Types of the left ventricle geometry and changes in functional parameters of the heart in patients with atrial fibrillation

Aim. To study the features of the left ventricle remodeling and changes in its functional signs in patients with atrial fibrillation (AF). Materials and methods. In total, 2423 patients aged from 18 to 94 years (mean age – 57.9 ± 16.4 years), 51 % men, with pathologies of the cardiovascular and respiratory systems and patients without diagnosed diseases of cardiovascular system were enrolled in the study. Echocardiography was performed on an Esaote MyLab Seven device (Italy) according to generally accepted rules. The indicators of systolic and diastolic, valvular functions, the distribution of patients according to four classic types of the left ventricular geometry were studied. Statistical analysis was performed using the Statistica 13.0 software package for Windows. Statistically significant differences were calculated using the Mann–Whitney U test, Pearson’s χ2 test, Kruskal–Wallis test. A level of p < 0.05 was taken to indicate statistical significance. Results. The prevalence of AF in the group of normal geometry was 6.5 %, concentric remodeling – 11.8 %, eccentric hypertrophy – 17.4 %, concentric hypertrophy – 21.7 %. Left ventricular hypertrophy was diagnosed in 56.2 % of patients with AF (32.0 % – eccentric hypertrophy, 27.8 % – concentric hypertrophy), while in the patient group without AF, left ventricular hypertrophy was detected in only 33.9 % of the examined (20.4 % – eccentric hypertrophy, 13.5 % – concentric hypertrophy). In groups of concentric and eccentric hypertrophy, the patients were older, there was a higher prevalence of mitral, aortic, tricuspid valve regurgitation, and lower indicators of systolic function (EF, TEI, S’), diastolic function (e’med) than those in groups with normal geometry and concentric remodeling. In 29.3 % of patients with AF, the geometry of the left ventricle remained normal. Conclusions. The prevalence of AF increased according to the geometric patterns of the left ventricular remodeling with the highest rates in the groups of eccentric and concentric hypertrophy, which were also associated with worse indicators of systolic, diastolic, and valve functions

Modelling Li+ Ion Battery Electrode Properties

We formulated two detailed models for an electrolytic cell with particulate electrodes based on a lithium atom concentration dependent Butler-Volmer condition at the interface between electrode particles and the electrolyte. The first was based on a dilute-ion assumption for the electrolyte, while the second assumed that Li ions are present in excess. For the first, we used the method of multiple scales to homogenize this model over the microstructure, formed by the small lithium particles in the electrodes. For the second, we gave rigorous bounds for the effective electrochemical conductivity for a linearized case. We expect similar results and bounds for the "full nonlinear problem" because variational results are generally not adversely affected by a sinh term. Finally we used the asymptotic methods, based on parameters estimated from the literature, to attain a greatly simplified one-dimensional version of the original homogenized model. This simplified model accounts for the fact that diffusion of lithium atoms within individual electrode particles is relatively much faster than that of lithium ions across the whole cell so that lithium ion diffusion is what limits the performance of the battery. However, since most of the potential drop occurs across the Debye layers surrounding each electrode particle, lithium ion diffusion only significantly affects cell performance if there is more or less complete depletion of lithium ions in some region of the electrolyte which causes a break in the current flowing across the cell. This causes catastrophic failure. Providing such failure does not occur the potential drop across the cell is determined by the concentration of lithium atoms in the electrode particles. Within each electrode lithium atom concentration is, to leading order, a function of time only and not of position within the electrode. The depletion of electrode lithium atom concentration is directly proportional to the current being drawn off the cell. This leads one to expect that the potential of the cell gradually drops as current is drawn of it. We would like to emphasize that all the homogenization methods employed in this work give a systematic approach for investigating the effect that changes in the microstructure have on the behaviour of the battery. However, due to lack of time, we have not used this method to investigate particular particle geometries

A CLINICAL CASE OF CROHN’S DISEASE

The article demonstrates a clinical case of Crohn’s disease. The clinical manifestation of the disease, a diagnostic approach based on laboratory and instrumental methods with discussion of obtained results, and the up-to-date methods of investigation based on the literature data are shown. The significance of lifestyle modification, optimal drug treatment and regular check-ups for improvement of prognosis is emphasized

A toy model of the five-dimensional universe with the cosmological constant

A value of the cosmological constant in a toy model of the five-dimensional universe is calculated in such a manner that it remains in agreement with both astronomical observations and the quantum field theory concerning the zero-point fluctuations of the vacuum. The (negative) cosmological constant is equal to the inverse of the Planck length squared, which means that in the toy model the vanishing of the observed value of the cosmological constant is a consequence of the existence of an energy cutoff exactly at the level of the Planck scale. In turn, a model for both a virtual and a real particle-antiparticle pair is proposed which describes properly some energetic properties of both the vacuum fluctuations and created particles, as well as it allows one to calculate the discrete "bare" values of an elementary-particle mass, electric charge and intrinsic angular momentum (spin) at the energy cutoff. The relationships between the discussed model and some phenomena such as the Zitterbewegung and the Unruh-Davies effect are briefly analyzed, too. The proposed model also allows one to derive the Lorentz transformation and the Maxwell equations while considering the properties of the vacuum filled with the sea of virtual particles and their antiparticles. Finally, the existence of a finite value of the vacuum-energy density resulting from the toy model leads us to the formulation of dimensionless Einstein field equations which can be derived from the Lagrangian with a dimensionless (naively renormalized) coupling constant.Comment: 52 pages, 1 figure; a post-final, rewritten version with a number of new remarks and conclusion

Дослідження готовності працівників міліції до дій в екстремальних умовах

Дослідження готовності працівників міліції до дій в екстремальних умовах / І. В. Власенко, А. П. Богун, А. В. Березняк // Вісник Харківського національного університету внутрішніх справ. – 2007. – Вип. 36. – С. 420-430.Проаналізовано дослідження готовності працівників міліції до дій в екстремальних умовах. Надано практичні рекомендації щодо вирішення зазначених питань. Проанализированы исследования готовности сотрудников милиции к действиям в экстремальных условиях. Даны практические рекомендации по решению указанных вопросов. The analysis of the police officers' readiness to act in extreme conditions is analyzed. Practical recommendations are given to address these issues

Clinically Suspected Myocarditis Temporally Related to COVID-19 Vaccination in Adolescents and Young Adults: Suspected Myocarditis After COVID-19 Vaccination

BACKGROUND: Understanding the clinical course and short-term outcomes of suspected myocarditis after the coronavirus disease 2019 (COVID-19) vaccination has important public health implications in the decision to vaccinate youth. METHODS: We retrospectively collected data on patients <21 years old presenting before July 4, 2021, with suspected myocarditis within 30 days of COVID-19 vaccination. Lake Louise criteria were used for cardiac MRI findings. Myocarditis cases were classified as confirmed or probable on the basis of the Centers for Disease Control and Prevention definitions. RESULTS: We report on 139 adolescents and young adults with 140 episodes of suspected myocarditis (49 confirmed, 91 probable) at 26 centers. Most patients were male (n=126, 90.6%) and White (n=92, 66.2%); 29 (20.9%) were Hispanic; and the median age was 15.8 years (range, 12.1-20.3; interquartile range [IQR], 14.5-17.0). Suspected myocarditis occurred in 136 patients (97.8%) after the mRNA vaccine, with 131 (94.2%) after the Pfizer-BioNTech vaccine; 128 (91.4%) occurred after the second dose. Symptoms started at a median of 2 days (range, 0-22; IQR, 1-3) after vaccination. The most common symptom was chest pain (99.3%). Patients were treated with nonsteroidal anti-inflammatory drugs (81.3%), intravenous immunoglobulin (21.6%), glucocorticoids (21.6%), colchicine (7.9%), or no anti-inflammatory therapies (8.6%). Twenty-six patients (18.7%) were in the intensive care unit, 2 were treated with inotropic/vasoactive support, and none required extracorporeal membrane oxygenation or died. Median hospital stay was 2 days (range, 0-10; IQR, 2-3). All patients had elevated troponin I (n=111, 8.12 ng/mL; IQR, 3.50-15.90) or T (n=28, 0.61 ng/mL; IQR, 0.25-1.30); 69.8% had abnormal ECGs and arrhythmias (7 with nonsustained ventricular tachycardia); and 18.7% had left ventricular ejection fraction <55% on echocardiogram. Of 97 patients who underwent cardiac MRI at a median 5 days (range, 0-88; IQR, 3-17) from symptom onset, 75 (77.3%) had abnormal findings: 74 (76.3%) had late gadolinium enhancement, 54 (55.7%) had myocardial edema, and 49 (50.5%) met Lake Louise criteria. Among 26 patients with left ventricular ejection fraction <55% on echocardiogram, all with follow-up had normalized function (n=25). CONCLUSIONS: Most cases of suspected COVID-19 vaccine myocarditis occurring in persons <21 years have a mild clinical course with rapid resolution of symptoms. Abnormal findings on cardiac MRI were frequent. Future studies should evaluate risk factors, mechanisms, and long-term outcomes

Clinically Suspected Myocarditis Temporally Related to COVID-19 Vaccination in Adolescents and Young Adults: Suspected Myocarditis After COVID-19 Vaccination

Background: Understanding the clinical course and short-term outcomes of suspected myocarditis after the coronavirus disease 2019 (COVID-19) vaccination has important public health implications in the decision to vaccinate youth. Methods: We retrospectively collected data on patients <21 years old presenting before July 4, 2021, with suspected myocarditis within 30 days of COVID-19 vaccination. Lake Louise criteria were used for cardiac MRI findings. Myocarditis cases were classified as confirmed or probable on the basis of the Centers for Disease Control and Prevention definitions. Results: We report on 139 adolescents and young adults with 140 episodes of suspected myocarditis (49 confirmed, 91 probable) at 26 centers. Most patients were male (n=126, 90.6%) and White (n=92, 66.2%); 29 (20.9%) were Hispanic; and the median age was 15.8 years (range, 12.1–20.3; interquartile range [IQR], 14.5–17.0). Suspected myocarditis occurred in 136 patients (97.8%) after the mRNA vaccine, with 131 (94.2%) after the Pfizer-BioNTech vaccine; 128 (91.4%) occurred after the second dose. Symptoms started at a median of 2 days (range, 0–22; IQR, 1–3) after vaccination. The most common symptom was chest pain (99.3%). Patients were treated with nonsteroidal anti-inflammatory drugs (81.3%), intravenous immunoglobulin (21.6%), glucocorticoids (21.6%), colchicine (7.9%), or no anti-inflammatory therapies (8.6%). Twenty-six patients (18.7%) were in the intensive care unit, 2 were treated with inotropic/vasoactive support, and none required extracorporeal membrane oxygenation or died. Median hospital stay was 2 days (range, 0–10; IQR, 2–3). All patients had elevated troponin I (n=111, 8.12 ng/mL; IQR, 3.50–15.90) or T (n=28, 0.61 ng/mL; IQR, 0.25–1.30); 69.8% had abnormal ECGs and arrhythmias (7 with nonsustained ventricular tachycardia); and 18.7% had left ventricular ejection fraction <55% on echocardiogram. Of 97 patients who underwent cardiac MRI at a median 5 days (range, 0–88; IQR, 3–17) from symptom onset, 75 (77.3%) had abnormal findings: 74 (76.3%) had late gadolinium enhancement, 54 (55.7%) had myocardial edema, and 49 (50.5%) met Lake Louise criteria. Among 26 patients with left ventricular ejection fraction <55% on echocardiogram, all with follow-up had normalized function (n=25). Conclusions: Most cases of suspected COVID-19 vaccine myocarditis occurring in persons <21 years have a mild clinical course with rapid resolution of symptoms. Abnormal findings on cardiac MRI were frequent. Future studies should evaluate risk factors, mechanisms, and long-term outcomes