Repetitive levosimendan infusions for patients with advanced chronic heart failure in the vulnerable post-discharge period

Hospitalization for acute heart failure (HF) is associated with a substantial morbidity burden and with associated healthcare costs and an increased mortality risk. However, few if any major medical innovations have been witnessed in this area in recent times. Levosimendan is a first-in-class calcium sensitizer and potassium channel opener indicated for the management of acute HF. Experience in several clinical studies has indicated that administration of intravenous levosimendan in intermittent cycles may reduce hospitalization and mortality rates in patients with advanced HF; however, none of those trials were designed or powered to give conclusive insights into that possibility. This paper describes the rationale and protocol of LeoDOR (levosimendan infusions for patients with advanced chronic heart failure), a randomized, double-blind, placebo-controlled, international, multicentre trial that will explore the efficacy and safety of intermittent levosimendan therapy, in addition to optimized standard therapy, in patients following hospitalization for acute HF. Salient features of LeoDOR include the use of two treatment regimens, in order to evaluate the effects of different schedules and doses of levosimendan during a 12 week treatment phase, and the use of a global rank primary endpoint, in which all patients are ranked across three hierarchical groups ranging from time to death or urgent heart transplantation or implantation of a ventricular assist device to time to rehospitalization and, lastly, time-averaged proportional change in N-terminal pro-brain natriuretic peptide. Secondary endpoints include changes in HF symptoms and functional status at 14 weeks

Effect of Ultrasonic-Assisted Blanching on Size Variation, Heat Transfer, and Quality Parameters of Mushrooms

The main aim of this work was to assess the influence of the application of power ultrasound during blanching of mushrooms (60 90 °C) on the shrinkage, heat transfer, and quality parameters. Kinetics of mushroom shrinkage was modeled and coupled to a heat transfer model for conventional (CB) and ultrasonic-assisted blanching (UB). Cooking value and the integrated residual enzymatic activity were obtained through predicted temperatures and related to the hardness and color variations of mushrooms, respectively. The application of ultrasound led to an increase of shrinkage and heat transfer rates, being this increase more intense at low process temperatures. Consequently, processing time was decreased (30.7 46.0 %) and a reduction in hardness (25.2 40.8 %) and lightness (13.8 16.8 %) losses were obtained. The best retention of hardness was obtained by the UB at 60 °C, while to maintain the lightness it was the CB and UB at 90 °C. For enhancing both quality parameters simultaneously, a combined treatment (CT), which consisted of a CB 0.5 min at 90 °C and then an UB 19.9min at 60 °C, was designed. In this manner, compared with the conventional treatment at 60 °C, reductions of 39.1, 27.2, and 65.5 % for the process time, hardness and lightness losses were achieved, respectively. These results suggest that the CT could be considered as an interesting alternative to CB in order to reduce the processing time and improve the overall quality of blanched mushrooms.The authors acknowledge the financial support of Consejo Nacional de Investigaciones Cientificas y Tecnicas and Universidad Nacional de La Plata from Argentina, Erasmus Mundus Action 2-Strand 1 and EuroTango II Researcher Training Program and Ministerio de Economia y Competitividad (SPAIN) and the FEDER (project DPI2012-37466-CO3-03).Lespinard, A.; Bon Corbín, J.; Cárcel Carrión, JA.; Benedito Fort, JJ.; Mascheroni, RH. (2015). 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Natural History of MYH7-Related Dilated Cardiomyopathy

BACKGROUND Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVES We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 +/- 19.2 years) recruited from 29 international centers. RESULTS At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% +/- 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of <= 35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Evidence of Erroneous Deductions and their Possible Effects on the Initial Learning of the Concept of Cell in Primary School

En este trabajo se han obtenido evidencias sobre dificultades para procesar información referida al concepto de célula en estudiantes de escuela primaria. Se identificaron posibles deducciones erróneas que podrían establecer estudiantes de 5to grado (10-11 años) que intentaran procesar cognitivamente, y por primera vez, la información de libros de texto escolares y del discurso docente sobre el tema y se diseñó un cuestionario con el objetivo de hallar evidencia de estas deducciones. Fue posible detectar algunas evidencias de construcción de modelos explicativos incipientes siendo destacable la aparición de modelos consistentes, pero científicamente incorrectos. Luego, se aplicó el mismo cuestionario a estudiantes de 6to y 7mo grado (11-13 años) y se observó que algunos patrones de respuesta se mantenían e, incluso, se afianzaban. Estos modelos podrían dar cuenta del origen de errores o dificultades en la comprensión del concepto célula en estudiantes de niveles educativos subsiguientes.In this paper we have obtained some evidence on difficulties in processing information about the cell among primary school students. We identified possible misleading deductions that 5th grade students (10-11 years) could establish when trying, for the first time, to cognitively process information on the subject from school textbooks and teacher discourse, and we designed a questionnaire to find evidence of these deductions. It was possible to detect some evidence of incipient explanatory models. It is important to highlight the emergence of consistent but scientifically incorrect models. Then, the same questionnaire was applied to 6th and 7th grade students (11-13 years), and it was found that some response patterns prevailed and were even reinforced. These models could account for the origin of errors or difficulties in understanding the concept of cell among students of subsequent educational levels.Fil: Edelsztein, Valeria Carolina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Formación e Investigación en Enseñanza de las Ciencias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Galagovsky, Lydia Raquel. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Formación e Investigación en Enseñanza de las Ciencias; Argentin

Electrical performance of ATLAS-SCT KB end-cap modules

The Semiconductor Tracker (SCT) is one of the ATLAS Inner Detector elements which aims to track charged particles in the ATLAS experiment. It consists of four cylindrical layers (barrels) of silicon strip detectors, with nine disks in each of the forward and backward directions. Carbon fibre structures will support a total of 4088 modules, which are the basic functional sub-unit of the SCT. Each module consists of single sided silicon micro-strip detectors glued back to back with a 40 mrad stereo-angle, and attached to a hybrid. The scope of this document is to present the electrical performances of prototype end-cap modules proposed for the ATLAS-SCT, as an alternative to the baseline. The layout of these modules is based on the implementation of the barrel module hybrid in the end-cap geometry. A complete set of electrical measurements is summarized in this paper, including irradiated module tests and beam tests