The year in cardiology: arrhythmias and pacing.

During this last year, there has been much progress with regard to anticoagulant and ablation therapy for atrial fibrillation (AF). Apart from recently issued European Society of Cardiology Guidelines for the management of patients with supraventricular arrhythmias, there has been little progress in research in this field. Ventricular arrhythmias and device therapy have seen modest progress

The Programming Power of the Placenta.

Size at birth is a critical determinant of life expectancy, and is dependent primarily on the placental supply of nutrients. However, the placenta is not just a passive organ for the materno-fetal transfer of nutrients and oxygen. Studies show that the placenta can adapt morphologically and functionally to optimize substrate supply, and thus fetal growth, under adverse intrauterine conditions. These adaptations help meet the fetal drive for growth, and their effectiveness will determine the amount and relative proportions of specific metabolic substrates supplied to the fetus at different stages of development. This flow of nutrients will ultimately program physiological systems at the gene, cell, tissue, organ, and system levels, and inadequacies can cause permanent structural and functional changes that lead to overt disease, particularly with increasing age. This review examines the environmental regulation of the placental phenotype with particular emphasis on the impact of maternal nutritional challenges and oxygen scarcity in mice, rats and guinea pigs. It also focuses on the effects of such conditions on fetal growth and the developmental programming of disease postnatally. A challenge for future research is to link placental structure and function with clinical phenotypes in the offspring.This is the final version of the article. It first appeared from Frontiers via https://doi.org/10.3389/fphys.2016.0003

Validity in market research Practice: `New' is not always `improved'

Market research suppliers want to provide a differentiated product or service offering to their clients. However, the frequent need to appear 'new' results in adaptation of research to different contexts. This has consequences for validity. In this paper we make the case for tempering the existing enthusiasm for constant 'innovation' in market research methodologies. In particular, we argue that unfettered adaptation can lead to the generation of invalid findings. We demonstrate some methods of how invalid results can develop. Finally we explain current concepts of 'validity' and provide an innovative way of showing the relationship between the dozen or more varieties of validity that are commonly used in the literature(s). This paper aims to remind practitioners and academics alike, that concepts of validity are important and that there is no point in having a perfectly reliable, but completely invalid, measurement tool

Long-range gravitational-like interaction in a neutral atomic cold gas

A quasi-resonant laser induces a long-range attractive force within a cloud of cold atoms. We take advantage of this force to build in the laboratory a system of particles with a one-dimensional gravitational-like interaction, at a fluid level of modeling. We give experimental evidences of such an interaction in a cold Strontium gas, studying the density profile of the cloud, its size as a function of the number of atoms, and its breathing oscillations.Comment: 4 pages, 4 figures. Published in PRA 87, 013401 (2013

Leveraging BIM and big data to deliver well maintained highways

The Highway infrastructure is one of the most valuable assets for any state or national Government. Efficient operations of Highways lead to success of national and local economies as well as improve the quality of life of the general public dependent on it.  In order to ensure aging road networks continues to move with its ever increasing number of users, requires maintenance and improvements to the road network at the highest standard. Increasing scrutiny over the cost of maintenance along with increasing pressure from Government and the public for transparency over road network spending, has made a strong case for more efficient management of the Highway road asset and traffic management data. Better management of information could allow for life cycle management of asset data and predictive analytics. This paper focuses on proposing a platform that integrates various technologies and systems of Highways Authority and its supply chain, to allow for continuous flow of data throughout an assets life-cycle, leading to seamless, collaborative and effecting working. The integration takes into account developments in the area of BIM and big data; BIM provides a platform to better integrate information whereas big data can provide analytical platform to draw insights

Relaxation to thermal equilibrium in the self-gravitating sheet model

We revisit the issue of relaxation to thermal equilibrium in the so-called "sheet model", i.e., particles in one dimension interacting by attractive forces independent of their separation. We show that this relaxation may be very clearly detected and characterized by following the evolution of order parameters defined by appropriately normalized moments of the phase space distribution which probe its entanglement in space and velocity coordinates. For a class of quasi-stationary states which result from the violent relaxation of rectangular waterbag initial conditions, characterized by their virial ratio R_0, we show that relaxation occurs on a time scale which (i) scales approximately linearly in the particle number N, and (ii) shows also a strong dependence on R_0, with quasi-stationary states from colder initial conditions relaxing much more rapidly. The temporal evolution of the order parameter may be well described by a stretched exponential function. We study finally the correlation of the relaxation times with the amplitude of fluctuations in the relaxing quasi-stationary states, as well as the relation between temporal and ensemble averages.Comment: 37 pages, 24 figures; some additional discussion of previous literature and other minor modifications, final published versio

Outcomes Associated With Oral Anticoagulants Plus Antiplatelets in Patients With Newly Diagnosed Atrial Fibrillation.

Importance: Patients with nonvalvular atrial fibrillation at risk of stroke should receive oral anticoagulants (OAC). However, approximately 1 in 8 patients in the Global Anticoagulant Registry in the Field (GARFIELD-AF) registry are treated with antiplatelet (AP) drugs in addition to OAC, with or without documented vascular disease or other indications for AP therapy. Objective: To investigate baseline characteristics and outcomes of patients who were prescribed OAC plus AP therapy vs OAC alone. Design, Setting, and Participants: Prospective cohort study of the GARFIELD-AF registry, an international, multicenter, observational study of adults aged 18 years and older with recently diagnosed nonvalvular atrial fibrillation and at least 1 risk factor for stroke enrolled between March 2010 and August 2016. Data were extracted for analysis in October 2017 and analyzed from April 2018 to June 2019. Exposure: Participants received either OAC plus AP or OAC alone. Main Outcomes and Measures: Clinical outcomes were measured over 3 and 12 months. Outcomes were adjusted for 40 covariates, including baseline conditions and medications. Results: A total of 24 436 patients (13 438 [55.0%] male; median [interquartile range] age, 71 [64-78] years) were analyzed. Among eligible patients, those receiving OAC plus AP therapy had a greater prevalence of cardiovascular indications for AP, including acute coronary syndromes (22.0% vs 4.3%), coronary artery disease (39.1% vs 9.8%), and carotid occlusive disease (4.8% vs 2.0%). Over 1 year, patients treated with OAC plus AP had significantly higher incidence rates of stroke (adjusted hazard ratio [aHR], 1.49; 95% CI, 1.01-2.20) and any bleeding event (aHR, 1.41; 95% CI, 1.17-1.70) than those treated with OAC alone. These patients did not show evidence of reduced all-cause mortality (aHR, 1.22; 95% CI, 0.98-1.51). Risk of acute coronary syndrome was not reduced in patients taking OAC plus AP compared with OAC alone (aHR, 1.16; 95% CI, 0.70-1.94). Patients treated with OAC plus AP also had higher rates of all clinical outcomes than those treated with OAC alone over the short term (3 months). Conclusions and Relevance: This study challenges the practice of coprescribing OAC plus AP unless there is a clear indication for adding AP to OAC therapy in newly diagnosed atrial fibrillation

Thermodynamics and collapse of self-gravitating Brownian particles in D dimensions

We address the thermodynamics (equilibrium density profiles, phase diagram, instability analysis...) and the collapse of a self-gravitating gas of Brownian particles in D dimensions, in both canonical and microcanonical ensembles. In the canonical ensemble, we derive the analytic form of the density scaling profile which decays as f(x)=x^{-\alpha}, with alpha=2. In the microcanonical ensemble, we show that f decays as f(x)=x^{-\alpha_{max}}, where \alpha_{max} is a non-trivial exponent. We derive exact expansions for alpha_{max} and f in the limit of large D. Finally, we solve the problem in D=2, which displays rather rich and peculiar features

The Cardiovascular Effects of a Meal: J-Tpeak and Tpeak -Tend Assessment and Further Insights Into the Physiological Effects.

Meal intake leads to a significant and prolonged increase in cardiac output to supply the splanchnic vasculature. A meal is associated with sympathetic activation of the cardiovascular system, and food ingestion is correlated with an increase in heart rate, an increase in cardiac stroke volume, and QTc interval shortening for up to 7 hours. Given the complexity of the system, one or several of many mechanisms could explain this observation. The shortening of the QTc interval was correlated with a rise of C-peptide following food ingestion, but the mechanisms by which C-peptide may be involved in the modulation of cardiac repolarization are still unknown. This shortening of the myocardial action potential caused by the ingestion of food was further investigated in the present study by measuring the QRS, J-Tpeak , and Tpeak -Tend intervals in search of further clues to better understand the underlying mechanisms. A retrospective analysis was conducted based on data collected in a formal thorough QT/QTc study in which 32 subjects received a carbohydrate-rich "continental" breakfast, moxifloxacin without food, and moxifloxacin with food. We assessed the effect of food on T-wave morphology using validated algorithms for measurement of J-Tpeak and Tpeak -Tend intervals. Our findings demonstrate that a standardized meal significantly shortened J-Tpeak for 4 hours after a meal and to a much lesser extent and shorter duration (up to 1 hour) prolonged the Tpeak -Tend and QRS intervals. This suggests that the QTc shortening occurs mainly during phase 2 of the cardiac action potential. As there was no corresponding effect on Tpeak -Tend beyond the first hour, we conclude that a meal does not interfere with the outward correcting potassium channels but possibly with Ca2+ currents. An effect on mainly Ca2+ aligns well with our understanding of physiology whereby an increase in stroke volume, as observed after a meal, is associated with changes in Ca2+ cycling in and out of the sarcoplasmic reticulum during cardiac myocyte contraction