Cardiovascular effects of flavanol-rich chocolate in patients with heart failure

Aims Flavanol-rich chocolate (FRC) is beneficial for vascular and platelet function by increasing nitric oxide bioavailability and decreasing oxidative stress. Congestive heart failure (CHF) is characterized by impaired endothelial and increased platelet reactivity. As statins are ineffective in CHF, alternative therapies are a clinical need. We therefore investigated whether FRC might improve cardiovascular function in patients with CHF. Methods and results Twenty patients with CHF were enrolled in a double-blind, randomized placebo-controlled trial, comparing the effect of commercially available FRC with cocoa-liquor-free control chocolate (CC) on endothelial and platelet function in the short term (2 h after ingestion of a chocolate bar) and long term (4 weeks, two chocolate bars/day). Endothelial function was assessed non-invasively by flow-mediated vasodilatation of the brachial artery. Flow-mediated vasodilatation significantly improved from 4.98 ± 1.95 to 5.98 ± 2.32% (P = 0.045 and 0.02 for between-group changes) 2h after intake of FRC to 6.86 ± 1.76% after 4 weeks of daily intake (P = 0.03 and 0.004 for between groups). No effect on endothelial-independent vasodilatation was observed. Platelet adhesion significantly decreased from 3.9 ± 1.3 to 3.0 ± 1.3% (P = 0.03 and 0.05 for between groups) 2 h after FRC, an effect that was not sustained at 2 and 4 weeks. Cocoa-liquor-free CC had no effect, either on endothelial function or on platelet function. Blood pressure and heart rate did not change in either group. Conclusion Flavanol-rich chocolate acutely improves vascular function in patients with CHF. A sustained effect was seen after daily consumption over a 4-week period, even after 12 h abstinence. These beneficial effects were paralleled by an inhibition of platelet function in the presence of FRC only. Trial Registration ClinicalTrials.gov Identifier: NCT0053894

Large eddy simulation of interacting barchan dunes in a steady, unidirectional flow

We have performed large-eddy simulations of turbulent flow 4 over barchan dunes in a channel with different interdune spacings in the downstream direction at Reynolds number, Re∞ ≃ 26000 (based on the free 6 stream velocity and channel height). Simulations are validated against ex-perimental data (at Re∞ = 55460); the largest interdune spacing (2.38λ, where λ is the length of the barchan model) presents similar characteristics to the isolated dune in the experiment, indicating that at this distance the sheltering effect of the upstream dune is rather weak. We examine 3D realizations of the mean and instantaneous flow to explain features of the flow field relevant to sediment transport. Barchan dunes induce two counter-rotating streamwise vortices, along each of the horns, which direct high-momentum fluid toward the symmetry plane and low-momentum fluid near the bed away from the centerline. The flow near the bed, upstream of the dune, diverges from the centerline plane, decelerates and then rises on the stoss side of the dune while accelerating; the flow close to the centerline plane separates at the crest and reattaches on the bed. Away from the centerline plane and along the horns, flow separation occurs intermittently. The flow in the separation bubble is routed towards the horns and leaves the dune at their tips. The separated flow at the crest reattaches on the bed, except on the centerline symmetry plane of the dune, where a weak saddle point of separation ap- pears at the bed. The distribution of the bed shear-stress, characteristics of the separation and reattachment regions, and instantaneous wall turbulence are discussed. Characteristics of the internal boundary layer developing on the bed after the reattachment region are studied. The interdune spacing isfound to affect significantly the turbulent flow over the stoss side of the downstream dunes; at smaller interdune-spacings, coherent high- and low- speed streaks are shorter but stronger, and the spanwise normal Reynolds stress is larger. The turbulent kinetic energy budgets show the importance of the pressure transport and mean-flow advection in transporting energy from the overlying wake layer to the internal boundary layer over the stoss side of the closely-spaced dunes. The characteristics of the separated-shear layer are altered slightly at smaller interdune spacing; the separation bubble is smaller, the separated-shear layer is stronger, and the bed shear-stress is larger. Away from the dunes, typical wall-turbulence structures are observed, but coher- ent eddies generated in the separated-shear layer due to the Kelvin-Helmholtz instability are dominant near the dune. Coherent structures are generated more frequently at smaller interdune spacing; they move farther away from the bed, towards the free surface, and remain in between the horns. At larger interdune spacings, these coherent structures are advected in the spanwise direction with the mean streamwise vortices and can be observed outside of the dunes

A Multisite Preregistered Paradigmatic Test of the Ego-Depletion Effect

We conducted a preregistered multilaboratory project (k = 36; N = 3,531) to assess the size and robustness of ego-depletion effects using a novel replication method, termed the paradigmatic replication approach. Each laboratory implemented one of two procedures that was intended to manipulate self-control and tested performance on a subsequent measure of self-control. Confirmatory tests found a nonsignificant result (d = 0.06). Confirmatory Bayesian meta-analyses using an informed-prior hypothesis (δ = 0.30, SD = 0.15) found that the data were 4 times more likely under the null than the alternative hypothesis. Hence, preregistered analyses did not find evidence for a depletion effect. Exploratory analyses on the full sample (i.e., ignoring exclusion criteria) found a statistically significant effect (d = 0.08); Bayesian analyses showed that the data were about equally likely under the null and informed-prior hypotheses. Exploratory moderator tests suggested that the depletion effect was larger for participants who reported more fatigue but was not moderated by trait self-control, willpower beliefs, or action orientation

Indogermanische Grammatik

Title from publisher's bibliographic system (viewed on 25 Nov 2014)

Deutsches Wörterbuch /

Facsimile : Giessen : Töpelmann, 1909-19101. A bis K2. L bis

Auricall: A new device for a non-invasive, wireless, continuous monitoring of oxygen saturation and heart rate in patients with heart failure

Sleep apnoea syndrome is frequent in patients with heart failure and associated with a worse prognosis. We evaluated a new device (Auricall) for non-invasive, continuous recording of oxygen saturation (SpO(2)) and heart rate (HR) in patients with heart failure. We studied 20 patients (mean age 48.43+/-14.4 years, NYHA class II-III). All patients were requested to carry the device for at least 36 h and to write a diary during the recording time. Satisfactory recording of SpO(2) and HR was possible to obtain in 18 of 20 patients. Indeed 9 out of 18 patients showed significant periodic changes in SpO(2) during sleep. Therefore, Auricall is a useful tool to non-invasively monitor SpO(2) and HR in patients with heart failure and to detect breathing disorders in these patients

Cardiovascular effects of flavanol-rich chocolate in patients with heart failure

AimsFlavanol-rich chocolate (FRC) is beneficial for vascular and platelet function by increasing nitric oxide bioavailability and decreasing oxidative stress. Congestive heart failure (CHF) is characterized by impaired endothelial and increased platelet reactivity. As statins are ineffective in CHF, alternative therapies are a clinical need. We therefore investigated whether FRC might improve cardiovascular function in patients with CHF.Methods and resultsTwenty patients with CHF were enrolled in a double-blind, randomized placebo-controlled trial, comparing the effect of commercially available FRC with cocoa-liquor-free control chocolate (CC) on endothelial and platelet function in the short term (2 h after ingestion of a chocolate bar) and long term (4 weeks, two chocolate bars/day). Endothelial function was assessed non-invasively by flow-mediated vasodilatation of the brachial artery. Flow-mediated vasodilatation significantly improved from 4.98 ± 1.95 to 5.98 ± 2.32% (P = 0.045 and 0.02 for between-group changes) 2h after intake of FRC to 6.86 ± 1.76% after 4 weeks of daily intake (P = 0.03 and 0.004 for between groups). No effect on endothelial-independent vasodilatation was observed. Platelet adhesion significantly decreased from 3.9 ± 1.3 to 3.0 ± 1.3% (P = 0.03 and 0.05 for between groups) 2 h after FRC, an effect that was not sustained at 2 and 4 weeks. Cocoa-liquor-free CC had no effect, either on endothelial function or on platelet function. Blood pressure and heart rate did not change in either group.ConclusionFlavanol-rich chocolate acutely improves vascular function in patients with CHF. A sustained effect was seen after daily consumption over a 4-week period, even after 12 h abstinence. These beneficial effects were paralleled by an inhibition of platelet function in the presence of FRC only.Trial Registration ClinicalTrials.gov Identifier: NCT00538941