CT-IGFBP-4 as a novel prognostic biomarker in acute heart failure

Aims Insulin-like growth factor binding protein-4 (IGFBP-4) fragments have been shown to predict the risk of major adverse cardiovascular events, including segment-elevation myocardial infarction, in patients with acute coronary syndrome. We evaluated the prognostic value of the carboxy-terminal fragment of IGFBP-4 (CT-IGFBP-4) for all-cause mortality in emergency room patients with acute heart failure (AHF). Methods and results CT-IGFBP-4, N-terminal pro brain natriuretic peptide (NT-proBNP), and C-reactive protein (CRP) were measured at admission from the lithium-heparin plasma of 156 patients with AHF. All-cause mortality was recorded for 1 year. Receiver operator characteristic (ROC) curves, Kaplan-Meier, and Cox proportional hazard ratio analyses were performed to evaluate the prognostic value of the various clinical variables, CT-IGFBP-4, NT-proBNP, CRP, and their combinations. During 1 year of follow-up, 52 (33.3%) patients died. CT-IGFBP-4 only weakly correlated with NT-proBNP (Pearson correlation coefficient r = 0.16, P = 0.044) and did not correlate with CRP (r = 0.08, P = 0.35), emphasizing the different nature of these biomarkers. The receiver operator characteristic area under the curve (ROC AUC) of CT-IGFBP-4 for the prediction of all-cause mortality (0.727) was significantly higher than that of NT-proBNP (0.680, P = 0.045) and CRP (0.669, P = 0.016). The combination of CT-IGFBP-4, NT-proBNP, and CRP predicted mortality significantly better (ROC AUC = 0.788) than any of the biomarkers alone (P <0.01 for all). The addition of CT-IGFBP-4 to a clinical prediction model that included age, gender, systolic blood pressure, creatinine, and sodium levels, as well as the history of previous heart failure, coronary artery disease, and hypertension significantly improved the mortality risk prediction (ROC AUC 0.774 vs. 0.699, P = 0.025). Cox hazard analysis indicated that elevated CT-IGFBP-4 was independently associated with 1 year mortality (hazard ratio 3.26, P = 0.0008) after adjustment for age, gender, history of previous heart failure, coronary artery disease, hypertension, chronic kidney failure, history of diabetes, heart rate, haemoglobin, plasma sodium, NT-proBNP, CRP, cystatin C, and elevated cardiac troponin I or T. Patients with increased levels of either two or three of the biomarkers CT-IGFBP-4, NT-proBNP, and CRP had significantly higher mortality risk (adjusted hazard ratio 10.04, P <0.0001) than patients with increased levels of one or none of the biomarkers. Conclusions CT-IGFBP-4 was independently associated with all-cause mortality in patients with AHF. Compared with single biomarkers, the combination of CT-IGFBP-4, NT-proBNP, and CRP improved the prediction of all-cause mortality in patients with AHF.Peer reviewe

The Influence of Low-hard Dispersed Additives on Impact Strength of Concrete

AbstractThe article presents the results of experiments on the use dispersed components with reduced stiffness in concrete mixtures to assess their influence on the dynamic strength of concrete. A crushed ceramic bricks, the polystyrene foam, cellular glass and expanded clay sand were used components with reduced stiffness. Samples-cubes were subjected to various dynamic loads, and then measured their strength and were compared with the results obtained for a control sample. Furthermore by vertical dynamic koper were measured impact strength of the obtained compositions. The results of experimental studies are showing the possibility of increasing the impact strength of concrete by introducing into the concrete mix an additive with reduced stiffness. In the same time there is some reduction in other properties of the resulting concrete. Has been defined the optimum additive and its amount to use in the concrete that subjected to dynamic loads

Dry mixes for the restoration: basic principles of design

To ensure compliance with historic solutions as the primary binder of dry mixes for the restoration is air lime. To date, almost all of the advantages and disadvantages of the lime-based mortars are known, and this allows implementing a scientific approach to the goal of ensuring the maximum possible durability of masonries and finishing designs. This article covers the main problems and goals faced by professionals in the field of producing dry building mixtures that are the most technologically and economically appropriate for the restoration of the historical buildings and constructions. The use of modern mineral additives opens up new prospects for improving the properties of lime dry mixtures, for both new construction and restoration works of the objects of historical heritage

Dry mixes for the restoration: basic principles of design

To ensure compliance with historic solutions as the primary binder of dry mixes for the restoration is air lime. To date, almost all of the advantages and disadvantages of the lime-based mortars are known, and this allows implementing a scientific approach to the goal of ensuring the maximum possible durability of masonries and finishing designs. This article covers the main problems and goals faced by professionals in the field of producing dry building mixtures that are the most technologically and economically appropriate for the restoration of the historical buildings and constructions. The use of modern mineral additives opens up new prospects for improving the properties of lime dry mixtures, for both new construction and restoration works of the objects of historical heritage

Snakes Elaphe Radiata May Acquire Awareness of Their Body Limits When Trying to Hide in a Shelter

Body awareness was studied experimentally in the rat snakes Elaphe radiata. The experimental design required that the snakes take into account the limits of their bodies when choosing a suitable hole for penetration into the shelter. The experimental setup consisted of two compartments, a launch chamber and a shelter, separated by a partition with openings of different diameters. The diameters of the holes and/or their position in the partition were changeable. The subjects were 20 snakes divided into two groups, for one of which only the locations of the holes varied; for another, both the location of the holes and the limits of the body varied. The body was increased by feeding the snakes. In the course of the first three experimental series the snakes formed the skill of taking into account the body limits, which manifested in the reduced number of unsuccessful attempts to select holes too small for their bodies. During the fourth series, with the locations of holes randomized for each trial, the snakes demonstrated behavioral flexibility, significantly more often penetrating into the shelter from the first attempt irrespectively of the location of the suitable hole. We argue that these results demonstrate the body-awareness in snakes

Spiral Caustics of Vortex Beams

We discuss the nonparaxial focusing of laser light into a three-dimensional (3D) spiral distribution. For calculating the tangential and normal components of the electromagnetic field on a preset curved surface we propose an asymptotic method, using which we derive equations for calculating stationary points and asymptotic relations for the electromagnetic field components in the form of one-dimensional (1D) integrals over a radial component. The results obtained through the asymptotic approach and the direct calculation of the Kirchhoff integral are identical. For a particular case of focusing into a ring, an analytical relation for stationary points is derived. Based on the electromagnetic theory, we design and numerically model the performance of diffractive optical elements (DOEs) to generate field distributions shaped as two-dimensional (2D) and 3D light spirals with the variable angular momentum. We reveal that under certain conditions, there is an effect of splitting the longitudinal electromagnetic field component. Experimental results obtained with the use of a spatial light modulator are in good agreement with the modeling results