Physiologic studies in normal and uremic sheep: I. The experimental model

Physiologic studies in normal and uremic sheep: I. The experimental model. A model of chronic renal failure was created in nine adult sheep by two-stage, subtotal nephrectomy. Carotid-jugular cannulas provided clot-free access for 72 to 274 days without exit-site infections. All sheep became uremic and anemic. Median survival, while uremic, was 145 days (72 to 327 days), although three were sacrificed. Five required dialysis within the first week of uremia, and median survival on dialysis was 70 days (41 to 177 days). Sheep that maintained adequate nutrition survived the longest on dialysis. Mean creatinine and BUN levels in the stable uremic and dialyzed sheep were 4.8/95 and 7.8/59 mg/dl, respectively. The other serum chemistries remained unchanged (mean values) from normal, although one sheep died of hypercalcemia (17.8 mg/dl). Renal blood flow correlated to GFR in both normal and uremic states. GFR fell more than serum creatinine rose, suggesting extrarenal excretion of creatinine.Etudes physiologiques chez le mouton normal et urémique: I. Le modèle expérimental. Un modèle d'insuffisance rénale chronique a été créé chez neuf moutons adultes par néphrectomie subtotale en deux étapes. Des canules carotido-jugulaires ont permis un accès sans coagulation pendant 72 à 274 jours sans qu'il y ait d'infection aux lieux de pénétration. Tous les moutons sont devenus urémiques et anémiques. La survie médiane, au cours de l'urémie, a été de 145 jours (72 à 327 jours) bien que trois d'entre eux aient été sacrifiés. Cinq ont dû être dialysés dès la première semaine de l'urémie et la survie médiane en dialyse a été de 70 jours (41 à 177 jours). Les animaux qui ont eu une alimentation adéquate ont eu la survie la plus longue en dialyse. Les concentrations moyennes de créatinine et d'azote uréique dans l'urémie stable et chez les moutons dialysés étaient de 4,8/95 et 7,8/59 mg/dl, respectivement. Les autres valeurs plasmatiques moyennes n'étaient pas différentes de la normale bien qu'un mouton soit mort d'hypercalcémie (17,8 mg/dl). Le débit sanguin rénal était corrélé au débit de filtration glomérulaire dans ces situations normales et urémiques. Le débit de filtration glomérulaire a diminué plus que la créatininémie n'a augmenté, ce qui suggère une excrétion extra-rénale de créatinine

The Ammount of Interstellar Carbon Locked in Solid Hydrogenated Amorphous Carbon

We review the literature and present new experimental data to determine the amount of carbon likely to be locked in form of solid hydrogenated amorphous carbon (HAC) grains. We conclude on the basis of a thorough analysis of the intrinsic strength of the C-H stretching band at 3.4 micron that between 10 and 80 ppM H of carbon is in the form of HAC grains. We show that it is necessary to know the level of hydrogenation (H/C) of the interstellar HAC to determine more precisely the amount of carbon it ties up. We present optical constants, photoluminescence spectroscopy, and IR absorption spectroscopy for a particular HAC sample that is shown to have a 3.4 micron absorption feature that is quantatively consistent with that observed in the diffuse interstellar medium.Comment: This paper is 14 pages long with 5 figures and will appear in the 1 December 1999 issue of Ap

Particle-in-cell Simulations of Ion Dynamics in a Pinched-beam Diode

article-in-cell simulations of a 1.6 MV, 800 kA, and 50 ns pinched-beam diode have been completed with emphasis placed on the quality of the ion beams produced. Simulations show the formation of multiple regions in the electron beam flow characterized by locally high charge and current density (“hot spots”). As ions flow through the electron-space-charge cloud, these hot spots electrostatically attract ions to produce a non-uniform ion current distribution. The length of the cavity extending beyond the anode-to-cathode gap (i.e., behind the cathode tip) influences both the number and amplitude of hot spots. A longer cavity length increases the number of hot spots yet significantly reduces the amplitude producing a smoother, more uniform ion beam than for shorter cavities. The net current and the ion bending angles are also significantly smaller with long cavities

PREVENtion of HeartMate II Pump Thrombosis Through Clinical Management: The PREVENT multi-center study

BACKGROUND: Recommended structured clinical practices including implant technique, anti-coagulation strategy, and pump speed management (PREVENT [PREVENtion of HeartMate II Pump Thrombosis Through Clinical Management] recommendations) were developed to address risk of early (<3 months) pump thrombosis (PT) risk with HeartMate II (HMII; St. Jude Medical, Inc. [Thoratec Corporation], Pleasanton, CA). We prospectively assessed the HMII PT rate in the current era when participating centers adhered to the PREVENT recommendations. METHODS: PREVENT was a prospective, multi-center, single-arm, non-randomized study of 300 patients implanted with HMII at 24 participating sites. Confirmed PT (any suspected PT confirmed visually and/or adjudicated by an independent assessor) was evaluated at 3 months (primary end-point) and at 6 months after implantation. RESULTS: The population included 83% men (age 57 years ± 13), 78% destination therapy, and 83% Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Profile 1-3. Primary end-point analysis showed a confirmed PT of 2.9% at 3 months and 4.8% at 6 months. Adherence to key recommendations included 78% to surgical recommendations, 95% to heparin bridging, and 79% to pump speeds ≥9,000 RPMs (92% >8,600 RPMs). Full adherence to implant techniques, heparin bridging, and pump speeds ≥9,000 RPMs resulted in a significantly lower risk of PT (1.9% vs 8.9%; p < 0.01) and lower composite risk of suspected thrombosis, hemolysis, and ischemic stroke (5.7% vs 17.7%; p < 0.01) at 6 months. CONCLUSIONS: Adoption of all components of a structured surgical implant technique and clinical management strategy (PREVENT recommendations) is associated with low rates of confirmed PT

Brain charts for the human lifespan

Over the past few decades, neuroimaging has become a ubiquitous tool in basic research and clinical studies of the human brain. However, no reference standards currently exist to quantify individual differences in neuroimaging metrics over time, in contrast to growth charts for anthropometric traits such as height and weight1. Here we assemble an interactive open resource to benchmark brain morphology derived from any current or future sample of MRI data (http://www.brainchart.io/). With the goal of basing these reference charts on the largest and most inclusive dataset available, acknowledging limitations due to known biases of MRI studies relative to the diversity of the global population, we aggregated 123,984 MRI scans, across more than 100 primary studies, from 101,457 human participants between 115 days post-conception to 100 years of age. MRI metrics were quantified by centile scores, relative to non-linear trajectories2 of brain structural changes, and rates of change, over the lifespan. Brain charts identified previously unreported neurodevelopmental milestones3, showed high stability of individuals across longitudinal assessments, and demonstrated robustness to technical and methodological differences between primary studies. Centile scores showed increased heritability compared with non-centiled MRI phenotypes, and provided a standardized measure of atypical brain structure that revealed patterns of neuroanatomical variation across neurological and psychiatric disorders. In summary, brain charts are an essential step towards robust quantification of individual variation benchmarked to normative trajectories in multiple, commonly used neuroimaging phenotypes

Vector boson pair production at the LHC

We present phenomenological results for vector boson pair production at the LHC, obtained using the parton-level next-to-leading order program MCFM. We include the implementation of a new process in the code, pp -> \gamma\gamma, and important updates to existing processes. We incorporate fragmentation contributions in order to allow for the experimental isolation of photons in \gamma\gamma, W\gamma, and Z\gamma production and also account for gluon-gluon initial state contributions for all relevant processes. We present results for a variety of phenomenological scenarios, at the current operating energy of \sqrt{s} = 7 TeV and for the ultimate machine goal, \sqrt{s} = 14 TeV. We investigate the impact of our predictions on several important distributions that enter into searches for new physics at the LHC.Comment: 35 pages, 14 figure

Lower Rates of Heart Failure and All-Cause Hospitalizations During Pulmonary Artery Pressure-Guided Therapy for Ambulatory Heart Failure: One-Year Outcomes From the CardioMEMS Post-Approval Study.

BACKGROUND: Ambulatory hemodynamic monitoring with an implantable pulmonary artery (PA) sensor is approved for patients with New York Heart Association Class III heart failure (HF) and a prior HF hospitalization (HFH) within 12 months. The objective of this study was to assess the efficacy and safety of PA pressure-guided therapy in routine clinical practice with special focus on subgroups defined by sex, race, and ejection fraction. METHODS: This multi-center, prospective, open-label, observational, single-arm trial of 1200 patients across 104 centers within the United States with New York Heart Association class III HF and a prior HFH within 12 months evaluated patients undergoing PA pressure sensor implantation between September 1, 2014, and October 11, 2017. The primary efficacy outcome was the difference between rates of adjudicated HFH 1 year after compared with the 1 year before sensor implantation. Safety end points were freedom from device- or system-related complications at 2 years and freedom from pressure sensor failure at 2 years. RESULTS: Mean age for the population was 69 years, 37.7% were women, 17.2% were non-White, and 46.8% had preserved ejection fraction. During the year after sensor implantation, the mean rate of daily pressure transmission was 76±24% and PA pressures declined significantly. The rate of HFH was significantly lower at 1 year compared with the year before implantation (0.54 versus 1.25 events/patient-years, hazard ratio 0.43 [95% CI, 0.39-0.47], CONCLUSIONS: In routine clinical practice as in clinical trials, PA pressure-guided therapy for HF was associated with lower PA pressures, lower rates of HFH and all-cause hospitalization, and low rates of adverse events across a broad range of patients with symptomatic HF and prior HFH. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02279888

Online dietary intake estimation : Reproducibility and validity of the Food4Me food frequency questionnaire against a 4-day weighed food record

©Rosalind Fallaize, Hannah Forster, Anna L Macready, Marianne C Walsh, John C Mathers, Lorraine Brennan, Eileen R Gibney, Michael J Gibney, Julie A Lovegrove. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 11.08.2014. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.Background: Advances in nutritional assessment are continuing to embrace developments in computer technology. The online Food4Me food frequency questionnaire (FFQ) was created as an electronic system for the collection of nutrient intake data. To ensure its accuracy in assessing both nutrient and food group intake, further validation against data obtained using a reliable, but independent, instrument and assessment of its reproducibility are required. Objective: The aim was to assess the reproducibility and validity of the Food4Me FFQ against a 4-day weighed food record (WFR). Methods: Reproducibility of the Food4Me FFQ was assessed using test-retest methodology by asking participants to complete the FFQ on 2 occasions 4 weeks apart. To assess the validity of the Food4Me FFQ against the 4-day WFR, half the participants were also asked to complete a 4-day WFR 1 week after the first administration of the Food4Me FFQ. Level of agreement between nutrient and food group intakes estimated by the repeated Food4Me FFQ and the Food4Me FFQ and 4-day WFR were evaluated using Bland-Altman methodology and classification into quartiles of daily intake. Crude unadjusted correlation coefficients were also calculated for nutrient and food group intakes. Results: In total, 100 people participated in the assessment of reproducibility (mean age 32, SD 12 years), and 49 of these (mean age 27, SD 8 years) also took part in the assessment of validity. Crude unadjusted correlations for repeated Food4Me FFQ ranged from .65 (vitamin D) to .90 (alcohol). The mean cross-classification into "exact agreement plus adjacent" was 92% for both nutrient and food group intakes, and Bland-Altman plots showed good agreement for energy-adjusted macronutrient intakes. Agreement between the Food4Me FFQ and 4-day WFR varied, with crude unadjusted correlations ranging from .23 (vitamin D) to .65 (protein, % total energy) for nutrient intakes and .11 (soups, sauces and miscellaneous foods) to .73 (yogurts) for food group intake. The mean cross-classification into "exact agreement plus adjacent" was 80% and 78% for nutrient and food group intake, respectively. There were no significant differences between energy intakes estimated using the Food4Me FFQ and 4-day WFR, and Bland-Altman plots showed good agreement for both energy and energy-controlled nutrient intakes. Conclusions: The results demonstrate that the online Food4Me FFQ is reproducible for assessing nutrient and food group intake and has moderate agreement with the 4-day WFR for assessing energy and energy-adjusted nutrient intakes. The Food4Me FFQ is a suitable online tool for assessing dietary intake in healthy adults.Peer reviewedFinal Published versio