Reversal of dysfunction in postischemic stunned myocardium by epinephrine and postextrasystolic potentiation

After brief coronary occlusions, myocardium may become "stunned," exhibiting prolonged depression of function despite the absence of necrosis. Because of the accompanying decline in adenosine triphosphate and adenine nucleotide precursors, a deficiency of energy supply has been proposed as the basis for postischemic dysfunction. This study examined whether sufficient functional and metabolic reserve exists in stunned myocardium to sustain a prolonged, maximal inotropic response to epinephrine and postextrasystolic potentiation. In 11 open chest dogs, the left anterior descending coronary artery was occluded for 5 minutes, followed by 10 minutes of reflow, repeated 12 times, with a final 1 hour recovery period. Regional myocardial function was measured using pairs of ultrasonic dimension crystals implanted in ischemic and nonischemic zones.During repetitive reflows a progressive decrease in mean systolic segment shortening occurred: baseline 21.8%, 1st reflow 15.2%, 12th reflow 4.3%, 1 hour recovery 7.9%. Intravenous epinephrine, titrated to produce a maximal inotropic response, caused segment shortening to increase to 21.6% after 10 minutes and to 24.8 % after 1 hour of infusion, despite a 20 mm Hg increase in systolic pressure. The same dose of epinephrine given before ischemia increased segment shortening to 30.5%. In six of the dogs, postextrasystolic potentiation before ischemia increased segment shortening from 21.8 to 31.1%, and after 1 hour of recovery from ischemia, from 7.9 to 24.8%. Lesser increases in segment shortening were also seen in nonischemic segments.The results indicate that stunned myocardium possesses considerable functional reserve. Deficient energy stores are therefore not likely to be the basis for depressed function seen at rest in stunned myocardium

Using a BDI Agent to Represent a Human on the Factory Floor of the ARIAC 2023 Industrial Automation Competition

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Antiphospholipid antibodies in black south africans with hiv and acute coronary syndromes: prevalence and clinical correlates

<p>Abstract</p> <p>Background</p> <p>HIV infection is associated with a high prevalence of antiphospholipid antibodies (aPL) and increased thrombotic events but the aetiopathogenic link between the two is unclear.</p> <p>Findings</p> <p>Prospective single centre study from Soweto, South Africa, comparing the prevalence of aPL in highly active anti-retroviral therapy (HAART) naïve HIV positive and negative patients presenting with Acute Coronary Syndromes (ACS). Between March 2004 and February 2008, 30 consecutive black South African HIV patients with ACS were compared to 30 black HIV negative patients with ACS. The HIV patients were younger (43 ± 7 vs. 54 ± 13, p = 0.004) and besides smoking (73% vs. 33%, p = 0.002) and lower HDL levels (0.8 ± 0.3 vs. 1.1 ± 0.4, p = 0.001) had fewer risk factors than the control group. HIV patients had a higher prevalence of anticardiolipin (aCL) IgG (47% vs. 10%, p = 0.003) and anti-prothrombin (aPT) IgG antibodies (87% vs. 21%, p < 0.001) but there was no difference in the prevalence of the antiphospholipid syndrome (44% vs. 24%, p = N/S) and aPL were not predictive of clinical or angiographic outcomes.</p> <p>Conclusions</p> <p>Treatment naïve black South African HIV patients with ACS are younger with fewer traditional coronary risk factors than HIV negative patients but have a higher prevalence and different expression of aPL which is likely to be an epiphenomenon of the HIV infection rather than causally linked to thrombosis and the pathogenesis of ACS.</p

Bremsstrahlung Suppression due to the LPM and Dielectric Effects in a Variety of Materials

The cross section for bremsstrahlung from highly relativistic particles is suppressed due to interference caused by multiple scattering in dense media, and due to photon interactions with the electrons in all materials. We present here a detailed study of bremsstrahlung production of 200 keV to 500 MeV photons from 8 and 25 GeV electrons traversing a variety of target materials. For most targets, we observe the expected suppressions to a good accuracy. We observe that finite thickness effects are important for thin targets.Comment: 52 pages, 13 figures (incorporated in the revtex LaTeX file

Dynamical chiral symmetry breaking and confinement with an infrared-vanishing gluon propagator?

We study a model Dyson-Schwinger equation for the quark propagator closed using an {\it Ansatz} for the gluon propagator of the form \mbox{$D(q) \sim q^2/[(q^2)^2 + b^4]$} and two {\it Ans\"{a}tze} for the quark-gluon vertex: the minimal Ball-Chiu and the modified form suggested by Curtis and Pennington. Using the quark condensate as an order parameter, we find that there is a critical value of $b=b_c$ such that the model does not support dynamical chiral symmetry breaking for $b>b_c$. We discuss and apply a confinement test which suggests that, for all values of $b$, the quark propagator in the model {\bf is not} confining. Together these results suggest that this Ansatz for the gluon propagator is inadequate as a model since it does not yield the expected behaviour of QCD.Comment: 21 Pages including 4 PostScript figures uuencoded at the end of the file. Replacement: slight changes of wording and emphasis. ADP-93-215/T133, ANL-PHY-7599-TH-93, FSU-SCRI-93-108, REVTEX 3.

Selection of Medical Diagnostic Codes for Analysis of Electronic Patient Records. Application to Stroke in a Primary Care Database

BACKGROUND: Electronic patient records from primary care databases are increasingly used in public health and health services research but methods used to identify cases with disease are not well described. This study aimed to evaluate the relevance of different codes for the identification of acute stroke in a primary care database, and to evaluate trends in the use of different codes over time.METHODS: Data were obtained from the General Practice Research Database from 1997 to 2006. All subjects had a minimum of 24 months of up-to-standard record before the first recorded stroke diagnosis. Initially, we identified stroke cases using a supplemented version of the set of codes for prevalent stroke used by the Office for National Statistics in Key health statistics from general practice 1998 (ONS codes). The ONS codes were then independently reviewed by four raters and a restricted set of 121 codes for 'acute stroke' was identified but the kappa statistic was low at 0.23.RESULTS: Initial extraction of data using the ONS codes gave 48,239 cases of stroke from 1997 to 2006. Application of the restricted set of codes reduced this to 39,424 cases. There were 2,288 cases whose index medical codes were for 'stroke annual review' and 3,112 for 'stroke monitoring'. The frequency of stroke review and monitoring codes as index codes increased from 9 per year in 1997 to 1,612 in 2004, 1,530 in 2005 and 1,424 in 2006. The one year mortality of cases with the restricted set of codes was 29.1% but for 'stroke annual review,' 4.6% and for 'stroke monitoring codes', 5.7%.CONCLUSION: In the analysis of electronic patient records, different medical codes for a single condition may have varying clinical and prognostic significance; utilisation of different medical codes may change over time; researchers with differing clinical or epidemiological experience may have differing interpretations of the relevance of particular codes. There is a need for greater transparency in the selection of sets of codes for different conditions, for the reporting of sensitivity analyses using different sets of codes, as well as sharing of code sets among researchers

Spectroscopy of High-Redshift Supernovae from the ESSENCE Project: The First Two Years

We present the results of spectroscopic observations of targets discovered during the first two years of the ESSENCE project. The goal of ESSENCE is to use a sample of ~200 Type Ia supernovae (SNe Ia) at moderate redshifts (0.2 < z < 0.8) to place constraints on the equation of state of the Universe. Spectroscopy not only provides the redshifts of the objects, but also confirms that some of the discoveries are indeed SNe Ia. This confirmation is critical to the project, as techniques developed to determine luminosity distances to SNe Ia depend upon the knowledge that the objects at high redshift are the same as the ones at low redshift. We describe the methods of target selection and prioritization, the telescopes and detectors, and the software used to identify objects. The redshifts deduced from spectral matching of high-redshift SNe Ia with low-redshift SNe Ia are consistent with those determined from host-galaxy spectra. We show that the high-redshift SNe Ia match well with low-redshift templates. We include all spectra obtained by the ESSENCE project, including 52 SNe Ia, 5 core-collapse SNe, 12 active galactic nuclei, 19 galaxies, 4 possibly variable stars, and 16 objects with uncertain identifications.Comment: 38 pages, 9 figures (many with multiple parts), submitted to A

A comparison of two cases of low-latitude thundersnow

http://solberg.snr.missouri.edu/gcc/Two cases of low-latitude snow with lightning are studied to determine their characteristics. Both cases had synoptic-scale origins, but also featured smaller-scale influences (e. g. orographic lift and elevated instability).The first event occurred in the Southern Hemisphere and was a late winter case that developed under the influence of underlying orography. Lightning was plentiful in that event (94 cloud-to-ground flashes in the region), but snow accumulations were not significant. Lightning flashes of negative polarity dominated this case, with a mean peak amplitude of -43.2 kA. The second event was a Northern Hemisphere case of elevated convection, with frontogenesis beneath an extended layer of potential instability. Appreciable lightning occurred with this event as well (706 cloud-to-ground flashes in the region), and snow accumulations were significant over a broad area. Lightning flashes of negative polarity dominated this case also, with a mean peak amplitude of -23.7 kA. Each of these events is worthy of further scrutiny, as studies of such storms do not appear often in the literature. Indeed, such warm, subtropical regions are often unprepared for the effects of just a little snow or ice accumulation. Future forecasters can anticipate better such anomalous events by looking for these broad features: 1) significant and well-defined synoptic-scale weather systems at low latitudes, 2) a strong baroclinic zone with a well-defined (≥60 ms-1) jet structure aloft, 3) cold air of appreciable depth and areal extent drawn much closer to the equator than is typical, and 4) a moist neutral to conditionally unstable layer above the frontal zone

Using Line Profiles to Test the Fraternity of Type Ia Supernovae at High and Low Redshifts

Using archival data of low-redshift (z < 0.01) Type Ia supernovae (SN Ia) and recent observations of high-redshift (0.16 < z <0.64; Matheson et al. 2005) SN Ia, we study the "uniformity'' of the spectroscopic properties of nearby and distant SN Ia. We find no difference in the measures we describe here. In this paper, we base our analysis solely on line-profile morphology, focusing on measurements of the velocity location of maximum absorption (vabs) and peak emission (vpeak). We find that the evolution of vabs and vpeak for our sample lines (Ca II 3945, Si II 6355, and S II 5454, 5640) is similar for both the low- and high-redshift samples. We find that vabs for the weak S II 5454, 5640 lines, and vpeak for S II 5454, can be used to identify fast-declining [dm15 > 1.7] SN Ia, which are also subluminous. In addition, we give the first direct evidence in two high-z SN Ia spectra of a double-absorption feature in Ca II 3945, an event also observed, though infrequently, in low-redshift SN Ia spectra (6/22 SN Ia in our local sample). We report for the first time the unambiguous and systematic intrinsic blueshift of peak emission of optical P-Cygni line profiles in Type Ia spectra, by as much as 8000 km/s. All the high-z SN Ia analyzed in this paper were discovered and followed up by the ESSENCE collaboration, and are now publicly available.Comment: 28 pages (emulateapj), 15 figures; accepted for publication in A