Differentiating Cognitive Impairment from Symptoms of Anxiety in Postcoronary Artery Bypass Grafting Encephalopathy: A Case Report

Post-coronary artery bypass grafting encephalopathy (CABGE) is associated with cognitive decline in a significant number of post-cardiac surgery cases. Patients may experience this condition as a result of being maintained on a heart-lung machine, which is referred to as the “pump”. The pump is used to circulate oxygenated blood during heart or valve surgery and may contribute to complication with oxygen flow to the brain. In some cases, the emotional traumatic effects of CABGE may produce symptoms of anxiety that can often mimic the cognitive decline associated with cardiac bypass and use of the pump. When this is the case, cognitive–behavioral assessment may be useful in helping patients to differentiate symptoms generated by anxiety from those produced by the effects of the pump. A discussion section addresses further implications of such overlapping symptoms and therapeutic strategies for treatment and remediation, along with the potential adverse effects that may occur through psychotherapy

Seismic reliability analysis of isolated deck bridges using friction pendulum devices

In this study, the seismic reliability of multi-span continuous deck bridges equipped with isolation friction pendulum (FP) devices is investigated. The relevant aleatory uncertainties associated to the sliding friction coefficient of the FP isolators and to the seismic inputs are considered. A six-degree-of-freedom model is established to reproduce the elastic behavior of the reinforced concrete (RC) pier, the stiff response of the deck supported by the isolation devices and the non-linear response of the FPS bearings which depends on the sliding velocity. Moreover, the RC abutment is assumed as infinitely rigid. For what concerns the seismic inputs, a group of natural seismic records having various characteristics is adopted and properly scaled to increasing levels of intensity. The random variability of the friction coefficient is modelled by suitable probabilistic distribution. Then, considering several bridges and isolator configurations, the fragility curves of the RC pier and of the isolator devices (FP) are determined. Finally, in agreement with the hazard curve of the specific site, the convolution integral is adopted to determine the seismic reliability curves in the performance domain

Differentiating cognitive impairment from symptoms of anxiety in postcoronary artery bypass grafting encephalopathy: a case report

Post-coronary artery bypass grafting encephalopathy (CABGE) is associated with cognitive decline in a significant number of post-cardiac surgery cases. Patients may experience this condition as a result of being maintained on a heart-lung machine, which is referred to as the “pump”. The pump is used to circulate oxygenated blood during heart or valve surgery and may contribute to complication with oxygen flow to the brain. In some cases, the emotional traumatic effects of CABGE may produce symptoms of anxiety that can often mimic the cognitive decline associated with cardiac bypass and use of the pump. When this is the case, cognitive–behavioral assessment may be useful in helping patients to differentiate symptoms generated by anxiety from those produced by the effects of the pump. A discussion section addresses further implications of such overlapping symptoms and therapeutic strategies for treatment and remediation, along with the potential adverse effects that may occur through psychotherapy

Magnetic control of DTT alternative plasma configurations

One of the main challenges concerning next generation tokamaks (such as DEMO) will be the development of a heat and power exhaust system able to withstand the large loads expected in the divertor region. A dedicated Divertor Tokamak Test (DTT) facility has been proposed in the EUROfusion Roadmap, with the aim of testing unconventional solutions, such as advanced magnetic configurations and liquid metal divertors. Magnetic control of alternative plasma configurations, such as the X-Divertor, will play a key role in the solution of the heat exhaust and yet can be a challenging point, due to increased sensitivity introduced by secondary x-points. To overcome the complications introduced by secondary x-points in advanced plasma shapes, magnetic control in DTT is achieved by resolving to the eXtreme Shape Controller, in order to control both the plasma shape and the secondary x-point position

Intense myocyte formation from cardiac stem cells in human cardiac hypertrophy

It is generally believed that increase in adult contractile cardiac mass can be accomplished only by hypertrophy of existing myocytes. Documentation of myocardial regeneration in acute stress has challenged this dogma and led to the proposition that myocyte renewal is fundamental to cardiac homeostasis. Here we report that in human aortic stenosis, increased cardiac mass results from a combination of myocyte hypertrophy and hyperplasia. Intense new myocyte formation results from the differentiation of stem-like cells committed to the myocyte lineage. These cells express stem cell markers and telomerase. Their number increased >13-fold in aortic stenosis. The finding of cell clusters with stem cells making the transition to cardiogenic and myocyte precursors, as well as very primitive myocytes that turn into terminally differentiated myocytes, provides a link between cardiac stem cells and myocyte differentiation. Growth and differentiation of these primitive cells was markedly enhanced in hypertrophy, consistent with activation of a restricted number of stem cells that, through symmetrical cell division, generate asynchronously differentiating progeny. These clusters strongly support the existence of cardiac stem cells that amplify and commit to the myocyte lineage in response to increased workload. Their presence is consistent with the notion that myocyte hyperplasia significantly contributes to cardiac hypertrophy and accounts for the subpopulation of cycling myocytes