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Sample records for stable disease sd

  1. Stable, geochemically mediated biospheres in the Deep Mine Microbial Observatory, SD, USA

    Science.gov (United States)

    Osburn, M. R.; Casar, C. P.; Kruger, B.; Flynn, T. M.

    2017-12-01

    The terrestrial subsurface is a vast reservoir of life, hosting diverse microbial ecosystems with varying levels of connectivity to surface inputs. Understanding long term ecosystem dynamics within the subsurface biosphere is very challenging due to limitations in accessibility, sample availability, and slow microbial growth rates. The establishment of the Deep Mine Microbial Observatory (DeMMO) at the Sanford Underground Research Facility, SD, USA has allowed for bimonthly sampling for nearly two years at six sites spanning 250 to 1500 m below the surface. Here we present a time-resolved analysis of the geomicrobiology of the six DeMMO sites, which have been created from legacy mine boreholes modified to allow for controlled sampling. Our interdisciplinary approach includes analysis of passively draining fracture fluid for aqueous and gas geochemistry, DNA sequencing, microscopy, and isotopic measurements of organic and inorganic substrates. Fluid geochemistry varies significantly between sites, but is relatively stable over time for a given site, even through significant external perturbations such as drilling and installation of permanent sampling devices into the boreholes. The fluid-hosted microbial diversity follows these trends, with consistent populations present at each site through time, even through drilling events. For instance, the shallowest site (DeMMO 1) consistently hosts >30% uncharacterized phyla and >25% Omnitrophica whereas the deepest site (DeMMO 6) is dominated by Firmicutes and Bacterioidetes. Microbial diversity appears to respond to the availability of energy sources such as organic carbon, sulfate, sulfide, hydrogen, and iron. Carbon isotopic measurements reveal closed system behavior with significant recycling of organic carbon into the DIC pool. Together these observations suggest DeMMO hosts isolated subsurface microbial populations adapted to local geochemistry that are stable on yearlong timescales.

  2. Importance of prumycin produced by Bacillus amyloliquefaciens SD-32 in biocontrol against cucumber powdery mildew disease.

    Science.gov (United States)

    Tanaka, Keijitsu; Fukuda, Mutsumi; Amaki, Yusuke; Sakaguchi, Takatoshi; Inai, Koji; Ishihara, Atsushi; Nakajima, Hiromitsu

    2017-12-01

    Powdery mildew disease of cucurbits is caused mainly by Podosphaera fusca, which is one of the most important limiting factors in cucurbit production worldwide. Previously we reported that Bacillus amyloliquefaciens biocontrol strain SD-32 produces C 17 bacillomycin D and [Ile 2002]surfactin, and that these metabolites play important roles in SD-32's biocontrol over cucumber gray mold disease. Our further investigation demonstrated that the culture broth and its supernatant suppressed cucumber powdery mildew disease in greenhouse experiments. However, the active principle(s) remained unknown. The active compound was isolated from the culture supernatant after anti-powdery mildew disease activity-guided purification and identified as prumycin. Prumycin significantly suppressed the disease, whereas bacillomycin D and [Ile 2002]surfactin did not. Prumycin did not induce the expression of plant defense genes (PR1a and VSP1), suggesting that it does not act via plant defense response. Light microscopic observations of prumycin-treated cucumber cotyledon suggested that prumycin inhibits the conidial germination of P. fusca. This study demonstrates that prumycin is a major factor in SD-32's suppression of cucumber powdery mildew disease. Our findings shed light for the first time on prumycin's role in biocontrol by Bacillus against this disease. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  3. Is sdLDL a valuable screening tool for cardiovascular disease in ...

    African Journals Online (AJOL)

    Radwa Momtaz Abdelsamie Zaki Khalil

    Many patients with cardiovascular disease have their low density lipoprotein cholesterol within normal range. This raises the question about the most important lipoprotein to use as a marker of atherogenecity. In fact, small dense low density lipoprotein has recently been suggested as a strong predictor of cardio- vascular ...

  4. Is sdLDL a valuable screening tool for cardiovascular disease in ...

    African Journals Online (AJOL)

    Many patients with cardiovascular disease have their low density lipoprotein cholesterol within normal range. This raises the question about the most important lipoprotein to use as a marker of atherogenecity. In fact, small dense low density lipoprotein has recently been suggested as a strong predictor of cardiovascular ...

  5. Detection of retinal nerve fiber layer defects in Alzheimer‘s disease using SD-OCT

    Directory of Open Access Journals (Sweden)

    Robert eKromer

    2014-02-01

    Full Text Available Introduction:To examine the clinical value of spectral-domain optical coherence tomography (Spectralis OCT to detect retinal nerve fibre layer defects in patients with clinically defined Alzheimer‘s disease (AD.Material and Methods:This cross-sectional study included 22 patients with AD (mean age: 75.9 ± 6.1 years and 22 healthy age- and sex-matched controls. Neuro-ophthalmologic examinations and a series of high-resolution OCT examinations of the peripapillary retinal nerve fibre layer (RNFL thickness using the Spectralis 3.5-mm circle scan protocol with ART-Modus and eye tracking were obtained, and compared to age- and sex-matched healthy control subjects.Results:Patients with AD showed a significant decrease in RNFL thickness in the nasal superior sector compared to the control group (101.0 ± 18.18 µm vs. 122.8 ± 28.08 µm; p

  6. Association of small dense LDL serum levels and circulating monocyte subsets in stable coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Konstantin A Krychtiuk

    Full Text Available Atherosclerosis is considered to be an inflammatory disease in which monocytes and monocyte-derived macrophages play a key role. Circulating monocytes can be divided into three distinct subtypes, namely in classical monocytes (CM; CD14++CD16-, intermediate monocytes (IM; CD14++CD16+ and non-classical monocytes (NCM; CD14+CD16++. Low density lipoprotein particles are heterogeneous in size and density, with small, dense LDL (sdLDL crucially implicated in atherogenesis. The aim of this study was to examine whether monocyte subsets are associated with sdLDL serum levels.We included 90 patients with angiographically documented stable coronary artery disease and determined monocyte subtypes by flow cytometry. sdLDL was measured by an electrophoresis method on polyacrylamide gel.Patients with sdLDL levels in the highest tertile (sdLDL≥4mg/dL;T3 showed the highest levels of pro-inflammatory NCM (15.2±7% vs. 11.4±6% and 10.9±4%, respectively; p<0.01 when compared with patients in the middle (sdLDL=2-3mg/dL;T2 and lowest tertile (sdLDL=0-1mg/dL;T1. Furthermore, patients in the highest sdLDL tertile showed lower CM levels than patients in the middle and lowest tertile (79.2±8% vs. 83.9±7% and 82.7±5%; p<0.01 for T3 vs. T2+T1. Levels of IM were not related to sdLDL levels (5.6±4% vs. 4.6±3% vs. 6.4±3% for T3, T2 and T1, respectively. In contrast to monocyte subset distribution, levels of circulating pro- and anti-inflammatory markers were not associated with sdLDL levels.The atherogenic lipoprotein fraction sdLDL is associated with an increase of NCM and a decrease of CM. This could be a new link between lipid metabolism dysregulation, innate immunity and atherosclerosis.

  7. The quest for stable circumbinary companions to post-common envelope sdB eclipsing binaries. Does the observational evidence support their existence?

    Science.gov (United States)

    Pulley, D.; Faillace, G.; Smith, D.; Watkins, A.; von Harrach, S.

    2018-03-01

    Context. Period variations have been detected in a number of eclipsing close compact binary subdwarf B stars (sdBs) and these have often been interpreted as being caused by circumbinary massive planets or brown dwarfs. According to canonical binary models, the majority of sdB systems are produced from low mass stars with degenerate cores where helium is ignited in flashes. Various evolutionary scenarios have been proposed for these stars, but a definite mechanism remains to be established. Equally puzzling is the formation of these putative circumbinary objects which must have formed from the remaining post-common envelope circumbinary disk or survived its evolution. Aim. In this paper we review the eclipse time variations (ETVs) exhibited by seven such systems (EC 10246-2707, HS 0705+6700, HS 2231+2441, J08205+0008, NSVS 07826147, NSVS 14256825, and NY Vir) and explore whether there is conclusive evidence that the ETVs observed over the last two decades can reliably predict the presence of one or more circumbinary bodies. Methods: We report 246 new observations of the seven sdB systems made between 2013 September and 2017 July using a worldwide network of telescopes. We combined our new data with previously published measurements to analyse the ETVs of these systems. Results: Our data show that period variations cannot be modelled simply on the basis of circumbinary objects. This implies that more complex processes may be taking place in these systems. These difficulties are compounded by the secondary star not being spectroscopically visible. From ETVs, it has historically been suggested that five of the seven binary systems reported here had circumbinary objects. Based on our recent observations and analysis, only three systems remain serious contenders. We find agreement with other observers that at least a decade of observations is required to establish reliable ephemerides. With longer observational baselines it is quite conceivable that the data will support

  8. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease

    NARCIS (Netherlands)

    Eikelboom, John W.; Connolly, Stuart J.; Bosch, Jackie; Dagenais, Gilles R.; Hart, Robert G.; Shestakovska, Olga; Diaz, Rafael; Alings, Marco; Lonn, Eva M.; Anand, Sonia S.; Widimsky, Petr; Hori, Masatsugu; Avezum, Alvaro; Piegas, Leopoldo S.; Branch, Kelley R. H.; Probstfield, Jeffrey; Bhatt, Deepak L.; Zhu, Jun; Liang, Yan; Maggioni, Aldo P.; Lopez-Jaramillo, Patricio; O'Donnell, Martin; Kakkar, Ajay K.; Fox, Keith A. A.; Parkhomenko, Alexander N.; Ertl, Georg; Störk, Stefan; Keltai, Matyas; Ryden, Lars; Pogosova, Nana; Dans, Antonio L.; Lanas, Fernando; Commerford, Patrick J.; Torp-Pedersen, Christian; Guzik, Tomek J.; Verhamme, Peter B.; Vinereanu, Dragos; Kim, Jae-Hyung; Tonkin, Andrew M.; Lewis, Basil S.; Felix, Camilo; Yusoff, Khalid; Steg, P. Gabriel; Metsarinne, Kaj P.; Cook Bruns, Nancy; Misselwitz, Frank; Chen, Edmond; Leong, Darryl; Yusuf, Salim; Aboyans, V.; Ha, J.; Keltai, K.; Lamy, A.; Liu, L.; Moayyedi, P.; Sharma, M.; Stoerk, S.; Varigos, J.; Bhagirath, V.; Bogaty, P.; Botto, F.; Catanese, L.; Donato Magno, J.; Fabbri, G.; Gabizon, I.; Gosselin, G.; Halon, D.; Heldmann, M.; Lamelas, P.; Lauw, M.; Leong, Y.; Liang, D.; Lutay, Y.; Maly, M.; Mikulik, R.; Nayar, S.; Ng, K.; Perera, K.; Pirvu, O.; Ronner, E.; Sato, S.; Smyth, A.; Sokolova, E.; Wiendl, M.; Winkelmann, B.; Yang, X.; Yufereva, Y.; Cairns, J.; Sleight, P.; deMets, D.; Momomura, S. I.; Prins, M. [=Martin H.; Ramsay, T.; Goto, S.; Rouleau, J. L.; Schumi, J.; Thabane, L.; Casanova, A.; Bangdiwala, S.; Deng, E.; Dyal, L.; Khatun, R.; Marsden, T.; Pogue, J.; Tang, C.; Wong, G.; Yuan, F.; Aman, S.; Ariz, A.; Ashton, H.; Belanger, J.; Belanger, M.; Brettell, K.; Chandra, J.; Choppick, C.; Cisternino, D.; Cuncins-Hearn, A.; Di Marino, M.; Diao, L.; Dwomoh, S.; Dykstra, A.; Galatsis, E.; Gasic, T.; Gutierrez, J.; Hamilton, L.; Irwin, L.; Lapensee, C.; Li, A.; Lu, X.; MacRae, L.; Malik, S.; Malvestiti, A.; Mastrangelo, J.; Maystrenko, A.; O'Donnell, L.; Reeh, K.; Szymkow, P.; Thomas, S.; Thrasher, D.; Tyrwhitt, J.; White, L.; Bastone, R.; Berkowitz, S.; Dias, A.; Ho, K.; Keller, L.; Lanius, V.; Lister, K.; Merten, C.; Muehlhofer, E.; Schmidt, K.; Tasto, C.; Tsihlias, E.; Woroniecka-Osio, A.; Orlandini, A.; Niemann, G.; Pascual, A.; Toscanelli, S.; Cabezón, M.; Debaveye, B.; Meeusen, K.; Luys, C.; Broos, K.; Vandenberghe, K.; Luyten, A.; Oliveira, G. B. F.; Vila Nova, D. C.; Konishi, M. Y. N.; Lonn, A.; Turbide, G.; Cayer, M.; Rovito, C.; Standen, D.; Li, J.; Lopez Pico, M.; Dusek, R.; Buzalka, V.; Larsen, J.; Paucar, M. J.; Saarinen, M.; Simon, T.; Bezault, M.; Le Lay, M.; Epstein, L.; Fajardo-Moser, M.; Röser, C.; Putz-Todd, G.; Scheidemantel, F.; Poehler, D.; Renner, J.; Hargitai, A.; Doherty, A. O.; Duffy, N.; Roarty, C.; Nolan, A.; Power, A.; Yuval, R.; Ben Ari, M.; Greenblatt, S.; Marmor, Y.; Lucci, D.; Ceseri, M.; Baldini, E.; Cipressa, L.; Miccoli, M.; Goto, M.; Yamasowa, H.; Kajiwara, M.; Takase, D.; Ikeguchi, K.; Matsumoto, M.; Ishii, M.; Asai, J.; Nozaki, D.; Akatsuka, T.; Yoshida, T.; Shahadan, S.; Md Nasir, N.; Schut, Astrid; Vinck, Leonie; van Leeuwen, Marjelle; Sanchez, J.; Aquino, M. R.; Mararac, T.; Benedyk, K.; Iordache, A.; Ciobanu, A.; Rimbas, R.; Dragoi Galrinho, R.; Magda, S.; Mihaila, S.; Mincu, R.; Suran, B.; Cotoban, A.; Matei, L.; Kursakov, A.; Rusnak, P.; Zakharova, A.; Demidova, E.; Commerford, A.; Lee, S.; Ju, I.; Gunolf, M.; Lorimer, A.; Parkhomenko, L.; Johnson, J.; Anderson, J.; Norby-Slycord., C.; Sala, J.; Sicer, M.; Rasmussen, M.; Luciani, C.; Cartasegna, L.; Beltrano, C.; Medek, G.; Vico, M.; Lanchiotti, P.; Martella, C.; Hominal, M.; Castoldi, M.; Casali, W.; Raimondi, S.; Hasbani, E.; Prado, A.; Paterlini, G.; Waisman, F.; Leonard, M.; Caccavo, A.; Alarcon, V.; Zaidman, C.; Guerlloy, F.; Vogel, D.; Imposti, H.; Dominguez, A.; Hrabar, A.; Fernandez, A.; Schygiel, P.; Sokn, F.; Cuneo, C.; Gutierrez Carrillo, N.; Martinez, G.; Luquez, H.; Costantino, M.; Ruiz, M.; Beccetti, N.; Mackinnon, I.; Cluigt, N.; Ahuad Guerrero, R.; Fanuele, M.; Campisi, V.; Costabel, J.; Romanelli, M.; Bartolacci, I.; Echeverria, M.; Pedrotti, M.; Montaña, O.; Camino, A.; Crespo, C.; Barbieri, M.; Lopez Santi, R.; Tonin, H.; Heffes, R.; Gomez Vilamajo, O.; Vanesio, F.; Allegrini, E.; Garcia Duran, R.; Garcia, C.; Garcia Duran, L.; Schiavi, L.; Mana, M.; Bordonava, A.; Rodriguez, M.; Gutierrez, M.; Garrido, M.; Rodriguez, C.; Ingaramo, A.; Costamagna, O.; Almagro, S.; Gerbaudo, C.; Pelagagge, M.; Bustamante Labarta, M.; Novaretto, L.; Maldini, A.; Lopez, L.; Albisu Di Gennero, J.; Ibanez Saggia, L.; Garcia Vilkas, A.; Alvarez, M.; Stoermann, W.; Vita, N.; Vottero, E.; Macin, S.; Cocco, M.; Onocko, M.; Dran, R.; Gimenez, C.; Cardona, M.; Guzman, L.; Guzman, P.; Martinez, D.; Sarjanovich, R.; Huerta, C.; Scaro, G.; Cuadrado, J.; Rodriguez, G.; Nani, S.; Guardiani, F.; Litvak Bruno, M.; Ceconi, G.; Chacon, C.; Casado, M.; Fernandez Moutin, M.; Maffei, L.; Sassone, S.; Yantorno, M.; Grinfeld, D.; Vensentini, N.; Rolandi, F.; Fallabrino, L.; Majul, C.; Paez, O.; Visser, M.; Luciardi, H.; Mansilla, V.; Gonzalez Colaso, P.; Ferre Pacora, F.; Jure, H.; Parody, M.; Espeche, E.; Whelan, A.; Boyle, A.; Collins, N.; Roberts-Thomson, P.; Rogers, J.; Caroll, P.; Colquhoun, D.; Williams, L.; Shaw, J.; Blombery, P.; Amerena, J.; Lee, C.; Hii, C.; Royse, A.; Royse, C.; Singh, B.; Selvanayagam, J.; Jansen, S.; Thompson, P.; Lo, W.; Hammett, C.; Poulter, R.; Graves, S.; Narasimhan, S.; van den Heuvel, P.; Wollaert, B.; Sinnaeve, P.; Fourneau, I.; Meuris, B.; Vanassche, T.; Ector, B.; Janssens, L.; Debonnaire, P.; Vandekerckhove, Y.; van de Borne, P.; Wautrecht, J.; Motte, S.; Leroy, J.; Schroë, H.; Vrolix, M.; Ferdinande, B.; Vranckx, P.; Benit, E.; Elegeert, I.; Lerut, P.; Wallaert, P.; Hoffer, E.; Borgoens, P.; Dujardin, K.; Brasil, C. K. O. I.; del Monaco, M. I.; Uint, L.; Pavanello, R.; Precoma, D. B.; Vianna, H. S.; Abrantes, J.; Morelli, J.; Manenti, E.; Jaeger, C.; Reis, G.; Giorgeto, F. E.; França, C. C. B.; Quadros, T. F. S.; Saraiva, J.; Costa, M.; de Camargo, O.; Marson Lopes, M.; Silva, J.; Maia, L. N.; Nakazone, M. A.; Mouco, O. M. C. C.; Lemos, M. A. B. T.; Hernandes, M. E.; Pântano, G. S.; de Castro, J. C. M.; Rossi, P. R. F.; Guedes, A. A. M.; Dos Santos, L. B.; dos Santos, F. R.; Vidotti, M. H.; Zimmermann, S. L.; Rech, R.; Nunes, C.; Abib, E.; Oliveira, K. L. C.; Leaes, P. E.; Botelho, R. V.; Navarro, A. L. C.; Silva, R. A.; Arantes, F. B. B.; Dutra, O.; Vaz, R.; Souza, W. K. S. B.; Souza, A. S. B.; Queiroz, W. C. B.; Braile, M.; Ferreira, V.; Izukawa, N. M.; Prakasan, A. K.; Nicolau, J. C.; Dalçóquio, T. F.; Tanajura, L. F. L.; Serrano, C. V.; Hueb, W. A.; Minelli, C.; Borsetti Neto, F. A.; Nasi, L. A.; Martins, S. C. O.; Oliveira, L. F. A.; Silva, M. A. V.; Ferreira, J. O.; de Carvalho Cantarelli, M. J.; Tytus, R.; Pasyk, E.; Pandey, A. S.; Rowe, A.; Cha, J.; Vizel, S.; Babapulle, M.; Semelhago, L.; Saunders, K.; Haligowski, D.; Berlingieri, J.; Nisker, W.; Kiaii, B.; Romsa, J.; Chu, M.; Nagpal, D.; Guo, R.; Mckenzie, N.; Quantz, M.; Bhargava, R.; Bhargava, M.; Mehta, P.; Hill, L.; Heslop, W.; Fell, D.; Hess, A.; Zadra, R.; Zeman, P.; Srivamadevan, M.; Lam, A.; Tai, S.; Al-Qoofi, F.; Spence, F.; Anderson, T.; Kieser, T.; Kidd, W.; Fedak, P.; Smith, E.; Har, B.; Brown, C.; Forgie, R.; Hassan, A.; Pelletier, M.; Searles, G.; Marr, D.; Bessoudo, R.; Douglas, G.; Legare, J.; Petrella, R.; Pavlosky, W.; Ricci, J.; Galiwango, P.; Janmohamed, A.; Kassam, S.; Mukherjee, A.; Vijayaraghavan, R.; Burstein, J.; D'Mello, N.; Glanz, A.; Noiseux, N.; Stevens, L. M.; Basile, F.; Prieto, I.; Normandin, L.; Helou, J.; Do, Q. B.; Bainey, K.; Tymchak, W.; Welsh, R.; Merali, F.; Pandith, V.; Heffernan, M.; Orfi, J.; Mcconachie, D.; Jedrzkiewicz, S.; Della Siega, A.; Robinson, S.; Nadra, I.; Poirier, P.; Dagenais, F.; Voisine, P.; Mohammadi, S.; Doyle, D.; Baillot, R.; Charbonneau, E.; Dumont, E.; Kalavrouziotis, D.; Perron, J.; Jacques, F.; Laflamme, M.; Brulotte, S.; Crete, M.; Degrâce, M.; Delage, F.; Grondin, F.; Lemieux, A.; Michaud, N.; Saulnier, D.; Ross, M. K.; Nguyen, M.; Harvey, R.; Daneault, B.; Hartleib, M.; Guzman, R.; Nguyen, T.; Singal, R.; Bourgeois, R.; Landry, D.; Kamel, S.; Rupka, D.; Kuritzky, R.; Khaykin, Y.; Phaneuf, D. C.; Desjardins, V.; Coll, X.; Huynh, T.; Pilon, C.; Mansour, S.; Lemire, F.; Kokis, A.; Potvin, J.; Campeau, J.; Audet, M.; Boulianne, M.; Dupuis, R.; Lauzon, C.; Pruneau, G.; Senay, B.; Pichette, F.; Cieza, T.; Breton, R.; Belisle, P.; Barabas, M.; Diaz, A.; Costa, R.; Absi, F.; Garand, M.; Rheault, A.; Lemay, C.; Gisbert, A.; Raymond, A.; Barrero, M.; Gagne, C. E.; Rheault, P.; Pepin-Dubois, Y.; Johnston, J.; Mundi, A.; Cohen, G.; Shukle, P.; Baskett, R.; Hirsch, G.; Ali, I.; Stewart, K.; Fenton, J.; Pudupakkam, S.; Willoughby, R.; Czarnecki, W.; Roy, A.; Montigny, M.; Descarries, L.; Mayrand, H.; Comtois, H.; Essiambre, R.; Ringuette, G.; Boutros, G.; Gendreau, R.; Pham, L.; Nguyen, V.; Nguyen-Thanh, H. K.; Ben-Yedder, N.; Nawaz, S.; Fremes, S.; Moussa, F.; Shukla, D.; Labonte., R.; Jano, G.; Bobadilla, B.; Saavedra, J.; Bahamondes, J.; Cobos, J.; Grunberg, E.; Corbalan, R.; Verdejo, H.; Medina, M.; Vega, M.; Nahuelpan, L.; Castañia, F.; Raffo, C.; Vargas, A.; Reyes, T.; Vargas, D.; Perez, L.; Arriagada, G.; Potthoff, S.; Godoy, J.; Stockins, B.; Larenas, G.; Quiñinao, F.; Sepulveda, P.; Trucco, V.; Pincetti, C.; Saavedra, S.; Silva, P.; Vejar, M.; Rodríguez, T.; Rodriguez, J.; Tian, H.; Zhang, J.; Meng, Y.; Wu, X.; Wu, Q.; Wang, Q.; Mu, Y.; Yang, J.; Wang, F.; Zhang, W.; Ke, Y.; Jiang, H.; Yin, P.; Jia, K.; Chen, C.; Wang, Z.; Qi, B.; Yu, L.; Feng, G.; Li, L.; Jiang, L.; Wu, S.; Yu, H.; Wu, Z.; Ding, R.; Liu, S.; Xu, H.; Cao, H.; Bai, X.; Zheng, Y.; Liu, Z.; Sun, H.; Yang, P.; Li, B.; Feng, Z.; Yang, Y.; Xu, Z.; Wu, W.; Meng, Q.; Ge, J.; Dai, Y.; Yang, H.; Chen, X.; Tian, X.; Shi, Y.; Hu, T.; Zhang, R.; Zhao, Q.; Quan, W.; Zhu, Y.; Zheng, Z.; Zhang, S.; Zhao, Y.; Zhao, C.; Wang, R.; Tao, L.; Hu, D.; Wang, Y.; Fan, F.; Huang, W.; Xia, X.; Fu, G.; Jiang, D.; Wang, M.; Li, C.; Xu, K.; Dong, Y.; Chen, Y.; Wu, D.; Wang, C.; Sun, X.; Lu, S.; Zhou, X.; Kong, Y.; Zhang, B.; Sotomayor, A.; Suarez, M.; Ripoll, D.; Herrera, O.; Accini Mendoza, J.; Saad Cure, C.; Reyes, M.; Vidal, T.; Donado Beltran, P.; Hernandez Jaimes, E.; Castillo, H.; Rocha, C.; Forero, L.; Zarate Bernal, D.; Vanstrrahle Gonzalez, L.; Urina Triana, M.; Quintero, A.; Ramirez, N.; Balaguera Mendoza, J.; Aroca Martinez, G.; Cotes, C.; Mercado, A.; Lastra Percy, X.; Perez Mayorga, M.; Rodriguez, N.; Molina de Salazar, D.; Perez Agudelo, J.; Lopez Villegas, L.; Agudelo Ramos, L.; Melo Polo, M.; Esparza Albornoz, A.; Forero Gomez, J.; Sanchez Vallejo, G.; Aristizabal, J.; Gallego, A.; Contreras, C.; Yepez, J.; Angel Escobar, J.; Manzur J, F.; Cohen, L.; Boneu, D.; Garcia Lozada, H.; Barrios, L.; Celemin, C.; Diego, M.; Garcia Ortiz, L.; Montoya, C.; Ramirez, E.; Arcos Palma, E.; Ceron, J.; Acosta, G.; Gomez Mesa, J.; Velasquez, J.; Barreto, D.; Trujillo Dada, F.; Trujillo Accini, F.; Cano, R.; Corredor de La Cruz, K.; Maria, V.; Palmera, J.; Vesga, B.; Hernandez, H.; Moreno Silgado, G.; Aruachan Vesga, S.; Burgos Martinez, E.; Quintero Villareal, G.; Solano Ayazo, F.; Porto Valiente, J.; Zidkova, E.; Krupicka, P.; Bultas, J.; Mandysova, E.; Lubanda, J.; Horak, J.; Belohlavek, J.; Kovarnik, T.; Gorican, K.; Rucka, D.; Smid, O.; Dostalova, G.; Skalicka, H.; Karetova, D.; Pavlinak, V.; Kuchynkova, S.; Marek, J.; Rob, D.; Ravlykova, K.; Prochazka, P.; Siranec, M.; Urbanec, T.; Vareka, T.; Nesvadbova, P.; Kaletova, M.; Indrakova, J.; Kryza, R.; Heczko, M.; Hanak, P.; Jancar, R.; Kocurkova, L.; Marcinek, G.; Cermak, O.; Drasnar, T.; Richter, M.; Kaspar, J.; Spinar, J.; Parenica, J.; Parenicova, I.; Schildberger, J.; Toman, O.; Ludka, O.; Poloczek, M.; Musil, V.; Miklik, R.; Labrova, R.; Lokaj, P.; Felsoci, M.; Bocek, O.; Kanovsky, J.; Zatocil, T.; Jerabek, P.; Matuska, J.; Jankovic, M.; Jankovicova, H.; Tesak, M.; Sulc, D.; Svacinova, H.; Radvan, M.; Bednar, J.; Motovska, Z.; Petr, R.; Fischerova, M.; Branny, M.; Vodzinska, A.; Cerny, J.; Indrak, J.; Sknouril, L.; Maly, J.; Vacek, T.; Prazak, O.; Broulikova, K.; Hajsl, M.; Jarkovsky, P.; Kamenik, L.; Kotik, I.; Krcova, E.; Sedlon, P.; Skvaril, J.; Cernohous, M.; Kohoutek, J.; Levcik, M.; Holek, M.; Hajdusek, P.; Foltynova Caisova, L.; Novak, V.; Kladivkova, M.; Slaby, J.; Houra, M.; Vojtisek, P.; Novotny, V.; Lazarak, T.; Pliva, M.; Pirk, J.; Barciakova, L.; Jandova, R.; Adamkova, V.; Galovcova, M.; Peterkova, L.; Turek, D.; Prochazka, J.; Belohoubek, J.; Spinarova, L.; Panovsky, R.; Novotny, P.; Krejci, J.; Hude, P.; Ozabalova, E.; Godava, J.; Honek, T.; Kincl, V.; Benesova, M.; Buckova, J.; Canadyova, J.; Mokracek, A.; Homza, M.; Stverka, P.; Florian, J.; Lukac, B.; Polasek, R.; Kucera, P.; Seiner, J.; Karasek, J.; Coufal, Z.; Stastny, J.; Cernicek, V.; Skalnikova, V.; Jiresova, E.; Brat, R.; Sieja, J.; Gloger, J.; Berger, P.; Prochazkova, I.; Samlik, J.; Brtko, M.; Tuna, M.; Polansky, P.; Omran, N.; Myjavec, A.; Hrdinova, M.; Jansky, P.; Kratochvilova, R.; Burkert, J.; Koubek, F.; Fiala, R.; Paulasova Schwabova, J.; Lindner, J.; Hlubocky, J.; Spacek, M.; Marcian, P.; Hanak, V.; Pozdisek, Z.; Lonsky, V.; Santavy, P.; Troubil, M.; Straka, Z.; Budera, P.; Fojt, R.; Talavera, D.; Tretina, M.; Nemec, P.; Orban, M.; Bedanova, H.; Wiggers, H.; Tougaard, R.; Larsen, A.; Nielsen, H.; Mattsson, N.; Gunnar, G.; Bruun, N.; Folke, F.; Soendergaard, K.; Koeber, L.; Frydland, M.; Fuchs, A.; Bang, L.; Houlind, K.; Olsen, M.; Soerensen, V.; Overgaard Andersen, U.; Dixen, U.; Refsgaard, J.; Moeller, D.; Zeuthen, E.; Lund, J.; Soegaard, P.; Jensen, S.; Duarte, Y.; Duarte, W.; Cáceres, S.; Pow Chon Long, F.; Peñaherrera, C.; Anzules, N.; Sánchez, M.; Zuleta, I.; López, J.; Villota, M.; Sánchez, H.; Perugachi, C.; Gómez, S.; Morejón, P.; Mármol, R.; Guamán, S.; Trujillo, F.; Escobar, M.; Carrera, F.; Ponce, F.; Terán, P.; Carrasco, S.; Tuomilehto, J.; Humaloja, K.; Lindberg, L.; Tuomilehto, H.; Tuominen, M.-L.; Kantola, I.; Juliard, J.; Feldman, L.; Ducrocq, G.; Boulogne, C.; Petitalot, V.; Leclercq, F.; Roubille, F.; Agullo, A.; Ferrari, E.; Chiche, O.; Moceri, P.; Boccara, F.; Charbonnier, M.; Azeddine, B.; Ederhy, S.; Soulat Dufour, L.; Cohen, A.; Etienney, A.; Messas, E.; Calvalido, A.; Galloula, A.; Zarka, S.; Courtois, M.-C.; Mismetti, P.; Accassat, S.; Buchmuller, A.; Moulin, N.; Bertoletti, L.; Seffert, B.; Sevestre, M.; Samy Modeliar Remond, S.; Dupas, S.; Mardyla, J.; Le Gloan, S.; Cayla, G.; Cornillet, L.; Schmutz, L.; Motreff, P.; Souteyrand, G.; Amonchot, A.; Barber-Charmoux, N.; Combaret, N.; Malcles, G.; Brenner, S.; Christa, M.; Duengen, H.; Krackhardt, F.; Bobenko, A.; Hashemi, D.; Stellbrink, C.; Stellbrink, E.; Köster, C.; Guerocak, O.; Bourhaial, H.; Oumbe Tiam, S.; Kemala, E.; Froemke, J.; Kadel, C.; Moellinger, H.; Friedrich, K.; Rafoud, K.; Braun-Dullaeus, R.; Herold, J.; Ganzer, M.; Jeserich, M.; Kimmel, S.; Haggenmiller, S.; Schoengart, H.; Voehringer, H.; Opitz, C.; Appel, K.; Appel, S.; Utech, A.; Finger, C.; Duersch, M.; Dorsel, T.; Wistorf, N.; Grude, M.; Nikol, S.; Ueberschaer, D.; Kast, P.; Darius, H.; Sommer, S.; Girke, F.; Oeztuerk, C.; Ranft, J.; Mikalo, A.; Schellong, S.; Voigts, B.; Mueller, C.; Jungmair, W.; Davierwala, P.; Misfeld, M.; Bomke, K.; Akhavuz, O.; Haensig, M.; Vorpahl, M.; Blem, A.; Langer, G.; Nover, I.; Koehler, T.; Bajnok, L.; Marton, Z.; Laszlo, Z.; Noori, E.; Veress, G.; Fogarassy, G.; Aradi, D.; Kelemen, B.; Vertes, A.; Davidovits, Z.; Zsary, A.; Kis, E.; Hepp, T.; Koranyi, L.; Peterfai, E.; Bezzegh, K.; Bakai, J.; Agardi, I.; Boda, Z.; Razso, K.; Poor, F.; Varallyay, Z.; Jarai, Z.; Sallai, L.; Dudas, M.; Barton, J.; Mahmood, K.; Makki, H.; McAdam, B.; Salim, T.; Murphy, A.; Crean, P.; Liddy, A. M.; Mahon, N.; Khan, I.; Hassan, S.; Curtin, R.; McFadden, E.; MacNeill, B.; Kyvelou, S.; Canavan, M.; Veerasingam, D.; Dinneen, S.; Halabi, M.; Rosenfeld, I.; Levinas, T.; Goldberg, A.; Khateeb, A.; Zimlichman, R.; Ben-Aharon, J.; Beniashvili, A.; Betsalel, A.; Zeltser, D.; Rogowski, O.; Mardi, T.; Rozenbaum, Z.; Turgeman, Y.; Or, T.; Rabkin, Y.; Klainman, E.; Halabi, S.; Halon, D. A.; Katz, A.; Plaev, T.; Drogenikov, T.; Atar, S.; Kilimnik, M.; Wishniak, A.; Merei, M.; Zvi, Y.; Nikolsky, E.; Zukermann, R.; Petcherski, S.; Bosi, S.; Gaitani, S.; Naldi, M.; Barbieri, A.; Faggiano, P.; Guidetti, F.; Adamo, M.; D’Aloia, A.; Magatelli, M.; Robba, D.; Mos, L.; Vriz, O.; Sinagra, G.; Maras, P.; Doimo, S.; Cosmi, F.; D'Orazio, S.; Oltrona Visconti, L.; Leonardi, S.; Vullo, E.; Sbaffi, A.; Azzara, G.; Mauri, S.; Gianni, U.; de Matteis, C.; Campidonico, U.; Di Pasquale, G.; Di Niro, M.; Riva, L.; Filippini, E.; Di Biase, M.; Ieva, R.; Martone, A.; Mandorla, S.; Regni, O.; Capponi, E. A.; Martinelli, S.; Bernardinangeli, M.; Proietti, G.; Piccinni, G. C.; Gualtieri, M. R.; Gulizia, M. M.; Francese, G. M.; Portale, A.; Galvani, M.; Ottani, F.; Capatano, O. G.; Conficoni, E.; Longhi, S.; Bachetti, C.; Venturi, F.; Capati, E.; Morocutti, G.; Bisceglia, T.; Fresco, C.; Baldin, M. G.; Gamba, C.; Olivieri, C.; Perna, G. P.; Battistoni, I.; Marini, M.; Cirrincione, V.; Ingrilli, F.; Kanno, T.; Ishii, Y.; Kohmura, C.; Igawa, T.; Izawa, K.; Daida, H.; Miyauchi, K.; Shimada, K.; Ohmura, H.; Ito, S.; Okazaki, S.; Konishi, H.; Miyazaki, T.; Hiki, M.; Kurata, T.; Suzuki, H.; Morimoto, R.; Yokoyama, M.; Yamamoto, T.; Okai, I.; Isoda, K.; Fujimoto, S.; Dohi, T.; Shimada, A.; Ozaki, Y.; Watanabe, E.; Kawai, H.; Naruse, H.; Takada, K.; Okuda, K.; Okumura, M.; Ishikawa, M.; Ohtsuki, M.; Ohta, M.; Sarai, M.; Koshikawa, M.; Kawai, M.; Miyagi, M.; Motoyama, S.; Matsui, S.; Ichikawa, T.; Kato, Y.; Nagahara, Y.; Muramatsu, T.; Hashimoto, Y.; Hoshino, N.; Harada, M.; Yamada, A.; Yoshiki, Y.; Motoike, Y.; Nomura, Y.; Miyajima, K.; Takatsu, H.; Nishimura, H.; Nagasaka, R.; Kawada, Y.; Miyamoto, N.; Seki, K.; Inoue, A.; Higashiue, S.; Kojima, S.; Kuroyanagi, S.; Furuya, O.; Komooka, M.; Yamamoto, S.; Wakabayashi, N.; Domae, H.; Ata, T.; Hashidomi, H.; Kawahara, R.; Hosokawa, S.; Hiasa, Y.; Otani, R.; Kishi, K.; Takahashi, T.; Yuba, K.; Miyajima, H.; Tobetto, Y.; Yoneda, K.; Ogura, R.; Kobayashi, H.; Takamura, T.; Enkou, K.; Ochi, Y.; Yamada, D.; Kuramochi, T.; Misumi, K.; Iiduka, D.; Hirose, M.; Tone, K.; Taniguchi, Y.; Ebihara, T.; Makino, M.; Yokota, M.; Nitta, M.; Udo, A.; Shimizu, S.; Fujii, K.; Iwakura, K.; Okamura, A.; Inoue, K.; Nagai, H.; Hirao, Y.; Tanaka, K.; Tanaka, N.; Yamasaki, T.; Oka, T.; Iwamoto, M.; Tanaka, T.; Nakamaru, R.; Okada, M.; Takayasu, K.; Sumiyoshi, A.; Inoue, H.; Kitagaki, R.; Ninomiya, Y.; Mizutomi, K.; Koizumi, I.; Funada, A.; Tagawa, S.; Kamide, S.; Saku, K.; Ideishi, M.; Ogawa, M.; Uehara, Y.; Iwata, A.; Nishikawa, H.; Ike, A.; Sugihara, M.; Imaizumi, S.; Fujimi, K.; Kawamura, A.; Sako, H.; Morito, N.; Morii, J.; Fukuda, Y.; Yahiro, E.; Matsunaga, A.; Matsumoto, N.; Noda, K.; Shiga, Y.; Nagata, Y.; Kimura, K.; Ebina, T.; Hibi, K.; Iwahashi, N.; Maejima, N.; Konishi, M.; Matsushita, K.; Minamimoto, Y.; Kawashima, C.; Nakahashi, H.; Kimura, Y.; Takahashi, H.; Matsuzawa, Y.; Kirigaya, J.; Sato, R.; Kikuchi, S.; Ogino, Y.; Kirigaya, H.; Kashiwase, K.; Hirata, A.; Takeda, Y.; Amiya, R.; Higuchi, Y.; Sakaguchi, T.; Nakano, T.; Matsusaki, N.; Suzuki, S.; Hayashi, T.; Nakatani, S.; Koide, M.; Kobayashi, T.; Hamanaka, Y.; Makino, N.; Sotomi, Y.; Abe, M.; Fujieda, H.; Hashimoto, K.; Teratani, Y.; Abe, Y.; Yokoyama, Y.; Higashino, H.; Okuda, H.; Yamazato, M.; Noda, T.; Arai, M.; Ono, K.; Hirose, T.; Iwama, M.; Warita, S.; Goto, Y.; Abe, S.; Kojima, T.; Yoshizane, T.; Tanihata, S.; Fujii, T.; Yagasaki, H.; Miwa, H.; Ishiguro, M.; Kato, T.; Watanabe, R.; Horio, S.; Mita, T.; Hirayama, A.; Watanabe, I.; Hiro, T.; Nakai, T.; Takayama, T.; Yoda, S.; Yajima, Y.; Okubo, K.; Okumura, Y.; Kato, M.; Fukamachi, D.; Aizawa, Y.; Sonoda, K.; Iida, K.; Sasaki, N.; Iso, K.; Takahashi, K.; Kougo, T.; Haruta, H.; Kurokawa, S.; Mano, H.; Nagashima, K.; Onaka, H.; Doi, H.; Hirano, N.; Okamoto, F.; Mori, K.; Ri, G.; Zushi, R.; Otsuka, K.; Inoko, M.; Haruna, T.; Nakane, E.; Miyamoto, S.; Izumi, T.; Honjo, S.; Ikeda, H.; Wada, Y.; Funasako, M.; Hayashi, H.; Hamasaki, A.; Sasaki, K.; Seko, Y.; Nakasone, K.; Hanyu, M.; Iwasaki, Y.; Iwasaki, K.; Ayano, S.; Hirokami, M.; Omoto, Y.; Sasaki, H.; Sato, H.; Yuda, S.; Okubo, M.; Matsuo, H.; Tsuchiya, K.; Kawase, Y.; Miyake, T.; Kondo, H.; Hattori, A.; Kikuchi, J.; Okamoto, S.; Hirata, T.; Kawamura, I.; Ota, H.; Omori, H.; Tanigaki, T.; Kamiya, H.; Sobue, Y.; Komoda, T.; Akatsuka, Y.; Yamamoto, M.; Isegawa, K.; Takanezawa, M.; Kataoka, C.; Imamaki, M.; Shibata, Y.; Yasuda, K.; Shimano, M.; Ozaki, R.; Morishita, Y.; Okabe, K.; Kondo, K.; Miura, A.; Manita, M.; Tabata, K.; Asahi, T.; Mashidori, T.; Higa, N.; Nakata, M.; Himi, T.; Matsudo, Y.; Sekine, T.; Hou, K.; Tonoike, N.; Hama, Y.; Tanaka, S.; Ge, B.; Takahara, M.; Ishimura, M.; Shikada, T.; Ueno, H.; Amemiya, H.; Hisamatsu, Y.; Sada, K.; Sato, T.; Harada, K.; Nakamura, T.; Ako, J.; Tojo, T.; Shimohama, T.; Kishihara, J.; Ishii, S.; Fukaya, H.; Meguro, K.; Nishino, Y.; Inoue, M.; Matsui, Y.; Omura, Y.; Kawakami, H.; Matsuoka, H.; Oshita, A.; Seike, F.; Kondo, N.; Miyoshi, T.; Yamada, Y.; Uchiya, T.; Kikuchi, Y.; Koretsune, Y.; Abe, H.; Shinouchi, K.; Nishida, H.; Yasumura, K.; Date, M.; Ueda, Y.; Iida, Y.; Idemoto, A.; Toriyama, C.; Yokoi, K.; Mishima, T.; Yamada, T.; Fukunami, M.; Morita, T.; Furukawa, Y.; Kawasaki, M.; Kikuchi, A.; Tamaki, S.; Seo, M.; Shirakawa, Y.; Ikeda, I.; Fukuhara, E.; Kawai, T.; Kayama, K.; Kawahira, M.; Tanabe, K.; Nakamura, J.; Shimomura, H.; Kudo, T.; Morisaki, S.; Ogura, Y.; Chazono, N.; Onoue, Y.; Matsumuro, Y.; Shirakawa, T.; Nishi, M.; Kinoshita, N.; Nakamura, R.; Miyai, N.; Ohta, K.; Sawanishi, T.; Takahashi, A.; Hada, T.; Nakajima, S.; Taniguchi, N.; Mizuguchi, Y.; Takahashi, Y.; Hashimoto, S.; Machida, M.; Hirabayashi, K.; Morimoto, S.; Higashino, Y.; Otsuji, S.; Takiuchi, S.; Yabuki, M.; Hasegawa, K.; Shishikura, D.; Ibuki, M.; Ishibuchi, K.; Nagayama, S.; Ishii, R.; Tamaru, H.; Yamamoto, W.; Utsu, N.; Miyakoshi, K.; Nakashima, D.; Tsukuda, K.; Ueda, K.; Nakano, A.; Fukuda, T.; Ikeda, S.; Tsuchiya, H.; Toshima, S.; Tateno, R.; Ishikubo, T.; Suguta, M.; Nakamura, S.; Funatsu, A.; Mizobuchi, M.; Tanaka, M.; Nagai, T.; Hirano, S.; Hashimoto, T.; Doi, T.; Shirasaka, A.; Takeda, S.; Sasaki, Y.; Ohya, H.; Hosokawa, A.; Nishina, N.; Koki, B.; Ando, K.; Hiramori, S.; Soga, Y.; Tomoi, Y.; Tohoku, S.; Shirai, S.; Hyodo, M.; Isotani, A.; Domei, T.; Kuramitsu, S.; Morinaga, T.; Hayashi, M.; Hiromasa, T.; Nagae, A.; Yamaji, Y.; Nakao, K.; Sakamoto, T.; Taguchi, E.; Tsurugi, T.; Tanaka, Y.; Suzuyama, H.; Koyama, J.; Nagano, M.; Okamatsu, H.; Kodama, K.; Nakamura, M.; Horibata, Y.; Sone, M.; Tsunemori, M.; Bando, M.; Nakayama, T.; Tanigaito, Y.; Nomoto, M.; Sawamura, T.; Unoki, T.; Lim, C. W.; Zainal Rashid, R.; Najme Khir, R.; Ibrahim, K. S.; Wan Azman, W. A.; Sridhar, G. S.; Watson, T.; Abu Kassim, Z.; Mahmood Zuhdi, A. S.; Abdul Hafidz, M. I.; Abu Hassan, M. R.; Wan Rahimi Shah, W. F.; Karthikesan, D.; Mohd Suan, M. A.; Md Ali, S. M.; Kasim, S.; Mohd Arshad, M. K.; Ismail, J. R.; Ibrahim, Z. O.; Chua, N. Y. L.; Abdul Rahim, A. A.; Rusani, B. I.; Yap, L. B.; Zamrin, D. M.; Amir, M. A.; Ismail, N. I.; Mohammad Razi, A. A.; Prins, F.; Bendermacher, P.; Burg, M.; Lok, D.; van der Sluis, A.; Martens, F.; Badings, E.; Milhous, J.; van Rossum, P.; Viergever, E.; van Hessen, M.; Willems, F.; Tjon Joe Gin, R.; Swart, H.; Oomen, A.; Kromhout, S.; Lauwerijssen, I.; Daalmans, M.; Breedveld, R.; de Vries, K.; Feenema Aardema, M.; Hofma, S.; van der Borgh, R.; van Nes, E.; Göbel, E.; Oei, F.; Dorman, H.; Bos, R.; Zoet-Nugteren, S.; Emans, M.; Kragten, H.; Lenderink, T.; Feld, R.; Herrman, J.; van Bergen, P.; Gosselink, M.; Elvan, A.; Hoekstra, E.; The, S.; de Vries, R.; Zegers, E.; Oude Ophuis, T.; Remmen, J.; Bech, J.; Kooistra, J.; den Hartog, F.; Oosterhof, T.; Bartels, G.; Posma, J.; Nierop, P.; Liem, A.; van der Zwaan, C.; Asselman, M.; van Eck, J.; Gevers, R.; van Gorselen, E.; van Hal, J.; Terpstra, W.; Groenemeijer, B.; Jerzewski, A.; Hoogslag, P.; Geertman, J.; de Groot, M.; Dijkstra, B.; Loyola, A.; Sulit, D.; Mercado, M. J.; Rey, N.; Evangelista, L.; Abola, M.; Padua, L.; Morales, D.; Palomares, E.; Abat, M.; Santos, R.; Rogelio, G.; Chua, P.; Baello, R.; del Pilar, J.; Alianza, M.; Alcaraz, J.; Alcaraz, L.; Ebo, G.; Guido-Saliot, I.; Tirador, L.; Estoce, E.; Ygpuara, M.; Cruz, J.; Anonuevo, J.; Pitargue, A.; Janion, M.; Drewniak, Z.; Guzik, B.; Nowak, M.; Nosal, M.; Niewiara, Ł; Gajos, G.; Bury, K.; Czubek, U.; Misztal, M.; Grzybczak, R.; Zalewski, J.; Kruszelnicka-Kwiatkowska, O.; Żabówka, M.; Rynkiewicz, A.; Grzybowski, A.; Szałkowski, P.; Broncel, M.; Gorzelak, P.; Możdżan, M.; Olszewska Banaszczyk, M.; Szuba, A.; Tabin, M.; Chachaj, A.; Czarnecka, D.; Terlecki, M.; Klocek, M.; Maga, P.; Coman, I.; Tarlea, M.; Ghionea, M.; Gavrila, C.; Dimulescu, D.; Popescu, A.; Stoicescu, C.; Vintila, V.; Florescu, M.; Baghilovici Cretu, D.; Suran, M.; Mihalcea, D.; Lungeanu Juravle, L.; Cinteza, M.; Calin, I.; Bicescu, G.; Vasile Toma, N.; Udroiu, C.; Gherghinescu, C.; Darabont, R.; Patrascu, N.; Constantinescu, C.; Popescu, I.; Sinescu, C.; Andrei, C.; Axente, L.; Arsenescu, C.; Statescu, C.; Ardeleanu, I.; Anghel, L.; Benedek, I.; Benedek, T.; Kinga, P.; Banga, D. K.; Bobescu, E.; Doka, B.; Dobreanu, D.; Sirbu, V.; Rudzik, R.; Kantor, K.; Sus, I.; Gaita, D.; Maximov, D.; Brie, D.; Mosteoru, S.; Olariu, I.; Iancu, A.; Marc, M.; Hagiu, R.; Manole, V.; Molnar, A.; Dregoesc, I.; Iliesiu, A.; Armean, P.; Parvu, I.; Deleanu, A.; Lighezan, D.; Buzas, R.; Petrescu, L.; Nicola, R.; Dan, R.; Crisan, S.; Trasca, L.; Teodorescu, I.; Zara, O.; Tiron, T.; Tesloianu, D.; Spiridon, M.; Vintila, M.; Baluta, M.; Chioncel, O.; Stoica, E.; Kulcsar, I.; Antohi, L.; Strazhesko, I.; Tkacheva, O.; Sharashkina, N.; Pykhtina, V.; Vasyuk, Y.; Shkolnik, E.; Khadzegova, A.; Sadulaeva, I.; Ivanova, S.; Nesterova, E.; Nesvetov, V.; Shupenina, E.; Shcherbak, M.; Sizova, Z.; Beloborodova, A.; Pozdnyakov, Y.; Tarasov, A.; Shvedov, I.; Zabashta, S.; Ryzhikova, I.; Barbarash, O.; Pecherina, T.; Vatutin, M.; Inozemceva, A.; Kazachek, Y.; Mineeva, E.; Kupriyanova, T.; Voevoda, M.; Gafarov, V.; Gromova, E.; Panov, D.; Voevoda, E.; Kovalkova, N.; Ragino, Y.; Poponina, T.; Poponina, Y.; Garganeeva, N.; Repin, A.; Vershinina, E.; Borodina, E.; Kalashnikova, T.; Safyanova, O.; Osipova, I.; Antropova, O.; Pyrikova, N.; Polyakova, I.; Efremushkina, A.; Guryanova, N.; Kiseleva, E.; Lomteva, E.; Shtyrova, T.; Novikova, N.; Parfenov, D.; Volovchenko, A.; Averkov, O.; Pavlikova, E.; Vaulina, L.; Pletnikova, I.; Mishchenko, L.; Saranin, S.; Tsupko, I.; Kuznetsova, N.; Zateyshchikov, D.; Dankovtseva, E.; Vlazneva, Y.; Tolokonnikova, N.; Zhurina, M.; Zubova, E.; Aseycheva, O.; Sigalovich, E.; Vertkin, A.; Rodiukova, I.; Komissarov, S.; Sokolova, R.; Ausheva, A.; Salbieva, A.; Yusubova, A.; Isakova, S.; Hranai, M.; Obona, P.; Cisar, P.; Semetko, J.; Vanova, P.; Ferencikova, Z.; Vykoukalova, T.; Gaspar, L.; Caprnda, M.; Bendzala, M.; Pella, D.; Fedacko, J.; Hatalova, K.; Drozdakova, E.; Peter, O.; Ntsekhe, M.; de Andrade, M.; Seedat, S.; Gani, M.; van Zyl, L.; Naude, M.; Cronje, T.; van Zyl, F.; Engelbrecht, J.; Jansen, J.; Roos, J.; Makotoko, E.; Pretorius, C.; Mirna, S.; Nell, H.; Pretorius, M.; Basson, M.; Njovane, X.; Mohamed, Z.; Pillay, T.; Dawood, S.; Horak, A.; Lloyd, E.; Hitzeroth, J.; Mabin, T.; Abelson, M.; Klug, E.; Gebka, M.; Hellig, F.; Alison, M.; Bae, J.; Kim, C.; Kim, D.; Joo, S.; Park, C.; Kim, Y.; Jarnert, C.; Rydén, L.; Mooe, T.; Binsell-Gerdin, E.; Dellborg, M.; Torstensson, I.; Albertsson, P.; Hiller, M.; Perers, E.; Johansson, L.; Jansson, J. H.; Al-Khalili, F.; Almroth, H.; Andersson, T.; Eriksson Östman, M.; Pantev, E.; Utter, F.; Tengmark, B. O.; Olsson, Å; Liu, B.; Rasmanis, G.; Wahlgren, C. M.; Thott, O.; Moccetti, T.; Rossi, M. 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M.; Tremblay, H.; Bergeron, A.; Dumont, J.; Keilani, S.; Landry, P.; Deneufbourg, I.; Breton, C.; Bilodeau, N.; Côté, M.; Dumont, F.; Dufort, L.; Marcoux, D.; David, M.; Otis, R.; Parks, J.; Cepidoza, C.; Janz, W.; Weighell, W.; Yaworski, S.; Boyd, K.; Lambert, J.; Shea-Landry, G.; Reid, K.; Thiessen, S.; Nemtean, D.; Futers, S.; Drouin, K.; Masson, C.; Arseneault, M. C.; Lachance, N.; Bergeron, C.; Boudreault, C.; Perkins, L.; Barnett, A.; Fortin, J.; Duclos, R.; Vallières, C.; Bouchard-Pilote, C.; Ouimet, F.; Roberge, B.; Couture, M. L.; Deshaies, D.; Bastien, A.; Chartrand, M. J.; Gagné, N. L.; Desbiens, K.; Alarie, P.; Cassan, J.; Ducharme, Y.; Roy D Tapps, I.; Bolduc, H.; Laliberté, J.; Hickey, L.; Spero, M.; Bernstein, M.; Clement, J.; Pawluch, A.; Ricci-Bonzey, M.; Richer, J.; Vaillancourt, J.; Ward, B.; Mostafai Rad, P.; Oleski, L.; Karkhanis, R.; Hartleib, V.; Poirier, R.; Hidalgo, J.; Hernandez, C.; Obreque, C.; Quilapi, D.; Villa, F.; Iturriaga, C.; Ferrada, M.; Navarrete, S.; Becerra, E.; Vargas, C.; Roque, C.; Alarcon, J.; Diaz, D.; Sepulveda, M.; Villan, C.; Garcia, N.; Lara, C.; Lezana, B.; Basso, N.; Torres, G.; Pasmino, C.; Gonzalez, S.; Medina, D.; Rodriguez, T.; Guo, T.; Chen, S.; Han, W.; Shi, D.; Zhang, Q.; Li, W.; Cui, L.; Huang, Z.; Gong, X.; Liu, D.; Tan, S.; Caicedo, L.; Rodriguez, A.; Mejia, I.; Escalante Ruiz, J.; Camera Ochoa, C.; Conrrado Ortega, Y.; Accini Diaz, A.; Rodriguez, B.; Lopez-Lopez, J.; Di Stefano, K.; Florez, L.; Manco, T.; Rodriguez, D.; Urina, A.; de La Hoz, L.; Almendrales, L.; Bello, O.; Urrea Valencia, H.; Correa Rivera, P.; Perdomo, I.; Alzate, J.; Rivera, E.; Jimenez, N. 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L.; Savoldi, D.; Fiorini, M.; Ramani, F.; Mariottoni, B.; Rizzotti, D.; Di Matteo, C.; Musio, S.; Pieroni Minciaroli, S.; Serani, S.; Aloisi, A.; Attanasio, C.; Tricoli, M.; Giordano, V.; Andrioli, V.; Biundo, V.; Tullio, L.; Schiff, D.; Trovarelli, P.; Chiodi, R.; Sampaolesi, S.; Cina, M. T.; Abatello, M.; de Tora, M.; Pietrucci, F.; Pezzetta, S.; Chiminelli, E.; Dall’Asta, A.; Bennati, M.; Elia, A.; Bizzoco, M.; Iaquaniello, A.; Spigarelli, R.; Cremonesi, C.; Gagliardi, M.; Torricelli, L.; Ijichi, N.; Shiraiwa, K.; Murakami, M.; Takeshita, K.; Sato, M.; Shiratori, A.; Kinjo, K.; Tomita, K.; Mizuno, M.; Kurihara, F.; Tachibana, M.; Nitta, Y.; Unno, K.; Hiramatsu, H.; Sano, A.; Nanatsumura, M.; Tanikawa, I.; Uesugi, K.; Banno, S.; Miyata, T.; Kujuji, A.; Kawai, K.; Maegawa, A.; Koseki, T.; Watanabe, Y.; Aoki, S.; Maesawa, M.; Suzuki, A.; Itose, Y.; Konishi, K.; Fujieda, K.; Nakade, S.; Minami, M.; Yoneda, J.; Akiyama, R.; Sakai, S.; Nakatani, K.; Yamazaki, A.; Funama, M.; Kaneko, E.; Morii, S.; Onishi, M.; Sone, A.; Sagawa, N.; Iwai, F.; Kawahara, A.; Hasimoto, C.; Ueki, M.; Kamiji, M.; Ando, M.; Yokoo, M.; Okada, Y.; Yamada, H.; Matsushige, N.; Nagato, A.; Matsumoto, R.; Nishikawa, M.; Oka, I.; Kitou, S.; Tachiuchi, M.; Nakagawa, M.; Yoneda, S.; Iwasa, K.; Matsuda, J.; Oda, A.; Tokudome, S.; Kaneyuki, Y.; Higaki, M.; Yoneda, H.; Kajita, C.; Suwa, K.; Sato, E.; Nagata, T.; Kubo, Y.; Umesu, A.; Ohashi, K.; Takeuchi, M.; Tanaka, I.; Nobehara, T.; Yamano, R.; Yumiba, A.; Hamada, M.; Nishihata, T.; Ohashi, Y.; Morita, M.; Endo, M.; Matsugi, M.; Tateishi, H.; Nakamori, R.; Yamashita, Y.; Okabe, M.; Matsuo, M.; Ono, T.; Shigeyama, Y.; Ichiyanagi, M.; Sugimori, K.; Ohmura, C.; Igarashi, M.; Aotsuka, S.; Komoda, N.; Watanabe, M.; Enomoto, Y.; Suzuki, Y.; Kawaguchi, A.; Kasahara, A.; Koide, A.; Sakatani, T.; Kurihara, T.; Yokota, S.; Futagi, R.; Amemiya, Y.; Ono, E.; Maeda, A.; Kadono, K.; Ishiguchi, Y.; Kikuchi, R.; Kuramatsu, M.; Nakamura, E.; Chiba, S.; Higa, A.; Kitahashi, M.; Tanaka, H.; Ito, T.; Oba, M.; Tsubouchi, M.; Toshima, M.; Morishita, M.; Miyano, A.; Kondo, M.; Watanabe, K.; Shibata, R.; Tosaki, Y.; Ito, Y.; Saoda, M.; Yamasaki, E.; Kadosaki, S.; Motooka, S.; Akiyoshi, H.; Morio, S.; Nemoto, H.; Yoshizawa, S.; Okabe, N.; Semba, K.; Yoshida, A.; Lee, Y.; Yoshida, M.; Iwashita, Y.; Takeda, A.; Maezato, M.; Kawahira, K.; Yoshikawa, M.; Okamoto, N.; Nishimura, M.; Matsuura, K.; Fukunaga, M.; Fukai, K.; Osakabe, Y.; Yamamura, K.; Koike, M.; Shibuya, S.; Shiramata, M.; Ono, Y.; Tsujimoto, Y.; Tadokoro, T.; Morishita, N.; Matsuo, Y.; Yumoto, I.; Sakazaki, S.; Atarashi, A.; Nabata, Y.; Okuda, N.; Fujita, A.; Matsuo, A.; Ishizawa, Y.; Shibata, H.; Ootsuka, M.; Taimatsu, R.; Takeuchi, A.; Sumi, Y.; Yamamoto, F.; Araki, Y.; Tanaka, A.; Kuroda, S.; Sakata, R.; Okada, N.; Sawada, Y.; Miyata, M.; Asayama, H.; Koga, N.; Miki, T.; Yamaguchi, N.; Hashimoto, A.; Fukuike, C.; Kubo, A.; Yamasaki, M.; Mori, Y.; Nakayama, S.; Kobayashi, Y.; Takenaka, S.; Mashima, M.; Katsuta, H.; Matsumura, T.; Yanagida, S.; Watanabe, N.; Kodama, S.; Kusano, M.; Yamamoto, N.; Kamada, R.; Suzuki, K.; Itami, K.; Hasebe, Y.; Fujita, N.; Kubota, S.; Usuki, A.; Okamoto, M.; Uno, S.; Chikuma, A.; Kishikawa, H.; Yano K Nakano, C.; Otaguro, M.; Kayashima, Y.; Shinoda, M.; Jaafar, S. M.; Baharuddin, S.; Gembor, J.; Ahmad, H.; Syed Mansor, S. M.; Abdullah, W. M.; Shafie, Z.; Muhamad Yunus, S.; Alwi, S. M.; Hussin, N.; Basri, N. A.; Ling Ling, L.; Naem, N. S.; Rutten, R.; Rademaker, H.; van Buijsen, M.; Scholten, M.; Stuij, S.; van Zeijst, M.; van Houwelingen, K.; Engelen, W.; Kramer, H.; Maassen, E.; Verhoeven, P.; Awater, J.; Terwisscha van Scheltinga, C.; Meijlis, P.; Blom, L.; Bos, M.; van der Wal, M.; van Laerhoven, G.; Jacobs, T.; Tan-Urgert, B.; van de Gaag, J.; den Boer, P.; Verlek, E.; Lardinois, R.; Coenjaerds, C.; Hendrick, R.; Schoep, J.; Froma, E.; van Nes, C.; Beuving, D.; Krikken, J.; Drent, I.; Geerlings, F.; Buvelot, S.; Wissenburg, A.; Dijkshoorn, A.; van Setten van der Meer, L.; Singerling, M.; van Wijk, D.; Bor, A.; Aukema-Wouda, Z.; Hendriks-van Woerden, M.; Kort, I.; Danse, I.; van der Knaap, M.; de Jong, C.; Temminck, M.; Schaefer, T.; van der Ven, N.; Drost, I.; Mulder, R.; de Vos, A.; de Hoop, M.; Post, G.; Wielandt, D.; Edorot, N.; de Castro, K.; Flotildes, M.; Mulingtapang, T.; Vasquez, S.; Facundo, S.; Peralta, M.; Jose, M.; Bandiez, J.; Sulit, P.; Joaquin, F.; Arbis, M. G.; Silva, C.; Delgado, D.; de Leon, R.; Maglasang, P.; Sian, A.; Alagban, C.; Alcorano, J.; Marcelo, M. J.; Dela Pena, C.; Hyra, I.; Malkiewicz, B.; Mosakowska, K.; Cana, I.; Dobrin, I.; Lautaru, A.; Manescu, G.; Samoila, N.; Lacatus, M.; Apostoie, A.; Prunoiu, M.; Tilinca, M.; Budeanu, A.; Nedelcu, C.; Dumitrache, N.; Boeru, L.; Zhuravleva, E.; Gundova, M.; Hoffmannova, J.; Svitkova, M.; Pekarova, T.; Ujacka, K.; Zsoriova, T.; Kubincova, K.; Jankovicova, Z.; Talliard, C.; Tyumbu, N.; Mngoma, N.; Kannemeyer, M.; Mostert, J.; Page, A.; Krahenbuhl, C.; Tredoux, C.; Hendricks, L.; Oliver, S.; Le Grange, M.; Naidoo, V.; Bae, Y.; Kim, H.; Lee, J.; Yu, N.; An, S.; Kim, E.; Yang, K.; Woo, J.; Kim, S.; Rasck, J.; Smetana, S.; Ajax, K.; Bylander, L.; Lindberg, A.; Dellborg, H.; Hultsberg-Olsson, G.; Harsmar, K.; Knutsson, A.; Håkansson, L.; Kåveryd-Holmström, M.; Lundmark, L. M.; Norrfors, B.; Löf, P.; Skoglund, K.; Torgersruud, M.; Johansson, K.; Mattsson, A.; Quist, M.; Haglund, P.; Lundell, L.; Gunvasdotter, S.; Rangman, B.; Liu, R.; Shi, J.; Förstedt, G.; Nylund, L.; Welin-Berger, B.; Nilsson, O.; Garcia-Värlid, A.; Forlenza, R.; Kaminska, K.; Nagorna, T.; Cottam, V.; Harper, R.; Gilchrist, M.; Musanhu, R.; Mackin, A.; Turner, A.; Willetts, S.; Cadd, A.; Evans, J.; Young, G.; Sevillano, A.; Brodie, K.; Eccles, A.; Kelly, S.; Doughty, A.; Gray, J.; Gibson, M.; Finlayson, M.; Domingo, D.; Brazee, L.; Renaud, K.; Doman, A.; Meyer, R.; Beatty, J.; Morgan, T.; Rodas, E.; Campbell, D.; Mcquarrie, M.; Battistelli, E.; Eisenbraun, P.; Farley, R.; Park, H.; Dwyer, J.; Adams, K.; Schneider, W.; Barbour, C.; Whyne, E.; Budzinski, S.; Craig, M.; Gilley Elmore, J.; Scott, D.; Bellini, S.; Pepper, M.; Gunderson, K.; Stipek, I.; Schwarz, L.; Watkins, K.; Moore, V.; Palao, A.; Keane-Richmond, P.; Franklin, L.; Ward, L.; Kostedt, G.; Bailey, S.; Hollenweger, L.; Solomon, A.; Johnson, D.; Gloer, K.; Meyer, M.; Boleyn, M.; Nieters, D.; Humphrey, K.; Bohn, A.; Mueller, G.; Mckenzie, H.; Edwards, T.; Velky, J.; Cole, C.; Diederick, M.; Burg, S.; Coulson, T.; Karunaratne, K.; Gunasekera, R.; Cook, S.; Fisher, S.; Garrison, K.; Passey, L.; Kuykendall, K.; Luck, K.; Ramia, L.; Joan, H.; Reynoso, F.; Farley, M.; Shuman, S.; Santana-Fernandes, E.; Ventimiglia, A.; Steele, V.; Gers, L.; Brown, P.; Wilson, J.; Freebersyser, J.; Reno, M.; Buettner, N.; McGovern, M.; Hubbard, T.; Elmore, H.; Payne, D.; Mccann, M.; Decker, S.; Sharp, A.; Forgey, E.; Broussard, E.; Juett, U.; Siddiqui, A.

    2017-01-01

    We evaluated whether rivaroxaban alone or in combination with aspirin would be more effective than aspirin alone for secondary cardiovascular prevention. In this double-blind trial, we randomly assigned 27,395 participants with stable atherosclerotic vascular disease to receive rivaroxaban (2.5 mg

  9. Ivabradine in stable coronary artery disease without clinical heart failure

    DEFF Research Database (Denmark)

    Fox, Kim; Ford, Ian; Steg, Philippe Gabriel

    2014-01-01

    BACKGROUND: An elevated heart rate is an established marker of cardiovascular risk. Previous analyses have suggested that ivabradine, a heart-rate-reducing agent, may improve outcomes in patients with stable coronary artery disease, left ventricular dysfunction, and a heart rate of 70 beats per m...

  10. Rationale, design, and baseline characteristics of the CLARIFY registry of outpatients with stable coronary artery disease.

    Science.gov (United States)

    Sorbets, Emmanuel; Greenlaw, Nicola; Ferrari, Roberto; Ford, Ian; Fox, Kim M; Tardif, Jean-Claude; Tendera, Michal; Steg, Philippe Gabriel

    2017-10-01

    Despite major advances in prevention and treatment, coronary artery disease (CAD) remains the leading cause of death worldwide. Whereas many sources of data are available on the epidemiology of acute coronary syndromes, fewer datasets reflect the contemporary management and outcomes of stable CAD patients. A worldwide contemporary registry would improve our knowledge about stable CAD. The main objectives are to describe the demographics, clinical profile, contemporary management and outcomes of outpatients with stable CAD; to identify gaps between evidence and treatment; and to investigate long-term prognostic determinants. CLARIFY (ProspeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease) is an ongoing international observational longitudinal registry. Stable CAD patients from 45 countries in Europe, Asia, America, Middle East, Australia and Africa were enrolled between November 2009 and June 2010. The inclusion criteria were previous myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischemia or prior revascularization procedure. The main exclusion criteria were serious non-cardiovascular disease, conditions interfering with life expectancy or severe other cardiovascular disease (including advanced heart failure). Follow-up visits were planned annually for up to 5 years, interspersed with 6-month telephone calls. Of the 32,703 patients enrolled, most (77.6%) were male, age (mean ± SD) was 64.2 ± 10.5 years, and 71.0% were receiving treatment for hypertension; mean ± SD resting heart rate was 68.2 ± 10.6 bpm. Patients were enrolled based on a history of myocardial infarction >3 months earlier (57.7%), having at least one stenosis >50% on coronary angiography (61.1%), proven symptomatic myocardial ischemia on non-invasive testing (23.1%), or history of percutaneous coronary intervention or coronary artery bypass graft (69.8%). Baseline characteristics were similar across the four

  11. Developing Scenarios for Uncertain Complex Risks : Using SD to Explore Futures of Lyme Disease in the Netherlands

    NARCIS (Netherlands)

    Pruyt, E.; Coumou, J.

    2012-01-01

    Lyme disease due to infection with Lyme borreliosis poses an uncertain dynamic threat to the Dutch and their public health system. This risk was used to develop and illustrate two variants of a National Risk Assessment approaches for slumbering/latent risks. This paper explains and illustrates the

  12. Stable ischemic heart disease in women: current perspectives

    Directory of Open Access Journals (Sweden)

    Samad F

    2017-09-01

    Full Text Available Fatima Samad,1 Anushree Agarwal,2 Zainab Samad3 1Aurora Cardiovascular Services, Aurora Sinai/Aurora St Luke’s Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, WI, 2Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, 3Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC, USA Abstract: Cardiovascular disease is the leading cause of death in women accounting for 1 in every 4 female deaths. Pathophysiology of ischemic heart disease in women includes epicardial coronary artery, endothelial dysfunction, coronary vasospasm, plaque erosion and spontaneous coronary artery dissection. Angina is the most common presentation of stable ischemic heart disease (SIHD in women. Risk factors for SIHD include traditional risks such as older age, obesity (body mass index [BMI] >25 kg/m2, smoking, hypertension, dyslipidemia, cerebrovascular and peripheral vascular disease, sedentary lifestyle, family history of premature coronary artery disease, metabolic syndrome and diabetes mellitus, and nontraditional risk factors, such as gestational diabetes, insulin resistance/polycystic ovarian disease, pregnancy-induced hypertension, pre-eclampsia, eclampsia, menopause, mental stress and autoimmune diseases. Diagnostic testing can be used effectively to risk stratify women. Guidelines-directed medical therapy including aspirin, statins, beta-blocker therapy, calcium channel blockers and ranolazine should be instituted for symptom and ischemia management. Despite robust evidence regarding the adverse outcomes seen in women with ischemic heart disease, knowledge gaps exist in several areas. Future research needs to be directed toward a greater understanding of the role of nontraditional risk factors for SIHD in women, gaining deeper insights into the sex differences in therapeutic effects and formulating a sex-specific algorithm for the

  13. Exhaled nitric oxide in stable chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Beg Mohammed

    2009-01-01

    Full Text Available Study Objective : The objective of the study was to test the hypothesis that fraction of exhaled nitric oxide (FENO is elevated in nonsmoking subjects with stable chronic obstructive pulmonary disease (COPD and compare it with the results in patients with asthma and a control population. Design : Cross-sectional study. Materials and Methods : Pulmonology Clinic at a University Hospital. Twenty five control subjects, 25 steroid naοve asthmatics and 14 COPD patients were studied. All the patients were nonsmokers and stable at the time of the study. All subjects completed a questionnaire and underwent spirometry. Exhaled nitric oxide was measured online by chemiluminescence, using single-breath technique. Results : All the study subjects were males. Subjects with stable COPD had significantly higher values of FENO than controls (56.54±28.01 vs 22.00±6.69; P =0.0001 but lower than the subjects with asthma (56.54±28.01 vs 84.78±39.32 P = 0.0285.The FENO values in COPD subjects were inversely related to the FEV 1 /FVC ratio. There was a significant overlap between the FENO values in COPD and the control subjects. Conclusion : There is a significant elevation in FENO in patients with stable COPD, but the elevation is less than in asthmatic subjects. Its value in clinical practice may be limited by the significant overlap with control subjects.

  14. Exhaled nitric oxide in stable chronic obstructive pulmonary disease

    Science.gov (United States)

    Beg, Mohammed F. S.; Alzoghaibi, Mohammad A.; Abba, Abdullah A.; Habib, Syed S.

    2009-01-01

    STUDY OBJECTIVE: The objective of the study was to test the hypothesis that fraction of exhaled nitric oxide (FENO) is elevated in nonsmoking subjects with stable chronic obstructive pulmonary disease (COPD) and compare it with the results in patients with asthma and a control population. DESIGN: Cross-sectional study. MATERIALS AND METHODS: Pulmonology Clinic at a University Hospital. Twenty five control subjects, 25 steroid naïve asthmatics and 14 COPD patients were studied. All the patients were nonsmokers and stable at the time of the study. All subjects completed a questionnaire and underwent spirometry. Exhaled nitric oxide was measured online by chemiluminescence, using single-breath technique. RESULTS: All the study subjects were males. Subjects with stable COPD had significantly higher values of FENO than controls (56.54±28.01 vs 22.00±6.69; P=0.0001) but lower than the subjects with asthma (56.54±28.01 vs 84.78±39.32 P=0.0285).The FENO values in COPD subjects were inversely related to the FEV1/FVC ratio. There was a significant overlap between the FENO values in COPD and the control subjects. CONCLUSION: There is a significant elevation in FENO in patients with stable COPD, but the elevation is less than in asthmatic subjects. Its value in clinical practice may be limited by the significant overlap with control subjects. PMID:19561927

  15. Exhaled nitric oxide in stable chronic obstructive pulmonary disease

    International Nuclear Information System (INIS)

    Beg Mohammed F S; Alzoghaibi, Mohammad A; Habib, Syed S; Abba, Abdullah A

    2009-01-01

    The objective of the study was to test the hypothesis that fraction of exhaled nitric oxide (FENO) is elevated in nonsmoking subjects with stable chronic obstructive pulmonary disease (COPD) and compare it with the results in patients with asthma and a control population. Pulmonology Clinic at a University Hospital. Twenty five control subjects, 25 steroid naive asthmatics and 14 COPD patients were studied. All the patients were nonsmokers and stable at the time of the study. All subjects completed a questionnaire and underwent spirometry. Exhaled nitric oxide was measured online by chemiluminescence, using single-breath technique. All the study subjects were males. Subjects with stable COPD had significantly higher values of FENO than controls (56.54+ - 28.01 vs 22.00 + -6.69; P =0.0001) but lower than the subjects with asthma (56.54+ - 28.01 vs 84.78+ - 39.32 P 0.0285). The FENO values in COPD subjects were inversely related to the FEV 1 /FVC ratio. There was a significant overlap between the FENO values in COPD and the control subjects. There is a significant elevation in FENO in patients with stable COPD, but the elevation is less than in asthmatic subjects. Its value in clinical practice may be limited by the significant overlap with control subjects. (author)

  16. Stable ischemic heart disease in women: current perspectives.

    Science.gov (United States)

    Samad, Fatima; Agarwal, Anushree; Samad, Zainab

    2017-01-01

    Cardiovascular disease is the leading cause of death in women accounting for 1 in every 4 female deaths. Pathophysiology of ischemic heart disease in women includes epicardial coronary artery, endothelial dysfunction, coronary vasospasm, plaque erosion and spontaneous coronary artery dissection. Angina is the most common presentation of stable ischemic heart disease (SIHD) in women. Risk factors for SIHD include traditional risks such as older age, obesity (body mass index [BMI] >25 kg/m 2 ), smoking, hypertension, dyslipidemia, cerebrovascular and peripheral vascular disease, sedentary lifestyle, family history of premature coronary artery disease, metabolic syndrome and diabetes mellitus, and nontraditional risk factors, such as gestational diabetes, insulin resistance/polycystic ovarian disease, pregnancy-induced hypertension, pre-eclampsia, eclampsia, menopause, mental stress and autoimmune diseases. Diagnostic testing can be used effectively to risk stratify women. Guidelines-directed medical therapy including aspirin, statins, beta-blocker therapy, calcium channel blockers and ranolazine should be instituted for symptom and ischemia management. Despite robust evidence regarding the adverse outcomes seen in women with ischemic heart disease, knowledge gaps exist in several areas. Future research needs to be directed toward a greater understanding of the role of nontraditional risk factors for SIHD in women, gaining deeper insights into the sex differences in therapeutic effects and formulating a sex-specific algorithm for the management of SIHD in women.

  17. Management standards for stable coronary artery disease in India

    Directory of Open Access Journals (Sweden)

    Sundeep Mishra

    2016-12-01

    Full Text Available Coronary artery disease (CAD is one of the important causes of cardiovascular morbidity and mortality globally, giving rise to more than 7 million deaths annually. An increasing burden of CAD in India is a major cause of concern with angina being the leading manifestation. Stable coronary artery disease (SCAD is characterised by episodes of transient central chest pain (angina pectoris, often triggered by exercise, emotion or other forms of stress, generally triggered by a reversible mismatch between myocardial oxygen demand and supply resulting in myocardial ischemia or hypoxia. A stabilised, frequently asymptomatic phase following an acute coronary syndrome (ACS is also classified as SCAD. This definition of SCAD also encompasses vasospastic and microvascular angina under the common umbrella.

  18. Silent disease progression in clinically stable heart failure.

    Science.gov (United States)

    Sabbah, Hani N

    2017-04-01

    Heart failure with reduced ejection fraction (HFrEF) is a progressive disorder whereby cardiac structure and function continue to deteriorate, often despite the absence of clinically apparent signs and symptoms of a worsening disease state. This silent yet progressive nature of HFrEF can contribute to the increased risk of death-even in patients who are 'clinically stable', or who are asymptomatic or only mildly symptomatic-because it often goes undetected and/or undertreated. Current therapies are aimed at improving clinical symptoms, and several agents more directly target the underlying causes of disease; however, new therapies are needed that can more fully address factors responsible for underlying progressive cardiac dysfunction. In this review, mechanisms that drive HFrEF, including ongoing cardiomyocyte loss, mitochondrial abnormalities, impaired calcium cycling, elevated LV wall stress, reactive interstitial fibrosis, and cardiomyocyte hypertrophy, are discussed. Additionally, limitations of current HF therapies are reviewed, with a focus on how these therapies are designed to counteract the deleterious effects of compensatory neurohumoral activation but do not fully prevent disease progression. Finally, new investigational therapies that may improve the underlying molecular, cellular, and structural abnormalities associated with HF progression are reviewed. © 2016 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

  19. Rivaroxaban with or without aspirin in stable cardiovascular disease

    DEFF Research Database (Denmark)

    Eikelboom, John W; Connolly, Stuart J; Bosch, Jackie

    2017-01-01

    BACKGROUND: We evaluated whether rivaroxaban alone or in combination with aspirin would be more effective than aspirin alone for secondary cardiovascular prevention. METHODS: In this double-blind trial, we randomly assigned 27,395 participants with stable atherosclerotic vascular disease to receive...... rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg once daily). The primary outcome was a composite of cardiovascular death, stroke, or myocardial infarction. The study was stopped for superiority of the rivaroxaban-plus-aspirin group after...... a mean follow-up of 23 months. RESULTS: The primary outcome occurred in fewer patients in the rivaroxaban-plus-aspirin group than in the aspirin-alone group (379 patients [4.1%] vs. 496 patients [5.4%]; hazard ratio, 0.76; 95% confidence interval [CI], 0.66 to 0.86; P

  20. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease.

    Science.gov (United States)

    Eikelboom, John W; Connolly, Stuart J; Bosch, Jackie; Dagenais, Gilles R; Hart, Robert G; Shestakovska, Olga; Diaz, Rafael; Alings, Marco; Lonn, Eva M; Anand, Sonia S; Widimsky, Petr; Hori, Masatsugu; Avezum, Alvaro; Piegas, Leopoldo S; Branch, Kelley R H; Probstfield, Jeffrey; Bhatt, Deepak L; Zhu, Jun; Liang, Yan; Maggioni, Aldo P; Lopez-Jaramillo, Patricio; O'Donnell, Martin; Kakkar, Ajay K; Fox, Keith A A; Parkhomenko, Alexander N; Ertl, Georg; Störk, Stefan; Keltai, Matyas; Ryden, Lars; Pogosova, Nana; Dans, Antonio L; Lanas, Fernando; Commerford, Patrick J; Torp-Pedersen, Christian; Guzik, Tomek J; Verhamme, Peter B; Vinereanu, Dragos; Kim, Jae-Hyung; Tonkin, Andrew M; Lewis, Basil S; Felix, Camilo; Yusoff, Khalid; Steg, P Gabriel; Metsarinne, Kaj P; Cook Bruns, Nancy; Misselwitz, Frank; Chen, Edmond; Leong, Darryl; Yusuf, Salim

    2017-10-05

    We evaluated whether rivaroxaban alone or in combination with aspirin would be more effective than aspirin alone for secondary cardiovascular prevention. In this double-blind trial, we randomly assigned 27,395 participants with stable atherosclerotic vascular disease to receive rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg once daily). The primary outcome was a composite of cardiovascular death, stroke, or myocardial infarction. The study was stopped for superiority of the rivaroxaban-plus-aspirin group after a mean follow-up of 23 months. The primary outcome occurred in fewer patients in the rivaroxaban-plus-aspirin group than in the aspirin-alone group (379 patients [4.1%] vs. 496 patients [5.4%]; hazard ratio, 0.76; 95% confidence interval [CI], 0.66 to 0.86; Paspirin group (288 patients [3.1%] vs. 170 patients [1.9%]; hazard ratio, 1.70; 95% CI, 1.40 to 2.05; Paspirin group as compared with 378 (4.1%) in the aspirin-alone group (hazard ratio, 0.82; 95% CI, 0.71 to 0.96; P=0.01; threshold P value for significance, 0.0025). The primary outcome did not occur in significantly fewer patients in the rivaroxaban-alone group than in the aspirin-alone group, but major bleeding events occurred in more patients in the rivaroxaban-alone group. Among patients with stable atherosclerotic vascular disease, those assigned to rivaroxaban (2.5 mg twice daily) plus aspirin had better cardiovascular outcomes and more major bleeding events than those assigned to aspirin alone. Rivaroxaban (5 mg twice daily) alone did not result in better cardiovascular outcomes than aspirin alone and resulted in more major bleeding events. (Funded by Bayer; COMPASS ClinicalTrials.gov number, NCT01776424 .).

  1. Heart rate and use of beta-blockers in stable outpatients with coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Ph Gabriel Steg

    Full Text Available BACKGROUND: Heart rate (HR is an emerging risk factor in coronary artery disease (CAD. However, there is little contemporary data regarding HR and the use of HR-lowering medications, particularly beta-blockers, among patients with stable CAD in routine clinical practice. The goal of the present analysis was to describe HR in such patients, overall and in relation to beta-blocker use, and to describe the determinants of HR. METHODS AND FINDINGS: CLARIFY is an international, prospective, observational, longitudinal registry of outpatients with stable CAD, defined as prior myocardial infarction or revascularization procedure, evidence of coronary stenosis of >50%, or chest pain associated with proven myocardial ischemia. A total of 33,438 patients from 45 countries in Europe, the Americas, Africa, Middle East, and Asia/Pacific were enrolled between November 2009 and July 2010. Most of the 33,177 patients included in this analysis were men (77.5%. Mean (SD age was 64.2 (10.5 years, HR by pulse was 68.3 (10.6 bpm, and by electrocardiogram was 67.2 (11.4 bpm. Overall, 44.0% had HR ≥ 70 bpm. Beta-blockers were used in 75.1% of patients and another 14.4% had intolerance or contraindications to beta-blocker therapy. Among 24,910 patients on beta-blockers, 41.1% had HR ≥ 70 bpm. HR ≥ 70 bpm was independently associated with higher prevalence and severity of angina, more frequent evidence of myocardial ischemia, and lack of use of HR-lowering agents. CONCLUSIONS: Despite a high rate of use of beta-blockers, stable CAD patients often have resting HR ≥ 70 bpm, which was associated with an overall worse health status, more frequent angina and ischemia. Further HR lowering is possible in many patients with CAD. Whether it will improve symptoms and outcomes is being tested.

  2. Periodontal disease and inflammatory blood cytokines in patients with stable coronary artery disease

    Directory of Open Access Journals (Sweden)

    Cassio KAMPITS

    Full Text Available ABSTRACT Periodontal disease has been associated with elevations of blood cytokines involved in atherosclerosis in systemically healthy individuals, but little is known about this association in stable cardiovascular patients. The aim of this study was to assess the association between periodontal disease (exposure and blood cytokine levels (outcomes in a target population of patients with stable coronary artery disease (CAD. Material and Methods This cross-sectional study included 91 patients with stable CAD who had been under optimized cardiovascular care. Blood levels of IL-1β, IL-6, IL-8, IL-10, IFN-γ, and TNF-α were measured by Luminex technology. A full-mouth periodontal examination was conducted to record probing depth (PD and clinical attachment (CA loss. Multiple linear regression models, adjusting for gender, body mass index, oral hypoglycemic drugs, smoking, and occurre:nce of acute myocardial infarction were applied. Results CAD patients that experienced major events had higher concentrations of IFN-γ (median: 5.05 pg/mL vs. 3.01 pg/mL; p=0.01, IL-10 (median: 2.33 pg/mL vs. 1.01 pg/mL; p=0.03, and TNF-α (median: 9.17 pg/mL vs. 7.47 pg/mL; p=0.02. Higher numbers of teeth with at least 6 mm of CA loss (R2=0.07 and PD (R2=0.06 were significantly associated with higher IFN-γ log concentrations. Mean CA loss (R2=0.05 and PD (R2=0.06 were significantly related to IL-10 concentrations. Elevated concentrations of TNF-α were associated with higher mean CA loss (R2=0.07. Conclusion Periodontal disease is associated with increased systemic inflammation in stable cardiovascular patients. These findings provide additional evidence supporting the idea that periodontal disease can be a prognostic factor in cardiovascular patients.

  3. Fractional flow reserve-guided PCI for stable coronary artery disease

    DEFF Research Database (Denmark)

    De Bruyne, Bernard; Fearon, William F; Pijls, Nico H J

    2014-01-01

    BACKGROUND: We hypothesized that in patients with stable coronary artery disease and stenosis, percutaneous coronary intervention (PCI) performed on the basis of the fractional flow reserve (FFR) would be superior to medical therapy. METHODS: In 1220 patients with stable coronary artery disease, we...... years was lower in the PCI group than in the medical-therapy group (4.6% vs. 8.0%, P=0.04). Among registry patients, the rate of the primary end point was 9.0% at 2 years. CONCLUSIONS: In patients with stable coronary artery disease, FFR-guided PCI, as compared with medical therapy alone, improved...

  4. Gender- and age-related differences in clinical presentation and management of outpatients with stable coronary artery disease.

    Science.gov (United States)

    Ferrari, Roberto; Abergel, Hélène; Ford, Ian; Fox, Kim M; Greenlaw, Nicola; Steg, Ph Gabriel; Hu, Dayi; Tendera, Michal; Tardif, Jean-Claude

    2013-09-10

    Contemporary generalizable data on the demographics and management of outpatients with stable coronary artery disease (CAD) in routine clinical practice are sparse. Using the data from the CLARIFY registry we describe gender- and age-related differences in baseline characteristics and management of these patients across broad geographic regions. This international, prospective, observational, longitudinal registry enrolled stable CAD outpatients from 45 countries in Africa, Asia, Australia, Europe, the Middle East, and North, Central, and South America. Baseline data were available for 33280 patients. Mean (SD) age was 64 (10.5) years and 22.5% of patients were female. The prevalence of CAD risk factors was generally higher in women than in men. Women were older (66.6 vs 63.4 years), more frequently diagnosed with diabetes (33% vs 28%), hypertension (79% vs 69%), and higher resting heart rate (69 vs 67 bpm), and were less physically active. Smoking and a history of myocardial infarction were more common in men. Women were more likely to have angina (28% vs 20%), but less likely to have undergone revascularization procedures. CAD was more likely to be asymptomatic in older patients perhaps because of reduced levels of physical activity. Prescription of evidence-based medication for secondary prevention varied with age, with patients ≥ 75 years treated less often with beta blockers, aspirin and angiotensin-converting enzyme inhibitors than patients age groups of outpatients with stable CAD. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Osteoprotegerin independently predicts mortality in patients with stable coronary artery disease

    DEFF Research Database (Denmark)

    Bjerre, Mette; Hilden, Jørgen; Kastrup, Jens

    2014-01-01

    OBJECTIVES: To elucidate the prognostic power of serum osteoprotegerin (OPG) in patients with stable coronary artery disease (CAD). METHODS: Serum OPG levels were measured in the CLARICOR trial cohort of 4063 patients with stable CAD on blood samples drawn at randomization. The follow-up was 2...

  6. Prognostic value of plasma brain natriuretic peptide in patients with stable chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ahmed E. Mansour

    2012-10-01

    Conclusions: Plasma BNP levels increased significantly with disease severity, progression of chronic respiratory failure, and secondary pulmonary hypertension in patients with stable COPD. These results suggest that plasma BNP can be a useful prognostic marker to monitor COPD progression and identify cases of secondary pulmonary hypertension in patients with stable COPD.

  7. Differential Associations Between Specific Depressive Symptoms and Cardiovascular Prognosis in Patients With Stable Coronary Heart Disease

    NARCIS (Netherlands)

    Hoen, Petra W.; Whooley, Mary A.; Martens, Elisabeth J.; Na, Beeya; van Melle, Joost P.; de Jonge, Peter

    2010-01-01

    Objectives The purpose of this research was to evaluate the relationship between cognitive and somatic depressive symptoms and cardiovascular prognosis. Background Depression in patients with stable coronary heart disease (CHD) is associated with poor cardiac prognosis. Whether certain depressive

  8. Stable ischemic heart disease in women: current perspectives

    OpenAIRE

    Samad, Fatima; Agarwal, Anushree; Samad, Zainab

    2017-01-01

    Fatima Samad,1 Anushree Agarwal,2 Zainab Samad3 1Aurora Cardiovascular Services, Aurora Sinai/Aurora St Luke’s Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, WI, 2Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, 3Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC, USA Abstract: Cardiovascular disease is the leading cause of death in women acc...

  9. Periodontal disease and inflammatory blood cytokines in patients with stable coronary artery disease.

    Science.gov (United States)

    Kampits, Cassio; Montenegro, Marlon M; Ribeiro, Ingrid W J; Furtado, Mariana V; Polanczyk, Carisi A; Rösing, Cassiano K; Haas, Alex N

    2016-01-01

    This cross-sectional study included 91 patients with stable CAD who had been under optimized cardiovascular care. Blood levels of IL-1β, IL-6, IL-8, IL-10, IFN-γ, and TNF-α were measured by Luminex technology. A full-mouth periodontal examination was conducted to record probing depth (PD) and clinical attachment (CA) loss. Multiple linear regression models, adjusting for gender, body mass index, oral hypoglycemic drugs, smoking, and occurre:nce of acute myocardial infarction were applied. CAD patients that experienced major events had higher concentrations of IFN-γ (median: 5.05 pg/mL vs. 3.01 pg/mL; p=0.01), IL-10 (median: 2.33 pg/mL vs. 1.01 pg/mL; p=0.03), and TNF-α (median: 9.17 pg/mL vs. 7.47 pg/mL; p=0.02). Higher numbers of teeth with at least 6 mm of CA loss (R2=0.07) and PD (R2=0.06) were significantly associated with higher IFN-γ log concentrations. Mean CA loss (R2=0.05) and PD (R2=0.06) were significantly related to IL-10 concentrations. Elevated concentrations of TNF-α were associated with higher mean CA loss (R2=0.07). Periodontal disease is associated with increased systemic inflammation in stable cardiovascular patients. These findings provide additional evidence supporting the idea that periodontal disease can be a prognostic factor in cardiovascular patients.

  10. YKL-40 a new biomarker in patients with acute coronary syndrome or stable coronary artery disease

    DEFF Research Database (Denmark)

    Wang, Y.Z.; Ripa, R.S.; Johansen, J.S.

    2008-01-01

    Background. YKL-40 is involved in remodelling and angiogenesis in non-cardiac inflammatory diseases. Aim was to quantitate plasma YKL-40 in patients with ST-elevation myocardial infarction (STEMI) or stable chronic coronary artery disease (CAD), and YKL-40 gene activation in human myocardium....... Methods and results. We included 73 patients: I) 20 patients with STEMI; II) 28 patients with stable CAD; III) 15 CAD patients referred for coronary by-pass surgery. YKL-40 mRNA expression was measured in myocardium subtended by stenotic or occluded arteries and areas with no apparent disease; and IV) 10...

  11. Transdiaphragmatic pressure and neural respiratory drive measured during inspiratory muscle training in stable patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Wu W

    2017-03-01

    Full Text Available Weiliang Wu,1 Xianming Zhang,2 Lin Lin,1 Yonger Ou,1 Xiaoying Li,1 Lili Guan,1 Bingpeng Guo,1 Luqian Zhou,1 Rongchang Chen1 1State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 2Department of Respiratory Medicine, The First Affiliated Hospital of Guizhou Medical University, Guizhou, People’s Republic of China Purpose: Inspiratory muscle training (IMT is a rehabilitation therapy for stable patients with COPD. However, its therapeutic effect remains undefined due to the unclear nature of diaphragmatic mobilization during IMT. Diaphragmatic mobilization, represented by transdiaphragmatic pressure (Pdi, and neural respiratory drive, expressed as the corrected root mean square (RMS of the diaphragmatic electromyogram (EMGdi, both provide vital information to select the proper IMT device and loads in COPD, therefore contributing to the curative effect of IMT. Pdi and RMS of EMGdi (RMSdi% were measured and compared during inspiratory resistive training and threshold load training in stable patients with COPD.Patients and methods: Pdi and neural respiratory drive were measured continuously during inspiratory resistive training and threshold load training in 12 stable patients with COPD (forced expiratory volume in 1 s ± SD was 26.1%±10.2% predicted.Results: Pdi was significantly higher during high-intensity threshold load training (91.46±17.24 cmH2O than during inspiratory resistive training (27.24±6.13 cmH2O in stable patients with COPD, with P<0.01 for each. Significant difference was also found in RMSdi% between high-intensity threshold load training and inspiratory resistive training (69.98%±16.78% vs 17.26%±14.65%, P<0.01.Conclusion: We concluded that threshold load training shows greater mobilization of Pdi and neural respiratory drive than inspiratory resistive training in stable patients with COPD. Keywords: diaphragmatic

  12. Clinical presentation and management of stable coronary artery disease in Austria.

    Directory of Open Access Journals (Sweden)

    Otto Pichlhöfer

    Full Text Available Cardiovascular disease is the main cause of death in Austria. However, no systematic information exists regarding characteristics and treatments of contemporary patients with stable coronary artery disease (CAD in Austria. We assembled two retrospective physicians' databases to describe demographics, clinical profiles, and therapeutic strategies in patients with stable CAD. In addition, we compared patient profiles of secondary care internists and hospital-based cardiologists with those of general practitioners in a primary care setting outside of hospital.The study population was identified from retrospective chart review of 1020 patients from 106 primary care physicians in Austria (ProCor II registry, and was merged with a previous similar database of 1280 patients under secondary care (ProCor I registry to yield a total patient number of 2300.Female patients with stable CAD were older, had more angina and/or heart failure symptoms, and more depression than males. Female gender, type 2 diabetes mellitus, higher CCS class and asthma/COPD were predictors of elevated heart rate, while previous coronary events/revascularization predicted a lower heart rate in multivariate analysis. There were no significant differences with regard to characteristics and management of patients of general practitioners in the primary care setting versus internists in secondary care.Characteristics and treatments of unselected patients with stable ischemic heart disease in Austria resemble the pattern of large international registries of stable ischemic heart disease, with the exception that diabetes and systemic hypertension were more prevalent.

  13. Low-dose aspirin in patients with stable cardiovascular disease: a meta-analysis.

    Science.gov (United States)

    Berger, Jeffrey S; Brown, David L; Becker, Richard C

    2008-01-01

    Many recommendations for aspirin in stable cardiovascular disease are based on analyses of all antiplatelet therapies at all dosages and in both stable and unstable patients. Our objective was to evaluate the benefit and risk of low-dose aspirin (50-325 mg/d) in patients with stable cardiovascular disease. Secondary prevention trials of low-dose aspirin in patients with stable cardiovascular disease were identified by searches of the MEDLINE database from 1966 to 2006. Six randomized trials were identified that enrolled patients with a prior myocardial infarction (MI) (n=1), stable angina (n=1), or stroke/transient ischemic attack (n=4). A random effects model was used to combine results from individual trials. Six studies randomized 9853 patients. Aspirin therapy was associated with a significant 21% reduction in the risk of cardiovascular events (nonfatal MI, nonfatal stroke, and cardiovascular death) (95% confidence interval [CI], 0.72-0.88), 26% reduction in the risk of nonfatal MI (95% CI, 0.60-0.91), 25% reduction in the risk of stroke (95% CI, 0.65-0.87), and 13% reduction in the risk of all-cause mortality (95% CI, 0.76-0.98). Patients treated with aspirin were significantly more likely to experience severe bleeding (odds ratio 2.2, 95% CI, 1.4-3.4). Treatment of 1000 patients for an average of 33 months would prevent 33 cardiovascular events, 12 nonfatal MIs, 25 nonfatal strokes, and 14 deaths, and cause 9 major bleeding events. Among those with ischemic heart disease, aspirin was most effective at reducing the risk of nonfatal MI and all-cause mortality; however, among those with cerebrovascular disease, aspirin was most effective at reducing the risk of stroke. In patients with stable cardiovascular disease, low-dose aspirin therapy reduces the incidence of adverse cardiovascular events and all-cause mortality, and increases the risk of severe bleeding.

  14. Serum YKL-40 for monitoring myocardial ischemia after revascularization in patients with stable coronary artery disease

    DEFF Research Database (Denmark)

    Harutyunyan, Marina Jurjevna; Johansen, Julia S; Mygind, Naja D

    2014-01-01

    AIM: The aim was to investigate the inflammatory biomarker YKL-40 as a monitor of myocardial ischemia in patients with coronary artery disease (CAD). METHODS: A total of 311 patients with stable CAD were included. Blood samples were taken at baseline, the day after coronary angiography and/or after...... percutaneous coronary intervention and after 6 months. RESULTS: A total of 148 (48%) patients were revascularized and 163 patients underwent only coronary angiography. In the entire population, serum YKL-40 increased significantly from baseline to 6 months (p = 0.05). This tendency was seen...... of disease progression but not of myocardial ischemia in patients with stable CAD....

  15. Prognostic Determinants of Coronary Atherosclerosis in Stable Ischemic Heart Disease: Anatomy, Physiology, or Morphology?

    Science.gov (United States)

    Ahmadi, Amir; Stone, Gregg W; Leipsic, Jonathon; Shaw, Leslee J; Villines, Todd C; Kern, Morton J; Hecht, Harvey; Erlinge, David; Ben-Yehuda, Ori; Maehara, Akiko; Arbustini, Eloisa; Serruys, Patrick; Garcia-Garcia, Hector M; Narula, Jagat

    2016-07-08

    Risk stratification in patients with stable ischemic heart disease is essential to guide treatment decisions. In this regard, whether coronary anatomy, physiology, or plaque morphology is the best determinant of prognosis (and driver an effective therapeutic risk reduction) remains one of the greatest ongoing debates in cardiology. In the present report, we review the evidence for each of these characteristics and explore potential algorithms that may enable a practical diagnostic and therapeutic strategy for the management of patients with stable ischemic heart disease. © 2016 American Heart Association, Inc.

  16. Patients with chronic obstructive pulmonary disease and chronically colonized with Haemophilus influenzae during stable disease phase have increased airway inflammation.

    Science.gov (United States)

    Tufvesson, Ellen; Bjermer, Leif; Ekberg, Marie

    2015-01-01

    Some patients with chronic obstructive pulmonary disease (COPD) show increased airway inflammation and bacterial colonization during stable phase. The aim of this study was to follow COPD patients and investigate chronic colonization with pathogenic bacteria during stable disease phase, and relate these findings to clinical parameters, inflammatory pattern, lung function, and exacerbations. Forty-three patients with COPD were included while in a stable state and followed up monthly until exacerbation or for a maximum of 6 months. The patients completed the Clinical COPD Questionnaire and Medical Research Council dyspnea scale questionnaires, and exhaled breath condensate was collected, followed by spirometry, impulse oscillometry, and sputum induction. Ten patients were chronically colonized (ie, colonized at all visits) with Haemophilus influenzae during stable phase. These patients had higher sputum levels of leukotriene B4 (Pchronically colonized patients. The difference in airway inflammation seen during stable phase in patients chronically colonized with H. influenzae was not observed during exacerbations. Some COPD patients who were chronically colonized with H. influenzae during stable phase showed increased airway inflammation and reduced lung volumes when compared with non-chronically colonized patients.

  17. Non-invasive positive pressure ventilation (NIPPV) in stable patients with chronic obstructive pulmonary disease (COPD)

    NARCIS (Netherlands)

    Wijkstra, PJ

    2003-01-01

    While non-invasive positive pressure ventilation (NIPPV) has become an accepted management approach for patients with acute hypercapnia, it remains unclear whether it can also be beneficial in stable chronic obstructive pulmonary disease (COPD) patients with chronic respiratory failure. Randomised

  18. Good interobserver agreement was attainable on outcome adjudication in patients with stable coronary heart disease

    DEFF Research Database (Denmark)

    Kjoller, Erik; Hilden, Jørgen; Winkel, Per

    2012-01-01

    In clinical trials, agreement on outcomes is of utmost importance for valid estimation of intervention effects. As there is limited knowledge about adjudicator agreement in cardiology, we examined the level of agreement among three cardiology specialists adjudicating all possible events in a rand...... in a randomized controlled clinical trial of patients with stable coronary heart disease....

  19. Predictors for major cardiovascular outcomes in stable ishaemic heart disease (PREMAC)

    DEFF Research Database (Denmark)

    Winkel, Per; Jakobsen, Janus Christian; Hilden, Jørgen

    2017-01-01

    The purpose of the predictors for major cardiovascular outcomes in stable ischaemic Heart disease (PREMAC) study is exploratory and hypothesis generating. We want to identify biochemical quantities which—conditionally on the values of available standard demographic, anamnestic, and biochemical da...

  20. Comparative Effectiveness Trials of Imaging-Guided Strategies in Stable Ischemic Heart Disease.

    Science.gov (United States)

    Shaw, Leslee J; Phillips, Lawrence M; Nagel, Eike; Newby, David E; Narula, Jagat; Douglas, Pamela S

    2017-03-01

    The evaluation of patients with suspected stable ischemic heart disease is among the most common diagnostic evaluations with nearly 20 million imaging and exercise stress tests performed annually in the United States. Over the past decade, there has been an evolution in imaging research with an ever-increasing focus on larger registries and randomized trials comparing the effectiveness of varying diagnostic algorithms. The current review highlights recent randomized trial evidence with a particular focus comparing the effectiveness of cardiac imaging procedures within the stable ischemic heart disease evaluation for coronary artery disease detection, angina, and other quality of life measures, and major clinical outcomes. Also highlighted are secondary analyses from these trials on the economic findings related to comparative cost differences across diagnostic testing strategies. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  1. Fractional flow reserve is not associated with inflammatory markers in patients with stable coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Jan-Willem E M Sels

    Full Text Available BACKGROUND: Atherosclerosis is an inflammatory condition and increased blood levels of inflammatory biomarkers have been observed in acute coronary syndromes. In addition, high expression of inflammatory markers is associated with worse prognosis of coronary artery disease. The presence and extent of inducible ischemia in patients with stable angina has previously been shown to have strong prognostic value. We hypothesized that evidence of inducible myocardial ischemia by local lesions, as measured by fractional flow reserve (FFR, is associated with increased levels of blood based inflammatory biomarkers. METHODS: Whole blood samples of 89 patients with stable angina pectoris and 16 healthy controls were analyzed. The patients with stable angina pectoris underwent coronary angiography and FFR of all coronary lesions. We analyzed plasma levels of cytokines IL-6, IL-8 and TNF-α and membrane expression of Toll-like receptor 2 and 4, CD11b, CD62L and CD14 on monocytes and granulocytes as markers of inflammation. Furthermore, we quantified the severity of hemodynamically significant coronary artery disease by calculating Functional Syntax Score (FSS, an extension of the Syntax Score. RESULTS: For the majority of biomarkers, we observed lower levels in the healthy control group compared with patients with stable angina who underwent coronary catheterization. We found no difference for any of the selected biomarkers between patients with a positive FFR (≤ 0.75 and negative FFR (>0.80. We observed no relationship between the investigated biomarkers and FSS. CONCLUSION: The presence of local atherosclerotic lesions that result in inducible myocardial ischemia as measured by FFR in patients with stable coronary artery disease is not associated with increased plasma levels of IL-6, IL-8 and TNF-α or increased expression of TLR2 and TLR4, CD11b, CD62L and CD14 on circulating leukocytes.

  2. Approaches to daily body condition management in patients with stable chronic obstructive pulmonary disease.

    Science.gov (United States)

    Kawada, Terue

    2016-11-01

    To clarify the characteristics of sub-groups of patients with stable chronic obstructive pulmonary disease having similar approaches to daily body condition management. Prior literature has shed light on the experience of patients with chronic obstructive pulmonary disease and revealed that these patients engage in many activities and try different things in their daily lives to regulate and manage their body condition. The research so far has all been qualitative, comprising mostly interviews, and no quantitative studies have been performed. In this study, cluster analysis was used to show that subgroups of patients with similar characteristics undertake similar approaches to body condition management. Descriptive, correlational study. Invitations to participate in the survey were extended to patients with stable chronic obstructive pulmonary disease. Cluster analysis was performed on the basis of questionnaire scores relating to nine different categories of daily body condition management actions. The characteristics of the body condition management approaches, in each subgroup, were investigated using analysis of variance and multiple comparisons. The cluster analysis produced six subgroups, each defined by the effort expended as part of their body condition management. The subgroups also differed depending on patient age and disease severity. Body condition management approaches taken by patients with stable chronic obstructive pulmonary disease are overall, comprehensive approaches. Patients with chronic obstructive pulmonary disease were subgrouped based on their engagement in body conditioning. Relationships between the subgroups and the engagement in body conditioning, age and shortness of breath severity were observed. The care of patient support should be comprehensive and depend on their age and the duration of the disease. In addition, it should be long term and recognise that the patients are living their own respective lives. Such considerations and

  3. Functional Testing or Coronary Computed Tomography Angiography in Patients With Stable Coronary Artery Disease

    DEFF Research Database (Denmark)

    Jørgensen, Mads E; Andersson, Charlotte; Nørgaard, Bjarne L

    2017-01-01

    BACKGROUND: The choice of either anatomical or functional noninvasive testing to evaluate suspected coronary artery disease might affect subsequent clinical management and outcomes. OBJECTIVES: This study analyzed the association of initial noninvasive cardiac testing in outpatients with stable.......05), and a lower risk of MI (hazard ratio: 0.71; 95% confidence interval: 0.61 to 0.82). CONCLUSIONS: In stable patients undergoing initial evaluation for suspected coronary artery disease, coronary CTA was associated with greater use of statins, aspirin, and invasive procedures, and higher costs than functional...... symptoms, with subsequent use of medications, invasive procedures, and clinical outcomes. METHODS: We studied patients enrolled in a Danish nationwide register who underwent initial noninvasive cardiac testing with either coronary computed tomography angiography (CTA) or functional testing (exercise...

  4. Serial measurements of high-sensitivity cardiac troponin T after exercise stress test in stable coronary artery disease

    DEFF Research Database (Denmark)

    Axelsson, Anna; Ruwald, Martin Huth; Dalsgaard, Morten

    2013-01-01

    The aim was to assess serial measurements of high-sensitivity cardiac troponin T (hs-cTNT) post-exercise in patients with stable coronary artery disease (CAD).......The aim was to assess serial measurements of high-sensitivity cardiac troponin T (hs-cTNT) post-exercise in patients with stable coronary artery disease (CAD)....

  5. Effects of TNF-? and Leptin on Weight Loss in Patients with Stable Chronic Obstructive Pulmonary Disease

    OpenAIRE

    Shin, Kyeong-Cheol; Chung, Jin Hong; Lee, Kwan Ho

    2007-01-01

    Background Weight loss is common in patients with chronic obstructive pulmonary disease (COPD). However, the mechanisms of this weight loss are still unclear. Methods Sixty male patients with stable COPD and 45 healthy male controls participated in this study. The COPD patients were divided into two groups, that is, the emphysema and chronic bronchitis groups, by the transfer coefficient of carbon monoxide. The body composition, resting energy expenditure (REE), plasma leptin levels and serum...

  6. Revascularisation versus medical treatment in patients with stable coronary artery disease

    DEFF Research Database (Denmark)

    Windecker, Stephan; Stortecky, Stefan; Stefanini, Giulio G

    2014-01-01

    OBJECTIVE: To investigate whether revascularisation improves prognosis compared with medical treatment among patients with stable coronary artery disease. DESIGN: Bayesian network meta-analyses to combine direct within trial comparisons between treatments with indirect evidence from other trials...... while maintaining randomisation. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: A strategy of initial medical treatment compared with revascularisation by coronary artery bypass grafting or Food and Drug Administration approved techniques for percutaneous revascularization: balloon angioplasty, bare metal...

  7. The influence of contrast media on kidney function in patients with stable coronary artery disease

    DEFF Research Database (Denmark)

    Reuter, Simon Bertram; Harutyunyan, Marina; Mygind, Naja Dam

    2014-01-01

    AIMS: To investigate the incidence of contrast media-induced nephropathy (CIN) in patients with stable coronary artery disease (CAD) referred for elective coronary intervention following hydration routines. The reversibility of CIN was followed in a 6 month-period. METHODS AND RESULTS: A total...... coronary interventions. Kidney function and the amount of contrast media used was not a predictor of CIN development. The induced CIN was not completely normalized in a 6-month follow-up period....

  8. Diagnostic models of the pre-test probability of stable coronary artery disease: A systematic review

    Directory of Open Access Journals (Sweden)

    Ting He

    Full Text Available A comprehensive search of PubMed and Embase was performed in January 2015 to examine the available literature on validated diagnostic models of the pre-test probability of stable coronary artery disease and to describe the characteristics of the models. Studies that were designed to develop and validate diagnostic models of pre-test probability for stable coronary artery disease were included. Data regarding baseline patient characteristics, procedural characteristics, modeling methods, metrics of model performance, risk of bias, and clinical usefulness were extracted. Ten studies involving the development of 12 models and two studies focusing on external validation were identified. Seven models were validated internally, and seven models were validated externally. Discrimination varied between studies that were validated internally (C statistic 0.66-0.81 and externally (0.49-0.87. Only one study presented reclassification indices. The majority of better performing models included sex, age, symptoms, diabetes, smoking, and hyperlipidemia as variables. Only two diagnostic models evaluated the effects on clinical decision making processes or patient outcomes. Most diagnostic models of the pre-test probability of stable coronary artery disease have had modest success, and very few present data regarding the effects of these models on clinical decision making processes or patient outcomes.

  9. Metabolic syndrome and mortality in stable coronary heart disease: relation to gender

    DEFF Research Database (Denmark)

    Kragelund, Charlotte; Køber, Lars; Faber, Jens

    2007-01-01

    is unknown. METHODS: 1041 patients with stable coronary heart disease, referred for elective coronary angiography were included in this study. At baseline, history of hypertension, body mass index, lipids, fasting plasma glucose, and insulin were recorded. All-cause mortality was determined after a median...... follow-up of 9.2 years. RESULTS: At follow-up 296 (28%) patients had died. 315 (30%) patients had MS based on the definition by the World Health Organization. Patients with MS more frequently had diabetes and three-vessel disease of the coronary arteries. Men had a more severe risk profile than women...

  10. ASSESSMENT OF AWARENESS LEVEL OF OWN DISEASE IN PATIENTS WITH STABLE ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    G. F. Andreeva

    2005-01-01

    Full Text Available Arterial hypertension (AH is the most frequent risk factor of cardiovascular diseases and related mortality in all developed countries. Altough therapy with antihypertensive drugs significantly reduces this risk, patients with stable mild hypertension have poor compliance with the treatment. The reasons and levels of inadequacy of antihypertensive therapy in this group of patients are well-known.Aim. To evaluate the awareness level of own disease, adequacy of therapy only in those patients with stable mild arterial hypertension, who are complied with recommendations of physicians concerning AH treatment and changing of mode of life. It was also planned to reveal possible grounds for inadequate secondary prevention of cardiovascular disease.Materials and methods. 76 patiens with stable mild arterial hypertension were included into study. They didn’t have any serious concomitant diseases and were complied with the recommendations of physicians concerning secondary prevention of cardiovascular disease. Questionnaire of State Research Center for Preventive Medicine “Assessment of awareness level of own disease in patients with stable arterial hypertension” was used in the study.Results. It was revealed, that the majority of patients, invoved in the study, were nonsmokers and regularly took antihypertensive drugs. 70% of questioned patients reached the target arterial blood pressure levels, while patients with arterial hypertension in general Russia population received regular and efficient treatment in less than 30-20%. Drugs treatment of questioned patients almost didn’t differ from that, which received patients in out-patient clinics of Moscow: in both cases ACE inhibitors were preferred. Only 29% of questioned patients knew their lipid levels in blood and none of the patients took drugs, reducing levels of lipids in blood. Half of the patients, that took part in our study, had increased level of body mass index.Conclusions. Inadequate

  11. State of the Art: Blood Biomarkers for Risk Stratification in Patients with Stable Ischemic Heart Disease.

    Science.gov (United States)

    Omland, Torbjørn; White, Harvey D

    2017-01-01

    Multiple circulating biomarkers have been associated with the incidence of cardiovascular events and proposed as potential tools for risk stratification in stable ischemic heart disease (IHD), yet current guidelines do not make any firm recommendations concerning the use of biomarkers for risk stratification in this setting. This state-of-the-art review provides an overview of biomarkers for risk stratification in stable IHD. Circulating biomarkers associated with the risk of cardiovascular events in patients with stable IHD reflect different pathophysiological processes, including myocardial injury, myocardial stress and remodeling, metabolic status, vascular inflammation, and oxidative stress. Compared to the primary prevention setting, biomarkers reflecting end-organ damage and future risk of heart failure development and cardiovascular death may play more important roles in the stable IHD setting. Accordingly, biomarkers that reflect chronic, low-grade myocardial injury, and stress, i.e., high-sensitivity cardiac troponins and natriuretic peptides, provide graded and incremental prognostic information to conventional risk markers. In contrast, in stable IHD patients the prognostic value of traditional metabolic biomarkers, including serum lipids, is limited. Among several novel biomarkers, growth-differentiation factor-15 may provide the most robust prognostic information, whereas most inflammatory markers provide limited incremental prognostic information to risk factor models that include conventional risk factors, natriuretic peptides, and high-sensitivity troponins. Circulating biomarkers hold promise as useful tools for risk stratification in stable IHD, but their future incorporation into clinically useful risk scores will depend on prospective, rigorously performed clinical trials that document enhanced risk prediction. © 2016 American Association for Clinical Chemistry.

  12. Quality of Life of Patients with Stable Coronary Artery Disease Combined with Non-Alcoholic Fatty Liver Disease

    OpenAIRE

    Vakalyuk, Iryna; Virstyuk, Nataliya; Petryna, Vitaliy

    2016-01-01

    Quality of life assessment is an integral part of a comprehensive treatment in modern medical practice. Analysis of quality of life of patients with comorbidities is an interesting and poorly understood issue.  The objective of the research was to evaluate the quality of life of patients with postinfarction cardiosclerosis depending on the presence and progression of non-alcoholic fatty liver disease (NAFLD). Material and methods. The research included 300 patients with stable coronary ...

  13. ENDOTHELIAL DYSFUNCTION IN STABLE ANGINA AND MYOCARDIAL INFARCTION COMBINED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

    Directory of Open Access Journals (Sweden)

    M. A. Popova

    2015-01-01

    Full Text Available The research objective is to determine the state of endothelium-dependent and endothelium-independent vasodilatation in patients with coronary heart disease (CHD associated with chronic obstructive pulmonary disease (COPD.Material and methods. In the cross-sectional study included 122 patients with CHD associated with COPD: 68 people of them are patients with stable angina without acute coronary events in history and 54 patients with acute ST segment elevation myocardial infarction (STEMI. Comparison group comprised 53 patients with stable angina and 51 patients after STEMI without concomitant COPD. Patients were included if they met the following inclusion criteria: male, age <60 years, verified forms of CHD (stable angina, STEMI, documented with COPD without exacerbation and forced expiratory volume in 1 second > 30% in the groups with CHD and COPD. Arterial endothelial function was tested with high-resolution ultrasonography: brachial artery diameter was measured at rest, after flow increase (which causes endothelium-dependent dilatation, and after administration of sublingual nitroglycerin (an endothelium-independent dilator.Results. We found that endothelial dysfunction in patients with acute and chronic forms of CHD in combination with COPD are more pronounced than in isolated CHD.Conclusion. Expressed depression functional vascular reserve in patients with CHD associated with COPD, should be taken into account when conducting individualized therapy of these patients.

  14. Relation of ABO blood groups to coronary lesion complexity in patients with stable coronary artery disease.

    Science.gov (United States)

    Kaya, Ahmet; Tanboğa, İbrahim Halil; Kurt, Mustafa; Işık, Turgay; Kaya, Yasemin; Günaydın, Zeki Yüksel; Aksakal, Enbiya

    2014-02-01

    We aimed to investigate the relationship between ABO blood groups and complexity of coronary lesions assessed by SYNTAX score (SS) in stable coronary artery disease (CAD) patients. Our cross-sectional and observational study population consisted of 559 stable CAD patients. From all patients, ABO blood group was determined and the SS was calculated as low SYNTAX score (0-22), intermediate SYNTAX (23-32) score and high SYNTAX score (>32). Statistical analysis was performed using Student's t-test or Mann-Whitney U test, ANOVA, or Kruskal-Wallis test and chi-square test. Multiple logistic regression analysis was used to identify the independent predictors of high SS. The analysis between the SS tertiles revealed that the frequency of non-O blood group was significantly higher in the upper SS tertiles (56.2% vs. 75.9 vs. 80.2%, pABO blood groups and complexity of angiographic CAD.

  15. Newer Therapies for Management of Stable Ischemic Heart Disease With Focus on Refractory Angina.

    Science.gov (United States)

    Singh, Mukesh; Arora, Rohit

    Ischemic heart disease remains a major public health problem nationally and internationally. Stable ischemic heart disease (SIHD) is one of the clinical manifestations of ischemic heart disease and is generally characterized by episodes of reversible myocardial demand/supply mismatch, related to ischemia or hypoxia, which are usually inducible by exercise, emotion, or other stress and reproducible-but which may also be occurring spontaneously. Improvements in the treatment of acute coronary syndromes along with increasing prevalence of cardiovascular risk factors, including diabetes and obesity, have led to increasing population of patients with SIHD. A significant number of these continue to have severe angina despite medical management and revascularization procedures performed and may progress to refractory angina. This article reviews the newer therapies in the treatment of SIHD with special focus in treating patients with refractory angina.

  16. Diagnosis of Coronary Heart Diseases Using Gene Expression Profiling; Stable Coronary Artery Disease, Cardiac Ischemia with and without Myocardial Necrosis.

    Directory of Open Access Journals (Sweden)

    Nabila Kazmi

    Full Text Available Cardiovascular disease (including coronary artery disease and myocardial infarction is one of the leading causes of death in Europe, and is influenced by both environmental and genetic factors. With the recent advances in genomic tools and technologies there is potential to predict and diagnose heart disease using molecular data from analysis of blood cells. We analyzed gene expression data from blood samples taken from normal people (n = 21, non-significant coronary artery disease (n = 93, patients with unstable angina (n = 16, stable coronary artery disease (n = 14 and myocardial infarction (MI; n = 207. We used a feature selection approach to identify a set of gene expression variables which successfully differentiate different cardiovascular diseases. The initial features were discovered by fitting a linear model for each probe set across all arrays of normal individuals and patients with myocardial infarction. Three different feature optimisation algorithms were devised which identified two discriminating sets of genes, one using MI and normal controls (total genes = 6 and another one using MI and unstable angina patients (total genes = 7. In all our classification approaches we used a non-parametric k-nearest neighbour (KNN classification method (k = 3. The results proved the diagnostic robustness of the final feature sets in discriminating patients with myocardial infarction from healthy controls. Interestingly it also showed efficacy in discriminating myocardial infarction patients from patients with clinical symptoms of cardiac ischemia but no myocardial necrosis or stable coronary artery disease, despite the influence of batch effects and different microarray gene chips and platforms.

  17. [The effects of coronary artery disease severity on left atrial deformation parameters in patients with stable coronary artery disease].

    Science.gov (United States)

    Kalaycı, Arzu; Karabay, Can Yücel; Taşar, Onur; İzci, Servet; Geçmen, Çetin; Oduncu, Vecih; İzgi, İbrahim Akın; Kırma, Cevat

    2017-03-01

    Aim of the present study was to investigate correlation between left atrial (LA) deformation parameters assessed using 2-dimensional (2D) speckle tracking echocardiography (STE) and complexity of coronary artery disease according to SYNTAX score (SXscore) in patients with stable coronary artery disease (SCAD). Total of 60 moderate-risk SCAD patients (40 men, 20 women) who underwent coronary angiography and 30 healthy controls were included. Measurements of conventional echocardiographic parameters as well as peak LA strain during ventricular systole (LA-RES), peak LA strain during atrial systole (LA-PUMP), peak LA strain rate during ventricular systole (LA-SRS), peak LA strain rate during early diastole (LA-SRE), and peak LA strain rate during atrial systole (LA-SRA) were obtained. Patients were categorized into 2 groups: low SXscore of SCAD who have high SXscore. In addition, evaluation of LA-RES and LA-PUMP functions might be useful in estimating severity of disease in patients with SCAD.

  18. Paraoxonase-1 and Simvastatin Treatment in Patients with Stable Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Rafał Januszek

    2016-01-01

    Full Text Available Background. Paraoxonase-1 (PON1 is the crucial antioxidant marker of high-density lipoproteins. The present study is aimed at assessing the effect of simvastatin treatment on PON1 activity and its relationship to Q192R and M55L polymorphisms in subjects with stable coronary artery disease (CAD. Methods. The patient group was composed of 53 individuals with stable CAD, and the control group included 53 sex-matched police officers without CAD. CAD patients were treated with simvastatin 40mg/day for 12 months. Respectively, flow mediated dilatation (FMD, serum hs-CRP and TNF-α levels, urinary 8-iso-PGF2α concentrations, and PON1 activity were evaluated in definitive intervals. Results. There was no effect of simvastatin treatment on urinary 8-iso-PGF2α. Simvastatin treatment significantly increased FMD value, decreased CRP and TNF-α concentration. After adjusting for PON1 genotypes, significantly higher PON1 activity was noted in the 192R allele carriers, in both groups. Regardless of genotype, PON1 activity remained stable after simvastatin treatment. Conclusions. The present study confirms a positive effect of simvastatin therapy on endothelial function and inflammatory markers in secondary prevention. Simvastatin treatment shows no effects on PON1 activity and 8-isoprostanes level. The effect of simvastatin therapy on PON1 activity is not modulated by Q192R and M55L polymorphisms.

  19. Neonatal Respiratory Diseases in the Newborn Infant: Novel Insights from Stable Isotope Tracer Studies.

    Science.gov (United States)

    Carnielli, Virgilio P; Giorgetti, Chiara; Simonato, Manuela; Vedovelli, Luca; Cogo, Paola

    2016-01-01

    Respiratory distress syndrome is a common problem in preterm infants and the etiology is multifactorial. Lung underdevelopment, lung hypoplasia, abnormal lung water metabolism, inflammation, and pulmonary surfactant deficiency or disfunction play a variable role in the pathogenesis of respiratory distress syndrome. High-quality exogenous surfactant replacement studies and studies on surfactant metabolism are available; however, the contribution of surfactant deficiency, alteration or dysfunction in selected neonatal lung conditions is not fully understood. In this article, we describe a series of studies made by applying stable isotope tracers to the study of surfactant metabolism and lung water. In a first set of studies, which we call 'endogenous studies', using stable isotope-labelled intravenous surfactant precursors, we showed the feasibility of measuring surfactant synthesis and kinetics in infants using several metabolic precursors including plasma glucose, plasma fatty acids and body water. In a second set of studies, named 'exogenous studies', using stable isotope-labelled phosphatidylcholine tracer given endotracheally, we could estimate surfactant disaturated phosphatidylcholine pool size and half-life. Very recent studies are focusing on lung water and on the endogenous biosynthesis of the surfactant-specific proteins. Information obtained from these studies in infants will help to better tailor exogenous surfactant treatment in neonatal lung diseases. © 2016 S. Karger AG, Basel.

  20. Determinants of heart rate turbulence in individuals without apparent heart disease and in patients with stable coronary artery disease.

    Science.gov (United States)

    Pinnacchio, Gaetano; Lanza, Gaetano Antonio; Stazi, Alessandra; Careri, Giulia; Coviello, Ilaria; Mollo, Roberto; Crea, Filippo

    2015-12-01

    To assess the characteristics and determinants of heart rate turbulence (HRT) in individuals without any apparent heart disease and in patients with coronary artery disease (CAD). Heart rate turbulence parameters, turbulence onset (TO), and turbulence slope (TS) were calculated on 24 h electrocardiogram recordings in 209 individuals without any heart disease (group 1) and in 157 CAD patients (group 2). In group 1, only age independently predicted abnormal TO (≥0%) [odds ratio (OR), 1.05; PCoronary artery disease group, however, did not predict abnormal HRT parameters in multivariable analyses, both in the whole population and when comparing two subgroups matched for age and gender. Age and (for TS) LVEF, indeed, were the only independent predictors of abnormal HRT. Age is a major HRT determinant both in subjects without any apparent heart disease and in stable CAD patients. Hypertension and LVEF contribute independently to HRT in these two groups, respectively. Coronary artery disease group was not by itself associated with abnormal HRT parameters in multivariable analyses. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  1. Predictive Model for Anxiety and Depression in Spanish Patients with Stable Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    González-Gutiérrez, María Victoria; Guerrero Velázquez, José; Morales García, Concepción; Casas Maldonado, Francisco; Gómez Jiménez, Francisco Javier; González Vargas, Francisco

    2016-03-01

    The association between chronic obstructive pulmonary disease (COPD) and anxiety and depression is not yet completely characterized, and differences between countries may exist. We used a predictive model to assess this association in a Spanish population. Prospective transversal descriptive study of 204 patients with stable COPD. Concomitant anxiety or depression were diagnosed by psychiatric assessment, using the diagnostic criteria of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Sociodemographic, clinical and lung function parameters were analyzed. In total, 36% of stable COPD patients had psychiatric comorbidities, but 76% were unaware of their diagnosis. Nineteen percent had a pure anxiety disorder, 9.8% had isolated depression, and 7.3% had a mixed anxiety-depression disorder. Predictive variables in the multivariate analysis were younger age, higher educational level, lack of home support, higher BODE index, and greater number of exacerbations. The ROC curve of the model had an AUC of 0.765 (P<0.001). In COPD, concomitant psychiatric disorders are significantly associated with sociodemographic factors. Anxiety disorders are more common than depression. Patients with more severe COPD, according to BODE, younger patients and those with a higher educational level have a greater risk of being diagnosed with anxiety or depression in a structured psychiatric interview. In our population, most patients with psychiatric comorbidities remain unidentified. Copyright © 2015 SEPAR. Published by Elsevier Espana. All rights reserved.

  2. Evidence suggesting that oral corticosteroids increase mortality in stable chronic obstructive pulmonary disease.

    Science.gov (United States)

    Horita, Nobuyuki; Miyazawa, Naoki; Morita, Satoshi; Kojima, Ryota; Inoue, Miyo; Ishigatsubo, Yoshiaki; Kaneko, Takeshi

    2014-04-03

    Oral corticosteroids were used to control stable chronic obstructive pulmonary disease (COPD) decades ago. However, recent guidelines do not recommend long-term oral corticosteroids (LTOC) use for stable COPD patients, partly because it causes side-effects such as respiratory muscle deterioration and immunosuppression. Nonetheless, the impact of LTOC on life prognosis for stable COPD patients has not been clarified. We used the data of patients randomized to non-surgery treatment in the National Emphysema Treatment Trial. Severe and very severe stable COPD patients who were eligible for volume reduction surgery were recruited at 17 clinical centers in the United States and randomized during 1998-2002. Patients were followed-up for at least five years. Hazard ratios for death by LTOC were estimated by three models using Cox proportional hazard analysis and propensity score matching. The pre-matching cohort comprised 444 patients (prescription of LTOC: 23.0%. Age: 66.6 ± 5.4 year old. Female: 35.6%. Percent predicted forced expiratory volume in one second: 27.0 ± 7.1%. Mortality during follow-up: 67.1%). Hazard ratio using a multiple-variable Cox model in the pre-matching cohort was 1.54 (P = 0.001). Propensity score matching was conducted with 26 parameters (C-statics: 0.73). The propensity-matched cohort comprised of 65 LTOC(+) cases and 195 LTOC(-) cases (prescription of LTOC: 25.0%. Age: 66.5 ± 5.3 year old. Female: 35.4%. Percent predicted forced expiratory volume in one second: 26.1 ± 6.8%. Mortality during follow-up: 71.3%). No parameters differed between cohorts. The hazard ratio using a single-variable Cox model in the propensity-score-matched cohort was 1.50 (P = 0.013). The hazard ratio using a multiple-variable Cox model in the propensity-score-matched cohort was 1.73 (P = 0.001). LTOC may increase the mortality of stable severe and very severe COPD patients.

  3. Physical Activity and Mortality in Patients With Stable Coronary Heart Disease.

    Science.gov (United States)

    Stewart, Ralph A H; Held, Claes; Hadziosmanovic, Nermin; Armstrong, Paul W; Cannon, Christopher P; Granger, Christopher B; Hagström, Emil; Hochman, Judith S; Koenig, Wolfgang; Lonn, Eva; Nicolau, José C; Steg, Philippe Gabriel; Vedin, Ola; Wallentin, Lars; White, Harvey D

    2017-10-03

    Recommendations for physical activity in patients with stable coronary heart disease (CHD) are based on modest evidence. The authors analyzed the association between self-reported exercise and mortality in patients with stable CHD. A total of 15,486 patients from 39 countries with stable CHD who participated in the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) study completed questions at baseline on hours spent each week taking mild, moderate, and vigorous exercise. Associations between the volume of habitual exercise in metabolic equivalents of task hours/week and adverse outcomes during a median follow-up of 3.7 years were evaluated. A graded decrease in mortality occurred with increased habitual exercise that was steeper at lower compared with higher exercise levels. Doubling exercise volume was associated with lower all-cause mortality (unadjusted hazard ratio [HR]: 0.82; 95% confidence interval [CI]: 0.79 to 0.85; adjusting for covariates, HR: 0.90; 95% CI: 0.87 to 0.93). These associations were similar for cardiovascular mortality (unadjusted HR: 0.83; 95% CI: 0.80 to 0.87; adjusted HR: 0.92; 95% CI: 0.88 to 0.96), but myocardial infarction and stroke were not associated with exercise volume after adjusting for covariates. The association between decrease in mortality and greater physical activity was stronger in the subgroup of patients at higher risk estimated by the ABC-CHD (Age, Biomarkers, Clinical-Coronary Heart Disease) risk score (p for interaction = 0.0007). In patients with stable CHD, more physical activity was associated with lower mortality. The largest benefits occurred between sedentary patient groups and between those with the highest mortality risk. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  4. Transdiaphragmatic pressure and neural respiratory drive measured during inspiratory muscle training in stable patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Wu, Weiliang; Zhang, Xianming; Lin, Lin; Ou, Yonger; Li, Xiaoying; Guan, Lili; Guo, Bingpeng; Zhou, Luqian; Chen, Rongchang

    2017-01-01

    Inspiratory muscle training (IMT) is a rehabilitation therapy for stable patients with COPD. However, its therapeutic effect remains undefined due to the unclear nature of diaphragmatic mobilization during IMT. Diaphragmatic mobilization, represented by transdiaphragmatic pressure (Pdi), and neural respiratory drive, expressed as the corrected root mean square (RMS) of the diaphragmatic electromyogram (EMGdi), both provide vital information to select the proper IMT device and loads in COPD, therefore contributing to the curative effect of IMT. Pdi and RMS of EMGdi (RMSdi%) were measured and compared during inspiratory resistive training and threshold load training in stable patients with COPD. Pdi and neural respiratory drive were measured continuously during inspiratory resistive training and threshold load training in 12 stable patients with COPD (forced expiratory volume in 1 s ± SD was 26.1%±10.2% predicted). Pdi was significantly higher during high-intensity threshold load training (91.46±17.24 cmH 2 O) than during inspiratory resistive training (27.24±6.13 cmH 2 O) in stable patients with COPD, with P training and inspiratory resistive training (69.98%±16.78% vs 17.26%±14.65%, P training shows greater mobilization of Pdi and neural respiratory drive than inspiratory resistive training in stable patients with COPD.

  5. Platelet turnover in stable coronary artery disease - influence of thrombopoietin and low-grade inflammation.

    Directory of Open Access Journals (Sweden)

    Sanne Bøjet Larsen

    Full Text Available BACKGROUND: Newly formed platelets are associated with increased aggregation and adverse outcomes in patients with coronary artery disease (CAD. The mechanisms involved in the regulation of platelet turnover in patients with CAD are largely unknown. AIM: To investigate associations between platelet turnover parameters, thrombopoietin and markers of low-grade inflammation in patients with stable CAD. Furthermore, to explore the relationship between platelet turnover parameters and type 2 diabetes, prior myocardial infarction, smoking, age, gender and renal insufficiency. METHODS: We studied 581 stable CAD patients. Platelet turnover parameters (immature platelet fraction, immature platelet count, mean platelet volume, platelet distribution width and platelet large cell-ratio were determined using automated flow cytometry (Sysmex XE-2100. Furthermore, we measured thrombopoietin and evaluated low-grade inflammation by measurement of high-sensitive CRP and interleukin-6. RESULTS: We found strong associations between the immature platelet fraction, immature platelet count, mean platelet volume, platelet distribution width and platelet large cell ratio (r = 0.61-0.99, p<0.0001. Thrombopoietin levels were inversely related to all of the platelet turnover parameters (r = -0.17--0.25, p<0.0001. Moreover, thrombopoietin levels were significantly increased in patients with diabetes (p = 0.03 and in smokers (p = 0.003. Low-grade inflammation evaluated by high-sensitive CRP correlated significantly, yet weakly, with immature platelet count (r = 0.10, p = 0.03 and thrombopoietin (r = 0.16, p<0.001. Also interleukin-6 correlated with thrombopoietin (r = 0.10, p = 0.02. CONCLUSION: In stable CAD patients, thrombopoietin was inversely associated with platelet turnover parameters. Furthermore, thrombopoietin levels were increased in patients with diabetes and in smokers. However, low-grade inflammation did not seem to have a

  6. Renin-angiotensin system antagonists and clinical outcomes in stable coronary artery disease without heart failure.

    Science.gov (United States)

    Sorbets, Emmanuel; Labreuche, Julien; Simon, Tabassome; Delorme, Laurent; Danchin, Nicolas; Amarenco, Pierre; Goto, Shinya; Meune, Christophe; Eagle, Kim A; Bhatt, Deepak L; Steg, Philippe Gabriel

    2014-07-01

    The aim of this study was to determine whether angiotensin-converting enzyme inhibitor (ACEI) or angiotensin-II receptor blocker (ARB) use is associated with lower rates of cardiovascular events in patients with stable coronary artery disease (CAD) but without heart failure (HF) receiving contemporary medical management. Using data from the Reduction of Atherothrombosis for Continued Health (REACH) registry, we examined, using propensity score approaches, relationships between cardiovascular outcomes and ACEI/ARB use (64.1% users) in 20 909 outpatients with stable CAD and free of HF at baseline. As internal control, we assessed the relation between statin use and outcomes. At 4-year follow-up, the risk of cardiovascular death, MI, or stroke (primary outcome) was similar in ACEI/ARB users compared with non-users (hazard ratio, 1.03; 95% confidence interval [CI], 0.91-1.16; P = 0.66). Similarly, the risk of the primary outcome and cardiovascular hospitalization for atherothrombotic events (secondary outcome) was not reduced in ACEI/ARB users (hazard ratio, 1.08; 95% CI, 1.01-1.16; P = 0.04), nor were the rates of any of its components. Analyses using propensity score matching yielded similar results, as did sensitivity analyses accounting for missing covariates, changes in medications over time, or analysing separately ACEI and ARB use. In contrast, in the same cohort, statin use was associated with lower rates for all outcomes. Use of ACEI/ARB was not associated with better outcomes in stable CAD outpatients without HF. The benefit of ACEI/ARB seen in randomized clinical trials was not replicated in this large contemporary cohort, which questions their value in this specific subset. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  7. Cognitive function in patients with stable coronary heart disease: Related cerebrovascular and cardiovascular responses.

    Directory of Open Access Journals (Sweden)

    Mathieu Gayda

    Full Text Available Chronic exercise has been shown to prevent or slow age-related decline in cognitive functions in otherwise healthy, asymptomatic individuals. We sought to assess cognitive function in a stable coronary heart disease (CHD sample and its relationship to cerebral oxygenation-perfusion, cardiac hemodynamic responses, and [Formula: see text] peak compared to age-matched and young healthy control subjects. Twenty-two young healthy controls (YHC, 20 age-matched old healthy controls (OHC and 25 patients with stable CHD were recruited. Cognitive function assessment included short term-working memory, perceptual abilities, processing speed, cognitive inhibition and flexibility and long-term verbal memory. Maximal cardiopulmonary function (gas exchange analysis, cardiac hemodynamic (impedance cardiography and left frontal cerebral oxygenation-perfusion (near-infra red spectroscopy were measured during and after a maximal incremental ergocycle test. Compared to OHC and CHD, YHC had higher [Formula: see text] peak, maximal cardiac index (CI max, cerebral oxygenation-perfusion (ΔO2 Hb, ΔtHb: exercise and recovery and cognitive function (for all items (P<0.05. Compared to OHC, CHD patients had lower [Formula: see text] peak, CI max, cerebral oxygenation-perfusion (during recovery and short term-working memory, processing speed, cognitive inhibition and flexibility and long-term verbal memory (P<0.05. [Formula: see text] peak and CI max were related to exercise cerebral oxygenation-perfusion and cognitive function (P<0.005. Cerebral oxygenation-perfusion (exercise was related to cognitive function (P<0.005. Stable CHD patients have a worse cognitive function, a similar cerebral oxygenation/perfusion during exercise but reduced one during recovery vs. their aged-matched healthy counterparts. In the all sample, cognitive functions correlated with [Formula: see text] peak, CI max and cerebral oxygenation-perfusion.

  8. Psychosocial stress and major cardiovascular events in patients with stable coronary heart disease.

    Science.gov (United States)

    Hagström, E; Norlund, F; Stebbins, A; Armstrong, P W; Chiswell, K; Granger, C B; López-Sendón, J; Pella, D; Soffer, J; Sy, R; Wallentin, L; White, H D; Stewart, R A H; Held, C

    2018-01-01

    Assess the risk of ischaemic events associated with psychosocial stress in patients with stable coronary heart disease (CHD). Psychosocial stress was assessed by a questionnaire in 14 577 patients (median age 65.0, IQR 59, 71; 81.6% males) with stable CHD on optimal secondary preventive therapy in the prospective randomized STABILITY clinical trial. Adjusted Cox regression models were used to assess associations between individual stressors, baseline cardiovascular risk factors and outcomes. After 3.7 years of follow-up, depressive symptoms, loss of interest and financial stress were associated with increased risk (hazard ratio, 95% confidence interval) of CV death (1.21, 1.09-1.34; 1.15, 1.05-1.27; and 1.19, 1.08-1.30, respectively) and the primary composite end-point of CV death, nonfatal MI or nonfatal stroke (1.21, 1.13-1.30; 1.19, 1.11-1.27; and 1.17, 1.10-1.24, respectively). Living alone was related to higher risk of CV death (1.68, 1.38-2.05) and the primary composite end-point (1.28, 1.11-1.48), whereas being married as compared with being widowed, was associated with lower risk of CV death (0.64, 0.49-0.82) and the primary composite end-point (0.81, 0.67-0.97). Psychosocial stress, such as depressive symptoms, loss of interest, living alone and financial stress, were associated with increased CV mortality in patients with stable CHD despite optimal medical secondary prevention treatment. Secondary prevention of CHD should therefore focus also on psychosocial issues both in clinical management and in future clinical trials. © 2017 The Association for the Publication of the Journal of Internal Medicine.

  9. Evaluation of brain stem auditory evoked potentials in stable patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Gupta Prem

    2008-01-01

    Full Text Available Though there are few studies addressing brainstem auditory evoked potentials (BAEP in patients with chronic obstructive pulmonary disease (COPD, subclinical BAEP abnormalities in stable COPD patients have not been studied. The present study aimed to evaluate the BAEP abnormalities in this study group. Materials and Methods : In the present study, 80 male subjects were included: COPD group comprised 40 smokers with stable COPD with no clinical neuropathy; 40 age-matched healthy volunteers served as the control group. Latencies of BAEP waves I, II, III, IV, and V, together with interpeak latencies (IPLs of I-III, I-V, and III-V, and amplitudes of waves I-Ia and V-Va were studied in both the groups to compare the BAEP abnormalities in COPD group; the latter were correlated with patient characteristics and Mini-Mental Status Examination Questionnaire (MMSEQ scores to seek any significant correlation. Results: Twenty-six (65% of the 40 COPD patients had BAEP abnormalities. We observed significantly prolonged latencies of waves I, III, V over left ear and waves III, IV, V over right ear; increased IPLs of I-V, III-V over left ear and of I-III, I-V, III-V over right side. Amplitudes of waves I-Ia and V-Va were decreased bilaterally. Over left ear, the latencies of wave I and III were significantly correlated with FEV 1 ; and amplitude of wave I-Ia, with smoking pack years. A weak positive correlation between amplitude of wave I-Ia and duration of illness; and a weak negative correlation between amplitude of wave V-Va and MMSEQ scores were seen over right side. Conclusions : We observed significant subclinical BAEP abnormalities on electrophysiological evaluation in studied stable COPD male patients having mild-to-moderate airflow obstruction.

  10. Plasma levels of myeloperoxidase are not elevated in patients with stable coronary artery disease.

    Science.gov (United States)

    Kubala, Lukas; Lu, Guijing; Baldus, Stephan; Berglund, Lars; Eiserich, Jason P

    2008-08-01

    Plasma and serum levels of myeloperoxidase (MPO), a redox-active hemoprotein released by polymorphonuclear neutrophils (PMN) upon activation, is now recognized as a powerful prognostic determinant of myocardial infarction in patients suffering acute coronary syndromes. However, there is limited information on whether systemic MPO levels are also elevated and of discriminating value in patients with stable coronary artery disease (CAD) representing different ethnic groups. Plasma levels of MPO and traditional CAD risk factors were quantified in African American and Caucasian patients (n=557) undergoing elective coronary angiography. MPO levels did not differ significantly between patients with or without CAD [421 pM (321, 533) vs. 412 pM (326, 500), p>0.05]. MPO levels were similar across ethnicity and gender, and correlated positively with CRP and fibrinogen levels (r=0.132, p=0.002 and r=0.106, p=0.011, respectively). In conclusion, plasma MPO levels were not elevated in patients with stable CAD, suggesting that systemic release of MPO is not a characteristic feature of asymptomatic CAD.

  11. Medical therapy v. PCI in stable coronary artery disease: a cost-effectiveness analysis.

    Science.gov (United States)

    Wijeysundera, Harindra C; Tomlinson, George; Ko, Dennis T; Dzavik, Vladimir; Krahn, Murray D

    2013-10-01

    Percutaneous coronary intervention (PCI) with either drug-eluting stents (DES) or bare metal stents (BMS) reduces angina and repeat procedures compared with optimal medical therapy alone. It remains unclear if these benefits are sufficient to offset their increased costs and small increase in adverse events. Cost utility analysis of initial medical therapy v. PCI with either BMS or DES. . Markov cohort decision model. Data Sources. Propensity-matched observational data from Ontario, Canada, for baseline event rates. Effectiveness and utility data obtained from the published literature, with costs from the Ontario Case Costing Initiative. Patients with stable coronary artery disease, confirmed after angiography, stratified by risk of restenosis based on diabetic status, lesion size, and lesion length. Time Horizon. Lifetime. Perspective. Ontario Ministry of Health and Long Term Care. Interventions. Optimal medical therapy, PCI with BMS or DES. Lifetime costs, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER). of Base Case Analysis. In the overall population, medical therapy had the lowest lifetime costs at $22,952 v. $25,081 and $25,536 for BMS and DES, respectively. Medical therapy had a quality-adjusted life expectancy of 10.1 v. 10.26 QALYs for BMS, producing an ICER of $13,271/QALY. The DES strategy had a quality-adjusted life expectancy of only 10.20 QALYs and was dominated by the BMS strategy. This ranking was consistent in all groups stratified by restenosis risk, except diabetic patients with long lesions in small arteries, in whom DES was cost-effective compared with medical therapy (ICER of $18,826/QALY). Limitations. There is the possibility of residual unobserved confounding. In patients with stable coronary artery disease, an initial BMS strategy is cost-effective.

  12. Long-term outcome of FFR-guided PCI for stable coronary artery disease in daily clinical practice

    DEFF Research Database (Denmark)

    De Backer, Ole; Biasco, Luigi; Lønborg, Jacob

    2016-01-01

    AIMS: Our aim was to investigate the strength of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD) in daily practice. METHODS AND RESULTS: For this study, 3,512 patients with stable CAD and at least one 50-89% coronary stenosis ...... that performing FFR has a significant impact on therapeutic strategy and demonstrates the favourable long-term outcome of FFR-guided PCI in an "all-comers" population of patients with stable CAD in daily clinical practice....

  13. Insufficient control of heart rate in stable coronary artery disease patients in Latvia.

    Science.gov (United States)

    Balode, Inga; Mintāle, Iveta; Latkovskis, Gustavs; Jēgere, Sanda; Narbute, Inga; Bajāre, Iveta; Greenlaw, Nicola; Steg, Philippe Gabriel; Ferrari, Roberto; Ērglis, Andrejs

    2014-01-01

    Heart rate (HR) ≥70 beats per minute (bpm) increases cardiovascular risk in coronary artery disease (CAD) patients. The objective of the analysis is to characterize HR as well as other clinical parameters in outpatients with stable CAD in Latvia. CLARIFY is an ongoing international registry of outpatients with established CAD. Latvian data regarding 120 patients enrolled in CLARIFY and collected at baseline visit during 2009-2010 were analyzed. The mean HR was 67.7±9.5 and 66.9±10.7bpm when measured by pulse palpation and electrocardiography, respectively. HR ≤60bpm and ≥70bpm was observed in 25% and 35.8% of patients, respectively. When analyzing patients with angina symptoms, 22.8% had HR ≤60bpm while HR ≥70bpm was observed in 33.3% of the cases. HR ≥70bpm was observed in 36.2% of patients with symptoms of chronic heart failure. Beta-blockers were used in 81.7% of the patients. Metoprolol (long acting succinate), bisoprolol, nebivolol and carvedilol in average daily doses 63.8, 5.3, 4.5, and 10.4mg/d were used in 47, 37, 11 and 3 cases, respectively. Among patients with HR ≥70bpm 79.1% were using beta-blockers. Medications did not differ significantly between the three groups according to HR level (≤60, 61-69 and ≥70bpm). Despite the wide use of beta-blockers, HR is insufficiently controlled in the analyzed sample of stable CAD patients in Latvia. Target HR ≤60bpm is achieved only in 25% of the patients while more than one third have increased HR ≥70bpm. Copyright © 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  14. Effect of doxycycline in patients of moderate to severe chronic obstructive pulmonary disease with stable symptoms

    Directory of Open Access Journals (Sweden)

    Prashant S Dalvi

    2011-01-01

    Full Text Available Background: The protease-antiprotease hypothesis proposes that inflammatory cells and oxidative stress in chronic obstructive pulmonary disease (COPD produce increased levels of proteolytic enzymes (neutrophil elastase, matrix metalloproteinases [MMP] which contribute to destruction of parenchyma resulting in progressive decline in forced expiratory volume in one second. Doxycycline, a tetracycline analogue, possesses anti-inflammatory properties and inhibits MMP enzymes. Objectives: To assess the effect of 4 weeks doxycycline in a dose of 100 mg once a day in patients of moderate to severe COPD with stable symptoms. Methods : In an interventional, randomized, observer-masked, parallel study design, the effect of doxycycline (100 mg once a day for 4 weeks was assessed in patients of COPD having stable symptoms after a run-in period of 4 weeks. The study participants in reference group did not receive doxycycline. The parameters were pulmonary functions, systemic inflammation marker C-reactive protein (CRP, and medical research council (MRC dyspnea scale. Use of systemic corticosteroids or antimicrobial agents was not allowed during the study period. Results: A total of 61 patients completed the study (31 patients in doxycycline group and 30 patients in reference group. At 4 weeks, the pulmonary functions significantly improved in doxycycline group and the mean reduction in baseline serum CRP was significantly greater in doxycycline group as compared with reference group. There was no significant improvement in MRC dyspnea scale in both groups at 4 weeks. Conclusion: The anti-inflammatory and MMP-inhibiting property of doxycycline might have contributed to the improvement of parameters in this study.

  15. [Efficacy comparison of 3 strategies for real-world stable coronary artery disease patients with three-vessel disease].

    Science.gov (United States)

    Liu, R; Jiang, L; Xu, L J; Tian, J; Zhao, X Y; Zhang, Y; Xu, J J; Song, Y; Wang, H H; Gao, Z; Song, L; Yuan, J Q

    2017-12-24

    Objective: To compare the effectiveness of percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) or medical therapy (MT) alone for real-world stable coronary artery disease (SCAD) patients with three-vessel disease (TVD) in mainland China. Methods: A total of 8 943 consecutive cases with TVD hospitalized in our center from April 2004 to February 2011 were screened for this study. In this cohort, 3 435 cases diagnosed as SCAD were analyzed. PCI, CABG, MT alone were performed in 1 313 (38.2%), 1 259 (36.7%) and 863 (25.1%) patients, respectively. Propensity score matching (PSM) analysis using nearest neighbor matching with a 1∶1 ratio was applied, and 758 pairs of CABG and PCI groups, 552 pairs of PCI and MT groups, 639 pairs of CABG and MT groups were selected, respectively. 1- and 2-year clinical outcomes were evaluated among PCI, CABG and MT group. Kaplan-Meier curves and multivariable Cox regression method were used for survival analysis. Results: Significant differences were found at baseline between PCI, CABG and MT group, including age, gender, body mass index, family history of coronary artery disease, hyperlipidemia, diabetes mellitus, previous myocardial infarction, stroke, previous revascularization, peripheral vascular disease, SNYTAX score, left ventricular ejection fraction, hemoglobin, serum creatinine, high-sensitivity C-reactive protein, triglyceride and medication (all PSCAD patients with TVD, CABG shows better effectiveness by reducing MI and revascularization risk as compared to PCI, even though stroke risk is somehow higher in CABG patients. Patients received MT alone are associated with worse outcomes than those undergoing revascularization strategies.

  16. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events

    DEFF Research Database (Denmark)

    Jespersen, L.; Hvelplund, A.; Abildstrom, S. Z.

    2012-01-01

    Aims Patients with chest pain and no obstructive coronary artery disease (CAD) are considered at low risk for cardiovascular events but evidence supporting this is scarce. We investigated the prognostic implications of stable angina pectoris in relation to the presence and degree of CAD with no o...... with stable angina and normal coronary arteries or diffuse non-obstructive CAD have elevated risks of MACE and all-cause mortality compared with a reference population without ischaemic heart disease.......Aims Patients with chest pain and no obstructive coronary artery disease (CAD) are considered at low risk for cardiovascular events but evidence supporting this is scarce. We investigated the prognostic implications of stable angina pectoris in relation to the presence and degree of CAD...... (MACE), defined as cardiovascular death, myocardial infarction, stroke or heart failure, and all-cause mortality. Significantly more women (65%) than men (32%) had no obstructive CAD (P

  17. Selective Heart Rate Reduction With Ivabradine Increases Central Blood Pressure in Stable Coronary Artery Disease.

    Science.gov (United States)

    Rimoldi, Stefano F; Messerli, Franz H; Cerny, David; Gloekler, Steffen; Traupe, Tobias; Laurent, Stéphane; Seiler, Christian

    2016-06-01

    Heart rate (HR) lowering by β-blockade was shown to be beneficial after myocardial infarction. In contrast, HR lowering with ivabradine was found to confer no benefits in 2 prospective randomized trials in patients with coronary artery disease. We hypothesized that this inefficacy could be in part related to ivabradine's effect on central (aortic) pressure. Our study included 46 patients with chronic stable coronary artery disease who were randomly allocated to placebo (n=23) or ivabradine (n=23) in a single-blinded fashion for 6 months. Concomitant baseline medication was continued unchanged throughout the study except for β-blockers, which were stopped during the study period. Central blood pressure and stroke volume were measured directly by left heart catheterization at baseline and after 6 months. For the determination of resting HR at baseline and at follow-up, 24-hour ECG monitoring was performed. Patients on ivabradine showed an increase of 11 mm Hg in central systolic pressure from 129±22 mm Hg to 140±26 mm Hg (P=0.02) and in stroke volume by 86±21.8 to 107.2±30.0 mL (P=0.002). In the placebo group, central systolic pressure and stroke volume remained unchanged. Estimates of myocardial oxygen consumption (HR×systolic pressure and time-tension index) remained unchanged with ivabradine.The decrease in HR from baseline to follow-up correlated with the concomitant increase in central systolic pressure (r=-0.41, P=0.009) and in stroke volume (r=-0.61, Pcoronary artery disease patients. CLINICAL TRIALSURL: http://www.clinicaltrials.gov. Unique identifier NCT01039389. © 2016 American Heart Association, Inc.

  18. Persistent psychological distress and mortality in patients with stable coronary artery disease.

    Science.gov (United States)

    Stewart, Ralph A H; Colquhoun, David M; Marschner, Simone L; Kirby, Adrienne C; Simes, John; Nestel, Paul J; Glozier, Nick; O'Neil, Adrienne; Oldenburg, Brian; White, Harvey D; Tonkin, Andrew M

    2017-12-01

    A single assessment of psychological distress, which includes depression and anxiety, has been associated with increased mortality in patients with coronary heart disease, but the prognostic importance of persistence of distress symptoms is less certain. To determine whether intermittent and/or persistent psychological distress is associated with long-term cardiovascular (CV) and total mortality in patients with stable coronary artery disease. 950 participants in the Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) trial completed at least four General Health Questionnaires (GHQ-30) at baseline and after ½, 1, 2 and 4 years. In a landmark analysis from 4 years, Cox proportional hazards models evaluated the risk of CV and total mortality by increasing levels of psychological distress: never distressed, sometimes any severity (GHQ score >5), persistent mild (GHQ score >5 on three or more occasions) and persistent moderate distress (GHQ score >10) on three or more occasions, over a median of 12.1 (IQR 8.6-12.5) years. The models were both unadjusted and adjusted for known baseline risk factors. Persistent moderate or greater psychological stress was reported on three or more assessments by 35 (3.7%) subjects. These patients had a higher risk of both CV death (adjusted HR 3.94, 95% CI 2.05 to 7.56, ppsychological distress of at least moderate severity is associated with a substantial increase in CV and all-cause mortality. © 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. Impact of aspirin according to type of stable coronary artery disease: insights from a large international cohort.

    Science.gov (United States)

    Bavry, Anthony A; Gong, Yan; Handberg, Eileen M; Cooper-DeHoff, Rhonda M; Pepine, Carl J

    2015-02-01

    Aspirin is recommended in stable coronary artery disease based on myocardial infarction and stroke studies. However, benefit among stable coronary artery disease patients who have not suffered an acute ischemic event is uncertain. The objective of this study was to evaluate the impact of aspirin in stable coronary artery disease. We hypothesized that aspirin's benefit would be attenuated among individuals with stable coronary artery disease but no prior ischemic event. An observational study was conducted from the INternational VErapamil-SR/Trandolapril STudy cohort. Ambulatory patients ≥ 50 years of age with clinically stable coronary artery disease requiring antihypertensive drug therapy (n = 22,576) were classified "ischemic" if they had a history of unstable angina, myocardial infarction, transient ischemic attack, or stroke at the baseline visit. All others were classified "non-ischemic." Aspirin use was updated at each clinic visit and considered as a time-varying covariate in a Cox regression model. The primary outcome was first occurrence of all-cause mortality, myocardial infarction, or stroke. At baseline, 56.7% of all participants used aspirin, which increased to 69.3% at study close out. Among the "non-ischemic" group (n = 13,091), aspirin was not associated with a reduction in risk (hazard ratio [HR] 1.11; 95% confidence interval [CI], 0.97-1.28; P = .13); however, among the "ischemic" group (n = 9485), aspirin was associated with a reduction in risk (HR 0.87; 95% CI, 0.77-0.99; P = .033). In patients with stable coronary artery disease and hypertension, aspirin use was associated with reduced risk for adverse cardiovascular outcomes among those with prior ischemic events. Among patients with no prior ischemic events, aspirin use was not associated with a reduction in risk. Published by Elsevier Inc.

  20. Biological effects of ticagrelor over clopidogrel in patients with stable coronary artery disease and chronic obstructive pulmonary disease.

    Science.gov (United States)

    Campo, Gianluca; Vieceli Dalla Sega, Francesco; Pavasini, Rita; Aquila, Giorgio; Gallo, Francesco; Fortini, Francesca; Tonet, Elisabetta; Cimaglia, Paolo; Del Franco, Annamaria; Pestelli, Gabriele; Pecoraro, Alessandro; Contoli, Marco; Balla, Cristina; Biscaglia, Simone; Rizzo, Paola; Ferrari, Roberto

    2017-03-23

    Patients with SCAD and concomitant COPD are at high risk of cardiovascular adverse events, due to chronic inflammation, responsible of endothelial dysfunction, oxidative stress and heightened platelet reactivity (PR). The objective of this randomised clinical trial was to test if ticagrelor is superior to clopidogrel in improving endothelial function in patients with stable coronary artery disease (SCAD) and concomitant chronic obstructive pulmonary disease (COPD). Forty-six patients with SCAD and COPD undergoing percutaneous coronary intervention (PCI) were randomly assigned to receive clopidogrel (n=23) or ticagrelor (n=23) on top of standard therapy with aspirin. The following parameters were assessed at baseline and after 1 month: i) rate of apoptosis and ii) nitric oxide (NO) levels in human umbilical vein endothelial cells (HUVECs), iii) levels of reactive oxygen species (ROS) in peripheral blood mononuclear cell, iv) 29 cytokines/chemokines, v) on-treatment PR. The primary endpoint of the study was the 1-month rate of HUVECs apoptosis. The rate of apoptosis after 1 month was significantly lower in patients treated with ticagrelor (7.4 ± 1.3 % vs 9.3 ± 1.5 %, pSCAD and COPD undergoing PCI, ticagrelor, as compared to clopidogrel is superior in improving surrogate markers of endothelial function and on-treatment PR (ClinicalTrials.gov, NCT02519608).

  1. Bioelectrical impedance phase angle relates to function, disease severity and prognosis in stable chronic obstructive pulmonary disease.

    Science.gov (United States)

    Maddocks, Matthew; Kon, Samantha S C; Jones, Sarah E; Canavan, Jane L; Nolan, Claire M; Higginson, Irene J; Gao, Wei; Polkey, Michael I; Man, William D-C

    2015-12-01

    Bioelectrical impedance analysis (BIA) provides a simple method to assess changes in body composition. Raw BIA variables such as phase angle provide direct information on cellular mass and integrity, without the assumptions inherent in estimating body compartments, e.g. fat-free mass (FFM). Phase angle is a strong functional and prognostic marker in many disease states, but data in COPD are lacking. Our aims were to describe the measurement of phase angle in patients with stable COPD and determine the construct and discriminate validity of phase angle by assessing its relationship with established markers of function, disease severity and prognosis. 502 outpatients with stable COPD were studied. Phase angle and FFM by BIA, quadriceps strength (QMVC), 4-m gait speed (4MGS), 5 sit-to-stand time (5STS), incremental shuttle walk (ISW), and composite prognostic indices (ADO, iBODE) were measured. Patients were stratified into normal and low phase angle and FFM index. Phase angle correlated positively with FFM and functional outcomes (r = 0.35-0.66, p < 0.001) and negatively with prognostic indices (r = -0.35 to -0.48, p < 0.001). In regression models, phase angle was independently associated with ISW, ADO and iBODE whereas FFM was removed. One hundred and seventy patients (33.9% [95% CI, 29.9-38.1]) had a low phase angle. Phenotypic characteristics included lower QMVC, ISW, and 4MGS, higher 5STS, ADO and iBODE scores, and more exacerbations and hospital days in past year. The proportion of patients to have died was significantly higher in patients with low phase angle compared to those with normal phase angle (8.2% versus 3.6%, p = 0.02). Phase angle relates to markers of function, disease severity and prognosis in patients with COPD. As a directly measured variable, phase angle offers more useful information than fat-free mass indices. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  2. A randomized controlled trial of acupuncture in stable ischemic heart disease patients.

    Science.gov (United States)

    Mehta, Puja K; Polk, Donna M; Zhang, Xiao; Li, Ning; Painovich, Jeannette; Kothawade, Kamlesh; Kirschner, Joan; Qiao, Yi; Ma, Xiuling; Chen, Yii-Der Ida; Brantman, Anna; Shufelt, Chrisandra; Minissian, Margo; Merz, C Noel Bairey

    2014-09-20

    Heart rate variability (HRV) is reduced in stable ischemic heart disease (SIHD) patients and is associated with sudden cardiac death (SCD). We evaluated the impact of traditional acupuncture (TA) on cardiac autonomic function measured by HRV in SIHD patients. We conducted a randomized controlled study of TA, sham acupuncture (SA), and waiting control (WC) in 151 SIHD subjects. The TA group received needle insertion at acupuncture sites, the SA group received a sham at non-acupuncture sites, while the WC group received nothing. The TA and SA groups received 3 treatments/week for 12 weeks. 24-Hour, mental arithmetic stress, and cold pressor (COP) HRV was collected at entry and exit, along with BP, lipids, insulin resistance, hs-CRP, salivary cortisol, peripheral endothelial function by tonometry (PAT), and psychosocial variables. Mean age was 63 ± 10; 50% had prior myocardial infarction. Comparison of WC and SA groups demonstrated differences consistent with the unblinded WC status; therefore by design, the control groups were not merged. Exit mental stress HRV was higher in TA vs. SA for markers of parasympathetic tone (p ≤ 0.025), including a 17% higher vagal activity (p=0.008). There were no differences in exit 24-hour or COP HRV, BP, lipids, insulin resistance, hs-CRP, salivary cortisol, PAT, or psychosocial variables. TA results in intermediate effects on autonomic function in SIHD patients. TA effect on HRV may be clinically relevant and should be explored further. These data document feasibility and provide sample size estimation for a clinical trial of TA in SIHD patients for the prevention of SCD. We conducted a randomized, single-blind trial of traditional acupuncture (TA) vs. sham acupuncture (SA) vs waiting control (WC) in stable ischemic heart disease (SIHD) patients to evaluate cardiac autonomic function measured by heart rate variability (HRV). Exit mental stress HRV was higher in the TA compared to SA group for time and frequency domain markers of

  3. [Systemic inflammation among stable ex smokers with chronic obstructive pulmonary disease].

    Science.gov (United States)

    Morales S, Arturo; Dreyse D, Jorge; Díaz P, Orlando; Saldías P, Fernando; Carrasco, Marcela; Lisboa B, Carmen

    2010-08-01

    Low grade systemic inflammation is commonly observed in chronic obstructive pulmonary disease (COPD). To evaluate the extent of systemic inflammation in a group of ex-smokers with COPD in stable condition and its relation with pulmonary function and clinical manifestations. We studied 104 ex-smokers aged 69 ± 8 years (62 males) with mild to very severe COPD and 52 healthy non-smoker subjects aged 66 ± 11 years (13 males) as control group. High sensitivity serum C reactive protein (CRP), interleukin 6 (IL6), fibrinogen (F) and neutrophil count (Nc) were measured. Forced expiratory volume in the first minute (FEV1), inspiratory capacity (IC), arterial blood gases, six minutes walking test, dyspnea and body mass index (BMI) were measured, calculating the BODE index. Health status was assessed using the Saint George Respiratory Questionnaire (SGRQ), the chronic respiratory questionnaire (CRQ), registering the number of acute exacerbations (AE) during the previous year and inhaled steroids use. Systemic inflammation was considered present when levels of CRP or IL6 were above the percentile 95 of controls (7.98 mg/L and 3.42 pg/ml, respectively). COPD patients had significantly higher CRP and IL6 levels than controls. Their F and Nc levels were within normal limits. Systemic inflammation was present in 56 patients, which had similar disease severity and frequency of inhaled steroid use, compared with patients without inflammation. Patients with systemic inflammation had more AE in the previous year; lower inspiratory capacity, greater dyspnea during the six minutes walk test and worse SGRQ and CRQ scores. Low-grade systemic inflammation was found in 56 of 104 ex-smokers with COPD. This group showed a greater degree of lung hyperinflation, dyspnea on exercise and poor quality of life.

  4. Usefulness of Beta blockade in contemporary management of patients with stable coronary heart disease.

    Science.gov (United States)

    Winchester, David E; Pepine, Carl J

    2014-11-15

    Considerable progress has been made over the last few decades in the management of clinically stable coronary heart disease (SCHD), including improvements in interventions (e.g., percutaneous revascularization), pharmacological management, and risk factor control (e.g., smoking, diet, activity level, hypercholesterolemia, hypertension). Although β blockers have long been used for the treatment of SCHD, their efficacy was established in the era before widespread use of reperfusion interventions, modern medical therapy (e.g., angiotensin-converting enzyme inhibitors, angiotensin receptor blockers), or preventive treatments (e.g., aspirin, statins). On the basis of these older data, β blockers are assumed beneficial, and their use has been extrapolated beyond patients with heart failure and previous myocardial infarction, which provided the best evidence for efficacy. However, there are no randomized clinical trials demonstrating that β blockers decrease clinical events in patients with SCHD in the modern era. Furthermore, these agents are associated with weight gain, problems with glycemic control, fatigue, and bronchospasm, underscoring the fact that their use is not without risk. In conclusion, data are currently lacking to support the widespread use of β blockers for all SCHD patients, but contemporary data suggest that they be reserved for a well-defined high-risk group of patients with evidence of ongoing ischemia, left ventricular dysfunction, heart failure, and perhaps some arrhythmias. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Revascularisation versus medical treatment in patients with stable coronary artery disease

    DEFF Research Database (Denmark)

    Windecker, Stephan; Stortecky, Stefan; Stefanini, Giulio G

    2014-01-01

    stent, early generation paclitaxel eluting stent, sirolimus eluting stent, and zotarolimus eluting (Endeavor) stent, and new generation everolimus eluting stent, and zotarolimus eluting (Resolute) stent among patients with stable coronary artery disease. DATA SOURCES: Medline and Embase from 1980.......80, 95% credibility interval 0.70 to 0.91) compared with medical treatment. New generation drug eluting stents (everolimus: 0.75, 0.59 to 0.96; zotarolimus (Resolute): 0.65, 0.42 to 1.00) but not balloon angioplasty (0.85, 0.68 to 1.04), bare metal stents (0.92, 0.79 to 1.05), or early generation drug...... eluting stents (paclitaxel: 0.92, 0.75 to 1.12; sirolimus: 0.91, 0.75 to 1.10; zotarolimus (Endeavor): 0.88, 0.69 to 1.10) were associated with improved survival compared with medical treatment. Coronary artery bypass grafting reduced the risk of myocardial infarction compared with medical treatment (0...

  6. SD variations on magnetically quiet days

    International Nuclear Information System (INIS)

    Pogrebnoj, V.N.

    1991-01-01

    A method for determining the degree of evolution of the SD variations field in magnetically quiet days is proposed. The method takes into account the asymmetry in the daily variations of the geomagnetic field Y component occurred during simultaneous development of the SD- and S q current systems. Using a particular example it is shown that SD variations take place in the world quiet days. Application of the given method will improve the manifestation of the space-time structure of the geomagnetic perturbation field and specify the classification of days according to the degree of their magnetic disturbance

  7. SD card projects using the PIC microcontroller

    CERN Document Server

    Ibrahim, Dogan

    2010-01-01

    PIC Microcontrollers are a favorite in industry and with hobbyists. These microcontrollers are versatile, simple, and low cost making them perfect for many different applications. The 8-bit PIC is widely used in consumer electronic goods, office automation, and personal projects. Author, Dogan Ibrahim, author of several PIC books has now written a book using the PIC18 family of microcontrollers to create projects with SD cards. This book is ideal for those practicing engineers, advanced students, and PIC enthusiasts that want to incorporate SD Cards into their devices. SD cards are che

  8. [Efficacy on chronic obstructive pulmonary disease at stable stage treated with cutting method and western medication].

    Science.gov (United States)

    Xu, Jian-hua; Xu, Bin; Deng, Yan-qing

    2014-10-01

    To compare the difference in clinical efficacy on chronic obstructive pulmonary disease (COPD) at stable stage in the patients among the combined therapy of cutting method and western medication (combined therapy), simple cutting method and simple western medication. One hundred and twenty cases of COPD were randomized into three groups, 40 cases in each one. In the cutting method group, for excessive phlegm pattern/syndrome, Feishu (BL 13), Danzhong (CV 17), Dingchuan (EX-B 1) and Yuji (LU 10) were selected as the main acupoints, and Lieque (LU 7) and Pianli (LI 6) were as the supplementary acupoints. For the pattern/syndrome of failure to consolidate kidney primary, Shenshu (BL 23), Pishu (BL 20), Guanyuan (CV 4) and Yuji (LU 10) were selected as main acupoints, and Jueyinshu (BL 14) and Zusanli (ST 36) were as the supplementary acupoint. Three acupoints were selected alternatively in each treatment and the cutting method was applied once every 10 days. Three treatments made one session. Two sessions of treatment were required. In the western medication group, salbutamol sulfate aerosol, one press (200 μg/press) was used each night, as well as salmeterol xinafoate and fluticasone propionate powder for inhalation, one inhalation each night. The treatment of 1 month made one session. Two sessions were required. In the combined therapy group, the cutting method and western medication were applied in combination. The results of clinical symptom score, lung function test, arterial blood gas analysis, degree of inflation as well as clinical efficacy were observed before and after treatment in each group. Except the degree of lung inflation, the clinical symptom score, indices of lung function test, partial pressure of arterial blood gas (PaO2) and partial pressure of carbon dioxide (PaCO2) were all obviously improved after treatment as compared with those before treatment in each group (all Psyndrome differentiation and the combined therapy with western medication

  9. Randomized trial of stopping TNF-inhibitors in rheumatoid arthrisis: patients with stable low disease activity in the Netherlands

    NARCIS (Netherlands)

    Vonkeman, Harald Erwin; Moghadam, M.G.; van de Laar, Mart A F J; ten Klooster, Peter M.; Jansen, T.; van Riel, P.

    2014-01-01

    Background/Purpose: The effectiveness of TNF-inhibitors (TNFi) in the treatment of rheumatoid arthritis has already been demonstrated in many studies. However, little is known on stopping TNFi in patients with stable low disease activity and the subsequent likelihood of exacerbation of rheumatoid

  10. Implementation of recommended measures in patients with stable coronary artery disease: the data from 2014 Russian registry

    Directory of Open Access Journals (Sweden)

    Korotin A.S.

    2015-03-01

    Full Text Available A report presents the data on assessment of recommended treatment implementation in patients with stable coronary artery disease (CAD. The source of the data of the year 2014 was multicenter Russian registry of hypertension, CAD and chronic heart failure.

  11. Antiplatelet Therapy for Stable Coronary Artery Disease in Atrial Fibrillation Patients Taking an Oral Anticoagulant A Nationwide Cohort Study

    DEFF Research Database (Denmark)

    Lamberts, M.; Gislason, G. H.; Lip, G. Y. H.

    2014-01-01

    Background The optimal long-term antithrombotic treatment of patients with coexisting atrial fibrillation and stable coronary artery disease is unresolved, and commonly, a single antiplatelet agent is added to oral anticoagulation. We investigated the effectiveness and safety of adding antiplatelet...

  12. The composition and daily variation of microparticles in whole blood in stable coronary artery disease.

    Science.gov (United States)

    Christersson, Christina; Lindahl, Bertil; Siegbahn, Agneta

    2016-01-01

    The knowledge of circadian variation of microparticles (MPs) in stable coronary artery disease (SCAD) is limited. The aim of this study was to evaluate the daily variation of platelet-, endothelial- and monocyte-derived MPs in whole blood and their tissue factor expression (TF) in SCAD and whether these MPs were related to other endothelial and coagulation markers. Serial blood samples from patients with SCAD were collected during one day. Flow cytometry was used to evaluate the amount of large MPs 0.5-1.0 μm, positive for annexin, and their expression of CD41, CD62P, CD144, CD14 and TF. The lag time and endogenous thrombin potential (ETP) was calculated by Calibrated Automated Thrombogram and soluble (s)P-selectin, sTF and vWF by ELISA. The majority of MPs in whole blood consisted of CD41 + MPs with no significant daily variation. In contrast, the concentration of CD62P + MPs described a daily variation with the lowest concentrations found in the evening (p = 0.031). CD62P + and CD144 + MPs had the highest expression of TF, 52.6% and 42.9%, respectively, and correlated to the endothelial activity evaluated by vWF. There was a circadian rhythm of lag time (p monocyte-derived MPs do not present the same circadian variation and they differ in TF expression in SCAD. The MPs from activated platelets, endothelial cells and monocytes exist in low concentrations in whole blood but are related to the endothelial and coagulation activity found in SCAD.

  13. Development of new technology for the use of stable isotopic tracers in the study of human health and disease

    International Nuclear Information System (INIS)

    Hacyey, D.L.; Klein, P.D.; Szczepanik, P.A.; Niu, W.; Stellaard, F.; Tserng, K.Y.

    1977-01-01

    This program has five major aspects: first, the development of analytical instrumentation of requisite sensitivity, stability, and simplicity to conduct stable isotope measurements in a routine manner; second, the development of appropriately labeled compounds for metabolic investigations, initially through custom syntheses but eventually through commercial sources; third, development of analytical methodology to isolate, purify, and determine the isotopic content of specific organic compounds reflecting metabolic processes or disease states; fourth, collaborative development of clinical applications and testing on a routine basis, through a network of clinical centers around the country; and finally, the collection and dissemination of stable isotope information on an international scale through survey publications and conferences

  14. Characteristics of stable chronic obstructive pulmonary disease patients in the pulmonology clinics of seven Asian cities

    Directory of Open Access Journals (Sweden)

    Oh YM

    2013-01-01

    Full Text Available Yeon-Mok Oh,1 Arvind B Bhome,2 Watchara Boonsawat,3 Kirthi Dias Gunasekera,4 Dushantha Madegedara,5 Luisito Idolor,6 Camilo Roa,6 Woo Jin Kim,7 Han-Pin Kuo,8 Chun-Hua Wang,8 Le Thi Tuyet Lan,9 Li-Cher Loh,10 Choo-Khoon Ong,10 Alan Ng,11 Masaharu Nishimura,12 Hironi Makita,12 Edwin K Silverman,13 Jae Seung Lee,1 Ting Yang,14 Yingxiang Lin,14 Chen Wang,14 Sang-Do Lee1  1Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; 2Department of Pulmonary and Critical Care, "Friends of the Breathless" Foundation, Pune, India; 3Department of Medicine, Khon Kaen University, Khon Kaen, Thailand; 4Central Chest Clinic, Colombo and National Hospital of Sri Lanka; 5Respiratory Disease Treatment Unit and Teaching Hospital Kandy, Sri Lanka; 6Section of Respiratory Services and Physical Therapy and Rehabilitation Lung Center of the Philippines, Quezon City, Philippines; 7Department of Internal Medicine, Kangwon National University, Kang Won, Korea; 8Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan; 9Respiratory Care Center, University Medical Center Ho Chi Minh City, Vietnam; 10Department of Medicine, Penang Medical College, Penang, Malaysia; 11Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore; 12Division of Respiratory Medicine, Department of Internal Medicine, Hokkaido University Hospital, Sapporo, Japan; 13Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; 14Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaAll authors made an equal contribution to this studyBackground and objectives: Chronic obstructive pulmonary disease (COPD is responsible for significant morbidity and mortality worldwide. We evaluated the characteristics of stable COPD patients in

  15. Diagnosis and Pharmacotherapy of Stable Chronic Obstructive Pulmonary Disease: The Finnish Guidelines

    Science.gov (United States)

    Kankaanranta, Hannu; Harju, Terttu; Kilpeläinen, Maritta; Mazur, Witold; Lehto, Juho T; Katajisto, Milla; Peisa, Timo; Meinander, Tuula; Lehtimäki, Lauri

    2015-01-01

    The Finnish Medical Society Duodecim initiated and managed the update of the Finnish national guideline for chronic obstructive pulmonary disease (COPD). The Finnish COPD guideline was revised to acknowledge the progress in diagnosis and management of COPD. This Finnish COPD guideline in English language is a part of the original guideline and focuses on the diagnosis, assessment and pharmacotherapy of stable COPD. It is intended to be used mainly in primary health care but not forgetting respiratory specialists and other healthcare workers. The new recommendations and statements are based on the best evidence available from the medical literature, other published national guidelines and the GOLD (Global Initiative for Chronic Obstructive Lung Disease) report. This guideline introduces the diagnostic approach, differential diagnostics towards asthma, assessment and treatment strategy to control symptoms and to prevent exacerbations. The pharmacotherapy is based on the symptoms and a clinical phenotype of the individual patient. The guideline defines three clinically relevant phenotypes including the low and high exacerbation risk phenotypes and the neglected asthma–COPD overlap syndrome (ACOS). These clinical phenotypes can help clinicians to identify patients that respond to specific pharmacological interventions. For the low exacerbation risk phenotype, pharmacotherapy with short-acting β2-agonists (salbutamol, terbutaline) or anticholinergics (ipratropium) or their combination (fenoterol–ipratropium) is recommended in patients with less symptoms. If short-acting bronchodilators are not enough to control symptoms, a long-acting β2-agonist (formoterol, indacaterol, olodaterol or salmeterol) or a long-acting anticholinergic (muscarinic receptor antagonists; aclidinium, glycopyrronium, tiotropium, umeclidinium) or their combination is recommended. For the high exacerbation risk phenotype, pharmacotherapy with a long-acting anticholinergic or a fixed

  16. Management of outpatients in France with stable coronary artery disease. Findings from the prospeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease (CLARIFY) registry.

    Science.gov (United States)

    Danchin, Nicolas; Ferrieres, Jean; Guenoun, Maxime; Cattan, Simon; Rushton-Smith, Sophie K; Greenlaw, Nicola; Ferrari, Roberto; Steg, Philippe Gabriel

    2014-01-01

    Improvements in the treatment of coronary artery disease mean that an increasing number of patients survive acute cardiovascular events and live as outpatients with or without anginal symptoms. To determine the characteristics and management of contemporary outpatients with stable coronary artery disease in Western Europe, and to compare France with the other Western European countries. CLARIFY (prospeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease) is an international, prospective, observational, longitudinal study. Between November 2009 and July 2010, 32,954 adult outpatients with stable coronary artery disease (defined as a history of documented myocardial infarction [of >3 months], prior coronary revascularization, chest pain with myocardial ischaemia, or coronary stenosis of>50% proven by angiography) were enrolled in 45 countries. The demographics and management of CLARIFY patients enrolled in France were compared with those enrolled in other Western European countries (Austria, Belgium, Denmark, Germany, Greece, Ireland, Italy, Netherlands, Portugal, Spain, Switzerland and the UK). Of the 14,726 patients enrolled in Western Europe (mean age 66.2 [10.2] years; 79.6% male), 2432 (16.5%) were from France. The use of aspirin was lower in France than in other Western European countries (74.5% vs. 86.9%, respectively), whereas use of thienopyridines (48.5% vs. 21.7%), oral anticoagulants (12.3% vs. 9.0%) and lipid-lowering drugs (95.8% vs. 92.5%) was higher. Beta-blockers were used in 73% of both groups. Angina was less prevalent in France (6.3% vs. 15.5%) and French patients showed higher levels of physical activity than their counterparts in Western Europe. The management of patients with stable CAD in France appears favourable, with good adherence to guideline-based therapies, but there remains room for improvement in terms of symptom and risk factor control. Copyright © 2014. Published by Elsevier Masson SAS.

  17. Detection of adenovirus and respiratory syncytial virus in patients with chronic obstructive pulmonary disease: Exacerbation versus stable condition.

    Science.gov (United States)

    Kokturk, Nurdan; Bozdayi, Gulendam; Yilmaz, Senay; Doğan, Bora; Gulbahar, Ozlem; Rota, Seyyal; Tatlicioglu, Turkan

    2015-08-01

    Latent infection with adenovirus and respiratory syncytial virus (RSV) is associated with chronic obstructive pulmonary disease (COPD). The role of respiratory viral infections are emerging in COPD exacerbations. The present study aimed to investigate the prevalence of adenovirus and RSV serotypes A and B in individuals with acute exacerbations of COPD (COPD-AE) and stable COPD. Twenty seven patients with COPD-AE were evaluated using a prospective longitudinal study design. Induced sputum, sera and nasal smears were sampled from patients experiencing COPD-AE and those in a stable condition. Adenoplex® multiplex polymerase chain reaction (PCR) kits and Invitek RTP® DNA/RNA Virus Mini kits were used for PCR assays of adenovirus and RSV, respectively. Eighteen patients who experienced a COPD-AE were also evaluated while in a stable condition. The results showed that three sputum samples were positive for adenovirus in patients experiencing an exacerbation, while one was positive among the patients in a stable condition. RSV serotype A was detected in 17/27 (63%) patients with COPD-AE and 10/18 (55.6%) patients in a stable condition. RSV serotype B was not detected. Patients with COPD-AE, who were positive for RSV serotype A exhibited higher serum fibrinogen levels than those who were negative (438.60 ± 126.08 mg/dl compared with 287.60 ± 85.91 mg/dl; P=0.004). Eight/ten patients who were positive for RSV serotype A while in a stable condition, were also positive during COPD-AE. The results of the present study suggested that RSV infection may be prevalent in patients with COPD-AE and in those in a stable condition. Therefore, chronic RSV infection may occur in COPD. The detection and prevention of RSV may be useful in the management of COPD.

  18. PROTHROMBOTIC POLYMORPHISMS AND LONG-TERM PROGNOSIS OF PATIENTS WITH STABLE ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    A. L. Komarov

    2011-01-01

    Full Text Available Aim. To estimate influence of thrombosis associated genetic factors on cardiovascular complications (CVC occurrence in patients with stable ischemic heart disease (IHD on the base of 5-year prospective survey. Material and methods. A total of 503 patients with the mean age of 59.4 years were enrolled into the study. The follow-up period was 5.4 years. Composite endpoint included the following cases of fatal and nonfatal CVC: death, acute coronary syndrome, ischemic stroke/transient ischemic attack, peripheral arterial thrombosis and revascularization of affected vascular system. We determined prevalence and prognostic value of mutations and polymorphisms in genes that encode blood clotting factors (factor V Leiden G1691A, prothrombin G20210A, ß-fibrinogen 455G> A, platelet GPIIIa receptor (C1565T and enzymes involved in homocysteine metabolism (methylentetrahydrofolate reductase  (C667 T MTHFR and A1298C, methionine synthase (MTR A2756G, methionine synthase-reductase (MTRR A66G and transcobalamin (TCN C776G. Results. Overall incidence rate of vascular events made up 31.0%. MTHFR and TCN polymorphisms proved to be significant in regard to cardiovascular risk among all studied genetic indices. Carriage of at least C667 T one MTHFR polymorphic allele increased risk of CVC 1.64 times (95% confidence interval (CI 1.2-2.3, p=0.003. Homozygous carriage of MTHFR 1298 AА and TCN 776 СС “wild” genotypes increased risk of CVC 1.63 times (95% CI 1.2-2.3, р=0.006 and 1.37 times (95% CI 1.001-1.89, р=0.04, respectively. Such genetic variants as MTHFR C667 T/СТ and 1298 AА impacted prognosis only given concomitant decrease in plasma folate level, which was observed in 56.1% of the patients. Conclusion. It can be recommended to test the presence of MTHFR C667 T, MTHFR 1298 AА and TCN 776 СС, and to simultaneously assess folate level in IHD patients in order to clarify risk of unfavorable cardiovascular events.

  19. High tumour cannabinoid CB1 receptor immunoreactivity negatively impacts disease-specific survival in stage II microsatellite stable colorectal cancer.

    Directory of Open Access Journals (Sweden)

    Sofia B Gustafsson

    Full Text Available BACKGROUND: There is good evidence in the literature that the cannabinoid system is disturbed in colorectal cancer. In the present study, we have investigated whether CB(1 receptor immunoreactive intensity (CB(1IR intensity is associated with disease severity and outcome. METHODOLOGY/PRINCIPAL FINDINGS: CB(1IR was assessed in formalin-fixed, paraffin-embedded specimens collected with a consecutive intent during primary tumour surgical resection from a series of cases diagnosed with colorectal cancer. Tumour centre (n = 483 and invasive front (n = 486 CB(1IR was scored from 0 (absent to 3 (intense staining and the data was analysed as a median split i.e. CB(1IR <2 and ≥2. In microsatellite stable, but not microsatellite instable tumours (as adjudged on the basis of immunohistochemical determination of four mismatch repair proteins, there was a significant positive association of the tumour grade with the CB(1IR intensity. The difference between the microsatellite stable and instable tumours for this association of CB(1IR was related to the CpG island methylation status of the cases. Cox proportional hazards regression analyses indicated a significant contribution of CB(1IR to disease-specific survival in the microsatellite stable tumours when adjusting for tumour stage. For the cases with stage II microsatellite stable tumours, there was a significant effect of both tumour centre and front CB(1IR upon disease specific survival. The 5 year probabilities of event-free survival were: 85±5 and 66±8%; tumour interior, 86±4% and 63±8% for the CB(1IR<2 and CB(1IR≥2 groups, respectively. CONCLUSIONS/SIGNIFICANCE: The level of CB(1 receptor expression in colorectal cancer is associated with the tumour grade in a manner dependent upon the degree of CpG hypermethylation. A high CB(1IR is indicative of a poorer prognosis in stage II microsatellite stable tumour patients.

  20. Statin treatment prevents increased cardiovascular and all-cause mortality associated with clarithromycin in patients with stable coronary heart disease

    DEFF Research Database (Denmark)

    Jensen, Gorm B; Hilden, Jørgen; Als-Nielsen, Bodil

    2010-01-01

    In the CLARICOR trial, significantly increased cardiovascular (CV) and all-cause mortality in stable patients with coronary heart disease were observed after a short course of clarithromycin. We report on the impact of statin treatment at entry on the CV and all-cause mortality. The multicenter...... CLARICOR trial randomized patients to oral clarithromycin (500 mg daily; n = 2172) versus matching placebo (daily; n = 2201) for 2 weeks. Patients were followed through public databases. In the 41% patients on statin treatment at entry, no significant effect of clarithromycin was observed on CV (hazard.......0003; statin-clarithromycin interaction P = 0.0029) and all-cause mortality (HR, 1.33; 95% CI, 1.05-1.67; P = 0.016; statin-clarithromycin interaction P = 0.41). Multivariate analysis and 6-year follow up confirmed these results. Concomitant statin treatment in stable patients with coronary heart disease...

  1. [ANMCO/GICR-IACPR/SICI-GISE Consensus document: Clinical management of patients with stable coronary artery disease].

    Science.gov (United States)

    Riccio, Carmine; Gulizia, Michele Massimo; Colivicchi, Furio; Di Lenarda, Andrea; Musumeci, Giuseppe; Faggiano, Pompilio Massimo; Abrignani, Maurizio Giuseppe; Rossini, Roberta; Fattirolli, Francesco; Valente, Serafina; Mureddu, Gian Francesco; Temporelli, Pier Luigi; Olivari, Zoran; Amico, Antonio Francesco; Casolo, Giancarlo; Fresco, Claudio; Menozzi, Alberto; Nardi, Federico

    2016-01-01

    Stable coronary artery disease is of epidemiological importance. It is becoming increasingly common due to the longer life expectancy, being strictly related to age and to advances in diagnostic techniques and pharmacological and non-pharmacological interventions.Stable coronary artery disease encompasses a variety of clinical and anatomic presentations, making the identification of its clinical and anatomical features challenging. Therapeutic interventions should be defined on an individual basis according to the patient's risk profile. To this aim, management flow-charts have been reviewed based on sustainability and appropriateness derived from recent evidence. Special emphasis has been placed on non-pharmacological interventions, stressing the importance of lifestyle changes, including smoking cessation, regular physical activity and diet. Adherence to therapy as an emerging risk factor is also discussed.

  2. Leptin hormone in obese and non-obese stable and exacerbated cases of chronic obstructive pulmonary disease

    OpenAIRE

    Mahmoud, Ahmad Elsayed; Omar, Magdy Mohammed; Abdelghaffar Hibah, Nabil A.; Issa, Hisham Ali

    2015-01-01

    Objective: The aim of this study was to assess the level of serum leptin hormone in chronic obstructive pulmonary disease patients during acute exacerbation and in stable conditions and also, to determine if these changes correlate with changes in the ventilatory functions. Methods: Sixty cases were included in this prospective study (40 COPD patients and 20 age related smokers without symptoms or signs of COPD and within normal pulmonary functions as a control). Patients and control were ...

  3. Heart rate modulation in stable coronary artery disease without clinical heart failure: What we have already learned from SIGNIFY?

    Directory of Open Access Journals (Sweden)

    Gian Piero Perna

    2016-12-01

    In conclusion, heart rate is a marker of risk but is not a risk factor and/or a target of therapy in patients with stable coronary artery disease and preserved ventricular systolic function. Standard doses of ivabradine are indicated for treatment of angina as an alternative or in addition to beta-blockers, but should not be administered in association with CYP3A4 inhibitors or heart rate-lowering calcium-channel blockers.

  4. Comparison of Autoimmune Thyroid Disease in Patients With Progressive and Stable Vitiligo.

    Science.gov (United States)

    Yazdanpanah, Mohammad Javad; Seyedi Noghabi, Seyed Ali; Taghavi, Morteza; Afzal Aghaee, Monavar; Zabolinejad, Naghmeh

    2016-01-01

    Activity of vitiligo has not been considered as a patient selection criteria in previous studies; we decided to compare the presence of elevated thyroid auto-antibodies in patients with progressive and stable vitiligo. Seventy-two patients with vitiligo were examined for thyroid problems and were divided into 2 groups of stable and progressive vitiligo according to their history and physical examination. Anti-thyroid peroxidase antibodies (anti-TPO antibodies), thyroxine (T4), and thyroid stimulating hormone (TSH) levels were assessed for all patients. Elevated levels of anti-TPO antibodies were observed in 43.7% of the patients with stable vitiligo and in 37.5% of patients with progressive vitiligo, which was not statistically significant (P = .315). This study not only confirmed thyroid dysfunction in patients with vitiligo but also showed that there was no difference in thyroid dysfunction and anti-TPO antibody levels in the subgroups of patients with stable or progressive vitiligo. © The Author(s) 2015.

  5. Insufficient control of heart rate in stable coronary artery disease patients in Latvia

    Directory of Open Access Journals (Sweden)

    Inga Balode

    2014-01-01

    Conclusions: Despite the wide use of beta-blockers, HR is insufficiently controlled in the analyzed sample of stable CAD patients in Latvia. Target HR ≤60 bpm is achieved only in 25% of the patients while more than one third have increased HR ≥70 bpm.

  6. Quantitative Gingival Crevicular Fluid Proteome in Health and Periodontal Disease Using Stable-Isotope Chemistries and Mass Spectrometry

    Science.gov (United States)

    Carneiro, Leandro G.; Nouh, Hesham; Salih, Erdjan

    2014-01-01

    Aim Application of quantitative stable-isotope-labeling chemistries and mass spectrometry (MS) to determine alterations in gingival crevicular fluid (GCF) proteome in periodontal disease. Materials and Methods Quantitative proteome of GCF from 40 healthy individuals versus 40 patients with periodontal disease was established using 320 GCF samples and stable-isotope-labeling reagents, ICAT and mTRAQ, with MS technology and validated by enzyme-linked immunosorbent methods. Results We have identified 238 distinct proteins of which 180 were quantified in GCF of both healthy and periodontal patients with additional 26 and 32 distinct proteins that were found only in GCF of healthy or periodontal patients. In addition, 42 pathogenic bacterial proteins and 11 yeast proteins were quantified. The data highlighted a series of proteins not quantified previously by large-scale MS approaches in GCF with relevance to periodontal disease, such as host derived Ig alpha-2 chain C, Kallikrein-4, S100-A9, transmembrane proteinase 13, peptidase S1 domain, several collagen types and pathogenic bacterial proteins e.g., formamidase, leucine amidopeptidase and virulence factor OMP85. Conclusions The innovative analytical approaches provided detailed novel changes in both host and microbial derived GCF proteomes of periodontal patients. The study defined 50 host and 16 pathogenic bacterial proteins significantly elevated in periodontal disease most of which were novel with significant potential for application in the clinical arena of periodontal disease. PMID:24738839

  7. Ad hoc vs. Non-ad hoc Percutaneous Coronary Intervention Strategies in Patients With Stable Coronary Artery Disease.

    Science.gov (United States)

    Toyota, Toshiaki; Morimoto, Takeshi; Shiomi, Hiroki; Ando, Kenji; Ono, Koh; Shizuta, Satoshi; Kato, Takao; Saito, Naritatsu; Furukawa, Yutaka; Nakagawa, Yoshihisa; Horie, Minoru; Kimura, Takeshi

    2017-03-24

    Few studies have evaluated the prevalence and clinical outcomes of ad hoc percutaneous coronary intervention (PCI), performing diagnostic coronary angiography and PCI in the same session, in stable coronary artery disease (CAD) patients.Methods and Results:From the CREDO-Kyoto PCI/CABG registry cohort-2, 6,943 patients were analyzed as having stable CAD and undergoing first PCI. Ad hoc PCI and non-ad hoc PCI were performed in 1,722 (24.8%) and 5,221 (75.1%) patients, respectively. The cumulative 5-year incidence and adjusted risk for all-cause death were not significantly different between the 2 groups (15% vs. 15%, P=0.53; hazard ratio: 1.15, 95% confidence interval: 0.98-1.35, P=0.08). Ad hoc PCI relative to non-ad hoc PCI was associated with neutral risk for myocardial infarction, any coronary revascularization, and bleeding, but was associated with a trend towards lower risk for stroke (hazard ratio: 0.78, 95% confidence interval: 0.60-1.02, P=0.06). Ad hoc PCI in stable CAD patients was associated with at least comparable 5-year clinical outcomes as with non-ad hoc PCI. Considering patients' preference and the cost-saving, the ad hoc PCI strategy might be a safe and attractive option for patients with stable CAD, although the prevalence of ad hoc PCI was low in the current study population.

  8. Fractional flow reserve derived from coronary CT angiography in stable coronary disease: a new standard in non-invasive testing?

    Energy Technology Data Exchange (ETDEWEB)

    Noergaard, B.L.; Jensen, J.M. [Aarhus University Hospital Skejby, Department of Cardiology B, Aarhus N (Denmark); Leipsic, J. [St. Paul' s Hospital, Department Radiology, Vancouver, British Columbia (Canada)

    2015-08-15

    Fractional flow reserve (FFR) measured during invasive coronary angiography is the gold standard for lesion-specific decisions on coronary revascularization in patients with stable coronary artery disease (CAD). Current guidelines recommend non-invasive functional or anatomic testing as a gatekeeper to the catheterization laboratory. However, the ''holy grail'' in non-invasive testing of CAD is to establish a single test that quantifies both coronary lesion severity and the associated ischemia. Most evidence to date of such a test is based on the addition of computational analysis of FFR to the anatomic information obtained from standard-acquired coronary CTA data sets at rest (FFR{sub CT}). This review summarizes the clinical evidence for the use of FFR{sub CT} in stable CAD in context to the diagnostic performance of other non-invasive testing modalities. (orig.)

  9. Fractional flow reserve derived from coronary CT angiography in stable coronary disease: a new standard in non-invasive testing?

    International Nuclear Information System (INIS)

    Noergaard, B.L.; Jensen, J.M.; Leipsic, J.

    2015-01-01

    Fractional flow reserve (FFR) measured during invasive coronary angiography is the gold standard for lesion-specific decisions on coronary revascularization in patients with stable coronary artery disease (CAD). Current guidelines recommend non-invasive functional or anatomic testing as a gatekeeper to the catheterization laboratory. However, the ''holy grail'' in non-invasive testing of CAD is to establish a single test that quantifies both coronary lesion severity and the associated ischemia. Most evidence to date of such a test is based on the addition of computational analysis of FFR to the anatomic information obtained from standard-acquired coronary CTA data sets at rest (FFR CT ). This review summarizes the clinical evidence for the use of FFR CT in stable CAD in context to the diagnostic performance of other non-invasive testing modalities. (orig.)

  10. Can mean platelet component be used as an index of platelet activity in stable coronary artery disease?

    LENUS (Irish Health Repository)

    Cooke, John

    2012-01-31

    Acute coronary syndrome is associated with intracoronary thrombosis secondary to platelet activation. Previous groups have investigated platelet activation in both stable and unstable vascular disease. Most measures of platelet activation are not routinely available or easily adaptable to large scale clinical use. Recently, measurement of the mean platelet component (MPC) has become part of the routine data provided by an automated full blood count analyser, the Advia 120. MPC measures platelet density which changes on platelet activation. Our objectives were to determine if platelet activation, as measured by MPC, is increased in patients with stable coronary artery disease (CAD) and to determine if MPC could be useful in differentiating people with stable CAD from controls on an everyday clinical basis. Three hundred and forty-five consecutive patients attending for elective coronary angiography had full blood count analysis and MPC measurement performed using an ADVIA-120 analyser. Three hundred and twenty-four were analysed in our final dataset. Two hundred and fifty-three (78%) had CAD. Patients with CAD were significantly (p<0.001) older than those without (63.8 versus 56.0 years). Results failed to demonstrate a difference (p=0.467) in MPC between patients with CAD and those with normal coronary arteries (25.8 versus 26.0). Likewise, there was no correlation between MPC and the severity of CAD (Kendall\\'s tau b=-0.086, p=0.04). MPC is not a useful index of platelet activity in stable CAD when used in everyday clinical practice.

  11. Can mean platelet component be used as an index of platelet activity in stable coronary artery disease?

    LENUS (Irish Health Repository)

    Cooke, John

    2009-04-01

    Acute coronary syndrome is associated with intracoronary thrombosis secondary to platelet activation. Previous groups have investigated platelet activation in both stable and unstable vascular disease. Most measures of platelet activation are not routinely available or easily adaptable to large scale clinical use. Recently, measurement of the mean platelet component (MPC) has become part of the routine data provided by an automated full blood count analyser, the Advia 120. MPC measures platelet density which changes on platelet activation. Our objectives were to determine if platelet activation, as measured by MPC, is increased in patients with stable coronary artery disease (CAD) and to determine if MPC could be useful in differentiating people with stable CAD from controls on an everyday clinical basis. Three hundred and forty-five consecutive patients attending for elective coronary angiography had full blood count analysis and MPC measurement performed using an ADVIA-120 analyser. Three hundred and twenty-four were analysed in our final dataset. Two hundred and fifty-three (78%) had CAD. Patients with CAD were significantly (p<0.001) older than those without (63.8 versus 56.0 years). Results failed to demonstrate a difference (p=0.467) in MPC between patients with CAD and those with normal coronary arteries (25.8 versus 26.0). Likewise, there was no correlation between MPC and the severity of CAD (Kendall\\'s tau b=-0.086, p=0.04). MPC is not a useful index of platelet activity in stable CAD when used in everyday clinical practice.

  12. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease

    DEFF Research Database (Denmark)

    Kragelund, Charlotte; Grønning, Bjørn; Køber, Lars

    2005-01-01

    BACKGROUND: The level of the inactive N-terminal fragment of pro-brain (B-type) natriuretic peptide (BNP) is a strong predictor of mortality among patients with acute coronary syndromes and may be a strong prognostic marker in patients with chronic coronary heart disease as well. We assessed...... quartile was 2.4 (95 percent confidence interval, 1.5 to 4.0; Prisk factors, including the patient's age; sex; family history with respect to ischemic heart disease; the presence or absence of a history......-term mortality in patients with stable coronary disease and provides prognostic information above and beyond that provided by conventional cardiovascular risk factors and the degree of left ventricular systolic dysfunction....

  13. Outcome with invasive versus medical treatment of stable coronary artery disease

    DEFF Research Database (Denmark)

    Simonsen, Jane A; Johansen, Allan; Gerke, Oke

    2016-01-01

    AIMS: Our aim was to address the combined influence of myocardial perfusion defects and left ventricular ejection fraction (LVEF) on outcome with coronary revascularisation in stable CAD patients. METHODS AND RESULTS: Of 527 patients with ischaemia by myocardial perfusion scintigraphy, 343 had...... the effect of large compared to small/moderate defects vanished when adjusted for LVEF and ischaemia (HR=1.01, p=0.99). Considering the outcome difference as a function of both LVEF and ischaemia, we found no advantage or even a disadvantage of revascularisation in patients with mild/moderate ischaemia...

  14. Filtration Markers, Cardiovascular Disease, Mortality, and Kidney Outcomes in Stable Kidney Transplant Recipients: The FAVORIT Trial.

    Science.gov (United States)

    Foster, M C; Weiner, D E; Bostom, A G; Carpenter, M A; Inker, L A; Jarolim, P; Joseph, A A; Kusek, J W; Pesavento, T; Pfeffer, M A; Rao, M; Solomon, S D; Levey, A S

    2017-09-01

    Cystatin C and beta-2-microglobulin (B2M) are filtration markers associated with adverse outcomes in nontransplant populations, sometimes with stronger associations than for creatinine. We evaluated associations of estimated glomerular filtration rate from cystatin C (eGFR cys ), B2M (eGFR B 2M ), and creatinine (eGFR cr ) with cardiovascular outcomes, mortality, and kidney failure in stable kidney transplant recipients using a case-cohort study nested within the Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) Trial. A random subcohort was selected (N = 508; mean age 51.6 years, median transplant vintage 4 years, 38% women, 23.6% nonwhite race) with enrichment for cardiovascular events (N = 306; 54 within the subcohort), mortality (N = 208; 68 within the subcohort), and kidney failure (N = 208; 52 within the subcohort). Mean eGFR cr , eGFR cys , and eGFR B 2M were 46.0, 43.8, and 48.8 mL/min/1.73m 2 , respectively. After multivariable adjustment, hazard ratios for eGFR cys and eGFR B 2M mortality; and 9.49 (4.28-21.00) and 15.53 (6.99-34.51; both p mortality, and kidney failure in stable kidney transplant recipients. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  15. Randomised placebo controlled multicentre trial to assess short term clarithromycin for patients with stable coronary heart disease: CLARICOR trial

    DEFF Research Database (Denmark)

    Jespersen, Christian M; Als-Nielsen, Bodil; Damgaard, Morten

    2005-01-01

    OBJECTIVE: To determine if the macrolide clarithromycin affects mortality and cardiovascular morbidity in patients with stable coronary heart disease. DESIGN: Centrally randomised multicentre trial. All parties at all stages were blinded. Analyses were by intention to treat. SETTING: Five...... Copenhagen University cardiology departments and a coordinating centre. PARTICIPANTS: 13,702 patients aged 18 to 85 years who had a discharge diagnosis of myocardial infarction or angina pectoris in 1993-9 and alive in August 1999 were invited by letter; 4373 were randomised. INTERVENTIONS: Two weeks...

  16. Randomised placebo controlled multicentre trial to assess short term clarithromycin for patients with stable coronary heart disease: CLARICOR trial

    DEFF Research Database (Denmark)

    Jespersen, CM; Als-Nielsen, B; Damgaard, M

    2006-01-01

    OBJECTIVE: To determine if the macrolide clarithromycin affects mortality and cardiovascular morbidity in patients with stable coronary heart disease. DESIGN: Centrally randomised multicentre trial. All parties at all stages were blinded. Analyses were by intention to treat. SETTING: Five...... Copenhagen University cardiology departments and a coordinating centre. PARTICIPANTS: 13,702 patients aged 18 to 85 years who had a discharge diagnosis of myocardial infarction or angina pectoris in 1993-9 and alive in August 1999 were invited by letter; 4373 were randomised. INTERVENTIONS: Two weeks...

  17. A genetic risk score predicts cardiovascular events in patients with stable coronary artery disease

    DEFF Research Database (Denmark)

    Christiansen, Morten Krogh; Nyegaard, Mette; Larsen, Sanne Bøjet

    2017-01-01

    BACKGROUND: Genetic risk scores (GRSs) may predict cardiovascular risk in community-based populations. However, studies investigating the association with recurrent cardiovascular events in patients with established coronary artery disease (CAD) are conflicting. METHODS: We genotyped 879 patients...

  18. C-Reactive Protein Concentrations Among Crop and Dairy Farmers with Stable Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Sasho Stoleski

    2017-09-01

    CONCLUSION: Data obtained suggest that systemic inflammation is present in farmers with COPD and CRP is an important biomarker in COPD in means of reflecting disease severity and prognosis of exposed farmers.

  19. Stable Size Distribution of Amyloid Plaques Over the Course of Alzheimer Disease

    Science.gov (United States)

    Serrano-Pozo, Alberto; Mielke, Matthew L.; Muzitansky, Alona; Gómez-Isla, Teresa; Growdon, John H.; Bacskai, Brian J.; Betensky, Rebecca A.; Frosch, Matthew P.; Hyman, Bradley T.

    2012-01-01

    Amyloid-β plaques are a key pathological feature of Alzheimer disease (AD), but whether plaque sizes increase or stabilize over the course of AD is unknown. We measured the size distribution of total immunoreactive (10D5-positive) and dense-core (Thioflavine-S-positive) plaques in the temporal neocortex of a large group of AD and plaque-bearing age-matched non-demented subjects to test the hypothesis that amyloid plaques continue to grow along with the progression of the disease. The size of amyloid-β (10D5)-positive plaques did not differ between groups whereas dense-core plaques from the AD group were slightly larger than those in the non-demented group (~25%–30%, p = 0.01). Within the AD group, dense-core plaque size did not independently correlate with duration of clinical disease (from 4 to 21 years, p = 0.68), whereas 10D5-positive plaque size correlated negatively with disease duration (p = 0.01). By contrast, an earlier age of symptom onset strongly predicted a larger postmortem plaque size; this effect was independent of disease duration and the presence of the APOEε4 allele (p = 0.0001). We conclude that plaques vary in size among patients, with larger size distributions correlating with an earlier age of onset, but plaques do not substantially increase in size over the clinical course of the disease. PMID:22805771

  20. Diagnostic and prognostic value of a careful symptom evaluation and high sensitive troponin in patients with suspected stable angina pectoris without prior cardiovascular disease

    DEFF Research Database (Denmark)

    Madsen, Debbie Maria; Diederichsen, Axel C P; Hosbond, Susanne E

    2017-01-01

    -TnI in stable chest pain patients without prior cardiovascular disease. METHODS: During a one-year period, 487 patients with suspected stable AP underwent invasive or CT-coronary angiography (significant stenosis ≥50%). At study inclusion, a careful symptom evaluation was obtained, and patients were classified...

  1. Stable markers of oxidant damage to proteins and their application in the study of human disease

    DEFF Research Database (Denmark)

    Davies, Michael Jonathan; Fu, S; Wang, H

    1999-01-01

    The mechanisms of formation and the nature of the altered amino acid side chains formed on proteins subjected to oxidant attack are reviewed. The use of stable products of protein side chain oxidation as potential markers for assessing oxidative damage in vivo in humans is discussed. The methods...... developed in the authors laboratories are outlined, and the advantages and disadvantages of these techniques compared with other methodologies for assessing oxidative damage to proteins and other macromolecules. Evidence is presented to show that protein oxidation products are sensitive markers of oxidative...... damage, that the pattern of products detected may yield information as to the nature of the original oxidative insult, and that the levels of oxidized side-chains can, in certain circumstances, be much higher than those of other markers of oxidation such as lipid hydroperoxides....

  2. The Eating Assessment Tool-10 Predicts Aspiration in Adults with Stable Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Regan, Julie; Lawson, Susan; De Aguiar, Vânia

    2017-10-01

    Adults with COPD frequently present with dysphagia, which often leads to clinical complications and hospital admissions. This study investigates the ability of the Eating Assessment Tool (EAT-10) to predict aspiration during objective dysphagia evaluation in adults with stable COPD. Thirty adults (20 male, 10 female; mean age = 69.07 ± 16.82) with stable COPD attended an outpatient dysphagia clinic for a fiberoptic endoscopic evaluation of swallowing (FEES) in an acute teaching hospital (January 2015-November 2016). During evaluations, individuals completed an EAT-10 rating scale followed immediately by a standardised FEES exam. Aspiration status during FEES was rated using the penetration-aspiration scale by clinicians blinded to EAT-10 scores. Data were retrospectively analysed. Significant differences in mean EAT-10 scores were found between aspirators (16.3; SEM = 2.165) and non-aspirators (7.3; SEM = 1.009) (p = 0.000). The EAT-10 predicted aspiration with a high level of accuracy (AUC = 0.88). An EAT-10 cut-off value of >9 presented a sensitivity of 91.67, specificity of 77.78 with positive and negative likelihood ratios of 4.12 and 0.11, respectively. Positive and negative predictive values were 73.30 and 93.30, respectively. Diagnostic odds ratio was 38.50 (p EAT-10 is a quick, easy to administer tool, which can accurately predict the presence of aspiration in adults with COPD. The scale can also very accurately exclude the absence of aspiration, helping clinicians to determine the need for onward referral for a comprehensive dysphagia evaluation. This may ultimately reduce clinical complications and hospital admissions resulting from dysphagia in this clinical population.

  3. Are sdAs helium core stars?

    Directory of Open Access Journals (Sweden)

    Pelisoli Ingrid

    2017-12-01

    Full Text Available Evolved stars with a helium core can be formed by non-conservative mass exchange interaction with a companion or by strong mass loss. Their masses are smaller than 0.5 M⊙. In the database of the Sloan Digital Sky Survey (SDSS, there are several thousand stars which were classified by the pipeline as dwarf O, B and A stars. Considering the lifetimes of these classes on the main sequence, and their distance modulus at the SDSS bright saturation, if these were common main sequence stars, there would be a considerable population of young stars very far from the galactic disk. Their spectra are dominated by Balmer lines which suggest effective temperatures around 8 000-10 000 K. Several thousand have significant proper motions, indicative of distances smaller than 1 kpc. Many show surface gravity in intermediate values between main sequence and white dwarf, 4.75 < log g < 6.5, hence they have been called sdA stars. Their physical nature and evolutionary history remains a puzzle. We propose they are not H-core main sequence stars, but helium core stars and the outcomes of binary evolution. We report the discovery of two new extremely-low mass white dwarfs among the sdAs to support this statement.

  4. Are sdAs helium core stars?

    Science.gov (United States)

    Pelisoli, Ingrid; Kepler, S. O.; Koester, Detlev

    2017-12-01

    Evolved stars with a helium core can be formed by non-conservative mass exchange interaction with a companion or by strong mass loss. Their masses are smaller than 0.5 M⊙. In the database of the Sloan Digital Sky Survey (SDSS), there are several thousand stars which were classified by the pipeline as dwarf O, B and A stars. Considering the lifetimes of these classes on the main sequence, and their distance modulus at the SDSS bright saturation, if these were common main sequence stars, there would be a considerable population of young stars very far from the galactic disk. Their spectra are dominated by Balmer lines which suggest effective temperatures around 8 000-10 000 K. Several thousand have significant proper motions, indicative of distances smaller than 1 kpc. Many show surface gravity in intermediate values between main sequence and white dwarf, 4.75 < log g < 6.5, hence they have been called sdA stars. Their physical nature and evolutionary history remains a puzzle. We propose they are not H-core main sequence stars, but helium core stars and the outcomes of binary evolution. We report the discovery of two new extremely-low mass white dwarfs among the sdAs to support this statement.

  5. Prognostic Value of Plasma Pentraxin-3 Levels in Patients with Stable Coronary Artery Disease after Drug-Eluting Stent Implantation

    Directory of Open Access Journals (Sweden)

    Liu Haibo

    2014-01-01

    Full Text Available Pentraxin-3 (PTX3 is an inflammatory marker thought to be more specific to cardiovascular inflammation than C-reactive protein (CRP. Our aim was to assess the prognostic value of PTX3 in patients with stable coronary artery disease (CAD after drug eluting stent (DES implantation. Plasma PTX3 levels were measured before percutaneous coronary intervention (PCI and at 24 h post-PCI in 596 consecutive patients with stable CAD. Patients were followed up for a median of 3 years (range 1–5 for major adverse cardiovascular events (MACEs. We found that the post-PCI plasma PTX3 levels were significantly higher at 24 h after PCI than pre-PCI, patients with MACEs had higher post-PCI PTX3 levels compared with MACEs-free patients, patients with higher post-PCI PTX3 levels (median > 4.384 ng/mL had a higher risk for MACEs than those with PTX3 < 4.384 ng/mL, and post-PCI PTX3, cTnI, multiple stents, and age but not high-sensitivity CRP (hsCRP were independently associated with the prevalence of MACEs after DES implantation. The present study shows that post-PCI PTX3 may be a more reliable inflammatory predictor of long-term MACEs in patients with stable CAD undergoing DES implantation than CRP. Measurement of post-PCI PTX3 levels could provide a rationale for risk stratification of patients with stable CAD after DES implantation.

  6. Current Role of Ivabradine in Stable Coronary Artery Disease Without Heart Failure.

    Science.gov (United States)

    Porres-Aguilar, Mateo; Muñoz, Oscar C; Abbas, Aamer

    2016-02-01

    Increase in heart rate represents a significant contribution in the pathophysiology of coronary artery disease and heart failure, by promoting atherosclerotic process and endothelial dysfunction. Thus, it negatively influences cardiovascular risk in the general population. The aim of this review is to analyze the current, controversial, and future role of ivabradine as an anti-anginal agent in the setting of coronary artery disease without heart failure. Ivabradine represents a selective heart rate-lowering agent that increased diastolic perfusion time and improving energetics in the ischemic myocardium.

  7. Relationships Between Components of Blood Pressure and Cardiovascular Events in Patients with Stable Coronary Artery Disease and Hypertension.

    Science.gov (United States)

    Vidal-Petiot, Emmanuelle; Greenlaw, Nicola; Ford, Ian; Ferrari, Roberto; Fox, Kim M; Tardif, Jean-Claude; Tendera, Michal; Parkhomenko, Alexander; Bhatt, Deepak L; Steg, P Gabriel

    2018-01-01

    Observational studies have shown a J-shaped relationship between diastolic blood pressure (BP) and cardiovascular events in hypertensive patients with coronary artery disease. We investigated whether the increased risk associated with low diastolic BP reflects elevated pulse pressure (PP). In 22 672 hypertensive patients with coronary artery disease from the CLARIFY registry (Prospective Observational Longitudinal Registry of Patients With Stable Coronary Artery Disease), followed for a median of 5.0 years, BP was measured annually and averaged. The relationships between PP and diastolic BP, alone or combined, and the primary composite outcome (cardiovascular death or myocardial infarction) were analyzed using multivariable Cox proportional hazards models. Adjusted hazard ratios for the primary outcome were 1.62 (95% confidence interval [CI], 1.40-1.87), 1.00 (ref), 1.07 (95% CI, 0.94-1.21), 1.54 (95% CI, 1.32-1.79), and 2.34 (95% CI, 1.95-2.81) for PPhypertensive patients with coronary artery disease persists in patients within the lowest-risk PP range and is therefore unlikely to be solely the consequence of an increased PP reflecting advanced vascular disease. URL: http://www.clarify-registry.com. Unique identifier: ISRCTN43070564. © 2017 American Heart Association, Inc.

  8. The diagnostic value of mean platelet volume in males with premature atherosclerotic coronary artery disease having stable angina pectoris

    Directory of Open Access Journals (Sweden)

    Özgül Malçok Gürel

    2014-09-01

    Full Text Available Objective: In this study, we aimed to investigate whether platelet count and mean platelet volume (MPV could be new biomarkers addition to classical risk factors in premature coronary artery disease (CAD. Methods: Totally 124 male patients (mean age: 45.8±13.0 year; range of age: 27-78 year, with stable angina pectoris, were included. Clinical and laboratory findings (whole blood cell count, glucose, creatinine, lipid profile were recorded. Automatic blood counter was used for hematological parameters. Conventional coronary angiography was performed. Patients having acute coronary syndrome within the last six months, with severe valvular, structural or congenital heart disease, thyroid and hepatic dysfunction or signs of any infection were excluded. Results: The study population were separated into three groups by coronary angiography: 51 with stable CAD aged ≤40 years (premature CAD, 38 with stable CAD older than 40 (mature CAD and 35 with the normal coronary arteries (NCA. No significant difference was found in MPV values between premature CAD and mature CAD and also between premature CAD and NCA (p>0.05. A significant negative correlation was found between MPV and platelet count in premature CAD (r=-0.419, p=0.002. Both in premature CAD and mature CAD groups, higher MPV values was found in critical CAD subgroup than noncritical CAD subgroup, but the difference was not statistically significant (p>0.05. Conclusion: There was no significant difference in MPV between premature and mature male CAD patients compared to NCA group. A positive but non-significant correlation was found between the MPV values and the severity of CAD. J Clin Exp Invest 2014; 5 (3: 381-385

  9. Newcastle disease virus induces stable formation ofbona fidestress granules to facilitate viral replication through manipulating host protein translation.

    Science.gov (United States)

    Sun, Yingjie; Dong, Luna; Yu, Shengqing; Wang, Xiaoxu; Zheng, Hang; Zhang, Pin; Meng, Chunchun; Zhan, Yuan; Tan, Lei; Song, Cuiping; Qiu, Xusheng; Wang, Guijun; Liao, Ying; Ding, Chan

    2017-04-01

    Mammalian cells respond to various environmental stressors to form stress granules (SGs) by arresting cytoplasmic mRNA, protein translation element, and RNA binding proteins. Virus-induced SGs function in different ways, depending on the species of virus; however, the mechanism of SG regulation of virus replication is not well understood. In this study, Newcastle disease virus (NDV) triggered stable formation of bona fide SGs on HeLa cells through activating the protein kinase R (PKR)/eIF2α pathway. NDV-induced SGs contained classic SG markers T-cell internal antigen (TIA)-1, Ras GTPase-activating protein-binding protein (G3BP)-1, eukaryotic initiation factors, and small ribosomal subunit, which could be disassembled in the presence of cycloheximide. Treatment with nocodazole, a microtubule disruption drug, led to the formation of relatively small and circular granules, indicating that NDV infection induces canonical SGs. Furthermore, the role of SGs on NDV replication was investigated by knockdown of TIA-1 and TIA-1-related (TIAR) protein, the 2 critical components involved in SG formation from the HeLa cells, followed by NDV infection. Results showed that depletion of TIA-1 or TIAR inhibited viral protein synthesis, reduced extracellular virus yields, but increased global protein translation. FISH revealed that NDV-induced SGs contained predominantly cellular mRNA rather than viral mRNA. Deletion of TIA-1 or TIAR reduced NP mRNA levels in polysomes. These results demonstrate that NDV triggers stable formation of bona fide SGs, which benefit viral protein translation and virus replication by arresting cellular mRNA.-Sun, Y., Dong, L., Yu, S., Wang, X., Zheng, H., Zhang, P., Meng, C., Zhan, Y., Tan, L., Song, C., Qiu, X., Wang, G., Liao, Y., Ding, C. Newcastle disease virus induces stable formation of bona fide stress granules to facilitate viral replication through manipulating host protein translation. © FASEB.

  10. The contributions of fasting and postprandial blood glucose increments to oxidative stress and inflammation in dyslipidemic type 2 diabetic patients with stable ischemic heart disease.

    Science.gov (United States)

    Djindjic, Boris; Kostic, Tomislav; Radovanovic, Zoran; Djindjic, Natasa; Lazovic, Marko; Zivic, Misko; Perisic, Zoran; Krstic, Nebojsa

    2017-01-15

    Contributions of fasting and postprandial blood glucose increments on level of inflammation and oxidative stress biomarkers in patients with stable ischemic heart disease (IHD) and diabetes mellitus type 2 (T2DM) was evaluated. Ninety T2DM patients (60 with IHD and 30 without IHD) treated with metformin and/or sulphonylurea were enrolled in cross-sectional nested case-control clinical study. The areas under the six-point daily glucose curve above the fasting glucose concentrations (AUCpp) and over 5.5mmol/L (AUCbg) were calculated to determine postprandial (AUCpp) and fasting (AUCbg-AUCpp) glucose increments. Malondialdehyde (MDA), protein carbonyl group (PCO), fibrinogen, C-reactive protein (hsCRP), leukocyte count and adhesion molecules ICAM-1 and VCAM-1 were determined. AUCbg-AUCpp 58.2 (95%CI 40.6-75.8) was higher in IHD group compared to non-IHD 36.9 (95%CI 23.5-50.2) mmol*h/L. They had significantly higher ICAM-1 (mean±SD) 72.70±30.6 vs. 60.22±22.6ng/mL and MDA 16.47±4.5 vs. 13.42±4.01μmol/g plasma proteins, but similar PCO, VCAM-1, fibrinogen, hsCRP concentration and leukocyte count. AUCpp positively correlated with MDA (r=0.45) and ICAM-1 (r=0.32) in the presence of IHD, and VCAM-1 (r=0.44) in the absence of IHD. AUCbg-AUCpp positively correlated with PCO (r=0.45) in the absence of IHD. The analysis revealed that AUCpp over turning point of 0mmol*h/L was associated with high MDA and ICAM-1 expression in diabetics with IHD. AUCbg-AUCpp over 30mmol*h/L leads to high oxidative protein modification in diabetics without IHD. In T2DM patients with stable IHD, AUCpp at any point, significantly contributes to increasing of MDA and ICAM-1 expression. Fasting blood glucose increment showed significant correlation with carbonyl content in diabetics without IHD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. The effect of acute magnesium loading on the maximal exercise performance of stable chronic obstructive pulmonary disease patients.

    Science.gov (United States)

    Amaral, Angélica Florípedes do; Gallo, Lourenco; Vannucchi, Hélio; Crescêncio, Júlio César; Vianna, Elcio Oliveira; Martinez, José Antônio Baddini

    2012-01-01

    The potential influence of magnesium on exercise performance is a subject of increasing interest. Magnesium has been shown to have bronchodilatatory properties in asthma and chronic obstructive pulmonary disease patients. The aim of this study was to investigate the effects of acute magnesium IV loading on the aerobic exercise performance of stable chronic obstructive pulmonary disease patients. Twenty male chronic obstructive pulmonary disease patients (66.2 + 8.3 years old, FEV1: 49.3+19.8%) received an IV infusion of 2 g of either magnesium sulfate or saline on two randomly assigned occasions approximately two days apart. Spirometry was performed both before and 45 minutes after the infusions. A symptom-limited incremental maximal cardiopulmonary test was performed on a cycle ergometer at approximately 100 minutes after the end of the infusion. Magnesium infusion was associated with significant reductions in the functional residual capacity (-0.41 l) and residual volume (-0.47 l), the mean arterial blood pressure (-5.6 mmHg) and the cardiac double product (734.8 mmHg.bpm) at rest. Magnesium treatment led to significant increases in the maximal load reached (+8 w) and the respiratory exchange ratio (0.06) at peak exercise. The subgroup of patients who showed increases in the work load equal to or greater than 5 w also exhibited significantly greater improvements in inspiratory capacity (0.29 l). The acute IV loading of magnesium promotes a reduction in static lung hyperinflation and improves the exercise performance in stable chronic obstructive pulmonary disease patients. Improvements in respiratory mechanics appear to be responsible for the latter finding.

  12. High relative abundance of the stable fly Stomoxys calcitrans is associated with lumpy skin disease outbreaks in Israeli dairy farms.

    Science.gov (United States)

    Kahana-Sutin, E; Klement, E; Lensky, I; Gottlieb, Y

    2017-06-01

    The vector of lumpy skin disease (LSD), a viral disease affecting Bovidae, is currently unknown. To evaluate the possible vector of LSD virus (LSDV) under field conditions, a yearlong trapping of dipterans was conducted in dairy farms that had been affected by LSD, 1-2 years previously. This was done in order to calculate monthly relative abundances of each dipteran in each farm throughout the year. The relative abundances of Stomoxys calcitrans (Diptera: Muscidae) in the months parallel to the outbreaks (December and April) were significantly higher than those of other dipterans. A stable fly population model based on weather parameters for the affected area was used to validate these findings. Its results were significantly correlated with S. calcitrans abundance. This model, based on weather parameters during the epidemic years showed that S. calcitrans populations peaked in the months of LSD onset in the studied farms. These observations and model predictions revealed a lower abundance of stable flies during October and November, when LSD affected adjacent grazing beef herds. These findings therefore suggest that S. calcitrans is a potential vector of LSD in dairy farms and that another vector is probably involved in LSDV transmission in grazing herds. These findings should be followed up with vector competence studies. © 2016 The Royal Entomological Society.

  13. Slowing of oscillatory brain activity is a stable characteristic of Parkinson's disease without dementia

    NARCIS (Netherlands)

    Stoffers, D.; Bosboom, JL; Deijen, J.B.; Wolters, E.C.M.J.; Berendse, H.W.; Stam, L.

    2007-01-01

    Extensive changes in resting-state oscillatory brain activity have recently been demonstrated using magnetoencephalography (MEG) in moderately advanced, non-demented Parkinson's disease patients relative to age-matched controls. The aim of the present study was to determine the onset and evolution

  14. Vitamin D-mediated calcium absorption in patients with clinically stable Crohn's disease: a pilot study

    Science.gov (United States)

    Vitamin D is the critical hormone for intestinal absorption of calcium. Optimal calcium absorption is important for proper mineralization of bone in the prevention of osteoporosis and osteoporotic fractures, among other important functions. Diseases associated with gut inflammation, such as Crohn's ...

  15. Plasma levels of myeloperoxidase are not elevated in patients with stable coronary artery disease

    Czech Academy of Sciences Publication Activity Database

    Kubala, Lukáš; Lu, G.; Baldus, S.; Berglund, L.; Eiserich, J.

    2008-01-01

    Roč. 394, - (2008), s. 59-62 ISSN 0009-8981 R&D Projects: GA ČR(CZ) GA524/06/1197 Institutional research plan: CEZ:AV0Z50040507; CEZ:AV0Z50040702 Keywords : cardiovascular disease s * myeloperoxidase * polymorphonuclear neutrophils Subject RIV: BO - Biophysics Impact factor: 2.960, year: 2008

  16. Prognostic assessment of stable coronary artery disease as determined by coronary computed tomography angiography

    DEFF Research Database (Denmark)

    Hüche Nielsen, Lene; Bøtker, Hans Erik; Sørensen, Henrik T.

    2017-01-01

    included 16,949 patients (median age 57 years; 57% women) with new-onset symptoms suggestive of CAD, who underwent CCTA between January 2008 and December 2012. The endpoint was a composite of late coronary revascularization procedure >90 days after CCTA, myocardial infarction, and all-cause death...... 90 days. The composite endpoint occurred in 486 patients. Risk of the composite endpoint was 1.5% for patients without CAD, 6.8% for obstructive CAD, and 15% for three-vessel/left main disease. Compared with patients without CAD, higher relative risk of the composite endpoint was observed for non......, and comorbidity. Conclusion: Coronary artery disease determined by CCTA in real-world practice predicts the 3.5 year composite risk of late revascularization, myocardial infarction, and all-cause death across different groups of age, sex, or comorbidity burden....

  17. The effects of short-duration exercise on arterial stiffness in patients with stable coronary artery disease.

    Science.gov (United States)

    Sung, Jidong; Yang, Jeong Hoon; Cho, Soo Jin; Hong, Sun Hee; Huh, Eun Hee; Park, Seung Woo

    2009-10-01

    Arterial stiffness is an important contributor to the development of cardiovascular disease. We investigated the effect of short duration exercise using the treadmill test on arterial stiffness in the presence of coronary artery disease. We enrolled patients with and without coronary artery diseases (CAD and control group, 50 patients each) referred for treadmill testing. Brachial-ankle pulse wave velocity (baPWV) were measured before and after treadmill testing. Values of baPWV were significantly reduced at 10 min after exercise in both groups, more in the CAD group than in the control group (baseline baPWV and post-exercise change [cm/sec]: 1,527+/-245 and -132+/-155 in the CAD group, 1,439+/-202 and -77+/-93 in the control group, respectively, P for change in each group arterial pressure (MAP), MAP decreases, and baseline baPWV. Significant post-exercise baPWV reductions were observed in both groups, and more prominently in the CAD group. This finding suggests that short-duration exercise may effectively improve arterial stiffness even in patients with stable coronary artery disease.

  18. Prognostic Value of High-sensitivity Troponin T After Percutaneous Coronary Intervention in Patients With Stable Coronary Artery Disease.

    Science.gov (United States)

    Ndrepepa, Gjin; Braun, Siegmund; Cassese, Salvatore; Mayer, Katharina; Lohaus, Raphaela; Lahmann, Anna L; Fusaro, Massimiliano; Laugwitz, Karl-Ludwig; Schunkert, Heribert; Kastrati, Adnan

    2016-08-01

    The prognostic value of high-sensitivity troponin T after percutaneous coronary intervention in patients with stable coronary artery disease is unclear. We investigated this clinically relevant question in 3463 consecutive patients undergoing percutaneous coronary intervention. This study included patients with stable coronary artery disease and baseline high-sensitivity troponin T below the 99th percentile upper reference limit (0.014μg/L). High-sensitivity troponin T was measured before and at 6, 12 and 24hours after the procedure. The primary outcome was all-cause mortality. Patients were divided into a group with peak postprocedural troponin T≤99th percentile (n=742), a group with peak postprocedural troponin T>99th to 5×99th percentile (n=1928), and a group with peak postprocedural troponin T>5×99th percentile upper reference limit (n=793). Advanced age, smaller body mass index, baseline troponin level, complex lesions, bifurcation lesions and stented length were independently associated with elevated troponin T levels after the procedure. The median follow-up was 15.5 months. There were 56 deaths: 5 deaths (1.7%) among patients with peak postprocedural troponin T≤99th percentile, 35 deaths (4.5%) among patients with peak postprocedural troponin T>99th to 5×99th percentile and 16 deaths (4.3%) among patients with peak postprocedural troponin T>5×99th percentile upper reference limit (hazard ratio=1.50; 95% confidence interval, 1.01-2.25; P=.047). After adjustment, peak postprocedural troponin T level was not independently associated with mortality after percutaneous coronary intervention (P=.094). In patients with stable coronary artery disease and without elevated baseline high-sensitivity troponin T, elevated high-sensitivity troponin T level after percutaneous coronary intervention was not associated with postprocedural mortality. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  19. [The Relationship of Serum Leptin Level and Metabolism in Elderly People with Stable Chronic Obstructive Pulmonary Disease].

    Science.gov (United States)

    Yang, Lu; Zhang, Xue-mei; Hu, Xiu-ying; Zhang, Yan-ling

    2016-01-01

    To investigate the correlation of serum leptin and to energy consumption and metabolization in the patients with chronic obstructive pulmonary disease (COPD). We included 92 outpatients with stable COPD in West China Hospital of Sichuan University as trail group (COPD group) and 80 healthy elderly people in community as control group. All patients and healthy control received the measurements of body mass index (BMI), fat mass, resting energy expenditure (REE), lung function, serum leptin and tumor necrosis factor-α (TNF-α). The concentrations of serum leptin, BMI and lung function were lower in COPD group than those in control group (P leptin between two groups were not difference after the adjusted results of BMI and fat mass.. There was no difference of REE and TNF-α concentrations in these two groups. The serum leptin had positive correlation with BMI and fat mass, but there were no correlation between of TNF-α and serum leptin. In elderly people with stable COPD, the decline on the serum leptin is related to the decrease of BMI and fat mass, but barely related to the level of TNF-α.

  20. Metabolic syndrome is independently associated with increased 20-year mortality in patients with stable coronary artery disease.

    Science.gov (United States)

    Younis, Arwa; Younis, Anan; Tzur, Boaz; Peled, Yael; Shlomo, Nir; Goldenberg, Ilan; Fisman, Enrique Z; Tenenbaum, Alexander; Klempfner, Robert

    2016-10-28

    Data regarding long-term association of metabolic syndrome (MetS) with adverse outcomes are conflicting. We aim to determine the independent association of MetS (based on its different definitions) with 20 year all-cause mortality among patients with stable coronary artery disease (CAD). Our study comprised 15,524 patients who were enrolled in the Bezafibrate Infarction Prevention registry between February 1, 1990, and October 31, 1992, and subsequently followed-up for the long-term mortality through December 31, 2014. MetS was defined according to two definitions: The International Diabetes Federation (IDF); and the National Cholesterol Education Program-Third Adult Treatment Panel (NCEP). According to the IDF criteria 2122 (14%) patients had MetS, whereas according to the NCEP definition 7446 (48%) patients had MetS. Kaplan-Meier survival analysis showed that all-cause mortality was significantly higher among patients with MetS defined by both the IDF (67 vs. 61%; log rank-p definition. Subgroup analysis demonstrated that long-term increased mortality risk associated with MetS was consistent among most clinical subgroups excepted patients with renal failure (p value for interaction Metabolic syndrome is independently associated with an increased 20-year all-cause mortality risk among patients with stable CAD. This association was consistent when either the IDF or NCEP definitions were used. Trial registration retrospective registered.

  1. Isospin symmetry breaking in sd shell nuclei

    International Nuclear Information System (INIS)

    Lam, Y.W.

    2011-12-01

    In the thesis, we develop a microscopic approach to describe the isospin-symmetry breaking effects in sd-shell nuclei. The work is performed within the nuclear shell model. A realistic isospin-conserving Hamiltonian is perfected by a charge-dependent part consisting of the Coulomb interaction and Yukawa-type meson exchange potentials to model charge-dependent forces of nuclear origin. The extended database of the experimental isobaric mass multiplet equation coefficients was compiled during the thesis work and has been used in a fit of the Hamiltonian parameters. The constructed Hamiltonian provides an accurate theoretical description of the isospin mixing nuclear states. A specific behaviour of the IMME (Isobaric Multiplet Mass Equation) coefficients have been revealed. We present two important applications: (i) calculations of isospin-forbidden proton emission amplitudes, which is often of interest for nuclear astrophysics, and (ii) calculation on corrections to nuclear Fermi beta decay, which is crucial for the tests of fundamental symmetries of the weak interaction. (author)

  2. Association between Depression, Pressure Pain Sensitivity, Stress and Autonomous Nervous System Function in Stable Ischemic Heart Disease

    DEFF Research Database (Denmark)

    Ballegaard, Søren; Bergmann, Natasha; Karpatschof, Benny

    2016-01-01

    Background: Depression and ischemic heart disease (IHD) are associated with persistent stress and autonomic nervous system (ANS) dysfunction. The former can be measured by pressure pain sensitivity (PPS) of the sternum, and the latter by the PPS and systolic blood pressure (SBP) response to a tilt...... table test (TTT). Beta-blocker treatment reduces the efferent beta-adrenergic ANS function, and thus, the physiological stress response. Objective: To test the effect of beta-blockers on changes in depression score in patients with IHD, as well as the influence on persistent stress and ANS dysfunction....... Methods: Three months of non-pharmacological intervention aiming at reducing PPS and depression score in patients with stable IHD. Beta-blocker users (N = 102) were compared with non-users (N = 75), with respect to signs of depression measured by the Major Depressive Inventory questionnaire (MDI), resting...

  3. Conservative versus invasive stable ischemic heart disease management strategies: what do we plan to learn from the ISCHEMIA trial?

    Science.gov (United States)

    Cheng-Torres, Kathleen A; Desai, Karan P; Sidhu, Mandeep S; Maron, David J; Boden, William E

    2016-01-01

    Over the past decade, landmark randomized clinical trials comparing initial management strategies in stable ischemic heart disease (SIHD) have demonstrated no significant reduction in 'hard' end points (all-cause mortality, cardiac death or myocardial infarction) with one strategy versus another. The main advantage derived from early revascularization is improved short-term quality of life. Nonetheless, questions remain regarding how best to manage SIHD patients, such as whether a high-risk subgroup can be identified that may experience a survival or myocardial infarction benefit from early revascularization, and if not, when should diagnostic catheterization and revascularization be performed. The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches trial is designed to address these questions by randomizing SIHD patients with at least moderate ischemia to an initial conservative strategy of optimal medical therapy or an initial invasive strategy of optimal medical therapy plus cardiac catheterization and revascularization.

  4. The correlation between lymphocyte/monocyte ratio and coronary collateral circulation in stable coronary artery disease patients.

    Science.gov (United States)

    Kurtul, Alparslan; Duran, Mustafa

    2017-01-01

    Coronary collateral circulation (CCC) has an important impact on cardiovascular prognosis and well-developed CCC is associated with better clinical outcomes. We investigated whether lymphocyte/monocyte ratio (LMR) has an association with CCC in patients with stable coronary artery disease (SCAD). The study population consisted of 245 patients with SCAD. Patients were classified into a poor CCC group (Rentrop grades 0/1, n = 87), or good CCC group (Rentrop grades 2/3, n = 158). LMR values were significantly higher in patients with good CCC than in those with poor CCC (4.41 ± 1.58 vs 2.76 ± 1.10; p 3.38 (OR 4.637; p = 0.004), high sensitivity C-reactive protein (OR 0.810, p SCAD patients.

  5. Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease

    DEFF Research Database (Denmark)

    Anand, Sonia S; Bosch, Jackie; Eikelboom, John W

    2018-01-01

    Trials.gov, number NCT01776424, and is closed to new participants. FINDINGS: Between March 12, 2013, and May 10, 2016, we enrolled 7470 patients with peripheral artery disease from 558 centres. The combination of rivaroxaban plus aspirin compared with aspirin alone reduced the composite endpoint of cardiovascular...... death, myocardial infarction, or stroke (126 [5%] of 2492 vs 174 [7%] of 2504; hazard ratio [HR] 0·72, 95% CI 0·57-0·90, p=0·0047), and major adverse limb events including major amputation (32 [1%] vs 60 [2%]; HR 0·54 95% CI 0·35-0·82, p=0·0037). Rivaroxaban 5 mg twice a day compared with aspirin alone....... The use of the rivaroxaban plus aspirin combination increased major bleeding compared with the aspirin alone group (77 [3%] of 2492 vs 48 [2%] of 2504; HR 1·61, 95% CI 1·12-2·31, p=0·0089), which was mainly gastrointestinal. Similarly, major bleeding occurred in 79 (3%) of 2474 patients with rivaroxaban 5...

  6. Resistin, exercise capacity, and inducible ischemia in patients with stable coronary heart disease: data from the Heart and Soul study.

    Science.gov (United States)

    Zhang, Mary H; Na, Beeya; Schiller, Nelson B; Whooley, Mary A

    2010-12-01

    Resistin is an adipocytokine involved in insulin resistance, inflammation, and atherosclerosis. Its role in the development and progression of coronary heart disease (CHD) is not yet well-characterized. We performed a cross-sectional study to evaluate the association between serum resistin levels, exercise capacity, and exercise-induced cardiac ischemia among patients with stable CHD. We measured serum resistin concentrations and determined treadmill exercise capacity and inducible ischemia by stress echocardiography in 899 outpatients with documented CHD. Of these, 215 (24%) had poor exercise capacity (<5 metabolic equivalent tasks), and 217 (24%) had inducible ischemia. As compared with participants who had resistin levels in the lowest quartile, those with resistin levels in the highest quartile were more likely to have poor exercise capacity (33% versus 16%, odds ratio [OR] 2.68, P<0.0001) and inducible ischemia (30% versus 17%, OR 2.08, P=0.001). Both associations remained robust after adjusting for numerous clinical risk factors, metabolic variables, and markers of insulin resistance (poor exercise capacity adjusted OR 1.73, P=0.04; inducible ischemia adjusted OR 1.82, P=0.01). However, further adjustments for C-reactive protein, interleukin-6, and tumor necrosis factor-α eliminated the association with poor exercise capacity (adjusted OR 1.50, P=0.14) and substantially weakened the association with inducible ischemia (adjusted OR 1.72, P=0.03). Elevated serum resistin is associated with poor exercise capacity and exercise-induced cardiac ischemia in patients with stable coronary disease. Adjustment for inflammatory markers attenuated these associations, suggesting a possible role for resistin in inflammation and CHD pathophysiology. Published by Elsevier Ireland Ltd.

  7. Effects of tiotropium on sympathetic activation during exercise in stable chronic obstructive pulmonary disease patients.

    Science.gov (United States)

    Yoshimura, Kenji; Maekura, Ryoji; Hiraga, Toru; Kitada, Seigo; Miki, Keisuke; Miki, Mari; Tateishi, Yoshitaka

    2012-01-01

    Tiotropium partially relieves exertional dyspnea and reduces the risk of congestive heart failure in chronic obstructive pulmonary disease (COPD) patients. However, its effect on the sympathetic activation response to exercise is unknown. This study aimed to determine whether tiotropium use results in a sustained reduction in sympathetic activation during exercise. We conducted a 12-week, open-label (treatments: tiotropium 18 μg or oxitropium 0.2 mg × 3 mg), crossover study in 17 COPD patients. Treatment order was randomized across subjects. The subjects underwent a pulmonary function test and two modes of cardiopulmonary exercise (constant work rate and incremental exercise) testing using a cycle ergometer, with measurement of arterial catecholamines after each treatment period. Forced expiratory volume in 1 second and forced vital capacity were significantly larger in the tiotropium treatment group. In constant exercise testing, exercise endurance time was longer, with improvement in dyspnea during exercise and reduction in dynamic hyperinflation in the tiotropium treatment group. Similarly, in incremental exercise testing, exercise time, carbon dioxide production, and minute ventilation at peak exercise were significantly higher in the tiotropium treatment group. Plasma norepinephrine concentrations and dyspnea intensity were also lower during submaximal isotime exercise and throughout the incremental workload exercise in the tiotropium treatment group. Tiotropium suppressed the increase of sympathetic activation during exercise at the end of the 6-week treatment, as compared with the effect of oxipropium. This effect might be attributed to improvement in lung function and exercise capacity and reduction in exertional dyspnea, which were associated with decreases in respiratory frequency and heart rate and reduced progression of arterial acidosis.

  8. Changes in myocardial perfusion due to physical exercise in patients with stable coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Kendziorra, Kai; Foerster, Marcus; Sabri, Osama; Kluge, Regine [University of Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Walther, Claudia; Moebius-Winkler, Sven; Conradi, Katrin; Schuler, Gerhard; Hambrecht, Rainer [University of Leipzig, Heart Center, Leipzig (Germany)

    2005-07-01

    Percutaneous transluminal coronary angioplasty (PTCA) is one of the main therapy options for patients with coronary artery disease (CAD), resulting in an improvement in myocardial perfusion and exercise capacity. Nevertheless, studies have also demonstrated a positive effect of regular exercise training on myocardial perfusion and maximum exercise capacity. The aim of this study was to evaluate changes in myocardial stress perfusion after 1 year of exercise training in comparison with the effects of PTCA in patients with CAD. In 66 male patients with angiographically confirmed significant coronary artery stenosis in one target vessel, myocardial perfusion scintigraphy was performed at baseline and 12 months after randomisation into either a physical exercise group or a PTCA group. Circumferential count rate profiles in 16 wall segments were classified according to their relative count rate and localisation within or outside the area supplied by the stenosed vessel. Ischaemic segments showed a significant improvement in myocardial count rate within the target area after 12 months in both the PTCA and the training group (PTCA group: from 76.8{+-}4.9% to 86.6{+-}10.9%, p=0.03; training group: from 74.0{+-}7.3% to 83.7{+-}10.8%, p<0.01). Outside the target area only the training group showed a significant improvement (from 77.7{+-}4.4% to 91.7{+-}4.8%, p<0.01). Our data indicate a significant improvement in stress myocardial perfusion in the training group after 12 months. The ischaemia is reduced not only in the target region of the leading stenosis but also in other ischaemic myocardial areas. In contrast, after PTCA stress perfusion improves only in the initially ischaemic parts of the target area. (orig.)

  9. Which Costs Matter? Costs Included in Economic Evaluation and their Impact on Decision Uncertainty for Stable Coronary Artery Disease.

    Science.gov (United States)

    Lomas, James; Asaria, Miqdad; Bojke, Laura; Gale, Chris P; Richardson, Gerry; Walker, Simon

    2018-02-14

    Variation exists in the resource categories included in economic evaluations, and National Institute for Health and Care Excellence (NICE) guidance suggests the inclusion only of costs related to the index condition or intervention. However, there is a growing consensus that all healthcare costs should be included in economic evaluations for Health Technology Assessments (HTAs), particularly those related to extended years of life. We aimed to quantify the impact of a range of cost categories on the adoption decision about a hypothetical intervention, and uncertainty around that decision, for stable coronary artery disease (SCAD) based on a dataset comprising 94,966 patients. Three costing scenarios were considered: coronary heart disease (CHD) costs only, cardiovascular disease (CVD) costs and all costs. The first two illustrate different interpretations of what might be regarded as related costs. Employing a 20-year time horizon, the highest mean expected incremental cost was when all costs were included (£2468) and the lowest when CVD costs only were included (£2377). The probability of the treatment being cost effective, estimating health opportunity costs using a ratio of £30,000 per quality-adjusted life-year (QALY), was different for each of the CHD (70%) costs, CVD costs (73%) and all costs (56%) scenarios. The results concern a hypothetical intervention and are illustrative only, as such they cannot necessarily be generalised to all interventions and diseases. Cost categories included in an economic evaluation of SCAD impact on estimates of both cost effectiveness and decision uncertainty. With an aging and co-morbid population, the inclusion of all healthcare costs may have important ramifications for the selection of healthcare provision on economic grounds.

  10. Change in Leukocyte Telomere Length Predicts Mortality in Patients with Stable Coronary Heart Disease from the Heart and Soul Study.

    Directory of Open Access Journals (Sweden)

    Sarah E Goglin

    Full Text Available Short telomere length independently predicts mortality in patients with coronary heart disease. Whether 5-year change in telomere length predicts subsequent mortality in patients with coronary heart disease has not been evaluated.In a prospective cohort study of 608 individuals with stable coronary artery disease, we measured leukocyte telomere length at baseline and after five years of follow-up. We divided the sample into tertiles of telomere change: shortened, maintained or lengthened. We used Cox survival models to evaluate 5-year change in telomere length as a predictor of mortality.During an average of 4.2 years follow-up, there were 149 deaths. Change in telomere length was inversely predictive of all-cause mortality. Using the continuous variable of telomere length change, each standard deviation (325 base pair greater increase in telomere length was associated with a 24% reduction in mortality (HR 0.76, 95% CI 0.61-0.94; p = 0.01, adjusted for age, sex, waist to hip ratio, exercise capacity, LV ejection fraction, serum creatinine, and year 5 telomere length. Mortality occurred in 39% (79/203 of patients who experienced telomere shortening, 22% (45/203 of patients whose telomere length was maintained, and 12% (25/202 of patients who experienced telomere lengthening (p<0.001. As compared with patients whose telomere length was maintained, those who experienced telomere lengthening were 56% less likely to die (HR 0.44, 95% CI, 0.23-0.87.In patients with coronary heart disease, an increase in leukocyte telomere length over 5 years is associated with decreased mortality.

  11. Evaluation of Complience to Treatment and Frequency of Comorbidities in Patients with Stable Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Sami Deniz

    2016-01-01

    Full Text Available Aim: It%u2019s recommended that comorbidities should be treated properly due to effecting on severity of COPD. Purpose: In this study, we aimed to evaluate comorbidity frequencies and compliance to treatment of co-morbid diseases in COPD patients according to their self reported medical history. Material and Method: 339 patients with stable COPD from five different centers were included in the study. Spirometry was performed to all the patients. Body Mass Index (BMI, modified Medical Research Council Dyspnea Score (mMRC and COPD Assessment Tool (CAT were calculated. Patients were questioned about their smoking habit and medical history, including comorbidities as diabetes mellitus (DM, hypertension (HT, and coronary artery disease (CAD. Results: Average age of the study population was 67,5 ± 10,5. Patients were separated into 4 stages of COPD according to predicted forced expiratory volume in one second (FEV1 value and two groups were obtained by combining stage 1 and 2 (group 1; and stage 3 and 4 (group 2. There was statistically significant difference between groups with respect to age (p=0.01. There was not any positive correlation between the frequency of DM, CAD and the stage of COPD, while patients with HT were higher in group 2. Patients were categorized 3 groups in terms of BMI (Group A:

  12. Blood pressure and antihypertensive medication profile in a multiethnic Asian population of stable chronic kidney disease patients.

    Science.gov (United States)

    Teo, Boon Wee; Chua, Horng Ruey; Wong, Weng Kin; Haroon, Sabrina; Subramanian, Srinivas; Loh, Ping Tyug; Sethi, Sunil; Lau, Titus

    2016-05-01

    Clinical practice guidelines recommend different blood pressure (BP) goals for chronic kidney disease (CKD) patients. Usage of antihypertensive medication and attainment of BP targets in Asian CKD patients remain unclear. This study describes the profile of antihypertensive agents used and BP components in a multiethnic Asian population with stable CKD. Stable CKD outpatients with variability of serum creatinine levels 3 months apart, were recruited. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using automated manometers, according to practice guidelines. Serum creatinine was assayed and the estimated glomerular filtration rate (GFR) calculated using the CKD Epidemiology Collaboration equation. BP and antihypertensive medication profile was examined using univariate analyses. 613 patients (55.1% male; 74.7% Chinese, 6.4% Indian, 11.4% Malay; 35.7% diabetes mellitus) with a mean age of 57.8 ± 14.5 years were recruited. Mean SBP was 139 ± 20 mmHg, DBP was 74 ± 11 mmHg, serum creatinine was 166 ± 115 µmol/L and GFR was 53 ± 32 mL/min/1.73 m(2). At a lower GFR, SBP increased (p < 0.001), whereas DBP decreased (p = 0.0052). Mean SBP increased in tandem with the number of antihypertensive agents used (p < 0.001), while mean DBP decreased when ≥ 3 antihypertensive agents were used (p = 0.0020). Different targets are recommended for each BP component in CKD patients. A majority of patients cannot attain SBP targets and/or exceed DBP targets. Research into monitoring and treatment methods is required to better define BP targets in CKD patients. Copyright: © Singapore Medical Association.

  13. Prognosis by C-reactive protein and matrix metalloproteinase-9 levels in stable coronary heart disease during 15 years of follow-up

    DEFF Research Database (Denmark)

    Eldrup, N; Kragelund, C; Steffensen, R

    2012-01-01

    associate with prognosis in patients with stable coronary heart disease. METHODS AND RESULTS: We measured baseline plasma CRP and matrix metalloproteinase-9 in 1090 patients with stable coronary heart disease and as the primary composite endpoint detected incident unstable angina, myocardial infarction......BACKGROUND AND AIM: Elevated CRP and matrix metalloproteinase-9 associate with increased risk of cardiovascular events, possibly because these plasma proteins mark vulnerable atherosclerotic plaques. We tested the hypothesis that levels of C-reactive protein (CRP) and matrix metalloproteinase-9...

  14. Charge radii of neon isotopes across the sd neutron shell

    CERN Document Server

    Marinova, K; Kowalska, M; Kotrotsios, G; Kloos, S; Neugart, R; Blaum, K; Simon, H; Keim, M; Lievens, P; Wilbert, S; Kappertz, S

    2011-01-01

    We report on the changes in mean square charge radii of unstable neon nuclei relative to the stable (20)Ne, based on the measurement of optical isotope shifts. The studies were carried out using collinear laser spectroscopy on a fast beam of neutral neon atoms. High sensitivity on short-lived isotopes was achieved thanks to nonoptical detection based on optical pumping and state-selective collisional ionization, which was complemented by an accurate determination of the beam kinetic energy. The new results provide information on the structural changes in the sequence of neon isotopes all across the neutron sd shell, ranging from the proton drip line nucleus and halo candidate (17)Ne up to the neutron-rich (28)Ne in the vicinity of the ``island of inversion.{''} Within this range the charge radius is smallest for (24)Ne with N = 14 corresponding to the closure of the neutron d(5/2) shell, while it increases toward both neutron shell closures, N = 8 and N = 20. The general trend of the charge radii correlates w...

  15. Stability of fatigue, pain, patient global assessment and the Bath Ankylosing Spondylitis Functional Index (BASFI) in spondyloarthropathy patients with stable disease according to the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)

    DEFF Research Database (Denmark)

    Madsen, Ole Rintek

    2018-01-01

    The study objective was to examine natural variation of the patient-reported outcome measures fatigue, pain, patient global assessment (PaGl) and the Bath Ankylosing Spondylitis Functional Index (BASFI) in patients with stable axial spondyloarthropathy (ax-SpA) defined on the basis of the Bath...... Spondylitis Ankylosing Disease Activity Index (BASDAI). 107 TNF-inhibitor treated stable ax-SpA patients were identified in the Danish rheumatology registry (DANBIO). According to the Assessment of SpondyloArthritis international Society (ASAS) response criteria, stable disease was defined as a change...

  16. Diagnostic significance of the newest biomarkers of steatosis progression in patients with stable coronary heart disease, combined with nonalcoholic fatty liver disease

    Directory of Open Access Journals (Sweden)

    I. I. Vakalyuk

    2018-03-01

    Full Text Available The purpose was to determine the diagnostic value of selenoprotein P and M30 fragments of cytokeratin 18 in conjunction with proinflammatory cytokines for early diagnosis and progression of non-alcoholic fatty liver disease (NAFLD in patients with stable coronary heart disease (CHD. Materials and methods. 140 patients with NAFLD and stable CHD of II-III functional classes were examined: 89 patients with non-alcoholic steatosis (Group I; 51 patients with non-alcoholic steatohepatitis (Group II. General-clinical examination, electrocardiography, coronary angiography, echocardiography, liver ultrasound, determination of cytokeratin 18 M30, selenoprotein P, TNF-alpha, interleukin-6, high-sensitivity C-reactive protein serum levels were performed to all patients. Results. The presence of liver steatosis of different degrees was established in all examined patients. However, the majority of the patients of Group I had steatosis of 1 and 2 degrees; in group 2 – steatosis of 3 degree prevailed. Selenoprotein P level in patients with steatosis of 1 degree was on 39.6 % higher compared with 0 degree; at 2 degree – it was by 2.8 times higher vs. its level in the control group and by 1.9 times vs. its level at steatosis of 1 degree (P < 0.05. Cytokeratin 18 M30 level at steatosis of 1 degree was by 1.8 times higher than its value in the control group; at 2 degree – it exceed this value by 2.3 times; at 3 degree – it reached its highest value (P < 0.05. TNF-alpha level at 1 degree of steatosis was by 2.5 times higher than its value in the control group; at 2 degree – it exceed this value by 3.7 times; at 3 degree – it was by 5.4; 2.2 and 1.5 times higher vs. its value at steatosis 0, 1 and 2 degrees (P < 0.05. Similar patterns were observed by IL-6 and hsCRP levels. Positive correlation relationships between serum selenoprotein P, cytokeratin 18 M30 and proinflammatory cytokines levels were revealed. Conclusion. Increasing of serum selenoprotein

  17. Intravenous administration of brain-targeted stable nucleic acid lipid particles alleviates Machado-Joseph disease neurological phenotype.

    Science.gov (United States)

    Conceição, Mariana; Mendonça, Liliana; Nóbrega, Clévio; Gomes, Célia; Costa, Pedro; Hirai, Hirokazu; Moreira, João Nuno; Lima, Maria C; Manjunath, N; Pereira de Almeida, Luís

    2016-03-01

    Others and we showed that RNA interference holds great promise for the treatment of dominantly inherited neurodegenerative disorders such as Machado-Joseph disease (MJD), for which there is no available treatment. However, successful experiments involved intracranial administration of viral vectors and there is a need for a safer and less invasive procedure. In this work, we successfully generated stable nucleic acid lipid particles (SNALPs), incorporating a short peptide derived from rabies virus glycoprotein (RVG-9r) and encapsulating small interfering RNAs (siRNAs), which can target mutant ataxin-3. The developed formulation exhibited important features that make it adequate for systemic administration: high encapsulation efficiency of siRNAs, ability to protect the encapsulated siRNAs, appropriate and homogeneous particle size distribution. Following optimization of the formulation and in vitro validation of its efficacy to silence the MJD-causing protein - mutant ataxin-3 - in neuronal cells, in vivo experiments showed that intravenous administration of RVG-9r-targeted SNALPs efficiently silenced mutant ataxin-3 reducing neuropathology and motor behavior deficits in two mouse models of MJD. To our knowledge, this is the first report showing beneficial impact of a non-viral gene silencing strategy in MJD and the first time that a non-invasive systemic administration proved to be beneficial on a polyglutamine disorder. Our study opens new avenues towards MJD therapy that can also be applied to other neurodegenerative diseases linked to the production of pathogenic proteins. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. The role of vaspin as a predictor of coronary angiography result in SCAD (stable coronary artery disease) patients.

    Science.gov (United States)

    Stančík, Matej; Ságová, Ivana; Kantorová, Ema; Mokáň, Marián

    2017-05-08

    The role of vaspin in the pathogenesis of stable coronary artery disease (SCAD) have been repeatedly addressed in clinical studies. However, from the point of view of clinical practice, the results of earlier studies are still inconclusive. The data of 106 SCAD patients who received coronary angiography and 85 coronary artery disease-free controls were collected and analysed. The patients were divided into subgroups according to their pre-test probability (PTP) and according to the result of coronary angiography. Fasting vaspin concentrations were compared between subgroups of SCAD patients and between target group and controls. The effect of age and smoking on the result of coronary angiography was compared to the effect of vaspin using the binomial regression. We did not find significant difference in vaspin level between target group and controls. Unless the pre-test probability was taken into account, we did not find vaspin difference in the target group, when dividing patients on the basis of presence/absence of significant coronary stenosis. In the subgroup of SCAD patients with PTP between 15% - 65%, those with significant coronary stenoses had higher mean vaspin concentration (0,579 ± 0,898 ng/ml) than patients without significant stenoses. (0,379 ± 0,732 ng/ml) (t = -2595; p = 0,012; d = 0,658; 1-β = 0,850). Age, smoking status and vaspin significantly contributed to the HSCS prediction in binomial regression model in patients with low PTP (OR: 1.1, 4.9, 8.7, respectively). According to our results, vaspin cannot be used as an independent marker for the presence of CAD in general population. However, our results indicate that measuring vaspin in SCAD patients might be clinically useful in patients with PTP below 66%.

  19. A stable producer cell line for the manufacture of a lentiviral vector for gene therapy of Parkinson's disease.

    Science.gov (United States)

    Stewart, Hannah J; Fong-Wong, Liang; Strickland, Iain; Chipchase, Daniel; Kelleher, Michelle; Stevenson, Laura; Thoree, Vinay; McCarthy, Janine; Ralph, G Scott; Mitrophanous, Kyriacos A; Radcliffe, Pippa A

    2011-03-01

    ProSavin is an equine infectious anemia virus vector-based gene therapy for Parkinson's disease for which inducible HEK293T-based producer cell lines (PCLs) have been developed. These cell lines demonstrate stringent tetracycline-regulated expression of the packaging components and yield titers comparable to the established transient production system. A prerequisite for the use of PCL-derived lentiviral vectors (LVs) in clinical applications is the thorough characterization of both the LV and respective PCL with regard to identity and genetic stability. We describe the detailed characterization of two ProSavin PCLs (PS5.8 and PS46.2) and resultant ProSavin vector. The two cell lines demonstrate stable production of vector over a time period sufficient to allow generation of master and working cell banks, and subsequent large-scale vector production. ProSavin generated from the PCLs performs comparably in vivo to that produced by the standard transient transfection process with respect to transduction efficiency and immunogenicity. The development of ProSavin PCLs, and the detailed characterization described here, will aid the advancement of ProSavin for clinical application.

  20. A randomized study of coconut oil versus sunflower oil on cardiovascular risk factors in patients with stable coronary heart disease.

    Science.gov (United States)

    Vijayakumar, Maniyal; Vasudevan, D M; Sundaram, K R; Krishnan, Sajitha; Vaidyanathan, Kannan; Nandakumar, Sandya; Chandrasekhar, Rajiv; Mathew, Navin

    2016-01-01

    Coronary artery disease (CAD) and its pathological atherosclerotic process are closely related to lipids. Lipids levels are in turn influenced by dietary oils and fats. Saturated fatty acids increase the risk for atherosclerosis by increasing the cholesterol level. This study was conducted to investigate the impact of cooking oil media (coconut oil and sunflower oil) on lipid profile, antioxidant mechanism, and endothelial function in patients with established CAD. In a single center randomized study in India, patients with stable CAD on standard medical care were assigned to receive coconut oil (Group I) or sunflower oil (Group II) as cooking media for 2 years. Anthropometric measurements, serum, lipids, Lipoprotein a, apo B/A-1 ratio, antioxidants, flow-mediated vasodilation, and cardiovascular events were assessed at 3 months, 6 months, 1 year, and 2 years. Hundred patients in each arm completed 2 years with 98% follow-up. There was no statistically significant difference in the anthropometric, biochemical, vascular function, and in cardiovascular events after 2 years. Coconut oil even though rich in saturated fatty acids in comparison to sunflower oil when used as cooking oil media over a period of 2 years did not change the lipid-related cardiovascular risk factors and events in those receiving standard medical care. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  1. Evaluation of a train-the-trainer program for stable coronary artery disease management in community settings: A pilot study.

    Science.gov (United States)

    Shen, Zhiyun; Jiang, Changying; Chen, Liqun

    2018-02-01

    To evaluate the feasibility and effectiveness of conducting a train-the-trainer (TTT) program for stable coronary artery disease (SCAD) management in community settings. The study involved two steps: (1) tutors trained community nurses as trainers and (2) the community nurses trained patients. 51 community nurses attended a 2-day TTT program and completed questionnaires assessing knowledge, self-efficacy, and satisfaction. By a feasibility and non-randomized control study, 120 SCAD patients were assigned either to intervention group (which received interventions from trained nurses) or control group (which received routine management). Pre- and post-intervention, patients' self-management behaviors and satisfaction were assessed to determine the program's overall impact. Community nurses' knowledge and self-efficacy improved (PSCAD management in community settings in China was generally feasible and effective, but many obstacles remain including patients' noncompliance, nurses' busy work schedules, and lack of policy supports. Finding ways to enhance the motivation of community nurses and patients with SCAD are important in implementing community-based TTT programs for SCAD management; further multicenter and randomized control trials are needed. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Metabolic therapy in the comprehensive treatment of patients with comorbidity of chronic pancreatitis and stable coronary artery disease

    Directory of Open Access Journals (Sweden)

    L.S. Babinets

    2017-02-01

    Full Text Available Metabolic therapy is one of the few ways to restore normal functions of all the vital organs and systems. The goal of the research was to explore the effectiveness of a course of treatment using metabolic drug Vazonat (meldonium dihydrate to correct prooxidant-antioxidant and trophological disorders in patients with comorbid course of chronic pancreatitis (CP and stable coronary artery disease (SCAD. The study included 90 patients with CP in combination with SCAD, who were divided into two groups (depending on the treatment program: I group (45 patients received conventional treatment (CT; group II (45 patients in addition to CT received Vazonat as follows: 5 ml intravenous bolus injection 1 time a day for 10 days followed by administration of 1 capsule (250 mg, 2 times per day for one month. It has been shown that the addition of Vazonat to the treatment of patients with comorbidity of CP and SCAD is more conducive to improving the performance and trophological prooxidant-antioxidant status than the standard basic therapy.

  3. SdPI, the first functionally characterized Kunitz-type trypsin inhibitor from scorpion venom.

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    Ruiming Zhao

    Full Text Available BACKGROUND: Kunitz-type venom peptides have been isolated from a wide variety of venomous animals. They usually have protease inhibitory activity or potassium channel blocking activity, which by virtue of the effects on predator animals are essential for the survival of venomous animals. However, no Kunitz-type peptides from scorpion venom have been functionally characterized. PRINCIPAL FINDINGS: A new Kunitz-type venom peptide gene precursor, SdPI, was cloned and characterized from a venom gland cDNA library of the scorpion Lychas mucronatus. It codes for a signal peptide of 21 residues and a mature peptide of 59 residues. The mature SdPI peptide possesses a unique cysteine framework reticulated by three disulfide bridges, different from all reported Kunitz-type proteins. The recombinant SdPI peptide was functionally expressed. It showed trypsin inhibitory activity with high potency (K(i = 1.6×10(-7 M and thermostability. CONCLUSIONS: The results illustrated that SdPI is a potent and stable serine protease inhibitor. Further mutagenesis and molecular dynamics simulation revealed that SdPI possesses a serine protease inhibitory active site similar to other Kunitz-type venom peptides. To our knowledge, SdPI is the first functionally characterized Kunitz-type trypsin inhibitor derived from scorpion venom, and it represents a new class of Kunitz-type venom peptides.

  4. Practice Patterns for Outpatients With Stable Coronary Artery Disease: A Case Vignette-based Survey Among French Cardiologists

    Directory of Open Access Journals (Sweden)

    Christophe Bauters

    2015-11-01

    Interpretation: When not guided by high-level recommendations, practice patterns for routine clinical situations in stable CAD vary considerably. Future clinical trials should address these clinical interrogations.

  5. [ISCHEMIA - the Largest Ever R andomized Study in Stable Coronary Artery Disease. Baseline Characteristics of Enrolled Patients in One Russian Site].

    Science.gov (United States)

    Sayganov, S A; Bershteyn, L L; Andreeva, A E; Katamadze, N O; Zbyshevskaya, E V; Kuzmina-Krutetskaya, A M; Volkov, A V; Gumerova, V E; Bitakova, F I

    2017-10-01

    Indications for coronary revascularization in patients with stable coronary heart disease (CHD), presented in the current international guidelines are largely based on the clinical trials conducted sometimes more than 30 years ago. ISCHEMIA is the major multicenter international randomized trial intended to answer the question about the optimal treatment strategy in stable coronary artery disease at the present time. To analyze the most important baseline characteristics of patients enrolled in the ISCHEMIA study in one Russian site. The principal inclusion criteria are a positive stress test (in our center, exercise stress echocardiography) of at least moderate risk and obstructive coronary heart disease confirmed by coronary computed tomography angiography (CCTA). Main exclusion criteria are a significant stenosis of the left main coronary artery by CCTA, clinical progression/destabilization of the ischemic heart disease, angina of IV CCS class, left ventricular ejection fraction (EF) 80% - beta blockers, >80% - ACE inhibitors/ARBs. They are at well controlled resting heart rate (.

  6. Effects of TNF-alpha and leptin on weight loss in patients with stable chronic obstructive pulmonary disease.

    Science.gov (United States)

    Shin, Kyeong-Cheol; Chung, Jin Hong; Lee, Kwan Ho

    2007-12-01

    Weight loss is common in patients with chronic obstructive pulmonary disease (COPD). However, the mechanisms of this weight loss are still unclear. Sixty male patients with stable COPD and 45 healthy male controls participated in this study. The COPD patients were divided into two groups, that is, the emphysema and chronic bronchitis groups, by the transfer coefficient of carbon monoxide. The body composition, resting energy expenditure (REE), plasma leptin levels and serum tumor necrosis factor-alpha (TNF-alpha) were measured in all the study participants. The difference and correlation of these parameters were investigated between the two groups. Emphysematous patients were characterized by a lower body mass index (BMI) and fat-mass (FM) compared with the chronic bronchitis patients (p leptin levels, as corrected for the FM, were not different between the COPD patients and healthy controls (78.3 +/- 30.9 pg/mL/kg vs. 70.9 +/- 17.3 pg/mL/kg, respectively), and the plasma leptin levels, as adjusted for the FM, were also not different between the two groups of COPD patients. In the chronic bronchitis patients, the plasma leptin concentration was correlated with the BMI (r = 0.866, p COPD patients than those in the controls, but there was no statistical difference (10.7 +/- 18.6 pg/mL vs. 7.2 x 3.5 pg/mL, respectively, p0.05). The leptin concentration was well correlated with the BMI and %FM in the patients with chronic bronchitis and the leptin concentration was only correlated with the %FM (r = 0.450, p = 0.027) in emphysema patients. There was no correlation between the plasma leptin concentration, as adjusted for the fat mass, and the activity of the TNF-alpha system. The interaction of leptin and the activity of the TNF-alpha system in the pathogenesis of tissue depletion may not play an important role in chronic stable COPD patients.

  7. Effects of TNF-α and Leptin on Weight Loss in Patients with Stable Chronic Obstructive Pulmonary Disease

    Science.gov (United States)

    Shin, Kyeong-Cheol; Chung, Jin Hong

    2007-01-01

    Background Weight loss is common in patients with chronic obstructive pulmonary disease (COPD). However, the mechanisms of this weight loss are still unclear. Methods Sixty male patients with stable COPD and 45 healthy male controls participated in this study. The COPD patients were divided into two groups, that is, the emphysema and chronic bronchitis groups, by the transfer coefficient of carbon monoxide. The body composition, resting energy expenditure (REE), plasma leptin levels and serum tumor necrosis factor-alpha (TNF-α) were measured in all the study participants. The difference and correlation of these parameters were investigated between the two groups. Results Emphysematous patients were characterized by a lower body mass index (BMI) and fat-mass (FM) compared with the chronic bronchitis patients (pleptin levels, as corrected for the FM, were not different between the COPD patients and healthy controls (78.3±30.9 pg/mL/kg vs. 70.9±17.3 pg/mL/kg, respectively), and the plasma leptin levels, as adjusted for the FM, were also not different between the two groups of COPD patients. In the chronic bronchitis patients, the plasma leptin concentration was correlated with the BMI (r=0.866, pCOPD patients than those in the controls, but there was no statistical difference (10.7±18.6 pg/mL vs. 7.2×3.5 pg/mL, respectively, p0.05). The leptin concentration was well correlated with the BMI and %FM in the patients with chronic bronchitis and the leptin concentration was only correlated with the %FM (r=0.450, p=0.027) in emphysema patients. There was no correlation between the plasma leptin concentration, as adjusted for the fat mass, and the activity of the TNF-α system. Conclusions The interaction of leptin and the activity of the TNF-α system in the pathogenesis of tissue depletion may not play an important role in chronic stable COPD patients. PMID:18309683

  8. Sex Differences in Platelet Reactivity and Cardiovascular and Psychological Response to Mental Stress in Patients With Stable Ischemic Heart Disease

    Science.gov (United States)

    Samad, Zainab; Boyle, Stephen; Ersboll, Mads; Vora, Amit N.; Zhang, Ye; Becker, Richard C.; Williams, Redford; Kuhn, Cynthia; Ortel, Thomas L.; Rogers, Joseph G.; O’Connor, Christopher; Velazquez, Eric J.; Jiang, Wei

    2016-01-01

    BACKGROUND Although emotional stress is associated with ischemic heart disease (IHD) and related clinical events, sex-specific differences in the psychobiological response to mental stress have not been clearly identified. OBJECTIVES We aimed to study the differential psychological and cardiovascular responses to mental stress between male and female patients with stable IHD. METHODS Patients with stable IHD enrolled in the REMIT (Responses of Mental Stress–Induced Myocardial Ischemia to Escitalopram) study underwent psychometric assessments, transthoracic echocardiography, and platelet aggregation studies at baseline and after 3 mental stress tasks. Mental stress–induced myocardial ischemia (MSIMI) was defined as the development or worsening of regional wall motion abnormality, reduction of left ventricular ejection fraction (LVEF) ≥8% by transthoracic echocardiography, and/or ischemic ST-segment change on electrocardiogram during 1 or more of the 3 mental stress tasks. RESULTS In the 310 participants with known IHD (18% women, 82% men), most baseline characteristics were similar between women and men (including heart rate, blood pressure, and LVEF), although women were more likely to be nonwhite, living alone (p < 0.001), and unmarried (p < 0.001); they also had higher baseline depression and anxiety (p < 0.05). At rest, women had heightened platelet aggregation responses to serotonin (p = 0.007) and epinephrine (p = 0.004) compared with men. Following mental stress, women had more MSIMI (57% vs. 41%, p < 0.04), expressed more negative (p = 0.02) and less positive emotion (p < 0.001), and demonstrated higher collagen-stimulated platelet aggregation responses (p = 0.04) than men. Men were more likely than women to show changes in traditional physiological measures, such as blood pressure (p < 0.05) and double product. CONCLUSIONS In this exploratory analysis, we identified clear, measurable, and differential responses to mental stress in women and men

  9. Skin autofluorescence is elevated in patients with stable coronary artery disease and is associated with serum levels of neopterin and the soluble receptor for advanced glycation end products

    NARCIS (Netherlands)

    Mulder, Douwe J.; van Haelst, Paul L.; Gross, Sascha; de Leeuw, Karina; Bijzet, Johannes; Graaff, Reindert; Gans, Rijk O.; Zijlstra, Felix; Smit, Andries J.

    Aims: To investigate whether skin autofluorescence (AF), a non-invasive marker for advanced glycation end products (AGEs), is elevated in stable coronary artery disease (sCAD) and to investigate its relationship with serum levels of the soluble receptor for AGEs (sRAGE), neopterin and C-reactive

  10. The rationale and design of the PERindopril GENEtic association study (PERGENE): a pharmacogenetic analysis of angiotensin-converting enzyme inhibitor therapy in patients with stable coronary artery disease

    NARCIS (Netherlands)

    Brugts, J. J.; de Maat, M. P. M.; Boersma, E.; Witteman, J. C. M.; van Duijn, C.; Uitterlinden, A. G.; Bertrand, M.; Remme, W.; Fox, K.; Ferrari, R.; Danser, A. H. J.; Simoons, M. L.; Remme, W. J.; Aldershville, J.; Hildebrandt, P.; Bassand, J. P.; Cokkinos, D.; Toutouzas, P.; Eha, J.; Erhardt, L.; Erikssen, J.; Grybauskas, R.; Kalnins, U.; Karsch, K.; Sechtem, U.; Keltai, M.; Klein, W.; Luescher, T.; Mulcahy, D.; Nieminen, M.; Oto, A.; Ozsaruhan, O.; Paulus, W.; Providencia, L.; Riecansky, I.; Ruzyllo, W.; Santini, U.; Tavazzi, L.; Soler-Soler, J.; Widimsky, P.; Julian, D.; Dargie, H.; Kobler, W.; Duprez, D.; Steg, G.; Thygesen, K.; Drexel, H.; Gombotz, G.; Stoeckl, G.; Heyndrickx, G. H.; Legrand, V.; Materne, P.; van Mieghem, W.; Bocek, P.; Branny, M.; Cech, M.; Charouzek, J.; Drazka, J.; Fabik, L.; Florian, J.; Francek, L.; Groch, L.; Havranek, P.; Herman, A.; Hradec, J.; Jansky, P.; Jirmar, R.; Jokl, I.; Krejcova, H.; Kvasnak, M.; Maratka, T.; Marcinek, G.; Moravcova, J.; Nedbal, P.; Peterka, K.; Povolny, J.; Rosolova, H.; Semrad, B.; Sochor, K.; Spacek, R.; Spinar, J.; Stipal, R.; Stuchlik, K.; Sulda, M.; Ulman, J.; Vaclavicek, A.; Vojtisek, P.; Bjerregard Andersen, H.; Dorff, B.; Kristensen, K.; Madsen, J. K.; Markenvard, J.; Meibom, J.; Norgaard, A.; Scheibel, M.; Leht, A.; Teesalu, R.; Vahulaa, V.; Itkonen, A.; Juvonen, J.; Karmakoski, J.; Kilkki, E.; Koskela, E.; Kotila, M. J.; Melin, J.; Nieminen, M. S.; Savola, R.; Terho, T.; Voipio Pulkki, L. M.; Apffel, F.; Attali, P.; Baron, B.; Berthier, Y.; Dambrine, P.; Danchin, N.; Decoulx, E.; Deshayes, P.; Fouche, R.; Genest, M.; Godard, S.; Guillot, J. P.; Hanania, G.; Lelguen, C.; Leroy, F.; Mansourati, J.; Mery, D.; Michel, A. N.; Quiret, J. C.; Raynaud, P.; Rondepierre, D.; Roynard, J. L.; van Belle, E.; Veyrat, A.; Gaudron, P.; Karsch, K. R.; Lauer, B.; Rettig Stsrmer, G.; Riessen, R.; Rutsch, W.; Sigel, H. A.; Simon, R.; Stork, S.; von Schacky, C.; Winkelmann, B. R.; Christakos, S.; Feggos, S.; Geleris, P.; Georgiadis, S.; Gialafos, J.; Goudevenos, I.; Kardara, D.; Kardaras, F.; Karidis, C.; Kelesides, C.; Kyriakidis, M.; Koliopoulos, N.; Kremastinos, D.; Liberi, S.; Manolis, A. N.; Pyrgakis, V.; Papasteriadis, E.; Papazoglou, N.; Skoufas, P.; Stamatelopoulos, S.; Stambola, S.; Stavridis, A.; Syribeis, S.; Vardas, P.; Vassiliadis, I.; Voudris, V.; Zacharoulis, A.; Zobolos, S.; Zouras, C.; Berenyi, I.; Bocsa, Z.; Csendes, E.; Edes, I.; Gelesz, E.; Janosi, A.; Kalo, E.; Karpati, P.; Kornel, S.; Pap, I.; Pinter, I.; Polak, G.; Reiber, I.; Rusznak, M.; Simon, A.; Tarjan, J.; Tihanyi, L.; Timar, S.; Toth, K.; Veress, G.; Barton, J.; Crean, P.; Daly, K.; Kearney, P.; Meany, T. B.; Quigley, P.; Azzolini, P.; Barone, G.; Barsotti, A.; Bellone, E.; Borghetti, A.; Branzi, A.; Brunelli, C.; Capponi, E.; Capucci, A.; Casaccia, M.; Casali, G.; Cecchetti, E.; Ceci, V.; Celegon, L.; Chimini, C.; Colombo, A.; Corsini, G.; Cucchini, F.; Dalla Volta, S.; de Luca, I.; de Servi, S.; Delise, P.; Di Donato, M.; Di Giacomo, U.; Di Pasquale, G.; Fiorentini, C.; Gaddi, O.; Giannetto, M.; Giannuzzi, P.; Giordano, A.; Giovannini, E.; Iacono, A.; Inama, G.; Ippoliti, G.; Leghissa, R.; Lorusso, R.; Marzilli, M.; Minutiello, L.; Moretti, G.; Mosele, G. M.; Pasotti, C.; Pettinati, G.; Pezzano, A.; Polimeni, M. R.; Portaluppi, F.; Proto, C.; Riva, S.; Sanguinetti, M.; Santini, M.; Severi, S.; Sinagra, G.; Tantalo, L.; Vajola, S. F.; Vincenzi, M.; Volterrani, M.; Zavatteri, G.; Zogno, M.; Gailiss, E.; Gersamija, A.; Ozolina, M. A.; Skards, J.; Baubiniene, A.; Berukstis, E.; Grigoniene, L.; Grybauskas, A. N.; Kibarskis, A.; Kirkutis, A.; Marcinkus, R.; Milvidaite, I.; Vasiliauskas, D.; Aalders, J. C. A.; Bruggeling, W. A. J.; Bucx, J. J. J.; de Feyter, P. J.; de Leeuw, M. J.; de Waard, D. E. P.; de Weerd, G. J.; de Zwaan, C.; Dijkgraaf, R.; Droste, H. T.; Freericks, M. P.; Hagoort Kok, A. W.; Jap, W. T. J.; Jochemsen, G. M.; Kiemeney, K.; Kuijer, P. J. P.; Mannaerts, H. F. J.; Piek, J. J.; Saelman, J. P. M.; Slob, F. D.; Smits, W. C. G.; Spierenburg, H. A. M.; Suttorp, M. J.; Tan, T. B.; van Beek, G. J.; van Daele, M. E. R. M.; van den Merkhof, L. F. M.; van den Toren, E. W.; van Hessen, M. W. J.; van Langeveld, R. A. M.; van Loo, L. W. H.; van Nierop, P. R.; van Rey, F. J. W.; van Straalen, M. J.; Vos, J.; Werner, H. A.; Westendorp, J. J. C.; Zwiers, G.; Achremczyk, P.; Adamus, J.; Baska, J.; Bolinska Soltysiak, H.; Bubinski, R.; Ceremuzynski, L.; Cieslinski, A.; Dariusz, D.; Deptulski, T.; Drewla, P.; Drozdowski, P.; Dubiel, J. S.; Dudek, D.; Galewicz, M.; Ghlebus, K.; Halawa, B.; Jakubowska Majnigier, M.; Janion, M.; Jaworska, K.; Kaszewska, I.; Kleinrok, A.; Kornacewicz Jach, Z.; Krawczyk, W.; Krynicki, R.; Krzciuk, M.; Krzeminska Pakula, M.

    2009-01-01

    BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitors reduce clinical symptoms and improve outcome in patients with hypertension, heart failure, and stable coronary artery disease (CAD) and are among the most frequently used drugs in these patient groups. For hypertension, treatment is guided

  11. Effects of high-dose atorvastatin on cerebrovascular events in patients with stable coronary disease in the TNT (treating to new targets) study

    NARCIS (Netherlands)

    Waters, David D.; LaRosa, John C.; Barter, Philip; Fruchart, Jean-Charles; Gotto, Antonio M.; Carter, Roddy; Breazna, Andrei; Kastelein, John J. P.; Grundy, Scott M.

    2006-01-01

    OBJECTIVE: We sought to assess the effects on cerebrovascular events of treating patients with stable coronary disease with low-density lipoprotein cholesterol (LDL-C) levels substantially below 100 mg/dl. BACKGROUND: Lowering LDL-C with statins has been shown to reduce the risk of stroke in

  12. Confluence of depression and acute psychological stress among patients with stable coronary heart disease: effects on myocardial perfusion.

    Science.gov (United States)

    Burg, Matthew M; Meadows, Judith; Shimbo, Daichi; Davidson, Karina W; Schwartz, Joseph E; Soufer, Robert

    2014-10-30

    Depression is prevalent in coronary heart disease (CHD) patients and increases risk for acute coronary syndrome (ACS) recurrence and mortality despite optimal medical care. The pathways underlying this risk remain elusive. Psychological stress (PS) can provoke impairment in myocardial perfusion and trigger ACS. A confluence of acute PS with depression might reveal coronary vascular mechanisms of risk. We tested whether depression increased risk for impaired myocardial perfusion during acute PS among patients with stable CHD. Patients (N=146) completed the Beck Depression Inventory-I (BDI-I), a measure of depression linked to recurrent ACS and post-ACS mortality, and underwent single-photon emission computed tomography myocardial perfusion imaging at rest and during acute PS. The likelihood of new/worsening impairment in myocardial perfusion from baseline to PS as a function of depression severity was tested. On the BDI-I, 41 patients scored in the normal range, 48 in the high normal range, and 57 in the depressed range previously linked to CHD prognosis. A BDI-I score in the depressed range was associated with a significantly greater likelihood of new/worsening impairment in myocardial perfusion from baseline to PS (odds ratio =2.89, 95% CI: 1.26 to 6.63, P=0.012). This remained significant in models controlling ACS recurrence/mortality risk factors and medications. There was no effect for selective serotonin reuptake inhibitor medications. Depressed patients with CHD are particularly susceptible to impairment in myocardial perfusion during PS. The confluence of PS with depression may contribute to a better understanding of the depression-associated risk for ACS recurrence and mortality. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  13. Range and distribution of NT-proBNP values in stable corrected congenital heart disease of various types.

    Science.gov (United States)

    Popelová, Jana; Kotaška, Karel; Černý, Stěpán; Prokopová, Milena; Rubáček, Miroslav

    2012-01-01

    Elevated levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) are an expected finding in many adults with congenital heart disease (ACHD) but no reports have described the range of values within different diagnostic groups. Between the years 2003 and 2011 we measured NT-proBNP in consecutive ACHD patients attending the outpatient department. Further NT-proBNP analysis was performed on 705 blood samples from 394 stable patients with the defect corrected. The results were compared among different diagnostic groups and with a control group of healthy volunteers. The median value of NT-proBNP in the whole cohort was signifinatly higher than in the control group (211 vs 42 pg/mL; P value of NT-proBNP in pg/mL and the percentage of normal NT-proBNP values in the listed diagnostic groups were as follows: coarctation of the aorta (COA), 97 (64%); pulmonary stenosis (PS),160 (48%); secundum atrial septal defect (ASD), 254 (44%); incomplete atrioventricular septal defect (AVSD), 211 (32%); ventricular septal defect (VSD), 154 (58%); tetralogy of Fallot (TOF), 177 (38%); transposition of the great arteries (TGA) after Mustard, 237 (20%) or Senning correction, 143 (39%); Ebstein anomaly 287, (26%); pulmonary atresia (PA), 327 (18%); and complex defects after Fontan procedure, 184 (31%). Normal levels of NT-proBNP were found most often in patients after the correction of coarctation of the aorta and ventricular septal defect with the highest levels found in pulmonary atresia and Ebstein anomaly. Our results may serve as reference values for different ACHD groups. Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  14. Impact of anaemia on lung function and exercise capacity in patients with stable severe chronic obstructive pulmonary disease.

    Science.gov (United States)

    Guo, Jian; Zheng, Cong; Xiao, Qiang; Gong, Sugang; Zhao, Qinhua; Wang, Lan; He, Jing; Yang, Wenlan; Shi, Xue; Sun, Xingguo; Liu, Jinming

    2015-10-08

    This study intended to search for potential correlations between anaemia in patients with severe chronic obstructive pulmonary disease (COPD; GOLD stage III) and pulmonary function at rest, exercise capacity as well as ventilatory efficiency, using pulmonary function test (PFT) and cardiopulmonary exercise testing (CPET). The study was undertaken at Shanghai Pulmonary Hospital, a tertiary-level centre affiliated to Tongji University. It caters to a large population base within Shanghai and referrals from centres in other cities as well. 157 Chinese patients with stable severe COPD were divided into 2 groups: the anaemia group (haemoglobin (Hb) patients. (1) Diffusing capacity for carbon monoxide (DLCO) corrected by Hb was significantly lower in the anaemia group ((15.3±1.9) mL/min/mm Hg) than in the non-anaemia group ((17.1±2.1) mL/min/mm Hg) (p0.05). (2) Peak Load, Peak oxygen uptake (VO2), Peak VO2%pred, Peak VO2/kg, Peak O2 pulse and the ratio of VO2 increase to WR increase (ΔVO2/ΔWR) were significantly lower in the anaemia group (p0.05). (3) A strong positive correlation was found between Hb concentration and Peak VO2 in patients with anaemia (r=0.702, pexercise tolerance during exercise in patients with severe COPD. The decrease in amplitude of Hb levels is related to the quantity of oxygen uptake. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Relation of Leukocytes and Its Subsets Counts with the Severity of Stable Coronary Artery Disease in Patients with Diabetic Mellitus

    Science.gov (United States)

    Luo, Song-Hui; Guo, Yuan-Lin; Liu, Jun; Zhu, Cheng-Gang; Qing, Ping; Xu, Rui-Xia; Wu, Na-Qiong; Jiang, Li-Xin; Li, Jian-Jun

    2014-01-01

    Background Both coronary artery disease (CAD) and diabetes mellitus (DM) are associated with inflammation. However, whether and which leukocytes can predict the presence and extent of CAD in patients with DM has not been investigated. The aim of the present study was to examine the association of leukocyte and its subsets counts with the severity of CAD in patients with DM. Methods and Findings Three hundred and seventy-three diabetic patients who were scheduled for coronary angiography due to typical stable angina pectoris were enrolled in this study. They were classified into the three groups according to tertiles of Gensini score (GS, low group 28, n = 121). The relationship between the leukocyte and its subsets counts with the severity of CAD were evaluated. The data indicated that there were significant correlations between leukocyte and neutrophil counts with GS (r = 0.154 and 0.156, respectively, all Pleukocyte and neutrophil counts were 0.61 and 0.60 respectively (95%CI: 0.55–0.67, all P = 0.001) for predicting high GS. Multivariate logistic regression analysis demonstrated that leukocyte count was an independent predictor for high GS patients with DM (OR = 1.20, 95%CI 1.03–1.39, P = 0.023) after adjusting for conventional risk factors of CAD. Conclusions Compared with its subsets, leukocyte count appeared to be an independent predictor for the severity of CAD and the optimal cut-off value for predicting high GS (>28 points) was 5.0×109 cells/L in diabetic patients. PMID:24599246

  16. Impact of double filtration plasmapheresis on adhesion molecules levels in patients with stable coronary heart disease after coronary stenting.

    Science.gov (United States)

    Tishko, Valerii V; Sokolov, Alexey A; Belskih, Andrei N; Ivanov, Andrei M; Meshkova, Marina E; Skorinova, Tatyana S

    2017-11-01

    Endothelial dysfunction and inflammatory reaction at the site of damage plays a key role in the formation of neointimal hyperplasia, and in the progression of atherosclerosis. The initiating role in these processes is assigned to adhesion molecules. We studied the dynamics of the level of adhesion molecules soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular adhesion molecule-1 (sVCAM-1), soluble form of the molecule platelet adhesion and endothelial type-1 (sPECAM-1), sL-, sP-, sE-selectins during double filtration plasmapheresis (DFPP) with use of plasma fractionators (PF) Cascadeflo EC-50W and EC-40W (Asahi Kasei Medical Co., Japan) in patients with stable coronary heart disease and hyperlipidemia-(a) in the early post-implantation period after coronary stenting. DFPP reduces the level of plasma adhesion molecules. When using PF Cascadeflo EC-40W, a more pronounced decrease occurs. The rejection coefficient (RC) of adhesion molecules has been identified for these PF. These RCs reflect the immediate removal efficiency of adhesion molecules in the perfusion of plasma through PF. The removal effectiveness of adhesion molecules when using PF Cascadeflo EC-40W is higher than when using the PF Cascadeflo EC-50W (sICAM-1 - 2.5 times, sVCAM-1 - 2.2 times, sPECAM-1.6 times, sL-selectin - 5 times, sP-selectin - 2.8 times, sE - selectin - 3 times). Reducing adhesion molecule levels when using DFPP may play an important role in correcting of endothelial dysfunction in response to damage to the arterial wall in percutaneous coronary intervention (PCI) during the early post-implantation period after coronary stenting. DFPP is a promising approach to prevent in-stent restenosis (ISR). Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Application of stable isotopic techniques in the prevention of degenerative diseases like obesity and NIDDM in developing societies

    International Nuclear Information System (INIS)

    Shetty, P.; Iyengar, V.; Sawaya, A.

    2002-01-01

    Economic development in developing societies characterized by industrialization, urbanization and globalization has seen the emergence of an epidemic of diet and life-style related chronic degenerative diseases. A research project has been initiated under the aegis of the International Atomic Energy Agency (IAEA), Vienna, Austria, under its Co-ordinated Research Programme (CRP) to promote the use of stable isotopic techniques to document the extent of the problem and to understand the determinants of this epidemic. The principal objectives of this CRP involving countries both in the North and the South are to define the magnitude of the problem of obesity and non-insulin Dependent diabetes mellitus (NIDDM) in developing countries, to identify the vulnerable groups at increased risk and to attempt to describe the metabolic and physiological mechanisms underlying this phenomenon. These comparative international studies of obesity and NIDDM are looking at the effects of childhood malnutrition (Brazil and socio-economic differentials (Mexico) on adult risk factors; the composition of the daily diet on obesity (Chile); levels of patterns of physical activity of older adults (China) as well as their influence on weight gain and obesity (Cuba, Nigeria); the impact of body composition and energy expenditure on the evolution frank diabetes from impaired glucose tolerance (Jamaica), and of body compositional changes and the role of inflammatory cytokines on impaired glucose tolerance (India). The last study conducted in New Zealand was aimed at comparing the energy expenditures of Maori (Pacific Island) with New Zealanders of European descent. The findings of the CRP of the MEA in this area carried out in several countries are presented in this article. (author)

  18. SD-PAMs: What, Where, When and How?

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    This paper examines what ''sustainable development policies and measures'' (SD-PAMs) could be, and how they could be implemented and could fit into a post-2012 climate regime. This paper assumes that the option to implement SD-PAMs instead of quantified GHG emission commitments post-2012 is an option that would be likely to be only open to non-Annex I countries. There are several key, but unanswered, questions related to SD-PAMs. These include policy-related issues such as which countries could take on commitments to implement SD-PAMs (rather than quantified emission commitments)? Why would particular countries decide to take on such commitments? They also include questions related to how SD-PAMs could be implemented. For many other options for possible post-2012 GHG mitigation actions, including by non-Annex I countries, have also been proposed. However, this paper focuses solely on SD-PAMs.

  19. Clarithromycin for stable coronary heart disease increases all-cause and cardiovascular mortality and cerebrovascular morbidity over 10years in the CLARICOR randomised, blinded clinical trial

    DEFF Research Database (Denmark)

    Winkel, Per; Hilden, Jørgen; Hansen, Jørgen Fischer

    2015-01-01

    -cause mortality (hazard ratio (HR): 1.10, 95% confidence interval (CI): 1.00-1.21) and cerebrovascular disease during 10years (HR: 1.19, 95% CI: 1.02-1.38). The increased mortality and morbidity were restricted to patients not on statin at entry (HR: 1.16, 95% CI: 1.04-1.31, and HR: 1.25, 95% CI: 1...... death outside hospital and cerebrovascular morbidity in patients with stable coronary heart disease who were not on statin. The increased cardiovascular mortality was years later compensated, likely through frailty attrition.......BACKGROUND: The CLARICOR trial reported that clarithromycin compared with placebo increased all-cause mortality in patients with stable coronary heart disease. This study investigates the effects of clarithromycin versus placebo during 10years follow up. METHODS: The CLARICOR trial is a randomised...

  20. Pregnancy associated plasma protein-A as a marker for myocardial infarction and death in patients with stable coronary artery disease: A prognostic study within the CLARICOR Trial

    DEFF Research Database (Denmark)

    Iversen, Kasper K; Teisner, Børge; Winkel, Per

    2011-01-01

    OBJECTIVE: Pregnancy associated plasma protein-A (PAPP-A) is a potential new marker for vulnerable plaques in the coronary arteries only examined in stable coronary disease (CAD) in patients undergoing coronary angiography. Here we address the prognostic value of serum PAPP-A in unselected stable...... outcomes were all-cause mortality and myocardial infarction. RESULTS: Patients (n=4243) were followed for a median of 2.8 years. In a Cox analysis, elevated PAPP-A was significantly related to the composite outcome of myocardial infarction and death (HR 1.99, 95% CI 1.62-2.45, p...

  1. The clinical profile of women with stable ischaemic heart disease in Spain. More effort is needed in secondary prevention. SIRENA study.

    Science.gov (United States)

    Gámez, J M; Ripoll, T; Barrios, V; Anguita, M; Pedreira, M; Madariaga, I

    2016-01-01

    Cardiovascular diseases are the leading cause of death for women, especially ischaemic heart disease, which is still considered a man's disease. In Spain, there are various registries on ischaemic heart disease, although none are exclusively for women. The objectives of the SIRENA study were to describe the clinical profile of women with ischaemic heart disease treated in cardiology consultations, to estimate its prevalence of cardiovascular risk factors and understand its clinical management. A multicentre observational study was conducted with a sample of 631 women with stable ischaemic heart disease, consecutively included during cardiology consultations. Forty-one researchers from all over Spain participated in the study. The mean age was 68.5 years. The clinical presentation was in the form of acute coronary syndrome in up to 67.2% of the patients. The prevalence of cardiovascular risk factors was high (77.7% of the patients had hypertension, 40.7% had diabetes and 68% had dyslipidaemia), with 30.7% having uncontrolled hypertension, 78.4% having LDL-cholesterol levels higher than 70mg/dL and 49.2% having HbA1c levels greater than 7%. The considerable majority of the patients underwent optimal medical treatment with antiplatelet agents, beta-blockers, renin-angiotensin-aldosterone system blockers and hypolipidaemic agents. Coronary angiography was performed for 88.3% of the patients, and 63.4% underwent percutaneous coronary intervention. Women with stable ischaemic heart disease in Spain initially present some form of acute coronary syndrome and a high prevalence of inadequately controlled cardiovascular risk factors, despite undergoing optimal medical therapy. A high percentage of these women undergo coronary revascularisation. Increased efforts are required for secondary prevention in women with stable ischaemic heart disease. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  2. Stable isotopes

    International Nuclear Information System (INIS)

    Evans, D.K.

    1986-01-01

    Seventy-five percent of the world's stable isotope supply comes from one producer, Oak Ridge Nuclear Laboratory (ORNL) in the US. Canadian concern is that foreign needs will be met only after domestic needs, thus creating a shortage of stable isotopes in Canada. This article describes the present situation in Canada (availability and cost) of stable isotopes, the isotope enrichment techniques, and related research programs at Chalk River Nuclear Laboratories (CRNL)

  3. Bridging sd1 molecular knowledge with recent breeding strategies ...

    African Journals Online (AJOL)

    The rice semidwarfing gene, sd1, also known as the “green revolution gene”, has been studied intensively due to its contribution to the increase of crop production. Although sd1 breeding was extensively applied since the 1960s, the recent advances in the molecular basis of this gene allowed designing a more precise ...

  4. Follow-Up Consultation Through a Healthcare Kiosk for Patients with Stable Chronic Disease in a Primary Care Setting: A Prospective Study.

    Science.gov (United States)

    Bahadin, Juliana; Shum, Eugene; Ng, Grace; Tan, Nicolette; Sellayah, Pushpavalli; Tan, Sze Wee

    2017-05-01

    The global healthcare kiosk market is growing, and kiosks are projected to be a larger part of healthcare delivery in the coming decades. We developed an unmanned healthcare kiosk that automates the management of stable patients with chronic conditions to complement face-to-face primary care physician (PCP) visits. The aim of our study was to show that the kiosk could be a feasible means of delivering care for stable patients with chronic conditions and could generate cost savings for the management of patients with stable chronic disease. We conducted a prospective single-arm study of 95 participants with well-controlled chronic cardiovascular diseases who visited our clinic in Singapore every 3 months for review and medication refill. During their subsequent appointments for chronic disease management at 3 and 6 months, participants used the kiosk instead of consulting a physician. All participants who used the kiosk were also evaluated by a nurse clinician (NC). The kiosk assessment of whether the patient was well controlled was then compared to the NC's assessment to determine rates of agreement. Patient satisfaction was evaluated through a questionnaire, and any adverse outcomes were documented. Cohen's κ for agreement between the kiosk and the NC assessment of patients' chronic care control was 0.575 (95% CI, 0.437-0.713). The modest agreement was due to differences in systolic blood pressure measurements between the kiosk and the NC. The 96% of participants who completed two kiosk visits were all satisfied with the kiosk as a care delivery alternative. None of the participants managed through the kiosk suffered any adverse outcomes. Use of the kiosk resulted in a reduction of 128 face-to-face PCP visits. Healthcare kiosks can potentially be used to complement primary care clinician visits for managing patients with stable chronic diseases and can generate cost savings.

  5. The antiplatelet effect of clopidogrel is not attenuated by statin treatment in stable patients with ischemic heart disease

    DEFF Research Database (Denmark)

    Vinholt, Pernille Just; Poulsen, Tina Svenstrup; Korsholm, Lars

    2005-01-01

    Recent studies suggest that cytochrome P450 (CYP) 3A4 metabolized statins attenuate the antiaggregatory effect of clopidogrel. We evaluated how CYP3A4 metabolized statins and non-CYP3A4 metabolized statins influence platelet aggregation when given concomitantly with clopidogrel. Sixty-six stable ...

  6. Bypass surgery versus stenting for the treatment of multivessel disease in patients with unstable angina compared with stable angina

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P. van den Heuvel; F. Unger (Felix); R. Beyar; W.K. Lindeboom (Wietze); V. de Valk (Vincent); S. Milo; R. Simon (Rudiger); G.F.O. Tyers (Frank); D. Regensburger; P.A. Crean (Peter); I.M. Penn (Ian); E. McGovern; C. van Cauwelaert; P.W.J.C. Serruys (Patrick)

    2002-01-01

    textabstractBACKGROUND: Earlier reports have shown that the outcome of balloon angioplasty or bypass surgery in unstable angina is less favorable than in stable angina. Recent improvements in percutaneous treatment (stent implantation) and bypass surgery (arterial grafts) warrant reevaluation of the

  7. Clarithromycin for 2 Weeks for Stable Coronary Heart Disease: 6-Year Follow-Up of the CLARICOR Randomized Trial and Updated Meta-Analysis of Antibiotics for Coronary Heart Disease

    DEFF Research Database (Denmark)

    Gluud, Christian; Als-Nielsen, Bodil; Damgaard, Morten

    2008-01-01

    Objectives: We have reported increased 2.6-year mortality in clarithromycin- versus placebo-exposed stable coronary heart disease patients, but meta-analysis of randomized trials in coronary heart disease patients showed no significant effect of antibiotics on mortality. Here we report the 6-year......,372 patients with stable coronary heart disease to clarithromycin 500 mg (n = 2,172) or placebo (n = 2,200) once daily for 2 weeks. Mortality was followed through public register. Nine hundred and twenty-three patients (21.1%) died. Six-year mortality was significantly higher in the clarithromycin group...... disease versus placebo/no intervention (17 trials, 25,271 patients, 1,877 deaths) showed a significantly increased relative risk of death from antibiotics of 1.10 (1.01-1.20) without heterogeneity. Conclusions: Our results stress the necessity to consider carefully the strength of the indication before...

  8. 77 FR 4617 - Environmental Impact Statement: Pennington County, SD

    Science.gov (United States)

    2012-01-30

    ... DEPARTMENT OF TRANSPORTATION Federal Highway Administration Environmental Impact Statement: Pennington County, SD AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice of Intent. SUMMARY: The FHWA is issuing this notice to advise the public that an Environmental Impact Statement will be...

  9. Biota - 2011 Vegetation Inventory - Mud Lake, MN/SD

    Data.gov (United States)

    Army Corps of Engineers, Department of the Army, Department of Defense — 2011 Vegetation Classification for Mud Lake, MN/SD Vegetation Project Report, OMBIL Environmental Stewardship - Level 1 Inventory. Mud Lake, located on the Minnesota...

  10. UTVÄRDERING AV UTVALDA SD-WAN PRODUKTER

    OpenAIRE

    Åkerblom, Jacob

    2016-01-01

    Denna jämförelsestudie ämnar att undersöka marknadens leverantörer av nätverksutrustning de- finierade som Software Defined Wide Area Networks(SD-WAN). SD-WAN är en innovativ teknik som applicerar virtualisering och Software defined networking koncept i Wide Area Networks (WAN) för att skapa kostnadseffektiva nätverk. Studien har utförts på företaget Curitiba som idag arbetar med konsulttjänster inom utvalda WAN-optimering och SD-WAN-produkter. Arbetets syfte är att utvärdera SD-WAN-lösningar...

  11. Adiponectin as a biomarker of systemic inflammatory response in smoker patients with stable and exacerbation phases of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Kirdar, Sevin; Serter, Mukadder; Ceylan, Emel; Sener, Asli Gamze; Kavak, Tülay; Karadağ, Fisun

    2009-01-01

    Adiponectin is an adipose tissue-derived specific protein that has a role in energy homeostasis, that has a protective role against the development of insulin resistance and atherosclerosis and that exhibits anti-inflammatory properties. We investigated serum adiponectin as a biomarker of systemic inflammatory response and its relation with leptin, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and nitric oxide (NO) in chronic obstructive pulmonary disease (COPD) patients. We studied 36 male patients with COPD (15 stable and 21 exacerbated) and 17 age and sex-matched healthy subjects. The adiponectin and leptin levels were measured by enzyme-linked immunosorbent assay. Serum CRP levels were measured using the nephelometric method. ESR was determined using the Westergren method and NO by the cadmium reduction method. Adiponectin levels in COPD patients were significantly higher than those in control subjects (pleptin or NO levels. Serum levels of CRP, ESR and adiponectin were significantly higher in the exacerbated COPD patients compared to the stable group (pleptin and NO levels were not significant. Serum levels of adiponectin were not correlated with FEV(1), FEV(1)/FVC, dyspnoea score, BMI or other inflammatory parameters in the stable COPD group. CRP and ESR correlated negatively with FEV(1) in the stable COPD group. Adiponectin may be a marker of low-grade systemic inflammatory response in COPD. A further rise in serum adiponectin in the exacerbation period denotes that this may also be a biomarker of the exacerbation phase as well as CRP and ESR.

  12. Expert Statement on the Single-Agent Use of Inhaled Bronchodilator in the Treatment of Stable Mild-Moderate Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Riesco Miranda, Juan Antonio; Alcázar, Bernardino; Alfageme, Inmaculada; Casanova, Ciro; Celli, Bartolomé; de-Torres, Juan P; Jiménez Ruiz, Carlos A

    2017-10-01

    To describe the evidence- and experience-based expert consensus on the use of single-agent bronchodilators in patients with stable mild-moderate chronic obstructive pulmonary disease (COPD). Using Delphi methodology, a panel of 7 respiratory medicine experts was established, who, in the first nominal group meeting defined the scope, users, and document sections. The panel drew up 14 questions on the use of single-agent bronchodilators in patients with mild-moderate stable COPD to be answered with a systematic review of the literature. The results of the review were discussed in a second nominal group meeting and 17 statements were generated. Agreement/disagreement with the statements was tested among16 different experts including respiratory medicine experts and primary care physicians. Statements were scored from1 (total disagreement) to10 (total agreement). Agreement was considered if at least 70% voted ≥7. The level of evidence and grade of recommendation of the systematic literature review was assessed using the Oxford Centre for Evidence-based Medicine levels. A total of 12 of the 17 statements were selected. Specific statements were generated on different profiles of patients with stable mild-moderate COPD in whom single-agent bronchodilators could be prescribed. These statements on the use of single-agent bronchodilators might improve the outcomes and prognosis of patients with stable mild-moderate COPD. Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Sierra/SD User's Notes.

    Energy Technology Data Exchange (ETDEWEB)

    Munday, Lynn Brendon; Day, David M.; Bunting, Gregory; Miller, Scott T; Crane, Nathan K

    2018-03-01

    Sierra/SD provides a massively parallel implementation of structural dynamics finite element analysis, required for high fidelity, validated models used in modal, vibration, static and shock analysis of weapons systems. This document provides a users guide to the input for Sierra/SD. Details of input specifications for the different solution types, output options, element types and parameters are included. The appendices contain detailed examples, and instructions for running the software on parallel platforms.

  14. Photometric Survey to Search for Field sdO Pulsators

    Science.gov (United States)

    Johnson, C.; Green, E.; Wallace, S.; O'Malley, C.; Amaya, H.; Biddle, L.; Fontaine, G.

    2014-04-01

    We present the results of a campaign to search for subdwarf O (sdO) star pulsators among bright field stars. The motivation for this project is the recent discovery by Randall et al. (2011) of four rapidly pulsating sdO stars in the globular cluster ω Cen, with Teff near 50,000 K, 5.4 -0.1 and similar temperatures and gravities. To date, we have found no detectable pulsations at amplitudes above 0.08% (4 times the mean noise level) in any of the 36 field sdO stars that we observed. The presence of pulsations in ω Cen sdO stars and their apparent absence in seemingly comparable field sdO stars is perplexing. While very suggestive, the significance of this result is difficult to assess more completely right now due to remaining uncertainties about the temperature width and purity of the ω Cen instability strip and the existence of any sdO pulsators with weaker amplitudes than the current detection limit in globular clusters.

  15. Characterization of stable RNAs from the resected intestinal tissues of individuals with either Crohn’s disease or ulcerative colitis

    Science.gov (United States)

    Roy, Guylaine; Mercure, Stéphane; Beuvon, Frédéric; Perreault, Jean-Pierre

    2010-01-01

    Circular RNAs reminiscent of viroids and the human hepatitis delta virus have been proposed as possible nonconventional pathogens responsible for Crohn’s disease and ulcerative colitis, two inflammatory bowel diseases. Consequently, RNA was extracted from various areas of intestinal tissues from individuals with either Crohn’s disease or ulcerative colitis as well as several appropriate control diseases, and analyzed by two-dimensional gel electrophoresis. No circular viroid-like RNAs (28S ribosomal RNA cleavage product characterized previously; a 5.8S ribosomal RNA conformer; and a fragment homologous to transcripts from DNA CpG islands. The two last RNAs were detected prior to visible morphological tissue alterations, suggesting that they are produced early during the inflammation and that they have value as molecular diagnostic tools for the inflammatory bowel diseases. The potential cellular mechanisms producing these RNAs and their involvement in inflammatory bowel disease are discussed. PMID:9599669

  16. Multifactor dimensionality reduction analysis of the correlation of Chinese medicine syndrome evolvement and cardiovascular events in patients with stable coronary heart disease.

    Science.gov (United States)

    Jiao, Yang; Li, Si-wei; Shang, Qing-hua; Fu, Chang-geng; Gao, Zhu-ye; Xu, Hao; Shi, Da-zhuo; Chen, Ke-ji

    2014-05-01

    To analyze the correlation of Chinese medicine syndrome evolvement and cardiovascular: events in patients with stable coronary heart disease (CHD). This prospective cohort study investigated and: collected the clinical information of patients with stable CHD and observed the syndrome type at the baseline and 6-month at follow-up, as well as the cardiovascular events during the 6-month and 12-month follow-up. The patients were divided into the event group and the non-event group. The interaction and the impact of syndrome evolvement on cardiovascular events were examined through multifactor dimensionality reduction (MDR) analysis and the results were verified by Chi-square test. Totally 1,333 of 1,503 stable CHD patients enrolled met the inclusion criteria: of MDR analysis. Among them, 959 (71.9%) cases were males and 374 (28.1%) cases were females. Thirty seven cases had cardiovascular events during 6 to 12 months after the study began. The results of the MDR analysis and verification using Chi-square test showed that the development of cardiovascular events was positively correlated with interaction between blood stasis and toxic syndrome at the baseline, blood stasis at the baseline and qi deficiency at the 6-month follow-up, toxic syndrome at the baseline and qi deficiency at the 6-month follow-up, toxic syndrome at the base line and blood stasis at the 6-month follow-up, qi deficiency and blood stasis at the 6-month follow-up (P<0.05 for all). Blood stasis, toxic syndrome and qi deficiency are important factors of stable CHD. There: are positive correlation between cardiovascular events and syndrome evolution from blood stasis to qi deficiency, from toxic syndrome to qi deficiency and from toxic syndrome to blood stasis, indicating the pathogenesis of toxin consuming qi, toxin leading to blood-stasis in stable CHD patients prone to recurrent cardiovascular events.

  17. RECORD OF THE BINARY DATA ON SD CARD ARDUINO DUE

    Directory of Open Access Journals (Sweden)

    V. G. Mikhailov

    2016-01-01

    Full Text Available The short review of microcontrollers of family Arduino, their characteristics and application fields is given. Importance of record of parameters of researched object is marked to produce debugging of control systems on microcontrollers Arduino. Unique possibility of registration of parameters in family Arduino is record on SD a card in an alpha mode with usage of functions print (, write (. The problems connected to record of the binary data on SD a card on microcontroller Arduino Due are considered. The analysis of methods of record of the binary data on SD card Arduino Due, originating problems with neo-cleaning of memory from the previous program leading to possibility of duplication of the data on SD to a card, presence of the erratic point of view about restriction of volumes of data record and necessity of usage become outdated SD cards is carried out. Ways of elimination of the marked lacks are considered. The estimation of high-speed performance of various approaches of a data recording on SD a card is led. On the basis of the led researches the approach of multiplexing of the writeable information at the expense of conversion of the binary data is offered is byte-serial in a character array in code ASCI without magnification of their volume and record by units on 240 byte. It allows to use as much as possible standard function possibilities write ( Arduino and specificity of the organization of memory SD of cards and to increase high-speed performance more than in 1100 times in comparison with record in a character type on one byte.It is marked that usage of decisions of an exception of duplication of the data offered at forums does not provide completeness of their elimination. For Arduino Due for storage cleaning it is necessary usages of the special programmator or setting of the new program of loading.

  18. [Influence of the Potassium Channels Activator Nicorandil to the Quality of Life in Patients With Ishemic Heart Disease and Stable Angina Pectoris].

    Science.gov (United States)

    Sizova, Zh M; Zakharova, V L; Kozlova, N V; Kuchkina, T S

    2016-06-01

    The aim of the study to assess the influence of medicamentous therapy to the quality of life of ischemic heart disease patients with stable angina pectoris by activator potassium channels nicorandil in comparison with traditional therapy by isosorbide dinitrate. The study included 84 ischemic heart disease patients. Authors consider quality of life as an estimated category of state of the subject in an illness situation. The dynamic of physical and psychological components of quality of life are compared in ischemic heart disease patients under the treatment by nicorandil and isosorbide dinitrate. Indicators of quality of life, defined on the basis of a questionnaires of SAQ and GHQ supplementing an illness picture, are an multiple-factor criterion of an assessment of a condition of this category of patients. The benefits of nicorandil in influence on quality of life indicators were revealed in the study.

  19. Serum levels of C-reactive protein in patients with stable coronary artery disease: JUPITER in perspective.

    Science.gov (United States)

    Saely, Christoph H; Rein, Philipp; Vonbank, Alexander; Drexel, Heinz

    2010-10-29

    The JUPITER trial has recently demonstrated an outstanding reduction of cardiovascular events by 20 mg rosuvastatin/day in subjects with high CRP who were apparently healthy at baseline. However, absence of atherosclerosis in JUPITER was based on the subjects' history and not proven objectively. To put the results of JUPITER in perspective, we evaluated serum CRP in a consecutive series of 703 statin-naïve Caucasian patients with angiographically proven stable CAD. From these stable CAD patients, only 69.2% met the ≥2.0 mg/l serum CRP inclusion criterion of the JUPITER trial. Median CRP [interquartile range] in our CAD patients was 3.3 [1.6-6.6] mg/l, which was significantly (pJUPITER (4.2 mg/l). Our results point to considerable subclinical atherosclerosis in the patients studied in JUPITER. The impressive results of that trial may not be generalizable to healthy populations all over the world. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  20. Treatment with triple combination of atorvastatin, perindopril, and amlodipine in patients with stable coronary artery disease: A subgroup analysis from the PAPA-CAD study.

    Science.gov (United States)

    Dézsi, Csaba András

    2018-01-01

    Background In patients with stable coronary artery disease, aspirin, a statin, and an angiotensin-converting enzyme inhibitor are recommended as first-line agents for secondary prevention. Subgroup analyses of the previously published Hungarian Perindopril plus Amlodipine in PAtients with Coronary Artery Disease (PAPA-CAD) non-interventional trial demonstrated that the addition of the metabolically beneficial, fixed combination of perindopril + amlodipine to atorvastatin further improves the patient's lipid profile. Methods The PAPA-CAD study, a 6-month open-label, prospective, multicenter, observational/non-interventional survey evaluated data accumulated from patients with hypertensive patients with stable coronary artery disease. The herein-reported subgroup analysis was conducted using the findings from those 1130 patients, who were taking atorvastatin in addition to the fixed combination of perindopril + amlodipine at the time of all four study visits (i.e., at baseline and 1, 3, and 6 months later). Results In the subgroup of patients taking atorvastatin as an add-on agent, 82.5% reached the target blood pressure of 140/90 mmHg compared with 78.8% of those not taking a statin. The addition of atorvastatin to the fixed combination of perindopril + amlodipine resulted in further significant improvements of key metabolic parameters. Conclusion This subgroup analysis confirmed that favorable synergism exists among perindopril, amlodipine, and atorvastatin.

  1. Periodontal status affects C-reactive protein and lipids in patients with stable heart disease from a tertiary care cardiovascular clinic.

    Science.gov (United States)

    Flores, Manuela F; Montenegro, Marlon M; Furtado, Mariana V; Polanczyk, Carisi A; Rösing, Cassiano K; Haas, Alex N

    2014-04-01

    There are scarce data on the impact of the periodontal condition in the control of biomarkers in patients with cardiovascular disease (CVD). The aim of this study is to assess whether periodontal inflammation and tissue breakdown are associated with C-reactive protein (CRP) and lipids in patients with stable heart disease. This cross-sectional study included 93 patients with stable coronary artery disease (57 males; mean age: 63.5 ± 9.8 years) who were in outpatient care for at least 6 months. After applying a structured questionnaire, periodontal examinations were performed by two calibrated periodontists in six sites per tooth at all teeth. Blood samples were collected from patients on the day of periodontal examination to determine levels of CRP, lipids, and glycated hemoglobin. Multiple linear regression models were fitted to evaluate the association among different periodontal and blood parameters controlling for sex, body mass index, glycated hemoglobin, use of oral hypoglycemic drugs, and smoking. Overall, the sample presented high levels of periodontal inflammation and tissue breakdown. Unadjusted mean concentrations of triglycerides (TGs), very-low-density lipoprotein cholesterol, and glucose were significantly higher in individuals with severe periodontitis. When multiple linear regression models were applied, number of teeth with clinical attachment loss ≥6 mm and presence of severe periodontitis were significantly associated with higher CRP concentrations. Bleeding on probing was significantly associated with TGs, total cholesterol, and non-high-density lipoprotein cholesterol. In this sample of patients with stable CVD, current periodontal inflammation and tissue breakdown are associated with cardiovascular inflammatory markers, such as CRP and lipid profile.

  2. [Effects of aerobic exercise combined with resistance training on the cardiorespiratory fitness and exercise capacity of patients with stable coronary artery disease].

    Science.gov (United States)

    Liu, S X; Chen, Y Y; Xie, K L; Zhang, W L

    2017-12-24

    Objective: To observe the effects of aerobic exercise combined with resistance training on the cardiorespiratory fitness and exercise capacity of patients with stable coronary artery disease (CAD) . Methods: From June 2014 to December 2015, 73 patients with stable CAD in our department were recruited and randomly assigned to two groups: the control group ( n= 38) and the exercise group ( n= 35) . Patients in both groups received conventional medical treatment for CAD and related cardiac health education. While for patients in exercise group, a twelve-week aerobic exercise combined with resistance training program were applied on top of conventional treatment and health education. Cardiorespiratory fitness and exercise capacity were evaluated by cardiopulmonary exercise testing. Results: (1) The exercise capacity was significantly increased in the exercise group after 12 weeks training as compared to baseline level: peak oxygen uptake per kilogram ( (26.25±5.14) ml·kg(-1)·min(-1) vs. (20.88±4.59) ml·kg(-1)·min(-1)) , anaerobic threshold ( (15.24±2.75) ml·kg(-1)·min(-1) vs. (13.52±2.92) ml·kg(-1)·min(-1)], peak oxygen pulse ( (11.91±2.89) ml/beat vs. (9.77±2.49) ml/beat) , peak Watts ( (113.2±34.0) W vs. (103.7±27.9) W) , peak metabolic equivalent ( (7.57±1.46) METs vs. (6.00±1.32) METs) (all Pexercise group than in control group (all Pcoronary artery disease. This combined exercise program can significantly improve the cardiorespiratory fitness and exercise capacity of patients with stable coronary artery disease.

  3. Central hemodynamics and left-ventricural contractility in patients with chronic obstructive pulmonary diseases and stable pulmonary hypertension: a radionuclide study

    International Nuclear Information System (INIS)

    Paleev, N.R.; Malov, G.A.; Cherejskaya, N.K.; Oblovatskaya, O.G.; Tsar'kova, L.N.; Zil'berman, E.Eh.; Akademiya Meditsinskikh Nauk SSSR, Moscow. Inst. Serdechno-Sosudistoj Khirurgii)

    1987-01-01

    Systemic, central and intracardiac hemodynamics and left-ventricular contractility were studied radiocardiographically and radioventriculographically in 22 patients with stable pulmanory hypertension, developing in the presence of chronic obstructive pulmanory diseases. A tendency to increased circulating blood volume, significantly elevated end diastolic and end systolic indices, reduced total ejection fraction, and a tendency to decreased segmental ejection fractions were demonstrated. A significant reduction of the speed and percetage of left-ventricular myocardial circular fibre contraction is another evedence of incompetent left-ventricular contractility, in addition to the reduced ejection fraction

  4. Effects of the glucagon-like peptide-1receptor agonist liraglutide on 24-h ambulatory blood pressure in patients with type 2 diabetes and stable coronary artery disease

    DEFF Research Database (Denmark)

    Kumarathurai, Preman; Anholm, Christian; Fabricius-Bjerre, Andreas

    2017-01-01

    -one patients with type 2 diabetes and stable coronary artery disease were randomized to receive liraglutide or placebo to a backbone therapy of metformin in this double-blind, placebo-controlled 12 along with 12 weeks crossover study. Ambulatory blood pressure monitoring (ABPM) was performed at the start...... or the nocturnal BP dipping. Conclusions: We could not demonstrate any BP-lowering effect of liraglutide when using 24-h ABPM. Liraglutide exhibited diurnal variation in the effect on BP without affecting the BP variability or nocturnal BP dipping....

  5. PUNISHMENT BY SD ASSOCIATED WITH FIXED-RATIO REINFORCEMENT.

    Science.gov (United States)

    THOMPSON, D M

    1965-05-01

    Two pigeons were trained with positive reinforcement on a multiple FR VI 2 schedule. The VI 2 component was held constant while the FR component was changed from ratios of 1 to 300. After responding had stabilized at each FR value, VI responses produced briefly either the fixed-ratio S(D) or a stimulus uncorrelated with either schedule component. Compared to the effects of the uncorrelated stimulus change, the fixed-ratio S(D) produced a decrease in VI responding proportional to the size of the FR requirement. It is concluded that stimuli associated with high FR schedules served as punishment for the ongoing behavior.

  6. Sugarcane bagasse dietary fiber as an adjuvant therapy for stable chronic obstructive pulmonary disease: a four-center, randomized, double-blind, placebo-controlled study.

    Science.gov (United States)

    Liu, Miao; Zheng, Fengjie; Ni, Lei; Sun, Yan; Wu, Ruohan; Zhang, Tianyu; Zhang, Jinchao; Zhong, Xianggen; Li, Yuhang

    2016-08-01

    To evaluate the efficacy and safety of sugarcane bagasse dietary fiber as an adjuvant therapy for improving quality of life in patients with stable chronic obstructive pulmonary disease (COPD). This was a multicenter, randomized, double-blind, placebo-controlled trial. A total of 196 participants were randomized into a trial group (treated with 6 g/day sugarcane bagasse plus conventional treatment, n = 98) and a control group (treated with placebo plus conventional treatment, n = 98). All efficacy analyses were performed according to the intention-to-treat (ITT) principle. A per-protocol analysis set (PPS) was used to analyze the cases that completed the clinical trial with good compliance. The trial period was 30 days, with a 6-month follow-up. Pre- and post-treatment pulmonary symptom scores (cough, sputum, wheezing, and dyspnea) were recorded for both groups. The St. George's Respiratory Questionnaire (SGRQ) and the modified Medical Research Council (mMRC) dyspnea scale were assessed before treatment and at the end of the 6-month follow- up. The ITT population was 178 and the PPS population was 166. Post-treatment pulmonary clinical symptoms and severity of dyspnea (mMRC and SGRQ evaluation) were significantly improved in both the trial group and the control group (ITT and PPS: P Sugarcane bagasse combined with conventional treatment improved quality of life in patients with stable COPD. Sugarcane bagasse appears to be a safe herbal medicine with potential for treating patients with stable COPD when taken orally as an adjuvant therapy.

  7. Serum Uric Acid Levels and Uric Acid/Creatinine Ratios in Stable Chronic Obstructive Pulmonary Disease (COPD) Patients: Are These Parameters Efficient Predictors of Patients at Risk for Exacerbation and/or Severity of Disease?

    Science.gov (United States)

    Durmus Kocak, Nagihan; Sasak, Gulsah; Aka Akturk, Ulku; Akgun, Metin; Boga, Sibel; Sengul, Aysun; Gungor, Sinem; Arinc, Sibel

    2016-11-03

    BACKGROUND Serum uric acid (sUA) levels were previously found to be correlated with hypoxic states. We aimed to determine the levels of sUA and sUA/creatinine ratios in stable COPD patients and to evaluate whether sUA level and sUA/creatinine ratio can be used as predictors of exacerbation risk and disease severity. MATERIAL AND METHODS This cross-sectional study included stable COPD patients and healthy controls. The sUA levels and sUA/creatinine ratios in each group were evaluated and their correlations with the study parameters were investigated. ROC analyses for exacerbation risk and disease severity were reported. RESULTS The study included 110 stable COPD patients and 52 healthy controls. The mean sUA levels and sUA/creatinine ratios were significantly higher in patients with COPD compared to healthy controls. The most common comorbidities in COPD patients were hypertension, diabetes, and coronary artery disease. While sUA levels were significantly higher in patients with hypertension (p=0.002) and malignancy (p=0.033), sUA/creatinine ratios was higher in patients with malignancy (p=0.004). The ROC analyses indicated that sUA/creatinine ratios can be more useful than sUA levels in predicting exacerbation risk (AUC, 0.586 vs. 0.426) and disease severity (AUC, 0.560 vs. 0.475) especially at higher cut-off values, but with low specificity. CONCLUSIONS Our study suggested that sUA levels and sUA/creatinine ratios increased in patients with stable COPD, especially among patients with certain comorbidities compared to healthy controls. At higher cut-off values, sUA levels and especially sUA/creatinine ratios, might be useful in predicting COPD exacerbation risk and disease severity. Also, their association with comorbidities, especially with malignancy and hypertension, may benefit from further investigation.

  8. Traditional Risk Factors Versus Biomarkers for Prediction of Secondary Events in Patients With Stable Coronary Heart Disease: From the Heart and Soul Study.

    Science.gov (United States)

    Beatty, Alexis L; Ku, Ivy A; Bibbins-Domingo, Kirsten; Christenson, Robert H; DeFilippi, Christopher R; Ganz, Peter; Ix, Joachim H; Lloyd-Jones, Donald; Omland, Torbjørn; Sabatine, Marc S; Schiller, Nelson B; Shlipak, Michael G; Skali, Hicham; Takeuchi, Madoka; Vittinghoff, Eric; Whooley, Mary A

    2015-07-06

    Patients with stable coronary heart disease (CHD) have widely varying prognoses and treatment options. Validated models for risk stratification of patients with CHD are needed. We sought to evaluate traditional and novel risk factors as predictors of secondary cardiovascular (CV) events, and to develop a prediction model that could be used to risk stratify patients with stable CHD. We used independent derivation (912 participants in the Heart and Soul Study) and validation (2876 participants in the PEACE trial) cohorts of patients with stable CHD to develop a risk prediction model using Cox proportional hazards models. The outcome was CV events, defined as myocardial infarction, stroke, or CV death. The annual rate of CV events was 3.4% in the derivation cohort and 2.2% in the validation cohort. With the exception of smoking, traditional risk factors (including age, sex, body mass index, hypertension, dyslipidemia, and diabetes) did not emerge as the top predictors of secondary CV events. The top 4 predictors of secondary events were the following: N-terminal pro-type brain natriuretic peptide, high-sensitivity cardiac troponin T, urinary albumin:creatinine ratio, and current smoking. The 5-year C-index for this 4-predictor model was 0.73 in the derivation cohort and 0.65 in the validation cohort. As compared with variables in the Framingham secondary events model, the Heart and Soul risk model resulted in net reclassification improvement of 0.47 (95% CI 0.25 to 0.73) in the derivation cohort and 0.18 (95% CI 0.01 to 0.40) in the validation cohort. Novel risk factors are superior to traditional risk factors for predicting 5-year risk of secondary events in patients with stable CHD. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  9. ICHPER-SD Asia Youth Health Related Physical Fitness Test.

    Science.gov (United States)

    Journal of the International Council for Health, Physical Education, Recreation, Sport, and Dance, 1994

    1994-01-01

    Presents necessary information for administering the ICHPER-SD Asia Youth Health Related Physical Fitness Test, including descriptions of and scoring for each test item, needed equipment, notes, and suggested preparations for test leaders. The test includes the endurance run, situps in 60 seconds, pullups, sit and reach test, and skinfold…

  10. The sdA problem - I. Physical properties

    Science.gov (United States)

    Pelisoli, Ingrid; Kepler, S. O.; Koester, D.

    2018-04-01

    The so-called sdA stars are defined by having H-rich spectra and surface gravities similar to hot subdwarf stars, but effective temperature below the zero-age horizontal branch. Their evolutionary history is an enigma: their surface gravity is too high for main-sequence stars, but too low for single evolution white dwarfs. They are most likely byproducts of binary evolution, including blue-stragglers, extremely-low mass white dwarf stars (ELMs) and their precursors (pre-ELMs). A small number of ELMs with similar properties to sdAs is known. Other possibilities include metal-poor A/F dwarfs, second generation stars, or even stars accreted from dwarf galaxies. In this work, we analyse colours, proper motions, and spacial velocities of a sample of sdAs from the Sloan Digital Sky Survey to assess their nature and evolutionary origin. We define a probability of belonging to the main sequence and a probability of being a (pre-)ELM based on these properties. We find that 7 per cent of the sdAs are more likely to be (pre-)ELMs than main-sequence stars. However, the spacial velocity distribution suggests that over 35 per cent of them cannot be explained as single metal-poor A/F stars.

  11. 75 FR 4417 - Wind Cave National Park, Custer County, SD

    Science.gov (United States)

    2010-01-27

    ... Wind Cave National Park, Custer County, SD AGENCY: National Park Service. ACTION: Notice of... Statement, Wind Cave National Park, Custer County, South Dakota. SUMMARY: Pursuant to Section 102(2)(C) of... Environmental Impact Statement (Plan), Wind Cave National Park, Custer County, South Dakota. On December 3, the...

  12. Interactions during the TRM acquisition of SD hematite

    Czech Academy of Sciences Publication Activity Database

    Kletetschka, Günther

    2004-01-01

    Roč. 34, Spec. (2004), s. 77-78 ISSN 1335-2806. [Paleo, Rock and Environmental Magnetism. Castle /9./. Tatranská Javorina, 27.06.2004-03.07.2004] Institutional research plan: CEZ:AV0Z3013912 Keywords : thermoremanent/saturation remanence magnetization * SD Hematite Subject RIV: DB - Geology ; Mineralogy

  13. Level density and shape changes in excited sd shell nuclei

    Indian Academy of Sciences (India)

    Level density and shape changes in excited sd shell nuclei. S SANTHOSH KUMAR. Department of Physics, Mahatma Gandhi Government Arts College, Chalakkara,. Mahe 673 311, India. E-mail: santhosh.physics@gmail.com. MS received 27 November 2006; revised 25 February 2008; accepted 26 February 2008.

  14. Design and rationale of the MR-INFORM study: stress perfusion cardiovascular magnetic resonance imaging to guide the management of patients with stable coronary artery disease

    Directory of Open Access Journals (Sweden)

    Hussain Shazia T

    2012-09-01

    Full Text Available Abstract Background In patients with stable coronary artery disease (CAD, decisions regarding revascularisation are primarily driven by the severity and extent of coronary luminal stenoses as determined by invasive coronary angiography. More recently, revascularisation decisions based on invasive fractional flow reserve (FFR have shown improved event free survival. Cardiovascular magnetic resonance (CMR perfusion imaging has been shown to be non-inferior to nuclear perfusion imaging in a multi-centre setting and superior in a single centre trial. In addition, it is similar to invasively determined FFR and therefore has the potential to become the non-invasive test of choice to determine need for revascularisation. Trial design The MR-INFORM study is a prospective, multi-centre, randomised controlled non-inferiority, outcome trial. The objective is to compare the efficacy of two investigative strategies for the management of patients with suspected CAD. Patients presenting with stable angina are randomised into two groups: 1 The FFR-INFORMED group has subsequent management decisions guided by coronary angiography and fractional flow reserve measurements. 2 The MR-INFORMED group has decisions guided by stress perfusion CMR. The primary end-point will be the occurrence of major adverse cardiac events (death, myocardial infarction and repeat revascularisation at one year. Clinical trials.gov identifier NCT01236807. Conclusion MR INFORM will assess whether an initial strategy of CMR perfusion is non-inferior to invasive angiography supplemented by FFR measurements to guide the management of patients with stable coronary artery disease. Non-inferiority of CMR perfusion imaging to the current invasive reference standard (FFR would establish CMR perfusion imaging as an attractive non-invasive alternative to current diagnostic pathways.

  15. [Efficacy of integrative respiratory rehabilitation training in exercise ability and quality of life of patients with chronic obstructive pulmonary disease in stable phase: a randomized controlled trial].

    Science.gov (United States)

    Xu, Yuan-hong; Wang, Jun-hua; Li, Hai-feng; Zhu, Xiao-hu; Wang, Gang

    2010-05-01

    Chronic obstructive pulmonary disease (COPD) is an important clinical disease, and its global prevalence and mortality rates are high. It is meaningful to investigate the efficacy of integrative respiratory rehabilitation training in quality of life and respiratory physiology of COPD patients in stable phase. To observe the efficacy of integrative respiratory rehabilitation training in exercise ability and quality of life of COPD patients in stable phase. Eighty outpatients and inpatients with COPD from Department of Respiratory Medicine, Taihe Hospital, Yunyang Medical College were randomly divided into 4 groups, with 20 patients in each group. The patients in group A only received drug therapy, the patients in group B received traditional qigong training, the patients in group C received modern rehabilitation training, and the patients in group D received integrative respiratory rehabilitation training. Chronic respiratory questionnaire (CRQ), 6-minute walking distance and Borg score in each group were examined before and after one-, three-, and six-month and one-year treatment. The 6-minute walking distance, Borg score and CRQ score in group A had no significant changes after treatment (P>0.05). After one-month treatment, there were no significant differences in 6-minute walking distance and Borg score in groups B, C and D as compared with those before treatment (Pexercise ability of COPD patients, and integrative respiratory rehabilitation training program is better than modern rehabilitation training and traditional qigong training programs. The efficacy of respiratory rehabilitation training is time-dependent, and need long-time adherence to the therapy.

  16. TP53 mutations in de novo acute myeloid leukemia patients: longitudinal follow-ups show the mutation is stable during disease evolution.

    Science.gov (United States)

    Hou, H-A; Chou, W-C; Kuo, Y-Y; Liu, C-Y; Lin, L-I; Tseng, M-H; Chiang, Y-C; Liu, M-C; Liu, C-W; Tang, J-L; Yao, M; Li, C-C; Huang, S-Y; Ko, B-S; Hsu, S-C; Chen, C-Y; Lin, C-T; Wu, S-J; Tsay, W; Chen, Y-C; Tien, H-F

    2015-07-31

    The TP53 mutation is frequently detected in acute myeloid leukemia (AML) patients with complex karyotype (CK), but the stability of this mutation during the clinical course remains unclear. In this study, TP53 mutations were identified in 7% of 500 patients with de novo AML and 58.8% of patients with CK. TP53 mutations were closely associated with older age, lower white blood cell (WBC) and platelet counts, FAB M6 subtype, unfavorable-risk cytogenetics and CK, but negatively associated with NPM1 mutation, FLT3/ITD and DNMT3A mutation. Multivariate analysis demonstrated that TP53 mutation was an independent poor prognostic factor for overall survival and disease-free survival among the total cohort and the subgroup of patients with CK. A scoring system incorporating TP53 mutation and nine other prognostic factors, including age, WBC counts, cytogenetics and gene mutations, into survival analysis proved to be very useful to stratify AML patients. Sequential study of 420 samples showed that TP53 mutations were stable during AML evolution, whereas the mutation was acquired only in 1 of the 126 TP53 wild-type patients when therapy-related AML originated from different clone emerged. In conclusion, TP53 mutations are associated with distinct clinic-biological features and poor prognosis in de novo AML patients and are rather stable during disease progression.

  17. Relation of whole blood n-3 fatty acid levels to exercise parameters in patients with stable coronary artery disease (from the heart and soul study).

    Science.gov (United States)

    Moyers, Brian; Farzaneh-Far, Ramin; Harris, William S; Garg, Sachin; Na, Beeya; Whooley, Mary A

    2011-04-15

    Dietary intake of n-3 polyunsaturated fatty acids is associated with a lower incidence of cardiovascular events. Mechanisms underlying this association are poorly understood but may include beneficial effects on physical conditioning and vagal tone. We investigated the association of n-3 fatty acid levels to exercise parameters in 992 subjects with stable coronary artery disease. Cross-sectional associations of heart rate recovery time, treadmill exercise capacity, and exercise time with docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) levels were evaluated in multivariable linear and logistic regression models adjusted for demographics, cardiovascular risk factors, co-morbidities, self-reported physical activity, medication use, and left ventricular function. After multivariable adjustment, n-3 fatty acid levels (DHA + EPA) were strongly associated with heart rate recovery (beta 2.1, p = 0.003), exercise capacity (beta 0.8, p exercise time (beta 0.9, p exercise time (odds ratio 0.7, p = 0.01) and trended toward significance for exercise capacity (odds ratio 0.8, p = 0.07). These associations were not modified by demographics, body mass index, smoking, co-morbid conditions, statin use, or β-blocker use (p for interaction >0.1 for all comparisons). In conclusion, an independent association exists between n-3 fatty acid levels and important exercise parameters in patients with stable coronary artery disease. These findings support the hypothesis that n-3 fatty acids may increase vagal tone and physical conditioning. Published by Elsevier Inc.

  18. A case-control validation of Type D personality in Greek patients with stable coronary heart disease

    NARCIS (Netherlands)

    Christodoulou, C.; Douzenis, A.; Mommersteeg, P.M.C.; Rallidis, L.S.; Poulios, A.; Efstathiou, V.; Bouras, G.; Varounis, C.; Korkoliakou, P.; Palios, J.; Kremastinos, D.T.; Lykouras, L.

    2013-01-01

    Background Type D personality has been associated with a variety of emotional and social difficulties as well as with poor prognosis in patients with established coronary heart disease (CHD). We examined the psychometric properties and validity of the Type D Scale-14 (DS14) and the prevalence of

  19. Autotransplantation of mesenchymal stromal cells from bone-marrow to heart in patients with severe stable coronary artery disease and refractory angina — Final 3-year follow-up

    DEFF Research Database (Denmark)

    Mathiasen, Anders Bruun; Haack-Sørensen, Mandana; Jørgensen, Erik

    2013-01-01

    The study assessed long-term safety and efficacy of intramyocardial injection of autologous bone-marrow derived mesenchymal stromal cells (BMMSCs) in patients with severe stable coronary artery disease (CAD) and refractory angina.......The study assessed long-term safety and efficacy of intramyocardial injection of autologous bone-marrow derived mesenchymal stromal cells (BMMSCs) in patients with severe stable coronary artery disease (CAD) and refractory angina....

  20. Stable particles

    International Nuclear Information System (INIS)

    Samios, N.P.

    1994-01-01

    I have been asked to review the subject of stable particles, essentially the particles that eventually comprised the meson and baryon octets, with a few more additions - with an emphasis on the contributions made by experiments utilizing the bubble chamber technique. In this activity, much work had been done by the photographic emulsion technique and cloud chambers - exposed to cosmic rays as well as accelerator based beams. In fact, many if not most of the stable particles were found by these latter two techniques, however, the foree of the bubble chamber (coupled with the newer and more powerful accelerators) was to verify, and reinforce with large statistics, the existence of these states, to find some of the more difficult ones, mainly neutrals and further to elucidate their properties, i.e., spin, parity, lifetimes, decay parameters, etc. (orig.)

  1. Stable particles

    International Nuclear Information System (INIS)

    Samios, N.P.

    1993-01-01

    I have been asked to review the subject of stable particles, essentially the particles that eventually comprised the meson and baryon octets. with a few more additions -- with an emphasis on the contributions made by experiments utilizing the bubble chamber technique. In this activity, much work had been done by the photographic emulsion technique and cloud chambers-exposed to cosmic rays as well as accelerator based beams. In fact, many if not most of the stable particles were found by these latter two techniques, however, the forte of the bubble chamber (coupled with the newer and more powerful accelerators) was to verify, and reinforce with large statistics, the existence of these states, to find some of the more difficult ones, mainly neutrals and further to elucidate their properties, i.e., spin, parity, lifetimes, decay parameters, etc

  2. Characterization of serological neo-epitope biomarkers reflecting collagen remodeling in clinically stable chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Sand, Jannie M B; Martinez, Gerd; Midjord, Anne-Kirsten

    2016-01-01

    OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation that leads to excessive remodeling of the lung extracellular matrix (ECM), resulting in release of protein fragments (neo-epitopes) to the blood. Serological markers assessing this have previously been...... of COPD, blood oxygen saturation, shuttle walk test distance, GOLD grades, or CAT scores. CONCLUSIONS: Serological biomarkers of collagen remodeling were elevated in subjects with COPD as compared with healthy individuals. Biomarker levels were significantly correlated with measures of dyspnea, indicating...... a relationship with degree of symptoms, while only C6M showed a weak but significant association with lung function. Biomarker levels were not related to GOLD grades, which was in line with previous studies indicating that ECM remodeling may be related to disease activity rather than severity....

  3. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease

    DEFF Research Database (Denmark)

    Kragelund, Charlotte; Grønning, Bjørn; Køber, Lars

    2005-01-01

    heart disease. The rate of death from all causes was determined after a median follow-up of nine years. RESULTS: At follow-up, 288 patients had died. The median NT-pro-BNP level was significantly lower among patients who survived than among those who died (120 pg per milliliter [interquartile range, 50...... to 318] vs. 386 pg per milliliter [interquartile range, 146 to 897], P

  4. Biomarker-Based Risk Model to Predict Cardiovascular Mortality in Patients With Stable Coronary Disease.

    Science.gov (United States)

    Lindholm, Daniel; Lindbäck, Johan; Armstrong, Paul W; Budaj, Andrzej; Cannon, Christopher P; Granger, Christopher B; Hagström, Emil; Held, Claes; Koenig, Wolfgang; Östlund, Ollie; Stewart, Ralph A H; Soffer, Joseph; White, Harvey D; de Winter, Robbert J; Steg, Philippe Gabriel; Siegbahn, Agneta; Kleber, Marcus E; Dressel, Alexander; Grammer, Tanja B; März, Winfried; Wallentin, Lars

    2017-08-15

    Currently, there is no generally accepted model to predict outcomes in stable coronary heart disease (CHD). This study evaluated and compared the prognostic value of biomarkers and clinical variables to develop a biomarker-based prediction model in patients with stable CHD. In a prospective, randomized trial cohort of 13,164 patients with stable CHD, we analyzed several candidate biomarkers and clinical variables and used multivariable Cox regression to develop a clinical prediction model based on the most important markers. The primary outcome was cardiovascular (CV) death, but model performance was also explored for other key outcomes. It was internally bootstrap validated, and externally validated in 1,547 patients in another study. During a median follow-up of 3.7 years, there were 591 cases of CV death. The 3 most important biomarkers were N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT), and low-density lipoprotein cholesterol, where NT-proBNP and hs-cTnT had greater prognostic value than any other biomarker or clinical variable. The final prediction model included age (A), biomarkers (B) (NT-proBNP, hs-cTnT, and low-density lipoprotein cholesterol), and clinical variables (C) (smoking, diabetes mellitus, and peripheral arterial disease). This "ABC-CHD" model had high discriminatory ability for CV death (c-index 0.81 in derivation cohort, 0.78 in validation cohort), with adequate calibration in both cohorts. This model provided a robust tool for the prediction of CV death in patients with stable CHD. As it is based on a small number of readily available biomarkers and clinical factors, it can be widely employed to complement clinical assessment and guide management based on CV risk. (The Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy Trial [STABILITY]; NCT00799903). Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights

  5. Amyloid-β Plaques in Clinical Alzheimer’s Disease Brain Incorporate Stable Isotope Tracer In Vivo and Exhibit Nanoscale Heterogeneity

    Science.gov (United States)

    Wildburger, Norelle C.; Gyngard, Frank; Guillermier, Christelle; Patterson, Bruce W.; Elbert, Donald; Mawuenyega, Kwasi G.; Schneider, Theresa; Green, Karen; Roth, Robyn; Schmidt, Robert E.; Cairns, Nigel J.; Benzinger, Tammie L. S.; Steinhauser, Matthew L.; Bateman, Randall J.

    2018-01-01

    Alzheimer’s disease (AD) is a neurodegenerative disorder with clinical manifestations of progressive memory decline and loss of executive function and language. AD affects an estimated 5.3 million Americans alone and is the most common form of age-related dementia with a rapidly growing prevalence among the aging population—those 65 years of age or older. AD is characterized by accumulation of aggregated amyloid-beta (Aβ) in the brain, which leads to one of the pathological hallmarks of AD—Aβ plaques. As a result, Aβ plaques have been extensively studied after being first described over a century ago. Advances in brain imaging and quantitative measures of Aβ in biological fluids have yielded insight into the time course of plaque development decades before and after AD symptom onset. However, despite the fundamental role of Aβ plaques in AD, in vivo measures of individual plaque growth, growth distribution, and dynamics are still lacking. To address this question, we combined stable isotope labeling kinetics (SILK) and nanoscale secondary ion mass spectrometry (NanoSIMS) imaging in an approach termed SILK–SIMS to resolve plaque dynamics in three human AD brains. In human AD brain, plaques exhibit incorporation of a stable isotope tracer. Tracer enrichment was highly variable between plaques and the spatial distribution asymmetric with both quiescent and active nanometer sub-regions of tracer incorporation. These data reveal that Aβ plaques are dynamic structures with deposition rates over days indicating a highly active process. Here, we report the first, direct quantitative measures of in vivo deposition into plaques in human AD brain. Our SILK–SIMS studies will provide invaluable information on plaque dynamics in the normal and diseased brain and offer many new avenues for investigation into pathological mechanisms of the disease, with implications for therapeutic development. PMID:29623063

  6. Amyloid-β Plaques in Clinical Alzheimer’s Disease Brain Incorporate Stable Isotope Tracer In Vivo and Exhibit Nanoscale Heterogeneity

    Directory of Open Access Journals (Sweden)

    Norelle C. Wildburger

    2018-03-01

    Full Text Available Alzheimer’s disease (AD is a neurodegenerative disorder with clinical manifestations of progressive memory decline and loss of executive function and language. AD affects an estimated 5.3 million Americans alone and is the most common form of age-related dementia with a rapidly growing prevalence among the aging population—those 65 years of age or older. AD is characterized by accumulation of aggregated amyloid-beta (Aβ in the brain, which leads to one of the pathological hallmarks of AD—Aβ plaques. As a result, Aβ plaques have been extensively studied after being first described over a century ago. Advances in brain imaging and quantitative measures of Aβ in biological fluids have yielded insight into the time course of plaque development decades before and after AD symptom onset. However, despite the fundamental role of Aβ plaques in AD, in vivo measures of individual plaque growth, growth distribution, and dynamics are still lacking. To address this question, we combined stable isotope labeling kinetics (SILK and nanoscale secondary ion mass spectrometry (NanoSIMS imaging in an approach termed SILK–SIMS to resolve plaque dynamics in three human AD brains. In human AD brain, plaques exhibit incorporation of a stable isotope tracer. Tracer enrichment was highly variable between plaques and the spatial distribution asymmetric with both quiescent and active nanometer sub-regions of tracer incorporation. These data reveal that Aβ plaques are dynamic structures with deposition rates over days indicating a highly active process. Here, we report the first, direct quantitative measures of in vivo deposition into plaques in human AD brain. Our SILK–SIMS studies will provide invaluable information on plaque dynamics in the normal and diseased brain and offer many new avenues for investigation into pathological mechanisms of the disease, with implications for therapeutic development.

  7. Resonances in collisions between S-D shell nuclei

    International Nuclear Information System (INIS)

    Betts, R.R.

    1984-01-01

    Experimental evidence relating to the existence of resonances in collisions between s-d shell nuclei will be reviewed. The determination of the spins and spectroscopic properties of some of these resonances will be discussed. The behaviour of both the resonance and background cross-sections will be compared with model expectations. Some future directions in this area of study will be indicated and the relationship of this work to other results briefly discussed. (author)

  8. Evaluation of microvision SD2500 scanning laser display

    Science.gov (United States)

    Harding, Thomas H.; Rash, Clarence E.; Dennis, Scott J.

    2006-05-01

    Microvision's Spectrum TM SD2500 is a candidate technology for the Modular Integrated Helmet Display System (MIHDS)program. This HMD design is intended to provide a full-color, see-through, daylight and night-readable, moderate-resolution (800X600 pixels) display. The employed technology is that of scanning lasers. This paper presents the testing results for the latest version of this prototype system.

  9. Coronary revascularization does not decrease cardiac events in patients with stable ischemic heart disease but might do in those who showed moderate to severe ischemia.

    Science.gov (United States)

    Moroi, Masao; Yamashina, Akira; Tsukamoto, Kazumasa; Nishimura, Tsunehiko

    2012-07-12

    As an initial management strategy for stable ischemic heart disease (IHD), coronary revascularization therapy is thought to be equal to optimal medical therapy alone regarding prognosis. Whether or not the effects of revascularization on the prognosis of patients with stable IHD are associated with the amount of ischemic myocardium detected by nuclear stress imaging was evaluated. This retrospective study analyzed data from 4629 patients with suspected or known IHD who underwent gated stress myocardial-perfusion SPECT at 117 hospitals in Japan. The follow-up periods were three years and the combined endpoints consisted of cardiac death, nonfatal myocardial infarction, and congestive heart failure requiring hospitalization. After matching propensity scores between patients who underwent early revascularization and those who did not (n=316 per group), we compared cardiac event rates in relation to the amount of ischemic myocardium. Cardiac event rates did not significantly differ between patients who underwent early revascularization and those who did not (5.4% vs. 6.4%). Among patients with ≤ 5%, 6-10%, and >10% ischemic myocardium, cardiac event rates were 8%, 3% and 0% respectively, who underwent early revascularization compared with 4.5%, 6.1%, and 12.3%, respectively, among those who did not. Cardiac event rates were significantly lower among patients with >10% ischemic myocardium who underwent early revascularization compared with those who did not (0% vs. 12.3%, p=0.0062). Coronary revascularization for stable IHD does not decrease major cardiac events in all patients but might do in patients with moderate to severe ischemia. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  10. Prevalence and prognostic significance of incidental cardiac troponin T elevation in ambulatory patients with stable coronary artery disease: Data from The Heart and Soul Study

    Science.gov (United States)

    Hsieh, Bill P. C.; Rogers, Adam M.; Na, Beeya; Wu, Alan H. B.; Schiller, Nelson B.; Whooley, Mary A.

    2009-01-01

    Background The significance of troponin elevation and clinical utility of troponin testing in ambulatory patients with coronary artery disease (CAD) have not been examined. We sought to investigate the prevalence and prognostic value of cardiac troponin T (cTnT) elevation in a population with stable CAD. Methods We studied 987 patients with stable CAD enrolled in the Heart & Soul study who had plasma cTnT measurements before performing exercise treadmill testing. Results Of the studied population, 58 patients or 6.2% had detectable cTnT levels, ≥0.01 ng/mL (0.01–0.72 ng/mL). During a mean follow-up period of 4.3 (0.1–6.5) years, 58.6% of participants with detectable cTnT had cardiovascular events compared with 22.5% of those without detectable cTnT (hazard ratio [HR] 3.8, 95% CI 2.6–5.4, P <.001). This association remained strong after adjustment for traditional risk factors and C-reactive protein (HR 2.0, 95% CI 1.3–3.1, P = .002). However, after further adjustment for N-terminal pro–B-type natriuretic peptide and echocardiographic parameters of left ventricular function, cTnT elevation was not an independent predictor of cardiovascular events (HR 1.3, 95% CI, 0.8–2.3, P = .28). Conclusions In ambulatory patients with stable CAD, the prevalence of cTnT elevation was 6.2%. Cardiac troponin T elevation detected using the conventional troponin assay was associated with increased risk of adverse cardiovascular outcomes, but its prognostic value was not incremental over N-terminal pro–B-type natriuretic peptide and echocardiographic evidence of cardiac abnormalities. PMID:19781430

  11. Stable beams

    CERN Multimedia

    2015-01-01

    Stable beams: two simple words that carry so much meaning at CERN. When LHC page one switched from "squeeze" to "stable beams" at 10.40 a.m. on Wednesday, 3 June, it triggered scenes of jubilation in control rooms around the CERN sites, as the LHC experiments started to record physics data for the first time in 27 months. This is what CERN is here for, and it’s great to be back in business after such a long period of preparation for the next stage in the LHC adventure.   I’ve said it before, but I’ll say it again. This was a great achievement, and testimony to the hard and dedicated work of so many people in the global CERN community. I could start to list the teams that have contributed, but that would be a mistake. Instead, I’d simply like to say that an achievement as impressive as running the LHC – a machine of superlatives in every respect – takes the combined effort and enthusiasm of everyone ...

  12. Clinical proteomics identifies urinary CD14 as a potential biomarker for diagnosis of stable coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Min-Yi Lee

    Full Text Available Inflammation plays a key role in coronary artery disease (CAD and other manifestations of atherosclerosis. Recently, urinary proteins were found to be useful markers for reflecting inflammation status of different organs. To identify potential biomarker for diagnosis of CAD, we performed one-dimensional SDS-gel electrophoresis followed by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS. Among the proteins differentially expressed in urine samples, monocyte antigen CD14 was found to be consistently expressed in higher amounts in the CAD patients as compared to normal controls. Using enzyme-linked immunosorbent assays to analyze the concentrations of CD14 in urine and serum, we confirmed that urinary CD14 levels were significantly higher in patients (n = 73 with multi-vessel and single vessel CAD than in normal control (n = 35 (P < 0.001. Logistic regression analysis further showed that urinary CD14 concentration level is associated with severity or number of diseased vessels and SYNTAX score after adjustment for potential confounders. Concomitantly, the proportion of CD14+ monocytes was significantly increased in CAD patients (59.7 ± 3.6% as compared with healthy controls (14.9 ± 2.1% (P < 0.001, implicating that a high level of urinary CD14 may be potentially involved in mechanism(s leading to CAD pathogenesis. By performing shotgun proteomics, we further revealed that CD14-associated inflammatory response networks may play an essential role in CAD. In conclusion, the current study has demonstrated that release of CD14 in urine coupled with more CD14+ monocytes in CAD patients is significantly correlated with severity of CAD, pointing to the potential application of urinary CD14 as a novel noninvasive biomarker for large-scale diagnostic screening of susceptible CAD patients.

  13. Prognostic Value of High-Sensitivity Cardiac Troponin T Compared with Risk Scores in Stable Cardiovascular Disease.

    Science.gov (United States)

    Biener, Moritz; Giannitsis, Evangelos; Kuhner, Manuel; Zelniker, Thomas; Mueller-Hennessen, Matthias; Vafaie, Mehrshad; Trenk, Dietmar; Neumann, Franz-Josef; Hochholzer, Willibald; Katus, Hugo A

    2017-05-01

    Risk stratification of patients with cardiovascular disease remains challenging despite consideration of risk scores. We aimed to evaluate the prognostic performance of high-sensitivity cardiac troponin T in a low-risk outpatient population presenting for nonsecondary and secondary prevention. All-cause mortality, a composite of all-cause mortality, acute myocardial infarction, and stroke (end point 2), and a composite of all-cause mortality, acute myocardial infarction, stroke and rehospitalization for acute coronary syndrome, and decompensated heart failure (end point 3) were defined. The prognostic performance of high-sensitivity cardiac troponin T on index visit was compared with the PROCAM score and 3 FRAMINGHAM subscores. In 693 patients with a median follow-up of 796 days, we observed 16 deaths, 32 patients with end point 2, and 83 patients with end point 3. All risk scores performed better in the prediction of all-cause mortality in nonsecondary prevention (area under the curve [AUC]: PROCAM: 0.922 vs 0.523, P = .001, consistent for all other scores). In secondary prevention, high-sensitivity cardiac troponin T outperformed all risk scores in the prediction of all-cause mortality (ΔAUC: PROCAM: 0.319, P risk scores. Our findings on the prediction of all-cause mortality compared with the FRAMINGHAM-Hard Coronary Heart Disease score were confirmed in an independent validation cohort on 2046 patients. High-sensitivity troponin T provides excellent risk stratification regarding all-cause mortality and all-cause mortality, acute myocardial infarction, and stroke in a secondary prevention cohort in whom risk scores perform poorly. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Effects of two types of equal-intensity inspiratory muscle training in stable patients with chronic obstructive pulmonary disease: A randomised controlled trial.

    Science.gov (United States)

    Wu, Weiliang; Guan, Lili; Zhang, Xianming; Li, Xiaoying; Yang, Yuqiong; Guo, Bingpeng; Ou, Yonger; Lin, Lin; Zhou, Luqian; Chen, Rongchang

    2017-11-01

    We conducted a randomised controlled trial to assess the effects of daily breathing pattern changes to stable patients with COPD excluding the confounding factors of inspiratory muscle mobilization, by ensuring the load intensities of two inspiratory training devices were equal. Sixty patients with COPD were randomised to three groups: resistive-IMT group (T-IMT, 21 patients), threshold-IMT (R-IMT, 19 patients), and a control group (20 patients). Inspiratory load intensity for both methods was set at 60% of maximal inspiratory pressure (MIP), a measure of inspiratory muscle strength, which, along with health-related quality of life (HRQoL), degree of dyspnoea, and exercise capacity, were conducted before and after 8 weeks of daily IMT. At 8 weeks, there was no significantly difference of MIP between the R- and T-IMT groups (P > 0.05). Chronic Respiratory Disease Questionnaire and Transition Dyspnea Index scores improved significantly after each training program compared with controls (P < 0.05), and R-IMT was significant better (P < 0.05). R-IMT was better than T-IMT in performance of exercise (P < 0.05). In summary, in clinically stable patients with COPD, 8 weeks of R-IMT was superior to 8 weeks of equal-intensity T-IMT in improving HRQoL, degree of dyspnoea, and exercise capacity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Sex differences in platelet reactivity and cardiovascular and psychological response to mental stress in patients with stable ischemic heart disease: insights from the REMIT study.

    Science.gov (United States)

    Samad, Zainab; Boyle, Stephen; Ersboll, Mads; Vora, Amit N; Zhang, Ye; Becker, Richard C; Williams, Redford; Kuhn, Cynthia; Ortel, Thomas L; Rogers, Joseph G; O'Connor, Christopher M; Velazquez, Eric J; Jiang, Wei

    2014-10-21

    Although emotional stress is associated with ischemic heart disease (IHD) and related clinical events, sex-specific differences in the psychobiological response to mental stress have not been clearly identified. We aimed to study the differential psychological and cardiovascular responses to mental stress between male and female patients with stable IHD. Patients with stable IHD enrolled in the REMIT (Responses of Mental Stress-Induced Myocardial Ischemia to Escitalopram) study underwent psychometric assessments, transthoracic echocardiography, and platelet aggregation studies at baseline and after 3 mental stress tasks. Mental stress-induced myocardial ischemia (MSIMI) was defined as the development or worsening of regional wall motion abnormality, reduction of left ventricular ejection fraction (LVEF) ≥8% by transthoracic echocardiography, and/or ischemic ST-segment change on electrocardiogram during 1 or more of the 3 mental stress tasks. In the 310 participants with known IHD (18% women, 82% men), most baseline characteristics were similar between women and men (including heart rate, blood pressure, and LVEF), although women were more likely to be nonwhite, living alone (p stress, women had more MSIMI (57% vs. 41%; p stress in women and men. Further studies should test the association of sex differences in cardiovascular and platelet reactivity in response to mental stress and long-term outcomes. (Responses of Myocardial Ischemia to Escitalopram Treatment [REMIT]; NCT00574847). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  16. Exercise capacity and heart rate responses to exercise as predictors of short-term outcome among patients with stable coronary artery disease.

    Science.gov (United States)

    Kiviniemi, Antti M; Lepojärvi, Samuli; Kenttä, Tuomas V; Junttila, M Juhani; Perkiömäki, Juha S; Piira, Olli-Pekka; Ukkola, Olavi; Hautala, Arto J; Tulppo, Mikko P; Huikuri, Heikki V

    2015-11-15

    Although exercise capacity (EC) and autonomic responses to exercise predict clinical outcomes in various populations, they are not routinely applied in patients with coronary artery disease (CAD). We hypothesized that the composite index of EC and exercise heart rate responses would be a powerful determinant of short-term risk in CAD. Patients with angiographically documented stable CAD and treated with β blockers (n = 1,531) underwent exercise testing to allow the calculation of age- and gender-adjusted EC, maximal chronotropic response index (CRI), and 2-minute postexercise heart rate recovery (HRR, percentage of maximal heart rate). Cardiovascular deaths and hospitalization due to heart failure, registered during a 2-year follow-up (n = 39, 2.5%), were defined as the composite primary end point. An exercise test risk score was calculated as the sum of hazard ratios related to abnormal (lowest tertile) EC, CRI, and HRR. Abnormal EC, CRI, and HRR predicted the primary end point, involving 4.5-, 2.2-, and 6.2-fold risk, respectively, independently of each other. The patients with intermediate and high exercise test risk score had 11.1-fold (95% confidence interval 2.4 to 51.1, p = 0.002) and 25.4-fold (95% confidence interval 5.5 to 116.8, p exercise and recovery is a powerful predictor of short-term outcome in patients with stable CAD. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Elucidating the 16S rRNA 3' boundaries and defining optimal SD/aSD pairing in Escherichia coli and Bacillus subtilis using RNA-Seq data.

    Science.gov (United States)

    Wei, Yulong; Silke, Jordan R; Xia, Xuhua

    2017-12-15

    Bacterial translation initiation is influenced by base pairing between the Shine-Dalgarno (SD) sequence in the 5' UTR of mRNA and the anti-SD (aSD) sequence at the free 3' end of the 16S rRNA (3' TAIL) due to: 1) the SD/aSD sequence binding location and 2) SD/aSD binding affinity. In order to understand what makes an SD/aSD interaction optimal, we must define: 1) terminus of the 3' TAIL and 2) extent of the core aSD sequence within the 3' TAIL. Our approach to characterize these components in Escherichia coli and Bacillus subtilis involves 1) mapping the 3' boundary of the mature 16S rRNA using high-throughput RNA sequencing (RNA-Seq), and 2) identifying the segment within the 3' TAIL that is strongly preferred in SD/aSD pairing. Using RNA-Seq data, we resolve previous discrepancies in the reported 3' TAIL in B. subtilis and recovered the established 3' TAIL in E. coli. Furthermore, we extend previous studies to suggest that both highly and lowly expressed genes favor SD sequences with intermediate binding affinity, but this trend is exclusive to SD sequences that complement the core aSD sequences defined herein.

  18. Inhibiting α-synuclein oligomerization by stable cell-penetrating β-synuclein fragments recovers phenotype of Parkinson's disease model flies.

    Directory of Open Access Journals (Sweden)

    Ronit Shaltiel-Karyo

    Full Text Available The intracellular oligomerization of α-synuclein is associated with Parkinson's disease and appears to be an important target for disease-modifying treatment. Yet, to date, there is no specific inhibitor for this aggregation process. Using unbiased systematic peptide array analysis, we identified molecular interaction domains within the β-synuclein polypeptide that specifically binds α-synuclein. Adding such peptide fragments to α-synuclein significantly reduced both amyloid fibrils and soluble oligomer formation in vitro. A retro-inverso analogue of the best peptide inhibitor was designed to develop the identified molecular recognition module into a drug candidate. While this peptide shows indistinguishable activity as compared to the native peptide, it is stable in mouse serum and penetrates α-synuclein over-expressing cells. The interaction interface between the D-amino acid peptide and α-synuclein was mapped by Nuclear Magnetic Resonance spectroscopy. Finally, administering the retro-inverso peptide to a Drosophila model expressing mutant A53T α-synuclein in the nervous system, resulted in a significant recovery of the behavioral abnormalities of the treated flies and in a significant reduction in α-synuclein accumulation in the brains of the flies. The engineered retro-inverso peptide can serve as a lead for developing a novel class of therapeutic agents to treat Parkinson's disease.

  19. Stable expression of foot-and-mouth disease virus protein VP1 fused with cholera toxin B subunit in the potato (Solanum tuberosum).

    Science.gov (United States)

    He, Dong-Mei; Qian, Kai-Xian; Shen, Gui-Fang; Li, Yi-Nü; Zhang, Zhi-Fang; Su, Zhong-Liang; Shao, Hong-Bo

    2007-04-01

    The expression vector, pBI121CTBVP1, containing the fusion of the foot and mouth disease virus (FMDV) VP1 gene and the cholera toxin B subunit (CTB) gene was constructed by fused PCR and transferred into potato (Solanum tuberosum L.) by Agrobacterium-mediated transformation. Transformed plants were obtained by selecting on kanamycin-resistant medium strictly and regenerated. The transgenic plantlets were identified by PCR, Southern-blot and the production of fused protein was confirmed and quantified by Western-blot and ELISA assays. The results showed that the fused genes were expressed stablely under the control of specific-tuber patatin promoter. The expressed fused proteins have a certain degree of immunogenicity.

  20. FAME 2 – The best initial strategy for patients with stable coronary artery disease: Do we have an answer at last?

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    Ahmed M ElGuindy

    2012-12-01

    Full Text Available Results of the Fractional flow reserve versus Angiography for Multivessel Evaluation 2 (FAME 2 trial were recently presented at the European Society of Cardiology (ESC meeting in Munich and published concurrently in the New England Journal of Medicine1. Interpretation of the results and clinical significance of the study continue to be topics of considerable controversy. FAME 2 is a randomized “all-comers” multicenter trial, designed to test the hypothesis that in patients with stable ischemic heart disease (IHD, stenting ischemia-producing stenoses – defined as fractional flow reserve (FFR < 0.80 – plus optimal medical treatment (OMT, would reduce the composite end-point of death, nonfatal myocardial infarction (MI and urgent revascularization, compared to OMT alone. Secondary endpoints included individual components of the primary endpoint, cardiac death, non-urgent revascularization and angina class. The trial was funded by St. Jude Medical, Inc.

  1. Lipoprotein(a as a predictor of poor collateral circulation in patients with chronic stable coronary heart disease

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    Y. Fan

    Full Text Available As a mechanism compensating for obstructive coronary artery disease, coronary collateral circulation (CCC has attracted cardiologists for a long time to explore its potential impact. In the present study, Chinese patients suffering from ≥95% coronary stenosis, as diagnosed by angiography, have been investigated for the correlation between CCC and lipoprotein(a [Lp(a] levels. A cohort of 654 patients was divided into four categories according to Rentrop grades 0, 1, 2, and 3. Lp(a levels were divided into model 1, discretized with critical values of 33 and 66%, and model 2, discretized with a cutoff value of 30.0 mg/dL. Furthermore, we evaluated the correlation between CCC and serum Lp(a levels. The four groups had significantly different Lp(a levels (25.80±24.72, 18.99±17.83, 15.39±15.80, and 8.40±7.75 mg/dL; P30.0 group (OR=6.77, 95%CI=4.44-10.4 was greater than that of Lp(a <30.0 mg/dL. The worst condition of CCC can be predicted independently by Lp(a levels. In addition to clinical usage, Lp(a levels can also be utilized as biological markers.

  2. Association of Fibrinogen with Severity of Stable Coronary Artery Disease in Patients with Type 2 Diabetic Mellitus

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    Li-Feng Hong

    2014-01-01

    Full Text Available Background. Some studies have suggested a relation of plasma fibrinogen to the severity of coronary artery disease (CAD. However, whether plasma fibrinogen can predict the presence and severity of CAD in patients with diabetes mellitus has not been determined. Methods. A total of consecutive 373 diabetic patients with typical angina pectoris who received coronary angiography were enrolled and classified into three groups by tertiles of Gensini score (GS, low group 28. The relationship between fibrinogen and GS was evaluated. Results. There were correlations of fibrinogen with hemoglobin A1c, C-reactive protein, and GS (r=0.17, r=0.52, and r=0.21, resp.; all P<0.001. Area under the receivers operating characteristic curve of fibrinogen was 0.62 (95% CI 0.56–0.68, P<0.001 for predicting a high GS. Multivariate analysis suggested that plasma fibrinogen was an independent predictor of a high GS for diabetic patients (OR=1.40, 95% CI 1.04–1.88, and P=0.026 after adjusting for traditional risk factors of CAD. Conclusions. The present data indicated that plasma fibrinogen, a readily measurable systematic inflammatory marker, appeared to be an independent predictor for the severity of CAD in diabetic patients.

  3. The effects of implementation of guideline-directed medical therapy on relief of angina in patients with stable coronary artery disease in Serbia

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    Ilić Ivan

    2016-01-01

    Full Text Available Introduction. Adherence to proposed lifestyle changes and prescribed medication in patients with stable coronary artery disease (SCAD is poor. Objective. We sought to investigate the influence of adjusting guideline proposed medications on relief of angina in a large group of patients with SCAD in Serbia. Methods. The study included a total of 3,490 patients from 15 cardiology clinics with symptoms of stable angina and at least one of the following criteria: abnormal electrocardiogram (ECG, history of myocardial infarction (MI, positive stress test, significant coronary artery disease on coronary angiogram or previous revascularization. All the patients underwent comprehensive evaluation at initial visit and after two months. The relief of angina was study end-point defined as any reduction in Canadian Cardiology Society (CCS class, number of angina attacks per week and/or number of tablets of short-acting nitrates per week. Results. Most patients were included based on abnormal ECG (48.4%. At Visit 1, the average number of prescribed classes of medications to a single patient increased from 4.16 ± 1.29 to 4.63 ± 1.57 (p < 0.001. At the follow-up, the patients had significantly lower blood pressure (141 ± 19 / 85 ± 11 vs. 130 ± 12 / 80 ± 8 mmHg; p < 0.001 and most of them reported CCS class I (63.3%. The average weekly number of angina attacks was reduced from 2.82 ± 2.50 at Visit 1 to 1.72 0 ± 1.66 at Visit 2, as well as average weekly use of short-acting nitrates to treat these attacks (2.69 ± 2.53 to 1.74 ± 1.47 tablets; p < 0.001 for all. Conclusion. Adjustment of prescribed medications to guideline recommendations in a large Serbian patient population with prevalent risk factors led to significant relief of angina.

  4. Ivabradine and Bisoprolol on Doppler-derived Coronary Flow Velocity Reserve in Patients with Stable Coronary Artery Disease: Beyond the Heart Rate.

    Science.gov (United States)

    Tagliamonte, Ercole; Cirillo, Teresa; Rigo, Fausto; Astarita, Costantino; Coppola, Antonino; Romano, Carlo; Capuano, Nicola

    2015-08-01

    Coronary flow velocity reserve (CFVR) is an important prognostic marker in patients with stable coronary artery disease (CAD). Beta-blockers and ivabradine have been shown to improve CFVR in patients with stable CAD, but their effects were never compared. The aim of the current study was to compare the effects of bisoprolol and ivabradine on CFVR in patients with stable CAD. Patients in sinus rhythm with stable CAD were enrolled in this prospective, randomized, double-blind trial. Patients had to be in a stable condition for at least 15 days before enrollment, on their usual therapy. Patients who were receiving beta-blockers or ivabradine entered a 2-week washout period from these drugs before randomization. Transthoracic Doppler-derived CFVR was assessed in left anterior descending coronary artery, and was calculated as the ratio of hyperemic to baseline diastolic coronary flow velocity (CFV). Hyperemic CFV was obtained using dipyridamole administration using standard protocols. After CFVR assessment, patients were randomized to ivabradine or bisoprolol and entered an up-titration phase, and CFVR was assessed again 1 month after the end of the up-titration phase. Fifty-nine patients (38 male, 21 female; mean age 69 ± 9 years) were enrolled. Transthoracic Doppler-derived assessment of CFV and CFVR was successfully performed in all patients. Baseline characteristics were similar between the bisoprolol and ivabradine groups. No patient dropped out during the study. At baseline, rest and hyperemic peak CFV as well as CFVR was not significantly different in the ivabradine and bisoprolol groups. After the therapy, resting peak CFV significantly decreased in both the ivabradine and bisoprolol groups, but there was no significant difference between the groups (ivabradine group 20.7 ± 4.6 vs. 22.8 ± 5.2, P < 0.001; bisoprolol group 20.1 ± 4.1 vs. 22.1 ± 4.3, P < 0.001). However, hyperemic peak CFV significantly increased in both groups, but to a

  5. High Prevalence of Metabolic Syndrome and Cardiovascular Disease Risk Among People with HIV on Stable ART in Southwestern Uganda.

    Science.gov (United States)

    Muyanja, Daniel; Muzoora, Conrad; Muyingo, Anthony; Muyindike, Winnie; Siedner, Mark J

    2016-01-01

    The objectives of this study were to determine the epidemiology and correlates of cardiovascular disease (CVD) risk among Ugandans on first-line antiretroviral therapy (ART). We conducted a cross-sectional study at an HIV clinic in southwestern Uganda. We enrolled adult patients on non-nucleoside-based ART regimens for a minimum of 2 years. We collected anthropometric and clinical measurements, smoking history, and blood for fasting lipid profile and blood sugar (FBS). Outcomes of interest were (1) presence of metabolic syndrome (at least two of the following: FBS >100 mg/dL, blood pressure of ≥130/85 mmHg, triglycerides ≥150 mg/dL, HDL 5% 10-year CVD risk. Of the 250 participants enrolled, metabolic syndrome was detected in 145/250 (58%) of participants (62% in females and 50% in males). Forty-three participants (17%) had a Framingham risk correlating to a 5% or greater risk for CVD within 10 years (26% in males and 13% in females). In multivariate analyses, being female (AOR 3.13; 95% CI: 1.0-9.70; p = 0.04) and over 40 years of age (AOR 1.78; 95% CI: 1.00-3.17; p = 0.05) was independently associated with having metabolic syndrome. We found no independent risk factors for a Framingham risk score 10-year risk exceeding 5%, or associations between ART regimen and CVD risk profiles. We conclude that metabolic abnormalities are common among patients on first-line ART in rural Uganda, and appear to be more common in women than men.

  6. Core Genome Multilocus Sequence Typing Scheme for Stable, Comparative Analyses of Campylobacter jejuni and C. coli Human Disease Isolates.

    Science.gov (United States)

    Cody, Alison J; Bray, James E; Jolley, Keith A; McCarthy, Noel D; Maiden, Martin C J

    2017-07-01

    Human campylobacteriosis, caused by Campylobacter jejuni and C. coli , remains a leading cause of bacterial gastroenteritis in many countries, but the epidemiology of campylobacteriosis outbreaks remains poorly defined, largely due to limitations in the resolution and comparability of isolate characterization methods. Whole-genome sequencing (WGS) data enable the improvement of sequence-based typing approaches, such as multilocus sequence typing (MLST), by substantially increasing the number of loci examined. A core genome MLST (cgMLST) scheme defines a comprehensive set of those loci present in most members of a bacterial group, balancing very high resolution with comparability across the diversity of the group. Here we propose a set of 1,343 loci as a human campylobacteriosis cgMLST scheme (v1.0), the allelic profiles of which can be assigned to core genome sequence types. The 1,343 loci chosen were a subset of the 1,643 loci identified in the reannotation of the genome sequence of C. jejuni isolate NCTC 11168, chosen as being present in >95% of draft genomes of 2,472 representative United Kingdom campylobacteriosis isolates, comprising 2,207 (89.3%) C. jejuni isolates and 265 (10.7%) C. coli isolates. Validation of the cgMLST scheme was undertaken with 1,478 further high-quality draft genomes, containing 150 or fewer contiguous sequences, from disease isolate collections: 99.5% of these isolates contained ≥95% of the 1,343 cgMLST loci. In addition to the rapid and effective high-resolution analysis of large numbers of diverse isolates, the cgMLST scheme enabled the efficient identification of very closely related isolates from a well-defined single-source campylobacteriosis outbreak. Copyright © 2017 Cody et al.

  7. Clinical characteristics and usage of statins in patients with stable ischemic heart disease referred for angiography or coronary artery bypass grafting

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    I.V. Shklianka

    2017-12-01

    Full Text Available The aim – to compare the clinical characteristics and frequency of statins usage in real clinical practice in patients referred to a specialized clinic for angiography or coronary artery bypass grafting. Materials and methods. In a retrospective slice single-center study data from a primary examination of 155 patients with stable ischemic heart disease, consecutively selected for coronary artery bypass grafting surgery, were analyzed. Depending on the inclusion of statins in the list of medicinal prescriptions, patients were retrospectively divided into two groups: those who had been prescribed statins while they were initially referred to a specialized cardiac surgery center for angiography or revascularization (n = 84 and those who were not prescribed statins (n ​​= 71. Results. The studied patients’ cohort was characterized by earlier coronary events, signs of the peripheral artery atherosclerosis and other absolute indications for treatment with statins in vast majority of cases. At the same time, groups of patients who had been and had not been prescribed statins, did not differ by vast majority of demographic, clinical and instrumental characteristics, concomitant diseases and risk factors. No statin therapy was associated with higher levels of total cholesterol and interleukin-6 compared with the group of patients taking statins (total cholesterol, respectively, 4.8 versus 4.2 mmol/l (p = 0.016 and interleukin-6, respectively, 4.4 versus. 3.1 p/ml (p = 0.022. In general, statins were prescribed in 54,2 % of patients, among them high doses – in 17 patients (20.2 %, moderate – 46 patients (54.8 %, low – 21 patients (25 %. Conclusions. The obtained data show the insufficient level of ambulatory statins usage in patients with ischemic heart disease referred for myocardial revascularization and significant discrepancy between clinical characteristics and real statins usage. Therefore, there is a great need to determine the

  8. A weak magnetic field inhibits hippocampal neurogenesis in SD rats

    Science.gov (United States)

    Zhang, B.; Tian, L.; Cai, Y.; Pan, Y.

    2017-12-01

    Geomagnetic field is an important barrier that protects life forms on Earth from solar wind and radiation. Paleomagnetic data have well demonstrated that the strength of ancient geomagnetic field was dramatically weakened during a polarity transition. Accumulating evidence has shown that weak magnetic field exposures has serious adverse effects on the metabolism and behaviors in organisms. Hippocampal neurogenesis occurs throughout life in mammals' brains which plays a key role in brain function, and can be influenced by animals' age as well as environmental factors, but few studies have examined the response of hippocampal neurogenesis to it. In the present study, we have investigated the weak magnetic field effects on hippocampal neurogenesis of adult Sprague Dawley (SD) rats. Two types of magnetic fields were used, a weak magnetic field (≤1.3 μT) and the geomagnetic fields (51 μT).The latter is treated as a control condition. SD rats were exposure to the weak magnetic field up to 6 weeks. We measured the changes of newborn nerve cells' proliferation and survival, immature neurons, neurons and apoptosis in the dentate gyrus (DG) of hippocampus in SD rats. Results showed that, the weak magnetic field (≤1.3 μT) inhibited their neural stem cells proliferation and significantly reduced the survival of newborn nerve cells, immature neurons and neurons after 2 or 4 weeks continuous treatment (i.e. exposure to weak magnetic field). Moreover, apoptosis tests indicated the weak magnetic field can promote apoptosis of nerve cells in the hippocampus after 4 weeks treatment. Together, our new data indicate that weak magnetic field decrease adult hippocampal neurogenesis through inhibiting neural stem cells proliferation and promoting apoptosis, which provides useful experimental constraints on better understanding the mechanism of linkage between life and geomagnetic field.

  9. ANALISIS REKRUITMEN TENAGA PENDIDIK PADA SD KALAM KUDUS PEKANBARU

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    Murnawati Murnawati

    2015-04-01

    Full Text Available Abstrak: Penelitian ini dilakukan untuk mengetahui sistem rekrutmen tenaga pendidik pada SD kalam kudus kota Pekanbaru. Populasi dalam penelitian ini adalah tenaga pendidik di SD Kalam Kudus Kota Pekanbaru, kebutuhan guru sebanyak 65 sedangkan guru tetap sebanyak 40 guru dan sisanya guru honor sebanyak 25 guru. Dalam penelitian ini penulis mengambil sampel seluruh populasi. Pengambilan sampel dilakukan secara sensus. Data yang digunakan adalah data primer yang diperoleh dari wawancara langsung dan penyebaran kuesioner. Analisis data dalam penelitian ini adalah menggunakan metode deskriptif. Berdasarkan hasil penelitian dapat disimpulkan bahwa persyaratan administrasi dalam rekruitmen guru diperoleh rata – rata skor sebesar 3,49. Artinya persyaratan administrasi dalam rekruitmen guru pada SD Kalam Kudus Pekanbaru dinilai baik. Abstract: This research aimed to determine the system of teachers’s recruitment in Kalam Kudus elementary school of Pekanbaru. The population in this study were educators in in Kalam Kudus elementary school of Pekanbaru, the teacher needs as much as 65 while the teacher remains as much as 40 teachers and teacher salaries remaining 25 teachers. In this study the authors took samples of the entire population. Sampling was done by census. The data used is primary data obtained from interviews and questionnaires. Data analyzed by descriptive method. Based on the results of this study concluded that the administrative requirements for the recruitment of teachers obtained average - average score of 3.49. This means that the administrative requirements for the recruitment of teachers in elementary Holy Kalam Pekanbaru considered good. Kata Kunci : Rekruitmen, Tenaga Pendidik

  10. Area SM12/SD12 - Reintegrated into the Meyrin Site

    CERN Multimedia

    Relations with the Host States Service

    2005-01-01

    Area SM12/SD12 near the Saint-Genis-Pouilly roundabout will be reintegrated into the Meyrin Site on Friday, 8 July at 2.00 p.m. From this date the area concerned will be accessible exclusively via the Route Siegbahn. The gate onto the main road RD 984 will be used exclusively for the exceptional loads of the LHC dipole cryomagnets under conditions laid down by the relevant authorities. Relations with the Host States Service and TS-IC Group

  11. Automated choroid segmentation of three-dimensional SD-OCT images by incorporating EDI-OCT images.

    Science.gov (United States)

    Chen, Qiang; Niu, Sijie; Fang, Wangyi; Shuai, Yuanlu; Fan, Wen; Yuan, Songtao; Liu, Qinghuai

    2018-05-01

    The measurement of choroidal volume is more related with eye diseases than choroidal thickness, because the choroidal volume can reflect the diseases comprehensively. The purpose is to automatically segment choroid for three-dimensional (3D) spectral domain optical coherence tomography (SD-OCT) images. We present a novel choroid segmentation strategy for SD-OCT images by incorporating the enhanced depth imaging OCT (EDI-OCT) images. The down boundary of the choroid, namely choroid-sclera junction (CSJ), is almost invisible in SD-OCT images, while visible in EDI-OCT images. During the SD-OCT imaging, the EDI-OCT images can be generated for the same eye. Thus, we present an EDI-OCT-driven choroid segmentation method for SD-OCT images, where the choroid segmentation results of the EDI-OCT images are used to estimate the average choroidal thickness and to improve the construction of the CSJ feature space of the SD-OCT images. We also present a whole registration method between EDI-OCT and SD-OCT images based on retinal thickness and Bruch's Membrane (BM) position. The CSJ surface is obtained with a 3D graph search in the CSJ feature space. Experimental results with 768 images (6 cubes, 128 B-scan images for each cube) from 2 healthy persons, 2 age-related macular degeneration (AMD) and 2 diabetic retinopathy (DR) patients, and 210 B-scan images from other 8 healthy persons and 21 patients demonstrate that our method can achieve high segmentation accuracy. The mean choroid volume difference and overlap ratio for 6 cubes between our proposed method and outlines drawn by experts were -1.96µm3 and 88.56%, respectively. Our method is effective for the 3D choroid segmentation of SD-OCT images because the segmentation accuracy and stability are compared with the manual segmentation. Copyright © 2017. Published by Elsevier B.V.

  12. IDH mutations are closely associated with mutations of DNMT3A, ASXL1 and SRSF2 in patients with myelodysplastic syndromes and are stable during disease evolution.

    Science.gov (United States)

    Lin, Chien-Chin; Hou, Hsin-An; Chou, Wen-Chien; Kuo, Yuan-Yeh; Liu, Chieh-Yu; Chen, Chien-Yuan; Lai, Yan-Jun; Tseng, Mei-Hsuan; Huang, Chi-Fei; Chiang, Ying-Chieh; Lee, Fen-Yu; Liu, Ming-Chih; Liu, Chia-Wen; Tang, Jih-Luh; Yao, Ming; Huang, Shang-Yi; Ko, Bor-Sheng; Wu, Shang-Ju; Tsay, Woei; Chen, Yao-Chang; Tien, Hwei-Fang

    2014-02-01

    Current information about clinical significance of IDH mutations in myelodysplastic syndromes (MDS), their association with other genetic alterations and the stability during disease progression is limited. In this study, IDH mutations were identified in 4.6% of 477 patients with MDS based on the FAB classification and in 2.2 % of 368 patients based on the 2008 WHO classification. IDH mutations were closely associated with older age, higher platelet counts, and mutations of DNMT3A (36.4% vs. 8.7%, P IDH2 mutation was a poor prognostic factor for overall survival in patients with lower-risk MDS, based on international prognosis scoring system (IPSS), FAB classification, WHO classification, or revised IPSS (all P ≦ 0.001), but not in higher-risk groups. Sequential studies in 151 patients demonstrated that all IDH-mutated patients retained the same mutation during disease evolution while none of the IDH-wild patients acquired a novel mutation during follow-ups. In conclusion, IDH mutation is a useful biomarker for risk stratification of patients with lower-risk MDS. IDH mutations are stable during the clinical course. The mutation, in association with other genetic alterations, may play a role in the development, but not progression of MDS. Copyright © 2013 Wiley Periodicals, Inc.

  13. Adiponectin is associated with increased mortality and heart failure in patients with stable ischemic heart disease: data from the Heart and Soul Study.

    Science.gov (United States)

    Beatty, Alexis L; Zhang, Mary H; Ku, Ivy A; Na, Beeya; Schiller, Nelson B; Whooley, Mary A

    2012-02-01

    Serum adiponectin protects against incident ischemic heart disease (IHD). However, in patients with existing IHD, higher adiponectin levels are paradoxically associated with worse outcomes. We investigated this paradox by evaluating the relationship between adiponectin and cardiovascular events in patients with existing IHD. We measured total serum adiponectin and cardiac disease severity by stress echocardiography in 981 outpatients with stable IHD who were recruited for the Heart and Soul Study between September 2000 and December 2002. Subsequent heart failure hospitalizations, myocardial infarction, and death were recorded. During an average of 7.1 years of follow-up, patients with adiponectin levels in the highest quartile were more likely than those in the lowest quartile to be hospitalized for heart failure (23% vs. 13%; demographics-adjusted hazard ratio (HR) 1.63, 95% confidence interval (CI) 1.04-2.56, p=0.03) or die (49% vs. 31%; HR 1.67, 95% CI 1.24-2.26, pheart failure, or death occurred in 56% (136/245) of participants in the highest quartile of adiponectin vs. 38% (94/246) of participants in the lowest quartile (HR 1.54, 95% CI 1.31-2.21, pheart failure and mortality among patients with existing IHD. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  14. Risk of Stroke in Patients with Stable Coronary Artery Disease Undergoing Percutaneous Coronary Intervention versus Optimal Medical Therapy: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Nevio Taglieri

    Full Text Available Stroke is a rare but serious adverse event associated with percutaneous coronary intervention (PCI. However, the relative risk of stroke between stable patients undergoing a direct PCI strategy and those undergoing an initial optimal medical therapy (OMT strategy has not been established yet. This study sought to investigate if, in patients with stable coronary artery disease (SCAD, an initial strategy PCI is associated with a higher risk of stroke than a strategy based on OMT alone.We performed a meta-analysis of 6 contemporary randomized control trials in which 5673 patients with SCAD were randomized to initial PCI or OMT. Only trials with stent utilization more than 50% were included. Study endpoint was the rate of stroke during follow up.Mean age of patients ranged from 60 to 65 years and stent utilization ranged from 72% to 100%. Rate of stroke was 2.0% at a weighted mean follow up of 55.3 months. On pooled analysis, the risk of stroke was similar between patients undergoing a PCI plus OMT and those receiving only OMT (2.2% vs. 1.8%, OR on fixed effect = 1.24 95%CI: 0.85-1.79. There was no heterogeneity among the studies (I2 = 0.0%, P = 0.15. On sensitivity analysis after removing each individual study the pooled effect estimate remains unchanged.In patients with SCAD an initial strategy based on a direct PCI is not associated with an increased risk of stroke during long-term follow up compared to an initial strategy based on OMT alone.

  15. [Impact of platelet distribution width on the extent and long-term outcome of patients with stable coronary artery disease post percutaneous coronary intervention].

    Science.gov (United States)

    Jiang, P; Song, Y; Xu, J J; Ma, Y L; Tang, X F; Yao, Y; Jiang, L; Wang, H H; Zhang, X; Diao, X L; Yang, Y J; Gao, R L; Qiao, S B; Xu, B; Yuan, J Q

    2017-10-24

    Objective: To evaluate the relationship between platelet distribution width(PDW) and the extent of coronary artery disease and 2-year outcome in patients received percutaneous coronary artery intervention(PCI) because of stable coronary artery disease(SCAD). Methods: We consecutively enrolled 4 293 patients who received PCI because of SCAD in Fuwai Hospital from Jan 2013 to Dec 2013, patients were followed up for 2 years. Patients were divided into three groups according to tertiles values of PDW as follows: PDW≤11.4%(1 402 patients), 11.4%12.9% (1 450 patients). Major adverse cardiovascular and cerebrovascular events (MACCE) were defined as the occurrence of death, myocardial infarction, target vessel revascularization, intra stent thrombosis and stroke during follow-up. Multivariable logistic regression was used to evaluate the relationship between PDW and the extent of CAD. Multivariable Cox regression was used to evaluate the relationship between PDW and prognosis of SCAD patients. Results: PDW was associated with diabetes mellitus, body mass index, red cell distribution width, mean platelet volume (MPV), platelet counts and glycosylated haemoglobin ( P 0.05). PDW was not correlated with the extent of CAD( P =0.990), SYNTAX score( P =0.721), no-reflow phenomenon after PCI( P =0.978). Multivariable logistic regression also showed no relationship between PDW and extent of CAD ( OR =0.994, 95% CI 0.961-1.029, P =0.73). PDW was found to be an independent risk factor of 2-year cardiac death ( HR =1.242, 95% CI 1.031-1.497, P =0.022), but was not an independent risk factor of all-cause death and MACCE. Conclusions: PDW is not related with the extent of coronary artery disease. PDW is an independent risk factor of 2-year cardiac death, but is not an independent risk factor of all-cause death and MACCE in this patient cohort.

  16. SdH oscillations and pressure effect of the Weyl semimetal NbAs

    Science.gov (United States)

    Luo, Yongkang; Ghimire, N. J.; Wartenbe, M.; Choi, Hongchul; Neupane, M.; McDonald, R. D.; Bauer, E. D.; Zhu, Jianxin; Thompson, J. D.; Ronning, F.

    Via angular Shubnikov-de Hass (SdH) quantum oscillations measurements, we determine the Fermi surface topology of NbAs. The SdH oscillations consist of two frequencies, corresponding to two Fermi surface extrema: 20.8 T (α-pocket) and 15.6 T (β-pocket). The analysis shows that the β-pocket has a Berry phase of π and a small effective mass 0.033 m0, indicative of a nontrivial topology; whereas the α-pocket has a trivial Berry phase of 0 and a heavier effective mass 0.066 m0. Subtle changes can be seen in the ρxx(T) profiles with pressure up to 2.31 GPa. The Fermi surfaces undergo an anisotropic evolution under pressure, while the topological features of the two pockets remain unchanged. Specific heat measurements reveal a small Sommerfeld coefficient γ0 = 0.09(1) mJ/(molK2) and a large Debye temperature, ΘD = 450(9) K, confirming a ``hard'' crystalline lattice that is stable under pressure. We also studied the Kadowaki-Woods ratio of this low-carrier-density massless system, RKW = 3.2×104µ Ω cm mol2K2J-2. After accounting for the small carrier density in NbAs, this RKW indicates a suppressed transport scattering rate relative to other metals.

  17. Prognostic impact of nutritional status assessed by the Controlling Nutritional Status score in patients with stable coronary artery disease undergoing percutaneous coronary intervention.

    Science.gov (United States)

    Wada, Hideki; Dohi, Tomotaka; Miyauchi, Katsumi; Doi, Shinichiro; Konishi, Hirokazu; Naito, Ryo; Tsuboi, Shuta; Ogita, Manabu; Kasai, Takatoshi; Okazaki, Shinya; Isoda, Kikuo; Suwa, Satoru; Daida, Hiroyuki

    2017-11-01

    Recently, malnutrition has been shown to be related to worse clinical outcomes in patients with heart failure. However, the association between nutritional status and clinical outcomes in patients with coronary artery disease (CAD) remains unclear. We investigated the prognostic value of malnutrition assessed by the Controlling Nutritional Status (CONUT; range 0-12, higher = worse, consisting of serum albumin, cholesterol and lymphocytes) score in patients with CAD. The CONUT score was measured on admission in a total of 1987 patients with stable CAD who underwent elective percutaneous coronary intervention (PCI) between 2000 and 2011. Patients were divided into two groups according to their CONUT score (0-1 vs. ≥2). The incidence of major adverse cardiac events (MACE), including all-cause death and non-fatal myocardial infarction, was evaluated. The median CONUT score was 1 (interquartile range 0-2). During the median follow-up of 7.4 years, 342 MACE occurred (17.2%). Kaplan-Meier curves revealed that patients with high CONUT scores had higher rates of MACE (log-rank p Nutritional status assessed by the CONUT score was significantly associated with long-term clinical outcomes in patients with CAD. Pre-PCI assessment of the CONUT score may provide useful prognostic information.

  18. [Stress Echocardiography in the Assessment of Long-Term Outcomes After Percutaneous Coronary Intervention in Patients With Stable Coronary Heart Disease].

    Science.gov (United States)

    Karpov, A Y; Elkanova, M M; Shitov, N V; Botvina, V U; Lopukhova, V V; Saidova, A M

    2017-07-01

    To study the possibilities of stress echocardiography (EchoCG) in the assessment of clinical state of patients after percutaneous coronary intervention (PCI). We included into this study 80 patients with stable ischemic heart disease. After preliminary examination, all patients underwent PCI. Stress EchoCG was carried out in 6 and 12 months after PCI. Clinical effect assessed in 12 months after revascularization was good in 90% of patients. We registered significant increase of exercise capacity (from 97 to 118 W; p=0.001), increase of double product (from 232 to 275; p=0.009), decrease of myocardial ischemia volume (regional contractility impairment index before PCI 1.36, a year after PCI 1.16; p=0.001). The incidence of restenosis was 7.5%. Restenosis was accompanied by a deterioration of clinical status of patients (silent myocardial ischemia, angina recurrence). The accuracy of stress echocardiography in detecting myocardial ischemia in patients after PCI was 94%. Stress EchoCG has high diagnostic accuracy for detection of myocardial ischemia in patients after PCI during the first 12 months after revascularization.

  19. Chemical fingerprints of He-sdO stars

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    Schindewolf Markus

    2018-02-01

    Full Text Available The chemical composition of helium-rich hot subluminous O stars plays an important role to understand and model their formation history. We present a spectroscopic analysis of four He-sdO stars,CD-31° 4800, [CW83] 0904- 02, LSS 1274 and LS IV +10° 9. The analysis is based on archival optical and UV high-resolution spectra. We used Tlusty200/Synspec48 to compute line blanketed non-LTE model atmospheres and their corresponding synthetic spectra and derive the atmospheric parameters as well as the abundances of the most prominent elements. All stars have helium-dominated atmospheres with hardly any hydrogen and temperatures between 42000 K and 47000 K while their surface gravity spans between log g = 5.4 and 5.7. CD-31° 4800 shows an enrichment of nitrogen and the characteristic pattern of hydrogen burning via the CNO-cycle, while the rest of the elements have about the solar abundance. This points to the slow merger of two helium white dwarfs as the most likely origin for this system. The other three stars are enriched in carbon, nitrogen and neon while their intermediate mass element’s abundance scatters around the solar value. They were possibly formed in the deep mixing late hot flasher scenario.

  20. BENTUK POLA ASUH DEMOKRATIS DALAM KEDISIPLINAN SISWA SD

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    Jihan Filisyamala

    2016-04-01

    Full Text Available Parenting is the treatment of parents in order to meet the needs and educate the child in daily life. In a family, parents presence is of great significance for the development of a child's personality, because the family is the first and most important environment which will give effect to some aspects of child development, including discipline of the. The students discipline is to give an understanding of what is good and bad. This article will describe democratic parenting the discipline of elementary students. Pola asuh adalah perlakuan orangtua dalam rangka memenuhi kebutuhan dan mendidik anak dalam kehidupan sehari-hari. Dalam sebuah keluarga, kehadiran orangtua sangatlah besar artinya bagi perkembangan kepribadian seorang anak, karena keluarga merupakan lingkungan pertama dan paling utama yang nantinya akan memberikan pengaruh terhadap beberapa aspek perkembangan anak, termasuk kedisiplinan siswa. Kedisiplinan pada siswa adalah memberikan pengertian akan mana yang baik dan yang buruk. Pada artikel ini akan mendeskripsikan bentuk pola asuh demokratis dalam kedisiplinan siswa SD.

  1. Chemical fingerprints of He-sdO stars

    Science.gov (United States)

    Schindewolf, Markus; Németh, Peter; Heber, Ulrich; Battich, Tiara; Bertolami, Marcelo M. Miller; Latour, Marilyn

    2018-02-01

    The chemical composition of helium-rich hot subluminous O stars plays an important role to understand and model their formation history. We present a spectroscopic analysis of four He-sdO stars,CD-31° 4800, [CW83] 0904- 02, LSS 1274 and LS IV +10° 9. The analysis is based on archival optical and UV high-resolution spectra. We used Tlusty200/Synspec48 to compute line blanketed non-LTE model atmospheres and their corresponding synthetic spectra and derive the atmospheric parameters as well as the abundances of the most prominent elements. All stars have helium-dominated atmospheres with hardly any hydrogen and temperatures between 42000 K and 47000 K while their surface gravity spans between log g = 5.4 and 5.7. CD-31° 4800 shows an enrichment of nitrogen and the characteristic pattern of hydrogen burning via the CNO-cycle, while the rest of the elements have about the solar abundance. This points to the slow merger of two helium white dwarfs as the most likely origin for this system. The other three stars are enriched in carbon, nitrogen and neon while their intermediate mass element's abundance scatters around the solar value. They were possibly formed in the deep mixing late hot flasher scenario.

  2. Identification of a New Marine Bacterial Strain SD8 and Optimization of Its Culture Conditions for Producing Alkaline Protease

    Science.gov (United States)

    Cui, Hongxia; Yang, Muyang; Wang, Liping; Xian, Cory J.

    2015-01-01

    While much attention has been given to marine microorganisms for production of enzymes, which in general are relatively more stable and active compared to those from plants and animals, studies on alkaline protease production from marine microorganisms have been very limited. In the present study, the alkaline protease producing marine bacterial strain SD8 isolated from sea muds in the Geziwo Qinhuangdao sea area of China was characterized and its optimal culture conditions were investigated. Strain SD8 was initially classified to belong to genus Pseudomonas by morphological, physiological and biochemical characterizations, and then through 16S rDNA sequence it was identified to be likely Pseudomonas hibiscicola. In addition, the culture mediums, carbon sources and culture conditions of strain SD8 were optimized for maximum production of alkaline protease. Optimum enzyme production (236U/mL when cultured bacteria being at 0.75 mg dry weight/mL fermentation broth) was obtained when the isolate at a 3% inoculum size was grown in LB medium at 20 mL medium/100mL Erlenmeyer flask for 48h culture at 30°C with an initial of pH 7.5. This was the first report of strain Pseudomonas hibiscicola secreting alkaline protease, and the data for its optimal cultural conditions for alkaline protease production has laid a foundation for future exploration for the potential use of SD8 strain for alkaline protease production. PMID:26716833

  3. Long acting β2 agonists for stable chronic obstructive pulmonary disease with poor reversibility: a systematic review of randomised controlled trials

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    Mensinkai Shaila

    2004-08-01

    Full Text Available Abstract Background The long acting β2-agonists, salmeterol and formoterol, have been recommended, by some, as first line treatment of stable chronic obstructive pulmonary disease (COPD. We reviewed evidence of efficacy and safety when compared with placebo or anticholinergic agents in patients with poorly reversible COPD. Methods After searching MEDLINE, EMBASE, HealthSTAR, BIOSIS Previews, PASCAL, ToxFile, SciSearch, the Cochrane Library, and PubMed, as well as Web sites, selected journals, reference lists, and contacting drug manufacturers, two reviewers independently screened reports of randomised controlled trials of parallel or crossover design lasting four weeks or longer and including patients with a forced expiratory volume in one second (FEV1 ≤ 75% of predicted, a ratio of FEV1 to forced vital capacity (FVC ≤ 88% of predicted, and Results Twelve trials satisfied our inclusion criteria; eight were high quality (Jadad score >2 and four were low quality (≤ 2. The adequacy of allocation concealment was unclear in all of them. We did not perform a meta-analysis due to differences in trial design and how outcomes were reported. Two trials comparing salmeterol with ipratropium did not detect differences; one trial comparing formoterol and ipratropium described greater improvement with formoterol in morning PEFR (15.3 versus 7.1 l/min, p = 0.040. Of twelve trials comparing long acting β2 agonists with placebo, six reported no improvement in exercise capacity, eleven reported improvements in FEV1 lung function (one reported no improvement, six reported less rescue inhaler usage (one reported no difference and five reported improved dyspnea scores (two reported no improvement. Differences in quality of life were detected in one salmeterol trial ; however, two salmeterol, and one formoterol trial reported no differences. Adverse effects of interest were not reported. Conclusion In terms of clinical outcomes and safety, we could not find

  4. Cognitive Performance Is Highly Stable over a 2-Year-Follow-Up in Chronic Kidney Disease Patients in a Dedicated Medical Environment.

    Science.gov (United States)

    Gronewold, Janine; Todica, Olga; Seidel, Ulla K; Volsek, Michaela; Kribben, Andreas; Bruck, Heike; Hermann, Dirk M

    2016-01-01

    As kidney and brain functions decline with aging, chronic kidney disease (CKD) and dementia are becoming increasing health burdens worldwide. Among the risk factors for cognitive impairment, CKD is increasingly recognized. The precise impact of CKD on the development of cognitive impairment is poorly understood. In the New Tools for the Prevention of Cardiovascular Disease in Chronic Kidney Disease (NTCVD) cohort, which was recruited in a dedicated nephrology department, we examined the 2-year course of cognitive performance in 120 patients (73 patients with CKD stages 3-5D, 47 control patients without CKD with similar vascular risk profile) using a comprehensive battery of 10 neuropsychological tests. Kidney function, vascular risk factors and cognitive performance were highly stable both in CKD and control patients. The summary score of cognitive performance in CKD patients was very similar at baseline (z = -0.63±0.76) and follow-up (z = -0.54±0.79, p = 0.113), as was cognitive performance in control patients (z = -0.01±0.59 and 0.01±0.70, p = 0.862, at baseline and follow-up, respectively). Total serum cholesterol (199.6±36.0 and 186.0±32.9, p = 0.005 in controls; 194.4±46.1 and 181.2±41.2, p = 0.008 in CKD) and common carotid intima-media thickness (0.87±0.18 and 0.84±0.17, p = 0.351 in controls; 0.88±0.21 and 0.82±0.16, p = 0.002 in CKD) moderately but significantly decreased during the follow-up. In multivariable regression analyses, high age (β = -0.28, 95%CI = -0.48 to 0.08, p = 0.007) predicted decrease in cognitive performance. In this well-defined cohort receiving state-of-the-art therapy, cognitive performance did not decrease over 2 years. Our data emphasize the aspect of risk factor control, suggesting that dedicated medical care might prevent cognitive decline in CKD patients.

  5. A Respiratory Syncytial Virus Vaccine Vectored by a Stable Chimeric and Replication-Deficient Sendai Virus Protects Mice without Inducing Enhanced Disease.

    Science.gov (United States)

    Wiegand, Marian Alexander; Gori-Savellini, Gianni; Gandolfo, Claudia; Papa, Guido; Kaufmann, Christine; Felder, Eva; Ginori, Alessandro; Disanto, Maria Giulia; Spina, Donatella; Cusi, Maria Grazia

    2017-05-15

    Respiratory syncytial virus (RSV) is a major cause of severe respiratory infections in children and elderly people, and no marketed vaccine exists. In this study, we generated and analyzed a subunit vaccine against RSV based on a novel genome replication-deficient Sendai virus (SeV) vector. We inserted the RSV F protein, known to be a genetically stable antigen, into our vector in a specific way to optimize the vaccine features. By exchanging the ectodomain of the SeV F protein for its counterpart from RSV, we created a chimeric vectored vaccine that contains the RSV F protein as an essential structural component. In this way, the antigen is actively expressed on the surfaces of vaccine particles in its prefusion conformation, and as recently reported for other vectored vaccines, the occurrence of silencing mutations of the transgene in the vaccine genome can be prevented. In addition, its active gene expression contributes to further stimulation of the immune response. In order to understand the best route of immunization, we compared vaccine efficacies after intranasal (i.n.) or intramuscular (i.m.) immunization of BALB/c mice. Via both routes, substantial RSV-specific immune responses were induced, consisting of serum IgG and neutralizing antibodies, as well as cytotoxic T cells. Moreover, i.n. immunization was also able to stimulate specific mucosal IgA in the upper and lower respiratory tract. In virus challenge experiments, animals were protected against RSV infection after both i.n. and i.m. immunization without inducing vaccine-enhanced disease. Above all, the replication-deficient SeV appeared to be safe and well tolerated. IMPORTANCE Respiratory syncytial virus (RSV) is a major cause of respiratory diseases in young children and elderly people worldwide. There is a great demand for a licensed vaccine. Promising existing vaccine approaches based on live-attenuated vaccines or viral vectors have suffered from unforeseen drawbacks related to immunogenicity

  6. KEMAMPUAN BERPIKIR KREATIF SISWA SD DALAM PEMBELAJARAN IPA

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    Jamaluddin Jamaluddin

    2016-02-01

    Full Text Available Abstract: Elementary School Studens' Creative Thinking Skills in Science Learning. This study aims (1 to investigate the differences of creative thinking skills among elementary school students who applied various learning methods (questioning, Think-Pair-Share, and Numbered-Head together and those who applied conventional learning methods; (2 to find out the differences in creative thinking skills between students of high and low academic ability; (3 to investigate the differences of creative thinking skills as influ­enced by learning methods and academic ability. Using a quasi -experimental design, this study found out that there are differences in creative thinking skills among students applying different learning methods and among students of different academic abilities and that these differences in creative thinking are skills as influenced by learning methods and academic abilities. Abstrak: Kemampuan Berpikir Kreatif Siswa SD dalam Pembelajaran IPA. Artikel ini didasarkan pada laporan penelitian yang bertujuan untuk mengetahui (1 perbedaan keterampilan berpikir kreatif, antara siswa yang belajar dengan strategi pembelajaran PBMP, PBMPTPS, PBMPNHT, dan strategi pembelajaran konvensional; (2 perbedaan keterampilan berpikir kreatif siswa berkemampuan akademik tinggi dan rendah; (3 perbedaan keterampilan berpikir kreatif akibat dari interaksi antara strategi pembelajaran dengan kemampuan akademik siswa. Hasil penelitian menunjukkan (1 ada perbedaan keterampilan berpikir kreatif antara siswa yang belajar dengan strategi PBMP, PBMPTPS, PBMPNHT, dan strategi Konven­sional; (2 ada perbedaan keterampilan berpikir kreatif, antara siswa berkemampuan akademik tinggi dengan siswa berkemampuan akademik rendah; (3 interaksi strategi pembelajaran PBMP, PBMP.TPS, PBMP.NHT, dan konvensional dengan kemampuan akademik siswa tidak berpengaruh signifikan terhadap keterampilan berpikir kreatif.

  7. The changes of oxidative stress and endothelial function biomarkers after 6 weeks of aerobic physical training in patients with stable ischemic coronary disease

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    Đinđić Boris J.

    2017-01-01

    Full Text Available Introduction: Exercise-based cardiac rehabilitation improves endothelialBackground/Aim. Exercise-based cardiac rehabilitation improves endothelial function, reduces cardiac mortality and anginal symptoms in patients with established cardiovascular disease. We evaluated the changes of oxidative stress and endothelial function biomarkers after 6 weeks of aerobic physical training in patients with stable ischemic coronary disease (IHD participating in a cardiovascular rehabilitation exercise program. Methods. Thirty-five patients with stable IHD engaged in cardiovascular rehabilitation program with the regular aerobic physical activity during 6 weeks were consecutively included together with 37 control, age and sex-matched, IHD patients with a sedentary lifestyle. Clinical data about anthropometric and cardiovascular parameters and laboratory data: serum cell adhesion molecules intracellular (sICAM-1 and vascular (sVCAM-1, reactive carbonyl derivatives (RCD, lipid peroxidation products malondialdehyde (MDA and nitric oxide (NO concentration were determined at the beginning and after 6 weeks of aerobic training (45 minutes of continuous exercise up to 80% of maximal heart rate, 3 times a week. Results. The baseline characteristics of examined groups were similar according to age, gender, and cardiovascular risk profiles. The regular aerobic physical activity induced significant reduction of body mass index, blood pressure, heart rate, triglycerides, RCD (1.27 ± 0.48 μmol/g proteins vs. 1.04 ± 0.22 μmol/g proteins, sVCAM-1 [100.4, interquartile range (IQR(78.4–118.3 ng/mL vs. 80.0 IQR(68.5–97.2 ng/mL] and increasing of NO (64.72 ± 16.06 nmol/mg proteins vs. 74.38 ± 18.57 nmol/mg proteins and HDL cholesterol (p < 0.05, which was not seen in sedentary control RCD (1.16 ± 0.25 interquartile range vs. 1.12 ± 0.14 interquartile range, sVCAM-1 [92.2 IQR (73.6–106.8 ng/mL vs. 91.3 IQR (73.0–105.3 ng/mL and NO (68.5 ± 17.9 nmol/mg vs. 65.7

  8. Diagnosing coronary artery disease by sound analysis from coronary stenosis induced turbulent blood flow: diagnostic performance in patients with stable angina pectoris.

    Science.gov (United States)

    Winther, Simon; Schmidt, Samuel Emil; Holm, Niels Ramsing; Toft, Egon; Struijk, Johannes Jan; Bøtker, Hans Erik; Bøttcher, Morten

    2016-02-01

    Optimizing risk assessment may reduce use of advanced diagnostic testing in patients with symptoms suggestive of stable coronary artery disease (CAD). Detection of diastolic murmurs from post-stenotic coronary turbulence with an acoustic sensor placed on the chest wall can serve as an easy, safe, and low-cost supplement to assist in the diagnosis of CAD. The aim of this study was to evaluate the diagnostic accuracy of an acoustic test (CAD-score) to detect CAD and compare it to clinical risk stratification and coronary artery calcium score (CACS). We prospectively enrolled patients with symptoms of CAD referred to either coronary computed tomography or invasive coronary angiography (ICA). All patients were tested with the CAD-score system. Obstructive CAD was defined as more than 50 % diameter stenosis diagnosed by quantitative analysis of the ICA. In total, 255 patients were included and obstructive CAD was diagnosed in 63 patients (28 %). Diagnostic accuracy evaluated by receiver operating characteristic curves was 72 % for the CAD-score, which was similar to the Diamond-Forrester clinical risk stratification score, 79 % (p = 0.12), but lower than CACS, 86 % (p < 0.01). Combining the CAD-score and Diamond-Forrester score, AUC increased to 82 %, which was significantly higher than the standalone CAD-score (p < 0.01) and Diamond-Forrester score (p < 0.05). Addition of the CAD-score to the Diamond-Forrester score increased correct reclassification, categorical net-reclassification index = 0.31 (p < 0.01). This study demonstrates the potential use of an acoustic system to identify CAD. The combination of clinical risk scores and an acoustic test seems to optimize patient selection for diagnostic investigation.

  9. A double blind randomized placebo control crossover trial on the effect of dietary nitrate supplementation on exercise tolerance in stable moderate chronic obstructive pulmonary disease.

    Science.gov (United States)

    Leong, Paul; Basham, Jane E; Yong, Theresa; Chazan, Adrian; Finlay, Paul; Barnes, Sara; Bardin, Phillip G; Campbell, Donald

    2015-05-02

    Dietary nitrate supplementation has been shown to decrease the oxygen cost of exercise and prolong exercise tolerance, as measured by sub-maximal exercise endurance distance and time at 85% V̇O2max, in both elite athletes and normal healthy subjects. Patients with chronic obstructive pulmonary disease (COPD) have reduced quality of life and ability to perform activities of daily living attributable to diminished exercise tolerance, and dietary nitrate may be able to ameliorate this. We performed a double-blind, computer-randomized placebo control crossover trial at a tertiary Australian hospital to investigate whether dietary nitrate supplementation as beetroot juice (BR) would augment submaximal exercise endurance in individuals with spirometrically confirmed stable moderate COPD. Volunteers underwent an incremental shuttle walk test to determine V̇O2max followed by a test dose of BR to establish safety in the study population. Participants performed an endurance shuttle walk test (ESWT) at 85% V̇O2max after randomization to either a 3 day wash-in of BR (4.8 mmol twice a day) or placebo (nitrate deplete BR), with a final dose on the morning of testing. They then crossed over after 4 day washout. Repeated measures two sided paired t-tests were employed. 35 participants were recruited with 19 completing the trial. In the initial safety phase, we measured systolic blood pressure over four hours post first dose of BR, and found a mean 10 mmHg decrement maximal at 1 hour. One individual developed symptomatic postural hypotension and was excluded. The primary outcomes of ESWT distance and time to fatigue improved by 11% and 6% respectively; however these differences did not achieve statistical significance (p = 0.494 and 0.693 respectively). Our study does not support a role for routine dietary nitrate supplementation for enhancement of exercise endurance in COPD. Australia and New Zealand Clinical Trial Register: ACTRN12611001088932.

  10. Low paraoxonase 1 arylesterase activity and high von Willebrand factor levels are associated with severe coronary atherosclerosis in patients with non-diabetic stable coronary artery disease.

    Science.gov (United States)

    Ding, Jieying; Chen, Qizhi; Zhuang, Xing; Feng, Zhilei; Xu, Lili; Chen, Fuxiang

    2014-11-25

    Paraoxonase 1 (PON1) activity and von Willebrand factor (VWF) release are associated with lesion initiation in atherosclerosis. Diabetes can complicate coronary artery disease (CAD) due to the production of advanced glycation end products. This study evaluated PON1 activity and VWF levels in non-post-acute coronary syndrome, stable CAD (SCAD) patients without diabetes. Non-diabetic SCAD patients and patients experiencing acute stress periods were selected (n=130). Forty-seven cases with normal coronary angiography and 50 healthy individuals served as controls. The non-diabetic SCAD group was then stratified into single-vessel lesions, multiple-vessel lesions, and mild or severe luminal stenosis according to the number and the degree of luminal stenoses. Serum PON1 paraoxonase and arylesterase activities, and plasma VWF levels were measured, as well as serum total cholesterol, total triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and apolipoprotein A1. PON1 arylesterase activity was detected with an ordinary chemistry system using a novel phenylacetate derivative. Both PON1 paraoxonase and arylesterase were lower in the non-diabetic SCAD group, but VWF levels were higher (versus controls, all Pparaoxonase activity (OR=0.991), PON1 arylesterase activity (OR=0.981), and VWF (OR 2.854) influenced SCAD in multiple logistic regression. Decreased PON1 arylesterase activity and increased VWF levels were associated with severe atherosclerosis in non-diabetic SCAD patients. We also observed a slight negative correlation between VWF and PON1 paraoxonase/arylesterase. PON1 and VWF are detectable markers that may predict the severity of stenoses, ideally facilitating a non-diabetic SCAD diagnosis before the sudden onset of life-threatening symptoms.

  11. Baseline stress myocardial perfusion imaging results and outcomes in patients with stable ischemic heart disease randomized to optimal medical therapy with or without percutaneous coronary intervention.

    Science.gov (United States)

    Shaw, Leslee J; Weintraub, William S; Maron, David J; Hartigan, Pamela M; Hachamovitch, Rory; Min, James K; Dada, Marcin; Mancini, G B John; Hayes, Sean W; O'Rourke, Robert A; Spertus, John A; Kostuk, William; Gosselin, Gilbert; Chaitman, Bernard R; Knudtson, Merill; Friedman, John; Slomka, Piotr; Germano, Guido; Bates, Eric R; Teo, Koon K; Boden, William E; Berman, Daniel S

    2012-08-01

    The COURAGE trial reported similar clinical outcomes for patients with stable ischemic heart disease (SIHD) receiving optimal medical therapy (OMT) with or without percutaneous coronary intervention (PCI). The current post hoc substudy analysis examined the relationship between baseline stress myocardial ischemia and clinical outcomes based on randomized treatment assignment. A total of 1,381 randomized patients (OMT n = 699, PCI + OMT n = 682) underwent baseline stress myocardial perfusion single-photon emission computed tomographic imaging. Site investigators interpreted the extent of ischemia by the number of ischemic segments using a 6-segment myocardial model. Patients were divided into those with no to mild (ischemic segments) and moderate to severe ischemia (≥ 3 ischemic segments). Cox proportional hazards models were calculated to assess time to the primary end point of death or myocardial infarction. At baseline, moderate to severe ischemia occurred in more than one-quarter of patients (n = 468), and the incidence was comparable in both treatment groups (P = .36). The primary end point, death or myocardial infarction, was similar in the OMT and PCI + OMT treatment groups for no to mild (18% and 19%, P = .92) and moderate to severe ischemia (19% and 22%, P = .53, interaction P value = .65). There was no gradient increase in events for the overall cohort with the extent of ischemia. From the COURAGE trial post hoc substudy, the extent of site-defined ischemia did not predict adverse events and did not alter treatment effectiveness. Currently, evidence supports equipoise as to whether the extent and severity of ischemia impact on therapeutic effectiveness. Copyright © 2012 Mosby, Inc. All rights reserved.

  12. Meta-analysis of trials on mortality after percutaneous coronary intervention compared with medical therapy in patients with stable coronary heart disease and objective evidence of myocardial ischemia.

    Science.gov (United States)

    Gada, Hemal; Kirtane, Ajay J; Kereiakes, Dean J; Bangalore, Sripal; Moses, Jeffrey W; Généreux, Philippe; Mehran, Roxana; Dangas, George D; Leon, Martin B; Stone, Gregg W

    2015-05-01

    Outcomes of percutaneous coronary intervention (PCI) versus medical therapy (MT) in the management of stable ischemic heart disease (SIHD) remain controversial, with some but not all studies showing improved results in patients with ischemia. We sought to elucidate whether PCI improves mortality compared to MT in patients with objective evidence of ischemia (assessed using noninvasive imaging or its invasive equivalent). We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing PCI to MT in patients with SIHD. To maintain a high degree of specificity for ischemia, studies were only included if ischemia was defined on the basis of noninvasive stress imaging or abnormal fractional flow reserve. The primary outcome was all-cause mortality. We identified 3 RCTs (Effects of Percutaneous Coronary Interventions in Silent Ischemia After Myocardial Infarction II, Fractional Flow Reserve versus Angiography for Multivessel Evaluation 2, and a substudy of the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation trial) enrolling a total of 1,557 patients followed for an average of 3.0 years. When compared with MT in this population of patients with objective ischemia, PCI was associated with lower mortality (hazard ratio 0.52, 95% confidence interval 0.30 to 0.92, p=0.02). There was no evidence of study heterogeneity or bias among included trials. In this meta-analysis of published RCTs, PCI was shown to have a mortality benefit over MT in patients with SIHD and objective assessment of ischemia using noninvasive imaging or its invasive equivalent. In conclusion, this study provides insight into the management of a higher-risk SIHD population that is the focus of the ongoing International Study of Comparative Health Effectiveness with Medical and Invasive Approaches trial. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. The use of SD-OCT in the differential diagnosis of dots, spots and other white retinal lesions.

    Science.gov (United States)

    Zaharova, Elena; Sherman, Jerome

    2011-01-01

    To demonstrate the utility of a retinal imaging technique using spectral domain optical coherence tomography (SD-OCT) for creating a B-scan layer-by-layer analysis to aid in the differential diagnosis of various retinal dots, spots, and other white lesions. Review. A retrospective review of imaging studies performed with SD-OCT (Topcon, 3DOCT-2000, Oakland, NJ) at SUNY State College of Optometry. B-scan layer-by-layer analysis and unique SD-OCT reflectivity patterns of the following retinal white lesions are reviewed in the order of their retinal layer localization: myelinated nerve fiber layer, cotton wool spot, exudates, edema residues, drusen, fundus albipunctatus, Stargardt disease, Bietti crystalline dystrophy, punctate inner choroidopathy (PIC), presumed ocular histoplasmosis syndrome (POHS), post-photocoagulation chorioretinal scarring, and osseous choristoma. The reviewed images demonstrate the utility of SD-OCT in the identification of the unique characteristics of the presented retinal pathologies. SD-OCT is ideal for retinal layer localization of lesions, thus enhancing the differential diagnosis of retinal dots, spots, and other white lesions. Even though true pathognomonic patterns are rare, highly suggestive findings of certain retinal abnormalities often facilitate immediate recognition and diagnosis.

  14. Serum Cardiac Troponin-I is Superior to Troponin-T as a Marker for Left Ventricular Dysfunction in Clinically Stable Patients with End-Stage Renal Disease.

    Directory of Open Access Journals (Sweden)

    Maurits S Buiten

    Full Text Available Serum troponin assays, widely used to detect acute cardiac ischemia, might be useful biomarkers to detect chronic cardiovascular disease (CVD. Cardiac-specific troponin-I (cTnI and troponin-T (cTnT generally detect myocardial necrosis equally well. In dialysis patients however, serum cTnT levels are often elevated, unlike cTnI levels. The present study aims to elucidate the associations of cTnI and cTnT with CVD in clinically stable dialysis patients.Troponin levels were measured using 5th generation hs-cTnT assays (Roche and STAT hs-cTnI assays (Abbott in a cohort of dialysis patients. Serum troponin levels were divided into tertiles with the lowest tertile as a reference value. Serum troponins were associated with indicators of CVD such as left ventricular mass index (LVMI, left ventricular ejection fraction (LVEF and the presence of coronary artery disease (CAD. Associations were explored using regression analysis.We included 154 consecutive patients, 68±7 years old, 77% male, 70% hemodialysis. Median serum cTnT was 51ng/L (exceeding the 99th percentile of the healthy population in 98% and median serum cTnI was 13ng/L (elevated in 20%. A high cTnI (T3 was significantly associated with a higher LVMI (Beta 31.60; p=0.001 and LVEF (Beta -4.78; p=0.005 after adjusting for confounders whereas a high serum cTnT was not. CAD was significantly associated with a high cTnT (OR 4.70 p=0.02 but not with a high cTnI. Unlike cTnI, cTnT was associated with residual renal function (Beta:-0.09; p=0.006.In the present cohort, serum cTnI levels showed a stronger association with LVMI and LVEF than cTnT. However, cTnT was significantly associated with CAD and residual renal function, unlike cTnI. Therefore, cTnI seems to be superior to cTnT as a marker of left ventricular dysfunction in asymptomatic dialysis patients, while cTnT might be better suited to detect CAD in these patients.

  15. Serum cytokine profiling and enrichment analysis reveal the involvement of immunological and inflammatory pathways in stable patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Bade G

    2014-08-01

    Full Text Available Geetanjali Bade,1 Meraj Alam Khan,2 Akhilesh Kumar Srivastava,1 Parul Khare,1 Krishna Kumar Solaiappan,1 Randeep Guleria,3 Nades Palaniyar,2 Anjana Talwar1 1Department of Physiology, All India Institute of Medical Sciences, New Delhi, India; 2Program in Physiology and Experimental Medicine, The Hospital for Sick Children, Department of Laboratory Medicine and Pathobiology, and Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; 3Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India Abstract: Chronic obstructive pulmonary disease (COPD is a major global health problem. It results from chronic inflammation and causes irreversible airway damage. Levels of different serum cytokines could be surrogate biomarkers for inflammation and lung function in COPD. We aimed to determine the serum levels of different biomarkers in COPD patients, the association between cytokine levels and various prognostic parameters, and the key pathways/networks involved in stable COPD. In this study, serum levels of 48 cytokines were examined by multiplex assays in 30 subjects (control, n=9; COPD, n=21. Relationships between serum biomarkers and forced expiratory volume in 1 second, peak oxygen uptake, body mass index, dyspnea score, and smoking were assessed. Enrichment pathways and networks analyses were implemented, using a list of cytokines showing differential expression between healthy controls and patients with COPD by Cytoscape and GeneGo Metacore™ softwares (Thomson-Reuters Corporation, New York, NY, USA. Concentrations of cutaneous T-cell attracting chemokine, eotaxin, hepatocyte growth factor, interleukin 6 (IL-6, IL-16, and stem cell factor are significantly higher in COPD patients compared with in control patients. Notably, this study identifies stem cell factor as a biomarker for COPD. Multiple regression analysis predicts that cutaneous T

  16. Liraglutide effects on beta-cell, insulin sensitivity and glucose effectiveness in patients with stable coronary artery disease and newly diagnosed type 2 diabetes

    DEFF Research Database (Denmark)

    Anholm, Christian; Kumarathurai, Preman; Pedersen, Lene R.

    2017-01-01

    characteristics were: HbA1c 47 mmol/mol (SD 6), BMI 31.6 kg/m2 (SD 4.8), fasting plasma-glucose 6.9 mmol/L (IQR 6.1; 7.4) and HOMA-IR 4.9 (IQR 3.0; 7.5). Liraglutide treatment improved AIRg by 3-fold, 497 mU × L−1 × min (IQR 342; 626, P ... weight loss of −2.7 kg (−6.7; −0.6) during liraglutide treatment, we found no improvement in HOMA-IR, Si or Sg. Weight loss during liraglutide therapy did not result in a carry-over effect. Conclusion: Liraglutide as add-on to metformin induces a clinically significant improvement in beta-cell function...

  17. Stable Isotope Data

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Tissue samples (skin, bone, blood, muscle) are analyzed for stable carbon, stable nitrogen, and stable sulfur analysis. Many samples are used in their entirety for...

  18. Penerapan Metoda Serial Peripheral Interface (SPI pada Rancang Bangun Data Logger berbasis SD card

    Directory of Open Access Journals (Sweden)

    RATNA SUSANA

    2018-03-01

    Full Text Available ABSTRAK Serial Peripheral Interface (SPI adalah protokol komunikasi yang dapat digunakan sebagai interface komunikasi antara mikrokontroler dengan SD Card. Dengan menerapkan metoda SPI pada data logger berbasis SD Card, maka dapat diketahui karakteristik protokol komunikasi SPI antara mikrokontroler dengan SD Card. SD Card diformat dengan tipe FAT 16, dan data di dalam SD Card berupa sekumpulan paket data sensor yang diambil secara periodik dan disimpan dalam bentuk file dengan format.csv. Berdasarkan format paket data sensor yang dibuat, dapat dihitungwaktu perekaman data yang diperlukan agar kapasitas SD Card terisi penuh oleh data sensor. Hasil penelitian menunjukkan,bahwa metoda SPI yang diterapkan pada penelitian ini memiliki sifat akan melakukan pemeriksaan berulang pada pin MISO terhadap command yang dikirimkan oleh mikrokontroler melalui pin MOSI. Proses read/write data pada SD Card data logger memiliki keberhasilan 100%, karena SD Card telah terinisialisasi dalam mode SPI melalui perintah reset dan init SD Card. Komunikasi ini dapat dilakukan dengan menggunakan crystal 4 Mhz – 20 Mhz. Untuk pengujian konfigurasi SPI, hanya Independent Slave Configuration yang dapat digunakan pada komunikasi SPI dengan 2 SD card sebagai slave. Kata kunci: Serial Peripheral Interface (SPI, Data Logger, SD card, FAT16 ABSTRACT Serial Peripheral Interface (SPI is a communication protocol that can be applied as a communication interface between microcontroller to SD Card. By implementing the SPI method to a data logger based on SD Card, it can be known the characteristics of the SPI communications protocol between microcontroller to SD Card. SD Card formatted in FAT 16 type, and data on the SD Card is the form of sensor data packets collection which be captured periodically and saved in .csv format file. Based on the sensor data packet format is created, it can be calculated recording time data required so that the SD Card capacity completely filled by the

  19. Comparison of Efficacy and Safety between First and Second Generation Drug-eluting Stents in Patients with Stable Coronary Artery Disease: A Single-center Retrospective Study.

    Science.gov (United States)

    Liu, Ru; Xiong, Fei; Wen, Yuan; Ma, Yuan-Liang; Yao, Yi; Gao, Zhan; Xu, Bo; Yang, Yue-Jin; Qiao, Shu-Bin; Gao, Run-Lin; Yuan, Jin-Qing

    2017-07-20

    Lots of trials demonstrate that second-generation drug-eluting stents (G2-DES), with their improved properties, offer significantly superior efficacy and safety profiles compared to first generation DES (G1-DES) for patients with coronary artery disease (CAD) receiving percutaneous coronary intervention (PCI). This study aimed to verify the advantage of G2-DES over G1-DES in Chinese patients with stable CAD (SCAD). For this retrospective observational analysis, 2709 SCAD patients with either G1-DES (n = 863) or G2-DES (n = 1846) were enrolled consecutively throughout 2013. Propensity score matching (PSM) was applied to control differing baseline factors. Two-year outcomes, including major adverse coronary events as well as individual events, including target vessel-related myocardial infarction, target lesion revascularization (TLR), target vessel revascularization, and cardiogenic death were evaluated. The incidence of revascularization between G1- and G2-DES showed a trend of significant difference with a threshold P - value (8.6% vs. 6.7%, χ2 = 2.995, P = 0.084). G2-DES significantly improved TLR-free survival compared to G1-DES (96.6% vs. 97.9%, P = 0.049) and revascularization-free survival curve showed a trend of improvement of G2-DES (92.0% vs. 93.8%, P = 0.082). These differences diminished after PSM. Multivariate Cox proportional hazard regression analysis showed a trend for G1-associated increase in revascularization (hazard ratio: 1.28, 95% confidence interval: 0.95-1.72, P = 0.099) while no significance was found after PSM. Other endpoints showed no significant differences after multivariate adjustment regardless of PSM. G1-DES showed the same safety as G2-DES in this large Chinese cohort of real-world patients. However, G2-DES improved TLR-free survival of SCAD patients 2 years after PCI. The advantage was influenced by baseline clinical factors. G1-DES was associated with a trend of increase in revascularization risk and was not an independent

  20. Metabolic alkalosis in adults with stable cystic fibrosis.

    Science.gov (United States)

    Al-Ghimlas, Fahad; Faughnan, Marie E; Tullis, Elizabeth

    2012-01-01

    The frequency of metabolic alkalosis among adults with stable severe CF-lung disease is unknown. Retrospective chart review. Fourteen CF and 6 COPD (controls) patients were included. FEV1 was similar between the two groups. PaO2 was significantly higher in the COPD (mean ± 2 SD is 72.0 ± 6.8 mmHg,) than in the CF group (56.1 ± 4.1 mmHg). The frequency of metabolic alkalosis in CF patients (12/14, 86%) was significantly greater (p=0.04) than in the COPD group (2/6, 33%). Mixed respiratory acidosis and metabolic alkalosis was evident in 4 CF and 1 COPD patients. Primary metabolic alkalosis was observed in 8 CF and none of the COPD patients. One COPD patient had respiratory and metabolic alkalosis. Metabolic alkalosis is more frequent in stable patients with CF lung disease than in COPD patients. This might be due to defective CFTR function with abnormal electrolyte transport within the kidney and/ or gastrointestinal tract.

  1. The use of SD-OCT in the differential diagnosis of dots, spots and other white retinal lesions

    Directory of Open Access Journals (Sweden)

    Zaharova E

    2011-10-01

    Full Text Available Elena Zaharova1, Jerome Sherman1-31State University of New York's State College of Optometry, University Eye Center, New York, NY, USA; 2SUNY Eye Institute, New York, NY, USA; 3New York Eye Institute and Laser Center, New York, NY, USAPurpose: To demonstrate the utility of a retinal imaging technique using spectral domain optical coherence tomography (SD-OCT for creating a B-scan layer-by-layer analysis to aid in the differential diagnosis of various retinal dots, spots, and other white lesions.Design: Review.Methods: A retrospective review of imaging studies performed with SD-OCT (Topcon, 3DOCT-2000, Oakland, NJ at SUNY State College of Optometry.Results: B-scan layer-by-layer analysis and unique SD-OCT reflectivity patterns of the following retinal white lesions are reviewed in the order of their retinal layer localization: myelinated nerve fiber layer, cotton wool spot, exudates, edema residues, drusen, fundus albipunctatus, Stargardt disease, Bietti crystalline dystrophy, punctate inner choroidopathy (PIC, presumed ocular histoplasmosis syndrome (POHS, post-photocoagulation chorioretinal scarring, and osseous choristoma.Conclusion: The reviewed images demonstrate the utility of SD-OCT in the identification of the unique characteristics of the presented retinal pathologies. SD-OCT is ideal for retinal layer localization of lesions, thus enhancing the differential diagnosis of retinal dots, spots, and other white lesions. Even though true pathognomonic patterns are rare, highly suggestive findings of certain retinal abnormalities often facilitate immediate recognition and diagnosis.Keywords: SD-OCT, photoreceptor integrity line, retinal pigment epithelium, white dot syndrome, retinal pathology, imaging

  2. Production and Characterization of Alkaline Protease from a High Yielding and Moderately Halophilic Strain of SD11 Marine Bacteria

    Directory of Open Access Journals (Sweden)

    Hongxia Cui

    2015-01-01

    Full Text Available A marine bacterium SD11, which was isolated from sea muds (Geziwo Qinhuangdao Sea area, China, was used to produce thermostable alkaline serine nonmetal protease in the skim milk agar plate medium with 10% NaCl. The optimal temperature about the manufacture of the extracellular protease was ~60°C. The crude enzyme was stable at 20–50°C. The activity was retained to 60% and 45% after heating for 1 h at 60 and 70°C, respectively. The protease was highly active in a wide pH scope (8.0–10.0 and maximum protease activity exhibited at pH 10.0. The activity was restrained by phenylmethylsulfonyl fluoride (PMSF but mildly increased (~107% in the presence of ethylenediaminetetraacetic acid (EDTA, indicating that the production contains serine-protease(s and nonmetal protease(s. Moreover, the crude alkaline protease was active with the 5 mM Ca2+, Mn2+, Zn2+, Cu2+, Na+, and K+ that existed separately. In addition, the protease showed superduper stability when exposed to an anionic surfactant (5 mM SDS, an oxidizing agent (1% H2O2, and several organic solvents (methanol, isopropanol, and acetone. These results suggest that the marine bacterium SD11 is significant in the industry from the prospects of its ability to produce thermally stable alkaline protease.

  3. Stable convergence and stable limit theorems

    CERN Document Server

    Häusler, Erich

    2015-01-01

    The authors present a concise but complete exposition of the mathematical theory of stable convergence and give various applications in different areas of probability theory and mathematical statistics to illustrate the usefulness of this concept. Stable convergence holds in many limit theorems of probability theory and statistics – such as the classical central limit theorem – which are usually formulated in terms of convergence in distribution. Originated by Alfred Rényi, the notion of stable convergence is stronger than the classical weak convergence of probability measures. A variety of methods is described which can be used to establish this stronger stable convergence in many limit theorems which were originally formulated only in terms of weak convergence. Naturally, these stronger limit theorems have new and stronger consequences which should not be missed by neglecting the notion of stable convergence. The presentation will be accessible to researchers and advanced students at the master's level...

  4. Comparison of plaque characteristics in narrowings with ST-elevation myocardial infarction (STEMI), non-STEMI/unstable angina pectoris and stable coronary artery disease (from the ADAPT-DES IVUS Substudy).

    Science.gov (United States)

    Dong, Liang; Mintz, Gary S; Witzenbichler, Bernhard; Metzger, D Christopher; Rinaldi, Michael J; Duffy, Peter L; Weisz, Giora; Stuckey, Thomas D; Brodie, Bruce R; Yun, Kyeong Ho; Xu, Ke; Kirtane, Ajay J; Stone, Gregg W; Maehara, Akiko

    2015-04-01

    Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents (ADAPT-DES) was a prospective, multicenter registry of 8,582 consecutive stable and unstable patients who underwent percutaneous coronary intervention using a drug-eluting stent. We sought to identify key morphologic features leading to ST-segment elevation myocardial infarction (STEMI) versus non-STEMI (NSTEMI) or unstable angina pectoris (UA) versus stable coronary artery disease (CAD) presentation. In the prespecified grayscale and virtual histology (VH) substudy of ADAPT-DES, preintervention imaging identified 676 patients with a single culprit lesion. The relation between lesion morphology and clinical presentation was compared among patients with (1) STEMI, (2) NSTEMI or UA, and (3) stable CAD. Intravascular ultrasound identified more plaque rupture and VH thin-cap fibroatheroma (TCFA) in STEMI lesions compared with NSTEMI/UA or stable CAD lesions; conversely, fibroatheromas appeared more often calcified with a thick fibrous cap in stable CAD. Minimum lumen cross-sectional area (MLA) was smaller with larger plaque burden and positive remodeling in STEMI lesions. Lesions with plaque rupture versus those without plaque rupture showed higher prevalence of VH-TCFA and larger plaque burden with positive remodeling, especially in patients with STEMI. Multivariate analysis showed that in the lesions with plaque rupture, plaque burden at the MLA site was the only independent predictor for STEMI (cutoff of plaque burden = 85%) and in lesions without plaque rupture, MLA was the only independent predictor for STEMI (cutoff of MLA = 2.3 mm(2)). In conclusion, culprit lesions causing STEMI have smaller lumen areas, greater plaque burden, and more plaque rupture or VH-TCFA compared with NSTEMI/UA or stable CAD; in lesions with plaque rupture, only plaque burden predicted STEMI, and in lesions without plaque rupture, only MLA area predicted STEMI. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Impact of active and stable psoriasis on health-related quality of life: the PSO-LIFE study.

    Science.gov (United States)

    Daudén, E; Herrera, E; Puig, L; Sánchez-Carazo, J L; Toribio, J; Perulero, N

    2013-10-01

    The aim of this study was to assess the impact of psoriasis on health-related quality of life (HRQOL) using different questionnaires. Prospective observational study of patients with plaque psoriasis of at least 6 months' duration stratified by active and stable disease. The patients were evaluated at baseline, 7 days, and 12 weeks. At the 3 visits, the investigators recorded sociodemographic and clinical data and the patients completed the following HRQOL questionnaires: the Dermatology Life Quality Index (DLQI), the Psoriasis Disability Index (PDI), and psoriasis quality of life questionnaire (PSO-LIFE). In total, 304 patients (182 with active psoriasis and 122 with stable psoriasis) were evaluated. The mean (SD) age was 45.3 (14.5) years, and 56.3% of the group were men. At baseline, the mean (SD) psoriasis and area severity index (PASI) score was 17.0 (7.4) in patients with active disease and 5.6 (5.3) in those with stable disease; a reduction was seen in PASI scores during the evaluation period (P<.01). The mean (SD) score on the PSO-LIFE questionnaire increased significantly from 57.4 (20.4) to 72.2 (19.6) in patients with active psoriasis and from 76.4 (20.6) to 82.3 (18.3) in those with stable disease (P<0.01 in both groups). The difference in standardized mean scores between the 2 groups was 0.79 for the DLQI, 0.62 for the PDI, and 0.85 for the PSO-LIFE questionnaire. The impact of psoriasis on HRQOL as assessed by the PSO-LIFE questionnaire was greater in patients with lesions in visible areas than in those with less visible lesions (P<.01). Changes in PSO-LIFE and PASI scores were moderately and significantly correlated (r=-0.4). The impact of psoriasis on HRQOL is higher in patients with active disease. The PSO-LIFE questionnaire showed a greater tendency to discriminate between active and stable psoriasis than either the DLQI or the PDI. PSO-LIFE scores correlated significantly with lesion site and disease severity as measured by PASI. Copyright

  6. stableGP

    Data.gov (United States)

    National Aeronautics and Space Administration — The code in the stableGP package implements Gaussian process calculations using efficient and numerically stable algorithms. Description of the algorithms is in the...

  7. Characterization of Asia 1 sdAb from camels bactrianus (C. bactrianus and conjugation with quantum dots for imaging FMDV in BHK-21 cells.

    Directory of Open Access Journals (Sweden)

    Shuanghui Yin

    Full Text Available Foot-and-mouth disease (FMD, caused by FMD virus (FMDV, is a highly contagious viral disease affecting cloven-hoofed animals. Camelids have a unique immunoglobulin profile, with the smallest functional heavy-chain antibodies (sdAb or VHH naturally devoid of light chains with antigen-binding capacity. We screened and characterized five sdAbs against FMDV by immunized library from C. bactrianus with Asia 1 virus-like particles (VLPs. Three of five recombinant sdAbs were stably expressed in E.coli, remained highly soluble, and were serotype-specific for VP1 protein of FMDV Asia 1 by ELISA. These failed to completely neutralize the Asia 1 virus. According to the KD value of binding affinity to three sdAbs, which ranged from 0.44 to 0.71 nm by SPR, sdAb-C6 was selected and conjugated with Zn/CdSe quantum dots (QDs to form a QDs-C6 probe, which was used to trace and image the subcellular location of FMDV in BHK-21 cells. The results show that FMD virions were observed from 3 h.p.i., and most of virions were distributed on one side of the nucleus in the cytoplasm. We demonstrate the utility of sdAbs as functionalized QDs are powerful tools for FMDV research.

  8. STUDI KOMPARASI BUDAYA SEKOLAH SDSN DAN SD EKS RSBI DI DAERAH ISTIMEWA YOGYAKARTA

    Directory of Open Access Journals (Sweden)

    Taufik Muhtarom

    2013-07-01

    Full Text Available Penelitian ini bertujuan untuk: (1 mengetahui perbedaan budaya sekolah di SDSN dan SD Eks RSBI DIY, (2 memaparkan perbedaan masing-masing aspek budaya sekolah antara SDSN dengan SD Eks RSBI. Jenis penelitian ini adalah komparasi. Populasi penelitian ini adalah semua kepala sekolah, guru, dan staf SDSN dan SD RSBI di Daerah Istimewa Yogyakarta yang berjumlah 797 orang untuk SDSN dan 155 orang untuk SD Eks RSBI. Sampel dari SDSN berjumlah 256 orang dan sampel dari SD Eks RSBI sebanyak 116 orang ditentukan menggunakan teknik proportional sampling. Pengumpulan data dilakukan menggunakan kuesioner. Teknik analisis data yang digunakan adalah analisis univariat, bivariat, dan uji-t. Hasil penelitian ini menunjukkan bahwa: (1 tidak terdapat perbedaan yang signifikan antara budaya sekolah SDSN dengan SD Eks RSBI di Daerah Istimewa Yogyakarta; (2 ditemukan perbedaan skor dari masing-masing aspek budaya sekolah di SDSN dan SD Eks RSBI DIY. Aspek budaya sekolah yang lebih baik di SDSN adalah kolaborasi profesional, hubungan kolegial, self determination, visi-misi, konsensus, dan disiplin. Sedangkan aspek budaya sekolah yang lebih unggul pada SD Eks RSBI adalah aspek komitmen, hormat, empati, bebas bullying dan artefak fisik. Kata kunci: budaya sekolah, SDSN, SD Eks RSBI

  9. Revisiting PSS and service design in the light of the SD-logic

    DEFF Research Database (Denmark)

    Costa, Nina; Patrício, Lia; Morelli, Nicola

    2016-01-01

    Researchers and practitioners have increasingly recognized the importance of offering value propositions to customers that enable value co-creation as discussed in the service dominant logic (SD-logic). SD-logic recognizes customers as active co-creators and posits that products and services...... design (SD). Whereas PSS focuses on designing required functions and aims at sustainability, embedding a more organizationcentred approach and problem-solving way of thinking; SD adopts a more human-centred perspective for creative enquiry and focuses on the customer experience, orchestrating...

  10. Incidence, prognostic impact, and optimal definition of contrast-induced acute kidney injury in consecutive patients with stable or unstable coronary artery disease undergoing percutaneous coronary intervention. insights from the all-comer PRODIGY trial.

    Science.gov (United States)

    Crimi, Gabriele; Leonardi, Sergio; Costa, Francesco; Ariotti, Sara; Tebaldi, Matteo; Biscaglia, Simone; Valgimigli, Marco

    2015-07-01

    Contrast-induced acute kidney injury (CI-AKI) is associated with poor outcome. Whether this association differs in stable coronary artery disease (CAD) as compared to acute coronary syndrome (ACS) patients is unknown. Definitions and Methods: PRODIGY trial patients were defined as stable CAD or ACS according to the initial presentation. CI-AKI was defined as an increase (Δ) of serum creatinine (SCr) ≥25% above baseline. Two endpoints were considered: all-cause death and the composite of death, stroke, or myocardial infarction (MI). The interaction between CI-AKI, clinical setting, and the impact of increasing ΔSCr% cut-offs were also explored. Two thousand three patients were enrolled in the PRODIGY trial, 85 patients were excluded for missing SCr data, leading to a population of 1,918 patients. CI-AKI incidence was 6.7% in stable CAD and 12.2% in ACS patients. CI-AKI was associated with all-cause mortality [adjusted hazard ratio (aHR) of 2.05, 95% confidence interval (CI) 1.38-3.05, P  0.001]. In a large, contemporary, all-comers percutaneous coronary intervention population, CI-AKI was associated with an increased risk of all-cause death and the composite of death, stroke, or MI. While CI-AKI is more common in ACS than in stable CAD patients, its adjusted prognostic impact on the composite endpoint appears to be more pronounced in patients with stable CAD. © 2015 Wiley Periodicals, Inc.

  11. The plasma B-type natriuretic peptide levels are low in males with stable ischemic heart disease (IHD compared to those observed in patients with non-IHD: a retrospective study.

    Directory of Open Access Journals (Sweden)

    Kosuke Minai

    Full Text Available OBJECTIVE: Although the plasma B-type natriuretic peptide (BNP level is a marker of heart failure, it is unclear whether BNP per se plays a pivotal role for pathogenic mechanisms underlying the development of ischemic heart disease (IHD. In this study, we retrospectively examined the plasma BNP levels in stable patients with IHD and compared to stable patients with cardiovascular diseases other than IHD. METHODS: The study population was 2088 patients (1698 males and 390 females who were admitted to our hospital due to IHD (n = 1,661 and non-IHD (n = 427 and underwent cardiac catheterization. Measurements of the hemodynamic parameters and blood sampling were performed. RESULTS: The plasma BNP levels were significantly lower in the IHD group than in the non-IHD group (p<0.001. The multiple regression analysis examining the logBNP values showed that age, a male gender, low left ventricular ejection fraction, low body mass index, serum creatinine, atrial fibrillation and IHD per se were significant explanatory variables. When the total study population was divided according to gender, the plasma BNP levels were found to be significantly lower in the IHD group than in the non-IHD group among males (p<0.001, but not females (p = NS. Furthermore, a multiple logistic regression analysis of IHD showed the logBNP value to be a significant explanatory variable in males (regression coefficient: -0.669, p<0.001, but not females (p = NS. CONCLUSIONS: The plasma BNP levels were relatively low in stable patients with IHD compared with those observed in stable patients with non-IHD; this tendency was evident in males. Perhaps, the low reactivity of BNP is causally associated with IHD in males. We hope that this study will serve as a test of future prospective studies.

  12. Dyslipidemia in subclinical hypothyroidism requires assessment of small dense low density lipoprotein cholesterol (sdLDL-C

    Directory of Open Access Journals (Sweden)

    Saric Maida Seferovic

    2017-09-01

    Full Text Available Background. Usually both hypothyroidism and hyperthyroidism are related to the cardiovascular and cerebrovascular disease development. The relationship between subclinical hypothyroidism has been widely investigated but the findings remain controversial. The aim of the present study was to evaluate the lipid profile in patients with subclinical hypothyroidism (SHypo in comparison to controls and to determine the association of SHypo and dyslipidemia in attempt to find importance of small dense low-density lipoprotein cholesterol (sdLDL-C in atherosclerosis. Material and methods. In this study we included 100 women, aged 30 to 70 years that were divided into subgroups according to their age. According to the values of levels of thyroid hormones they were divided into euthyroid (control group (n = 64 and (newly discovered subclinical hypothyroidism (SHypo group (n = 36. A high-sensitivity C-reactive protein (hs-CRP and lipid profile, including small dense low-density lipoprotein cholesterol (sdLDL-C were determined. Body weight and height were measured and BMI calculated. History of the current illness, medication, alcohol consumption and cigarettes smoking were noted. Results. Changed lipid profile as well as elevated triglycerides and sdLDL-C were observed in the group with subclinical hypothyroidism compared to the control group. Conclusions. It is important to determine serum lipid levels, especially serum sdLDL-C levels at an early stage of subclinical hypothyroidism, since they represent atherogenic LDL particles and are better indicators for dyslipidaemia in subclinical hypothyroidism and the development of atherosclerosis with potential complications such as cardiovascular and cerebrovascular diseases.

  13. Elastic Stable Intramedullary Nailing for Treatment of Pediatric Tibial Fractures

    OpenAIRE

    Sandeep Gurung; Dipendra KC; Roshni Khatri

    2016-01-01

    Introduction: Tibia fractures in the skeletally immature patient can usually be treated with above knee cast or patellar tendon bearing cast. The purpose of our study was to evaluate epidemiology and outcome of Elastic stable intramedullary nailing fixation of pediatric tibial shaft fractures treated at our institution. Methods: Over a period of one year, fifty pediatric patients of tibial shaft fractures, with average age of 9.68 yr (SD=2.37), were treated with elastic stable intramedul...

  14. Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebo-controlled trial

    DEFF Research Database (Denmark)

    Fox, Kim; Ford, Ian; Steg, P Gabriel

    2008-01-01

    of cardiovascular death, admission to hospital for acute myocardial infarction, and admission to hospital for new onset or worsening heart failure. We analysed patients by intention to treat. The study is registered with ClinicalTrials.gov, number NCT00143507. FINDINGS: Mean heart rate at baseline was 71.6 (SD 9......, double-blind, placebo-controlled, parallel-group trial. 5479 patients received 5 mg ivabradine, with the intention of increasing to the target dose of 7.5 mg twice a day, and 5438 received matched placebo in addition to appropriate cardiovascular medication. The primary endpoint was a composite...... the primary composite outcome (hazard ratio 0.91, 95% CI 0.81-1.04, p=0.17), cardiovascular death, or admission to hospital for new-onset or worsening heart failure. However, it did reduce secondary endpoints: admission to hospital for fatal and non-fatal myocardial infarction (0.64, 95% CI 0.49-0.84, p=0...

  15. Automated Segmentability Index for Layer Segmentation of Macular SD-OCT Images

    NARCIS (Netherlands)

    Lee, K.; Buitendijk, G.H.; Bogunovic, H.; Springelkamp, H.; Hofman, A.; Wahle, A.; Sonka, M.; Vingerling, J.R.; Klaver, C.C.W.; Abramoff, M.D.

    2016-01-01

    PURPOSE: To automatically identify which spectral-domain optical coherence tomography (SD-OCT) scans will provide reliable automated layer segmentations for more accurate layer thickness analyses in population studies. METHODS: Six hundred ninety macular SD-OCT image volumes (6.0 x 6.0 x 2.3 mm3)

  16. 77 FR 68716 - Proposed Amendment of Class E Airspace; Hot Springs, SD

    Science.gov (United States)

    2012-11-16

    ...-0655; Airspace Docket No. 12-AGL-6] Proposed Amendment of Class E Airspace; Hot Springs, SD AGENCY... action proposes to amend Class E airspace at Hot Springs, SD. Additional controlled airspace is necessary to accommodate new Standard Instrument Approach Procedures (SIAPs) at Hot Springs Municipal Airport...

  17. 78 FR 14911 - Amendment of Class E Airspace; Hot Springs, SD

    Science.gov (United States)

    2013-03-08

    ...-0655; Airspace Docket No. 12-AGL-6] Amendment of Class E Airspace; Hot Springs, SD AGENCY: Federal... Springs, SD. Additional controlled airspace is necessary to accommodate new Area Navigation (RNAV) Standard Instrument Approach Procedures at Hot Springs Municipal Airport. The FAA is taking this action to...

  18. Comparison of teh performance of SD Bioline Syphilis 3.0 assay ...

    African Journals Online (AJOL)

    Methods: A total of 498 serum samples were initially tested on both SD BIOLINE Syphilis 3.0 and rapid plasma reagin (RPR) tests and were then confirmed on Treponema pallidum hemaagglutination (TPHA) test. Results: The overall seroprevalence of syphilis was 5.6% (28/498) on TPHA, 8.2% (41/498) on SD BIOLINE ...

  19. A PSDPF interaction to describe the 1 h{omega} intruder states in sd shell nuclei

    Energy Technology Data Exchange (ETDEWEB)

    Bouhelal, M., E-mail: m_bouhelal@yahoo.fr [Laboratoire de Physique Appliquee et Theorique, Universite de Tebessa, Tebessa (Algeria); Haas, F.; Caurier, E.; Nowacki, F. [IPHC, CNRS/IN2P3, Universite de Strasbourg, Strasbourg (France); Bouldjedri, A. [Departement de Physique, Faculte des Sciences, Universite de Batna, Batna (Algeria)

    2011-08-01

    In the level schemes of sd shell nuclei, there is generally at relatively low excitation energies, coexistence of normal 0 h{omega} positive parity states and of intruder 1 h{omega} negative parity states. The aim of the present work is to describe these intruder states in the full p-sd-pf model space with a {sup 4}He core allowing one nucleon jump between the major shells. To construct our PSDPF interaction, we first modified the p-sd and sd-pf cross-monopole terms and then applied a fitting procedure to adjust all PSDPF parameters by comparing an extended set of experimental and calculated excitation energies. Results obtained with the new interaction have been finally compared with experimental data for nuclei throughout the sd shell.

  20. Clinical, hematological and genetic data of a cohort of children with hemoglobin SD

    Directory of Open Access Journals (Sweden)

    Paulo do Val Rezende

    Full Text Available ABSTRACT INTRODUCTION: The hemoglobin FSD is very uncommon in newborn screening programs for sickle cell disease. In the program of Minas Gerais, Brazil, the clinical course of children with hemoglobin SD was observed to be heterogeneous. The objective of this study was to estimate the incidence (1999-2012 and to describe the natural history of a cohort of newborns with hemoglobin SD. METHODS: Isoelectric focusing was the primary method used in newborn screening. Polymerase chain reaction-restriction fragment length polymorphism and gene sequencing were used to identify mutant alleles and for haplotyping. Gap-polymerase chain reaction was used to detect alpha-thalassemia. RESULTS: Eleven cases of hemoglobin S/D-Punjab and eight of Hb S-Korle Bu were detected. Other variants with hemoglobin D mobility were not identified. All hemoglobin D-Punjab and hemoglobin Korle Bu alleles were associated with haplotype I. Among the children with hemoglobin S/D-Punjab, there were four with the ßS CAR haplotype, six with the Benin haplotype, and one atypical. Results of laboratory tests for hemoglobin S/D-Punjab and hemoglobin S-Korle Bu were: hemoglobin 8.0 and 12.3 g/dL (p-value <0.001, leukocyte count 13.9 × 109/L and 10.5 × 109/L (p-value = 0.003, reticulocytes 7.5% and 1.0% (p-value <0.001, hemoglobin F concentration 16.1% and 6.9% (p-value = 0.001 and oxygen saturation 91.9% and 97% (p-value = 0.002, respectively. Only hemoglobin S/D-Punjab children had acute pain crises and needed blood transfusions or hydroxyurea. Those with the Benin ßS haplotype had higher total hemoglobin and hemoglobin F concentrations compared to the CAR haplotype. Transcranial Doppler was normal in all children. CONCLUSION: The clinical course and blood cell counts of children with hemoglobin S/D-Punjab were very similar to those of hemoglobin SS children. In contrast, children with hemoglobin S-Korle Bu had clinical course and blood cell counts like children with the sickle

  1. Delay-controlled primary and stochastic resonances of the SD oscillator with stiffness nonlinearities

    Science.gov (United States)

    Yang, Tao; Cao, Qingjie

    2018-03-01

    This work presents analytical studies of the stiffness nonlinearities SD (smooth and discontinuous) oscillator under displacement and velocity feedback control with a time delay. The SD oscillator can capture the qualitative characteristics of quasi-zero-stiffness and negative-stiffness. We focus mainly on the primary resonance of the quasi-zero-stiffness SD oscillator and the stochastic resonance (SR) of the negative-stiffness SD oscillator. Using the averaging method, we have been analyzed the amplitude response of the quasi-zero-stiffness SD oscillator. In this regard, the optimum time delay for changing the control intensity according to the optimization standard proposed can be obtained. For the optimum time delay, increasing the displacement feedback intensity is advantageous to suppress the vibrations in resonant regime where vibration isolation is needed, however, increasing the velocity feedback intensity is advantageous to strengthen the vibrations. Moreover, the effects of time-delayed feedback on the SR of the negative-stiffness SD oscillator are investigated under harmonic forcing and Gaussian white noise, based on the Langevin and Fokker-Planck approaches. The time-delayed feedback can enhance the SR phenomenon where vibrational energy harvesting is needed. This paper established the relationship between the parameters and vibration properties of a stiffness nonlinearities SD which provides the guidance for optimizing time-delayed control for vibration isolation and vibrational energy harvesting of the nonlinear systems.

  2. Comorbidity in chronic obstructive pulmonary disease. Related to disease severity?

    Science.gov (United States)

    Echave-Sustaeta, Jose M; Comeche Casanova, Lorena; Cosio, Borja G; Soler-Cataluña, Juan Jose; Garcia-Lujan, Ricardo; Ribera, Xavier

    2014-01-01

    Background and objective Several diseases commonly co-exist with chronic obstructive pulmonary disease (COPD), especially in elderly patients. This study aimed to investigate whether there is an association between COPD severity and the frequency of comorbidities in stable COPD patients. Patients and methods In this multicenter, cross-sectional study, patients with spirometric diagnosis of COPD attended to by internal medicine departments throughout Spain were consecutively recruited by 225 internal medicine specialists. The severity of airflow obstruction was graded using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and data on demographics, smoking history, comorbidities, and dyspnea were collected. The Charlson comorbidity score was calculated. Results Eight hundred and sixty-six patients were analyzed: male 93%, mean age 69.8 (standard deviation [SD] 9.7) years and forced vital capacity in 1 second 42.1 (SD 17.7)%. Even, the mean (SD) Charlson score was 2.2 (2.2) for stage I, 2.3 (1.5) for stage II, 2.5 (1.6) for stage III, and 2.7 (1.8) for stage IV (P=0.013 between stage I and IV groups), independent predictors of Charlson score in the multivariate analysis were age, smoking history (pack-years), the hemoglobin level, and dyspnea, but not GOLD stage. Conclusion COPD patients attended to in internal medicine departments show high scores of comorbidity. However, GOLD stage was not an independent predictor of comorbidity. PMID:25429213

  3. Complete versus incomplete revascularization with drug-eluting stents for multi-vessel disease in stable, unstable angina or non-ST-segment elevation myocardial infarction: A meta-analysis.

    Science.gov (United States)

    Ando, Tomo; Takagi, Hisato; Grines, Cindy L

    2017-08-01

    To determine whether drug-eluting stent (DES) coronary complete revascularization (CR) confers clinical benefit over incomplete revascularization (IR) in patients with multivessel coronary artery disease (MVD). Clinical benefit of CR over IR in patients with MVD with angina (both stable and unstable) and non-ST-segment elevation myocardial infarction (NSTEMI) in DES has not been well studied. We conducted a systematic online literature search of PUBMED and EMBASE. Literatures that compared the clinical outcomes between CR and IR with exclusively or majority (>80%) using DES in patients without or included only small portion (meta-analysis. CR was associated with lower incident of all-cause mortality (HR 0.71, P = 0.001), major adverse events (HR 0.75, P Meta-regression analysis showed that CR significantly reduced the risk of all-cause mortality in advanced age, triple vessel disease and male sub-groups. CR with DES conferred favorable outcomes compared to IR in MVD patients with stable, unstable angina or NTEMI. Further research to achieve higher CR in MVD patients may lead to improvement in prognosis in these cohorts. © 2017, Wiley Periodicals, Inc.

  4. Diabetes, glycemic control, and new-onset heart failure in patients with stable coronary artery disease : data from the heart and soul study

    NARCIS (Netherlands)

    van Melle, J.P.; Bot, M.; de Jonge, P.; de Boer, R.A.; van Veldhuisen, D.J.; Whooley, M.A.

    2010-01-01

    OBJECTIVE Diabetes is a predictor of both coronary artery disease (CAD) and heart failure. It is unknown to what extent the association between diabetes and heart failure is influenced by other risk factors for heart failure. RESEARCH DESIGN AND METHODS We evaluated the association of diabetes and

  5. The BEAUTIFUL study: randomized trial of ivabradine in patients with stable coronary artery disease and left ventricular systolic dysfunction - baseline characteristics of the study population

    NARCIS (Netherlands)

    Ferrari, R.; Ford, I.; Fox, K.; Steg, P. G.; Tendera, M.; Cohen Arazi, H.; Nul, D. R.; Ahuad Guerrero, R. A.; Luciardi, H. L.; Sinisi, V. A.; Perna, E. R.; Schygiel, P. O.; Sanjurjo, M. S.; Fernandez, A. A.; del Valle Lobo Marquez, L. L.; Fuselli, J. J.; Hasbani, E.; Ibañez, J. O.; Cartasegna, L. R.; Lembo, L. A.; Thierer, J.; Varini, S.; Buscema, J. J.; Orlandini, A. D.; Bustos, B.; Guzmán, L. A.; Luquez, H. A.; Amuchastegui, M.; Allall, O. A.; Iglesias, R. M.; Sokn, F. J.; Montaña, O. R.; Sanchez, A.; Vogel, D.; Eber, B.; Huber, K.; Lang, I.; Pichler, A. N.; Dendale, P. A. C.; Vanderheyden, M.; van Mieghem, W.; Chenu, P.; Friart, A.; Missault, L.; Vachiery, J. L.; Materne, P.; François, B. A. A.; Sirakova, V.; Penkov, N.; Georgiev, B.; Grigorov, M.; Taseva, T.; Nachev, C.; Guenova, D.; Perchev, I.; Denchev, S.; Donova, T.; Torbova, S.; Goudev, A.; Raev, D.; Gotchev, D.; Tzekova, M.; Chompalova, B.; Hergeldjieva, V.; Kamenova, Z.; Dzhurzdhev, A.; Tardif, J. C.; Talbot, P.; Yao, L.; Ma, P.; Constance, C.; Bernstein, V.; Heath, J.; Lalani, A.; Haddad, H.; To, T. B.; Pandey, S.; Desrochers, D.; Fortin, C.; Poirier, P.; Savard, D.; Baird, M.; Lonn, E.; Coutu, B.; Vertes, G. E.; Rebane, T.; Kouz, S.; Raco, D.; Rajda, M.; Parker, J. O.; Glanz, A.; Lepage, S.; Parker, J. D.; Klinke, W. P.; Rupka, D.; Hill, L. L.; Nawaz, S.; Chehayeb, R.; Lauzon, C.; Matangi, M.; Syan, G. S.; Hu, D.; Lv, S.; Yan, X.; Gai, L.; Ge, J. B.; Dong, Y.; Sun, Y.; Yuan, Z.; Zhang, F.; Wang, X.; Wang, W.; Hradec, J.; Florian, J.; Sulda, M.; Spinar, J.; Fábik, L.; Stípal, R.; Kaislerová, M.; Vitovec, J.; Vojtísek, P.; Krejcova, H.; Maratka, T.; Sochor, K.; Marcinek, G.; Povolný, J.; Jerábek, O.; Karetová, D.; Vojacek, J.; Lavicka, V.; Vencour, D.; Kotík, L.; Kuchar, J.; Drazka, J.; Penicka, M.; Kryza, R.; Soucek, M.; Ballek, L.; Spacek, R.; Brønnum Schou, J.; Torp-Pedersen, C.; Nielsen, T.; Markenvard, J.; Tuxen, C.; Hildebrandt, P.; Sejersen, H.; Rokkedal, J.; Ralfkiaer, N.; Agner, E.; Skagen, K.; Roseva Nielsen, N.; Vigholt, E.; Dodt, K. K.; Lind Rasmussen, L.; Pedersen, L.; Stentebjerg, S. E.; Asklund, M.; Klarlund, K.; Haghfelt, T.; Gøtzsche, L.; Rickers, H.; Køber, L.; Jensen, G.; Dahlstrøm, C. G.; Gøtzsche, O.; Egstrup, K.; Petersen, J.; Larsen, J.; McNair, A.; Jakobsen, T.; Larsen, C. T.; Eha, J.; Vahula, V.; Averina, O.; Viigimaa, M.; Sildmäe, S.; Kolbassova, O.; Melin, J.; Peuhkurinen, K.; Harjola, V. P.; Luoma, J.; Ovize, M.; Sellier, P.; Barthelemy, J. C.; Beaune, J.; Magnin, D.; Dambrine, P.; Khalife, K.; Wolf, J. E.; Roudaut, R.; Gabrovescu, M.; Dubois-Rande, J. L.; Galinier, M.; Genest, M.; Mansourati, J.; Aliot, E.; Carlioz, R.; Cherbi, C.; Slama, M.; Colin, P.; Decoulx, E.; Escande, M.; Fournier, P. Y.; Galley, D.; Khanoyan, P.; Jaboureck, O.; Leborgne, L.; Mann, H.; Pierre-Justin, E.; Roynard, J. L.; Soto, F. X.; Bourdon, A.; Bauer, F.; Belin, A.; Boudahne, A.; Bouvier, J. M.; Chati, Z.; Chevalier, J. M.; Chevrier, J.; Doucet, B.; Drawin, T.; Mansour, N. El; Funck, F.; Godenir, J. P.; Guillot, J. P.; Gully, C.; Habib, G.; Kahn, J. C.; Koenig, A.; Martelet, M.; Matina, D.; Gay, A.; Meurice, T.; Perret, T.; Riou, A.; Thisse, J. Y.; Demarcq, J. M.; Bodur, G.; Claudon, O.; Lemoine, C.; Roul, G.; Olive, T. G.; Huyghe de Mahenge, A.; Meinertz, T.; Baumann, G.; Böhm, M.; Cieslinski, G.; Figulla, H. R.; Gonska, B. D.; Hasenfuss, G.; Heckel, D.; Hoppe, U.; Katus, H.; Kombächer, H. D.; Müller, O.; Münzel, T.; Nienaber, C.; Oeff, M.; Rupprecht, H. J.; von Schacky, C.; Schmidt, J.; Schreckenberg, A.; Schuler, G.; Schultheiss, H. P.; Seidl, K.; Steindorf, J.; Strasser, R.; Werdan, K.; Hengstenberg, C.; Haverkamp, W.; Windstetter, U.; Al-Zoebi, A.; Pötsch, T.; Proskynitopoulos, N.; Baar, M.; Winkelmann, B. R.; Jeserich, M.; Tammen, A.; Appel, K. F.; Fries, P.; Ammer, K.; Droese, A. N.; Bergmann, K.; Bott, J.; Lange, R.; Taggeselle, J.; Rummel, R.; Kleinertz, K.; Deissner, M.; Drescher, T.; Zahorsky, R.; Schenkenberger, I.; Grooterorst, P.; Frick, H. M.; Spengler, U.; Jahnke, N.; Bauknecht, C.; Lehmann, G.; Spanier, C.; Wolde, C. H.; Natour, M.; Bosch, R.; Rüdell, U.; Gola, G.; Hering, R.; Heuer, H.; Gärtner, J.; Vardas, P.; Kremastinos, D.; Anastasiou-Nana, M.; Kallikazaros, I.; Theodorakis, G.; Kyriakides, Z.; Pyrgakis, V. N.; Siogas, K.; Kapordelis, C.; Apostolou, T.; Karvounis, H.; Papadopoulos, C.; Tziakas, D.; Tryposkiadis, F.; Koliopoulos, N.; Alexopoulos, D.; Fotiadis, I.; Kolettis, T.; Manolis, A.; Pras, A.; Lee, K.; Borbola, J.; Préda, U.; Tomcsányi, J.; Edes, I.; Nagy, A.; Lippai, J.; Regos, L.; Tóth, K.; Takács, J.; Cziráki, A.; Matoltsy, A.; Sidó, Z.; Nagy, L.; Nyárádi, A.; Mohay, A.; Rumi, G.; Polgár, P.; Zámolyi, K.; Tahy, A.; Piros, G.; Veress, G.; Barsi, B.; Kovács, A.; Sereg, M.; Pálinkás, A.; Sármán, P.; Juhász, A.; Mohácsi, A.; Harmati, L.; Lupkovics, G.; Dézsi, C. A.; Nagy, K.; Vegh, G.; Váradi, A.; Farsang, C.; Lakatos, F.; Barton, J.; Crean, P.; Foley, D.; Daly, K.; de Luca, I.; Urbinati, S.; Zanetta, M.; Porcu, M.; Cocchieri, M.; Buia, E.; Minneci, C.; Leghissa, R.; Della Cassa, S.; Pizzimenti, G.; Ingrilli, F.; Fuscaldo, G.; Bellone, E.; Pulitano, G.; Santini, M.; Uguccioni, M.; Carbonieri, E.; Barbuzzi, S.; Alberti, E.; Proto, C.; Pettinati, G.; Cosmi, F.; Colombo, A.; de Cristofaro, M.; Ambrosio, G.; Maresta, A.; de Matteis, C.; Mos, L.; Giustiniani, S.; Paparoni, S.; Proietti, G.; Giannuzzi, P.; Cardona, N.; Perna, B.; Gavazzi, A.; Capucci, A.; Reggianini, L.; Zanini, R.; Keisa, M.; Erglis, A.; Ozolina, M. A.; Gersamija, A.; Gailiss, E.; Volans, E.; Stoma, M.; Libins, A.; Grabauskiene, V.; Petrulioniene, Z.; Berukstis, E.; Kibarskis, A.; Zaliunas, R.; Marcinkeviciene, J.; Naudziunas, A.; Kirkutis, A.; Varoneckas, G.; Cornel, J. H.; Hamer, B. J. B.; Hoedemaker, G.; van den Berg, B. J.; Somer, S. T.; van der Veen, M.; van Rossum, P.; Bartels, G. L.; van Vlies, B.; Lionarons, R. J.; Dijkgraaf, R.; Wesdorp, J. C. L.; Kragten, J. A.; Fast, J.; de Milliano, P. A. R.; van Rugge, F. P.; Hoogslag, P. A. M.; Göbel, E. J. A.; Leenders, C. M.; van der Heijden, R.; Swart, H.; van Beek, G. J.; van der Zwaan, C.; Holwerda, N. J.; Winter, J. B.; Galema, T. W.; Voors, A. A.; Kirkels, J. H.; Jaarsma, W.; Zwart, P. A. G.; Thijssen, H.; Linssen, G. C. M.; Verheul, J. A.; Maas, A. H. E. M.; Willems, A. R.; Nagelsmit, M. J.; Freericks, M. P.; Pinto, Y. M.; Bruning, T. A.; Michels, H. M.; Withagen, A. J. A. M.; Jap Tjoen San, W. T. J.; Robles de Medina, R.; Nierop, P. R.; Daniels, M. C. G.; van Kempen, L. H. J.; Herrman, J. P. R.; van Wijk, L. M.; Atar, D.; Myhre, E. P.; Dickstein, K.; Musial, W.; Pulkowski, G.; Sinkiewicz, W.; Kubica, J.; Janik, K.; Rynkiewicz, A.; Miekus, P.; Szpajer, M.; Zadrozna, Z.; Krzeminska-Pakula, M.; Goch, J.; Krynicki, R.; Trusz-Gluza, M.; Janion, M.; Zinka, E.; Kawecka-Jaszcz, K.; Piwowarska, W.; Piotrowski, W.; Bloch, C.; Trojnar, R.; Targonski, R.; Pluta, W.; Krzciuk, M.; Achremczyk, P.; Kuzniar, J.; Baska, J.; Ruszkowski, P.; Drozdowski, P.; Kurowski, M.; Krupa, E.; Slowinski, S.; Skura, M.; Pusz, T.; Jaworska, K.; Dluzniewski, M.; Opolski, G.; Piepiorka, M.; Andrzejak, R.; Wrabec, K.; Ponikowski, P.; Loboz-Grudzien, K.; Wodniecki, J.; Kalarus, Z.; Tracz, W.; Kozlowski, A.; Ruzyllo, W.; Mazurek, W.; Szolkiewicz, M.; Paisana Lopes, J. P.; Carvalho, N.; Teixeira, M.; Ferreira Da Silva, G.; Aguiar, J.; Lousada, N.; Salgado, A.; Providencia, L. A.; Freitas, J.; Oliveira Soares, A.; Capalneanu, R.; Macarie, C.; Bruckner, I.; Cinteza, M.; Nanea, T.; Dorobantu, M.; Vintila, M.; Dan, G. A.; Dimulescu, D. R.; Arsenescu, C.; Ionescu, D. D.; Dragulescu, I. S.; Avram, R.; Opris, M.; Manitiu, I.; Craiu, E.; Babes, K.; Tase, A.; Tintoiu, I.; Apetrei, E.; Olinic, N. C.; Radoi, M.; Minescu, B.; Tanaseanu, C. M.; Sinescu, C. J.; Tomescu, M.; Loariu, C.; Carasca, E.; Datcu, M. D.; Dumitrascu, D. L.; Ionascu-Fometescu, C. R.; Pop, C.; Radu, I.; Vladoianu, M.; Kiss, L.; Toplnitchi, L.; Aroutiounov, G. P.; Beloussov, Y. B.; Vasyuk, Y. A.; Vertkine, A. L.; Zadionchenko, V. S.; Zateyshchikov, D. A.; Ya Ivleva, A.; Karpov, Y. A.; Kisliak, O. A.; Kobalava, J. D.; Yu Konyakhin, A.; Kukes, V. G.; Yu Mareev, V.; Mkrtchyan, V. R.; Orlov, V. A.; Sidorenko, B. A.; Stryuk, R. I.; Tereschenko, S. N.; Shpektor, A. V.; Pozdnyakov, Y. M.; Khrustalev, O. A.; Yakusevich, V. V.; Yakushin, S. S.; Azarin, O. G.; Karpov, Y. B.; Moiseeva, O. M.; Perepech, N. B.; Sayganov, S. A.; Svistov, A. S.; Sorokin, L. A.; Shlyakhto, E. V.; Lopatin, Y. M.; Nedogoda, S. V.; Arkhipov, M. V.; Kuimov, A. D.; Tsyba, L. P.; Yakhontova, P. K.; Chumakova, G. A.; Barbarsh, O. L.; Bart, B. Y.; Bychkova, L.; Golukhova, E.; Zhilyaev, E. V.; Rodoman, G. V.; Rudnev, D. V.; Tankhilevich, B. M.; Shostak, N. A.; Kastanaian, A. A.; Pimenov, L. T.; Murín, J.; Kamenský, G.; Gonsorcík, J.; Bada, V.; Pella, D.; Sojka, G.; Vahala, P.; Bugán, V.; Kmec, J.; Micko, K.; Rakovec, P.; Kanic, V.; Skrabl-Mocnik, F.; Slemenik-Pusnik, C.; Melihen-Bartolic, C.; Markez, J.; Macaya de Miguel, C.; Grande, A.; Jimenez Navarro, M.; Romero Hinojosa, J. A.; Bertomeu Martinez, V.; Paz Bermejo, M. A.; Illa Gay, J.; Gusi Tragant, G.; Calvo Gomez, C.; Iglesias Cubero, G.; Balaguer Recena, J.; López García-Aranda, V.; Caparos Valderrama, J.; Iglesias Alonso, L. F.; San Román Calvar, A.; Fernanez Aviles, F.; Perez Villa, F.; Bruguera Cortada, J.; Fernandez Alvarez, R.; Noriega Peiro, F.; Calvo Iglesias, F.; Sevilla Toral, B.; López Bescós, L.; Garcia de Burgos, F.; Sola Casado, R.; Galve, E.; Casares Garcia, G.; Delborg, M.; Herlitz, J.; Ullman, B.; Blomgren, J.; Bandh, S.; Ohlin, H.; Dubach, P.; Gallino, A.; Hess, O.; Moccetti, T.; Eeckhout, E.; Vontobel, H.; Delabays, A.; Erol, K.; Kozan, O.; Mutlu, B.; Ergene, O.; Acarturk, E.; Yilmaz, H.; Ural, D.; Parkhomenko, O.; Polyvoda, S.; Dyadyk, A.; Vatutin, M.; Karpenko, O.; Kubyshkin, V.; Rudenko, L.; Putintsev, V.; Krayz, I.; Kovalsky, I.; Rudyk, Y.; Yurlov, V.; Mostovoy, Y.; Rishko, M.; Barna, O.; Slyvka, Y.; Perepelytsya, M.; Seredyuk, N.; Bazylevych, A.; Glushko, L.; Tashchuk, V.; Girina, O.; Vizir, V.; Pertseva, T.; Vlasenko, M.; Goloborodko, B.; Kolomiets, S.; Dzyak, G.; Sharuk, O.; Storozhuk, B.; Kovalenko, V.; Khomazyuk, T.; Soldatchenko, S.; Lutay, M.; Zharinov, O.; Serkova, V.; Korkushko, O.; Korzh, O.; Netyazheko, V.; Sakharchuck, I.; Stadnyuk, L.; Bereznyakov, I.; Semidotska, Z.; Kolchin, Y.; Voronkov, L.; Tseluyko, V.; Amosova, K.; Batuschkin, V.; Hall, A.; Lindsay, S.; Moriarty, A.; Kadr, H.; Francis, C. M.; Saltissi, S.; Rozkovec, A.; Groves, P.; Crook, J. R.; Purvis, J.; Brooksby, P.; Stewart, M.; Dutka, D.; Timmis, A.; Baig, M. W.; Brady, A.; Williams, S.; Brooks, N.; Greaves, K.

    2008-01-01

    OBJECTIVES: Ivabradine is a selective heart rate-lowering agent that acts by inhibiting the pacemaker current If in sinoatrial node cells. Patients with coronary artery disease and left ventricular dysfunction are at high risk of death and cardiac events, and the BEAUTIFUL study was designed to

  6. Diabetes, Glycemic Control, and New-Onset Heart Failure in Patients With Stable Coronary Artery Disease Data from the Heart and Soul Study

    NARCIS (Netherlands)

    van Melle, Joost P.; Bot, Marisica; De Jonge, Peter; De Boer, Rudolf A.; van Veldhuisen, Dirk J.; Whooley, Mary A.

    OBJECTIVE- Diabetes is a predictor of both coronary artery disease (CAD) and heart failure. It is unknown to what extent the association between diabetes and heart failure is influenced by other risk factors for heart failure. RESEARCH DESIGN AND METHODS- We evaluated the association of diabetes and

  7. Immunoglobulin kappa deleting element rearrangements in precursor-B acute lymphoblastic leukemia are stable targets for detection of minimal residual disease by real-time quantitative PCR

    NARCIS (Netherlands)

    van der Velden, V. H. J.; Willemse, M. J.; van der Schoot, C. E.; Hählen, K.; van Wering, E. R.; van Dongen, J. J. M.

    2002-01-01

    Immunoglobulin gene rearrangements are used as PCR targets for detection of minimal residual disease (MRD) in acute lymphoblastic leukemia (ALL). We Investigated the occurrence of monoclonal immunoglobulin kappa-deleting element (IGK-Kde) rearrangements by Southern blotting and PCR/heteroduplex

  8. Scared to Death? Generalized Anxiety Disorder and Cardiovascular Events in Patients With Stable Coronary Heart Disease The Heart and Soul Study

    NARCIS (Netherlands)

    Martens, Elisabeth J.; de Jonge, Peter; Na, Beeya; Cohen, Beth E.; Lett, Heather; Whooley, Mary A.

    Context: Anxiety is common in patients with coronary heart disease (CHD), but studies examining the effect of anxiety on cardiovascular prognosis and the role of potential mediators have yielded inconsistent results. Objectives: To evaluate the effect of generalized anxiety disorder (GAD) on

  9. Trends in Risk Factors and Treatments in Patients With Stable Ischemic Heart Disease Seen at Cardiology Clinics Between 2006 and 2014.

    Science.gov (United States)

    Cordero, Alberto; Galve, Enrique; Bertomeu-Martínez, Vicente; Bueno, Héctor; Fácila, Lorenzo; Alegría, Eduardo; Cequier, Ángel; Ruiz, Emilio; González-Juanatey, José Ramón

    2016-04-01

    Chronic ischemic heart disease is the most prevalent of all cardiovascular diseases. Patients are at high risk of complications. In recent decades, changes may have occurred in the clinical characteristics of the disease, its treatment and control of risk factors. A direct comparison of 2 national registries of patients with chronic ischemic heart disease carried out in 2006 (n=1583) and 2014 (n=1110). We observed statistically significant differences between the 2 registries, with a higher percentage of men and smokers in the 2014 registry, but a lower prevalence of diabetes mellitus and hypertension. Heart failure and stroke were more prevalent in the 2006 registry. Patients in the 2014 registry had better results for lipid profile, blood glucose, creatinine, and glomerular filtration rate. We observed higher use of recommended drugs for secondary prevention and an increased percentage of patients receiving optimal medical therapy, from 32.5% to 49.5% (P<.01). Use of high-intensity statin doses also increased from 10.5% to 42.8% (P<.01). We found better control of some risk factors (improved dyslipidemia, heart rate, and blood glucose in patients with diabetes) but worse blood pressure control. The clinical profile of patients with chronic ischemic heart disease is similar in the 2 registries. There has been an improvement in patients' medical therapy and dyslipidemia control, blood glucose, and heart rate, but there is still much room for improvement in the control of other cardiovascular risk factors. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  10. Composite hot-subdwarf binaries -- I. The spectroscopically confirmed sdB sample

    OpenAIRE

    Vos, Joris; Németh, Péter; Vučković, Maja; Østensen, Roy; Parsons, Steven

    2017-01-01

    Hot subdwarf-B (sdB) stars in long-period binaries are found to be on eccentric orbits, even though current binary-evolution theory predicts that these objects are circularized before the onset of Roche lobe overflow (RLOF). To increase our understanding of binary interaction processes during the RLOF phase, we started a long-term observing campaign to study wide sdB binaries. In this paper, we present a sample of composite binary sdBs, and the results of the spectral analysis of nine such sy...

  11. Beyond Retinal Layers: A Deep Voting Model for Automated Geographic Atrophy Segmentation in SD-OCT Images.

    Science.gov (United States)

    Ji, Zexuan; Chen, Qiang; Niu, Sijie; Leng, Theodore; Rubin, Daniel L

    2018-01-01

    To automatically and accurately segment geographic atrophy (GA) in spectral-domain optical coherence tomography (SD-OCT) images by constructing a voting system with deep neural networks without the use of retinal layer segmentation. An automatic GA segmentation method for SD-OCT images based on the deep network was constructed. The structure of the deep network was composed of five layers, including one input layer, three hidden layers, and one output layer. During the training phase, the labeled A-scans with 1024 features were directly fed into the network as the input layer to obtain the deep representations. Then a soft-max classifier was trained to determine the label of each individual pixel. Finally, a voting decision strategy was used to refine the segmentation results among 10 trained models. Two image data sets with GA were used to evaluate the model. For the first dataset, our algorithm obtained a mean overlap ratio (OR) 86.94% ± 8.75%, absolute area difference (AAD) 11.49% ± 11.50%, and correlation coefficients (CC) 0.9857; for the second dataset, the mean OR, AAD, and CC of the proposed method were 81.66% ± 10.93%, 8.30% ± 9.09%, and 0.9952, respectively. The proposed algorithm was capable of improving over 5% and 10% segmentation accuracy, respectively, when compared with several state-of-the-art algorithms on two data sets. Without retinal layer segmentation, the proposed algorithm could produce higher segmentation accuracy and was more stable when compared with state-of-the-art methods that relied on retinal layer segmentation results. Our model may provide reliable GA segmentations from SD-OCT images and be useful in the clinical diagnosis of advanced nonexudative AMD. Based on the deep neural networks, this study presents an accurate GA segmentation method for SD-OCT images without using any retinal layer segmentation results, and may contribute to improved understanding of advanced nonexudative AMD.

  12. Sensitivity, specificity and predictive values of linear and nonlinear indices of heart rate variability in stable angina patients

    Directory of Open Access Journals (Sweden)

    Pivatelli Flávio

    2012-10-01

    Full Text Available Abstract Background Decreased heart rate variability (HRV is related to higher morbidity and mortality. In this study we evaluated the linear and nonlinear indices of the HRV in stable angina patients submitted to coronary angiography. Methods We studied 77 unselected patients for elective coronary angiography, which were divided into two groups: coronary artery disease (CAD and non-CAD groups. For analysis of HRV indices, HRV was recorded beat by beat with the volunteers in the supine position for 40 minutes. We analyzed the linear indices in the time (SDNN [standard deviation of normal to normal], NN50 [total number of adjacent RR intervals with a difference of duration greater than 50ms] and RMSSD [root-mean square of differences] and frequency domains ultra-low frequency (ULF ≤ 0,003 Hz, very low frequency (VLF 0,003 – 0,04 Hz, low frequency (LF (0.04–0.15 Hz, and high frequency (HF (0.15–0.40 Hz as well as the ratio between LF and HF components (LF/HF. In relation to the nonlinear indices we evaluated SD1, SD2, SD1/SD2, approximate entropy (−ApEn, α1, α2, Lyapunov Exponent, Hurst Exponent, autocorrelation and dimension correlation. The definition of the cutoff point of the variables for predictive tests was obtained by the Receiver Operating Characteristic curve (ROC. The area under the ROC curve was calculated by the extended trapezoidal rule, assuming as relevant areas under the curve ≥ 0.650. Results Coronary arterial disease patients presented reduced values of SDNN, RMSSD, NN50, HF, SD1, SD2 and -ApEn. HF ≤ 66 ms2, RMSSD ≤ 23.9 ms, ApEn ≤−0.296 and NN50 ≤ 16 presented the best discriminatory power for the presence of significant coronary obstruction. Conclusion We suggest the use of Heart Rate Variability Analysis in linear and nonlinear domains, for prognostic purposes in patients with stable angina pectoris, in view of their overall impairment.

  13. Stable isotopes labelled compounds

    International Nuclear Information System (INIS)

    1982-09-01

    The catalogue on stable isotopes labelled compounds offers deuterium, nitrogen-15, and multiply labelled compounds. It includes: (1) conditions of sale and delivery, (2) the application of stable isotopes, (3) technical information, (4) product specifications, and (5) the complete delivery programme

  14. Stable Boundary Layer Issues

    NARCIS (Netherlands)

    Steeneveld, G.J.

    2012-01-01

    Understanding and prediction of the stable atmospheric boundary layer is a challenging task. Many physical processes are relevant in the stable boundary layer, i.e. turbulence, radiation, land surface coupling, orographic turbulent and gravity wave drag, and land surface heterogeneity. The

  15. Evolutionary Stable Strategy

    Indian Academy of Sciences (India)

    IAS Admin

    After Maynard-Smith and Price [1] mathematically derived why a given behaviour or strategy was adopted by a certain proportion of the population at a given time, it was shown that a strategy which is currently stable in a population need not be stable in evolutionary time (across generations). Additionally it was sug-.

  16. Evaluating the quality of research into a single prognostic biomarker: a systematic review and meta-analysis of 83 studies of C-reactive protein in stable coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Harry Hemingway

    2010-06-01

    Full Text Available Systematic evaluations of the quality of research on a single prognostic biomarker are rare. We sought to evaluate the quality of prognostic research evidence for the association of C-reactive protein (CRP with fatal and nonfatal events among patients with stable coronary disease.We searched MEDLINE (1966 to 2009 and EMBASE (1980 to 2009 and selected prospective studies of patients with stable coronary disease, reporting a relative risk for the association of CRP with death and nonfatal cardiovascular events. We included 83 studies, reporting 61,684 patients and 6,485 outcome events. No study reported a prespecified statistical analysis protocol; only two studies reported the time elapsed (in months or years between initial presentation of symptomatic coronary disease and inclusion in the study. Studies reported a median of seven items (of 17 from the REMARK reporting guidelines, with no evidence of change over time. The pooled relative risk for the top versus bottom third of CRP distribution was 1.97 (95% confidence interval [CI] 1.78-2.17, with substantial heterogeneity (I(2 = 79.5. Only 13 studies adjusted for conventional risk factors (age, sex, smoking, obesity, diabetes, and low-density lipoprotein [LDL] cholesterol and these had a relative risk of 1.65 (95% CI 1.39-1.96, I(2 = 33.7. Studies reported ten different ways of comparing CRP values, with weaker relative risks for those based on continuous measures. Adjusting for publication bias (for which there was strong evidence, Egger's p<0.001 using a validated method reduced the relative risk to 1.19 (95% CI 1.13-1.25. Only two studies reported a measure of discrimination (c-statistic. In 20 studies the detection rate for subsequent events could be calculated and was 31% for a 10% false positive rate, and the calculated pooled c-statistic was 0.61 (0.57-0.66.Multiple types of reporting bias, and publication bias, make the magnitude of any independent association between CRP and prognosis

  17. Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease: an international, randomised, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Anand, Sonia S; Bosch, Jackie; Eikelboom, John W; Connolly, Stuart J; Diaz, Rafael; Widimsky, Peter; Aboyans, Victor; Alings, Marco; Kakkar, Ajay K; Keltai, Katalin; Maggioni, Aldo P; Lewis, Basil S; Störk, Stefan; Zhu, Jun; Lopez-Jaramillo, Patricio; O'Donnell, Martin; Commerford, Patrick J; Vinereanu, Dragos; Pogosova, Nana; Ryden, Lars; Fox, Keith A A; Bhatt, Deepak L; Misselwitz, Frank; Varigos, John D; Vanassche, Thomas; Avezum, Alvaro A; Chen, Edmond; Branch, Kelley; Leong, Darryl P; Bangdiwala, Shrikant I; Hart, Robert G; Yusuf, Salim

    2017-11-10

    Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications. This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90. After a 30-day run-in period, patients were randomly assigned (1:1:1) to receive oral rivaroxaban (2·5 mg twice a day) plus aspirin (100 mg once a day), rivaroxaban twice a day (5 mg with aspirin placebo once a day), or to aspirin once a day (100 mg and rivaroxaban placebo twice a day). Randomisation was computer generated. Each treatment group was double dummy, and the patient, investigators, and central study staff were masked to treatment allocation. The primary outcome was cardiovascular death, myocardial infarction or stroke; the primary peripheral artery disease outcome was major adverse limb events including major amputation. This trial is registered with ClinicalTrials.gov, number NCT01776424, and is closed to new participants. Between March 12, 2013, and May 10, 2016, we enrolled 7470 patients with peripheral artery disease from 558 centres. The combination of rivaroxaban plus aspirin compared with aspirin alone reduced the composite endpoint of cardiovascular death, myocardial infarction, or stroke (126 [5%] of 2492 vs 174 [7%] of 2504; hazard ratio [HR] 0·72, 95% CI 0·57-0·90, p=0·0047), and major adverse limb events including major amputation (32

  18. Close-In Substellar Companions and the Formation of sdB-Type Close Binary Stars

    Directory of Open Access Journals (Sweden)

    L. Y. Zhu

    2015-02-01

    Full Text Available The sdB-type close binaries are believed to have experienced a common-envelope phase and may evolve into cataclysmic binaries (CVs. About 10% of all known sdB binaries are eclipsing binaries consisting of very hot subdwarf primaries and low-mass companions with short orbital periods. The eclipse profiles of these systems are very narrow and deep, which benefits the determination of high precise eclipsing times and makes the detection of small and close-in tertiary bodies possible. Since 2006 we have monitored some sdB-type eclipsing binaries to search for the close-in substellar companions by analyzing the light travel time effect. Here some progresses of the program are reviewed and the formation of sdB-type binary is discussed.

  19. Transcriptional analysis of heterologous gene expression using the endogenous sD promoter from Bacillus halodurans

    CSIR Research Space (South Africa)

    Crampton, Michael C

    2010-07-01

    Full Text Available This presentation focused on the transcriptional analysis of heterologous gene expression using the endogenous sD promoter from Bacillus halodurans. It concludes to a successful implementation of a high throughput mRNA sandwich hybridisation...

  20. ANALISIS PEDAGOGICAL CONTENT KNOWLEDGE (PCK TERHADAP BUKU GURU SD KURIKULUM 2013

    Directory of Open Access Journals (Sweden)

    Gaguk Resbiantoro

    2016-09-01

    Full Text Available Analisis buku pegangan guru SD dalam implementasi kurikulum 2013 perlu dilakukan karena buku ini menjadi acuan guru dalam mengajar. Guru SD harus menguasai konten materi dan cara penyampaian (pengajarannya kepada peserta didik atau yang dikenal sebagai PCK (Pedagogical Content Knowledge. Buku pegangan guru harus sesuai dengan kaidah-kaidah PCK. Penelitian ini merupakan penelitian deskriptif yang bertujuan untuk memperoleh informasi mengenai ruang lingkup Pedagogical Content Knowledge pada buku pegangan guru SD. Populasi pada penelitian ini adalah semua bab pada buku pegangan guru SD yang digunakan dalam implementasi kurikulum 2013. Sedangkan sampel pada penelitian ini adalah beberapa bab pada buku yang dianalisis, diambil sebanyak 20% dengan cara purposive random dari sebuah buku yang menjadi acuan mengajar SD yang digunakan dalam implementasi kurikulum 2013, khususnya muatan IPA. Hal tersebut atas pertimbangan bahwa karakteristik materi IPA sangat sesuai dengan teori konstruktivisme anak SD dan pendekatan saintifik. Data dijaring dengan lembar observasi berupa instrumen evaluasi buku guru yang berisi perpaduan indikator PCK dari lima komponen PCK yang dikembangkan oleh Magnusson et al. dalam Newsome dan Lederman (2002 dan instrumen yang telah dikembangkan Swanepoel (2010. Identifikasi dilakukan pada dua sampel buku guru SD kurikulum 2013 pada satu sub tema. Rata-rata prosentase masing-masing sub komponen PCK dalam buku guru SD kurikulum 2013 yaitu capaian pembelajaran 82%, pengetahuan inti 44%, hakekat ilmu pengetahuan 52%, kegiatan pembelajaran 74%, penilaian 50%, contoh dan penjelasan 67%, kerangka metakognisi 58%, perbedaan perlakuan siswa 58%, serta pemberian motivasi pada siswa 79%. Sub komponen Content Knowledge perlu dilengkapi tentang pengetahuan miskonsepsi dan pengetahuan tambahan. Sedangkan sub komponen Pedagogical Knowledge perlu dilengkapi tentang kelengkapan penilaian dan kerangka metakognisi. Beberapa permasalahan tersebut dapat

  1. Penggunaan Media Ilustrasi Pop-up Sejarah Dalam Pembelajaran IPS Di SD Negeri Batursari

    OpenAIRE

    Purmintasari, Yulita Dewi; PU, Eka Jaya

    2017-01-01

    This study aims: (1to know the process of learning social science in SD Negeri Batursari, (2) to know the use of illustration pop-up media in relieve the teacher to foster student‟s understanding toward the social science subject. This study was conducted in SD Negeri Batursari by using qualitative research strategies. The technique in collecting data were interview, direct observation, questionnaires and research document. The data validated by using triangulation researcher, theoretical and...

  2. An evaluation of the SD Bioline HIV/syphilis duo test.

    Science.gov (United States)

    Holden, Jeffrey; Goheen, Joshua; Jett-Goheen, Mary; Barnes, Mathilda; Hsieh, Yu-Hsiang; Gaydos, Charlotte A

    2018-01-01

    Many health agencies now recommend routine HIV and syphilis testing for pregnant women and most-at-risk populations such as men who have sex with men. With the increased availability of highly sensitive, low cost rapid point-of-care tests, the ability to meet those recommendations has increased, granting wider access to quick and accurate diagnoses. Using blood specimens collected from a Baltimore City Health Department (BCHD) sexually transmitted infection clinic, we evaluated the SD Bioline HIV/Syphilis Duo, a rapid test that simultaneously detects antibodies to HIV and syphilis and has the potential to further benefit clinics and patients by reducing costs, testing complexity, and patient wait times. SD DUO HIV sensitivity and specificity, when compared to BCHD results, were 91.7 and 99.5%, respectively. SD DUO syphilis sensitivity and specificity, when compared to rapid plasma reagin, were 85.7 and 96.8%, respectively, and 69.7 and 99.7%, respectively, when compared to Treponema pallidum particle agglutination (TPPA). SD DUO syphilis sensitivity and specificity, when compared to a traditional screening algorithm, improved to 92.3 and 100%, respectively, and improved to 72.9 and 99.7%, respectively, when compared to a reverse screening algorithm. The HIV component of the SD DUO performed moderately well. However, results for the SD DUO syphilis component, when compared to TPPA, support the need for further testing and assessment.

  3. G eobacter sp. SD-1 with enhanced electrochemical activity in high-salt concentration solutions

    KAUST Repository

    Sun, Dan

    2014-07-16

    © 2014 Society for Applied Microbiology and John Wiley & Sons Ltd. Summary: An isolate, designated strain SD-1, was obtained from a biofilm dominated by Geobacter sulfurreducens in a microbial fuel cell. The electrochemical activity of strain SD-1 was compared with type strains, G.sulfurreducensPCA and Geobacter metallireducensGS-15, and a mixed culture in microbial electrolysis cells. SD-1 produced a maximum current density of 290±29Am-3 in a high-concentration phosphate buffer solution (PBS-H, 200mM). This current density was significantly higher than that produced by the mixed culture (189±44Am-3) or the type strains (<70Am-3). In a highly saline water (SW; 50mM PBS and 650mM NaCl), current by SD-1 (158±4Am-3) was reduced by 28% compared with 50mM PBS (220±4Am-3), but it was still higher than that of the mixed culture (147±19Am-3), and strains PCA and GS-15 did not produce any current. Electrochemical tests showed that the improved performance of SD-1 was due to its lower charge transfer resistance and more negative potentials produced at higher current densities. These results show that the electrochemical activity of SD-1 was significantly different than other Geobacter strains and mixed cultures in terms of its salt tolerance.

  4. Normal modified stable processes

    DEFF Research Database (Denmark)

    Barndorff-Nielsen, Ole Eiler; Shephard, N.

    2002-01-01

    This paper discusses two classes of distributions, and stochastic processes derived from them: modified stable (MS) laws and normal modified stable (NMS) laws. This extends corresponding results for the generalised inverse Gaussian (GIG) and generalised hyperbolic (GH) or normal generalised inverse...... Gaussian (NGIG) laws. The wider framework thus established provides, in particular, for added flexibility in the modelling of the dynamics of financial time series, of importance especially as regards OU based stochastic volatility models for equities. In the special case of the tempered stable OU process...

  5. Applications of stable isotopes

    International Nuclear Information System (INIS)

    Letolle, R.; Mariotti, A.; Bariac, T.

    1991-06-01

    This report reviews the historical background and the properties of stable isotopes, the methods used for their measurement (mass spectrometry and others), the present technics for isotope enrichment and separation, and at last the various present and foreseeable application (in nuclear energy, physical and chemical research, materials industry and research; tracing in industrial, medical and agronomical tests; the use of natural isotope variations for environmental studies, agronomy, natural resources appraising: water, minerals, energy). Some new possibilities in the use of stable isotope are offered. A last chapter gives the present state and forecast development of stable isotope uses in France and Europe

  6. Weight loss is superior to exercise in improving the atherogenic lipid profile in a sedentary, overweight population with stable coronary artery disease

    DEFF Research Database (Denmark)

    Pedersen, Lene Rørholm; Olsen, Rasmus Huan; Anholm, Christian

    2016-01-01

    BACKGROUND: Dyslipidemia and low-grade inflammation are integral in the pathogenesis of atherosclerosis. We aim to compare the effects of a considerable weight loss and intensive exercise training on lipid atherogenicity and low-grade inflammation in a high-risk population with coronary artery...... disease (CAD). METHODS: Seventy non-diabetic participants with CAD, BMI 28-40 kg/m(2), age 45-75 years were randomized to 12 weeks' aerobic interval training (AIT) at 85-90% of peak heart rate three times/week or a low energy diet (LED, 800-1000 kcal/day) for 8-10 weeks followed by 2-4 weeks' weight...

  7. Epicardial Adipose Tissue Thickness Correlates with the Presence and Severity of Angiographic Coronary Artery Disease in Stable Patients with Chest Pain

    Science.gov (United States)

    Picard, Fabien A.; Gueret, Pascal; Laissy, Jean-Pierre; Champagne, Stéphane; Leclercq, Florence; Carrié, Didier; Juliard, Jean-Michel; Henry, Patrick; Niarra, Ralph; Chatellier, Gilles; Steg, Philippe Gabriel

    2014-01-01

    Objective Epicardial adipose tissue (EAT) is suggested to correlate with metabolic risk factors and to promote plaque development in the coronary arteries. We sought to determine whether EAT thickness was associated or not with the presence and extent of angiographic coronary artery disease (CAD). Methods We measured epicardial fat thickness by computed tomography and assessed the presence and extent of CAD by coronary angiography in participants from the prospective EVASCAN study. The association of EAT thickness with cardiovascular risk factors, coronary artery calcification scoring and angiographic CAD was assessed using multivariate regression analysis. Results Of 970 patients (age 60.9 years, 71% male), 75% (n = 731) had CAD. Patients with angiographic CAD had thicker EAT on the left ventricle lateral wall when compared with patients without CAD (2.74±2.4 mm vs. 2.08±2.1 mm; p = 0.0001). The adjusted odds ratio (OR) for a patient with a LVLW EAT value ≥2.8 mm to have CAD was OR = 1.46 [1.03–2.08], p = 0.0326 after adjusting for risk factors. EAT also correlated with the number of diseased vessels (p = 0.0001 for trend). By receiver operating characteristic curve analysis, an EAT value ≥2.8 mm best predicted the presence of>50% diameter coronary artery stenosis, with a sensitivity and specificity of 46.1% and 66.5% respectively (AUC:0.58). Coronary artery calcium scoring had an AUC of 0.76. Conclusion Although left ventricle lateral wall EAT thickness correlated with the presence and extent of angiographic CAD, it has a low performance for the diagnosis of CAD. PMID:25335187

  8. Coronary Collateral Growth Induced by Physical Exercise: Results of the Impact of Intensive Exercise Training on Coronary Collateral Circulation in Patients With Stable Coronary Artery Disease (EXCITE) Trial.

    Science.gov (United States)

    Möbius-Winkler, Sven; Uhlemann, Madlen; Adams, Volker; Sandri, Marcus; Erbs, Sandra; Lenk, Karsten; Mangner, Norman; Mueller, Ulrike; Adam, Jennifer; Grunze, Martin; Brunner, Susanne; Hilberg, Thomas; Mende, Meinhard; Linke, Axel P; Schuler, Gerhard

    2016-04-12

    A well-developed coronary collateral circulation provides a potential source of blood supply in coronary artery disease. However, the prognostic importance and functional relevance of coronary collaterals is controversial with the association between exercise training and collateral growth still unclear. This prospective, open-label study randomly assigned 60 patients with significant coronary artery disease (fractional flow reserve ≤0.75) to high-intensity exercise (group A, 20 patients) or moderate-intensity exercise (group B, 20 patients) for 4 weeks or to a control group (group C, 20 patients). The primary end point was the change of the coronary collateral flow index (CFI) after 4 weeks. Analysis was based on the intention to treat. After 4 weeks, baseline CFI increased significantly by 39.4% in group A (from 0.142±0.07 at beginning to 0.198±0.09 at 4 weeks) in comparison with 41.3% in group B (from 0.143±0.06 to 0.202±0.09), whereas CFI in the control group remained unchanged (0.7%, from 0.149±0.09 to 0.150±0.08). High-intensity exercise did not lead to a greater CFI than moderate-intensity training. After 4 weeks, exercise capacity, Vo2 peak and ischemic threshold increased significantly in group A and group B in comparison with group C with no difference between group A and group B. A significant improvement in CFI was demonstrated in response to moderate- and high-intensity exercise performed for 10 hours per week. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01209637. © 2016 American Heart Association, Inc.

  9. Analysing Stable Time Series

    National Research Council Canada - National Science Library

    Adler, Robert

    1997-01-01

    We describe how to take a stable, ARMA, time series through the various stages of model identification, parameter estimation, and diagnostic checking, and accompany the discussion with a goodly number...

  10. Repeatability, reproducibility, agreement characteristics of 2 SD-OCT devices for anterior chamber angle measurements.

    Science.gov (United States)

    Akil, Handan; Dastiridou, Anna; Marion, Kenneth; Francis, Brian; Chopra, Vikas

    2017-04-01

    To evaluate the agreement, reproducibility, and repeatability of 2 spectral domain optical coherence tomography (SD-OCT) devices in Schwalbe's line (SL)-based anterior chamber angle parameters. The inferior anterior chamber angle of 65 eyes from 65 participants (33 right eyes and 32 left eyes) were scanned twice with the Nidek RS 3000 Advanced SD-OCT and Cirrus SD-OCT. SL angle opening distance (SL-AOD) and SL trabecular-iris-space area (SL-TISA) were graded by masked certified graders at the Doheny Image Reading Center. The mean SL-AOD/SL-TISA was 617.3 ± 237.9 µm/0.211 ± 0.086 mm 2 for the Cirrus and 633.7 ± 219.3 µm/0.218 ± 0.080 mm 2 for the Nidek RS 3000 Advanced SD-OCT. The repeatability (intraclass correlation coefficients [ICCs] >0.936) and intergrader reproducibility (ICCs >0.915) in SL-AOD and SL-TISA with Cirrus OCT were excellent. The repeatability (ICCs >0.948) and intergrader reproducibility (ICCs >0.709) in SL-AOD and SL-TISA with the Nidek RS 3000 Advanced SD-OCT were moderate to good. Moderate agreement between the 2 devices was also documented with a mean difference of -15.3 (limits of agreement [LoA] -246.5 to 277.1) mm for SL-AOD and 0.006 (LoA -0.096 to 0.108) mm in SL-TISA. Both devices were able to provide consistent angle measurements, but repeatability and reproducibility were better in Cirrus SD-OCT than in Nidek RS 3000 Advanced SD-OCT. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  11. Quality not quantity for transglutaminase antibody 2: the performance of an endomysial and tissue transglutaminase test in screening coeliac disease remains stable over time.

    Science.gov (United States)

    Swallow, K; Wild, G; Sargur, R; Sanders, D S; Aziz, I; Hopper, A D; Egner, W

    2013-01-01

    National Institute of Clinical Excellence (NICE) and European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidance for the diagnosis of coeliac disease has been published. However, there is some controversy regarding the advice on the use of stratifying levels of immunoglobulin (IgA) tissue transglutaminase antibody (TG2) test positivity in the absence of test standardization and the vagueness of the indication to test equivocal samples. Using repeat service audit, we demonstrate that a combination of TG2 followed by IgA endomysial antibodies (EMA) is the best strategy for all degrees of mucosal abnormality using our test combination. Reliance upon immunoassay titre is not as effective, and cannot be applied consistently across populations in the absence of assay standardization. Guidelines advocating the use of tests should involve experts in laboratory diagnostics and external quality assurance to ensure that errors of generalization do not occur and that test performance is achievable in routine diagnostic use. © 2012 British Society for Immunology.

  12. Three Huntington's Disease Specific Mutation-Carrying Human Embryonic Stem Cell Lines Have Stable Number of CAG Repeats upon In Vitro Differentiation into Cardiomyocytes.

    Directory of Open Access Journals (Sweden)

    Laureen Jacquet

    Full Text Available Huntington disease (HD; OMIM 143100, a progressive neurodegenerative disorder, is caused by an expanded trinucleotide CAG (polyQ motif in the HTT gene. Cardiovascular symptoms, often present in early stage HD patients, are, in general, ascribed to dysautonomia. However, cardio-specific expression of polyQ peptides caused pathological response in murine models, suggesting the presence of a nervous system-independent heart phenotype in HD patients. A positive correlation between the CAG repeat size and severity of symptoms observed in HD patients has also been observed in in vitro HD cellular models. Here, we test the suitability of human embryonic stem cell (hESC lines carrying HD-specific mutation as in vitro models for understanding molecular mechanisms of cardiac pathology seen in HD patients. We have differentiated three HD-hESC lines into cardiomyocytes and investigated CAG stability up to 60 days after starting differentiation. To assess CAG stability in other tissues, the lines were also subjected to in vivo differentiation into teratomas for 10 weeks. Neither directed differentiation into cardiomyocytes in vitro nor in vivo differentiation into teratomas, rich in immature neuronal tissue, led to an increase in the number of CAG repeats. Although the CAG stability might be cell line-dependent, induced pluripotent stem cells generated from patients with larger numbers of CAG repeats could have an advantage as a research tool for understanding cardiac symptoms of HD patients.

  13. Detection of Additional Be+sdO Systems from IUE  Spectroscopy

    Science.gov (United States)

    Wang, Luqian; Gies, Douglas R.; Peters, Geraldine J.

    2018-02-01

    There is growing evidence that some Be stars were spun up through mass transfer in a close binary system, leaving the former mass donor star as a hot, stripped-down object. There are five known cases of Be stars with hot subdwarf (sdO) companions that were discovered through International Ultraviolet Explorer (IUE) spectroscopy. Here we expand the search for Be+sdO candidates using archival FUV spectra from IUE. We collected IUE spectra for 264 stars and formed cross-correlation functions with a model spectrum for a hot subdwarf. Twelve new candidate Be+sdO systems were found, and eight of these display radial velocity variations associated with orbital motion. The new plus known Be+sdO systems have Be stars with spectral subtypes of B0–B3, and the lack of later-type systems is surprising given the large number of cooler B-stars in our sample. We discuss explanations for the observed number and spectral type distribution of the Be+sdO systems, and we argue that there are probably many Be systems with stripped companions that are too faint for detection through our analysis.

  14. Anti-jugular vein thrombotic effect of Morinda citrifolia L. [noni] in male SD rats

    Directory of Open Access Journals (Sweden)

    Mian-Ying Wang

    2011-09-01

    Full Text Available Background: Venous thromboembolism (VTE is a common and serious medical condition, which is estimably responsible for more than 300,000 hospital admissions annually in the USA. Pulmonary embolism (PE is a major complication of VTE, which contributes to 12% death of hospitalized patients. Heparin is the most common anti-coagulant, but severe allergic reactions, bleeding, and thrombocytopenia limit its use. Thus, seeking a botanical, nontoxic antithrombotic alternative is an interesting area. Morinda citrifolia L. [noni] is a medicinal plant used in folk remedies by Polynesians for over 2,000 years. It has been reported to have a broad range of therapeutic and preventive effects. The bioactivities of NJ have been continuously discovered with antioxidative, anti-inflammatory, analgesic, and immune modifying activities. Our novel hypothesis is whether NJ has an anti-venous thrombotic effect in rodents. To examine our hypothesis, this study was designed to examine the anti-thrombotic effect of NJ on the jugular vein thrombosis model induced by ferric chloride in SD rats.Material and Methods: NJ and placebo used in this study were donated by Morinda Holding Inc. NJ was formulated with grape juice and blue berry juice. Placebo was prepared by using the same procedure of NJ preparation, but without NJ in it. Thirty-six male SD rats were divided into six groups. Anti-venous thrombotic activities of 5% NJ, 10% NJ, heparin, and 10% NJ plus heparin were examined and compared with the positive and blank controls. Thrombosis was induced by application of a filter paper soaked in 50% ferric chloride on the right jugular vein. AFunctional Foods in Health and Disease 2011; 9:297-3092-cm fragment of the occluded vein (thrombus was removed and weighed after 1-hour maturation. Blood samples were collected for platelet count, aPTT, and PT tests.Results: The weight of a 2-cm fragment of normal jugular vein was 9.9 ± 2.1 mg, while the weight of the occluded vein in

  15. Variability in proteinase-antiproteinase balance, nutritional status, and quality of life in stable chronic obstructive pulmonary disease due to tobacco and nontobacco etiology

    Directory of Open Access Journals (Sweden)

    Anant Mohan

    2016-01-01

    Full Text Available Context: Although the role of proteinase/antiproteinase imbalance in chronic obstructive pulmonary disease (COPD due to tobacco is well established, information in COPD due to nontobacco etiology is sparse. Aims: To assess the variability in metalloproteinase activity in COPD related to tobacco and nontobacco causes. Settings and Design: This is a hospital-based, prospective, observational study. Subjects and Methods: Serum matrix metalloproteinase-9 (MMP-9 and tissue inhibitor of metalloproteinases-1 (TIMP-1 were estimated in 200 subjects divided equally into four groups, i.e. COPD in tobacco smokers, COPD in nonsmokers but with exposure to biomass-related indoor air pollution, smokers without COPD, and nonsmoking healthy controls. Anthropometric skinfold measurements, quality of life (QOL using St. George Respiratory Questionnaire, and exercise capacity using the 6-min walk test (6-MWT were carried out. Groups were compared using analysis of variance and Kruskal–Wallis plus Mann–Whitney U-test to assess differences between groups. The Chi-square and Fisher's exact tests were used to evaluate associations among categorical variables. Spearman's rank correlation was calculated to assess the correlation between data. Results: Patients with COPD due to either tobacco or nontobacco etiology were older, more malnourished, had worse QOL, and poorer exercise capacity compared to non-COPD subjects. Triceps, subscapular, and suprailiac skinfold thicknesses were less in smokers with COPD than biomass-related COPD. MMP-9 and TIMP-1 levels were similar across all groups. TIMP-1 significantly correlated with 6-MWT among all groups. Conclusions: The protease-antiprotease balance in COPD is similar irrespective of the presence or absence of tobacco exposure but is related to poor exercise capacity.

  16. Spectroscopic twin to the hypervelocity sdO star US 708 and three fast sdB stars from the Hyper-MUCHFUSS project

    Science.gov (United States)

    Ziegerer, E.; Heber, U.; Geier, S.; Irrgang, A.; Kupfer, T.; Fürst, F.; Schaffenroth, J.

    2017-05-01

    Important tracers for the dark matter halo of the Galaxy are hypervelocity stars (HVSs), which are faster than the local escape velocity of the Galaxy and their slower counterparts, the high-velocity stars in the Galactic halo. Such HVSs are believed to be ejected from the Galactic centre (GC) through tidal disruption of a binary by the super-massive black hole (Hills mechanism). The Hyper-MUCHFUSS survey aims at finding high-velocity potentially unbound hot subdwarf stars. We present the spectroscopic and kinematical analyses of a He-sdO as well as three candidates among the sdB stars using optical Keck/ESI and VLT (X-shooter, FORS) spectroscopy. Proper motions are determined by combining positions from early-epoch photographic plates with those derived from modern digital sky surveys. The Galactic rest frame velocities range from 203 km s-1 to 660 km s-1, indicating that most likely all four stars are gravitationally bound to the Galaxy. With Teff = 47 000 K and a surface gravity of log g = 5.7, SDSS J205030.39-061957.8 (J2050) is a spectroscopic twin of the hypervelocity He-sdO US 708. As for the latter, the GC is excluded as a place of origin based on the kinematic analysis. Hence, the Hills mechanism can be excluded for J2050. The ejection velocity is much more moderate (385 ± 79 km s-1) than that of US 708 (998 ± 68 km s-1). The binary thermonuclear supernova scenario suggested for US 708 would explain the observed properties of J2050 very well without pushing the model parameters to their extreme limits, as required for US 708. Accordingly, the star would be the surviving donor of a type Ia supernova. Three sdB stars also showed extreme kinematics; one could be a HVS ejected from the GC, whereas the other two could be ejected from the Galactic disk through the binary supernova mechanism. Alternatively, they might be extreme halo stars.

  17. The importance of dyspnoea in the diagnosis of chronic obstructive pulmonary disease – a descriptive analysis of a stable cohort in Portugal (SAFE Trial

    Directory of Open Access Journals (Sweden)

    C. Bárbara

    Full Text Available Introduction: The aim of this study was to determine patient-perceived characteristics of Chronic Obstructive Pulmonary Disease (COPD in patients participating in a large trial evaluating tiotropium bromide. Patients and methods: Baseline symptoms were assessed by means of a standardized questionnaire. Patients reported symptoms that led to diagnosis as well as their current most troublesome symptom. Results: Data were obtained from 298 patients, mostly male (95 %, with mean (standard deviation baseline forced expiratory volume in 1 second of 1.1 (0.4 L (40.6 [13.3] % of predicted, mean disease duration of 14.4 (10.1 years and smoking history of 55.1 (25.3 pack-years. Dyspnoea was the most frequently reported symptom leading to COPD diagnosis (55.0 % of patients, followed by cough (33.2 %. Dyspnoea was also the current most troublesome symptom (82.6 %, followed by cough (8.4 %. The presence of dyspnoea or cough was independent of COPD severity. The most commonly reported co-morbidities were cardiovascular disorders (49 % of patients, gastrointestinal disorders (20 % and metabolic disorders (16 %, mainly diabetes mellitus. Conclusions: This analysis confirms the importance of dyspnoea as the most common symptom leading to initial COPD diagnosis and the symptom most troublesome to patients. Co-morbidities are common among COPD patients, and hence spirometric testing is appropriate in a patient who presents with dyspnoea associated with such a condition. Resumo: Introdução: Este estudo teve como objectivo determinar os principais sintomas percepcionados pelos doentes com doença pulmonar obstrutiva crónica (DPOC numa coorte de doentes que participaram num grande ensaio clínico, que avaliou o tiotrópio e que decorreu em Portugal. População e métodos: A caracterização dos sintomas, no momento de avaliação basal dos doentes foi efectuada através do recurso a um questionário padronizado. Os doentes foram

  18. Weight loss is superior to exercise in improving the atherogenic lipid profile in a sedentary, overweight population with stable coronary artery disease: A randomized trial.

    Science.gov (United States)

    Pedersen, Lene Rørholm; Olsen, Rasmus Huan; Anholm, Christian; Walzem, Rosemary L; Fenger, Mogens; Eugen-Olsen, Jesper; Haugaard, Steen Bendix; Prescott, Eva

    2016-03-01

    Dyslipidemia and low-grade inflammation are integral in the pathogenesis of atherosclerosis. We aim to compare the effects of a considerable weight loss and intensive exercise training on lipid atherogenicity and low-grade inflammation in a high-risk population with coronary artery disease (CAD). Seventy non-diabetic participants with CAD, BMI 28-40 kg/m(2), age 45-75 years were randomized to 12 weeks' aerobic interval training (AIT) at 85-90% of peak heart rate three times/week or a low energy diet (LED, 800-1000 kcal/day) for 8-10 weeks followed by 2-4 weeks' weight maintenance diet. Lipid profile atherogenicity was described using lipoprotein particle size and density profiling. Low-grade inflammation was evaluated by tumor necrosis factor alpha (TNFα), C-reactive protein, interleukin 6 and soluble urokinase plasminogen activator receptor. Twenty-six (74%) AIT and 29 (83%) LED participants completed intervention per protocol. AIT and LED decreased total (AIT: -518 {-906;-129},P = 0.011, LED: -767 {-1128:-406},P < 0.001) and low-density lipoprotein (LDL, AIT: -186 {-306;-65},P = 0.004, LED: -277 {-433;-122},P < 0.001) assessed as the area under the density profile curve. LED was superior to AIT in decreasing atherogenicity reflected by increased LDL (between-group: 1.0 Å {0.4; 1.7},P = 0.003) and high-density lipoprotein (between-group: 1.2 Å {0.2; 2.4},P = 0.026) particle size and a decreased proportion of total lipoprotein constituted by the small, dense LDL5 subfraction (between-group: -5.0% {-8.4;-1.7},P = 0.004). LED decreased TNFα (9.5% {-15.8;-2.6},P = 0.009). No changes were seen following AIT. LED and AIT decreased total and LDL lipoprotein. LED was superior in decreasing atherogenicity assessed by a shift in density profile and increased particle size. Effect on low-grade inflammation was limited. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. TEKNIK DAN STRATEGI TINDAK KESANTUNAN DIREKTIF DI KALANGAN ANDIK SD BERLATAR BELAKANG BUDAYA JAWA

    Directory of Open Access Journals (Sweden)

    Harun Joko Prayitno

    2011-12-01

    Full Text Available Studi ini bertujuan untuk merumuskan taksonomi tindak kesantunan direktif dikalangan andik SD yang berlatar belakang budaya Jawa. Tujuan spesifik studi iniadalah untuk merumuskan taksonomi dan pola semestaan realisasi tindakkesantunan direktif andik SD dalam hubungannya dengan prinsip dasar berbahasa PKS dan PSS; prinsip harmoni sosial PI dan PK. Objek penelitian ini adalah skala kelangsungan dan peringkat tindak kesantunandirektif dalam kaitannya PKS, PSS, prinsip harmoni sosial PI, PK, dn prinsip kultural budaya Jawa. Sumber data penelitian meliputi keseluruhan aktivitas berbahasa andik SD yang direfleksikan oleh guru kelas SD melalui FGD, baik dalam suasana formal maupun nonformal. Data penelitian berupa skala kelangsungan dan peringkat kesantunan pertuturan menurut PKS, PSS, PI, PK, dan Pk. Interpretasi perwujudan tindak kesantunan direktif dilakukan dengan kerja analisis pragmatik yang mengacu pada analisis heuristik model Grice, skala kelangsungan dan peringkat kesantunan model BrownLevinson. Hasil studi ini menunjukkan bahwa (1 perwujudan tindak kesantunan direktif (TKD di kalangan andik SD berlatar belakang budaya Jawa berkecenderungan diwujudkan melaui tipe menyuruh pada kategori memerintah dan tipe meminta pada kategori memohon. Temuan ini menggambarkah bahwa sesuai dengan kodratnya sebagai anak pada dasarnya masih memerlukan suri tauladan dari orang tuanya di rumah, gurunya di sekolah, dan panutannya sebagai yang difigurkan atau ditokohkan di lingkungan masyarakatnya masing-masing. (2 realisasi TKD di kalangan andik SD berlatar belakang budaya Jawa berkecenderungan dinyatakan dengan cara-cara tak langsung dan modus-modus nonliteral daripada dengan cara-cara langsung atau modus literal. Realisasi ini menggambarkan bahwa andik SD pada hakikatnya masih dalam masa perkembangan mental lingual sehingga masih memerlukan bimbingan yang bernilai positif, santun, dan berkarakter dari orang tua, guru, dan lingkungan

  20. PENYELENGGARAAN PROGRAN SD-SMP SATU ATAP DALAM LATAR BUDAYA RUMAH BETANG KALIMANTAN TENGAH

    Directory of Open Access Journals (Sweden)

    Rudi Hasan

    2014-06-01

    Abstrak: Penyelenggaraan Progran SD-SMP Satu Atap dalam Latar Budaya Rumah Betang Kali­mantan Tengah. Penelitian ini bertujuan untuk mendeskripsikan penyelengaaraan program SD-SMP Satu Atap dalam latar budaya rumah Betang Kalimantan Tengah yang dikaitkan dengan struktur birokrasi, sumber daya, dan komunikasi. Penelitian kualitatif dilaksanakan di tiga lokasi, yaitu pada SMPN Satu Atap 1 Mihing Raya, SMPN Satu Atap 2 Kurun, dan SMPN Satu Atap 3 Tewah di Kabupaten Gunung Mas, Propinsi Kalimantan Tengah. Hasil penelitian menunjukkan bahwa acuan standar yang jelas, koordinasi yang intensif, dan pemberdayaan sumber daya manusia yang tepat sesuai dengan pendekatan nilai-nilai budaya rumah Betang dapat mencapai penyelenggaraan program SD-SMP Satu Atap yang efektif. Hal itu juga didukung oleh pengelolaan sumberdaya dan komunikasi yang mendasarkan diri pada nilai kekeluargaan, kebersamaan, loyalitas, dan keakraban.

  1. Nuclear structure of s-d shell nuclei: what is new?

    International Nuclear Information System (INIS)

    Shanmugam, G.

    1995-01-01

    In this paper the shape evolution of the even-even s-d shell nuclei with temperature and spin is studied using Landau theory of phase transitions. The most important thermal fluctuations are incorporated in this study. The ground state pairing is also included in the calculations. Both the summation and Strutinsky methods are used for extracting the Landau constants. Both yield qualitatively similar results. To conclude, Landau theory of phase transitions can be effectively and economically used to study the structure of excited s-d shell nuclei. 10 refs., 2 tabs., 8 figs

  2. Learning from CDM SD tool experience for Article 6.4 in the Paris Agreement

    DEFF Research Database (Denmark)

    Olsen, Karen Holm; Arens, Christof; Mersmann, Florian

    2017-01-01

    The Paris Agreement (PA) emphasizes the intrinsic relationship between climate change and sustainable development (SD) and welcomes the 2030 agenda for the global Sustainable Development Goals (SDGs). Yet, there is a lack of assessment approaches to ensure that climate and development goals...... are achieved in an integrated fashion and trade-offs avoided. Article 6.4 of the PA introduces a new Sustainable Mitigati on Mechanism (SMM) with the dual aim to contribute to the mitigation of greenhouse gas emissions and foster SD. The Kyoto Protocol’s Clean Development Mechanism (CDM) has a similar...

  3. Calcium stable isotope geochemistry

    Energy Technology Data Exchange (ETDEWEB)

    Gausonne, Nikolaus [Muenster Univ. (Germany). Inst. fuer Mineralogie; Schmitt, Anne-Desiree [Strasbourg Univ. (France). LHyGeS/EOST; Heuser, Alexander [Bonn Univ. (Germany). Steinmann-Inst. fuer Geologie, Mineralogie und Palaeontologie; Wombacher, Frank [Koeln Univ. (Germany). Inst. fuer Geologie und Mineralogie; Dietzel, Martin [Technische Univ. Graz (Austria). Inst. fuer Angewandte Geowissenschaften; Tipper, Edward [Cambridge Univ. (United Kingdom). Dept. of Earth Sciences; Schiller, Martin [Copenhagen Univ. (Denmark). Natural History Museum of Denmark

    2016-08-01

    This book provides an overview of the fundamentals and reference values for Ca stable isotope research, as well as current analytical methodologies including detailed instructions for sample preparation and isotope analysis. As such, it introduces readers to the different fields of application, including low-temperature mineral precipitation and biomineralisation, Earth surface processes and global cycling, high-temperature processes and cosmochemistry, and lastly human studies and biomedical applications. The current state of the art in these major areas is discussed, and open questions and possible future directions are identified. In terms of its depth and coverage, the current work extends and complements the previous reviews of Ca stable isotope geochemistry, addressing the needs of graduate students and advanced researchers who want to familiarize themselves with Ca stable isotope research.

  4. The System Dynamics Model User Sustainability Explorer (SD-MUSE): a user-friendly tool for interpreting system dynamic models

    Science.gov (United States)

    System Dynamics (SD) models are useful for holistic integration of data to evaluate indirect and cumulative effects and inform decisions. Complex SD models can provide key insights into how decisions affect the three interconnected pillars of sustainability. However, the complexi...

  5. Gender, apolipoprotein E genotype, and mesial temporal atrophy: 2-year follow-up in patients with stable mild cognitive impairment and with progression from mild cognitive impairment to Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Spampinato, M.V.; Patrick, K.E.; Collins, H. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Langdon, B.R. [Medical University of South Carolina, Department of Internal Medicine, Charleston, SC (United States); Parker, R.O. [Vanderbilt University, Department of Anesthesiology, Nashville, TN (United States); Pravata' , E. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Ospedale Regionale di Lugano, Department of Neuroradiology, Neurocenter of Southern Switzerland, Lugano (Switzerland); Collaboration: For the Alzheimer' s Disease Neuroimaging Initiative

    2016-11-15

    This study aimed to examine the relationship between gender, apolipoprotein E (APOE) genotype, and mesial temporal atrophy in mild cognitive impairment (MCI) with and without progression to Alzheimer's disease (AD). We evaluated 236 MCI patients with (n = 121) and without (n = 115) AD progression. Longitudinal MRI-based hippocampal volumes (HV) and entorhinal cortex (ERC) thickness were obtained. The Clinical Dementia Rating Sum of Boxes (CDR-SB) score was used to assess disease severity. We found a significant effect of APOE, gender, and clinical course (stable MCI versus MCI-AD progression) on HV. There was a significant effect of clinical course and APOE, but not gender, on ERC. Baseline HV and APOE4 status predicted MCI-AD progression in women. Baseline ERC and APOE4 status predicted MCI-AD progression in men. There were significant differences in CDR-SB scores between patients with and without MCI-AD progression, but not between males and females, or APOE4 carriers and non-carriers. HV, but not ERC, is strongly influenced by gender in MCI. The effects of gender and APOE4 on neuroimaging biomarkers have potentially important implications in the prediction of MCI-AD progression and should be taken into account in clinical trials. (orig.)

  6. Validity of automated choroidal segmentation in SS-OCT and SD-OCT

    NARCIS (Netherlands)

    L. Zhang (Li); G.H.S. Buitendijk (Gabrielle); K. Lee (Kyungmoo); M. Sonka (Milan); H. Springelkamp (Henriët); A. Hofman (Albert); J.R. Vingerling (Hans); R.F. Mullins (Robert F.); C.C.W. Klaver (Caroline); M.D. Abràmoff (Michael)

    2015-01-01

    textabstractPURPOSE. To evaluate the validity of a novel fully automated three-dimensional (3D) method capable of segmenting the choroid from two different optical coherence tomography scanners: swept-source OCT (SS-OCT) and spectral-domain OCT (SD-OCT). METHODS. One hundred eight subjects were

  7. The S-D mixing and dielectron widths of higher charmonium 1(--) states

    NARCIS (Netherlands)

    Badalian, A.M.; Bakker, B.L.G.; Danilkin, I.V.

    2009-01-01

    The dielectron widths of ψ(4040), ψ(4160), and ψ(4415), and their ratios are shown to be in good agreement with experiment, if in all cases the S-D mixing with a large mixing angle θ 34° is taken. Arguments are presented why continuum states give small contributions to the wave functions at the

  8. Semi-automatic geographic atrophy segmentation for SD-OCT images.

    Science.gov (United States)

    Chen, Qiang; de Sisternes, Luis; Leng, Theodore; Zheng, Luoluo; Kutzscher, Lauren; Rubin, Daniel L

    2013-01-01

    Geographic atrophy (GA) is a condition that is associated with retinal thinning and loss of the retinal pigment epithelium (RPE) layer. It appears in advanced stages of non-exudative age-related macular degeneration (AMD) and can lead to vision loss. We present a semi-automated GA segmentation algorithm for spectral-domain optical coherence tomography (SD-OCT) images. The method first identifies and segments a surface between the RPE and the choroid to generate retinal projection images in which the projection region is restricted to a sub-volume of the retina where the presence of GA can be identified. Subsequently, a geometric active contour model is employed to automatically detect and segment the extent of GA in the projection images. Two image data sets, consisting on 55 SD-OCT scans from twelve eyes in eight patients with GA and 56 SD-OCT scans from 56 eyes in 56 patients with GA, respectively, were utilized to qualitatively and quantitatively evaluate the proposed GA segmentation method. Experimental results suggest that the proposed algorithm can achieve high segmentation accuracy. The mean GA overlap ratios between our proposed method and outlines drawn in the SD-OCT scans, our method and outlines drawn in the fundus auto-fluorescence (FAF) images, and the commercial software (Carl Zeiss Meditec proprietary software, Cirrus version 6.0) and outlines drawn in FAF images were 72.60%, 65.88% and 59.83%, respectively.

  9. Pengembangan perangkat penilaian hasil belajar dalam pembelajaran tematik integratif kelas V SD

    Directory of Open Access Journals (Sweden)

    Teguh Prasetyo

    2017-01-01

    Kata Kunci: perangkat penilaian; pembelajaran tematik-integratif; sekolah dasar   Developing assessment kits of learning outcomes  on thematic integrative learning in class V SD Abstract This study aims to: (1 produce a feasible assessment kits for thematic integrative learning in class V SD, (2 determine the practicality of assessment kits developed, and (3 determine the effectiveness of assessment kits in class V SD in subtheme Ecosystem Components. The research refers to the 4-D model of the development of Thiagarajan, Semmel, & Semmel which has been modified into three procedures of development, namely: (1 define, (2 design, and (3 develop. The trial development subject consists of SDN Godean 1, SDN Cebongan 1, and SDN Purwomartani. The results showed that the assessment kits of learning outcomes in thematic-integrative learning in class V SD in subtema Ecosystem Components fit for use, practical, and effective. In addition, the product can also measure mastery learning achievements of learners. Keywords: assessment kits, thematic-integrative learning.

  10. 75 FR 70234 - City of Spearfish, SD; Notice of Availability of Final Environmental Assessment

    Science.gov (United States)

    2010-11-17

    ... environmental effects of licensing the project, and concludes that licensing the project, with appropriate... Spearfish, SD; Notice of Availability of Final Environmental Assessment November 8, 2010. In accordance with the National Environmental Policy Act of 1969 and the Federal Energy Regulatory Commission's...

  11. EVALUASI IMPLEMENTASI TQM PADA SDN KARANGREJEK II DAN SD MUHAMMADIYAH AL MUJAHIDIN WONOSARI GUNUNGKIDUL

    Directory of Open Access Journals (Sweden)

    Eko Pramono

    2015-10-01

    Full Text Available Penelitian ini bertujuan mengetahui: (1 seberapa besar tingkat implementasi TQM, (2 perbandingan implementasi, (3 aspek-aspek yang perlu mendapatkan perbaikan untuk ditingkatkan. Penelitian evaluasi dengan model descrepancy. Instrumen pengumpul data berupa angket jawaban skala 2 terdiri atas 69 butir. Teknik analisis data menggunakan teknik persentase. Hasil penelitian menunjukkan bahwa: (1 implementasi TQM di SD Negeri Karangrejek II rata-rata sebesar 87,73%, aspek-aspek yang mendekati standar: mutu pembelajaran, organisasi terbalik, perubahan kultur, kolega sebagai pelanggan, profesionalisme, dan pemasaran internal. Implementasi TQM di SD Muhammadiyah Al Mujahidin rata-rata sebesar 94,42%. Aspek-aspek yang mendekati standar: organisasi terbalik, mutu pembelajaran, perubahan kultur, profesionalisme, kaizen dan menjaga hubungan dengan pelanggan. (2 Perbandingan implementasi TQM sebagai berikut: aspek mutu pembelajaran, organisasi terbalik dan perubahan kultur merupakan aspek dengan rata-rata tertinggi di SD Karangrejek II, sedangkan di SD Muhammadiyah Al Mujahidin: aspek organisasi terbalik, mutu pembelajaran, dan perubahan kultur. (3 Aspek yang perlu mendapatkan perbaikan di kedua sekolah adalah perbaikan terus-menerus.

  12. PENGEMBANGAN SOAL PEMECAHAN MASALAH BERBASIS ARGUMEN UNTUK SISWA KELAS V DI SD NEGERI 79 PALEMBANG

    Directory of Open Access Journals (Sweden)

    Hartatiana Hartatiana

    2014-02-01

    Full Text Available Penelitian ini bertujuan untuk menghasilkan soal pemecahan masalah berbasis argumen yang valid dan praktis  pada pokok bahasan pecahan, bangun datar dan bangun ruang untuk siswa kelas V SD serta untuk mengetahui efek potensial soal yang dikembangkan terhadap hasil belajar siswa kelas V di SD Negeri 79 Palembang. Penelitian ini merupakan penelitian pengembangan (development research. Subjek penelitian adalah siswa kelas VB SD Negeri 79 Palembang sebanyak 35 orang. Pengumpulan data melalui walkthrough, lembar kepraktisan dan tes. Semua data yang dikumpulkan dianalisis secara deskriptif kualitatif. Hasil analisis data menyimpulkan bahwa penelitian ini telah menghasilkan produk soal pemecahan masalah berbasis argumen pada pokok bahasan pecahan, bangun datar dan bangun ruang untuk siswa kelas V SD yang valid dan praktis. Valid tergambar dari hasil penilaian validator, dimana semua validator menyatakan sudah baik berdasarkan konten, konstruk dan bahasa.  Praktis tergambar dari hasil uji coba siswa kelompok kecil dimana sebagian besar siswa dapat menyelesaikan soal-soal yang diberikan, dan memiliki efek potensial yang cukup baik hal ini terlihat dengan munculnya argumen-argumen siswa dalam menyelesaikan soal tes, dan rata-rata dua kali tes mencapai  65,03 dengan kategori cukup baik. Artinya soal yang dikembangkan cukup efektif untuk digunakan dalam pembelajaran matematika. Kata Kunci: Penelitian Pengembangan, Soal pemecahan masalah berbasis argumen.

  13. Persepsi Guru dan Siswa SD di Yogyakarta terhadap Program Conservation Scout

    Directory of Open Access Journals (Sweden)

    Wahyu Wido Sari

    2014-12-01

    Full Text Available Penanaman karakter cinta lingkungan dan pemahaman akan pentingnya konservasi perlu dilakukan sejak dini. Program conservation scout atau pandu konservasi menawarkan edukasi dan empowering siswa SD mengenai konservasi. Kegiatan ini bertempat di Pusat Studi Lingkungan, Universitas Sanata Dharma dan melibatkan 38 SD di Yogyakarta. Peserta conservation scout terdiri dari 32 guru dan 70 siswa SD.Penelitian ini bertujuan untuk melihat respon sekolah, persepsi guru, persepsi siswa, dan keberhasilan sekolah dalam mendukung program conservation scout. Metode yang digunakan adalah action reseach, survey, dan diskriptif kualitatif. Instrumen yang digunakan adalah kuesioner dengan hasil validasi sangat baik.Sekolah memberikan respon sangat positif (84% terhadap program conservation scout, dari 38 sekolah yang diundang, ada 32 sekolah yang mengikuti program ini. Guru memberikan persepsi negatif (2,50, bukan pada esensi program melainkan pada teknik pelaksanaan program. Siswa memberikan persepsi positif (3,51 dan 36 dari 70 siswa berhasil melakukan peer tutoring dan kampanye mengenai konservasi. Ada 53, 12 % SD yang siswanya menjadi duta konservasi lingkungan.

  14. A pilot study of a non-invasive oral nitrate stable isotopic method suggests that arginine and citrulline supplementation increases whole-body NO production in Tanzanian children with sickle cell disease.

    Science.gov (United States)

    Marealle, Alphonce I; Siervo, Mario; Wassel, Sara; Bluck, Les; Prentice, Andrew M; Minzi, Omary; Sasi, Philip; Kamuhabwa, Appolinary; Soka, Deogratias; Makani, Julie; Cox, Sharon E

    2018-04-01

    Low bioavailability of nitric oxide (NO) is implicated in the pathophysiology of sickle cell disease (SCD). We designed a nested pilot study to be conducted within a clinical trial testing the effects of a daily ready-to-use supplementary food (RUSF) fortified with arginine (Arg) and citrulline (Citr) vs. non-fortified RUSF in children with SCD. The pilot study evaluated 1) the feasibility of a non-invasive stable isotope method to measure whole-body NO production and 2) whether Arg+Citr supplementation was associated with increased whole-body NO production. Twenty-nine children (70% male, 9-11years, weight 16.3-31.3 kg) with SCD. Sixteen children received RUSF+Arg/Citr (Arg, 0.2  g/kg/day; Citr, 0.1  g/kg/day) in combination with daily chloroquine (50 mg) and thirteen received the base RUSF in combination with weekly chloroquine (150 mg). Plasma amino acids were assessed using ion-exchange elution (Biochrom-30, Biochrom, UK) and whole-body NO production was measured using a non-invasive stable isotopic method. The RUSF+Arg/Citr intervention increased plasma arginine (P = .02) and ornithine (P = .003) and decreased the ratio of asymmetric dimethylarginine to arginine (P = .01), compared to the base RUSF. A significant increase in whole-body NO production was observed in the RUSF-Arg/Citr group compared to baseline (weight-adjusted systemic NO synthesis 3.38 ± 2.29 μmol/kg/hr vs 2.35 ± 1.13 μmol/kg/hr, P = .04). No significant changes were detected in the base RUSF group (weight-adjusted systemic NO synthesis 2.64 ± 1.14 μmol/kg/hr vs 2.53 ± 1.12 μmol/kg/hr, P = .80). The non-invasive stable isotopic method was acceptable and the results provided supporting evidence that Arg/Citr supplementation may increase systemic NO synthesis in children with SCD. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Same Day Discharge versus Overnight Stay in the Hospital following Percutaneous Coronary Intervention in Patients with Stable Coronary Artery Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Pravesh Kumar Bundhun

    Full Text Available New research in interventional cardiology has shown the demand for percutaneous coronary interventions (PCI to have increased tremendously. Effective treatment with a lower hospital cost has been the aim of several PCI capable centers. This study aimed to compare the adverse clinical outcomes associated with same day discharge versus overnight stay in the hospital following PCI in a population of randomized patients with stable coronary artery disease (CAD.The National Library of Medicine (MEDLINE/PubMed, the Cochrane Registry of Randomized Controlled Trials and EMBASE databases were searched (from March to June 2016 for randomized trials comparing same-day discharge versus overnight stay in the hospital following PCI. Main endpoints in this analysis included adverse cardiovascular outcomes observed during a 30-day period. Statistical analysis was carried out by the RevMan 5.3 software whereby odds ratios (OR and 95% confidence intervals (CIs were calculated with respect to a fixed or a random effects model.Eight randomized trials with a total number of 3081 patients (1598 patients who were discharged on the same day and 1483 patients who stayed overnight in the hospital were included. Results of this analysis showed that mortality, myocardial infarction (MI and major adverse cardiac events (MACEs were not significantly different between same day discharge versus overnight stay following PCI with OR: 0.22, 95% CI: 0.04-1.35; P = 0.10, OR: 0.68, 95% CI: 0.33-1.41; P = 0.30 and OR: 0.45, 95% CI: 0.20-1.02; P = 0.06 respectively. Blood transfusion and re-hospitalization were also not significantly different between these two groups with OR: 0.64, 95% CI: 0.13-3.21; P = 0.59 and OR: 1.53, 95% CI: 0.88-2.65; P = 0.13 respectively. Similarly, any adverse event, major bleeding and repeated revascularization were also not significantly different between these two groups of patients with stable CAD, with OR: 0.42, 95% CI: 0.05-3.97; P = 0.45, OR: 0

  16. Evolutionary Stable Strategy

    Indian Academy of Sciences (India)

    2016-08-26

    Aug 26, 2016 ... Home; Journals; Resonance – Journal of Science Education; Volume 21; Issue 9. Evolutionary Stable Strategy: Application of Nash Equilibrium in Biology. General ... Using some examples of classical games, we show how evolutionary game theory can help understand behavioural decisions of animals.

  17. The Stable Concordance Genus

    OpenAIRE

    Kearney, M. Kate

    2013-01-01

    The concordance genus of a knot is the least genus of any knot in its concordance class. Although difficult to compute, it is a useful invariant that highlights the distinction between the three-genus and four-genus. In this paper we define and discuss the stable concordance genus of a knot, which describes the behavior of the concordance genus under connected sum.

  18. Manifolds admitting stable forms

    Czech Academy of Sciences Publication Activity Database

    Le, Hong-Van; Panák, Martin; Vanžura, Jiří

    2008-01-01

    Roč. 49, č. 1 (2008), s. 101-11 ISSN 0010-2628 R&D Projects: GA ČR(CZ) GP201/05/P088 Institutional research plan: CEZ:AV0Z10190503 Keywords : stable forms * automorphism groups Subject RIV: BA - General Mathematics

  19. Stable isotope studies

    International Nuclear Information System (INIS)

    Ishida, T.

    1992-01-01

    The research has been in four general areas: (1) correlation of isotope effects with molecular forces and molecular structures, (2) correlation of zero-point energy and its isotope effects with molecular structure and molecular forces, (3) vapor pressure isotope effects, and (4) fractionation of stable isotopes. 73 refs, 38 figs, 29 tabs

  20. Interactive Stable Ray Tracing

    DEFF Research Database (Denmark)

    Dal Corso, Alessandro; Salvi, Marco; Kolb, Craig

    2017-01-01

    Interactive ray tracing applications running on commodity hardware can suffer from objectionable temporal artifacts due to a low sample count. We introduce stable ray tracing, a technique that improves temporal stability without the over-blurring and ghosting artifacts typical of temporal post-pr...

  1. The stable subgroup graph

    Directory of Open Access Journals (Sweden)

    Behnaz Tolue

    2018-07-01

    Full Text Available In this paper we introduce stable subgroup graph associated to the group $G$. It is a graph with vertex set all subgroups of $G$ and two distinct subgroups $H_1$ and $H_2$ are adjacent if $St_{G}(H_1\\cap H_2\

  2. Detection of Be+sdO Evolved Binaries from Ultraviolet Spectroscopy

    Science.gov (United States)

    Gies, Douglas; Wang, Luqian; Peters, Geraldine

    2018-01-01

    Be stars are rapidly rotating, non-supergiant B-type stars that eject equatorial disks. Many of these stars may have been spun up through mass transfer in a close binary system, in which case the former mass donor star is now a hot, stripped-down, subdwarf. There are five known cases of Be stars with hot subdwarf (sdO) companions that were discovered through International Ultraviolet Explorer (IUE) spectroscopy. Here we expand the search for Be+sdO candidates using archival FUV spectra from IUE. Our search strategy involves calculation of a cross-correlation funtion (CCF) of each observed spectrum with a model spectrum for T_eff = 45 kK, the typical value for the known subdwarf companions. We collected IUE spectra for 264 targets, and selected for closer examination those with a CCF peak greater than three times the background CCF noise. We applied two selection criteria to select candidate Be+sdO binaries: targets showing a significant and narrow CCF feature (with a half-width much smaller than the projected rotational velocity of the Be star) and also displayed radial velocity shifts indicative of orbital motion. We identified eight candidate systems that met both criteria plus four other candidate systems with strong peaks but too few spectra to confirm orbital motion. These are important targets for follow up spectroscopy. The new plus known Be+sdO binaries comprise about 6% of the sample. This fraction is consistent with the idea that we only find sdO companions in their relatively short and bright evolutionary stage of He-shell burning, while the majority of He-core burning companions are too faint to detect with current methods.

  3. Intruder states in sd-shell nuclei: from 1p-1t to np-nt in Si isotopes

    International Nuclear Information System (INIS)

    Goasduff, A.

    2012-01-01

    New large-scale shell-model calculations with full 1ℎω valence space for the sd-nuclei has been used for the first time to predict lifetimes of positive and negative parity states in neutron rich Si isotopes. The predicted lifetimes (1 - 100 ps) fall in the range of the differential Doppler shift method. Using the demonstrator of the European next generation γ-ray array, AGATA, in coincidence with the large acceptance PRISMA magnetic spectrometer from LNL (Legnaro) and the differential plunger of the University of Cologne, lifetimes of excited states in 32;33 Si and 35;36 S nuclei were measured. In a second step, the nℎω structure in the stable 28 Si nucleus was also studied. 28 Si is an important nucleus in order to understand the competition between mean-field and cluster structures. It displays a wealth of structures in terms of deformation and clustering. Light heavy-ion resonant radiative capture 12 C+ 16 O has been performed at energies below the Coulomb barrier. The measure γ-spectra indicate for the first time at these energies that the strongest part of the resonance decay proceeds though intermediate states around 10 MeV. Comparisons with previous radiative capture studies above the Coulomb barrier have been performed and the results have been interpreted in terms of a favoured feeding of T=1 states in the 28 Si self-conjugate nucleus. (author)

  4. PEMBELAJARAN MEMBACA PEMAHAMAN PADA SISWA KELAS V SD NEGERI 1 CIDEMPET KECAMATAN ARAHAN KABUPATEN INDRAMAYU

    Directory of Open Access Journals (Sweden)

    MUHAFIDIN MUHAFIDIN

    2016-12-01

      Muhafidin, This research is motivated by the ability of fifth grade students' reading comprehension is low, evidenced by the students do not understand and comprehend the content of reading, students had difficulty answering questions relating to the content of reading, as well as the average value of students still under KKM. This study aims to determine the effect of learning methods talk think write on the ability of reading comprehension folklore in class V SD Negeri 1 Cidempet of Arahan District of Indramayu Regency. This study was an experimental study. The population in this study were students of class V SD Negeri 1 Cidempet of Arahan District of Indramayu Regency totaling 22 students. The sampling technique used is total sampling where authors set into the sample population. So the study sample used is a fifth grade students of SD Negeri 1 Cidempet of Arahan District of Indramayu Regency totaling 20 students. Data collection techniques used is to write test. Data analysis techniques in this study is the normality test and test hypotheses (z test is used to determine the effect of learning methods talk think write to the reading comprehension of folklore in class V SD Negeri 1 Cidempet of Arahan District of Indramayu Regency. Based on test results using a statistical hypothesis test obtained Z hit (7,458> Z daf (2.35, then thank Hi means that there are significant learning method talk think write to the reading comprehension of folklore in class V SD Negeri 1 Cidempet of Arahan District of Indramayu Regency. The conclusion of this study is the application of learning methods talk think write on the ability of reading comprehension folklore in class V SD Negeri 1 Cidempet of Arahan District of Indramayu Regency. Suggestions in this study is teachers can implement a wide variety of learning methods in the implementation of learning so that students are active in studying and understanding the concepts being taught, and teachers should use teaching methods

  5. Determination of the Accuracy of Echocardiographic Parameters Mitral Inflow S/D Ratio and Tei Index to Detect Left Ventricular Dysfunction in Pediatric Patients with Mitral Regurgitation

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Arjmandnia

    2013-02-01

    Full Text Available Background and Objectives: Congenital heart diseases are one of the most common anomalies in infancy. This study was performed aimed to determine the accuracy, sensitivity and specificity of the left ventricular Tei index (TX and the systolic to diastolic duration ratio (S/D to detect ventricular dysfunction in pediatric pediatrics with congenital heart defect accompanied by mitral regurgitation.Methods: In this study, systolic and diastolic function of left ventricle was evaluated by TX and S/D ratio parameters in 66 children with mitral regurgitation (34 children with normal ventricular function and 32 patients with ventricular dysfunction and the results were compared to the findings of echocardiography. Tei index>0.5 was defined as abnormal.Results: The accuracy, sensitivity, specificity, positive and negative predictive values of S/D ratio were obtained 89.3%, 87.5%, 91%, 90% and 88.5%, respectively and for TX, 87.8%, 87.5%, 88.2%, 87.5% and 88.2%, respectively.Conclusion: The results of this study showed that in general, accuracy, sensitivity, specificity, predictive values, and likelihood ratios of TX are less than those of S/D ratio in patients with congenital heart defect accompanied by mitral regurgitation.

  6. Cordycepin Down-Regulates Multiple Drug Resistant (MDR/HIF-1α through Regulating AMPK/mTORC1 Signaling in GBC-SD Gallbladder Cancer Cells

    Directory of Open Access Journals (Sweden)

    Wei-Ding Wu

    2014-07-01

    Full Text Available Gallbladder cancer is the most common malignancy of the bile duct, with low 5-year survival rate and poor prognosis. Novel effective treatments are urgently needed for the therapy of this disease. Here, we showed that cordycepin, the bioactive compound in genus Cordyceps, induced growth inhibition and apoptosis in cultured gallbladder cancer cells (Mz-ChA-1, QBC939 and GBC-SD lines. We found that cordycepin inhibited mTOR complex 1 (mTORC1 activation and down-regulated multiple drug resistant (MDR/hypoxia-inducible factor 1α (HIF-1α expression through activating of AMP-activated protein kinase (AMPK signaling in gallbladder cancer GBC-SD cells. Contrarily, AMPKα1-shRNA depletion dramatically inhibited cordycepin-induced molecular changes as well as GBC-SD cell apoptosis. Further, our results showed that co-treatment with a low concentration cordycepin could remarkably enhance the chemosensitivity of GBC-SD cells to gemcitabine and 5-fluorouracil (5-FU, and the mechanism may be attributed to AMPK activation and MDR degradation. In summary, cordycepin induces growth inhibition and apoptosis in gallbladder cancer cells via activating AMPK signaling. Cordycepin could be a promising new drug or chemo-adjuvant for gallbladder cancer.

  7. Stable isotope analysis

    International Nuclear Information System (INIS)

    Tibari, Elghali; Taous, Fouad; Marah, Hamid

    2014-01-01

    This report presents results related to stable isotopes analysis carried out at the CNESTEN DASTE in Rabat (Morocco), on behalf of Senegal. These analyzes cover 127 samples. These results demonstrate that Oxygen-18 and Deuterium in water analysis were performed by infrared Laser spectroscopy using a LGR / DLT-100 with Autosampler. Also, the results are expressed in δ values (‰) relative to V-SMOW to ± 0.3 ‰ for oxygen-18 and ± 1 ‰ for deuterium.

  8. Forensic Stable Isotope Biogeochemistry

    Science.gov (United States)

    Cerling, Thure E.; Barnette, Janet E.; Bowen, Gabriel J.; Chesson, Lesley A.; Ehleringer, James R.; Remien, Christopher H.; Shea, Patrick; Tipple, Brett J.; West, Jason B.

    2016-06-01

    Stable isotopes are being used for forensic science studies, with applications to both natural and manufactured products. In this review we discuss how scientific evidence can be used in the legal context and where the scientific progress of hypothesis revisions can be in tension with the legal expectations of widely used methods for measurements. Although this review is written in the context of US law, many of the considerations of scientific reproducibility and acceptance of relevant scientific data span other legal systems that might apply different legal principles and therefore reach different conclusions. Stable isotopes are used in legal situations for comparing samples for authenticity or evidentiary considerations, in understanding trade patterns of illegal materials, and in understanding the origins of unknown decedents. Isotope evidence is particularly useful when considered in the broad framework of physiochemical processes and in recognizing regional to global patterns found in many materials, including foods and food products, drugs, and humans. Stable isotopes considered in the larger spatial context add an important dimension to forensic science.

  9. Development of the New DAQ System for the SD Array of TA×4 and TALE

    Science.gov (United States)

    Takahashi, Yuichi; Sahara, Ryosuke; Konishi, Shogo; Goto, Takashi; Ogio, Shoichi

    The data acquisition (DAQ) system for the surface detector (SD) arrays of TA×4 and TALE will be presented. Each SD records digital signals with 50 MHz FADCs and sends the data to a central communication center (of the "communication tower") via a wireless network system. The technique employed here is based on the currently-running DAQ system of the Telescope Array, and there are some improvements including i) replacement of a wireless LAN module with a custom protocol to another with TCP/IP, and ii) replacement of the "tower electronics" to a generic Linux board PC of Raspberry Pi Type II B. The details and performance of the new DAQ system are described below.

  10. Using a community theatre as a self-directed introductory pharmacy practice experience (SD IPPE) site.

    Science.gov (United States)

    Franko, Thomas S

    To describe a novel setting and method for self-directed introductory pharmacy practice experiences (SD IPPE). Students presented health care information relative to the plot of a production at a local community theater throughout the season. Students developed a poster and handout that were presented in the theater lobby prior to each production. A six-question survey was provided to students after each presentation that identified their perceived benefit to play patrons and their overall experience using a 5-point Likert scale. Completing SD IPPE in a theater is a novel and innovative concept. Data suggest that students prefer presenting information in non-traditional settings. Students felt their work enhanced the theatrical experience of patrons. Results demonstrate that the theater is a viable setting for future presentations that benefit both students and public. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Spectral analysis of the He-enriched sdO-star HD 127493

    Science.gov (United States)

    Dorsch, Matti; Latour, Marilyn; Heber, Ulrich

    2018-02-01

    The bright sdO star HD127493 is known to be of mixed H/He composition and excellent archival spectra covering both optical and ultraviolet ranges are available. UV spectra play a key role as they give access to many chemical species that do not show spectral lines in the optical, such as iron and nickel. This encouraged the quantitative spectral analysis of this prototypical mixed H/He composition sdO star. We determined atmospheric parameters for HD127493 in addition to the abundance of C, N, O, Si, S, Fe, and Ni in the atmosphere using non-LTE model atmospheres calculated with TLUSTY/SYNSPEC. A comparison between the parallax distance measured by Hipparcos and the derived spectroscopic distance indicate that the derived atmospheric parameters are realistic. From our metal abundance analysis, we find a strong CNO signature and enrichment in iron and nickel.

  12. Realistic effective interactions for the sd shell: Global and discrete nuclear properties

    International Nuclear Information System (INIS)

    Dalton, B.J.; Baldridge, W.J.; Vary, J.P.

    1979-01-01

    Comparisons of the Kuo and Vary-Yang sd shell realistic effective shell-model interactions are presented through studies of the resulting global and discrete nuclear properties. The methods of spectral distributions are used to obtain energy moments for 21 Ne and spin cutoff factors for 28 Si for each interaction. Shell-model spectra are presented for some mass A = 18 to A = 21 sd shell nuclei. In each case we show for comparison the results using the Chung-Wildenthal empirical interaction. In addition to demonstrating the role of various approximations through resulting global and discrete properties, we show that certain conclusions drawn from global properties are consistent with those based upon discrete properties

  13. Somatoform abdominal pain in surgery: is SD worthy of surgical attention? Case reports and literature review.

    LENUS (Irish Health Repository)

    Abd Elwahab, Sami Medani

    2012-08-01

    Somatoform disorders (SD) or medically unexplained physical symptoms (MUPS) are a group of disorders that represent a group of symptoms that cannot be explained by an organic or physical pathology. These disorders are widely prevalent, and, if unrecognised, SD may lead medical professionals to embark on tests or procedures which may inflict unnecessary iatrogenic complications. Despite the high prevalence, they are only poorly included in medical training curricula, at both undergraduate and postgraduate levels. In this article, we review the literature and present two cases. The first one presented with a recurrent acute abdomen had an unnecessary CT abdomen. The second case had laparoscopy for acute right-sided abdominal pain which turned out to be normal, and was readmitted again after a short period with acute urine retention which resolved spontaneously following discussion with the patient and family. Both cases were referred for psychiatric assessment and their family doctors were informed.

  14. Complex dynamics of an archetypal self-excited SD oscillator driven by moving belt friction

    International Nuclear Information System (INIS)

    Li Zhi-Xin; Cao Qing-Jie; Alain, Léger

    2016-01-01

    We propose an archetypal self-excited system driven by moving belt friction, which is constructed with the smooth and discontinuous (SD) oscillator proposed by the Cao et al. and the classical moving belt. The moving belt friction is modeled as the Coulomb friction to formulate the mathematical model of the proposed self-excited SD oscillator. The equilibrium states of the unperturbed system are obtained to show the complex equilibrium bifurcations. Phase portraits are depicted to present the hyperbolic structure transition, the multiple stick regions, and the friction-induced asymmetry phenomena. The numerical simulations are carried out to demonstrate the friction-induced vibration of multiple stick-slip phenomena and the stick-slip chaos in the perturbed self-excited system. The results presented here provide an opportunity for us to get insight into the mechanism of the complex friction-induced nonlinear dynamics in mechanical engineering and geography. (paper)

  15. A Comparison of the Updated Diamond-Forrester, CAD Consortium, and CONFIRM History-Based Risk Scores for Predicting Obstructive Coronary Artery Disease in Patients With Stable Chest Pain: The SCOT-HEART Coronary CTA Cohort.

    Science.gov (United States)

    Baskaran, Lohendran; Danad, Ibrahim; Gransar, Heidi; Ó Hartaigh, Bríain; Schulman-Marcus, Joshua; Lin, Fay Y; Peña, Jessica M; Hunter, Amanda; Newby, David E; Adamson, Philip D; Min, James K

    2018-04-13

    This study sought to compare the performance of history-based risk scores in predicting obstructive coronary artery disease (CAD) among patients with stable chest pain from the SCOT-HEART study. Risk scores for estimating pre-test probability of CAD are derived from referral-based populations with a high prevalence of disease. The generalizability of these scores to lower prevalence populations in the initial patient encounter for chest pain is uncertain. We compared 3 scores among patients with suspected CAD in the coronary computed tomographic angiography (CTA) randomized arm of the SCOT-HEART study for the outcome of obstructive CAD by coronary CTA: the updated Diamond-Forrester score (UDF), CAD Consortium clinical score (CAD2), and CONFIRM risk score (CRS). We tested calibration with goodness-of-fit, discrimination with area under the receiver-operating curve (AUC), and reclassification with net reclassification improvement (NRI) to identify low-risk patients. In 1,738 patients (58 ± 10 years and 44.0% women), overall calibration was best for UDF, with underestimation by CRS and CAD2. Discrimination by AUC was highest for CAD2 at 0.79 (95% confidence interval [CI]: 0.77 to 0.81) than for UDF (0.77 [95% CI: 0.74 to 0.79]) or CRS (0.75 [95% CI: 0.73 to 0.77]) (p CAD2 (NRI 0.31, 95% CI: 0.27 to 0.35) followed by CRS (NRI 0.21, 95% CI: 0.17 to 0.25) compared with UDF (p CAD and uniform CAD evaluation by coronary CTA, CAD2 provided the best discrimination and classification, despite overestimation of obstructive CAD as evaluated by coronary CTA. CRS exhibited intermediate performance followed by UDF for discrimination and reclassification. Copyright © 2018. Published by Elsevier Inc.

  16. 320-row CT coronary angiography predicts freedom from revascularisation and acts as a gatekeeper to defer invasive angiography in stable coronary artery disease: a fractional flow reserve-correlated study

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Brian S.; Wong, Dennis T.L.; Cameron, James D.; Leung, Michael; Meredith, Ian T.; Nerlekar, Nitesh; Antonis, Paul; Harper, Richard; Malaiapan, Yuvaraj; Seneviratne, Sujith K. [Southern Health and Monash University, Monash Cardiovascular Research Centre, MonashHEART, Department of Medicine Monash Medical Centre (MMC), Melbourne (Australia); Leong, Darryl P. [University of Adelaide, Discipline of Medicine, Adelaide (Australia); Flinders University, Adelaide (Australia); Crossett, Marcus; Troupis, John [Southern Health and Monash University, Monash Cardiovascular Research Centre, MonashHEART, Department of Medicine Monash Medical Centre (MMC), Melbourne (Australia); Southern Health and Monash University, Department of Diagnostic Imaging, MMC, Melbourne (Australia)

    2014-03-15

    To determine the accuracy of 320-row multidetector coronary computed tomography angiography (M320-CCTA) to detect functional stenoses using fractional flow reserve (FFR) as the reference standard and to predict revascularisation in stable coronary artery disease. One hundred and fifteen patients (230 vessels) underwent M320-CCTA and FFR assessment and were followed for 18 months. Diameter stenosis on invasive angiography (ICA) and M320-CCTA were assessed by consensus by two observers and significant stenosis was defined as ≥50 %. FFR ≤0.8 indicated functionally significant stenoses. M320-CCTA had 94 % sensitivity and 94 % negative predictive value (NPV) for FFR ≤0.8. Overall accuracy was 70 %, specificity 54 % and positive predictive value 65 %. On receiver operating characteristic (ROC) curve analysis, the area under the curve (AUC) for CCTA to predict FFR ≤0.8 was 0.74 which was comparable with ICA. The absence of a significant stenosis on M320-CCTA was associated with a 6 % revascularisation rate. M320-CCTA predicted revascularisation with an AUC of 0.71 which was comparable with ICA. M320-CCTA has excellent sensitivity and NPV for functional stenoses and therefore may act as an effective gatekeeper to defer ICA and revascularisation. Like ICA, M320-CCTA lacks specificity for functional stenoses and only has moderate accuracy to predict the need for revascularisation. (orig.)

  17. 320-row CT coronary angiography predicts freedom from revascularisation and acts as a gatekeeper to defer invasive angiography in stable coronary artery disease: a fractional flow reserve-correlated study

    International Nuclear Information System (INIS)

    Ko, Brian S.; Wong, Dennis T.L.; Cameron, James D.; Leung, Michael; Meredith, Ian T.; Nerlekar, Nitesh; Antonis, Paul; Harper, Richard; Malaiapan, Yuvaraj; Seneviratne, Sujith K.; Leong, Darryl P.; Crossett, Marcus; Troupis, John

    2014-01-01

    To determine the accuracy of 320-row multidetector coronary computed tomography angiography (M320-CCTA) to detect functional stenoses using fractional flow reserve (FFR) as the reference standard and to predict revascularisation in stable coronary artery disease. One hundred and fifteen patients (230 vessels) underwent M320-CCTA and FFR assessment and were followed for 18 months. Diameter stenosis on invasive angiography (ICA) and M320-CCTA were assessed by consensus by two observers and significant stenosis was defined as ≥50 %. FFR ≤0.8 indicated functionally significant stenoses. M320-CCTA had 94 % sensitivity and 94 % negative predictive value (NPV) for FFR ≤0.8. Overall accuracy was 70 %, specificity 54 % and positive predictive value 65 %. On receiver operating characteristic (ROC) curve analysis, the area under the curve (AUC) for CCTA to predict FFR ≤0.8 was 0.74 which was comparable with ICA. The absence of a significant stenosis on M320-CCTA was associated with a 6 % revascularisation rate. M320-CCTA predicted revascularisation with an AUC of 0.71 which was comparable with ICA. M320-CCTA has excellent sensitivity and NPV for functional stenoses and therefore may act as an effective gatekeeper to defer ICA and revascularisation. Like ICA, M320-CCTA lacks specificity for functional stenoses and only has moderate accuracy to predict the need for revascularisation. (orig.)

  18. Hubungan Konsumsi Fastfood dengan Kejadian Obesitas pada Anak SD di Kota Manado

    OpenAIRE

    Damapolii, Winarsi; Mayulu, Nelly; Masi, Gresty

    2013-01-01

    : Kegemukan saat anak-anak bisa disebabkan akibat makan melebihi kebutuhan, kurangaktivitas fisik, dan karena pengaruh iklan makanan yang berlebihan. Gaya hidup masa kini juga bisamenyebabkan kegemukan yaitu adanya kecenderungan suka mengkonsumsi makan cepat saji ataufast food modern seperti burger, pizza, frenc fries peneletian bertujuan Untuk mengetahui hubungan konsumsi fast food dengan kejadian obesitas pada anak SD di Kota Manado dengan menggunakan metode penelitian survei analitik den...

  19. Machine learning techniques for diabetic macular edema (DME) classification on SD-OCT images.

    Science.gov (United States)

    Alsaih, Khaled; Lemaitre, Guillaume; Rastgoo, Mojdeh; Massich, Joan; Sidibé, Désiré; Meriaudeau, Fabrice

    2017-06-07

    Spectral domain optical coherence tomography (OCT) (SD-OCT) is most widely imaging equipment used in ophthalmology to detect diabetic macular edema (DME). Indeed, it offers an accurate visualization of the morphology of the retina as well as the retina layers. The dataset used in this study has been acquired by the Singapore Eye Research Institute (SERI), using CIRRUS TM (Carl Zeiss Meditec, Inc., Dublin, CA, USA) SD-OCT device. The dataset consists of 32 OCT volumes (16 DME and 16 normal cases). Each volume contains 128 B-scans with resolution of 1024 px × 512 px, resulting in more than 3800 images being processed. All SD-OCT volumes are read and assessed by trained graders and identified as normal or DME cases based on evaluation of retinal thickening, hard exudates, intraretinal cystoid space formation, and subretinal fluid. Within the DME sub-set, a large number of lesions has been selected to create a rather complete and diverse DME dataset. This paper presents an automatic classification framework for SD-OCT volumes in order to identify DME versus normal volumes. In this regard, a generic pipeline including pre-processing, feature detection, feature representation, and classification was investigated. More precisely, extraction of histogram of oriented gradients and local binary pattern (LBP) features within a multiresolution approach is used as well as principal component analysis (PCA) and bag of words (BoW) representations. Besides comparing individual and combined features, different representation approaches and different classifiers are evaluated. The best results are obtained for LBP[Formula: see text] vectors while represented and classified using PCA and a linear-support vector machine (SVM), leading to a sensitivity(SE) and specificity (SP) of 87.5 and 87.5%, respectively.

  20. PENERAPAN PERMAINAN BAHASA (KATARSIS UNTUK MENINGKATKAN KETERAMPILAN MEMBACA SISWA KELAS IVA SD NEGERI 01 METRO PUSAT

    Directory of Open Access Journals (Sweden)

    Arifin Ahmad

    2017-07-01

    Full Text Available Abstract:. Learning to read Bahasa Indonesia at grade IV A SD Negeri 01 Metro Pusat in the implementation still dominate by teachers with Lecture Methods (teacher centered so the learning process is not optimal, so the students are less interested and not giving attention. This study aims to improve reading skills through the application of language games (catharsis at grade IV A SD Negeri 01 Metro Pusat. The method used in this research is qualitative descriptive through the test and reading skill assessment sheet. Data analysis techniques used are qualitative and quantitative analysis. The result of data analysis explain that the students reading skill on cycle I (74,42%, cycle II (83,72%, increased by 9,3% and on cycle III become (90,70% so that it increased by 6,98 %. Keywords: skill, reading, language game (catharsis.   Abstrak: Pembelajaran membaca bahasa Indonesia di kelas IVA SD Negeri 01 Metro Pusat dalam pelaksanaannya guru masih mendominasi dengan metode ceramah (teacher centered sehingga proses pembelajarannya belum optimal, akibatnya siswa kurang tertarik dan kurang memperhatikan. Penelitian ini bertujuan untuk meningkatkan keterampilan membaca melalui penerapan permainan bahasa (katarsis di kelas IVA SD Negeri 01 Metro Pusat. Metode yang digunakan dalam penelitian ini yaitu deskriptif kualitatif melalui lembar tes, dan lembar penilaian keterampilan membaca. Teknik analisis data yang digunakan adalah analisis kualitatif dan analisis kuantitatif. Hasil analisis data diperoleh keterampilan membaca siswa pada siklus I (74,42%, siklus II (83,72%, mengalami peningkatan sebesar 9,3% dan siklus III menjadi (90,70% sehingga mengalami peningkatan sebesar 6,98%. Kata kunci: keterampilan, membaca, permainan bahasa (katarsis.

  1. Kerusakan Penglihatan Akibat Kelainan Refraksi Pada Anak Usia Sekolah di SD Negeri 10 Langsa

    OpenAIRE

    Agustina

    2012-01-01

    Visual Impairment effect of refractive error on school-age children more often happen. The severity of refractive error was not corrected by glasses can cause blindness. The researchs goal to know about visual impairment effect of refractive error on school-age childrenl at SD Negeri 10 Langsa. This research was using descriptive design by total sample as much as 158 respondents. The sample takes by used stratified sampling technique. Data collected do by used Snellen chart and Pinhole...

  2. Stripped Red Giants - Helium Core White Dwarf Progenitors and their sdB Siblings

    Science.gov (United States)

    Heber, U.

    2017-03-01

    Some gaps in the mosaic of binary star evolution have recently been filled by the discoveries of helium-core white dwarf progenitors (often called extremely low mass (ELM) white dwarfs) as stripped cores of first-giant branch objects. Two varieties can be distinguished. One class is made up by SB1 binaries, companions being white dwarfs as well. Another class, the so-called EL CVn stars, are composite spectrum binaries, with A-Type companions. Pulsating stars are found among both classes. A riddle is posed by the apparently single objects. There is a one-to-one correspondence of the phenomena found for these new classes of star to those observed for sdB stars. In fact, standard evolutionary scenarios explain the origin of sdB stars as red giants that have been stripped close to the tip of first red giant branch. A subgroup of subluminous B stars can also be identified as stripped helium-cores of red giants. They form an extension of the ELM sequence to higher temperatures. Hence low mass white dwarfs of helium cores and sdB stars in binaries are close relatives in terms of stellar evolution.

  3. PERAN ORANG TUA TERADAP PRESTASI BELAJAR SISWA SD AL-FURQAN JEMBER

    Directory of Open Access Journals (Sweden)

    Sofyan Rofi

    2016-04-01

    Full Text Available Objective of the study : (1 to know how far parents’ role student learning achievement at Al-furqan Jember, (2 how to correlation between parent of student and school at SD Al-Furqan Jember. This study was done at SD Al-Furqan Jember, by using qualitative approach. Data collecting technique was done by : (1 deep interview, (2 documentation. While checking up data validity was done by cross check with triangulation technique and colleagues discussion. Data analysis was done by (1 data reduction, (2 data presentation, (3 withdrawal of conclusion. From data analysis was found that parent has so central to student learning achievement, because education in school is still not enough increase student learning achievement. With the parents’ role so not just teacher wo strive to increase student learning achievement however parent does advising to their child by join the course. While relation between student old fellow with school intertwin intensive communications with meeting of pupil sponsor mothers in majelis ta’lim that conducted by institution of Al-Furqan Jember. From all data and the result of research finding is found that parents’ role is so necessary to student learning achievement of SD Al-Furqan Jember and relation among student old fellow with school is very good and communicative. As for researcher suggestion is school have to be more improve role of old fellow to student learning process, in order to student achievement progressively mount.       Key word : Parent, learning achievement

  4. Geology of the USW SD-12 drill hole Yucca Mountain, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    Rautman, C.A. [Sandia National Labs., Albuquerque, NM (United States); Engstrom, D.A. [Spectra Research Institute, Albuquerque, NM (United States)

    1996-11-01

    Drill hole USW SD-12 is one of several holes drilled under Site Characterization Plan Study 8.3.1.4.3.1, also known as the {open_quotes}Systematic Drilling Program,{close_quotes} as part of the U.S. Department of Energy characterization program at Yucca Mountain, Nevada, which has been proposed as the potential location of a repository for high-level nuclear waste. The SD-12 drill hole is located in the central part of the potential repository area, immediately to the west of the Main Test Level drift of the Exploratory Studies Facility and slightly south of midway between the North Ramp and planned South Ramp declines. Drill hole USW SD-12 is 2166.3 ft (660.26 m) deep, and the core recovered essentially complete sections of ash-flow tuffs belonging to the lower half of the Tiva Canyon Tuff, the Pah Canyon Tuff, and the Topopah Spring Tuff, all of which are part of the Miocene Paintbrush Group. A virtually complete section of the Calico Hills Formation was also recovered, as was core from the entire Prow Pass Tuff formation of the Crater Flat Group.

  5. SD-MSAEs: Promoter recognition in human genome based on deep feature extraction.

    Science.gov (United States)

    Xu, Wenxuan; Zhang, Li; Lu, Yaping

    2016-06-01

    The prediction and recognition of promoter in human genome play an important role in DNA sequence analysis. Entropy, in Shannon sense, of information theory is a multiple utility in bioinformatic details analysis. The relative entropy estimator methods based on statistical divergence (SD) are used to extract meaningful features to distinguish different regions of DNA sequences. In this paper, we choose context feature and use a set of methods of SD to select the most effective n-mers distinguishing promoter regions from other DNA regions in human genome. Extracted from the total possible combinations of n-mers, we can get four sparse distributions based on promoter and non-promoters training samples. The informative n-mers are selected by optimizing the differentiating extents of these distributions. Specially, we combine the advantage of statistical divergence and multiple sparse auto-encoders (MSAEs) in deep learning to extract deep feature for promoter recognition. And then we apply multiple SVMs and a decision model to construct a human promoter recognition method called SD-MSAEs. Framework is flexible that it can integrate new feature extraction or new classification models freely. Experimental results show that our method has high sensitivity and specificity. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Penerapan Model Pembelajaran TPS Untuk Meningkatkan Hasil Belajar IPA Siswa Kelas V SD No 1 Mengwitani

    Directory of Open Access Journals (Sweden)

    I W Daniel Winantara

    2017-05-01

    Full Text Available Tujuan penelitian ini untuk mengetahui peningkatan hasil belajar IPA siswa kelas V SD No. 1 Mengwitani setelah diterapkannya model pembelajaran think pair share (TPS. Penelitian ini adalah penelitian tindakan kelas yang dilakukan dalam dua siklus. Subjek dalam penelitian ini adalah siswa kelas V yang berjumlah 32 orang. Data penelitian ini tentang hasil belajar yang dikumpulkan dengan menggunakan metode tes. Data dianalisis dengan menggunakan statistik kuantitatif. Hasil penelitian menunjukkan adanya peningkatan terhadap hasil belajar IPA siswa kelas V SD No. 1 Mengwitani. Hal ini ditunjukkan dengan hasil penelitian yang diperoleh yaitu persentase rata-rata hasil belajar pada siklus I sebesar 75,31% yang berada pada kategori sedang dan pada siklus II menjadi 80,15% yang berada pada kategori tinggi. Dengan ketuntasan belajar siswa pada siklus I sebesar 65,62% dan pada siklus II mencapai 87,5%. Berdasarkan hasil penelitian tersebut dapat disimpulkan penerapan model pembelajaran think pair share dapat meningkatkan hasil belajar IPA siswa kelas V SD No. 1 Mengwitani.

  7. PENGGUNAAN MEDIA ILUSTRASI POP-UP SEJARAH DALAM PEMBELAJARAN IPS DI SD NEGERI BATURSARI

    Directory of Open Access Journals (Sweden)

    Yulita Dewi Purmintasari

    2017-06-01

    Full Text Available This study aims: (1to know the process of learning social science in SD Negeri Batursari, (2 to know the use of illustration pop-up media in relieve the teacher to foster student‟s understanding toward the social science subject. This study was conducted in SD Negeri Batursari by using qualitative research strategies. The technique in collecting data were interview, direct observation, questionnaires and research document. The data validated by using triangulation researcher, theoretical and methodological. The technique using data collection, data reduction, and data presentation and conclusion/ verification. The result showed that fourth and rade students SD Negeri Batursari very anthusiastic in participating learning social science, students were formed into small groups and students talk to each other discussing visula messages in pop-up media. Illustration pop-up media is very helpful the teacher inleraning social science, it can be seen when students most easily to understand the material by looking at the illustration in the material. The syudents helped with the media as if the were in the illustration. Keywords: Pop-Up Media, Social Science Learning

  8. Scientific Use of the Sampler, Drill and Distribution Subsystem (SD2)

    Science.gov (United States)

    Armellin, R.; Di Lizia, P.; Crepaldi, M.; Bernelli-Zazzera, F.; Ercoli Finzi, A.

    Rosetta is the third cornerstone mission of the European Space Agency scientific program "Horizon 2000". Rosetta will be the first spacecraft to orbit around a comet nucleus. It was launched in March 2004 and will reach the comet 67P/ChurymovGerasimenko in 2014. A lander (Philae) will be released and land on the comet surface for in-situ investigation. One of the key subsystems of the lander Philae is the Sampler, Drill and Distribution (SD2) subsystem. SD2 provides in-situ operations devoted to soil drilling, samples collection, and their distribution to two evolved gas analyzers (COSAC and PTOLEMY) and one imaging instrument (ÇIVA). Recent studies have proven the existence of a correlation between the drill behavior during perforation and the mechanical characteristics of the cometary soil. This outlines the possibility of using SD2 not only as a tool to support other instruments, but also as a scientific instrument itself. In this paper the possibility of using the drill as a quasi-static penetrator is presented. Within this approach, laboratory tests on glass-foam specimens of different porosity show that the drill behaviour during penetration can be exploited for cometary soil characterization.

  9. Experimental demonstration of building and operating QoS-aware survivable vSD-EONs with transparent resiliency.

    Science.gov (United States)

    Yin, Jie; Guo, Jiannan; Kong, Bingxin; Yin, Heqing; Zhu, Zuqing

    2017-06-26

    Software-defined elastic optical networks (SD-EONs) provide operators more flexibility to customize their optical infrastructures dynamically. By leveraging infrastructure-as-a-service (IaaS), virtual SD-EONs (vSD-EONs) can be realized to further enhance the adaptivity of SD-EONs and shorten the time-to-market of new services. In this paper, we design and demonstrate the building and operating of quality-of-service (QoS) aware survivable vSD-EONs that are equipped with transparent data plane (DP) resiliency. Specifically, when slicing a vSD-EON, our network hypervisor (NHV) chooses to use "1:1" virtual link (VL) protection or on-demand VL remapping as the DP restoration scheme, according to the service-level agreement (SLA) between the vSD-EON's operator and the infrastructure provider (InP). Then, during an actual substrate link (SL) failure, the NHV realizes automatic DP restoration that is transparent to the controllers of vSD-EONs. We build a network testbed to demonstrate the creation of QoS-aware survivable vSD-EONs, the activation of lightpaths in the vSD-EONs to support upper-layer applications, and the automatic and simultaneous QoS-aware DP restorations during an SL failure. The experimental results indicate that our vSD-EON slicing system can build QoS-aware survivable vSD-EONs on-demand, operate them to set up lightpaths for carrying real application traffic, and facilitate differentiated DP restorations during SL failures to recover the vSD-EONs' services according to their SLAs.

  10. Geology of the USW SD-7 drill hole Yucca Mountain, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    Rautman, C.A. [Sandia National Laboratories, Albuquerque, NM (United States); Engstrom, D.A. [Spectra Research Inst., Albuquerque, NM (United States)

    1996-09-01

    The USW SD-7 drill hole is one of several holes drilled under Site Characterization Plan Study 8.3.1.4.3.1, also known as the Systematic Drilling Program, as part of the U.S. Department of Energy characterization program at Yucca Mountain, Nevada. The Yucca Mountain site has been proposed as the potential location of a repository for high-level nuclear waste. The SD-7 drill hole is located near the southern end of the potential repository area and immediately to the west of the Main Test Level drift of the Exploratory Studies Facility. The hole is not far from the junction of the Main Test Level drift and the proposed South Ramp decline. Drill hole USW SD-7 is 2675.1 ft (815.3 m) deep, and the core recovered nearly complete sections of ash-flow tuffs belonging to the lower half of the Tiva Canyon Tuff, the Pah Canyon Tuff, and the Topopah Spring Tuff, all of which are part of the Miocene Paintbrush Group. Core was recovered from much of the underlying Calico Hills Formation, and core was virtually continuous in the Prow Pass Tuff and the Bullfrog Tuff. The SD-7 drill hole penetrated the top several tens of feet into the Tram Tuff, which underlies the Prow Pass and Bullfrog Tuffs. These latter three units are all formations of the Crater Flat Group, The drill hole was collared in welded materials assigned to the crystal-poor middle nonlithophysal zone of the Tiva Canyon Tuff; approximately 280 ft (85 m) of this ash-flow sheet was penetrated by the hole. The Yucca Mountain Tuff appears to be missing from the section at the USW SD-7 location, and the Pah Canyon Tuff is only 14.5 ft thick. The Pah Canyon Tuff was not recovered in core because of drilling difficulties, suggesting that the unit is entirely nonwelded. The presence of this unit is inferred through interpretation of down-hole geophysical logs.

  11. Ultra-Widefield Steering-Based SD-OCT Imaging of the Retinal Periphery

    Science.gov (United States)

    Choudhry, Netan; Golding, John; Manry, Matthew W.; Rao, Rajesh C.

    2016-01-01

    Objective To describe the spectral-domain optical coherence tomography (SD-OCT) features of peripheral retinal findings using an ultra-widefield (UWF) steering technique to image the retinal periphery. Design Observational study. Participants 68 patients (68 eyes) with 19 peripheral retinal features. Main Outcome Measures SD-OCT-based structural features. Methods Nineteen peripheral retinal features including: vortex vein, congenital hypertrophy of the retinal pigment epithelium (CHRPE), pars plana, ora serrata pearl, typical cystoid degeneration (TCD), cystic retinal tuft, meridional fold, lattice and cobblestone degeneration, retinal hole, retinal tear, rhegmatogenous retinal detachment (RRD), typical degenerative senile retinoschisis, peripheral laser coagulation scars, ora tooth, cryopexy scars (retinal tear and treated retinoblastoma scar), bone spicules, white without pressure, and peripheral drusen were identified by peripheral clinical examination. Near infrared (NIR) scanning laser ophthalmoscopy (SLO) images and SD-OCT of these entities were registered to UWF color photographs. Results SD-OCT resolved structural features of all peripheral findings. Dilated hyporeflective tubular structures within the choroid were observed in the vortex vein. Loss of retinal lamination, neural retinal attenuation, RPE loss or hypertrophy were seen in several entities including CHRPE, ora serrata pearl, TCD, cystic retinal tuft, meridional fold, lattice and cobblestone degenerations. Hyporeflective intraretinal spaces, indicating cystoid or schitic fluid, were seen in ora serrata pearl, ora tooth, TCD, cystic retinal tuft, meridional fold, retinal hole, and typical degenerative senile retinoschisis. The vitreoretinal interface, which often consisted of lamellae-like structures of the condensed cortical vitreous near or adherent to the neural retina, appeared clearly in most peripheral findings, confirming its association with many low-risk and vision-threatening pathologies

  12. Clinical characteristics and methods of treatment of patients with stable coronary heart disease in the primary care settings--the results of the Polish, Multicentre Angina Treatment Pattern (ATP) study.

    Science.gov (United States)

    Ruzyllo, W; Ponikowski, P; Wilkins, A

    2004-12-01

    For further improvement of coronary heart disease (CHD) management large epidemiological studies are required to characterise the real population of patients with CHD, treated in the primary care settings, and to evaluate how the guidelines are implemented in the everyday clinical practice. The aim of the Angina Treatment Pattern (ATP) survey was to characterise (i) the population of patients, treated by the primary care physicians for stable CHD, (ii) the methods applied by the primary care physicians to establish diagnosis of CHD and (iii) the pharmacological therapies for CHD. Across Poland, 397 primary care physicians were randomly selected. They recruited 7420 patients (49% men; mean age, 62 +/- 10 years; range: 25-93 years), treated for stable CHD. The duration of CHD was 7.4 +/- 6.6 years (range: 6 months-50 years), 2750 (37%) patients had myocardial infarction. The following risk factors of CHD were present: arterial hypertension in 58%, dyslipidaemia in 52%, smoking in 40%, family history of CHD in 56% and obesity or overweight in 73% of patients. Primary care physicians based a diagnosis of CHD predominantly on a history of anginal pain (in 33% patients), accompanied either by abnormal resting ECG or positive exercise test (in additional 31% patients). Only in 5% of patients, coronary angiography was applied to diagnose CAD. The following groups of drugs have been used: long-acting nitrates in 90%, anti-platelet drugs or anti-coagulants in 71% (aspirin in 65%), angiotensin-converting enzyme inhibitors in 51%, beta-blockers in 48%, calcium antagonists 31%, hypolipaemic drugs in 23% (statins in 10%) and metabolic agents in 16% of patients. Despite an extensive use of classical anti-anginal drugs (including at least one of the following: long-acting nitrates, beta-blockers, calcium antagonists in 95% of patients), 85% of patients still complained of anginal symptoms. Neither prevalence of angina among patients nor nitroglycerin intake depended on the number

  13. Aggressive Fibromatosis: Evidence for a Stable Phase

    Directory of Open Access Journals (Sweden)

    Gillian Mitchell

    1998-01-01

    Full Text Available Purpose. Aggressive fibromatosis (AF is an uncommon locally infiltrating benign disease of soft tissue for which treatment comprises complete surgical resection. Radiotherapy can be given postoperatively if the margin is incompletely resected. If the tumour is inoperable radiotherapy provides an alternative treatment. Hormone therapy and cytotoxic chemotherapy have also been used for unresectable or recurrent disease. All treatment modalities carry an associated morbidity. We believe that the natural history of aggressive fibromatosis may include a period of stable disease without progression, during which time, treatment is not always necessary.

  14. PENINGKATKAN HASIL BELAJAR MATEMATIKA MELALUI METODE DRILL DAN DISKUSI KELOMPOK PADA SISWA KELAS VI SD

    Directory of Open Access Journals (Sweden)

    Erlyn Juniati

    2017-09-01

    Full Text Available One of the main problems of today's Mathematics Lesson is the lack of understanding and motivation of teachers in schools, so that children are less active in the learning process. This phenomenon occurs in SD N I Badran. Based on the results of formative tests of class VI semester 2 subjects mathematics of the material change the common fractions into decimal fractions and percent or otherwise low, this is validated by the analysis of the average grade 58, 33. Of the 30 students who achieve the value of learning mastery only 11 students, The rest is still far below KKM (≤70. Students do not yet understand in changing the usual fractions to decimal fractions and percent or vice versa. This type of research is Classroom Action Research. The subjects studied were the 6th graders of SD Negeri I Badran, Kranggan Sub-district, Temanggung Semester 2 of the 2015/2016 Lesson Study. This study was conducted in 2 cycles, each cycle consisting of 3 meetings, and each cycle consisted of planning, action, observation and reflection. From the result of research by using Drill method and group work, there is an increase of student learning result. In learning mathematics subject matter converts the usual fractions into decimal fractions and percent and vice versa. Prior to the improvement of the number of 30 students who thoroughly studied with KKM 70 only 11 students, with an average score of 58, 33 with mastery learning 36, 66. Improvement of learning Cycle 2 first meetings average grade 83.33 complete 25 percentage of mastery 83.33%. The researcher concludes that the result of the study of the sixth graders of SD Negeri 1 Badran of Kranggan Sub-district of Temanggung Regency on the subject changed the common denominations to decimal and percent and vice versa through Drill method and Group Discussion of learning result increased.

  15. The genome of Shigella dysenteriae strain Sd1617 comparison to representative strains in evaluating pathogenesis.

    Science.gov (United States)

    Vongsawan, Ajchara A; Kapatral, Vinayak; Vaisvil, Benjamin; Burd, Henry; Serichantalergs, Oralak; Venkatesan, Malabi M; Mason, Carl J

    2015-03-01

    We sequenced and analyzed Shigella dysenteriae strain Sd1617 serotype 1 that is widely used as model strain for vaccine design, trials and research. A combination of next-generation sequencing platforms and assembly yielded two contigs representing a chromosome size of 4.34 Mb and the large virulence plasmid of 177 kb. This genome sequence is compared with other Shigella genomes in order to understand gene complexity and pathogenic factors. © The Author 2015. Published by Oxford University Press on behalf of on behalf of Federation of European Microbiological Society.

  16. Holter con memorias SD y sistema experto de evaluación cardíaca

    OpenAIRE

    Pfarher, Iván; Reula, Germán; Tovorosky, Pablo; Zanin, Miguel; Caballero, Raúl M.; Maggiolo, Gustavo Daniel

    2006-01-01

    Este desarrollo se enmarca dentro de las actividades de la cátedra de Técnicas Digitales de Ingeniería en Electrónica en UTN-FRP y tiene como objeto potenciar la capacidad de diseño de los alumnos. En este caso se ha desarrollado un sistema holter utilizando memorias SD comunes en el mercado de las cámaras fotográficas implementando además un sistema ordenador de control a partir del uso de un microcontrolador con el sistema de operación y de captura embebido correspondiente para la captura, ...

  17. Nitrogen Source Stabilization of Quorum Sensing in the Pseudomonas aeruginosa Bioaugmentation Strain SD-1.

    Science.gov (United States)

    Wang, Mei-Zhen; Lai, Bai-Min; Dandekar, Ajai A; Yang, Yu-Sheng; Li, Na; Yin, Jun; Shen, Dong-Sheng

    2017-08-15

    Pseudomonas aeruginosa SD-1 is efficient at degrading aromatic compounds and can therefore contribute to the bioremediation of wastewater. P. aeruginosa uses quorum sensing (QS) to regulate the production of numerous secreted "public goods." In wastewater bioaugmentation applications, there are myriad nitrogen sources, and we queried whether various nitrogen sources impact the stabilities of both QS and the bacterial populations. In a laboratory strain of P. aeruginosa , PAO1, the absence of a nitrogen source has been shown to destabilize these populations through the emergence of QS mutant "cheaters." We tested the ability of SD-1 to grow in casein broth, a condition that requires QS for growth, when the nitrogen source with either NH 4 Cl, NaNO 3 , or NaNO 2 or with no added nitrogen source. There was great variability in susceptibility to invasion by QS mutant cheaters and, by extension, the stability of the SD-1 population. When grown with NH 4 Cl as an extra nitrogen source, no population collapse was observed; by contrast, two-thirds of cultures grown in the presence of NaNO 2 collapsed. In the populations that collapsed, the frequency of social cheaters exceeded 40%. NaNO 3 and NaNO 2 directly favor QS mutants of P. aeruginosa SD-1. Although the mechanism by which these nitrogen sources act is not clear, these data indicate that the metabolism of nitrogen can affect the stability of bacterial populations, an important observation for continuing industrial applications with this species. IMPORTANCE Bioaugmentation as a method to help remediate wastewater pollutant streams holds significant potential to enhance traditional methods of treatment. Addition of microbes that can catabolize organic pollutants can be an effective method to remove several toxic compounds. Such bioaugmented strains of bacteria have been shown to be susceptible to competition from the microbiota that are present in wastewater streams, limiting their potential effectiveness. Here, we

  18. Temperature and angular momentum dependence of the quadrupole deformation in sd-shell

    Science.gov (United States)

    Ganai, P. A.; Sheikh, J. A.; Maqbool, I.; Singh, R. P.

    2009-12-01

    Temperature and angular momentum dependence of the quadrupole deformation is studied in the middle of the sd-shell for 28Si and 27Si isotopes using the spherical shell model approach. The shell model calculations have been performed using the standard USD interaction and the canonical partition function constructed from the calculated eigen-solutions. It is shown that the extracted average quadrupole moments show a transitional behavior as a function of temperature and the inferred transitional temperature is shown to vary with angular-momentum. The quadrupole deformation of the individual eigen-states is also analyzed.

  19. Shell model calculations for the mass 18 nuclei in the sd-shell

    International Nuclear Information System (INIS)

    Hamoudi, A.

    1997-01-01

    A simple effective nucleon-nucleon interaction for shell model calculations in the sd-shell is derived from the Reid soft-core potential folded with two-body correlation functions which take account of the strong short-range repulsion and large tensor component in the Reid force. Calculations of binding energies and low-lying spectra are performed for the mass A=18 with T=0 and 1 nuclei using this interaction. The results of this shell model calculations show a reasonable agreement with experiment

  20. The NFI TOKAI SD System - management of the capabilities of operators in fuel fabrication plants

    International Nuclear Information System (INIS)

    Fukushima, T.

    2008-01-01

    Since the JCO criticality accident occurred in 1999, even more emphasis has been placed on the management of nuclear safety in Japan. This is particularly true for the education of operators and the observance of operational procedures. Even prior to this accident, Nuclear Fuel Industries, Ltd., NFI, regarded the education and development of skilled operators very seriously and we have developed an education system, called the SD system (Skill Development system), to assure the careful education of the operators and the improvement of their skill in order to prevent human error events. Our education system in the Tokai works, is explained. (author)

  1. PENGEMBANGAN SSP TEMATIK INTEGRATIF UNTUK MEMBANGUN KARAKTER KEJUJURAN DAN KEPEDULIAN SISWA SD KELAS II

    Directory of Open Access Journals (Sweden)

    Sri Hariyati Qodriyah

    2015-07-01

    Full Text Available Penelitian ini bertujuan untuk menghasilkan perangkat pembelajaran berupa SSP Tematik yang dapat mengembangkan karakter siswa kelas 2 sekolah dasar, meliputi karakter kejujuran dan kepedulian. Penelitian ini merupakan penelitian dan pengembangan yang terdiri dari tujuh tahap, yaitu studi pendahuluan, perencanaan, mengembangkan produk awal, uji coba awal, revisi produk utama, uji coba lapangan, dan revisi terhadap produk operasional. SSP yang dikembangkan dievaluasi oleh seorang ahli materi dan media untuk mengetahui validitasnya. Subjek uji coba berjumlah 90 siswa terdiri dari 23 siswa SD Sonosewu, Kasihan, Bantul, DIY sebagai subjek uji coba terbatas dan 33 siswa untuk kelas control dan 34 siswa untuk kelas eksperimen SD 1 Kadipiro, Kasihan, Bantul, DIY. Hasil penelitian ini berupa SSP yang meliputi: silabus, RPP, LKS, dan lembar penilaian. Hasil evaluasi dari ahli materi dan ahli media untuk menguji tingkat kevalidan SSP menyatakan bahwa SSP yang dikembangkan adalah valid dan berkategori “baik”. Hasil uji coba menunjukkan bahwa SSP yang dikembangkan dinyatakan layak serta memenuhi kriteria praktis dan efektif dalam mengembangkan karakter siswa. Pembelajaran dengan SSP yang dikembangkan mampu mengembangkan karakter kejujuran dan kepedulian. Kata Kunci: SSP, karakter jujur dan peduli   DEVELOPING THEMATIC INTEGRATIVE SSP FOR BUILDING THE CHARACTERS OF HONESTY AND CARE GRADE II STUDENT OF ELEMENTARY SCHOOL Abstract This study aims to produce integrated learning sets in the form of thematic SSP that can develop the characters of honesty and care of grade II students of elementary school. This was a research and development study consisting of seven steps, i.e. preliminary study, planning, preliminary product development, preliminary tryout, main product revision, field tryout, revision of operational product, operational product revision, and revision of the final product. The developed SSP was evaluated by a science subject expert to assess

  2. Modification of Iraqi Asphalt 40/50 Properties Using Saw Dust (SD and Natural Rubber Latex

    Directory of Open Access Journals (Sweden)

    Rusul l M. Darwesh

    2018-04-01

    Full Text Available The aim of this research is to enhance the fundamental properties for asphalt binder as those spec-ifications relate to performance of asphalt mixtures. In this paper studied the effect of add (2, 4 % SD in different sizes and (3, 5 and 7% Natural rubber latex to the straight asphalt 40/50 produced from Al-Dura refinery at 160C, it was added each additive separately and then added together to asphalt in same temperature, then tested physically and mechanically according to the American Society for Testing and Materials (ASTM, the result showed largely improvement.

  3. Cytotoxic anthranilic acid derivatives from deep sea sediment-derived fungus Penicillium paneum SD-44.

    Science.gov (United States)

    Li, Chun-Shun; Li, Xiao-Ming; Gao, Shu-Shan; Lu, Yan-Hua; Wang, Bin-Gui

    2013-08-21

    Five new anthranilic acid derivatives, penipacids A-E (1-5), together with one known analogue (6), which was previously synthesized, were characterized from the ethyl acetate extract of the marine sediment-derived fungus Penicillium paneum SD-44. Their structures were elucidated mainly by extensive NMR spectroscopic and mass spectrometric analysis. The cytotoxicity and antimicrobial activity of the isolated compounds were evaluated. Compounds 1, and 5 exhibited inhibitory activity against human colon cancer RKO cell line, while compound 6 displayed cytotoxic activity against Hela cell line.

  4. Cytotoxic Anthranilic Acid Derivatives from Deep Sea Sediment-Derived Fungus Penicillium paneum SD-44

    Directory of Open Access Journals (Sweden)

    Bin-Gui Wang

    2013-08-01

    Full Text Available Five new anthranilic acid derivatives, penipacids A–E (1–5, together with one known analogue (6, which was previously synthesized, were characterized from the ethyl acetate extract of the marine sediment-derived fungus Penicillium paneum SD-44. Their structures were elucidated mainly by extensive NMR spectroscopic and mass spectrometric analysis. The cytotoxicity and antimicrobial activity of the isolated compounds were evaluated. Compounds 1, and 5 exhibited inhibitory activity against human colon cancer RKO cell line, while compound 6 displayed cytotoxic activity against Hela cell line.

  5. Comorbidity in chronic obstructive pulmonary disease. Related to disease severity?

    Directory of Open Access Journals (Sweden)

    Echave-Sustaeta JM

    2014-11-01

    Full Text Available Jose M Echave-Sustaeta,1 Lorena Comeche Casanova,1 Borja G Cosio,2 Juan Jose Soler-Cataluña,3 Ricardo Garcia-Lujan,1 Xavier Ribera41Respiratory Department, Hospital Universitario Quirón Madrid, Madrid, Spain; 2Respiratory Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain; 3Respiratory Department, Hospital Arnau de Vilanova, Valencia, Spain; 4Medical Deparment, Boehringer Ingelheim, Barcelona, SpainBackground and objective: Several diseases commonly co-exist with chronic obstructive pulmonary disease (COPD, especially in elderly patients. This study aimed to investigate whether there is an association between COPD severity and the frequency of comorbidities in stable COPD patients.Patients and methods: In this multicenter, cross-sectional study, patients with spirometric diagnosis of COPD attended to by internal medicine departments throughout Spain were consecutively recruited by 225 internal medicine specialists. The severity of airflow obstruction was graded using the Global Initiative for Chronic Obstructive Lung Disease (GOLD and data on demographics, smoking history, comorbidities, and dyspnea were collected. The Charlson comorbidity score was calculated.Results: Eight hundred and sixty-six patients were analyzed: male 93%, mean age 69.8 (standard deviation [SD] 9.7 years and forced vital capacity in 1 second 42.1 (SD 17.7%. Even, the mean (SD Charlson score was 2.2 (2.2 for stage I, 2.3 (1.5 for stage II, 2.5 (1.6 for stage III, and 2.7 (1.8 for stage IV (P=0.013 between stage I and IV groups, independent predictors of Charlson score in the multivariate analysis were age, smoking history (pack-years, the hemoglobin level, and dyspnea, but not GOLD stage.Conclusion: COPD patients attended to in internal medicine departments show high scores of comorbidity. However, GOLD stage was not an independent predictor of comorbidity.Keywords: Charlson, comorbidity, COPD

  6. Marginally Stable Nuclear Burning

    Science.gov (United States)

    Strohmayer, Tod E.; Altamirano, D.

    2012-01-01

    Thermonuclear X-ray bursts result from unstable nuclear burning of the material accreted on neutron stars in some low mass X-ray binaries (LMXBs). Theory predicts that close to the boundary of stability oscillatory burning can occur. This marginally stable regime has so far been identified in only a small number of sources. We present Rossi X-ray Timing Explorer (RXTE) observations of the bursting, high- inclination LMXB 4U 1323-619 that reveal for the first time in this source the signature of marginally stable burning. The source was observed during two successive RXTE orbits for approximately 5 ksec beginning at 10:14:01 UTC on March 28, 2011. Significant mHz quasi- periodic oscillations (QPO) at a frequency of 8.1 mHz are detected for approximately 1600 s from the beginning of the observation until the occurrence of a thermonuclear X-ray burst at 10:42:22 UTC. The mHz oscillations are not detected following the X-ray burst. The average fractional rms amplitude of the mHz QPOs is 6.4% (3 - 20 keV), and the amplitude increases to about 8% below 10 keV.This phenomenology is strikingly similar to that seen in the LMXB 4U 1636-53. Indeed, the frequency of the mHz QPOs in 4U 1323-619 prior to the X-ray burst is very similar to the transition frequency between mHz QPO and bursts found in 4U 1636-53 by Altamirano et al. (2008). These results strongly suggest that the observed QPOs in 4U 1323-619 are, like those in 4U 1636-53, due to marginally stable nuclear burning. We also explore the dependence of the energy spectrum on the oscillation phase, and we place the present observations within the context of the spectral evolution of the accretion-powered flux from the source.

  7. Relative clinical and economic impact of exercise echocardiography vs. exercise electrocardiography, as first line investigation in patients without known coronary artery disease and new stable angina: a randomized prospective study.

    Science.gov (United States)

    Zacharias, Konstantinos; Ahmed, Asrar; Shah, Benoy N; Gurunathan, Sothinathan; Young, Grace; Acosta, Dionisio; Senior, Roxy

    2017-02-01

    Exercise electrocardiography (ExECG) is widely used in suspected stable angina (SA) as the initial test for the evaluation of coronary artery disease (CAD). We hypothesized that exercise stress echo (ESE) would be efficacious with cost advantage over ExECG when utilized as the initial test. Consecutive patients with suspected SA, without known CAD were randomized into ExECG or ESE. Patients with positive tests were offered coronary angiography (CA) and with inconclusive tests were referred for further investigations. All patients were followed-up for cardiac events (death, myocardial infarction, and unplanned revascularization). Cost to diagnosis of CAD was calculated by adding the cost of all investigations, up to and including CA. In the 194 and 191 patients in the ExECG vs. ESE groups, respectively, pre-test probability of CAD was similar (34 ± 23 vs. 35 ± 25%, P = 0.6). Results of ExECG were: 108 (55.7%) negative, 14 (7.2%) positive, 72 (37.1%) inconclusive and of ESE were 181 (94.8%) negative, 9 (4.7%) positive, 1 (0.5%) inconclusive, respectively. Patients with obstructive CAD following positive ESE vs. Ex ECG were 9/9 vs. 9/14, respectively (P = 0.04). Cost to diagnosis of CAD was £266 for ESE vs. £327 for ExECG (P = 0.005). Over a mean follow-up period of 21 ± 5 months, event rates were similar between the two groups. In this first randomized study, ESE was more efficacious and demonstrated superior cost-saving, compared with ExECG when used as the initial investigation for the evaluation of CAD in patients with new-onset suspected SA without known CAD. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  8. Identifikasi Carrier Bakteri Streptococcus β hemolyticus Group A pada Murid SD Negeri 13 Padang Berdasarkan Perbedaan Umur dan Jenis Kelamin

    Directory of Open Access Journals (Sweden)

    Fadhila Aini

    2016-01-01

    Full Text Available AbstrakStreptococcus β hemolyticus Grup A atau yang disebut juga Streptococcus pyogenes merupakan salah satu bakteri patogen yang banyak menginfeksi manusia.Bakteri ini dapat ditemukan sebagai carrier di saluran pernafasan terutama pada anak-anak, tidak menimbulkan penyakit tetapi berisiko untuk menyebarkan penyakit. Tujuan penelitian ini adalah menentukan jumlah carrier  bakteri Streptococcus β hemolyticus Grup A pada murid berdasarkan perbedaan umur dan jenis kelamin. Jenis penelitian ini adalah deskriptif cross-sectional dengan menggunakan sampel seluruh murid SD Negeri 13 Padang. Hasil penelitian adalah didapatkan 2 orang murid yang menderita carrier, yaitu pada kelompok usia>8-9 tahun dan >11 tahun. Berdasarkan jenis kelamin yang terdiri dari 54 orang laki-laki dan 50 orang perempuan, didapatkan 2 orang carrier yaitu hanya pada anak laki-laki. Hasil penelitian menunjukkan bahwa carrier bakteri Streptococcus β hemolyticus Group  A terdapat pada anak usia tersebut karena masih kurangnya pengetahuan tentang kebersihan. Carrier yang ditemukan hanya pada anak laki-laki kemungkinan disebabkan mereka lebih sering bermain di luar rumah dan terpapar dengan berbagai bakteri patogen dan kurang memperhatikan kebersihan diri.Kata kunci: carrier, streptococcus β hemolyticus grup A, umur, jenis kelamin AbstractGroup A Streptococcus β hemolyticus or also called Streptococcus pyogenes is one of many pathogenic bacteria that infect humans. These bacteria can be found as a carrier in the respiratory tract especially in children, do not cause disease but can be a risk for spreading the disease. This objective of this study was to determine the amount of the carrier of bacteria group A Streptococcus β hemolyticus based on age and gender differences. This research is a descriptive cross - sectional study using a sample of all students of SD Negeri 13 Padang. Based on the age of 104 students found that students who suffer 2 carrier, which is in the age

  9. [Ginkgo biloba extract enhances the immune function of spleen and thymus in SD rats].

    Science.gov (United States)

    Wang, Yong; Si, Lifang; Li, Xiangneng; Li, Zhansheng

    2015-06-01

    To study the effect of Ginkgo biloba extract (GBE) on the immune function of spleen and thymus in SD rats. Forty SD rats were randomly divided into four groups (10 rats each group). Three experimental groups were given GBE daily by gavage in doses of 40, 120, 360 mg/(kg.d), respectively. Animals in the control group were fed the same amount of PBS. After 28 days, the rats were sacrificed by chloral hydrate anesthesia. The spleen and thymus were harvested to determine the organ index first. MTT assay was used to detect the concanavalin A (ConA)-induced splenic lymphocyte proliferation and transformation. Neutral red assay was performed to measure the rat peritoneal macrophage phagocytosis. The ultrastructural changes of spleen and thymus were observed under scanning electron microscope. Administration of GBE in the rats increased the mass indexes of rat thymus and spleen, dose-dependently elevated the lymphocyte proliferative responses and enhanced the peritoneal macrophage phagocytosis. In experimental groups, the numbers of mature spleen and thymus lymphocytes were significantly raised in comparison with the control rats. GBE plays a regulatory role in immune function of the rat by increasing the mass of immune organs, increasing the number of mature T lymphocytes as well as their proliferative responses, and enhancing the phagocytic capacity of peritoneal macrophages.

  10. EC03089-6421: a new, very rapidly pulsating sdO star

    Science.gov (United States)

    Kilkenny, D.; Worters, H. L.; Østensen, R. H.

    2017-06-01

    EC 03089-6421, classified sdO in the Edinburgh-Cape (EC) blue object survey, is shown to have unusually rapid pulsations with a dominant frequency near 32 mHz (amplitude ˜0.02 mag; period 31.1 s) - which appears to be strongly variable in amplitude on time-scales of hours and days - and a generally weaker frequency near 29 mHz (amplitude ˜0.004 mag; period 34.2 s), which is also variable in amplitude. This star varies at twice the frequency of any known hot subdwarf pulsator. Although the low-resolution EC spectrogram appears very similar to those of DAO stars, our analysis derives Teff = 40 200 ± 1600 K; log g = 6.25 ± 0.23 and log N(He)/N(H) = -1.63 ± 0.55; more recent spectrograms give Teff = 37 400 ± 1000 K; log g = 5.70 ± 0.13 and log N(He)/N(H) = -2.02 ± 0.17, both of which indicate that the gravity is too low for a white dwarf star, although the low temperature derived from the Balmer lines is at odds with the absence of neutral Helium and the strength of He II 4686. It is possible that EC 03089-6421 is a field analogue of the ω Cen sdO variables.

  11. Strategi Learning Community untuk Meningkatkan Keterampilan Menulis Wacana Deskriptif Siswa SD

    Directory of Open Access Journals (Sweden)

    - Supriyadi

    2013-01-01

    Full Text Available Abstract: Implementing Learning-community Strategy to Improve the Ability of the Fifth-grade Students in Writing Descriptive Texts. This classroom action research describes how the implementa­tion of learning-community strategy improves the ability of the fifth-grade students of an elementary school in Gorontalo in writing descriptive texts. After two cycles, each involving the stages of planning, implementing, observing, and reflecting, the study indicates that the implementation of learning-­community strategy can improve the students' writing ability as reflected in the data obtained from par­ticipant observation, interview, and tests. Additionally, the strategy can improve the students' learning activities, collaborative skills, learning effectiveness, and social competence. Abstrak: Strategi Learning Community untuk Meningkatkan Keterampilan Menulis Wacana Deskriptif Siswa SD. Masalah yang dikaji dalam PTK ini adalah bagaimanakah strategi belajar learn­ing community dapat digunakan untuk meningkatkan keterampilan menulis wacana disekriptif pada siswa SD. PTK ini dilaksanakan dalam dua siklus. Prosedur penelitian terdiri atas lima langkah, yakni persiapan tindakan, implementasi tindakan, observasi, evaluasi, dan refleksi. Teknik pengambilan data terdiri atas observasi berpartisipasi, wawancara, dan tes yang dilakukan pada setiap akhir siklus. Hasil penelitian menunjukkan bahwa implementasi strategi belajar learning community dapat meningkatkan keterampilan menulis wacana deskriptif dan hasil belajar bahasa Indonesia siswa. Implementasi strategi learning community juga dapat meningkatkan aktivitas belajar, kolaborasi antarsiswa, keefektifan bela­jar, dan kompetensi sosial siswa.

  12. Geology of the USW SD-9 drill hole, Yucca Mountain, Nevada

    International Nuclear Information System (INIS)

    Engstrom, D.A.; Rautman, C.A.

    1996-10-01

    Drill hole USW SD-9 is one of several holes drilled under Site Characterization Plan Study as part of the characterization program at Yucca Mountain, Nevada, which has been proposed as the potential location of a repository for high-level nuclear waste. The SD-9 drill hole is located in the northern part of the potential repository area. Quantitative and semiquantitative data are included in this report for cover recovery, rock-quality designation (RQD), lithophysal cavity abundance, and fracturing. These data are spatially variable, both within and among the major formational-level stratigraphic units. Nonwelded intervals in general exhibit higher recoveries and more intact (higher) RQD values than welded intervals. The most intact, highest-RQD materials encountered within the Topopah Spring belong to the lower 33.3 ft of the middle nonlithophysal zone. This report includes quantitative data for the framework material properties of porosity, bulk and particle density, and saturated hydraulic conductivity. Graphical analysis of variations in these laboratory hydrologic properties indicates first-order control of material properties by the degree of welding and the presence of zeolite minerals. Many major lithostratigraphic contacts are not well expressed in the material-property profiles; contacts of material-property units are related more to changes in the intensity of welding. Approximate in-situ saturation data of samples preserved immediately upon recovery from the hole are included in the data tabulation

  13. IMPLEMENTASI MODEL PEMBELAJARAN TWO STAY TWO STRAY DALAM PEMBELAJARAN BERBASIS KEMAMPUAN BERPIKIR KRITIS KELAS V SD

    Directory of Open Access Journals (Sweden)

    M. Yusuf Setia Wardana

    2017-04-01

    Full Text Available Benefits of mathematics are to equip students with the ability to think logically, analytical, systematically, critically, and creatively, as well as the ability to cooperate. Based on observations in elementary school, there are 40% of students have not reached KKM and students have lack of critical abilities to understand math problems, and they have low activity of the study. One of models that can be applied is Two Stay Two Stray. The study used True Experimental Design with Posttest-Only Control Design. The population in this study was all fifth grade students of SD Negeri Semarang Rejosari 03. Data of critical thinking skills of the students in average on test of critical thinking skills mastery was 3.31 ≥ 2.67, it can be said to have a complete description. The conclusion is a model of Two Stay Two Stray being effective for critical thinking skills and mathematics learning outcomes of fifth grade students in SD Negeri Rejosari 03 Semarang. Keywords: two stay two stray model, critical thinking ability.

  14. Mechanical Properties Variation of B500SD High Ductility Reinforcement Regarding its Corrosion Degree

    Directory of Open Access Journals (Sweden)

    Cobo, A.

    2011-12-01

    Full Text Available Corrosion effects on reinforcement become evident in the bar section reduction and in the variation of mechanical properties related to ductility. In this research work, 96 B500SD steel bars, previously subjected to different corrosion variables, have been tested. Results show that the elongation of the bars diminishes and the ratio between the maximum tensile stress and the elastic limit increases as the corrosion degree advances. These phenomena can be explained by studying the necking effect and the different steel composition through the manufacture process.

    Los efectos de la corrosión sobre las armaduras se manifiestan por la pérdida de sección y la variación de las propiedades mecánicas relacionadas con la ductilidad. En este trabajo se han ensayado a tracción 96 barras de acero B500SD que previamente se han sometido a niveles variables de corrosión. Los resultados muestran que los alargamientos de las barras disminuyen y el cociente entre la tensión máxima y el límite elástico aumenta conforme el nivel de corrosión avanza. A partir del estudio del efecto de entalla y de la distinta constitución metalográfica del acero a nivel de sección debido a su procedimiento de fabricación, se pueden explicar los fenómenos anteriores.

  15. Anisotropic SD2 brane: accelerating cosmology and Kasner-like space-time from compactification

    Energy Technology Data Exchange (ETDEWEB)

    Nayek, Kuntal; Roy, Shibaji [Saha Institute of Nuclear Physics, Calcutta (India); Homi Bhabha National Institute, Mumbai (India)

    2017-07-15

    Starting from an anisotropic (in all directions including the time direction of the brane) non-SUSY D2 brane solution of type IIA string theory we construct an anisotropic space-like D2 brane (or SD2 brane, for short) solution by the standard trick of a double Wick rotation. This solution is characterized by five independent parameters. We show that compactification on six-dimensional hyperbolic space (H{sub 6}) of a time-dependent volume of this SD2 brane solution leads to accelerating cosmologies (for some time t ∝ t{sub 0}, with t{sub 0} some characteristic time) where both the expansions and the accelerations are different in three spatial directions of the resultant four-dimensional universe. On the other hand at early times (t << t{sub 0}) this four-dimensional space, in certain situations, leads to four-dimensional Kasner-like cosmology, with two additional scalars, namely, the dilaton and a volume scalar of H{sub 6}. Unlike in the standard four-dimensional Kasner cosmology here all three Kasner exponents could be positive definite, leading to expansions in all three directions. (orig.)

  16. Testing refined shell-model interactions in the sd shell: Coulomb excitation of Na26

    CERN Document Server

    Siebeck, B; Blazhev, A; Reiter, P; Altenkirch, R; Bauer, C; Butler, P A; De Witte, H; Elseviers, J; Gaffney, L P; Hess, H; Huyse, M; Kröll, T; Lutter, R; Pakarinen, J; Pietralla, N; Radeck, F; Scheck, M; Schneiders, D; Sotty, C; Van Duppen, P; Vermeulen, M; Voulot, D; Warr, N; Wenander, F

    2015-01-01

    Background: Shell-model calculations crucially depend on the residual interaction used to approximate the nucleon-nucleon interaction. Recent improvements to the empirical universal sd interaction (USD) describing nuclei within the sd shell yielded two new interactions—USDA and USDB—causing changes in the theoretical description of these nuclei. Purpose: Transition matrix elements between excited states provide an excellent probe to examine the underlying shell structure. These observables provide a stringent test for the newly derived interactions. The nucleus Na26 with 7 valence neutrons and 3 valence protons outside the doubly-magic 16O core is used as a test case. Method: A radioactive beam experiment with Na26 (T1/2=1,07s) was performed at the REX-ISOLDE facility (CERN) using Coulomb excitation at safe energies below the Coulomb barrier. Scattered particles were detected with an annular Si detector in coincidence with γ rays observed by the segmented MINIBALL array. Coulomb excitation cross sections...

  17. EFEKTIVITAS PENGEMBANGAN MEDIA PERMAINAN ULAR TANGGA SEBAGAI SARANA BELAJAR TEMATIK SD

    Directory of Open Access Journals (Sweden)

    Moch. Chabib

    2017-07-01

    Full Text Available Playing by learning is a way of learning that appropriate with the characteristics of elementary school children today. Which (1 Start of critical thinking. (2 Start emerging competition between friends. (3 Having a deep curiosity. (4 Love asked and (5 Likes groups. This is supported by the results of the field observations showed that when the class is still a lot of students were busy playing and tend to be passive, when the teacher was giving a lesson. Traditional game of snakes and ladders is familiar with elementary school children. Therefore we need a through study on how to take advantage of this game help the studen learning, so it is can solve the problem of declining motivation and involvement of the student in the classroom. Bermain sambil belajar merupakan sebuah pendekatan pembelajaran yang sangat sesuai dengan karakteristik belajar anak SD saat ini, yaitu (1 mulai berpikir kritis, (2 mulai muncul persaingan antar teman, (3 mempunyai rasa ingin tahu yang mendalam, (4 suka bertanya, dan (5 suka berkelompok. Hal ini didukung dengan hasil pengamatan di lapangan yang menunjukkan bahwa ketika dikelas masih banyak siswa yang asyik bermain dan cenderung pasif, padahal guru sedang memberikan penjelasan.Permainan ular tangga merupakan permainan tradisional yang sudah akrab dengan anak SD. Oleh karena itu, diperlukan sebuah kajian yang mendalam tentang bagaimana cara memanfaatkan permainan ini dalam pembelajaran sehingga dapat mengatasi masalah tentang menurunnya motivasi dan keaktifan siswa di kelas.

  18. Level density of the sd-nuclei-Statistical shell-model predictions

    Science.gov (United States)

    Karampagia, S.; Senkov, R. A.; Zelevinsky, V.

    2018-03-01

    Accurate knowledge of the nuclear level density is important both from a theoretical viewpoint as a powerful instrument for studying nuclear structure and for numerous applications. For example, astrophysical reactions responsible for the nucleosynthesis in the universe can be understood only if we know the nuclear level density. We use the configuration-interaction nuclear shell model to predict nuclear level density for all nuclei in the sd-shell, both total and for individual spins (only with positive parity). To avoid the diagonalization in large model spaces we use the moments method based on statistical properties of nuclear many-body systems. In the cases where the diagonalization is possible, the results of the moments method practically coincide with those from the shell-model calculations. Using the computed level densities, we fit the parameters of the Constant Temperature phenomenological model, which can be used by practitioners in their studies of nuclear reactions at excitation energies appropriate for the sd-shell nuclei.

  19. Geology of the USW SD-9 drill hole, Yucca Mountain, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    Engstrom, D.A. [Spectra Research Inst., Albuquerque, NM (United States); Rautman, C.A. [Sandia National Labs., Albuquerque, NM (United States)

    1996-10-01

    Drill hole USW SD-9 is one of several holes drilled under Site Characterization Plan Study as part of the characterization program at Yucca Mountain, Nevada, which has been proposed as the potential location of a repository for high-level nuclear waste. The SD-9 drill hole is located in the northern part of the potential repository area. Quantitative and semiquantitative data are included in this report for cover recovery, rock-quality designation (RQD), lithophysal cavity abundance, and fracturing. These data are spatially variable, both within and among the major formational-level stratigraphic units. Nonwelded intervals in general exhibit higher recoveries and more intact (higher) RQD values than welded intervals. The most intact, highest-RQD materials encountered within the Topopah Spring belong to the lower 33.3 ft of the middle nonlithophysal zone. This report includes quantitative data for the framework material properties of porosity, bulk and particle density, and saturated hydraulic conductivity. Graphical analysis of variations in these laboratory hydrologic properties indicates first-order control of material properties by the degree of welding and the presence of zeolite minerals. Many major lithostratigraphic contacts are not well expressed in the material-property profiles; contacts of material-property units are related more to changes in the intensity of welding. Approximate in-situ saturation data of samples preserved immediately upon recovery from the hole are included in the data tabulation.

  20. Complex dynamics of an archetypal self-excited SD oscillator driven by moving belt friction

    Science.gov (United States)

    Zhi-Xin, Li; Qing-Jie, Cao; Léger, Alain

    2016-01-01

    We propose an archetypal self-excited system driven by moving belt friction, which is constructed with the smooth and discontinuous (SD) oscillator proposed by the Cao et al. and the classical moving belt. The moving belt friction is modeled as the Coulomb friction to formulate the mathematical model of the proposed self-excited SD oscillator. The equilibrium states of the unperturbed system are obtained to show the complex equilibrium bifurcations. Phase portraits are depicted to present the hyperbolic structure transition, the multiple stick regions, and the friction-induced asymmetry phenomena. The numerical simulations are carried out to demonstrate the friction-induced vibration of multiple stick-slip phenomena and the stick-slip chaos in the perturbed self-excited system. The results presented here provide an opportunity for us to get insight into the mechanism of the complex friction-induced nonlinear dynamics in mechanical engineering and geography. Project supported by the National Natural Science Foundation of China (Grant Nos. 11372082 and 11572096) and the National Basic Research Program of China (Grant No. 2015CB057405).

  1. Balance measures for discriminating between functionally unstable and stable ankles.

    Science.gov (United States)

    Ross, Scott E; Guskiewicz, Kevin M; Gross, Michael T; Yu, Bing

    2009-02-01

    To identify force plate measures that discriminate between ankles with functional instability and stable ankles and to determine the most accurate force plate measure for enabling this distinction. Twenty-two subjects (177 +/- 10 cm, 77 +/- 16 kg, 21 +/- 2 yr) without a history of ankle injury and 22 subjects (177 +/- 10 cm, 77 +/- 16 kg, 20 +/- 2 yr) with functional ankle instability (FAI) performed a single-leg static balance test and a single-leg jump-landing dynamic balance test. Static force plate measures analyzed in both anterior/posterior (A/P) and medial/lateral (M/L) directions included the following: ground reaction force (GRF) SD; center-of-pressure (COP) SD; mean, maximum, and total COP excursion; and mean and maximum COP velocity. COP area was also analyzed for static balance. A/P and M/L time to stabilization quantified dynamic balance. Greater values of force plate measures indicated impaired balance. A stepwise discriminant function analysis examined group differences, group classification, and accuracy of force plate measures for discriminating between ankle groups. The FAI group had greater values than the stable ankle group for A/P GRF SD (P = 0.027), M/L GRF SD (P = 0.006), M/L COP SD (P = 0.046), A/P mean COP velocity (P = 0.015), M/L mean COP velocity (P = 0.016), A/P maximum COP velocity (P = 0.037), M/L mean COP excursion (P = 0.014), M/L total COP excursion (P = 0.016), A/P time to stabilization (P = 0.011), and M/L time to stabilization (P = 0.040). M/L GRF SD and A/P time to stabilization had the greatest accuracy scores of 0.73 and 0.72, respectively. Although 10 measures identified group differences, M/L GRF SD and A/P time to stabilization were the most accurate in discriminating between ankle groups. These results provide evidence for choosing these GRF measures for evaluating static and dynamic balance deficits associated with FAI.

  2. Elastic Stable Intramedullary Nailing for Treatment of Pediatric Tibial Fractures

    Directory of Open Access Journals (Sweden)

    Sandeep Gurung

    2016-06-01

    Full Text Available Introduction: Tibia fractures in the skeletally immature patient can usually be treated with above knee cast or patellar tendon bearing cast. The purpose of our study was to evaluate epidemiology and outcome of Elastic stable intramedullary nailing fixation of pediatric tibial shaft fractures treated at our institution. Methods: Over a period of one year, fifty pediatric patients of tibial shaft fractures, with average age of 9.68 yr (SD=2.37, were treated with elastic stable intramedullary nail. Demographic data, union and complication rate were evaluated. Results: There were 36 closed and 14 open fractures. The average time to union was 11.6 weeks  (SD=2.65 for close and  14.3 weeks (SD=2.62 for open fracture. There were no instances of growth arrest, remanipulations, or refracture. Conclusion: We conclude that flexible intramedullary fixation is an easy and effective method of management of both open and closed unstable fractures of the tibia in children.

  3. Formulation of stable protein powders by supercritical fluid drying

    NARCIS (Netherlands)

    Jovanović, N.

    2007-01-01

    Protein pharmaceuticals are potent drugs for the treatment of several chronic and life-threatening diseases. However, the complex and sensitive nature of protein molecules requires special attention in the development of stable dosage forms. Developing stable aqueous protein formulations is often a

  4. PENGEMBANGAN SSP TEMATIK-INTEGRATIF UNTUK MEMBANGUN KARAKTER DISIPLIN DAN KREATIF SISWA KELAS I SD

    Directory of Open Access Journals (Sweden)

    Wawan Wahyu Setyawan

    2015-01-01

    DEVELOPING THEMATIC-INTEGRATED SSP FOR BUILDING THE CHARACTERS OF DISCIPLINE AND CREATIVE OF GRADE I STUDENT ELEMENTARY SCHOOL ABSTRACT This study aims to produce integrated learning sets in the form of thematic SSP that can develop the characters of discipline and creative of grade I students of elementary school.This was a research and development study consisting of seven steps, namely: preliminary study and data collection, planning, product draft development, preliminary field tryout, revision of the tryout result, field tryout, product finalization based the field tryout result, field implementation testing, final product finalization, and dissemination. The developed SSP was evaluated by a science subject expert to assess the validity. The tryout subjects comprised 82 students consisting of 26 students of SD Baran, Pundong, Bantul, DIY in the small-scale tryout, 25 students in the control class of SD Manding Tengah, Bantul, DIY and 31 students in the experimental class of SD 1 Tulung, Bantul, DIY. The results of this study are in the form of SSP consisting of: a syllabus, lesson plans, course sheets, student worksheets, and evaluation sheets. The results of the evaluation show that the developed syllabus is good score of 47. The developed lesson plans score of 67, student course sheets score of 65, student worksheets score of 47, and assessment instruments, are very good , while the developed learning media are good score of 66. The results of the tryout show that the developed SSP otherwise meet the criteria for the practical views of teacher assessment score of 281 and a score of 730 student responses. In field trials the results obtained for the control class average pretest score of 70.8 and an average posttest score of 80.8. While the experimental class scored an average of 74.1 pretest and posttest score of 90.9. Improved control class scores of 10 and an increase of 16.8 experimental class. Teaching using developed SSP is capable of developing

  5. The trade-off between DES and SD in modelling military manpower

    Directory of Open Access Journals (Sweden)

    Nethal K. Jajo

    2015-04-01

    Full Text Available Operations research techniques have been used widely in simulating the dynamics of workforce systems. Discrete Event Simulation (DES and System Dynamics (SD are among the techniques that have been increasingly used in modelling military workforces. In the last five years, DES has seen more interest in modelling both career management and the training pipeline. Two significant reasons for this are discussed in this paper. This article presents some notes in comparing the two techniques in modelling military workforce. The study found that DES is an appealing method in workforce modelling, especially with a small size population, as it more easily accommodates new personnel attributes and prevents the fractionalisation of personnel through the system.

  6. Intercomparison of natural radionuclide measurements in marine sediment sample SD-N-1/2

    International Nuclear Information System (INIS)

    1985-06-01

    This intercomparison exercise was organized with the aim of providing to the participating laboratories a possibility of testing the performance of their analytical methods and to acquire basic data for establishing reference values for a number of natural radionuclides in the sediment material SD-N-1/2 from the North Sea floor. In tables are presented results expressed in mBq.g -1 on potassium, uranium isotopes, thorium-232 with the respective decay products, thorium-230, radium-226 and lead-210. Altogether 98 laboratories from 42 Member States joined this intercomparison. The results show generally good agreement, but more analytical work is needed to improve the present status of the lead-210 certification. Gamma and alpha spectroscopy were the most frequently used as the analytical techniques

  7. Charge radii of magnesium isotopes by laser spectroscopy a structural study over the $sd$ shell

    CERN Multimedia

    Schug, M; Krieger, A R

    We propose to study the evolution of nuclear sizes and shapes over the magnesium chain by measuring the root-mean-square charge radii of $^{21 - 32}$Mg, essentially covering the entire $\\textit{sd}$ shell. Our goal is to detect the structural changes, which in the neutron-deficient isotopes may originate from clustering, in a way similar to neon, and on the neutron-rich side would characterize the transition to the "island of inversion". We will combine, for the first time, the sensitive $\\beta$-detection technique with traditional fluorescence spectroscopy for isotope-shift measurements and in such a way gain access to the exotic species near the ${N}$ = 8 and ${N}$ = 20 shell closures.

  8. Source identification in acoustics and structural mechanics using Sierra/SD.

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, Timothy Francis; Aquino, Wilkins [Duke University Durham, NC; Ross, Michael

    2013-03-01

    In this report we derive both time and frequency-domain methods for inverse identification of sources in elastodynamics and acoustics. The inverse/design problem is cast in a PDE-constrained optimization framework with efficient computation of gradients using the adjoint method. The implementation of source inversion in Sierra/SD is described, and results from both time and frequency domain source inversion are compared to actual experimental data for a weapon store used in captive carry on a military aircraft. The inverse methodology is advantageous in that it provides a method for creating ground based acoustic and vibration tests that can reduce the actual number of flight tests, and thus, saving costs and time for the program.

  9. Penelitian tentang ukuran acuan sepatu pelajar pria Indonesia tingkat SD, SLTP dan SLTA

    Directory of Open Access Journals (Sweden)

    Sri Bandi

    1994-08-01

    Full Text Available The study was subjected to 500 Indonesia School boy of North- Sumatra Province (Medan, West Java Province (Bandung, Central-Java Province (Semarang, East-Java Province (Surabaya and DKI Jaya. 100 samples of foot sizes which represented foot sizes of SD, SLTP, and SLTA School boy werw taken from each province. By analyzing the data of foot sizes of the school man, a suggestion on design of shoe lasts seritable with the shape and type of foot, fits and conform the requirements to be used as lost in shoe manufacturing could be proposed. The results of data analyse shown that : 1. The length of soles ranged from 30-37 ps, the mean of which was 34 ps. 2. Instep girth ranged withim F,G,H,I,J,K. 3. The foot sizes scattered between (8-12 years of age at (31-32 ps.

  10. Rydberg states of the SH(SD) radical revealed by multiphoton ionization spectroscopy

    Science.gov (United States)

    Ashfold, M. N. R.; Tutcher, B.; Western, C. M.

    Three hitherto uncharacterized Rydberg states of the SD radical, each arising from a … 5σ22π24p1 ← … 5σ22π3 electronic promotion, have been identified through analysis of the rotationally structured two photon resonance enhancements each provides to the multiphoton ionization spectrum of this species. One, possessing 2Σ- symmetry, had actually been observed (but not recognized as such) in an earlier absorption study. The others, of 2Π and 2Φ symmetry, have not been reported previously. The SH radical was also observed to exhibit fragmentary rotational structure in the wavelength regions of the 2Σ--X2Π and 2Φ-X2Π transitions. The results provide strong support for the ab initio theoretical analysis of the vertical electronic spectrum of the mercapto radical by Bruna and Hirsch (1987, Molec. Phys., 61, 1359).

  11. Penelitian tentang ukuran acuan sepatu pelajar wanita indonesia tingkat SD, SLTP dan SLTA

    Directory of Open Access Journals (Sweden)

    Sri Bandi

    1995-06-01

    Full Text Available The study was subjected to 500 Indonesia School girls from North Sumatra Province (Medan, West Java Province (Bandung, Central – Java Province (Semarang, East-Java Province (Surabaya and DKI Jaya. 100 samples of foot sizes which represented foot sizes of SD, SLTP and SLTA School girls werw taken from each province. By analyzing the data of foot sizes of the school girls, a suggestion on design of shoe lasts seritable with the shape and type of foot, fits and conform the requirements to be used as lost in shoe manufacturing could be proposed. The results of data analyse shown that : 1. The length of soles ranged from 30-35, 5 PS, the mean of which was 33 PS. 2. Instep girth ranged withim E, F, G, I.3. The foot sizes scattered between (4-17 years of age at (32-35 PS.

  12. KEEFEKTIFAN MULTIMEDIA BERBASIS KOMPUTER UNTUK PEMBELAJARAN ILMU PENGETAHUAN SOSIAL KELAS IV SD PERCOBAAN II DEPOK SLEMAN

    Directory of Open Access Journals (Sweden)

    Sri Budyartati

    2016-11-01

    Full Text Available This research aims at: (1 identifying the effecteiveness of multi media-based learning on Social Science; (2 describing the attractiveness of multi media-based learning on Social Science; which is carried out at SD Percobaan II Caturtunggal Depok Sleman Yogyakarta, term 2007/2008. The research design is pretest-posttest control group design. The data are drwan through tests which are analized quantitatively; and questionaire to measure the attractiveness of multimedia-based learning model, which will be analized qualitatavely. The treatment is carried out out by using storyboard, which is approved by experts of multimedia and teaching method. The result of the analysis shows that multi media-based learning model significantly influence the students’ achievement in Social Science. While the attractivemess of multi media-based learning relatively high, which is shown by 4.2 of average (in 1-5 scale measure.

  13. Sustainable development business case report : renewable electricity generation : SD business case

    International Nuclear Information System (INIS)

    2005-11-01

    This investment report is the first in a series that will be released by Sustainable Development Technology Canada as part of the SD Business Case. It focuses primarily on generating electricity from renewable energy sources and examines 4 primary technology groups or sub-sectors including wind generated electricity; solar PV generated electricity; stationary fuel cell generated electricity; and electricity generated from biological sources. Each sub-sector has been assessed in terms of its market dynamics, technology makeup and conditions, sustainability impacts, and investment risk. A selection of the leading technologies in each technology area are brought forward and rated in terms of their respective investment potential. The report first presents an overview of the SD business case plan. It defines the primary audience of the report, lists the sectors and investment categories to be assessed by the business case and provides some background information on Sustainable Development Technology Canada. The report presents the framework for data collection and analysis and an executive summary of the complete report. It then presents the results of the market assessment report for each of the 4 sectors. This includes demand, infrastructure renewal, environmental commitments, renewable energy value proposition, and future market potential. The section covering the technology assessment report discusses the various technologies and ranks them. The sustainability assessment report section provides an economic, environmental and societal assessment of each sub-sector. Risk assessment is conducted in terms of technology and non-technology related risk. Last, the report presents conclusions and investment priorities. 11 tabs., 7 figs

  14. Peningkatan Pengetahuan Dan Keterampilan Guru SD Muhammadiyah 4 Batu Dalam Mengelola Pembelajaran ABK melalui Lesson Study

    Directory of Open Access Journals (Sweden)

    Endang Poerwanti

    2015-08-01

    Full Text Available Anak-anak dengan kebutuhan khusus (ABK yang dikenal sebagai anak-anak cacat, atau anak-anak yang luar biasa, anak-anak yaitu yang menyimpang secara signifikan dari kriteria normal, baik dari aspek fisik, psikologis, emosional dan sosial. Mulai tahun 2001, pemerintah mulai program pendidikan inklusif, pendidikan inklusif adalah untuk memasukkan anak-anak dengan kebutuhan khusus belajar bersama dengan anak normal di kelas dan sekolah reguler. Masalahnya, guru di sekolah reguler tidak berpendidikan dan dipersiapkan khusus untuk mengelola proses belajar mengajar untuk ABK. Masalah juga dialami oleh SD Muhammadiyah 4 Batu, untuk membantu memecahkan masalah tim FKIP menerapkan aktivitas Lesson Study untuk meningkatkan pengetahuan guru dan keterampilan dalam mengelola ABK pembelajaran individual Lesson study yang dilakukan dalam tiga siklus yang dikemas dalam tiga model pembelajaran; ABK belajar sendiri di kelas khusus, pengajaran dan pembelajaran di kelas reguler dan pengajaran dan pembelajaran ABK di kelas reguler dengan bantuan GPK. Setiap siklus terdiri dari beberapa kegiatan. Studi pelajaran terdiri dari empat kegiatan yang disingkat PDCA; P (rencana atau perencanaan, D (lakukan adalah pelaksanaan pembelajaran oleh seorang guru sebagai model dan diamati oleh guru lainnya, C (cek merupakan cerminan dari perbaikan lebih lanjut proses pembelajaran, dan A (tindak adalah tindak lanjut.  Dari tiga tahapan pelaksanaan proses belajar mengajar ABK dapat memberikan manfaat bagi para guru untuk meningkatkan pemahaman dan keterampilan untuk mengelola pembelajaran untuk ABK. Melalui Lesson Study diharapkan ABK mendapatkan layanan yang tepat dan belajar yang optimal. Beberapa temuan dampak pada perilaku siswa di kelas adalah bahwa siswa dapat menerima keberadaan ABK di. Meskipun keterbatasan kelas fasilitas guru mendapatkan pengalaman berharga yang terkait dengan pengembangan pembelajaran melalui forum ABK Lesson Study. Jadi kebutuhan untuk pelaksanaan tindak

  15. Validated automatic segmentation of AMD pathology including drusen and geographic atrophy in SD-OCT images.

    Science.gov (United States)

    Chiu, Stephanie J; Izatt, Joseph A; O'Connell, Rachelle V; Winter, Katrina P; Toth, Cynthia A; Farsiu, Sina

    2012-01-05

    To automatically segment retinal spectral domain optical coherence tomography (SD-OCT) images of eyes with age-related macular degeneration (AMD) and various levels of image quality to advance the study of retinal pigment epithelium (RPE)+drusen complex (RPEDC) volume changes indicative of AMD progression. A general segmentation framework based on graph theory and dynamic programming was used to segment three retinal boundaries in SD-OCT images of eyes with drusen and geographic atrophy (GA). A validation study for eyes with nonneovascular AMD was conducted, forming subgroups based on scan quality and presence of GA. To test for accuracy, the layer thickness results from two certified graders were compared against automatic segmentation results for 220 B-scans across 20 patients. For reproducibility, automatic layer volumes were compared that were generated from 0° versus 90° scans in five volumes with drusen. The mean differences in the measured thicknesses of the total retina and RPEDC layers were 4.2 ± 2.8 and 3.2 ± 2.6 μm for automatic versus manual segmentation. When the 0° and 90° datasets were compared, the mean differences in the calculated total retina and RPEDC volumes were 0.28% ± 0.28% and 1.60% ± 1.57%, respectively. The average segmentation time per image was 1.7 seconds automatically versus 3.5 minutes manually. The automatic algorithm accurately and reproducibly segmented three retinal boundaries in images containing drusen and GA. This automatic approach can reduce time and labor costs and yield objective measurements that potentially reveal quantitative RPE changes in longitudinal clinical AMD studies. (ClinicalTrials.gov number, NCT00734487.).

  16. [Choroidal thickness assessment with SD-OCT in high myopia with dome-shaped macula].

    Science.gov (United States)

    Chebil, A; Ben Achour, B; Chaker, N; Jedidi, L; Mghaieth, F; El Matri, L

    2014-03-01

    To measure macular choroidal thickness (CT) using spectral-domain optical coherence tomography (SD-OCT) in highly myopic eyes with dome-shaped macula (DSM), and to investigate whether the choroid is thicker in these eyes compared to highly myopic eyes without MB. A cross-sectional study of 200 eyes was performed between January 2010 and June 2012. Twenty-four highly myopic eyes (12%) had a dome-shaped macula. All patients underwent a complete ophthalmological examination, SD-OCT (TOPCON 2000), and B-scan ultrasonography. OCT scans were analyzed in 7 sections, and subfoveal CT was measured manually between the Bruch's membrane and the internal aspect of the sclera. The 20 eyes with isolated dome-shaped macular were paired by age and axial length (AL) with 20 eyes without macular involvement. In the subgroup with isolated MB, the mean subfoveal CT was 101.86 μm (± 21.35 μm). A statistically significant negative correlation was found between CT and AL (r=-0.623, P=0.0001). The regression equation demonstrated a decrease of 8.3 μm per mm of AL. In the subgroup without MB, matched with the subgroup with MB by age (P=0.591), and AL (P=0.815), the mean subfoveal CT was 89.54 μm (± 20.12 μm). The comparison between the two subgroups found a statistically significant difference in subfoveal CT (Pmacula compared to highly myopic eyes without dome-shaped macula. These findings suggest that abnormalities of the choroid may play a role in the pathogenesis of dome-shaped macula. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  17. Lactogenic Activity of an Enzymatic Hydrolysate from Octopus vulgaris and Carica papaya in SD Rats.

    Science.gov (United States)

    Cai, Bingna; Chen, Hua; Sun, Han; Sun, Huili; Wan, Peng; Chen, Deke; Pan, Jianyu

    2015-11-01

    The traditional Chinese medicine theory believes that octopus papaya soup can stimulate milk production in lactating women. The objective of this study was to determine whether dietary supplementation with an enzymatic hydrolysate of Octopus vulgaris and Carica papaya (EHOC) could increase milk production and nutritional indexes in Sprague Dawley (SD) rats. Female SD rats (n = 24) were fed a control diet (n = 8), EHOC-supplemented diet, or a positive control diet (Shengruzhi) from day 10 of pregnancy to day 10 of lactation. Maternal serum, mammary gland (day 10 of lactation), milk, and pup weight (daily) were collected for analysis. Results showed that the EHOC diet obviously elevated daily milk yield and pup weight compared to the control group (P < .05). The EHOC diet was found to increase the concentration of prolactin (PRL), progesterone (P), estradiol (E2), and growth hormone (GH) significantly in the circulation and mammary gland. Mammary glands of EHOC-treated dams showed clear lobuloalveolar development and proliferation of myoepithelial cells, but no striking variations were observed among the groups. Furthermore, the nutrition content and immune globulin concentration in the milk of EHOC-supplemented dams were higher than those of the control group, especially the cholesterol, glucose, and IgG were higher by 44.98% (P < .001), 42.76% (P < .01), and 42.23% (P < .01), respectively. In conclusion, this article demonstrates that EHOC administration has beneficial effects on milk production in the dams and on performance of the dam and pup. These results indicate that EHOC could be explored as a potentially lactogenic nutriment for lactating women.

  18. Repetitive methylphenidate administration modulates the diurnal behavioral activity pattern of adult female SD rats.

    Science.gov (United States)

    Lee, Min J; Yang, Pamela B; Wilcox, Victor T; Burau, Keith D; Swann, Alan C; Dafny, Nachum

    2011-02-01

    Diurnal rhythms influence many of the physiological processes that act to maintain homeostasis of the body in response to different environmental changes. Thus, disturbances in diurnal rhythms can lead to various physiological complications. Repeated exposure to psychostimulants may cause long-term effects by disturbing diurnal rhythms. The aim of the present study is to use the open field assay to determine whether repeated exposure to the psychostimulant methylphenidate (MPD) changes diurnal locomotor activity patterns of female adult Sprague-Dawley (SD) rats. As much as 31 female adult SD rats were divided into four groups. On experimental day (ED) 1, all groups were given an injection of saline. On ED 2-7, animals were injected once a day with either saline, or 0.6 mg/kg MPD, or 2.5 mg/kg MPD, or 10 mg/kg MPD depending on the group. On ED 8-10, no injections were given (washout period). On ED 11, animals were treated as they were on ED 2-7. Locomotor movements were recorded using a computerized animal activity monitoring system. The horizontal activity (HA), total distance traveled (TDT), and number of stereotypies (NOS) were analyzed by cosine curve statistical analysis (CCSA) test. The HA and TDT diurnal rhythm activity patterns of ED 2, 7, 8, and 11 were significantly different (p < 0.05) from the control recording of ED 1 according to the CCSA test. The observation obtained in this study suggests that repeated administration of MPD (all doses tested) is able to change diurnal locomotor patterns, which indicates that chronic MPD treatment exerts long-term effects.

  19. INTERVENSI ERGONOMI DALAM PEMBELAJARAN SAINS MENGURANGI KELUHAN MUSKULOSKELETAL SISWA SD 1 SANGSIT KECAMATAN SAWAN KABUPATEN BULELENG

    Directory of Open Access Journals (Sweden)

    Nyoman Wijana

    2014-09-01

    Full Text Available Tujuan penelitian ini adalah untuk mengetahui peranan intervensi ergonomi dalam pembelajaran sains untuk menurunkan keluhan muskuloskeletal siswa SD. Jenis penelitian ini termasuk jenis penelitian quasi eksperimental dengan rancangan randomized pre-test and post-test control group design. Pada kelompok kontrol pembelajarannya dengan cara konvensional (tanpa intervensi ergonomi dan kelompok eksperimen dengan intervensi ergonomi. Intervensi ergonomi dalam pembelajaran sains mengacu pada pendekatan ergonomi (PE yakni gabungan antara SHIP dan TTG. Implementasi dari hal ini adalah melakukan perbaikan dan atau penataan terhadap instrumental input, environmental input dan porcess, sedangkan untuk di kelompok kontrol tidak dilakukan intervensi ergonomi, di mana kondisi instrumental input, environmental input dan process berlangsung secara konvensional. Pengambilan sampel dilakukan secara random. Analisis data dilakukan dengan menggunakan uji Mann-Whitney dengan taraf signifikansi 5 %. Simpulan dari hasil penelitian ini adalah (1 intervensi ergonomi dapat menurunkan keluhan muskuloskeletal siswa SD  (p < 0,05; (2 Hasil pengukuran dengan nordic body map pada kelompok kontrol terjadi keluhan pada otot pinggang (86,1%, otot pantat (86,1%, otot punggung (84,8%, otot lengan atas kiri (78,8%, otot lengan atas kanan (67,9%, otot siku kanan (78,2%, otot siku kiri (74,6%, paha kanan (76,9%, paha kiri (75,7%, otot betis kanan  (66,1%, otot betis kiri (64,2%, otot pergelangan kaki kanan (67,3%, dan otot pergelangan kaki kiri (65,5%. Dengan demikian dapat disarankan bahwa intervensi ergonomi dalam pembelajaran dengan menggunakan PE sebaiknya diterapkan dalam pembelajaran sains di SD karena telah terbukti dapat menurunkan keluhan muskuloskeletal.[MEDICINA 2009;40:11-20].  

  20. Quantitative analysis of N-glycans from human alfa-acid-glycoprotein using stable isotope labeling and zwitterionic hydrophilic interaction capillary liquid chromatography electrospray mass spectrometry as tool for pancreatic disease diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Giménez, Estela, E-mail: estelagimenez@ub.edu [Department of Analytical Chemistry, University of Barcelona, Diagonal 647, E-08028 Barcelona (Spain); Balmaña, Meritxell [Biochemistry and Molecular Biology Unit, Department of Biology, University of Girona, Campus Montilivi s/n, 17071 Girona (Spain); Figueras, Joan [Department of Surgery, Dr. Josep Trueta University Hospital, IdlBGi, 17007 Girona (Spain); Fort, Esther [Digestive Unit, Dr. Josep Trueta University Hospital, 17007 Girona (Spain); Bolós, Carme de [Gastroesophagic Cancer Research Group, Research Programme in Cancer, Hospital del Mar Medical Research Institute (IMIM), Dr. Aiguader, 88, 08003 Barcelona (Spain); Sanz-Nebot, Victòria [Department of Analytical Chemistry, University of Barcelona, Diagonal 647, E-08028 Barcelona (Spain); Peracaula, Rosa [Biochemistry and Molecular Biology Unit, Department of Biology, University of Girona, Campus Montilivi s/n, 17071 Girona (Spain); Rizzi, Andreas [Institute of Analytical Chemistry, University of Vienna, Währinger Straße 38, A-1090 Vienna (Austria)

    2015-03-25

    Highlights: • The method enables relative quantitation of hAGP glycans from pathological samples • Pancreatic cancer samples clearly showed an increase of hAGP fucosylated glycans. • Fucosylated glycans could be potential biomarkers for diagnosing pancreatic cancer. • The established method could be extremely useful to find novel glycoprotein biomarkers - Abstract: In this work we demonstrate the potential of glycan reductive isotope labeling (GRIL) using [{sup 12}C]- and [{sup 13}C]-coded aniline and zwitterionic hydrophilic interaction capillary liquid chromatography electrospray mass spectrometry (μZIC-HILIC-ESI-MS) for relative quantitation of glycosylation variants in selected glycoproteins present in samples from cancer patients. Human α{sub 1}-acid-glycoprotein (hAGP) is an acute phase serum glycoprotein whose glycosylation has been described to be altered in cancer and chronic inflammation. However, it is not clear yet whether some particular glycans in hAGP can be used as biomarker for differentiating between these two pathologies. In this work, hAGP was isolated by immunoaffinity chromatography (IAC) from serum samples of healthy individuals and from those suffering chronic pancreatitis and different stages of pancreatic cancer, respectively. After de-N-glycosylation, relative quantitation of the hAGP glycans was carried out using stable isotope labeling and μZIC-HILIC-ESI-MS analysis. First, protein denaturing conditions prior to PNGase F digestion were optimized to achieve quantitative digestion yields, and the reproducibility of the established methodology was evaluated with standard hAGP. Then, the proposed method was applied to the analysis of the clinical samples (control vs. pathological). Pancreatic cancer samples clearly showed an increase in the abundance of fucosylated glycans as the stage of the disease increases and this was unlike to samples from chronic pancreatitis. The results gained here indicate the mentioned glycan in h

  1. Quantitative analysis of N-glycans from human alfa-acid-glycoprotein using stable isotope labeling and zwitterionic hydrophilic interaction capillary liquid chromatography electrospray mass spectrometry as tool for pancreatic disease diagnosis

    International Nuclear Information System (INIS)

    Giménez, Estela; Balmaña, Meritxell; Figueras, Joan; Fort, Esther; Bolós, Carme de; Sanz-Nebot, Victòria; Peracaula, Rosa; Rizzi, Andreas

    2015-01-01

    Highlights: • The method enables relative quantitation of hAGP glycans from pathological samples • Pancreatic cancer samples clearly showed an increase of hAGP fucosylated glycans. • Fucosylated glycans could be potential biomarkers for diagnosing pancreatic cancer. • The established method could be extremely useful to find novel glycoprotein biomarkers - Abstract: In this work we demonstrate the potential of glycan reductive isotope labeling (GRIL) using [ 12 C]- and [ 13 C]-coded aniline and zwitterionic hydrophilic interaction capillary liquid chromatography electrospray mass spectrometry (μZIC-HILIC-ESI-MS) for relative quantitation of glycosylation variants in selected glycoproteins present in samples from cancer patients. Human α 1 -acid-glycoprotein (hAGP) is an acute phase serum glycoprotein whose glycosylation has been described to be altered in cancer and chronic inflammation. However, it is not clear yet whether some particular glycans in hAGP can be used as biomarker for differentiating between these two pathologies. In this work, hAGP was isolated by immunoaffinity chromatography (IAC) from serum samples of healthy individuals and from those suffering chronic pancreatitis and different stages of pancreatic cancer, respectively. After de-N-glycosylation, relative quantitation of the hAGP glycans was carried out using stable isotope labeling and μZIC-HILIC-ESI-MS analysis. First, protein denaturing conditions prior to PNGase F digestion were optimized to achieve quantitative digestion yields, and the reproducibility of the established methodology was evaluated with standard hAGP. Then, the proposed method was applied to the analysis of the clinical samples (control vs. pathological). Pancreatic cancer samples clearly showed an increase in the abundance of fucosylated glycans as the stage of the disease increases and this was unlike to samples from chronic pancreatitis. The results gained here indicate the mentioned glycan in hAGP as a

  2. The Relationships between Polymorphisms in Genes Encoding the Growth Factors TGF-β1, PDGFB, EGF, bFGF and VEGF-A and the Restenosis Process in Patients with Stable Coronary Artery Disease Treated with Bare Metal Stent.

    Directory of Open Access Journals (Sweden)

    Tadeusz Osadnik

    Full Text Available Neointima forming after stent implantation consists of vascular smooth muscle cells (VSMCs in 90%. Growth factors TGF-β1, PDGFB, EGF, bFGF and VEGF-A play an important role in VSMC proliferation and migration to the tunica intima after arterial wall injury. The aim of this paper was an analysis of functional polymorphisms in genes encoding TGF-β1, PDGFB, EGF, bFGF and VEGF-A in relation to in-stent restenosis (ISR.265 patients with a stable coronary artery disease (SCAD hospitalized in our center in the years 2007-2011 were included in the study. All patients underwent stent implantation at admission to the hospital and had another coronary angiography performed due to recurrence of the ailments or a positive result of the test assessing the coronary flow reserve. Angiographically significant ISR was defined as stenosis >50% in the stented coronary artery segment. The patients were divided into two groups-with angiographically significant ISR (n = 53 and without significant ISR (n = 212. Additionally, the assessment of late lumen loss (LLL in vessel was performed. EGF rs4444903 polymorphism was genotyped using the PCR-RFLP method whilst rs1800470 (TGFB1, rs2285094 (PDGFB rs308395 (bFGF and rs699947 (VEGF-A were determined using the TaqMan method.Angiographically significant ISR was significantly less frequently observed in the group of patients with the A/A genotype of rs1800470 polymorphism (TGFB1 versus patients with A/G and G/G genotypes. In the multivariable analysis, LLL was significantly lower in patients with the A/A genotype of rs1800470 (TGFB1 versus those with the A/G and G/G genotypes and higher in patients with the A/A genotype of the VEGF-A polymorphism versus the A/C and C/C genotypes. The C/C genotype of rs2285094 (PDGFB was associated with greater LLL compared to C/T heterozygotes and T/T homozygotes.The polymorphisms rs1800470, rs2285094 and rs6999447 of the TGFB1, PDGFB and VEGF-A genes, respectively, are associated with LLL

  3. Adherence to Treatment, Safety, Tolerance, and Effectiveness of Perindopril/Amlodipine Fixed-Dose Combination in Greek Patients with Hypertension and Stable Coronary Artery Disease: A Pan-Hellenic Prospective Observational Study of Daily Clinical Practice.

    Science.gov (United States)

    Liakos, Charalampos I; Papadopoulos, Dimitrios P; Kotsis, Vasilios T

    2017-10-01

    Initiation of antihypertensive therapy with a two-drug fixed-dose combination (FDC) in a single tablet may be recommended in patients at high risk of cardiovascular events to improve adherence and effectiveness. Preferred combinations include an angiotensin-converting enzyme inhibitor with a dihydropyridine calcium antagonist. This study assessed adherence to and the safety, tolerance, and effectiveness of the perindopril/amlodipine FDC in Greek patients with hypertension and stable coronary artery disease (CAD) over a 4-month period. A total of 1907 patients with hypertension and CAD (59.1% males) who had recently (≤2 weeks) commenced treatment with the perindopril/amlodipine FDC (5/5, 5/10, 10/5, or 10/10 mg) were studied at baseline and at 1 and 4 months. Adherence to treatment was assessed with the Morisky Medication-taking Adherence Scale (MMAS). Seven patients (0.4%) did not attend the scheduled visits. In total, 1607 (84.6%) patients received a constant treatment dose throughout the study. High adherence (MMAS score = 0) was reported by 1592 (83.6%), 1628 (85.7%), and 1477 (77.7%) patients at the second and the third visit and at both visits, respectively. Adverse reactions were reported by only 13 (0.7%) patients, were all minor, and did not result in treatment discontinuation. Office blood pressure (BP) was significantly decreased at the third visit (130.8 ± 8.4/78.2 ± 6.4 mmHg) compared with baseline (156.5 ± 15.0/89.9 ± 9.6 mmHg; p < 0.001), regardless of previous antihypertensive treatment. Patients with grade 1, 2, and 3 hypertension at baseline showed a reduction in BP of 19.3/9.4, 31.5/13.5, and 47.8/22.2 mmHg, respectively (p < 0.001). Uncontrolled hypertension (≥140/90 mmHg) was notably reduced from 90.3% at baseline to 18.5% at the third visit. The perindopril/amlodipine FDC is characterized by high adherence and effectiveness, regardless of previous treatment. Degree of BP reduction was related to baseline BP levels

  4. Influence of horse stable environment on human airways

    Directory of Open Access Journals (Sweden)

    Pringle John

    2009-05-01

    Full Text Available Abstract Background Many people spend considerable amount of time each day in equine stable environments either as employees in the care and training of horses or in leisure activity. However, there are few studies available on how the stable environment affects human airways. This study examined in one horse stable qualitative differences in indoor air during winter and late summer conditions and assessed whether air quality was associated with clinically detectable respiratory signs or alterations to selected biomarkers of inflammation and lung function in stable personnel. Methods The horse stable environment and stable-workers (n = 13 in one stable were investigated three times; first in the winter, second in the interjacent late summer and the third time in the following winter stabling period. The stable measurements included levels of ammonia, hydrogen sulphide, total and respirable dust, airborne horse allergen, microorganisms, endotoxin and glucan. The stable-workers completed a questionnaire on respiratory symptoms, underwent nasal lavage with subsequent analysis of inflammation markers, and performed repeated measurements of pulmonary function. Results Measurements in the horse stable showed low organic dust levels and high horse allergen levels. Increased viable level of fungi in the air indicated a growing source in the stable. Air particle load as well as 1,3-β-glucan was higher at the two winter time-points, whereas endotoxin levels were higher at the summer time-point. Two stable-workers showed signs of bronchial obstruction with increased PEF-variability, increased inflammation biomarkers relating to reported allergy, cold or smoking and reported partly work-related symptoms. Furthermore, two other stable-workers reported work-related airway symptoms, of which one had doctor's diagnosed asthma which was well treated. Conclusion Biomarkers involved in the development of airway diseases have been studied in relation to

  5. Long Term Sorption Diffusion Experiment (LTDE-SD). Performance of main in situ experiment and results from water phase measurements

    Energy Technology Data Exchange (ETDEWEB)

    Widestrand, Henrik; Byegaard, Johan; Nilsson, Kersti; Hoeglund, Susanne; Gustafsson, Erik (Geosigma AB, Uppsala (Sweden)); Kronberg, Magnus (Swedish Nuclear Fuel and Waste Management Co. (Sweden))

    2010-12-15

    The LTDE-SD experiment, (Long Term Sorption Diffusion Experiment) aimed at increasing the scientific knowledge of sorption and diffusion under in situ conditions and to provide data for performance and safety assessment calculations. Performance and results of the in situ experiment phase are presented in the report. In total, 21 radionuclide trace elements and one stable trace element were injected, circulated and sampled for approx6.5 months in a closed borehole section. The trace elements represented non-sorbing tracers and sorbing tracers for which the sorption was dominated by a cation exchange mechanism, a surface complexation mechanism, or dependent on an electrochemical reduction in order to reach the tetravalent state (oxidation state IV) considered very strongly sorbing. The borehole section in contact with the tracer labelled groundwater consisted in part of a natural fracture surface and a borehole section in the unaltered matrix rock, devoid of natural fractures. Water samples were regularly extracted and analysed for trace element concentration and a few ion exchange speciation and filtered samplings were also conducted. Independent colloid filtering and chemical speciation calculations were performed in support the evaluation. Sorption was demonstrated for a series of elements present in the experiment. The amounts lost of the different respective tracers from the aqueous phase follow very well the general understanding of the relative sorption strength of the tracers, as inferred from e.g. batch sorption experiments and dynamic in situ tracer experiments. The chemical speciation calculations of the different tracers were in line with the results of the ion exchange speciation performed during the experiment. With the exception of UO{sub 2} 2+ carbonate complexes formed, no strong indications were obtained that aqueous complexation prevents adsorption under the chemical conditions of the experiment. The 20 nm filtered sampling indicated that

  6. Effect of fermented milk containing Lactobacillus rhamnosus SD11 on oral microbiota of healthy volunteers: A randomized clinical trial.

    Science.gov (United States)

    Rungsri, P; Akkarachaneeyakorn, N; Wongsuwanlert, M; Piwat, S; Nantarakchaikul, P; Teanpaisan, R

    2017-10-01

    The aims of this study were to evaluate whether short-term consumption of fermented milk containing Lactobacillus rhamnosus SD11 affected levels of oral microbiota in vivo and whether L. rhamnosus SD11 could colonize in the human mouth. We also monitored for potential side effects of the probiotic. The applicability of using L. rhamnosus SD11 compared with Lactobacillus bulgaricus as a starter culture for fermented milk was evaluated. After informed consent, 43 healthy young adults were recruited and randomly assigned to either the probiotic or control group and received fermented milk containing L. rhamnosus SD11 or L. bulgaricus, respectively, once daily for 4 wk. The numbers of mutans streptococci, lactobacilli, and total bacteria in saliva were counted at baseline and then after 4 and 8 wk. An oral examination was performed at baseline and after 8 wk. The persistence of L. rhamnosus SD11 was investigated by DNA fingerprinting using arbitrary primer-PCR. Results demonstrated that statistically significant reductions in mutans streptococci and total bacteria were observed in the probiotic group compared with the control group, and the number of lactobacilli was significantly increased in both groups after receiving fermented milks. Lactobacillus rhamnosus SD11 could be detected (in >80% of subjects) up to 4 wk following cessation of dosing among subjects in the probiotic group. No side effects were reported. Thus, L. rhamnosus SD11 could be used as a starter culture for fermented milk. Daily consumption of L. rhamnosus SD11-containing fermented milk for 4 wk may have beneficial effects on oral health by reducing salivary levels of mutans streptococci. The probiotic was apparently able to colonize the oral cavity for a longer time than previously reported. However, the potential benefits of probiotic L. rhamnosus SD11 on oral health require further evaluation with a larger group of volunteers in a longer-term study. Copyright © 2017 American Dairy Science

  7. Dynamical attraction to stable processes

    OpenAIRE

    Fisher, Albert M.; Talet, Marina

    2012-01-01

    We apply dynamical ideas within probability theory, proving an almost-sure invariance principle in log density for stable processes. The familiar scaling property (self-similarity) of the stable process has a stronger expression, that the scaling flow on Skorokhod path space is a Bernoulli flow. We prove that typical paths of a random walk with i.i.d. increments in the domain of attraction of a stable law can be paired with paths of a stable process so that, after applying a non-random regula...

  8. [Optical coherence tomography in eyes with senile retinoschisis : SD-OCT versus ultrasound examinations and assessment of the vitreoretinal interface].

    Science.gov (United States)

    Bringewatt, A; Burzer, S; Feucht, N; Maier, M

    2017-05-15

    In addition to ocular ultrasonography (US), spectral domain optical coherence tomography (SD-OCT) is available in order to diagnose senile retinoschisis (sRS). SD-OCT also allows for classification of posterior vitreous detachment (PVD) in healthy eyes. Reevaluation of the value and additional benefit of both imaging procedures. SD-OCT-based evaluation of PVD stages in sRS patients. Diagnostic results of 33 eyes in 26 patients with clinical suspicion of sRS were retrospectively analysed. All patients received a SD-OCT and a 10 MHz US examination of the region of interest (RoI). In 32 eyes the PVD stage was classified by SD-OCT using the description by Uchino et al. The vitreous position in peripheral SD-OCT scans with sRS was reviewed. SD-OCT confirmed sRS in 29 eyes. US examination identified sRS in 26 eyes. In 11 eyes, the examination results of the two methods differed. In 7 eyes sRS was identified by SD-OCT but not by US examination. US examination confirmed sRS in 4 eyes for which SD-OCT scans were not useful. Most cases of sRS were detected in temporal located retinal lesions. There was no significant difference between the results of both imaging procedures regarding the RoI (p = 0.64). SD-OCT provided additional information in 27 eyes. Four eyes did not present PVD. Early and intermediate stages of PVD were detected in 9 eyes, while 19 eyes showed complete PVD. In most cases, the vitreous could not be identified in the SD-OCT scans of the periphery. In clinical practice, neither SD-OCT nor US ensure an explicit finding of sRS in each eye with sRS. However, both methods positively complement one another and together they improve image-based diagnosis. All stages of PVD may be found in eyes with sRS. The contribution of the vitreous to the pathogenesis of sRS remains uncertain.

  9. High-sensitivity C-reactive protein and N-terminal pro-B-type natriuretic peptide in patients with stable coronary artery disease: a prognostic study within the CLARICOR Trial

    DEFF Research Database (Denmark)

    Harutyunyan, Marina J; Mathiasen, Anders B; Winkel, Per

    2011-01-01

    be prognostic biomarkers in patients with stable CAD. MATERIALS AND METHODS: During the 2.6-year follow-up period 270 patients among the 4264 patients with stable CAD in the CLARICOR trial suffered myocardial infarction (MI) and 377 died (187 cardiovascular deaths (CVD)). RESULTS: Serum NT......-proBNP was significantly associated with MI (hazard ratio (HR), 1. 65 (refers to a 2.72 fold increase in serum level, p = 0.0005), CVD (HR, 2.42, p ....0005) and non-CVD (HR, 1.66, p 20, p = 0.001), CVD (HR, 1.39, p

  10. PENGEMBANGAN PERANGKAT PEMBELAJARAN MATERI PECAHAN BERBASIS TEORI BRUNER DI KELAS IV SD LABSCHOOL UNESA

    Directory of Open Access Journals (Sweden)

    Lina Wijayanti

    2015-07-01

    Full Text Available Penelitian ini bertujuan untuk menghasilkan perangkat pembelajaran pada materi pecahan tema 3 berbasis teori Bruner ditinjau dari kualitas produk secara umum (kevalidan, kepraktisan, dan keefektifan dan dalam peningkatan kemampuan pemecahan masalah dan prestasi belajar peserta didik di kelas IV SD Labschool Unesa. Penelitian ini termasuk penelitian dan pengembangan yang menggunakan model yang dikembangkan oleh Borg & Gall. Subjek penelitian dalam uji coba terbatas berjumlah 4 siswa, sedangkan dalam uji coba lapangan berjumlah 8 siswa. Subjek uji coba produk operasional pada kelas eksperimen sebanyak 17 siswa dan kelas kontrol sebanyak 18 siswa. Pengumpulan data dalam penelitian ini menggunakan lembar penilaian produk perangkat pembelajaran, lembar observasi guru, lembar observasi peserta didik, tes hasil belajar, angket respon guru, dan agket respon peserta didik. Analisis data menggunakan independent sample t-test dengan taraf signifikansi 0,05. Hasil penelitian menunjukkan bahwa perangkat pembelajaran hasil pengembangan dinyatakan valid dengan kategori sebagai berikut: silabus berkategori baik, RPP berkategori sangat baik, tes hasil belajar berkategori baik, dan media berkategori sangat baik, sehingga rerata hasil semua perangkat pembelajaran adalah berkategori baik. Penerapan perangkat pembelajaran secara umum dapat terlaksana dengan baik. Berdasarkan hasil uji coba kelas eksperimen dan kelas kontrol, terdapat perbedaan yang signifikan pada ketercapaian hasil belajar sehingga perangkat pembelajaran dikatakan efektif, sedangkan untuk kemampuan pemecahan masalah dan prestasi belajar siswa yang mengikuti pembelajaran menggunakan perangkat pembelajaran berbasis teori Bruner hasil pengembangan mengalami peningkatan. Kata Kunci: perangkat pembelajaran, teori Bruner, kemampuan pemecahan masalah, prestasi belajar DEVELOPING TEACHING KIT BASED ON THE THEORY OF BRUNER IN GRADE FOUR STUDENTS OF SD LABSCHOOL UNESA Abstract This study aims to develop a

  11. SISTEM INFORMASI COMMUNICATION BOOK BERBASIS WEB (Studi Kasus : SD Salman Al Farisi Bandung

    Directory of Open Access Journals (Sweden)

    Fitriyani Fitriyani

    2016-03-01

    Full Text Available ABSTRAK Communication Book kini sudah menjadi istilah yang akrab di kalangan murid SD. Sebagian sekolah sudah menerapkannya sebagai sarana komunikasi antara guru dengan orangtua. Communication Book berbeda dengan rapor atau laporan reguler. Rapor dan laporan reguler biasanya diberikan pada jangka waktu tertentu, sedangkan communication book bisa digunakan kapan saja saat diperlukan. Misalnya untuk menyampaikan pengumuman yang berkaitan dengan kegiatan proses belajar-mengajar. Communication book ini bertujuan agar orangtua mengetahui kejadian di sekolah atau hal-hal yang memang harus diketahui orangtua. Misalnya, alat-alat apa yang harus dibawa anak pada hari tertentu, dan sebagainya. Namun sistem komunikasi ini masih bersifat konvensional, dimana guru menulis informasi mengenai kegiatan belajar siswa di communication book yang harus dibawa setiap hari oleh siswa, sehingga jika siswa lupa untuk membawa communication book, maka guru tidak dapat menulis informasi yang akan disampaikan. Sistem informasi ini bertujuan untuk membuat sistem informasi communication book secara online di SD Salman Al Farisi Bandung. Sistem yang dibuat berbasis PHP dan menggunakan MySQL sebagai databasenya. Sistem informasi communication book terdapat menu-menu yang dapat mendukung komunikasi antara guru dan orangtua seperti menu informasi, kegiatan, tugas, ujian, surat panggilan dan lain-lain. Diharapkan dengan penerapan sistem ini di SD Salman Al Farisi Bandung dapat membantu komunikasi secara online dan real time. Sistem informasi ini dimulai dengan merancang hubungan antara database dan proses bisnis yang terjadi di dalam web. Kemudian dilanjutkan dengan desain tampilan dan pembuatan program. Kata Kunci : Web, Php, Mysql, Communication Book. ABSTRACT The Communication book has now become a familiar term among the elementary school students. Some schools have implemented it as a means of communication between teachers and parents. Different the communication book with

  12. PEMBERDAYAAN ANAK SD DALAM UPAYA PENINGKATAN KONSUMSI GARAM BERYODIUM DI DESA APUAN KECAMATAN SUSUT KABUPATEN BANGLI

    Directory of Open Access Journals (Sweden)

    Tresna Adhi K

    2012-10-01

    Full Text Available Iodine deficiency disorder (IDD is the most single common cause of preventable mental retardation and brain damage in the world. It decreases child survival, causes goiters, and impairs growth and development. Apuan Village, Bangli Regency is categorized as endemic areas (TGR=20,3% according to the definition from Health Office reports of Bali Province in 2008. One of the approaches that might be worth considering in alleviating the problem is the empowerment of elementary school children in an effort to increase the consumption of iodized salt in household. This approach aimed at empowering children to provide information to their parents on iodized salt consumption. Community services activities were conducted from December 16 to 21 October 2010 in SD 1 and SD 3 Apuan involving 62 elementary school children. The main activities were the provision of knowledge and guidance to elementary school children about the benefits of iodized salt. The first phase of the activities consists of examining the level of iodine in salt. This phase was then followed by giving the students a pre-test prior to the guidance and a post-test after the guidance for measuring the level of improvement on knowledge of elementary school children about iodized salt. The second phase was conducted one week after the first phase by measuring the level of iodine in the household salt of the same respondents. Data were analyzed using descriptive and analytical by computer program. Results pre-test and post-tests showed an increase in the knowledge for good knowledge category (0% to 31%, and moderate knowledge category (3.2% to 40.3% and while a decrease in the limited knowledge category (96.8% to 9.7%. Statistical analysis showed significant differences (p <0.05. Test results that contain iodine salt showed increased percentage of 72.6% in the first phase to 96.7% in the second phase. It can be concluded that elementary school children might become a good initiator to improve

  13. DESCRIPTION OF THE NUTRITIONAL STATUS OF STUDENTS IN SD NEGERI 3 PELIATAN, SUBDISTRICT UBUD, GIANYAR

    Directory of Open Access Journals (Sweden)

    Ayu Indah Hapsari

    2013-10-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Elementary school student are the group of student that potentialy having problem with nutrition due to their eating patern and development status. The cases of malnutrition in Ubud is still highly noted even if Ubud is kown as well-developed subdistrict. The aimed of the study is to descript the nutritional status and other factors related to among the students of SD Negeri 3 Peliatan, Subdistrict Ubud, Gianyar. This study was done on August 19th 2011 until August 20th 2011 and the study design was a cross-sectional. Subjects were the grade 5th and 6th students with a total of 70 student, were chosen by quota sampling technique. Every subject was asked to administer questionnaire, to get the informaton on characteristic, eating pattern and breakfast habit. Antropometric measurements were done to gain the nutritional status of sampel. History of low birth weight was collected from the parents through administering self-administered questionnaires. The data was analysed descriptively. Result showed that subjects tend to have high malnutrition cases, in whom 25.7% were undernutrition and 24.3% were overnutrition 24.3%. Majority of subjects who have good nutritional status were those who admitted to have balanced eating pattern and breakfast habit. In addition, subjects with good nutrition status tended to have good academic scores and those with history of low birth weight seemed to have good and over nutritional status. As the students of SD Negeri 3 Peliatan seemed to have remarkable problem of malnutrition, it is suggested to inform their parents regarding the best eating pattern and to emphasize the importance of berakfast habit to achieve and maintain the good nutritional status for their children. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso

  14. Proses Berpikir Siswa SD dalam Melakukan Estimasi Masalah Berhitung Berdasarkan Jenis Kelamin

    Directory of Open Access Journals (Sweden)

    Muh. Rizal

    2013-01-01

    Full Text Available Abstract: The Thinking Process of Primary-school Students of Different Sexes in Estimating Arithmetic Problems. This case study is intended to explore the thinking process of the fifth-year students of different sexes in estimating arithmetic problems. Two students, one male and one female, belonging to the high achievers in a mathematics test were selected for the study and then interviewed, assigned to solve arithmetic problems, and finally asked to think aloud their thinking process. The study reveals that the thinking process of both the male and female subjects is in the form of accommodation as they ap­proached the arithmetic problems by repeatedly reading the tasks. Though employing the same thinking process, in the planning stage, the male subject made use of rounding and compatible number strategies, whereas the female one used only rounding strategy. In implementing the plan, the male subject em­ployed mental counting through assimilation, but the female one used algorithm through accommoda­tion. In the evaluating stage, the male subject traced back his work through mental counting, while the female one utilized reverse operations. Abstrak: Proses Berpikir Siswa SD dalam Melakukan Estimasi Masalah Berhitung Berdasarkan Jenis Kelamin. Penelitian ini ingin mendeskripsikan proses berpikir siswa laki-laki dan perempuan yang berkemampuan matematika tinggi dalam melakukan estimasi. Penelitian dilakukan di kelas V SD, dengan subjek satu siswa laki-laki dan satu siswa perempuan yang memiliki skor 75 ke atas dalam tes kemampuan matematika. Data dikumpulkan dengan wawancara, pemberian tes dan think aloud. Analisis dilakukan dengan menelaah seluruh data, reduksi data, pengolompokan data, kategorisasi, pengkodean, dan pemeriksaan kredibilitas data dengan triangulasi waktu. Hasil penelitian menunjukkan bahwa proses berpikir keduanya adalah akomodasi. Dalam membuat rencana, laki-laki menggunakan rounding dan compatible number strategy, sedangkan

  15. Membangun Karakter Siswa Melalui Kegiatan Intrakurikuler, Ekstrakurikuler, dan Hidden Curriculum di SD Budi Mulia Dua Pandeansari Yogyakarta

    Directory of Open Access Journals (Sweden)

    Prawidya Lestari

    2016-02-01

    Full Text Available STUDENUDENUDENUDENTS CHARACTERER BUILDINUILDINUILDINUILDINUILDINUILDING THROUGH HIDDEN CURRICULUM CURRICULUM , IN TRACURRICULER , AND EXTRACURRICUL AR ACTIVITY (Study In Sd Budi Mulia Dua Pandeansari Yogyakarta This article aimed to know how the SD Budi Mulia dua Pandeansari character education concept, how the implementation of character education through the hidden curriculum extracurricular, and intracurriculer activities, supporting factor and resistance from thWe implementation. This research is a field research. In the form of qualitative research that is analytically descriptive. The results of the study showed that: First, the concept of character education in SD Budi Mulia Dua Pandeansari on the fact of the matter into the hidden curriculum that is based on the vision, mission, and eight learning base. Second, implementation of character education in SD Budi Mulia Dua Pandeansari realized through extracurricular and intracurriculer activities, and school culture. In intracurriculer activities and extracurricular activities there are hidden curriculum that the verbal curriculum or written curriculum.

  16. Paper pulp modification and deinking efficiency of cellulase-xylanase complex from Escherichia coli SD5.

    Science.gov (United States)

    Vinod Kumar, N; Rani, Mary Esther; Gunaseeli, R; Kannan, N D

    2018-05-01

    Ligno-cellulosic enzymes like cellulase and xylanase have potential for modification of paper pulp characteristics. A low molecular weight cellulase - xylanase complex (14KDa) was co-produced using Escherichia coli SD5. Co-existence of these enzymes was found to be advantageous in paper pulp modification and in deinking applications. The cellulase and xylanase exhibited specific activities of 51.95 and 24.64U/mg protein of respectively. Defibrillations, crack formation and changes in functional groups was evident from the SEM and FT-IR analysis of paper pulp following the enzyme treatment. The enzyme facilitated a better reduction of Kappa number and Hexenuronic acid (Hex A) compared to earlier studies. A Δ brightness of approximately 10% were achieved in case of both cellulase and xylanase for different treatment time. The tear strength of recycled paper was also found to increase after the enzymatic treatment. This is the first report on the application of a un-engineered E. coli isolate co-producing cellulase-xylanase for paper industrial application. Copyright © 2017. Published by Elsevier B.V.

  17. Spectrum of {gamma} rays from the decay of SD to normal states in {sup 191}Hg

    Energy Technology Data Exchange (ETDEWEB)

    Gassmann, D.; Khoo, T.L.; Lauritsen, T. [and others

    1995-08-01

    In B.a.7. we propose that the statistical spectrum emitted from a sharp single excited state serves as a probe of pairing in excited states. A specific test of this proposal is the comparison of the spectra from even-even and odd-even nuclei. Whereas a pair gap exists in an even-even nucleus, it gets filled in an odd-even nucleus. Consequently, low-energy transitions can arise in the latter case, whereas they are calculated to be absent in the former case because very few levels exist in the cold gap region. In addition, transitions between 1.4 - 2.2 MeV, which {open_quotes}jump{close_quotes} across the gap, are predicted to have lower yield in the odd-even nuclei. Serendipitously, decay from a superdeformed state serves as a good initial excited sharp state. We extracted the spectrum pairwise-coincident with SD lines in {sup 191}Hg from Gammasphere data and compared it with the equivalent spectra from the even-even nuclei {sup 192,194}Hg. The differences that are predicted to occur are indeed observed. Thus, the data support our proposal that the reduction of pairing with thermal excitation energy can be probed with statistical decay spectra.

  18. Dynamic assessment for life extension of nuclear power plants (NPPs) using system dynamics (SD) method

    International Nuclear Information System (INIS)

    Woo, Tae Ho

    2012-01-01

    It has been proposed to extend the life of nuclear power plants (NPPs) for the economic purpose. Especially, the primary systems in reactor are considered in the thermohydraulic and neutronic aspect, which is related to the safety system. The electric power and the lifespan of components are expressed as economic situation. In addition, political considerations are given by the presidential change and the nuclear non-proliferation characteristics. The dynamical investigation using system dynamics (SD) shows the effective time for the life extension of the NPPs by Monte-Carlo simulations. This non-linear algorithm is incorporated with the feedback loop of the event sequences. The expected event is related to the past event, which affects to the dynamical simulations of lifetime in the NPPs. In the conclusions, the safety guarantee as well as the economic profit in the re-use of long term operated power plants is presented, which is mentioned as the transient time between 2019 and 2021 in this paper. (orig.)

  19. PROBLEMATIKA PEMBELAJARAN BAHASA INDONESIA DI MI/SD DAN ALTERNATIF PEMECAHANNYA