High Output Heart Failure, A Lethal and Forgotten Cause of Heart Failure

Introduction Cardiac output (CO) is usually low or normal in patients with heart failure. However, some patients have a high CO deemed high-output heart failure (HOHF). HOHF is not well characterized and continues to be under-recognized clinically. At the Detroit VA, we conducted a quality improvement project to define the characteristics of this unique patient population, identify predictors and increase awareness of this entity. Methods Patients with HOHF were compared to patients with heart failure with preserved ejection fraction (HFpEF) and normal CO. HOHF was defined as CO \u3e8 L/minute on right heart catheterization performed between 2008-2021. Retrospective data regarding hemodynamics, comorbidities, and mortality were collected and compared using descriptive and univariate analyses. Results There were no significant differences in age or race between the groups or in the rate of comorbidities analyzed except for tobacco smoking and CKD which were higher in the HOHF group. Majority of the patients in the HOHF group had preserved EF (91%). Patients had a similar mean wedge pressure, but the HOHF group had significantly lower pulmonary vascular resistance and systemic vascular resistance. Mortality among patients with HOHF was 48.6% compared to the comparative group of 18.9% (p Conclusion In this single center study comparing HOHF to HFpEF, the HOHF group had significantly higher mortality compared to the HFpEF group, despite similar co-morbidities, wedge pressure and demographics. The diagnosis of HOHF was not made in majority of the cases, suggesting under recognition. We aim to create awareness of this entity among providers and highlight the need for early referral for right heart catheterization, given that HOHF can be erroneously diagnosed as HFpEF without invasive measurements. Clinical trials allocated towards management of this entity is overdue

Green concrete production incorporating waste carpet fiber and palm oil fuel ash

With the increasing amount of waste generation from various processes, there has been a growing interest in the utilization of waste in producing building materials to achieve potential benefits. This paper highlights the results of an experimental investigation on the performance of concrete incorporating waste carpet fiber (WCF) and palm oil fuel ash (POFA) as partial replacements of ordinary Portland cement (OPC). Six volume fractions varying from 0 to 1.25% of 20-mm-long carpet fiber were used with OPC concrete mixes. Another six mixes were made that replaced OPC with 20% POFA. The specimens were cured in water and tested for fresh and hardened state properties. The combination of WCF and POFA decreased the slump values and increased the VeBe time of fresh concrete. The addition of WCF to either OPC or POFA concrete mixes did not improve the compressive strength or modulus of elasticity. At 91 days, the compressive strength was in the range of 38.1e49.1 MPa. The positive interaction between WCF and POFA, however, leads to high tensile and flexural strengths, thereby increasing the concrete ductility with higher energy absorption and improved crack distribution. The maximum increases in tensile and flexural strengths compared to those of plain concrete were achieved by the addition of 0.5% carpet fiber at the age of 91 days. The ultrasonic pulse velocity (UPV) was examined and was classified as good quality concrete. The study showed that the use of waste carpet fiber and palm oil fuel ash in the production of sustainable green concrete is feasible both technically and environmentally

Evaluation of antibacterial, antifungal and modulatory activity of methanol and ethanol extracts of Padina sanctae-crucis

Background: Multi-resistant microorganisms such as Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Candida tropicalis e Candida krusei are the main causes of microbial infections. Padina sanctae-crucis is a seaweed often used to check the contamination of ecosystems by materials such as heavy metals, but studies of the antimicrobial activity of the same seaweed were not found.Methods: The tests for the minimum inhibitory concentration and   modulation of microbial resistance, with the use of ethanolic and  methanolic extracts of Padina Sanctae-cruces combined with drugs of the class of aminoglycosides and antifungal were used to evaluate the activity against the cited microorganisms.Results: Was observed a modulation of antibiotic activity between the natural products and the E. coli and S. aureus strains, indicating a synergism and antagonism respectively.Conclusions: The results showed a moderate modulatory effect against some microorganisms studied.Keywords: multi-resistant microorganisms, modulation, Padina Sanctae-crucis, antimicrobial activity

MiR-155 has a protective role in the development of non-alcoholic hepatosteatosis in mice

Hepatic steatosis is a global epidemic that is thought to contribute to the pathogenesis of type 2 diabetes. MicroRNAs (miRs) are regulators that can functionally integrate a range of metabolic and inflammatory pathways in liver. We aimed to investigate the functional role of miR-155 in hepatic steatosis. Male C57BL/6 wild-type (WT) and miR-155−/− mice were fed either normal chow or high fat diet (HFD) for 6 months then lipid levels, metabolic and inflammatory parameters were assessed in livers and serum of the mice. Mice lacking endogenous miR-155 that were fed HFD for 6 months developed increased hepatic steatosis compared to WT controls. This was associated with increased liver weight and serum VLDL/LDL cholesterol and alanine transaminase (ALT) levels, as well as increased hepatic expression of genes involved in glucose regulation (Pck1, Cebpa), fatty acid uptake (Cd36) and lipid metabolism (Fasn, Fabp4, Lpl, Abcd2, Pla2g7). Using miRNA target prediction algorithms and the microarray transcriptomic profile of miR-155−/− livers, we identified and validated that Nr1h3 (LXRα) as a direct miR-155 target gene that is potentially responsible for the liver phenotype of miR-155−/− mice. Together these data indicate that miR-155 plays a pivotal role regulating lipid metabolism in liver and that its deregulation may lead to hepatic steatosis in patients with diabetes

Calculating the energy spectra of magnetic molecules: application of real- and spin-space symmetries

The determination of the energy spectra of small spin systems as for instance given by magnetic molecules is a demanding numerical problem. In this work we review numerical approaches to diagonalize the Heisenberg Hamiltonian that employ symmetries; in particular we focus on the spin-rotational symmetry SU(2) in combination with point-group symmetries. With these methods one is able to block-diagonalize the Hamiltonian and thus to treat spin systems of unprecedented size. In addition it provides a spectroscopic labeling by irreducible representations that is helpful when interpreting transitions induced by Electron Paramagnetic Resonance (EPR), Nuclear Magnetic Resonance (NMR) or Inelastic Neutron Scattering (INS). It is our aim to provide the reader with detailed knowledge on how to set up such a diagonalization scheme.Comment: 29 pages, many figure