Abnormal Myocardial Blood Flow Reserve Observed in Cardiac Amyloidosis

We performed real-time myocardial contrast echocardiography on a patient with cardiac amyloidosis and previous normal coronary angiography presenting with atypical chest pain to assess myocardial blood flow reserve (MBFR). Myocardial contrast echocardiography was performed and flash microbubble destruction and replenishment analysis was used to calculate myocardial blood flow. Dipyridamole was used to achieve hyperemia. MBFR was derived from the ratio of peak myocardial blood flow at hyperemia and rest. The results show a marked reduction in MBFR in our patient. Previous reports of luminal obstruction of intramyocardial rather than epicardial vessels by amyloid deposition may be causing microvascular dysfunction

Molecular Hydrogen emission from disks in the eta Chamaeleontis cluster

Disks in the 6 Myr old cluster eta Chamaeleontis were searched for emission from hot H2. Around the M3 star ECHAJ0843.3-7905 we detect circumstellar gas orbiting at ~2 AU. If the gas is UV-excited, the ro-vibrational line traces a hot gas layer supported by a disk of mass ~0.03Msolar, similar to the minimum mass solar nebula. Such a gas reservoir at 6 Myr would promote the formation and inwards migration of gas giant planets.Comment: Accepted for publication in MNRAS. 9 page

Forming the first planetary systems: debris around Galactic thick disc stars

The thick disc contains stars formed within the first Gyr of Galactic history, and little is known about their planetary systems. The Spitzer MIPS instrument was used to search 11 of the closest of these old low-metal stars for circumstellar debris, as a signpost that bodies at least as large as planetesimals were formed. A total of 22 thick disc stars has now been observed, after including archival data, but dust is not found in any of the systems. The data rule out a high incidence of debris among star systems from early in the Galaxy's formation. However, some stars of this very old population do host giant planets, at possibly more than the general incidence among low-metal Sun-like stars. As the Solar System contains gas giants but little cometary dust, the thick disc could host analogue systems that formed many Gyr before the Sun.Comment: accepted by MNRAS Letters; 5 pages, 4 figure

Beyond Triage: The Diagnostic Accuracy of Emergency Department Nursing Staff Risk Assessment in Patients with Suspected Acute Coronary Syndromes.

Objectives To establish the accuracy of emergency department (ED) nursing staff risk assessment using an established chest pain risk score alone and when incorporated with presentation high-sensitivity troponin testing as part of an accelerated diagnostic protocol (ADP). Design Prospective observational study comparing nursing and physician risk assessment using the modified Goldman (m-Goldman) score and a predefined ADP, incorporating presentation high-sensitivity troponin. Setting A UK District ED. Patients Consecutive patients, aged 7ge;18, with suspected cardiac chest pain and non-ischaemic ECG, for whom the treating physician determined serial troponin testing was required. Outcome measures 30-day major adverse cardiac events (MACE). Results 960 participants were recruited. 912/960 (95.0%) had m-Goldman scores recorded by physicians and 745/960 (77.6%) by nursing staff. The area under the curve of the m-Goldman score in predicting 30-day MACE was 0.647 (95% CI 0.594 to 0.700) for physicians and 0.572 (95% CI 0.510 to 0.634) for nursing staff ( p=0.09). When incorporated into an ADP, sensitivity for the rule-out of MACE was 99.2% (95% CI 94.8% to 100%) and 96.7% (90.3% to 99.2%) for physicians and nurses, respectively. One patient in the physician group (0.3%) and three patients (1.1%) in the nursing group were classified as low risk yet had MACE. There was fair agreement in the identification of low-risk patients (kappa 0.31, 95% CI 0.24 to 0.38). Conclusions The diagnostic accuracy of ED nursing staff risk assessment is similar to that of ED physicians and interobserver reliability between assessor groups is fair. When incorporating high-sensitivity troponin testing, a nurse-led ADP has a miss rate of 1.1% for MACE at 30 days. Trial registration number Controlled Trials Database (ISRCTN no. 21109279)

Channel diffusion of sodium in a silicate glass

We use classical molecular dynamics simulations to study the dynamics of sodium atoms in amorphous Na$_2$O-4SiO$_2$. We find that the sodium trajectories form a well connected network of pockets and channels. Inside these channels the motion of the atoms is not cooperative but rather given by independent thermally activated hops of individual atoms between the pockets. By determining the probability that an atom returns to a given starting site, we show that such events are not important for the dynamics of this system.Comment: 10 pages of Latex, 5 figures, one figure added, text expande

The replacement histone H2A.Z in a hyperacetylated form is a feature of active genes in the chicken

The replacement histone H2A.Z is variously reported as being linked to gene expression and preventing the spread of heterochromatin in yeast, or concentrated at heterochromatin in mammals. To resolve this apparent dichotomy, affinity-purified antibodies against the N-terminal region of H2A.Z, in both a triacetylatedandnon- acetylatedstate, areusedin native chromatin immmuno-precipitation experiments with mononucleosomes from three chicken cell types. The hyperacetylated species concentrates at the 50 end of active genes, both tissue specific and housekeeping but is absent from inactive genes, while the unacetylated form is absent from both active and inactive genes. A concentration of H2A.Z is also found at insulators under circumstances implying a link to barrier activity but not to enhancer blocking. Although acetylated H2A.Z is widespread throughout the interphase genome, at mitosis its acetylation is erased, the unmodified form remaining. Thus, although H2A.Z may operate as an epigenetic marker for active genes, its N-terminal acetylation does not

The replacement histone H2A.Z in a hyperacetylated form is a feature of active genes in the chicken

The replacement histone H2A.Z is variously reported as being linked to gene expression and preventing the spread of heterochromatin in yeast, or concentrated at heterochromatin in mammals. To resolve this apparent dichotomy, affinity-purified antibodies against the N-terminal region of H2A.Z, in both a triacetylatedandnon- acetylatedstate, areusedin native chromatin immmuno-precipitation experiments with mononucleosomes from three chicken cell types. The hyperacetylated species concentrates at the 50 end of active genes, both tissue specific and housekeeping but is absent from inactive genes, while the unacetylated form is absent from both active and inactive genes. A concentration of H2A.Z is also found at insulators under circumstances implying a link to barrier activity but not to enhancer blocking. Although acetylated H2A.Z is widespread throughout the interphase genome, at mitosis its acetylation is erased, the unmodified form remaining. Thus, although H2A.Z may operate as an epigenetic marker for active genes, its N-terminal acetylation does not