Prevalence of pre-transplant electrocardiographic abnormalities and post-transplant cardiac events in patients with liver cirrhosis.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.Although cardiovascular disease is thouht to be common in cirrhosis, there are no systematic investigations on the prevalence of electrocardiographic (ECG) abnormalities in these patients and data on the occurrence of post-transplant cardiac events in comparison with the general population are lacking. We aimed to study the prevalence and predictors of ECG abnormalities in patients with cirrhosis undergoing liver transplantation and to define the risk of cardiac events post-transplant compared to the general population.Cirrhotic patients undergoing first-time liver transplantation between 1999-2007 were retrospectively enrolled. ECGs at pre-transplant evaluation were reviewed using the Minnesota classification and compared to healthy controls. Standardized incidence ratios for post-transplant cardiac events were calculated.234 patients with cirrhosis were included, 186 with an available ECG (36% with alcoholic and 24% with viral cirrhosis; mean follow-up 4 years). Cirrhotics had a prolonged QTc interval, a Q wave, abnormal QRS axis deviation, ST segment depression and a pathologic T wave more frequently compared to controls (p < 0.05 for all). Arterial hypertension, older age, cirrhosis severity and etiology were related to ECG abnormalities. Compared to the general Swedish population, patients were 14 times more likely to suffer a cardiac event post-transplant (p < 0.001). A prolonged QTc interval and Q wave were related to post-transplant cardiac events (p < 0.05 for all).Pre-transplant ECG abnormalities are common in cirrhosis and are associated with cardiovascular risk factors and cirrhosis severity and etiology. Post-transplant cardiac events are more common than in the general population.Medical research council of Vastra Gotaland in Sweden ALF-2210

A clinicopathological study of the neuropsychiatric features of Parkinson's disease

Imperial Users onl

Reducing Solar Dish Park Production Volatility Utilizing Lithium-ion Batteries

Solar dish-Stirling technology is the Concentrated Solar Power (CSP) technology that can be more easily integrated into Distribution networks due to its small size. However, a disadvantage of this technology is that features shorter thermal inertia and thus, the output is more volatile compared to large scale CSP plants. In this paper, the production of a solar dish-Stirling plant connected to a battery bank forming a Hybrid plant is studied, in order to determine up to what extent the production stabilization can be achieved. A modelling approach of the electricity output of a solar dish system integrated to a lithium-ion battery, is developed. A methodology based on the minimization of the mean square error between the actual and the proposed stabilized production is presented, in order to optimally size the battery bank. Results from the application of the Hybrid plant for typical days of various seasons prove the output capability of such a configuration and the guaranteed power amount of the relevant plant, along with the addition of volatility decrease

Promiscuous Substrate-Binding explains the Enzymatic stereo and Regiocontrolled Synthesis of Enantiopure Hydroxy Ketones and Diols

Financial support from the Spanish Ministerio de Ciencia e Innovación (MICINN, Project CTQ2007-61126) and the Spanish Ministerio de Asuntos Exteriores y de Cooperación (Programa de Cooperación Interuniversitaria, PCI Iberoamérica MAEC-AECID, Project A/8856/07) is gratefully acknowledged

Altered fasting and postprandial plasma ghrelin levels in patients with liver failure are normalized after liver transplantation

[Abstract] Context Anorexia is a problem of paramount importance in patients with advanced liver failure. Ghrelin has important actions on feeding and weight homeostasis. Experimental data exist, which suggest that ghrelin could protect hepatic tissue. Both fasting and post-oral glucose tolerance test (OGTT) ghrelin concentrations are controversial in liver cirrhosis and are unknown after liver transplantation. Objective Our aim was to study fasting ghrelin concentrations and their response to an OGTT in liver failure patients before and after liver transplantation. Design and methods We included 21 patients with severe liver failure studied before (pretransplantation, PreT) and 6 months after liver transplantation (posttransplantation, PostT), and 10 age- and body mass index-matched healthy or overweight subjects as the control group (Cont). After an overnight fast, 75 g of oral glucose were administered; glucose, insulin, and ghrelin were obtained at baseline and at times 30, 60, 90, and 120 min. Results Fasting ghrelin (median and range, pg/ml) levels were lower in PreT: 539 (309–1262) than in Cont: 643 (523–2163), P=0.045. Fasting ghrelin levels increased after liver transplantation, 539 (309–1262) vs 910 (426–3305), for PreT and PostT respectively, P=0.001. The area under the curve (AUC) of ghrelin (pg/ml min) was lower in PreT: 63 900 (37 260–148 410) than in Cont: 76 560 (56 160–206 385), P=0.027. The AUC of ghrelin increased in PostT, 63 900 (37 260–148 410) vs 107 595 (59 535–357 465), for PreT and PostT respectively, P=0.001. Fasting levels and the AUC of ghrelin were similar in PosT and Cont. Conclusions Decreased fasting and post-OGTT ghrelin levels in liver failure patients were normalized after liver transplantation.Instituto de Salud Carlos III; PI051024Instituto de Salud Carlos III; PI070413Xunta de Galicia; PS07/12Galicia. Consellería de Innovación, Industria e Comercio; PGIDT05PXIC91605PNGalicia. Consellería de Economía e Industria; INCITE08ENA916110E

Managing the transition period of dairy cows to prevent major metabolic postpartum disorders

Οι πρώτες εβδομάδες μετά τον τοκετό αποτελούν το χρονικό διάστημα με τη μεγαλύτερη συχνότητα εμφάνισης ασθενειών, σε σύγκριση με οποιοδήποτε άλλο στάδιο του παραγωγικού κύκλου των αγελάδων γαλακτοπαραγωγής. Πολλές από τις παθήσεις αυτές είναι αλληλένδετες και συχνά συνυπάρχουν. Η διαχείριση των αγελάδων γαλακτοπαραγωγής κατά τη μεταβατική περίοδο (3-4 εβδομάδες πριν έως και 4 εβδομάδες μετά τον τοκετό) αποσκοπεί στην κατάλληλη προετοιμασία τους για τη διατήρηση της υγείας τους και τη μεγιστοποίηση των αποδόσεων τους. Η επίτευξη υψηλής γαλακτοπαραγωγής προϋποθέτει, πέραν της διατήρησης της υγείας των αγελάδων, κατάλληλη διατροφή και εξασφάλιση ιδανικών συνθηκών διαβίωσης. Το παρόν άρθρο αποτελείται από δύο μέρη. Στο πρώτο μέρος, παραθέτονται επιλεγμένες πληροφορίες για τις σημαντικότερες επιλόχειες μεταβολικές παθήσεις (υπασβεστιαιμία, κέτωση) και γίνεται αναφορά στη σχέση της υπασβεστιαιμίας με επιλεγμένες ασθένειες της περιόδου αυτής (κατακράτηση εμβρυϊκών υμένων, μητρίτιδα, μαστίτιδα, μετατόπιση ηνΰστρου). Στο δεύτερο μέρος του άρθρου, προτείνονται διαχειριστικές παρεμβάσεις που αφορούν στη διατροφή των αγελάδων κατά το κρίσιμο διάστημα της μεταβατικής περιόδου, με έμφαση στην πρόληψη της υπασβεστιαιμίας.The transition period refers to the time between 3-4 weeks prior to and 4 weeks after calving. This is the period with the highest incidence of metabolic and other periparturient disorders. Many of these disorders interrelated and often coincide. Proper management and nutrition of the transition cow are critical for obtaining maximum dry matter intake, good health, increased reproductive efficiency and optimum milk production in the following lactation. The present review is comprised from two parts. In the first one, selected information is provided concerning the most important metabolic diseases of the transition period (hypocalcemia, ketosis) and, in brief, how hypocalcemia is interrelated to other diseases (mastitis, metritis, retained fetal membranes and abomasal displacement). In the second part, up-to-date nutritional methods applied in the transition period to prevent these metabolic periparturient diseases, with emphasis in hypocalcemia, are described

Limbic grey matter changes in early Parkinson's disease

The purpose of this study was to investigate local and network related changes of limbic grey matter in early Parkinson’s disease (PD) and their interrelation with non-motor symptom severity. We applied voxel-based morphometric methods in 538 T1 MRI images retrieved from the Parkinson's Progression Markers Initiative website. Grey matter densities and cross-sectional estimates of age-related grey matter change were compared between subjects with early PD (n=366) and age-matched healthy controls (n=172) within a regression model, and associations of grey matter density with symptoms were investigated. Structural brain networks were obtained using covariance analysis seeded in regions showing grey matter abnormalities in PD subject group. Patients displayed focally reduced grey matter density in the right amygdala, which was present from the earliest stages of the disease without further advance in mild-moderate disease stages. Right amygdala grey matter density showed negative correlation with autonomic dysfunction and positive with cognitive performance in patients, but no significant interrelations were found with anxiety scores. Patients with PD also demonstrated right amygdala structural disconnection with less structural connectivity of the right amygdala with the cerebellum and thalamus but increased covariance with bilateral temporal cortices compared with controls. Age-related grey matter change was also increased in PD preferentially in the limbic system. In conclusion, detailed brain morphometry in a large group of early PD highlights predominant limbic grey matter deficits with stronger age-associations compared with controls and associated altered structural connectivity pattern. This provides in vivo evidence for early limbic grey matter pathology and structural network changes that may reflect extranigral disease spread in PD

Uncrewed Aircraft Systems for Autonomous Infrastructure Inspection

Uncrewed Aircraft Systems (UAS) are becoming increasingly popular for infrastructure inspections since they offer increased safety, decreased costs and consistent results, compared to traditional methods. However, there are still many open challenges before fully autonomous, reliable, and repeatable UAS inspections. While a UAS platform has increased mobility and can easily approach hard to reach areas, it has limited range and payload capacity and is susceptible to environmental disturbances. Therefore, current operations are limited to Visual Line of Sight (VLOS) manual inspections that usually result in just a qualitative (visual) assessment of the structure. The objective of this work is to propose solutions to these limitations in an effort to improve the effectiveness of UAS as an autonomous inspection platform. First, a heterogeneous marsupial robotic system is proposed as a solution to the limited range and flight time of UAS. The proposed system uses an Autonomous Surface Vehicle (ASV) to ferry the UAS close to the area of interest, where the latter can perform an inspection. Combining these two different platforms in a single system takes advantage of the individual strengths resulting on a platform that has the reach and high point of view of a UAS but has the range and operation time of the ASV. The proposed system was extensively tested over a six-month period in field deployments at Lake Murray and at the Congaree River, SC, USA, to validate its capabilities. As a solution to go beyond visual UAS inspections, a UAS equipped with a Stereo Digital Image Correlation (StereoDIC) system is proposed. StereoDIC is a non-contact non-destructive evaluation method that can accurately measure displacements, strains, strain rates, and geometry profiles. StereoDIC has become a method of choice in experimental mechanics with most studies performed in controlled lab environments with controlled lighting and stationary cameras positioned in the appropriate distance from the measured object. A prototype is built and tested in a lab setting to investigate its effectiveness and understand the challenges that might arise from the deployment of such a system. A comparative study using a stationary StereoDIC system validates the accuracy of the measurements while the acquisition of measurements showing the onset and evolution of defects and the dynamic response of the structure during a harmonic oscillation verifies the ability of the system to produce a quantitative assessment. Finally, using the lessons learned from the lab experiments, a new, upgraded, StereoDIC enabled UAS is developed for outdoor deployment and infrastructure inspection. To allow safe field deployments, the new system features a state estimation framework enabling operation in GNSS degraded environments while also estimating any external disturbances acting on the platform. These disturbances are utilized by the controller to make the platform adaptable to challenging weather conditions. The new system was deployed over an eight-month period at a railroad bridge in Columbia, SC. Initial data were collected that guided the investigations of effective speckle pattern applications. Experimental results from bridge measurements, while loaded from crossing trains, are presented and discussed