Preoperative left ventricular ejection fraction and left atrium reverse remodeling after mitral regurgitation surgery

Background: Left atrium enlargement has been associated with cardiac events in patients with mitral regurgitation (MR). Left atrium reverse remodeling (LARR) occur after surgical correction of MR, but the preoperative predictors of this phenomenon are not well known. It is therefore important to identify preoperative predictors for postoperative LARR.Methods: We enrolled 62 patients with chronic severe MR (prolapse or flail leaflet) who underwent successful mitral valve surgery (repair or replacement); all with pre-and postoperative echocardiography. LARR was defined as a reduction in left atrium volume index (LAVI) of >= 25%. Stepwise multiple regression analysis was used to identify independent predictors of LARR.Results: LARR occurred in 46 patients (74.2%), with the mean LAVI decreasing from 85.5 mL/m(2) to 49.7 mL/m(2) (p = 25% with a sensitivity of 71.7% and a specificity of 56.3%.Conclusions: LARR occurs frequently after mitral valve surgery and is associated with preoperative LVEF higher than 63.5%.Inst Dante Pazzanese Cardiol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, BrazilDisciplina Cardiol, BR-04024002 São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, BrazilWeb of Scienc

Unveiling the Dynamics of the Universe

We explore the dynamics and evolution of the Universe at early and late times, focusing on both dark energy and extended gravity models and their astrophysical and cosmological consequences. Modified theories of gravity not only provide an alternative explanation for the recent expansion history of the universe, but they also offer a paradigm fundamentally distinct from the simplest dark energy models of cosmic acceleration. In this review, we perform a detailed theoretical and phenomenological analysis of different modified gravity models and investigate their consistency. We also consider the cosmological implications of well motivated physical models of the early universe with a particular emphasis on inflation and topological defects. Astrophysical and cosmological tests over a wide range of scales, from the solar system to the observable horizon, severely restrict the allowed models of the Universe. Here, we review several observational probes -- including gravitational lensing, galaxy clusters, cosmic microwave background temperature and polarization, supernova and baryon acoustic oscillations measurements -- and their relevance in constraining our cosmological description of the Universe.Comment: 94 pages, 14 figures. Review paper accepted for publication in a Special Issue of Symmetry. "Symmetry: Feature Papers 2016". V2: Matches published version, now 79 pages (new format

Power quality phenomena in electrified railways: Conventional and new trends in power quality improvement toward public power systems

Nowadays, railway electrification is the most efficient way to power the trains. However, power quality (PQ) phenomena toward public power systems (PPSs) have always a main concern to the railway operators, especially when the single phase traction power system is interconnected to the three phase PPS. The last decades have witnessed an on going evolution of PQ improvement and traction power supply systems, contributing to diminish the negative impacts of AC railway networks on PQ of the three phase PPS. In this context, this paper presents a global overview of the PQ phenomena in AC railway electrification, as well as the impacts of the potential hazards on the safe operation of electrified railways. The paper also reviews PQ improvement methods from the early use of AC railway electrification until the emergence of the new power electronics devices in railways industry.Mohamed Tanta was supported by FCT (Fundação para a Ciência e Tecnologia) PhD grant with a reference PD/BD/127815/2016. This work has been supported by COMPETE: POCI-01-0145–FEDER–007043 and FCT within the Project Scope: UID/CEC/00319/2013.info:eu-repo/semantics/publishedVersio

Cell Therapy in Chagas Disease

Chagas disease which is caused by the parasite Trypanosoma cruzi is an important cause of cardiomyopathy in Latin America. In later stages chagasic cardiomyopathy is associated with congestive heart failure which is often refractory to medical therapy. In these individuals heart transplantation has been attempted. However, this procedure is fraught with many problems attributable to the surgery and the postsurgical administration of immunosuppressive drugs. Studies in mice suggest that the transplantation of bone-marrow-derived cells ameliorates the inflammation and fibrosis in the heart associated with this infection. Cardiac magnetic resonance imaging reveals that bone marrow transplantation ameliorates the infection induced right ventricular enlargement. On the basis of these animal studies the safety of autologous bone marrow transplantation has been assessed in patients with chagasic end-stage heart disease. The initial results are encouraging and more studies need to be performed

Flexible random lasers in dye-doped bio-degradable cellulose nanocrystalline needles

M-ERA-NET2/0007/2016 POCI-01-0145-FEDER-007688 PTDC/CTM-BIO/6178/2014 PTDC/CTM-REF/30529/2017 UID/CTM/50025In this work, we developed and investigated a random laser based on rhodamine6G (Rh6G) in ethylene glycol (EG) solution with varying cellulose nanocrystalline (CNC) needles as scatterers in the lasing media. Besides the suspension-in-cuvette scheme, an alternative configuration was also employed: a dye-CNC flexible self-supported thick-film (70 µm) random laser made by drop casting of the CNCs + Rh6G + hydroxypropyl cellulose suspension. In relation to conventional scatterers, the biodegradable cellulose nanocompounds showed a comparable reduction in both the spectral full width at half-maximum and the energy threshold values, with an optimal concentration of 5 mg [CNC]/ml[EG] in suspension. Its performance was also compared with other cellulose-based random lasers, presenting advantages for some parameters. The flexible film configuration showed similar results, but contained 10% less Rh6G than the suspension.authorsversionpublishe

Effects of descending positive end-expiratory pressure on lung mechanics and aeration in healthy anaesthetized piglets

INTRODUCTION: Atelectasis and distal airway closure are common clinical entities of general anaesthesia. These two phenomena are expected to reduce the ventilation of dependent lung regions and represent major causes of arterial oxygenation impairment in anaesthetic conditions. The behaviour of the elastance of the respiratory system (E(rs)), as well as the lung aeration assessed by computed tomography (CT) scan, was evaluated during a descendent positive end-expiratory pressure (PEEP) titration. This work sought to evaluate the potential usefulness of E(rs )monitoring to set the PEEP in order to prevent tidal recruitment and hyperinflation of healthy lungs under general anaesthesia. METHODS: PEEP titration (from 16 to 0 cmH(2)O, tidal volume of 8 ml/kg) was performed, and at each PEEP, CT scans were obtained during end-expiratory and end-inspiratory pauses in six healthy, anaesthetized and paralyzed piglets. The distribution of lung aeration was determined and the tidal re-aeration was calculated as the difference between end-expiratory and end-inspiratory poorly aerated and normally aerated areas. Similarly, tidal hyperinflation was obtained as the difference between end-inspiratory and end-expiratory hyperinflated areas. E(rs )was estimated from the equation of motion of the respiratory system during all PEEP titration with the least-squares method. RESULTS: Hyperinflated areas decreased from PEEP 16 to 0 cmH(2)O (ranges decreased from 24–62% to 1–7% at end-expiratory pauses and from 44–73% to 4–17% at end-inspiratory pauses) whereas normally aerated areas increased (from 30–66% to 72–83% at end-expiratory pauses and from 19–48% to 73–77% at end-inspiratory pauses). From 16 to 8 cmH(2)O, E(rs )decreased with a corresponding reduction in tidal hyperinflation. A flat minimum of E(rs )was observed from 8 to 4 cmH(2)O. For PEEP below 4 cmH(2)O, E(rs )increased in association with a rise in tidal re-aeration and a flat maximum of the normally aerated areas. CONCLUSION: In healthy piglets under a descending PEEP protocol, the PEEP at minimum E(rs )presented a compromise between maximizing normally aerated areas and minimizing tidal re-aeration and hyperinflation. High levels of PEEP, greater than 8 cmH(2)O, reduced tidal re-aeration but increased hyperinflation with a concomitant decrease in normally aerated areas