria. Results. CASP led to continuous release of bacteria into the peritoneal cavity, an increase of cytokines, and differential regulation of receptors of innate immunity in the heart. Eighteen hours after CASP WT mice developed septic heart failure characterised by reduction of end-systolic pressure, stroke volume, cardiac output, and parameters of contractility. This coincided with reduced cardiomyocyte sarcomere shortening. TLR9 deficiency resulted in significant reduction of cardiac inflammation and a sustained heart function. This was consistent with reduced mortality in TLR9-D compared to WT mice. Conclusions. In polymicrobial sepsis TLR9 signalling is pivotal to cardiac inflammation and septic heart failure.

  11. Expression profiles of pivotal microRNAs and targets in thyroid papillary carcinoma: an analysis of The Cancer Genome Atlas

    Directory of Open Access Journals (Sweden)

    Cong D

    2015-08-01

    Full Text Available Dan Cong,1 Mengzi He,2 Silin Chen,2 Xiaoli Liu,1 Xiaodong Liu,2 Hui Sun11Jilin Provincial Key Laboratory of Surgical Translational Medicine, Department of Thyroid and Parathyroid Surgery, People’s Republic of China–Japan Union Hospital, 2Key Laboratory of Radiobiology (Ministry of Health, School of Public Health, Jilin University, Changchun, Jilin, People’s Republic of ChinaAbstract: In the present study, we analyzed microRNA (miRNA and gene expression profiles using 499 papillary thyroid carcinoma (PTC samples and 58 normal thyroid tissues obtained from The Cancer Genome Atlas database. A pivotal regulatory network of 18 miRNA and 16 targets was identified. Upregulated miRNAs (miR-222, miR-221, miR-146b, miR-181a/b/d, miR-34a, and miR-424 and downregulated miRNAs (miR-9-1, miR-138, miR-363, miR-20b, miR-195, and miR-152 were identified. Among them, the upregulation of miR-424 and downregulation of miR-363, miR-195, and miR-152 were not previously identified. The genes CCNE2 (also known as cyclin E2, E2F1, RARA, CCND1 (cyclin D1, RUNX1, ITGA2, MET, CDKN1A (p21, and COL4A1 were overexpressed, and AXIN2, TRAF6, BCL2, RARB, HSP90B1, FGF7, and PDGFRA were downregulated. Among them, CCNE2, COL4A1, TRAF6, and HSP90B1 were newly identified. Based on receiver operating characteristic curves, several miRNAs (miR-222, miR-221, and miR-34a and genes (CCND1 and MET were ideal diagnostic indicators, with sensitivities and specificities greater than 90%. The combination of inversely expressed miRNAs and targets improved diagnostic accuracy. In a clinical feature analysis, several miRNAs (miR-34a, miR-424, miR-20b, and miR-152 and genes (CCNE2, COL4A1, TRAF6, and HSP90B1 were associated with aggressive clinical features, which have not previously been reported. Our study not only identified a pivotal miRNA regulatory network associated with PTC but also provided evidence that miRNAs and target genes can be used as biomarkers in PTC diagnosis and clinical

  12. Improved throughput traction microscopy reveals pivotal role for matrix stiffness in fibroblast contractility and TGF-β responsiveness

    Science.gov (United States)

    Marinković, Aleksandar; Mih, Justin D.; Park, Jin-Ah; Liu, Fei

    2012-01-01

    Lung fibroblast functions such as matrix remodeling and activation of latent transforming growth factor-β1 (TGF-β1) are associated with expression of the myofibroblast phenotype and are directly linked to fibroblast capacity to generate force and deform the extracellular matrix. However, the study of fibroblast force-generating capacities through methods such as traction force microscopy is hindered by low throughput and time-consuming procedures. In this study, we improved at the detail level methods for higher-throughput traction measurements on polyacrylamide hydrogels using gel-surface-bound fluorescent beads to permit autofocusing and automated displacement mapping, and transduction of fibroblasts with a fluorescent label to streamline cell boundary identification. Together these advances substantially improve the throughput of traction microscopy and allow us to efficiently compute the forces exerted by lung fibroblasts on substrates spanning the stiffness range present in normal and fibrotic lung tissue. Our results reveal that lung fibroblasts dramatically alter the forces they transmit to the extracellular matrix as its stiffness changes, with very low forces generated on matrices as compliant as normal lung tissue. Moreover, exogenous TGF-β1 selectively accentuates tractions on stiff matrices, mimicking fibrotic lung, but not on physiological stiffness matrices, despite equivalent changes in Smad2/3 activation. Taken together, these results demonstrate a pivotal role for matrix mechanical properties in regulating baseline and TGF-β1-stimulated contraction of lung fibroblasts and suggest that stiff fibrotic lung tissue may promote myofibroblast activation through contractility-driven events, whereas normal lung tissue compliance may protect against such feedback amplification of fibroblast activation. PMID:22659883

  13. Pivotal Role of PGE2 and IL-10 in the Cross-Regulation of Dendritic Cell-Derived Inflammatory Mediators

    Institute of Scientific and Technical Information of China (English)

    Hedi Harizi; Norbert Gualde

    2006-01-01

    Exposure to pathogens induces antigen-presenting cells (APC) such as macrophages and dendritic cells (DC) to produce various endogenous mediators, including arachidonic acid (AA)-derived eicosanoids, cytokines, and nitric oxide (NO). Many secreted products of activated APC can act by themselves in an autocrine manner and modulate their function. Moreover, the cross-interaction between endogenous bioactive molecules regulates the function of professional APC with important consequences for their ability to activate and sustain immune and inflammatory responses, and to regulate immune homeostasis. Although neglected for many years when compared to their role in cardiovascular homeostasis, cancer and inflammation, the importance of eicosanoids in immunology is becoming more defined. The role of prostaglandin (PG) E2 (PGE2), one of the best known and most well studied eicosanoids,is of particular interest. It modulates the activities of professional DC by acting on their differentiation, maturation and their ability to secrete cytokines. Uniquely among haematopoietic cytokines, interleukin-10 (IL-10) is a pleiotropic molecule that displays both immunostimulatory and immunoregulatory activities. IL-10 has attached much attention because of its anti-inflammatory properties. It modulates expression of cytokines, soluble mediators and cell surface molecules by cells of myeloid origin, particularly macrophages and DC. We previously reported that PGE2 is a potent inducer of IL-10 in bone marrow-derived DC (BM-DC), and PGE2-induced IL-10 is a key regulator of the BM-DC pro-inflammatory phenotype. BM-DC may be considered as an important model to study complex interactions between endogenous mediators, and autocrine IL-10 plays a pivotal role in the crossregulation of AA-derived lipid mediators, cytokines, and NO, with critical effects on immune and inflammatory responses. Cellular & Molecular Immunology. 2006;3(4):271-277.

  14. Minimal Clinically Important Difference in Parkinson’s Disease as Assessed in Pivotal Trials of Pramipexole Extended Release

    Directory of Open Access Journals (Sweden)

    Robert A. Hauser

    2014-01-01

    Full Text Available Background. The minimal clinically important difference (MCID is the smallest change in an outcome measure that is meaningful for patients. Objectives. To calculate the MCID for Unified Parkinson’s Disease Rating Scale (UPDRS scores in early Parkinson’s disease (EPD and for UPDRS scores and “OFF” time in advanced Parkinson’s disease (APD. Methods. We analyzed data from two pivotal, double-blind, parallel-group trials of pramipexole ER that included pramipexole immediate release (IR as an active comparator. We calculated MCID as the mean change in subjects who received active treatment and rated themselves “a little better” on patient global impression of improvement (PGI-I minus the mean change in subjects who received placebo and rated themselves unchanged. Results. MCIDs in EPD (pramipexole ER, pramipexole IR for UPDRS II were −1.8 and −2.0, for UPDRS III −6.2 and −6.1, and for UPDRS II + III −8.0 and −8.1. MCIDs in APD for UPDRS II were −1.8 and −2.3, for UPDRS III −5.2 and −6.5, and for UPDRS II + III −7.1 and −8.8. MCID for “OFF” time (pramipexole ER, pramipexole IR was −1.0 and −1.3 hours. Conclusions. A range of MCIDs is emerging in the PD literature that provides the basis for power calculations and interpretation of clinical trials.

  15. PRICE-Ⅳ symposium: Electrophysiology and heart rhythm disorders in the elderly

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ The Fourth Pivotal Research in Cardiology in the Elderly (PRICE-Ⅳ) symposium, entitled "Electrophysiology and Heart Rhythm Disorders in the Elderly: Mechanisms and Management", was held on November 11, 2006 in Chicago. The program, sponsored by the Society of Geriatric Cardiology and supported by a conference grant from the National Institute on Aging (NIA), featured a distinguished cadre of over 25 internationally acclaimed experts on all aspects of heart rhythm disorders in the elderly, ranging from basic mechanisms to clinical features and management to end-of-life care. Dr. Michael W. Rich, from Washington University in St. Louis, and Dr. Anne B. Curtis, from the University of South Florida in Tampa, served as co-chairs.Meeting participants uniformly praised the superb faculty,the excellent blend of basic and clinical sciences, and the outstanding quality of the overall program.

  16. Heart fields and cardiac morphogenesis.

    Science.gov (United States)

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

    2014-10-01

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

  17. The Heart of Matter

    CERN Document Server

    Godbole, Rohini M

    2010-01-01

    In this article I trace the development of the human understanding of the "Heart of Matter" from early concepts of "elements" (or alternatively "Panchmahabhootas") to the current status of "quarks" and "leptons" as the fundamental constituents of matter, interacting together via exchange of the various force carrier particles called "gauge bosons" such as the photon, W/Z-boson etc. I would like to show how our understanding of the fundamental constituents of matter has gone hand in hand with our understanding of the fundamental forces in nature. I will also outline how the knowledge of particle physics at the "micro" scale of less than a Fermi(one millionth of a nanometer), enables us to offer explanations of Cosmological observations at the "macro" scale. Consequently these observations, may in turn, help us address some very fundamental questions of the Physics at the "Heart of the Matter".

  18. Heart, lipids and hormones

    Directory of Open Access Journals (Sweden)

    Peter Wolf

    2017-05-01

    Full Text Available Cardiovascular disease is the leading cause of death in general population. Besides well-known risk factors such as hypertension, impaired glucose tolerance and dyslipidemia, growing evidence suggests that hormonal changes in various endocrine diseases also impact the cardiac morphology and function. Recent studies highlight the importance of ectopic intracellular myocardial and pericardial lipid deposition, since even slight changes of these fat depots are associated with alterations in cardiac performance. In this review, we overview the effects of hormones, including insulin, thyroid hormones, growth hormone and cortisol, on heart function, focusing on their impact on myocardial lipid metabolism, cardiac substrate utilization and ectopic lipid deposition, in order to highlight the important role of even subtle hormonal changes for heart function in various endocrine and metabolic diseases.

  19. [Hypertension and heart].

    Science.gov (United States)

    Hennersdorf, Marcus G; Strauer, Bodo E

    2006-03-22

    The term hypertensive heart disease covers the entities left ventricular hypertrophy, microangiopathy, diastolic and systolic dysfunction, und increased risk of arrhythmias. From the pathophysiological point of view this is caused by hypertrophy of cardiac myocytes, interstitial fibrosis and media hypertrophy of the arterioles. As an earliest sign of hypertensive heart disease a microangiopathy can be diagnosed. Also a diastolic dysfunction can be found as an early change. In further persisting arterial hypertension left ventricular hypertrophy develops (often asymmetric), and later a systolic dysfunction. Clinically, the patients suffer from angina pectoris, dyspnea and rhythm disorders. Left ventricular hypertrophy is associated with an increased risk of ventricular malignant arrhythmias. Thus, the main therapeutic principle should be antihypertensive therapy with the goal of regression of hypertrophy and, as a consequence, a decreased mortality risk.

  20. Ischaemic heart disease

    DEFF Research Database (Denmark)

    Hansen, Louise Houlberg; Mikkelsen, Søren

    2013-01-01

    Purpose. Correct prehospital diagnosis of ischaemic heart disease (IHD) may accelerate and improve the treatment. We sought to evaluate the accuracy of prehospital diagnoses of ischemic heart diseases assigned by physicians. Methods. The Mobile Emergency Care Unit (MECU) in Odense, Denmark...... to the relevant ward. Of these patients, 40,0% had their preliminary diagnosis of IHD confirmed. 14,1% of all patients admitted to the hospital were diagnosed with nonheart conditions. Preliminary diagnoses of STEMI had an accuracy of 87,5%. Conclusions. The preliminary IHD diagnoses assigned by the MECU...... physicians were acceptable. In case of STEMI patients the diagnostic accuracy was excellent. In this study there was an apparent overtriage....

  1. "Head versus heart"

    Directory of Open Access Journals (Sweden)

    Paul Rozin

    2007-08-01

    Full Text Available Most American respondents give ``irrational,'' magical responses in a variety of situations that exemplify the sympathetic magical laws of similarity and contagion. In most of these cases, respondents are aware that their responses (usually rejections, as of fudge crafted to look like dog feces, or a food touched by a sterilized, dead cockroach are not ``scientifically'' justified, but they are willing to avow them. We interpret this, in some sense, as ``heart over head.'' We report in this study that American adults and undergraduates are substantially less likely to acknowledge magical effects when the judgments involve money (amount willing to pay to avoid an ``unpleasant'' magical contact than they are when using preference or rating measures. We conclude that in ``head-heart'' conflicts of this type, money tips the balance towards the former, or, in other words, that money makes the mind less magical.

  2. Heart Imaging System

    Science.gov (United States)

    1993-01-01

    Johnson Space Flight Center's device to test astronauts' heart function in microgravity has led to the MultiWire Gamma Camera, which images heart conditions six times faster than conventional devices. Dr. Jeffrey Lacy, who developed the technology as a NASA researcher, later formed Proportional Technologies, Inc. to develop a commercially viable process that would enable use of Tantalum-178 (Ta-178), a radio-pharmaceutical. His company supplies the generator for the radioactive Ta-178 to Xenos Medical Systems, which markets the camera. Ta-178 can only be optimally imaged with the camera. Because the body is subjected to it for only nine minutes, the radiation dose is significantly reduced and the technique can be used more frequently. Ta-178 also enables the camera to be used on pediatric patients who are rarely studied with conventional isotopes because of the high radiation dosage.

  3. Heart and radiation

    Directory of Open Access Journals (Sweden)

    Lauro Martins Júnior

    2011-12-01

    Full Text Available ABSTRATC The heart exposition to ionizing radiation may produce lesions in cardiac structures, acute (in most of cases benign and reversible, or months and even years later. There is a direct relationship of severity of lesions with radiation doses. The clinical picture receives a new denomination: radiation induced cardiopathy. The more frequent use of radiation in diagnosis and therapeutics increases the importance of their knowledge and especially their prevention.

  4. Thyroid and the Heart

    OpenAIRE

    A Karas; Obrezan, A.

    2009-01-01

    The cardiovascular signs and symptoms of thyroid disease are some of the most clinically relevant findings that accompany both hyperthyroidism and hypothyroidism. On the basis of the understanding of the mechanisms of thyroid hormone action on the heart and cardiovascular system, it is possible to explain the changes in cardiac output, cardiac contractility, blood pressure and rhythm disturbances that result from thyroid dysfunction. In the present review will integrate what is known about th...

  5. "Head versus heart"

    OpenAIRE

    2007-01-01

    Most American respondents give ``irrational,'' magical responses in a variety of situations that exemplify the sympathetic magical laws of similarity and contagion. In most of these cases, respondents are aware that their responses (usually rejections, as of fudge crafted to look like dog feces, or a food touched by a sterilized, dead cockroach) are not ``scientifically'' justified, but they are willing to avow them. We interpret this, in some sense, as ``heart over head.'' We report in this ...

  6. Pediatric heart transplantation

    OpenAIRE

    Schweiger, Martin; Stiasny, Brian; Dave, Hitendu; Cavigelli-Brunner, Anna; Balmer, Christian; Kretschmar, Oliver; Bürki, Christoph; Klauwer, Dietrich; Hübler, Michael

    2015-01-01

    Pediatric heart transplantation (pHTx) represents a small (14%) but very important and particular part in the field of cardiac transplantation. This treatment has lifelong impact on children. To achieve the best short and especially long-term survival with adequate quality of life, which is of crucial importance for this young patient population, one has to realize and understand the differences with adult HTx. Indication for transplantation, waitlist management including ABO incompatible (AB...

  7. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008277 Relationship between pulse wave velocity and the NYHA classification of coronary insufficiency.SUN Weiping(孙卫平),et al.Dept Cardiol,Tongji Hosp Tongji Univ,Shanghai 200065.Chin J Intern Med 2008;47(5):382-384.Objective To investigate the relationship between brachial-ankle pulse wave velocity(baPWV)and different stage of cardiac dysfunction.Methods 253 consecutive patients with coronary atherosclerotic heart disease

  8. Biological heart valves.

    Science.gov (United States)

    Ciubotaru, Anatol; Cebotari, Serghei; Tudorache, Igor; Beckmann, Erik; Hilfiker, Andres; Haverich, Axel

    2013-10-01

    Cardiac valvular pathologies are often caused by rheumatic fever in young adults, atherosclerosis in elderly patients, or by congenital malformation of the heart in children, in effect affecting almost all population ages. Almost 300,000 heart valve operations are performed worldwide annually. Tissue valve prostheses have certain advantages over mechanical valves such as biocompatibility, more physiological hemodynamics, and no need for life-long systemic anticoagulation. However, the major disadvantage of biological valves is related to their durability. Nevertheless, during the last decade, the number of patients undergoing biological, rather than mechanical, valve replacement has increased from half to more than three-quarters for biological implants. Continuous improvement in valve fabrication includes development of new models and shapes, novel methods of tissue treatment, and preservation and implantation techniques. These efforts are focused not only on the improvement of morbidity and mortality of the patients but also on the improvement of their quality of life. Heart valve tissue engineering aims to provide durable, "autologous" valve prostheses. These valves demonstrate adaptive growth, which may avoid the need of repeated operations in growing patients.

  9. Heart rate variability and heart rate recovery as prognostic factors

    OpenAIRE

    GRAD, COSMIN

    2015-01-01

    Background and aim Heart rate (HR) can appear static and regular at rest, during exercise or recovery after exercise. However, HR is constantly adjusted due to factors such as breathing, blood pressure control, thermoregulation and the renin-angiotensin system, leading to a more dynamic response that can be quantified using HRV (heart rate variability). HRV is defined as the deviation in time between successive normal heart beat and is a noninvasive method to measure the total variation in a ...

  10. Efficiency of pivot splints as jaw exercise apparatus in combination with stabilization splints in anterior disc displacement without reduction: a retrospective study.

    Science.gov (United States)

    Muhtarogullari, Mehmet; Avci, Mehmet; Yuzugullu, Bulem

    2014-10-09

    To evaluate efficiency of pivot splints in jaw exercises, in combination with stabilization splints, in cases of anterior disc displacement without reduction of temporomandibular joint. Twenty-three patients who referred to the prosthodontics clinic in 1995-1997 were included in the study, where anterior disc displacement without reduction of temporomandibular joint was diagnosed using magnetic resonance imaging and clinical examination. Pivot splints were used for jaw exercises for five minutes long; five times/day and stabilization splints were used at all other times. The patients were followed for 24 weeks. Lateral and protrusive excursions along with maximum mouth opening and were evaluated at each control. Bilateral palpation of temporal, masseter, sternocleidomastoid muscles and TMJ was assessed for pain perception before and after treatment. Data were statistically analyzed using Paired sample t-test and Independent Samples t-test (p displacement without reduction; as normal mandibular range of motion was established and pain was eliminated.

  11. Setting efficiency indicators for center pivots Ajuste de indicadores de eficiência para pivôs centrais

    Directory of Open Access Journals (Sweden)

    Ricardo L. Schons

    2012-06-01

    Full Text Available In this study, it was discussed the efficiency criteria in each of the elements that compose a central pivot, and this analysis was applied to two sets of systems located in regions of Cruz Alta and Santo Augusto, state of Rio Grande do Sul, Brazil. The methodology used combines water and energy assessment through an indicator called Normalized Specific Consumption in Irrigation (C ENI, allowing thus a comparison between equipment and projects. The C ENI in Cruz Alta region showed 72% of the equipment above the standard (8.68 kWh mm-1 ha-1 100m-1, and in Santo Augusto region 64.28% with consumption above the standard. The mean irrigation efficiency for Cruz Alta region was 29.85%, with standard deviation of 5.41%, and for Santo Augusto region, it was 29.02%, with standard deviation of 5.15%.Neste trabalho, são discutidos critérios de eficiência em cada um dos elementos que compõem um pivô central, sendo esta análise aplicada a dois conjuntos de sistemas localizados, nas regiões de Cruz Alta e Santo Augusto, Rio Grande do Sul. A metodologia utilizada associa as avaliações hídrica e energética por meio de um indicador denominado Consumo Específico Normalizado na Irrigação (C ENI, possibilitando, desta forma, uma comparação entre equipamentos e entre projetos. O C ENI na região de Cruz Alta apresentou 72% dos equipamentos acima do padrão (8,68 kWh mm-1 ha-1 100m-1, e na região de Santo Augusto, 64,28% com o consumo acima do padrão. A eficiência de irrigação média para a região de Cruz Alta foi de 29,85%, com desvio-padrão de 5,41%; e para a Região de Santo Augusto foi de 29,02%, com desvio padrão de 5,15%.

  12. Pivotal role of mouse mast cell protease 4 in the conversion and pressor properties of Big-endothelin-1.

    Science.gov (United States)

    Houde, Martin; Jamain, Marc-David; Labonté, Julie; Desbiens, Louisane; Pejler, Gunnar; Gurish, Michael; Takai, Shinji; D'Orléans-Juste, Pedro

    2013-07-01

    The serine protease chymase has been reported to generate intracardiac angiotensin-II (Ang-II) from Ang-I as well as an intermediate precursor of endothelin-1 (ET-1), ET-1 (1-31) from Big-ET-1. Although humans possess only one chymase, several murine isoforms are documented, each with its own specific catalytic activity. Among these, mouse mast cell protease 4 (mMCP-4) is the isoform most similar to the human chymase for its activity. The aim of this study was to characterize the capacity of mMCP-4 to convert Big-ET-1 into its bioactive metabolite, ET-1, in vitro and in vivo in the mouse model. Basal mean arterial pressure did not differ between wild-type (WT) and mMCP-4(-/-) mice. Systemic administration of Big-ET-1 triggered pressor responses and increased blood levels of immunoreactive (IR) ET-1 (1-31) and ET-1 that were reduced by more than 50% in mMCP-4 knockout (-/-) mice compared with WT controls. Residual responses to Big-ET-1 in mMCP-4(-/-) mice were insensitive to the enkephalinase/neutral endopeptidase inhibitor thiorphan and the specific chymase inhibitor TY-51469 {2-[4-(5-fluoro-3-methylbenzo[b]thiophen-2-yl)sulfonamido-3-methanesulfonylphenyl]thiazole-4-carboxylic acid}. Soluble fractions from the lungs, left cardiac ventricle, aorta, and kidneys of WT but not mMCP-4(-/-) mice generated ET-1 (1-31) from exogenous Big-ET-1 in a TY-51469-sensitive fashion as detected by high-performance liquid chromatography/ matrix-assisted laser desorption/ionization-mass spectrometry. Finally, pulmonary endogenous levels of IR-ET-1 were reduced by more than 40% in tissues derived from mMCP-4(-/-) mice compared with WT mice. Our results show that mMCP-4 plays a pivotal role in the dynamic conversion of systemic Big-ET-1 to ET-1 in the mouse model.

  13. Pivotal role of the muscle-contraction pathway in cryptorchidism and evidence for genomic connections with cardiomyopathy pathways in RASopathies

    KAUST Repository

    Cannistraci, Carlo

    2013-02-14

    Background: Cryptorchidism is the most frequent congenital disorder in male children; however the genetic causes of cryptorchidism remain poorly investigated. Comparative integratomics combined with systems biology approach was employed to elucidate genetic factors and molecular pathways underlying testis descent. Methods. Literature mining was performed to collect genomic loci associated with cryptorchidism in seven mammalian species. Information regarding the collected candidate genes was stored in MySQL relational database. Genomic view of the loci was presented using Flash GViewer web tool (http://gmod.org/wiki/Flashgviewer/). DAVID Bioinformatics Resources 6.7 was used for pathway enrichment analysis. Cytoscape plug-in PiNGO 1.11 was employed for protein-network-based prediction of novel candidate genes. Relevant protein-protein interactions were confirmed and visualized using the STRING database (version 9.0). Results. The developed cryptorchidism gene atlas includes 217 candidate loci (genes, regions involved in chromosomal mutations, and copy number variations) identified at the genomic, transcriptomic, and proteomic level. Human orthologs of the collected candidate loci were presented using a genomic map viewer. The cryptorchidism gene atlas is freely available online: http://www.integratomics-time.com/cryptorchidism/. Pathway analysis suggested the presence of twelve enriched pathways associated with the list of 179 literature-derived candidate genes. Additionally, a list of 43 network-predicted novel candidate genes was significantly associated with four enriched pathways. Joint pathway analysis of the collected and predicted candidate genes revealed the pivotal importance of the muscle-contraction pathway in cryptorchidism and evidence for genomic associations with cardiomyopathy pathways in RASopathies. Conclusions: The developed gene atlas represents an important resource for the scientific community researching genetics of cryptorchidism. The

  14. Evaluation and analysis of the energetic efficiency of center pivot irrigation systems; Avaliacao e analise da eficiencia energetica na irrigacao em sistemas pivo central

    Energy Technology Data Exchange (ETDEWEB)

    Lima, Aureo C. de [Universidade Federal da Grande Dourados (UFGD), Dourados, MS (Brazil). Unidade II], email: aureolima@ufgd.edu.br; Guimaraes Junior, Sebastiao C.; Camacho, Jose R. [Universidade Federal de Uberlandia (UFU), MG (Brazil). Nucleo de Energia Rural e Fontes Alternativas de Energia], emails: scguimaes@ufu.br, jrcamacho@ufu.br; Fietz, Carlos R. [EMBRAPA Agropecuaria Oeste, Dourados, MS (Brazil)], email: fietz@cpao.embrapa.br

    2009-07-01

    With an irrigated area of approximately 710,500 ha in Brazil, it is possible to estimate an annual electricity consumption of 1,928 G Wh per year due to center pivot systems. Considering the need of optimization of the irrigated agricultural production, the energies that are dissipated in the suction pipes, water supply, lateral lines and sprinkler systems are analyzed in this study and an equation is proposed to determine the useful power of center pivot irrigation systems. Three center pivot systems located in Itamarati I (a Government settlement for the landless in the city of Ponta Pora, State of Mato Grosso do Sul, Brazil) were evaluated and measures of energetic efficiency were simulated in order to determine a viable economic configuration to meet the life span of the equipment. The systems were characterized by the energy use and results show that the average irrigation energetic efficiency may be raised from 14.9 to 25.9% leading to a possible reduction of R$ 118,800 per year over 7,200 ha, equivalent to 11% of the yearly expenses with electricity of the whole area. (author)

  15. The heart and the liver

    DEFF Research Database (Denmark)

    Møller, Søren; Dümcke, Christine Winkler; Krag, Aleksander

    2009-01-01

    against the heart failure. Transjugular intrahepatic portosystemic shunt insertion and liver transplantation affect cardiac function in portal hypertensive patients and cause stress to the cirrhotic heart, with a risk of perioperative heart failure. The risk and prevalence of coronary artery disease......Cardiac failure affects the liver and liver dysfunction affects the heart. Chronic and acute heart failure can lead to cardiac cirrhosis and cardiogenic ischemic hepatitis. These conditions may impair liver function and treatment should be directed towards the primary heart disease and seek...... are increasing in cirrhotic patients and since perioperative mortality is high, careful evaluation of such patients with dobutamine stress echocardiography, coronary angiography and myocardial perfusion imaging is required prior to liver transplantation. Future research should focus on beneficial effects...

  16. Nuclear cardiology and heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Giubbini, Raffaele; Bertagna, Francesco [University of Brescia, Department of Nuclear Medicine, Brescia (Italy); Milan, Elisa [Ospedale Di Castelfranco Veneto, Nuclear Medicine Unit, Castelfranco Veneto (Italy); Mut, Fernando; Dondi, Maurizio [International Atomic Energy Agency, Nuclear Medicine Section, Division of Human Health, Vienna (Austria); Metra, Marco [University of Brescia, Department of Cardiology, Brescia (Italy); Rodella, Carlo [Health Physics Department, Spedali Civili di Brescia, Brescia (Italy)

    2009-12-15

    The prevalence of heart failure in the adult population is increasing. It varies between 1% and 2%, although it mainly affects elderly people (6-10% of people over the age of 65 years will develop heart failure). The syndrome of heart failure arises as a consequence of an abnormality in cardiac structure, function, rhythm, or conduction. Coronary artery disease is the leading cause of heart failure and it accounts for this disorder in 60-70% of all patients affected. Nuclear techniques provide unique information on left ventricular function and perfusion by gated-single photon emission tomography (SPECT). Myocardial viability can be assessed by both SPECT and PET imaging. Finally, autonomic dysfunction has been shown to increase the risk of death in patients with heart disease and this may be applicable to all patients with cardiac disease regardless of aetiology. MIBG scanning has a very promising prognostic value in patients with heart failure. (orig.)

  17. Fluid dynamics of heart development.

    Science.gov (United States)

    Santhanakrishnan, Arvind; Miller, Laura A

    2011-09-01

    The morphology, muscle mechanics, fluid dynamics, conduction properties, and molecular biology of the developing embryonic heart have received much attention in recent years due to the importance of both fluid and elastic forces in shaping the heart as well as the striking relationship between the heart's evolution and development. Although few studies have directly addressed the connection between fluid dynamics and heart development, a number of studies suggest that fluids may play a key role in morphogenic signaling. For example, fluid shear stress may trigger biochemical cascades within the endothelial cells of the developing heart that regulate chamber and valve morphogenesis. Myocardial activity generates forces on the intracardiac blood, creating pressure gradients across the cardiac wall. These pressures may also serve as epigenetic signals. In this article, the fluid dynamics of the early stages of heart development is reviewed. The relevant work in cardiac morphology, muscle mechanics, regulatory networks, and electrophysiology is also reviewed in the context of intracardial fluid dynamics.

  18. Reduced Heart Rate Volatility

    Science.gov (United States)

    Grogan, Eric L.; Morris, John A.; Norris, Patrick R.; France, Daniel J.; Ozdas, Asli; Stiles, Renée A.; Harris, Paul A.; Dawant, Benoit M.; Speroff, Theodore

    2004-01-01

    Objective: To determine if using dense data capture to measure heart rate volatility (standard deviation) measured in 5-minute intervals predicts death. Background: Fundamental approaches to assessing vital signs in the critically ill have changed little since the early 1900s. Our prior work in this area has demonstrated the utility of densely sampled data and, in particular, heart rate volatility over the entire patient stay, for predicting death and prolonged ventilation. Methods: Approximately 120 million heart rate data points were prospectively collected and archived from 1316 trauma ICU patients over 30 months. Data were sampled every 1 to 4 seconds, stored in a relational database, linked to outcome data, and de-identified. HR standard deviation was continuously computed over 5-minute intervals (CVRD, cardiac volatility–related dysfunction). Logistic regression models incorporating age and injury severity score were developed on a test set of patients (N = 923), and prospectively analyzed in a distinct validation set (N = 393) for the first 24 hours of ICU data. Results: Distribution of CVRD varied by survival in the test set. Prospective evaluation of the model in the validation set gave an area in the receiver operating curve of 0.81 with a sensitivity and specificity of 70.1 and 80.0, respectively. CVRD predict death as early as 24 hours in the validation set. Conclusions: CVRD identifies a subgroup of patients with a high probability of dying. Death is predicted within first 24 hours of stay. We hypothesize CVRD is a surrogate for autonomic nervous system dysfunction. PMID:15319726

  19. Yoga and the heart

    Directory of Open Access Journals (Sweden)

    Rahul Mehrotra

    2016-01-01

    Full Text Available The concept of "Yoga" is currently gaining a lot of popularity worldwide owing to its various health benefits and other advantages such as safety and ease of practice. There is considerable evidence accumulating related to its benefits on health, especially cardiovascular health. There is, however, a lot of confusion related to the term "Yoga" in the various studies as it comprises several different practices. More good quality studies are needed utilizing different components of "Yoga" investigating their effects on cardiovascular disease. There is also a change in the understanding of the role of the heart in the human body.

  20. 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.

  1. Heart Disease Detection Using Wavelets

    Science.gov (United States)

    González S., A.; Acosta P., J. L.; Sandoval M., M.

    2004-09-01

    We develop a wavelet based method to obtain standardized gray-scale chart of both healthy hearts and of hearts suffering left ventricular hypertrophy. The hypothesis that early bad functioning of heart can be detected must be tested by comparing the wavelet analysis of the corresponding ECD with the limit cases. Several important parameters shall be taken into account such as age, sex and electrolytic changes.

  2. Depression and Coronary Heart Disease

    OpenAIRE

    2012-01-01

    There are exciting findings in the field of depression and coronary heart disease. Whether diagnosed or simply self-reported, depression continues to mark very high risk for a recurrent acute coronary syndrome or for death in patients with coronary heart disease. Many intriguing mechanisms have been posited to be implicated in the association between depression and heart disease, and randomized controlled trials of depression treatment are beginning to delineate the types of depression manage...

  3. Heart rates during competitive orienteering.

    OpenAIRE

    Bird, S R; Bailey, R.; Lewis, J.

    1993-01-01

    This study investigated the heart rate profiles of 16 experienced, competitive orienteers (aged 15-62 years) during three competitive events. Each competitor was assessed over three different types of course which were classified as: fast run (FR), slow run (SR) and highly physical (HP). The results showed that all subjects recorded heart rates that were between 140 and 180 beats min-1 for the majority of each event (irrespective of age or course type). The heart rate data indicated that the ...

  4. [Cholinergic system of the heart].

    Science.gov (United States)

    Kučera, Matej; Hrabovská, Anna

    2015-12-01

    The cholinergic system of the heart can be either of neuronal or non-neuronal origin. The neuronal cholinergic system in the heart is represented by preganglionic parasympathetic pathways, intracardiac parasympathetic ganglia and postganglionic parasympathetic neurons projecting to the atria, SA node and AV node. The non-neuronal cholinergic system consists of cardiomyocytes that have complete equipment for synthesis and secretion of acetylcholine. Current knowledge suggests that the non-neuronal cholinergic system in the heart affects the regulation of the heart during sympathetic activation. The non-neuronal cholinergic system of the heart plays also a role in the energy metabolism of cardimyocites. Acetylcholine of both neuronal and non-neuronal origin acts in the heart through muscarinic and nicotinic receptors. The effect of acetylcholine in the heart is terminated by cholinesterases acetylcholinesterase and butyrylcholinesterase. Recently, papers suggest that the increased cholinergic tone in the heart by cholinesterase inhibitors has a positive effect on some cardiovascular disorders such as heart failure. For this reason, the cholinesterase inhibitors might be used in the treatment of certain cardiovascular disorders in the future.

  5. New medications for heart failure.

    Science.gov (United States)

    Gordin, Jonathan S; Fonarow, Gregg C

    2016-08-01

    Heart failure is common and results in substantial morbidity and mortality. Current guideline-based therapies for heart failure with reduced ejection fraction, including beta blockers, angiotensin converting enzyme (ACE) inhibitors, and aldosterone antagonists aim to interrupt deleterious neurohormonal pathways and have shown significant success in reducing morbidity and mortality associated with heart failure. Continued efforts to further improve outcomes in patients with heart failure with reduced ejection fraction have led to the first new-in-class medications approved for heart failure since 2005, ivabradine and sacubitril/valsartan. Ivabradine targets the If channels in the sinoatrial node of the heart, decreasing heart rate. Sacubitril/valsartan combines a neprilysin inhibitor that increases levels of beneficial vasodilatory peptides with an angiotensin receptor antagonist. On a background of previously approved, guideline-directed medical therapies for heart failure, these medications have shown improved clinical outcomes ranging from decreased hospitalizations in a select group of patients to a reduction in all-cause mortality across all pre-specified subgroups. In this review, we will discuss the previously established guideline-directed medical therapies for heart failure with reduced ejection fraction, the translational research that led to the development of these new therapies, and the results from the major clinical trials of ivabradine and sacubitril/valsartan. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Cardiomyocytic apoptosis and heart failure

    Institute of Scientific and Technical Information of China (English)

    Quanzhou Feng

    2008-01-01

    Heart failure is a major disease seriously threatening human health.Once left ventricular dysfunction develops,cardiac function usually deteriorates and progresses to congestive heart failure in several months or years even if no factors which accelerate the deterioration repeatedly exist.Mechanism through which cardiac function continually deteriorates is still unclear.Cardiomyocytic apoptosis can occur in acute stage of ischemic heart diseases and the compensated stage of cardiac dysfunction.In this review,we summarize recent advances in understanding the role of cardiomyocytic apoptosis in heart failure.

  7. Mushroom and Rape Heart Soup

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    100 grams mushrooms12 rape hearts5 grams salt2 grams MSG20 grams (2 tbsp) cooking oilWash mushrooms and slice. Clean the rape hearts, and cross-cut stem ends.Heat oil in a wok, and stir-fry the rape hearts for the short time it takes till their color changes. Add 750 grams (1 1/2 cups) of water. When boiling, add salt, MSG, and mushroom slices. Bring to the boil once more. Serve.Features: clear and refreshing.Effect: Nourishes the heart and stomach.

  8. Numerical Analysis of Blood Damage Potential of the HeartMate II and HeartWare HVAD Rotary Blood Pumps.

    Science.gov (United States)

    Thamsen, Bente; Blümel, Bastian; Schaller, Jens; Paschereit, Christian O; Affeld, Klaus; Goubergrits, Leonid; Kertzscher, Ulrich

    2015-08-01

    Implantable left ventricular assist devices (LVADs) became the therapy of choice in treating end-stage heart failure. Although survival improved substantially and is similar in currently clinically implanted LVADs HeartMate II (HM II) and HeartWare HVAD, complications related to blood trauma are frequently observed. The aim of this study was to compare these two pumps regarding their potential blood trauma employing computational fluid dynamics. High-resolution structured grids were generated for the pumps. Newtonian flow was calculated, solving Reynolds-averaged Navier-Stokes equations with a sliding mesh approach and a k-ω shear stress transport turbulence model for the operating point of 4.5 L/min and 80 mm Hg. The pumps were compared in terms of volumes subjected to certain viscous shear stress thresholds, below which no trauma was assumed (von Willebrand factor cleavage: 9 Pa, platelet activation: 50 Pa, and hemolysis: 150 Pa), and associated residence times. Additionally, a hemolysis index was calculated based on a Eulerian transport approach. Twenty-two percent of larger volumes above 9 Pa were observed in the HVAD; above 50 Pa and 150 Pa the differences between the two pumps were marginal. Residence times were higher in the HVAD for all thresholds. The hemolysis index was almost equal for the HM II and HVAD. Besides the gap regions in both pumps, the inlet regions of the rotor and diffuser blades have a high hemolysis production in the HM II, whereas in the HVAD, the volute tongue is an additional site for hemolysis production. Thus, in this study, the comparison of the HM II and the HVAD using numerical methods indicated an overall similar tendency to blood trauma in both pumps. However, influences of turbulent shear stresses were not considered and effects of the pivot bearing in the HM II were not taken into account. Further in vitro investigations are required.

  9. High Altitude and Heart

    Directory of Open Access Journals (Sweden)

    Murat Yalcin

    2011-04-01

    Full Text Available Nowadays, situations associated with high altitude such as mountaineering, aviation increasingly draw the attention of people. Gas pressure decreases and hypoxia is encountered when climbing higher. Physiological and pathological responses of human body to different heights are different. Therefore, physiological and pathological changes that may occur together with height and to know the clinical outcomes of these are important . Acute mountain sickness caused by high altitude and high altitude cerebral edema are preventable diseases with appropriate precautions. Atmospheric oxygen decreasing with height, initiates many adaptive mechanisms. These adaptation mechanisms and acclimatization vary widely among individuals because of reasons such as environmental factors, exercise and cold. High altitude causes different changes in the cardiovascular system with various mechanisms. Although normal individuals easily adapt to these changes, this situation can lead to undesirable results in people with heart disease. For this reason, it should be known the effective evaluation of the people with known heart disease before traveling to high altitude and the complications due to the changes with height and the recommendations can be made to these patients. [TAF Prev Med Bull 2011; 10(2.000: 211-222

  10. The maverick heart sound.

    Science.gov (United States)

    Witt, Chance M; Miranda, William R; Newman, Darrell B

    2016-07-01

    An asymptomatic 29-year-old woman presented for prenatal counselling. She had a history of a heart murmur since childhood and a previous echocardiogram suggesting 'enlargement of the heart'. Physical exam revealed normal jugular venous pressure and contour. Precordial palpation was unremarkable. Auscultation, however, was abnormal; findings on inspiration and expiration are presented in Figure 1, sound clip. Based on the phonocardiogram and online supplementary audio clip, which of the following is correct? An early diastolic filling sound (S3) is heard, indicating increased right ventricular filling pressures.An ejection click without respiratory variation and a systolic ejection murmur are heard, consistent with bicuspid aortic valve stenosis.An ejection click with respiratory variation and a systolic ejection murmur are heard, consistent with pulmonic valve stenosis.A holosystolic murmur with inspiratory augmentation is heard, indicating tricuspid regurgitation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Heart Failure Readmission Reduction.

    Science.gov (United States)

    Drozda, Joseph P; Smith, Donna A; Freiman, Paul C; Pursley, Janet; VanSlette, Jeffrey A; Smith, Timothy R

    Little is known regarding effectiveness of readmission reduction programs over time. The Heart Failure Management Program (HFMP) of St. John's Physician Group Practice (PGP) Demonstration provided an opportunity to assess outcomes over an extended period. Data from an electronic health record, an inpatient database, a disease registry, and the Social Security Death Master File were analyzed for patients admitted with heart failure (HF) for 5 years before (Period 1) and 5 years after (Period 2) inception of PGP. HF admissions decreased (Period 1, 58.3/month; Period 2, 52.4/month, P = .007). Thirty-day all-cause readmission rate dropped from Period 1 (annual average 18.8% [668/3545]) to year 1 of Period 2 (16.9% [136/804], P = .04) and remained stable thereafter (annual average 16.8% [589/3503]). Thirty-day mortality rate was flat throughout. HFMP was associated with decreased readmissions, primarily related to outpatient case management, while mortality remained stable.

  12. Heart failure etiology impacts survival of patients with heart failure

    DEFF Research Database (Denmark)

    Pecini, Redi; Møller, Daniel Vega; Torp-Pedersen, Christian

    2010-01-01

    BACKGROUND: The impact of heart failure (HF) etiology on prognosis of HF is not well known. METHODS: 3078 patients (median age 75years, 61% male) hospitalized with HF were studied. Patients were classified into six etiology groups: hypertension (HTN, 13.9%), ischemic heart disease (IHD, 42...

  13. Swan-Ganz - right heart catheterization

    Science.gov (United States)

    ... be due to: Blood flow problems, such as heart failure or shock Heart valve disease Lung disease Structural problems with the ... Burns Cardiac tamponade Congenital heart disease Heart attack Heart failure - overview Pulmonary ... Review Date 8/12/2014 Updated by: Michael ...

  14. Modern echocardiography in pediatric right heart assessment

    NARCIS (Netherlands)

    Kutty, S.

    2016-01-01

    Right heart function is a key determinant of clinical status, prognosis and outcome in a variety of heart diseases, particularly in patients with congenital heart disease. Various non-invasive imaging tools have been used to assess right heart function in the setting of adult heart disease; however

  15. Impact of KChIP2 on Cardiac Electrophysiology and the Progression of Heart Failure

    DEFF Research Database (Denmark)

    Grubb, Søren; Callø, Kirstine; Thomsen, Morten B

    2012-01-01

    Electrophysiological remodeling of cardiac potassium ion channels is important in the progression of heart failure. A reduction of the transient outward potassium current (I(to)) in mammalian heart failure is consistent with a reduced expression of potassium channel interacting protein 2 (KChIP2......, a K(V)4 subunit). Approaches have been made to investigate the role of KChIP2 in shaping cardiac I(to), including the use of transgenic KChIP2 deficient mice and viral overexpression of KChIP2. The interplay between I(to) and myocardial calcium handling is pivotal in the development of heart failure......, and is further strengthened by the dual role of KChIP2 as a functional subunit on both K(V)4 and Ca(V)1.2. Moreover, the potential arrhythmogenic consequence of reduced I(to) may contribute to the high relative incidence of sudden death in the early phases of human heart failure. With this review, we offer...

  16. Heart bypass surgery incision (image)

    Science.gov (United States)

    ... the left part of the chest between the ribs. This incision is much less traumatic than the traditional heart bypass surgery incision which separates the breast bone. Minimally invasive heart bypass surgery allows the patient less pain and a faster recovery.

  17. Sex differences in heart failure

    NARCIS (Netherlands)

    Meyer, Sven

    2016-01-01

    This thesis examined differences between men and women with heart failure. First, it was shown that biological sex is a strong modulator in the clinical expression of various cardiomyopathies. In the general population it was shown that men are more likely to develop heart failure with reduced eject

  18. Heart-lung transplant - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100147.htm Heart-lung transplant - series—Normal anatomy To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 4 Go to slide 2 out of ... to slide 4 out of 4 Overview The heart and lungs are located in the thorax, or chest cavity. ...

  19. Exercise Intolerance in Heart Failure

    DEFF Research Database (Denmark)

    Brassard, Patrice; Gustafsson, Finn

    2016-01-01

    Exercise tolerance is affected in patients with heart failure (HF). Although the inability of the heart to pump blood to the working muscle has been the conventional mechanism proposed to explain the lowered capacity of patients with HF to exercise, evidence suggests that the pathophysiological m...

  20. Circular RNAs in heart failure.

    Science.gov (United States)

    Devaux, Yvan; Creemers, Esther E; Boon, Reinier A; Werfel, Stanislas; Thum, Thomas; Engelhardt, Stefan; Dimmeler, Stefanie; Squire, Iain

    2017-06-01

    Cardiovascular disease, and particularly heart failure, is still a serious health care issue for which novel treatments and biomarkers are needed. The RNA family comprises different subgroups, among which the small-sized microRNAs and the larger long non-coding RNAs have shown some potential to aid in moving personalized health care of heart failure patients a step forward. Here, members of the Cardiolinc network review the recent findings suggesting that the less well-known circular RNAs may constitute a novel reservoir of therapeutic targets and biomarkers of heart failure. The knowledge of the mode of biogenesis of circular RNAs will first be reported, followed by a description of different features that make these RNA molecules of interest for the heart failure community. The functions of circular RNAs in the heart will be described, with some emphasis given to their regulation in the failing heart. Circulating in the bloodstream, circular RNAs have appeared as potential biomarkers and recent findings associated with the use of circular RNAs as heart failure biomarkers will be discussed. Finally, some directions for future research will be provided. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  1. Opportunities in the failing heart

    NARCIS (Netherlands)

    Gho, J.M.I.H.

    2015-01-01

    Heart failure (HF) is a syndrome with typical signs and symptoms that can result from abnormal cardiac structure or function. It can lead to impaired quality of life, decreased functional capacity, hospital admissions and mortality. Heart failure has been associated with focal and diffuse myocardial

  2. Childhood heart failure in Ibadan

    African Journals Online (AJOL)

    respiratory tract infections (36%), intrinsic heart disease. (31%) and severe ... la maladie de coeur intrinsèque 31%, et l'anémie grave 28%. D'autres causes qui ..... Colucci N, Braunwald E. Pathophysiology of heart failure. In: Braunwald E ed.

  3. Biomarkers in acute heart failure.

    Science.gov (United States)

    Mallick, Aditi; Januzzi, James L

    2015-06-01

    The care of patients with acutely decompensated heart failure is being reshaped by the availability and understanding of several novel and emerging heart failure biomarkers. The gold standard biomarkers in heart failure are B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide, which play an important role in the diagnosis, prognosis, and management of acute decompensated heart failure. Novel biomarkers that are increasingly involved in the processes of myocardial injury, neurohormonal activation, and ventricular remodeling are showing promise in improving diagnosis and prognosis among patients with acute decompensated heart failure. These include midregional proatrial natriuretic peptide, soluble ST2, galectin-3, highly-sensitive troponin, and midregional proadrenomedullin. There has also been an emergence of biomarkers for evaluation of acute decompensated heart failure that assist in the differential diagnosis of dyspnea, such as procalcitonin (for identification of acute pneumonia), as well as markers that predict complications of acute decompensated heart failure, such as renal injury markers. In this article, we will review the pathophysiology and usefulness of established and emerging biomarkers for the clinical diagnosis, prognosis, and management of acute decompensated heart failure. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  4. SDF-1/CXCR4/CXCR7 is pivotal for vascular smooth muscle cell proliferation and chronic allograft vasculopathy.

    Science.gov (United States)

    Thomas, Michael N; Kalnins, Aivars; Andrassy, Martin; Wagner, Anne; Klussmann, Sven; Rentsch, Markus; Habicht, Antje; Pratschke, Sebastian; Stangl, Manfred; Bazhin, Alexandr V; Meiser, Bruno; Fischereder, Michael; Werner, Jens; Guba, Markus; Andrassy, Joachim

    2015-12-01

    Chronic rejection remains a major obstacle in transplant medicine. Recent studies suggest a crucial role of the chemokine SDF-1 on neointima formation after injury. Here, we investigate the potential therapeutic effect of inhibiting the SDF-1/CXCR4/CXCR7 axis with an anti-SDF-1 Spiegelmer (NOX-A12) on the development of chronic allograft vasculopathy. Heterotopic heart transplants from H-2bm12 to B6 mice and aortic transplants from Balb/c to B6 were performed. Mice were treated with NOX-A12. Control animals received a nonfunctional Spiegelmer (revNOX-A12). Samples were retrieved at different time points and analysed by histology, RT-PCR and proliferation assay. Blockade of SDF-1 caused a significant decrease in neointima formation as measured by intima/media ratio (1.0 ± 0.1 vs. 1.8 ± 0.1, P SDF-1 inhibition (3.42 ± 0.37 vs. 1.67 ± 0.33, P SDF-1/CXCR4/CXCR7 plays a critical role in the development of chronic allograft vasculopathy (CAV). Therefore, pharmacological inhibition of SDF-1 with NOX-A12 may represent a therapeutic option to ameliorate chronic rejection changes.

  5. Artificial heart for humanoid robot

    Science.gov (United States)

    Potnuru, Akshay; Wu, Lianjun; Tadesse, Yonas

    2014-03-01

    A soft robotic device inspired by the pumping action of a biological heart is presented in this study. Developing artificial heart to a humanoid robot enables us to make a better biomedical device for ultimate use in humans. As technology continues to become more advanced, the methods in which we implement high performance and biomimetic artificial organs is getting nearer each day. In this paper, we present the design and development of a soft artificial heart that can be used in a humanoid robot and simulate the functions of a human heart using shape memory alloy technology. The robotic heart is designed to pump a blood-like fluid to parts of the robot such as the face to simulate someone blushing or when someone is angry by the use of elastomeric substrates and certain features for the transport of fluids.

  6. Genetics of valvular heart disease.

    Science.gov (United States)

    LaHaye, Stephanie; Lincoln, Joy; Garg, Vidu

    2014-01-01

    Valvular heart disease is associated with significant morbidity and mortality and often the result of congenital malformations. However, the prevalence is increasing in adults not only because of the growing aging population, but also because of improvements in the medical and surgical care of children with congenital heart valve defects. The success of the Human Genome Project and major advances in genetic technologies, in combination with our increased understanding of heart valve development, has led to the discovery of numerous genetic contributors to heart valve disease. These have been uncovered using a variety of approaches including the examination of familial valve disease and genome-wide association studies to investigate sporadic cases. This review will discuss these findings and their implications in the treatment of valvular heart disease.

  7. Embryonic Heart Progenitors and Cardiogenesis

    Science.gov (United States)

    Brade, Thomas; Pane, Luna S.; Moretti, Alessandra; Chien, Kenneth R.; Laugwitz, Karl-Ludwig

    2013-01-01

    The mammalian heart is a highly specialized organ, comprised of many different cell types arising from distinct embryonic progenitor populations during cardiogenesis. Three precursor populations have been identified to contribute to different myocytic and nonmyocytic cell lineages of the heart: cardiogenic mesoderm cells (CMC), the proepicardium (PE), and cardiac neural crest cells (CNCCs). This review will focus on molecular cues necessary for proper induction, expansion, and lineage-specific differentiation of these progenitor populations during cardiac development in vivo. Moreover, we will briefly discuss how the knowledge gained on embryonic heart progenitor biology can be used to develop novel therapeutic strategies for the management of congenital heart disease as well as for improvement of cardiac function in ischemic heart disease. PMID:24086063

  8. Heart transplantation from older donors

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov

    2017-01-01

    Full Text Available In the current situation of the shortage of suitable donor organs, heart transplantation from older donors is one of the ways to increase the performance of more heart transplants, particularly, in patients with urgent need of transplantation. While planning a heart transplantation from older donor one should consider increased risk of early cardiac allograft dysfunction, preexisting coronary artery disease, accelerated transplant vasculopathy which may adversely affect early and long-term survival of recipients. Subject to careful selection of donor–recipient pairs, effective prevention and treatment of early cardiac allograft dysfunction, pre-existing atherosclerosis and transplant vasculopathy the early and long-term survival of heart transplant recipients from older donors is comparable to heart transplantation from young donors.

  9. Vitamin therapy after heart transplantation.

    Science.gov (United States)

    Patel, Jignesh

    2015-10-01

    The need for routine nutritional supplementation with vitamins in most healthy individuals remains a matter of debate and current guidelines recommend that the need for these essential nutrients be met primarily through consuming an adequate diet. However, after heart transplantation, multiple factors, including the effects of prolonged debilitation prior to surgery and immunosuppression, may lead to physiological stress, which may justify consideration for vitamin supplementation. In general, clinical trials have not focused on vitamin supplementation after heart transplantation. There appears to be some limited clinical data to support the use of certain vitamins after heart transplantation. In particular, the putative antioxidant properties of vitamins C and E after heart transplantation may be beneficial as prophylaxis against cardiac allograft vasculopathy, and vitamin D, in conjunction with calcium, may help prevent post-transplant bone loss. Current guidelines only address the use of vitamin D after heart transplantation.

  10. Bisoprolol for congestive heart failure

    DEFF Research Database (Denmark)

    Rosenberg, J.; Gustafsson, F.

    2008-01-01

    Background: beta-Blockers are a cornerstone in the treatment of systolic heart failure treatment, but not all beta-blockers are effective or in this setting. Objective: To define the role of bisoprolol, a highly selective beta(1)-antagonist in congestive heart failure due to systolic dysfunction....... Methods: Using the keywords 'bisoprolol' and 'heart failure' PubMed and BIOSIS databases were searched for information regarding pharmacology and relevant randomised clinical trials. Supplementary publications were acquired by scrutinising reference lists of relevant papers. Additional information...... was obtained from the FDA website. Conclusion: Bisoprolol is an effective and well-tolerated first-line beta-blocker for patients with systolic heart failure. The knowledge is primarily based on study patients with moderate-to-severe heart failure from the three CIBIS trials Udgivelsesdato: 2008/2...

  11. Outdoor Air Pollution, Heart Attack and Stroke

    Science.gov (United States)

    Elevated outdoor ambient air particle pollution triggers heart attacks, strokes, and abnormal heart rhythms and worsens heart failure in individuals at high risk due to underlying medical conditions. Emergency Medical Services in communities are the first responders to these eme...

  12. Sleep Apnea and Heart Disease, Stroke

    Science.gov (United States)

    ... Aortic Aneurysm More Sleep Apnea and Heart Disease, Stroke Updated:Mar 14,2017 Plain old snoring can ... and is associated with high blood pressure , arrhythmia , stroke and heart failure . Heart disease is the leading ...

  13. On Two Hearts and Other Coronary Reflections.

    Science.gov (United States)

    Flannery, Maura C.

    1998-01-01

    Speculates as to how understanding of heart disease has developed and provides insight into how medical science makes progress. Summarizes the state of knowledge on arteriosclerosis, heart attacks, and exercising the heart. Contains 23 references. (DDR)

  14. Heart Disease and Asians and Pacific Islanders

    Science.gov (United States)

    ... Data > Minority Population Profiles > Asian American > Heart Disease Heart Disease and Asians and Pacific Islanders Overall, Asian American ... are less likely than white adults to have heart disease and they are less likely to die from ...

  15. Living with heart disease and angina

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000576.htm Living with heart disease and angina To use the sharing features on ... pain and reduce your risks from heart disease. Heart Disease and Angina CHD is a narrowing of the ...

  16. How Does Heart Disease Affect Women?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Does Heart Disease Affect Women? Español In the United States, 1 ... about coronary MVD and broken heart syndrome. Coronary Heart Disease CHD is a disease in which plaque (plak) ...

  17. Genetics Home Reference: critical congenital heart disease

    Science.gov (United States)

    ... Health Conditions critical congenital heart disease critical congenital heart disease Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Critical congenital heart disease (CCHD) is a term that refers to a ...

  18. How Is Diabetic Heart Disease Treated?

    Science.gov (United States)

    ... from the NHLBI on Twitter. How Is Diabetic Heart Disease Treated? Diabetic heart disease (DHD) is treated with lifestyle changes, medicines, and ... treating DHD include: Controlling diabetes and any other heart disease risk factors you have, such as unhealthy blood ...

  19. Insomnia Self-Management in Heart Failure

    Science.gov (United States)

    2016-12-07

    Cardiac Failure; Heart Failure; Congestive Heart Failure; Heart Failure, Congestive; Sleep Initiation and Maintenance Disorders; Chronic Insomnia; Disorders of Initiating and Maintaining Sleep; Fatigue; Pain; Depressive Symptoms; Sleep Disorders; Anxiety

  20. Celebrities Gather to Fight Heart Disease

    Science.gov (United States)

    ... Current Issue Past Issues Celebrities Gather to Fight Heart Disease Past Issues / Spring 2007 Table of Contents For ... Kit to offer community education programs on women's heart disease. Organize heart-health screening events and health fairs ...