Saltatory Conduction along Myelinated Axons Involves a Periaxonal Nanocircuit

The propagation of electrical impulses along axons is highly accelerated by the myelin sheath and pro- duces saltating or ‘‘jumping’’ action potentials across internodes, from one node of Ranvier to the next. The underlying electrical circuit, as well as the existence and role of submyelin conduction in salta- tory conduction remain, however, elusive. Here, we made patch-clamp and high-speed voltage-cali- brated optical recordings of potentials across the nodal and internodal axolemma of myelinated neocortical pyramidal axons combined with electron microscopy and experimentally constrained cable modeling. Our results reveal a nanoscale yet conduc- tive periaxonal space, incompletely sealed at the paranodes, which separates the potentials across the low-capacitance myelin sheath and internodal axolemma. The emerging double-cable model repro- duces the recorded evolution of voltage waveforms across nodes and internodes, including rapid nodal potentials traveling in advance of attenuated waves in the internodal axolemma, revealing a mechanism for saltation across time and space

Single-crystal neutron diffraction study of β-Cs_3(HSO_4)_2[H_(2-x)(S_xP_(1-x)O_4] (x ≃ 0.5) at 15 K

The structure of β-Cs_3(HSO_4)_2[H_(2-x)(S_xP_(1-x)O_4] has been examined by single-crystal neutron diffraction at 15 K. The compound crystallizes in space group C2/c and contains four formula units in the unit cell, with lattice parameters a = 19.769(9), b = 7.685(2), c = 8.858 (3) Å and β = 100.60 (4)°. Refinement of P, S and H site occupancies indicated that the value of x (in the stoichiometry) is 0.500 (6). This, together with the unit-cell volume of 1322.8(14) Å^3, implies a density of 3.463 Mg m^(-3). The structure contains zigzag rows of XO_4 anions, where X = P or S, that alternate, in a checkerboard fashion, with zigzag rows of Cs cations. Moreover, there is one proton site, H(3), with an occupancy of 0.25 and one X-atom site, X(1), that is occupied by 0.5 P and 0.5 S. These features are in general agreement with a previous X-ray structure determination carried out at 298 K. In contrast to the X-ray study, however, it was found that two different structural models adequately fit the diffraction data. In the first model, the proton vacancies and the P atoms were assumed to be randomly distributed over the H(3) and X(1) sites, respectively, and to have no impact on the local structure. In the second model, several atoms were assigned split occupancies over two neighboring sites, to reflect the presence or absence of a proton vacancy, and the presence of P or S on the X(1) site. Refinement assuming the first model, in which anisotropic displacement parameters for 12 of 14 atom sites in the asymmetric unit were employed, yielded residuals wR(F^2) = 0.084 and wR(F) = 0.038. For the second model, in which anisotropic displacement parameters were utilized for only the five atoms that were not split relative to the first model, the residuals were wR(F^2) = 0.081 and wR(F) = 0.036

Determining Static Hyperinflation in Patients with Severe Emphysema:Relation Between Lung Function Parameters and Patient-Related Outcomes

Background Bronchoscopic lung volume reduction techniques are minor invasive treatment modalities for severely hyperinflated emphysema patients. The severity of static lung hyperinflation determines eligibility and success rate for these treatments. However, it is not exactly known what parameter should be used to optimally reflect hyperinflation. Commonly used parameters are residual volume (RV) and the RV/Total lung capacity (TLC) ratio. Other parameters reflecting hyperinflation are Inspiratory Capacity/TLC and forced vital capacity. Objectives To define which of these function parameters is the most optimal reflection of hyperinflationin in relation to patient-related outcomes. Methods In a retrospective cohort study, data from measurements during baseline visits of eight studies were pooled. Primary outcomes were RV/TLC ratio and RV as percentage of predicted (RV%pred), both measured by bodyplethysmography, compared to the patient-related outcome variables: 6-min walk distance (6MWD), the St. George's Respiratory Questionnaire (SGRQ), and the modified Medical Research Council (mMRC). Results Two hundred seventy-four COPD patients (mean age 59 years; 66% female), FEV(1)0.74 +/- 0.28 L, RV 4.94 +/- 1.06 L, 6MWD of 339 +/- 95 m, were included in the analysis. Significant correlations (allp <0.01) were found between RV%pred and 6MWD (r = - 0.358), SGRQ (r = 0.184), and mMRC (r = 0.228). Also, there was a significant correlation between RV/TLC ratio and 6MWD (r = - 0.563), SGRQ (r = 0.289) and mMRC (r = 0.354). Linear regression analyses showed that RV/TLC ratio was a better predictor of patient outcomes than RV%pred. Conclusion This study demonstrates that both RV/TLC ratio and RV%pred are relevant indicators of hyperinflation in patients with severe emphysema in relation to patient-related outcomes. RV/TLC ratio is more strongly related to the patient-related outcomes than RV%pred

4D Dynamic RNP Annual Interim Report-Year 1

This Annual Interim Report summarizes the activities led by Raytheon, in collaboration with GE Aviation and SAIC, and presents the results obtained during the first year of this research effort to expand the RNP concept to 4 dimensions relative to a dynamic frame of reference. Joint Program Development Office (JPDO)Concepts of Operations for the Next Generation Air Transportation System (NextGen) considers 4 Dimension Trajectory (4DT) procedures a key enabler to Trajectory Based Operations (TBO). The JPDO defines 4DT as a precise description of an aircraft path in space and time . While NextGen assumes that this path is defined within an Earth-reference frame, many 4DT procedure implementations will require an aircraft to precisely navigate relative to a moving reference such as another aircraft to form aggregate flows or a weather cell to allow for flows to shift. Current methods of implementing routes and flight paths rely on aircraft meeting a Required Navigation Performance (RNP) specification and being equipped with a monitoring and alerting capability to annunciate when the aircraft system is unable to meet the performance specification required for the operation. Since all aircraft today operate within the NAS relative to fixed reference points, the current RNP definition is deemed satisfactory. However, it is not well understood how the current RNP construct will support NextGen 4DT procedures where aircraft operate relative to each other or to other dynamic frames of reference. The objective of this research effort is to analyze candidate 4DT procedures from both an Air Navigation Service Provider (ANSP) and aircraft perspective, to identify their specific navigational requirements, assess the shortcomings of the current RNP construct to meet these requirements, to propose an extended 4 Dimensional Dynamic RNP (4D Dynamic RNP) construct that accounts for the dynamic spatial and temporal nature of the selected 4DT procedures, and finally, to design an experiment using the Airspace and Traffic Operations Simulation (ATOS) system to validate the 4D Dynamic RNP construct. This Annual Interim Report summarizes the activities led by Raytheon, in collaboration with GE Aviation and SAIC, and presents the results obtained during the first year of this research effort to expand the RNP concept to 4 dimensions relative to a dynamic frame of reference. A comprehensive assessment of the state-of-the-art international implementation of current RNP was completed and presented in the Contractor Report RNP State-of-the-Art Assessment, Version 4, 17 December 2008 . The team defined in detail two 4DT operations, Airborne Precision Spacing and Self-Separation, that are ideally suited to be supported by 4D Dynamic RNP and developed their respective conceptual frameworks, Required Interval Management Performance (RIMP) Version 1.1, 13 April 2009 and Required Self Separation Performance (RSSP) Version 1.1, 13 April 2009 . Finally, the team started the development of a mathematical model and simulation tool for RIMP and RSSP scheduled to be delivered during the second year of this research effort

Patient Selection for Bronchoscopic Lung Volume Reduction

Purpose: Bronchoscopic lung volume reduction (BLVR) is a valuable treatment option for carefully selected patients with severe COPD. There is limited knowledge about the characteristics and outcomes of patients referred to a specialized center for BLVR. The study objectives were to investigate the selection rate for BLVR treatment in patients referred for this treatment and to investigate the differences between patients that were selected for BLVR and patients that were not. Patients and Methods: We performed a retrospective analysis of patients with severe COPD who were referred to our hospital to assess eligibility for BLVR treatment. Our parameters included demographics, comorbidity, chest computed tomography characteristics, reasons for rejection from BLVR treatment and patient survival. Results: In total, 1500 patients were included (mean age 62 years, 50% female and forced expiratory volume in 1 s 33% of predicted). Out of this group, 282 (19%) patients were selected for BLVR treatment. The absence of a suitable target lobe for treatment, an unsuitable disease phenotype and insufficient lung hyperinflation were the most important factors for not being selected. Patients that were selected for any BLVR option lived significantly longer than the group of patients that were not selected for BLVR (median 3060 versus 2079 days, P<0.001). Conclusion: We found that only a small proportion of patients that are referred for BLVR treatment is eligible for a BLVR treatment, indicating a need for both better referral tools and for the development of new therapies for this group of patients. Furthermore, our data suggest that selection for BLVR is associated with a significant survival benefit

Comparison of Multiple Diagnostic Tests to Measure Dynamic Hyperinflation in Patients with Severe Emphysema Treated with Endobronchial Coils

PURPOSE: For this study, we aimed to compare dynamic hyperinflation measured by cardiopulmonary exercise testing (CPET), a six-minute walking test (6-MWT), and a manually paced tachypnea test (MPT) in patients with severe emphysema who were treated with endobronchial coils. Additionally, we investigated whether dynamic hyperinflation changed after treatment with endobronchial coils. METHODS: Dynamic hyperinflation was measured with CPET, 6-MWT, and an MPT in 29 patients before and after coil treatment. RESULTS: There was no significant change in dynamic hyperinflation after treatment with coils. Comparison of CPET and MPT showed a strong association (rho 0.660, p < 0.001) and a moderate agreement (BA-plot, 202 ml difference in favor of MPT). There was only a moderate association of the 6-MWT with CPET (rho 0.361, p 0.024). CONCLUSION: MPT can be a suitable alternative to CPET to measure dynamic hyperinflation in severe emphysema but may overestimate dynamic hyperinflation possibly due to a higher breathing frequency

Нове видання з історії становлення кодикографії та бібліографії стародруків України

Розглядається монографічне видання, яке вперше комплексно представ-ляє загальний стан колекційних рукописних та книжкових фондів бібліотек і музеїв в Україні в другій половині ХІХ – 30-х роках ХХ ст.; формування та діяльність наукових центрів з вивчення історії книги в Україні у період, коли археографічна діяльність досягла найвищого рівня свого розвитку.Рассматривается монографическое издание, которое впервые комплексно представляет общее состояние коллекционных рукописных и книжных фондов библиотек и музеев в Украине во второй половине ХіХ – 30-х годах ХХ ст.; формирование и деятельность научных центров по изучению истории книги в Украине в период, когда археографическая деятельность достигла наивысшего уровня своего развития.The consideration of the monographic edition which for the firs time represents in complex the general condition of collection hand-written and book funds of libraries and museums in Ukraine in the second half of ХIХ–30-th years of ХХ century, the formation and activity of scientific centres on studying book history in Ukraine at the period of the highest level of the archaeographic activity development

Patterns in the Use of Heart Failure Telemonitoring: Post Hoc Analysis of the e-Vita Heart Failure Trial

BACKGROUND: Research on the use of home telemonitoring data and adherence to it can provide new insights into telemonitoring for the daily management of patients with heart failure (HF). OBJECTIVE: We described the use of a telemonitoring platform-including remote patient monitoring of blood pressure, pulse, and weight-and the use of the electronic personal health record. Patient characteristics were assessed in both adherent and nonadherent patients to weight transmissions. METHODS: We used the data of the e-Vita HF study, a 3-arm parallel randomized trial performed in stable patients with HF managed in outpatient clinics in the Netherlands. In this study, data were analyzed from the participants in the intervention arm (ie, e-Vita HF platform). Adherence to weight transmissions was defined as transmitting weight ≥3 times per week for at least 42 weeks during a year. RESULTS: Data from 150 patients (mean age 67, SD 11 years; n=37, 25% female; n=123, 82% self-assessed New York Heart Association class I-II) were analyzed. One-year adherence to weight transmissions was 74% (n=111). Patients adherent to weight transmissions were less often hospitalized for HF in the 6 months before enrollment in the study compared to those who were nonadherent (n=9, 8% vs n=9, 23%; P=.02). The percentage of patients visiting the personal health record dropped steadily over time (n=140, 93% vs n=59, 39% at one year). With univariable analyses, there was no significant correlation between patient characteristics and adherence to weight transmissions. CONCLUSIONS: Adherence to remote patient monitoring was high among stable patients with HF and best for weighing; however, adherence decreased over time. Clinical and demographic variables seem not related to adherence to transmitting weight. TRIAL REGISTRATION: ClinicalTrials.gov NCT01755988; https://clinicaltrials.gov/ct2/show/NCT01755988

Patterns in the Use of Heart Failure Telemonitoring:Post Hoc Analysis of the e-Vita Heart Failure Trial

Background: Research on the use of home telemonitoring data and adherence to it can provide new insights into telemonitoring for the daily management of patients with heart failure (HF). Objective: We described the use of a telemonitoring platform—including remote patient monitoring of blood pressure, pulse, and weight—and the use of the electronic personal health record. Patient characteristics were assessed in both adherent and nonadherent patients to weight transmissions. Methods: We used the data of the e-Vita HF study, a 3-arm parallel randomized trial performed in stable patients with HF managed in outpatient clinics in the Netherlands. In this study, data were analyzed from the participants in the intervention arm (ie, e-Vita HF platform). Adherence to weight transmissions was defined as transmitting weight ≥3 times per week for at least 42 weeks during a year. Results: Data from 150 patients (mean age 67, SD 11 years; n=37, 25% female; n=123, 82% self-assessed New York Heart Association class I-II) were analyzed. One-year adherence to weight transmissions was 74% (n=111). Patients adherent to weight transmissions were less often hospitalized for HF in the 6 months before enrollment in the study compared to those who were nonadherent (n=9, 8% vs n=9, 23%; P=.02). The percentage of patients visiting the personal health record dropped steadily over time (n=140, 93% vs n=59, 39% at one year). With univariable analyses, there was no significant correlation between patient characteristics and adherence to weight transmissions. Conclusions: Adherence to remote patient monitoring was high among stable patients with HF and best for weighing; however, adherence decreased over time. Clinical and demographic variables seem not related to adherence to transmitting weight.</p