Polymers in long-range-correlated disorder

We study the scaling properties of polymers in a d-dimensional medium with quenched defects that have power law correlations ~r^{-a} for large separations r. This type of disorder is known to be relevant for magnetic phase transitions. We find strong evidence that this is true also for the polymer case. Applying the field-theoretical renormalization group approach we perform calculations both in a double expansion in epsilon=4-d and delta=4-a up to the 1-loop order and secondly in a fixed dimension (d=3) approach up to the 2-loop approximation for different fixed values of the correlation parameter, 2=<a=<3. In the latter case the numerical results need appropriate resummation. We find that the asymptotic behavior of self-avoiding walks in three dimensions and long-range-correlated disorder is governed by a set of separate exponents. In particular, we give estimates for the 'nu' and 'gamma' exponents as well as for the correction-to-scaling exponent 'omega'. The latter exponent is also calculated for the general m-vector model with m=1,2,3.Comment: 13 pages, 5 figure

Baseline characteristics of patients in the reduction of events with darbepoetin alfa in heart failure trial (RED-HF)

&lt;p&gt;Aims: This report describes the baseline characteristics of patients in the Reduction of Events with Darbepoetin alfa in Heart Failure trial (RED-HF) which is testing the hypothesis that anaemia correction with darbepoetin alfa will reduce the composite endpoint of death from any cause or hospital admission for worsening heart failure, and improve other outcomes.&lt;/p&gt; &lt;p&gt;Methods and results: Key demographic, clinical, and laboratory findings, along with baseline treatment, are reported and compared with those of patients in other recent clinical trials in heart failure. Compared with other recent trials, RED-HF enrolled more elderly [mean age 70 (SD 11.4) years], female (41%), and black (9%) patients. RED-HF patients more often had diabetes (46%) and renal impairment (72% had an estimated glomerular filtration rate &#60;60 mL/min/1.73 m2). Patients in RED-HF had heart failure of longer duration [5.3 (5.4) years], worse NYHA class (35% II, 63% III, and 2% IV), and more signs of congestion. Mean EF was 30% (6.8%). RED-HF patients were well treated at randomization, and pharmacological therapy at baseline was broadly similar to that of other recent trials, taking account of study-specific inclusion/exclusion criteria. Median (interquartile range) haemoglobin at baseline was 112 (106–117) g/L.&lt;/p&gt; &lt;p&gt;Conclusion: The anaemic patients enrolled in RED-HF were older, moderately to markedly symptomatic, and had extensive co-morbidity.&lt;/p&gt

Guidance on the management of left ventricular assist device (LVAD) supported patients for the non-LVAD specialist healthcare provider: executive summary

The accepted use of left ventricular assist device (LVAD) technology as a good alternative for the treatment of patients with advanced heart failure together with the improved survival of patients on the device and the scarcity of donor hearts has significantly increased the population of LVAD supported patients. Device-related, and patient-device interaction complications impose a significant burden on the medical system exceeding the capacity of LVAD implanting centres. The probability of an LVAD supported patient presenting with medical emergency to a local ambulance team, emergency department medical team and internal or surgical wards in a non-LVAD implanting centre is increasing. The purpose of this paper is to supply the immediate tools needed by the non-LVAD specialized physician - ambulance clinicians, emergency ward physicians, general cardiologists, and internists - to comply with the medical needs of this fast-growing population of LVAD supported patients. The different issues discussed will follow the patient's pathway from the ambulance to the emergency department, and from the emergency department to the internal or surgical wards and eventually back to the general practitioner.Cardiolog

HFA of the ESC position paper on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider Part 3: at the hospital and discharge.

The growing population of left ventricular assist device (LVAD)-supported patients increases the probability of an LVAD- supported patient hospitalized in the internal or surgical wards with certain expected device related, and patient-device interaction complication as well as with any other comorbidities requiring hospitalization. In this third part of the trilogy on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider, definitions and structured approach to the hospitalized LVAD-supported patient are presented including blood pressure assessment, medical therapy of the LVAD supported patient, and challenges related to anaesthesia and non-cardiac surgical interventions. Finally, important aspects to consider when discharging an LVAD patient home and palliative and end-of-life approaches are described

Heart Failure Association of the European Society of Cardiology position paper on the management of left ventricular assist device-supported patients for the non-left ventricular assist device specialist healthcare provider: Part 2: at the emergency department.

The improvement in left ventricular assist device (LVAD) technology and scarcity of donor hearts have increased dramatically the population of the LVAD-supported patients and the probability of those patients to present to the emergency department with expected and non-expected device-related and patient-device interaction complications. The ageing of the LVAD-supported patients, mainly those supported with the 'destination therapy' indication, increases the risk for those patients to suffer from other co-morbidities common in the older population. In this second part of the trilogy on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider, definitions and structured approach to the LVAD-supported patient presenting to the emergency department with bleeding, neurological event, pump thrombosis, chest pain, syncope, and other events are presented. The very challenging issue of declaring death in an LVAD-supported patient, as the circulation is artificially preserved by the device despite no other signs of life, is also discussed in detail

HFA of the ESC Position paper on the management of LVAD supported patients for the non LVAD specialist healthcare provider Part 1: Introduction and at the non-hospital settings in the community.

The accepted use of left ventricular assist device (LVAD) technology as a good alternative for the treatment of patients with advanced heart failure together with the improved survival of the LVAD-supported patients on the device and the scarcity of donor hearts has significantly increased the population of LVAD-supported patients. The expected and non-expected device-related and patient-device interaction complications impose a significant burden on the medical system exceeding the capacity of the LVAD implanting centres. The ageing of the LVAD-supported patients, mainly those supported with the 'destination therapy' indication, increases the risk for those patients to experience comorbidities common in the older population. The probability of an LVAD-supported patient presenting with medical emergency to a local emergency department, internal, or surgical ward of a non-LVAD implanting centre is increasing. The purpose of this trilogy is to supply the immediate tools needed by the non-LVAD specialized physician: ambulance clinicians, emergency ward physicians, general cardiologists, internists, anaesthesiologists, and surgeons, to comply with the medical needs of this fast-growing population of LVAD-supported patients. The different issues discussed will follow the patient's pathway from the ambulance to the emergency department and from the emergency department to the internal or surgical wards and eventually to the discharge home from the hospital back to the general practitioner. In this first part of the trilogy on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider, after the introduction on the assist devices technology in general, definitions and structured approach to the assessment of the LVAD-supported patient in the ambulance and emergency department is presented including cardiopulmonary resuscitation for LVAD-supported patients

COEXISTENCE OF PSEUDOTACHYLYTE VEINS AND MYLONITIC ZONES AT THE BASE OF THE DEEP CRUST: AN EXAMPLE FROM THE CALABRIA (SOUTHERN ITALY)

Natural examples indicate that pseudotachylytes cohexist in the same outcrop with mylonites and ultramylonites. Pseudotachylytes intimately associated with mylonites and ultramylonites can develop in high strain zone close to the brittle-ductile transition (e.g. Passchier, 1982) or entirely within the ductile regime as result of plastic instabilities (e.g. Hobbs et al., 1986; Handy & Brun, 2004). This study report microstructural investigations on two pseudotachylyte veins found within the felsic granulites at the base of the ~20-25 km thick Variscan crustal section outcropping in the Serre Massif (southern Calabria). Felsic granulites consist of quartz, plagioclase, K-feldspar, biotite, garnet, sillimanite and accessory minerals. Stretched minerals and S-C composite foliations are detected in zones crystal-plastic deformation. In places, felsic granulites exhibit an alternance of mylonitic and ultramylonitic bands (a few millimeters thick). Pseudotachylyte fault-veins develop along planes, which have a parallel orientation to the mylonitic and/or ultramylonitic foliation. Locally, pseudotachylyte fault-veins occur along the S-C composite foliations of the felsic granulite. On the other hand, the pseudotachylyte injection-veins cross cut the mylonitic and/or ultramylonitic bands. Microstructural observations indicate that the felsic granulite exhibits a strong grain-size reduction along the S-C composite foliations and near the contact with the pseudotachylyte veins. Back scattered electron (BSE) images, obtained by scanning electron microscopy (SEM) and Field-Emission Gun SEM, show that in proximity of the contact with the pseudotachylyte the garnet of the felsic granulite is fractured and shows rims characterized by a new cristallization of very small euhedral garnet (3-4 m). On the other hand, the ultramylonitic bands display a very fine-grained matrix and have a dark appearance. However, the BSE images reveal a strong penetrative foliation, which is defined by the alignment of biotite and by the shape preferred orientation of quartz, plagioclase and garnet. Moreover, the ultramylonitic bands are characterized by a new crystallization of very small crystals (a few microns in length) of sillimanite and K-feldspar, aligned along the foliation planes. Matrix of the pseudotachylytes is microcrystalline and contains abundant clasts (>50%) made up of quartz, plagioclase, K-feldspar, garnet and rare biotite. Clasts in the matrix are aligned with a parallel orientation to oblique foliation of the mylonitic granulite. At the margin of the vein, garnet of the pseudotachylyte may occur in two habits: 1) garnet microlites with very small sizes (3-4 m) and an idiomorph habit, which formed by direct crystallization from the frictional melt, and 2) garnet clasts (a few ten micrometres in size), with rims characterized by a new crystallization of very small garnets (<2 m) and with a similar aspect to the garnet rims of the host rock. In the vein centre, the matrix is mainly composed of skeletal plagioclase and biotite (a few microns in lenght). Plagioclase and biotite microlites often nucleated on rounded clasts of quartz or plagioclase. Garnet microlites are absent in the vein centre. These data, combined with the indications for the formation depth of the pseudotachylytes (21-23 km) obtained by Altenberger et al. (2010), indicate that during propagation of the seismic rupture the shear deformation was highly heterogeneous and took place through the development of alternating pseudotachylyte and ultramylonite, as result of plastic instabilities. References Altenberger, U., Prosser, G. & Grande, A. (2010): Workshop Physico-chemical processes in seismic faults, 11 Handy, M.R. & Brun, J.P. (2004): Earth Planet. Sc. Lett., 223, 427-441 Hobbs, B.E., Ord, A. & Teyssier, C. (1986): Pure Appl. Geophys., 124, 309-336 Passchier, C.W. (1982): J. Struct. Geol., 4, 69-7