782 research outputs found

    Two-year clinical outcome from the Iberian registry patients after left atrial appendage closure

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    AIMS: The aim of this study was to observe the percentage of thromboembolic and haemorrhagic events over a 2-year follow-up in patients with non-valvular atrial fibrillation (NVAF) undergoing closure of the left atrial appendage (LAA) with an occlusion device. Observed events and CHADS2 (congestive heart failure, hypertension, age, diabetes, stroke history), CHA2DS2-VASc (also adding: vascular disease and sex) and HAS-BLED (hypertension, abnormal liver/renal function, stroke history, bleeding predisposition, labile international normalised ratios, elderly, drugs/alcohol use)-predicted events were compared. METHODS: LAA closure with an occlusion device was performed in 167 NVAF patients contraindicated for oral anticoagulants and recruited from 12 hospitals between 2009 and 2013. At least two transoesophageal echocardiograms were performed in the first 6 months postimplantation. Antithrombotics included clopidogrel and aspirin. Patients were monitored for death, stroke, major and relevant bleeding and hospitalisation for concomitant conditions. Mean age was 74.68±8.58, median follow-up was 24 months, 5.38% had intraoperative complications and implantation was successful in 94.6% of subjects. Mortality during follow-up was 10.8%, mostly (9.5%) non-cardiac related. Bleeding occurred in 10.1% of subjects, 5.7% major and 4.4% minor though relevant, and 4.4% suffered stroke. Major bleeding and stroke/transient ischaemic attack events within 2 years (annual event rates, 290 patients/year) were less frequent than expected from CHADS2 (2.4% vs 9.6%), CHA2DS2-VASc (2.4% vs 8.3%) and HAS-BLED (3.1% vs 6.6%) risk scores (p<0.001, p=0.003, p=0.047, respectively). CONCLUSIONS: LAA closure with an occlusion device in patients contraindicated for oral anticoagulants is a therapeutic option associated with fewer thromboembolic and haemorrhagic events than expected from risk scores, particularly in the second year postimplantation

    Tribological behaviour of microalloyed and conventional C–Mn rail steels in a pure sliding condition

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    This paper compares the tribological behaviour of microalloyed rail steel with conventional C–Mn rail steel under different test conditions (load, temperature and humidity). Pin-on-disc tribological tests were performed inside a climate chamber under different loads (20, 30 and 40 N), relative humidity (15, 55 and 70%) and temperatures (20 and 40 ℃). After the friction and wear tests, the worn surfaces were analysed using both confocal and scanning electron microscopies. The results obtained show that the use of microalloyed steel in railway applications under severe conditions (high loads and humidity) could lead to increased service life of the rails and could extend the time between maintenance operations

    An extremely primitive halo star

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    The early Universe had a chemical composition consisting of hydrogen, helium and traces of lithium1, almost all other elements were created in stars and supernovae. The mass fraction, Z, of elements more massive than helium, is called "metallicity". A number of very metal poor stars have been found some of which, while having a low iron abundance, are rich in carbon, nitrogen and oxygen. For theoretical reasons and because of an observed absence of stars with metallicities lower than Z=1.5E-5, it has been suggested that low mass stars (M<0.8M\odot, the ones that survive to the present day) cannot form until the interstellar medium has been enriched above a critical value, estimated to lie in the range 1.5E-8\leqZ\leq1.5E-6, although competing theories claiming the contrary do exist. Here we report the chemical composition of a star with a very low Z\leq6.9E-7 (4.5E-5 of that of the Sun) and a chemical pattern typical of classical extremely metal poor stars, meaning without the enrichment of carbon, nitrogen and oxygen. This shows that low mass stars can be formed at very low metallicity. Lithium is not detected, suggesting a low metallicity extension of the previously observed trend in lithium depletion. Lithium depletion implies that the stellar material must have experienced temperatures above two million K in its history, which points to rather particular formation condition or internal mixing process, for low Z stars.Comment: Published on Nature, 2011 Volume 477, Issue 7362, pp. 67-6

    Time Distribution of the Onset of Chest Pain in Subjects with Acute ST-Elevation Myocardial Infarction: An Eight-Year, Single-Center Study in China

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    Objective: The objective of this study was to explore the time distribution patterns of the onset of chest pain in subjects with acute ST-elevation myocardial infarction in a Chinese population. Methods: A total of 1467 patients with acute ST-elevation myocardial infarction were enrolled from 2003 to 2010. The hourly, daily, monthly, seasonal and day-of-week fluctuations in the prevalence of acute ST-elevation myocardial infarction were analyzed. Results: A peak was found between the morning hours of 07:31 and 08:30. A second peak was observed between 14:31 and 15:30, and a third peak was found between 23:31 and 00:30 (p,0.001). The monthly maximum was recorded in November and the minimum was in April (p,0.001). The number of daily cases was greatest in autumn and lowest in the spring (p = 0.001). Day-of-the-week variations of ST-elevation acute myocardial infarction were not found, except in patients more than 75-years-old. Conclusions: Periodic variations in the frequency of ST-elevation acute myocardial infarction in Chinese patients showed significant differences with regard to diurnal, monthly and seasonal patterns. The exact mechanisms underlying thes

    Antifriction and Antiwear Properties of an Ionic Liquid with Fluorine-Containing Anion Used as Lubricant Additive.

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    Tribological behavior of trihexyltetradecylphosphonium bis(trifluoromethylsulfonyl) imide [P66614][NTf2] ionic liquid (IL) used as additive in a diester oil at concentrations of 0.25, 0.5 and 1 wt% was studied in this research. The IL solubility in the base oil was measured using the inductively coupled plasma mass spectrometry (ICP-MS) technique, and corrosion analysis was done at room temperature at relative humidity of 49–77%. Tribological tests were conducted for 30 min at room temperature, 15 Hz frequency, 4 mm of stroke length, a load of 80 N (corresponding to 2 GPa of maximum contact pressure) and relative humidity of 35–53%. Friction coefficient was recorded during tests, and the wear scar was measured by confocal microscopy. Worn surface was also analyzed by SEM, EDS and XPS. Results showed that a saturated solution of [P66614][NTf2] in the base oil contains about 30 wt% of IL and corrosion activity for the highest concentration of IL (1 wt%) was not found after a 20-day test. Although the base oil and the mixtures had similar friction behavior, only the 1 wt% sample exhibited slightly lower wear volume than the base oil. SEM images exhibited similar wear track width (707–796 ”m) and wear mechanism (adhesive) for all samples tested. In addition, the EDS spectra only showed the elements present in the steel. Finally, the XPS measurements could not detect differences regarding iron chemical state among the samples, which is consistent with the tribological behavior obtained

    Observation of associated near-side and away-side long-range correlations in √sNN=5.02  TeV proton-lead collisions with the ATLAS detector

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    Two-particle correlations in relative azimuthal angle (Δϕ) and pseudorapidity (Δη) are measured in √sNN=5.02  TeV p+Pb collisions using the ATLAS detector at the LHC. The measurements are performed using approximately 1  Όb-1 of data as a function of transverse momentum (pT) and the transverse energy (ÎŁETPb) summed over 3.1<η<4.9 in the direction of the Pb beam. The correlation function, constructed from charged particles, exhibits a long-range (2<|Δη|<5) “near-side” (Δϕ∌0) correlation that grows rapidly with increasing ÎŁETPb. A long-range “away-side” (Δϕ∌π) correlation, obtained by subtracting the expected contributions from recoiling dijets and other sources estimated using events with small ÎŁETPb, is found to match the near-side correlation in magnitude, shape (in Δη and Δϕ) and ÎŁETPb dependence. The resultant Δϕ correlation is approximately symmetric about π/2, and is consistent with a dominant cos⁥2Δϕ modulation for all ÎŁETPb ranges and particle pT
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