1,501 research outputs found

    Pulmonary arterial hypertension and pulmonary hypertension due to left heart disease : so near and yet so far

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    A challenging phenotype of pulmonary arterial hypertension

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    Research of Parameters of a Compression Ignition Engine Using Various Fuel Mixtures of Hydrotreated Vegetable Oil (HVO) and Fatty Acid Esters (FAE)

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    The present study is aimed at studying the energy and environmental performance at various engine loads (BMEP) with identical start of injection (SOI) for all fuel types. The combustion parameters for the fuel mixtures were analyzed using the AVL BOOST software (BURN subroutine). Five different blends were tested, consisting completely of renewable raw materials based on hydrotreated vegetable oil (HVO) and fatty acid methyl ester (FE100), and the properties of diesel fuel (D) were compared with respect to these blends. The mixtures were mixed in the following proportions: FE25 (FE25HVO75), FE50 (FE50HVO50), FE75 (FE75HVO25). In this study, diesel exhaust was found to produce higher NOx values compared to FE blends, with HVO being the lowest. Hydrocarbon and smoke emissions were also significantly lower for blends than for diesel. Possible explanations are the physical properties and fatty acid composition of fuel mixtures, affecting injection and further combustion. The results showed that blends containing more unsaturated fatty acids release more nitrogen oxides, thus having a lower thermal efficiency compared to HVO. No essential differences in CO emissions between D and HVO were observed. An increase in this indicator was observed at low loads for mixtures with ester. CO2 was reduced in emissions for HVO compared to the aforementioned blends and diesel. The results of the combustion analysis show that with a high content of unsaturated fatty acids, mixtures have a longer combustion time than diesel fuel.© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).fi=vertaisarvioitu|en=peerReviewed

    Virtual histology to evaluate mechanisms of pulmonary artery lumen enlargement in response to balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension

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    Chronic thromboembolic pulmonary hypertension (CTEPH) results from an obstruction of pulmonary arteries (PAs) by organized thrombi. The stenosed PAs are targeted during balloon pulmonary angioplasty (BPA). We aimed to evaluate the mechanism of BPA in inoperable patients with CTEPH. We analyzed stenosed PAs with intravascular grey-scale ultrasound (IVUS) to determine the cross-sectional area (CSA) of arterial lumen and of organized thrombi. The composition of organized thrombi was assessed using virtual histology. We distinguished two mechanisms of BPA: Type A with dominant vessel stretching, and type B with dominant thrombus compression. PAs were assessed before (n = 159) and after (n = 98) BPA in 20 consecutive patients. Organized thrombi were composed of dark-green (57.1 (48.0–64.0)%), light-green (34.0 (21.4–46.4)%), red (6.4 (2.9–11.7)%;) and white (0.2 (0.0–0.9)%) components. The mechanism type depended on vessel diameter (OR = 1.09(1.01–1.17); p = 0.03). In type B mechanism, decrease in the amount of light-green component positively correlated with an increase in lumen area after BPA (r = 0.50; p = 0.001). The mechanism of BPA depends on the diameter of the vessel. Dilation of more proximal PAs depends mainly on stretching of the vessel wall while dilation of smaller PAs depends on compression of the organized thrombi. The composition of the organized thrombi contributes to the effect of BPA

    Electrocardiogram reading : a randomized study comparing 2 e-learning methods for medical students

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    Interpretation of the electrocardiogram (ECG) is an essential skill in most medical specialties; however, the best method of teaching how to read ECGs has not been determined. The aim of the study was to compare the effectiveness of collaborative (C‑eL) and self (S‑eL) e‑learning of ECG reading among medical students. A total of 60 fifth‑year medical students were randomly assigned to the C‑eL and S‑eL groups. S‑eL students received 15 ECG recordings with a comprehensive description by email (one every 48 hours), while C‑eL students received the same ECG recordings without description. C‑eL students were expected to analyze each ECG together within the subgroups using an internet platform and to submit the interpretation within 48 hours. Afterwards, they received a description of each ECG. C‑eL students' activity was assessed based on the number of words written on the internet platform during discussion. A final test consisted of 10 theoretical questions and 10 ECG recordings. The final score was a sum of points obtained for the interpretation of ECG recordings. The main endpoint of the study was the number of students whose final score was 56% or higher. The final test was completed by 53 students (88.3%). The main endpoint was achieved in 20 C‑eL students (77%) and in 13 S‑eL students (48.1%), P = 0.03. The final score was 6.4 (interquartile range [IQR], 5.8-7.6) in the C‑eL group and 5.6 (IQR, 4.2-7.2) in the S‑eL group, P = 0.04. It correlated with the results of the theoretical test and students’ activity during C‑eL (r = 0.42, P = 0.002 and r = 0.4, P = 0.04, respectively). C‑eL of ECG reading among fifth‑year medical students is superior to S‑eL

    Ring Signatures: Logarithmic Size, No Setup -- from Standard Assumptions

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    Ring signatures allow for creating signatures on behalf of an ad hoc group of signers, hiding the true identity of the signer among the group. A natural goal is to construct a ring signature scheme for which the signature size is short in the number of ring members. Moreover, such a construction should not rely on a trusted setup and be proven secure under falsifiable standard assumptions. Despite many years of research this question is still open. In this paper, we present the first construction of logarithmic-size ring signatures which do not rely on a trusted setup or the random oracle heuristic. Specifically, our scheme can be instantiated from standard assumptions and the size of signatures grows only logarithmically in the number of ring members. We also extend our techniques to the setting of linkable ring signatures, where signatures created using the same signing key can be linked

    Low-density lipoprotein cholesterol and survival in pulmonary arterial hypertension

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    Low-density lipoprotein cholesterol(LDL-C) is a well established metabolic marker of cardiovascular risk, however, its role in pulmonary arterial hypertension (PAH) has not been determined. Therefore we assessed whether LDL-C levels are altered in PAH patients, if they are associated with survival in this group and whether pulmonary hypertension (PH) reversal can influence LDL-C levels. Consecutive 46 PAH males and 94 females were age matched with a representative sample of 1168 males and 1245 females, respectively. Cox regression models were used to assess the association between LDL-C and mortality. The effect of PH reversal on LDL-C levels was assessed in 34 patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing invasive treatment. LDL-C was lower in both PAH (2.6±0.8mmol/l) and CTEPH (2.7±0.7mmol/l) patients when compared to controls (3.2±1.1mmol/l, p<0.001). In PAH patients lower LDL-C significantly predicted death (HR:0.44/1mmol/l, 95%CI:0.26–0.74, p=0.002) after a median follow-up time of 33(21–36) months. In the CTEPH group, LDL-C increased (from 2.6[2.1–3.2] to 4.0[2.8–4.9]mmol/l, p=0.01) in patients with PH reversal but remained unchanged in other patients (2.4[2.2–2.7] vs 2.3[2.1–2.5]mmol/l, p=0.51). We concluded that LDL-C level is low in patients with PAH and is associated with an increased risk of death. Reversal of PH increases LDL-C levels

    Inhibition of fatty acid synthesis induces differentiation and reduces tumor burden in childhood neuroblastoma

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    Many metabolic pathways, including lipid metabolism, are rewired in tumors tosupport energy and biomass production and to allow adaptation to stressful en-vironments. Neuroblastoma is the second deadliest solid tumor in children. Ge-netic aberrations, as the amplification of theMYCN-oncogene, correlate stronglywith disease progression. Yet, there are only a few molecular targets successfullyexploited in the clinic. Here we show that inhibition of fatty acid synthesis led toincreased neural differentiation and reduced tumor burden in neuroblastomaxenograft experiments independently ofMYCN-status. This was accompaniedby reduced levels of the MYCN or c-MYC oncoproteins and activation of ERKsignaling. Importantly, the expression levels of genes involved inde novofattyacid synthesis showed prognostic value for neuroblastoma patients. Our findingsdemonstrate that inhibition ofde novofatty acid synthesis is a promising pharma-cological intervention strategy for the treatment of neuroblastoma indepen-dently ofMYCN-status
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