Measurement of pulmonary arterial elastance in patients with systolic heart failure using Doppler echocardiography

Objective: A reliable and easy-to-perform method for measuring right ventricular (RV) afterload is desirable when scheduling patients with systolic heart failure to undergo heart transplantation. The present study aimed to investigate the accuracy of echocardiographically-derived pulmonary arterial elastance as a measurement of pulmonary vascular resistance by comparing it with invasive measures. Methods: Thirty-one patients with moderate to severe systolic heart failure, including 22 (71) male patients, with a mean age of 41.16±15.9 years were enrolled in the study. Right heart catheterization and comprehensive echocardiography during the first hour after completion of cardiac catheterization were performed in all the patients. The pulmonary artery elastance was estimated using the ratio of end-systolic pressure (Pes) over the stroke volume (SV) by both cardiac catheterization Ea (PV)-C and echocardiography Ea (PV)-E. Results: The mean Ea (PV)-C and Ea (PV)-E were estimated to be 0.73±0.49 mm Hg/mL and 0.67±0.44 mm Hg/mL, respectively. There was a significant relation between Ea (PV)-E and Ea (PV)-C (r=0.897, p<0.001). Agreement between echocardiography and catheterization methods for estimating Ea (PV), investigated by the Bland-Altman method, showed a mean bias of -0.06, with 95% limits of agreement from -0.36 mm Hg/mL to 0.48 mm Hg/mL. Conclusion: Doppler echocardiography is an easy, non-invasive, and inexpensive method for measuring pulmonary arterial elastance, which provides accurate and reliable estimation of RV afterload in patients with systolic heart failure. © 2016 by Turkish Society of Cardiology

Dissociation rates from single-molecule pulling experiments under large thermal fluctuations or large applied force

Theories that are used to extract energy-landscape information from single-molecule pulling experiments in biophysics are all invariably based on Kramers' theory of the thermally activated escape rate from a potential well. As is well known, this theory recovers the Arrhenius dependence of the rate on the barrier energy and crucially relies on the assumption that the barrier energy is much larger than $k_\text{B}T$ (limit of comparatively low thermal fluctuations). As was shown already in Dudko $\textit{et al.}$ [Phys. Rev. Lett. 96, 108101 (2006)], this approach leads to the unphysical prediction of dissociation time increasing with decreasing binding energy when the latter is lowered to values comparable to $k_\text{B}T$ (limit of large thermal fluctuations). We propose a theoretical framework (fully supported by numerical simulations) which amends Kramers' theory in this limit and use it to extract the dissociation rate from single-molecule experiments where now predictions are physically meaningful and in agreement with simulations over the whole range of applied forces (binding energies). These results are expected to be relevant for a large number of experimental settings in single-molecule biophysics.EPSRC (Ph.D. studentship

Microdust impact on leaf gas exchange parameters in oak species of Northern Zagros forests, west of Iran

In recent years, the microdust phenomenon has greatly changed in concentration, duration and continuity as well as the frequency of occurrence in comparison with dust storms in the past which has caused a great deal of concern. Microdust is one of the most devastating factors in the environment threatening all animal and plant species. Regarding to the microdust impending threat, its ecological and economic impacts on scarce species is critical. Zagros forests act as an intrinsic filter for microdust in the western region of Iran. This study investigates the effect of microdust on oak, the most important tree in the Zagros forests. So that, three-year old seedlings of three oak species (Quercus branti, Q. libni and Q. infectoria) were exposed to microdust under natural conditions during spring and summer 2016. We examined the rate of photosynthesis, stomatal conductance, transpiration, internal CO2, mesophyll conductance, water use efficiency in control and treated plants. The results indicated that microdust had a significant impact on the examined parameters of the three oak species (P≤0.01). The gas exchange and photosynthetic rates of the treated plants were significantly reduced. In Q. infectoria, microdust had the greatest impact on photosynthesis, stomatal conductance, leaf internal CO2, transpiration and mesophyll conductance. Accordingly, microdust had a substantial influence on photosynthesis and mesophyll conductance in Q. brantii as well as the leaf internal CO2 and mesophyll conductance in Q. libani. Therefore, based on these findings, it can be concluded that microdust can disrupt the physiological activities of the examined species. Hence, continuous - exposure to microdust will accelerate the process of destruction of these forests

Hoe kleurenblind is Vrouwe Justitia?

Criminal Justice: Legitimacy, accountability, and effectivit

Relationship between QRS complex notch and ventricular dyssynchrony in patients with heart failure and prolonged QRS duration

Background: Cardiac resynchronization therapy (CRT) has been accepted as an established therapy for advanced systolic heart failure. Electrical and mechanical dyssynchrony are usually evaluated to increase the percentage of CRT responders. We postulated that QRS notch can increase mechanical LV dyssynchrony independently of other known predictors such as left ventricular ejection fraction and QRS duration. Methods: A total of 87 consecutive patients with advanced systolic heart failure and QRS duration more than 120 ms with an LBBB-like pattern in V1 were prospectively evaluated. Twelve-lead electrocardiogram was used for detection of QRS notch. Complete echocardiographic examination including tissue Doppler imaging, pulse wave Doppler and M-mode echocardiography were done for all patients. Results: Eighty-seven patients, 65 male (75) and 22 female (25), with mean (SD) age of 56.7 (12.3) years were enrolled the study. Ischemic cardiomyopathy was the underlying heart disease in 58 of the subjects, and in the others it was idiopathic. Patients had a mean (SD) QRS duration of 155.13 (23.34) ms. QRS notch was seen in 49.4 of the patients in any of two precordial or limb leads. Interventricular mechanical delay was the only mechanical dyssynchrony index that was significantly longer in the group of patients with QRS notch. Multivariate analysis revealed that the observed association was actually caused by the effect of QRS duration, rather than the presence of notch per se. Conclusions: QRS notch was not an independent predictor of higher mechanical dyssynchrony indices in patients with wide QRS complex and symptomatic systolic heart failure; however, there was a borderline association between QRS notch and interventricular delay. © 2008 Via Medica

Determing some important extracted materials, such as: Alginates of sodium & calcium and alginic acid in three species of brown seaweeds (Sargassum illicifolium, Cystoseira indica and Nizimuddinia zanardinii) in coastal area of Sistan and Baluochestan Province

This study was determined some important extracted materials, Such as : Alginates of sodium & calcium and alginic acid in three species of brown seaweeds (Sargassum illicifolium , Cystoseira indica and Nizimuddinia zanardinii) during in different season in 1387 in coastal erea of Sistan and Baluochestan Provience. At First seaweeds sample were colected from sea beach and transferd to lab, so washed in fresh water and dried in the sun. So were under Alkaloid extraction with sodium carbonate (5 Persent), that were obtined fluid after filteration. The sodium alginate fibers extracted from fluid were combined by Alcohol. The calacium alginate fibers were deposited by calacium chlorids (5%) and Alginic acid resulted with chloridric acid (1N). The extraction yield of sodium alginate, calacium alginate and alginic acid in different samples of seaweeds with following Explaination: The presentage we have got, can be said , the present average of sodium alginate at Sargassum in Spring season in three areas (Chabahar, Tang and Pasabandar ) Respectively: 28.4±2 , 28.9±2 , 27.2±1.9 present, the present average of sodium alginate at Cystoseira in Spring in three areas at above mentioned goes in this way: 19.7±1.4, 18.6±1.4, 19.2±1.3 present and the present average of sodium alginate at Nizimuddinia in Spring were 23.4±1.5, 23.8±1.5 , 20.6±1.5 in these three areas. The present average of calacium alginate at Sargassum in Spring season in three areas (Chabahar, Tang and Pasabandar ): 33.7±0.5, 33.7±0.8, 33.1±1 present, the present average of calacium alginate at Cystoseira in Spring in three areas at above mentioned goes in this way: 28.8±1.5, 27.4±1, 27.4±1.5 present and the present average of calacium alginate at Nizimuddinia in Spring were 35.9±2.8, 23.9±1.5 , 35.9±2.8 in these three areas. The present average of Alginic acid at Sargassum in Spring season in three areas (Chabahar, Tang and Pasabandar ): 19.2±1.6 , 25.6±1.7 , 18.4±1.1 present, the present average of Alginic acid at Cystoseira in Spring in three areas at above mentioned goes in this way: 16.8±1.2, 15.8±1.1, 16.4±1 present and the present average of Alginic acid at Nizimuddinia in Spring were 19.2±1.6, 19.6±1.7 , 18.4±1.5 in these three areas. The present average of sodium alginate at Sargassum in Summer season in three areas (Chabahar, Tang and Pasabandar ) Respectively: 20.8±1, 21±1, 27.8±1.9 present, the present average of sodium alginate at Cystoseira in Summer in three areas at above mentioned goes in this way: 21±1.1, 13.2±1, 14.1±0.7 present and the present average of sodium alginate at Nizimuddinia in Summer were 25.3±2.3, 16.7±2.1, 15.3±1.3 in these three areas. The present average of calacium alginate at Sargassum in Summer season in three areas (Chabahar, Tang and Pasabandar): 29.5±2.1 , 29.7±2 , 28.3±2.2 present, the present average of calacium alginate at Cystoseira in Summer in three areas at above mentioned goes in this way: 21±1.1, 20.2±0.9, 20±0.7 present and the present average of calacium alginate at Nizimuddinia in Summer were 25.3±2.3, 29.7±2 , 23.1±1.5 in these three areas. The present average of Alginic acid at Sargassum in Summer season in three areas (Chabahar, Tang and Pasabandar): 19.5±0.7 , 19.7±0.6 , 18.7±0.7 present, the present average of Alginic acid at Cystoseira in Summer in three areas at above mentioned goes in this way: 21±1.1, 11.5±1.4, 11.1±1.5 present and the present average of Alginic acid at Nizimuddinia in Summer were 14.8±1.3, 15.3±1.3 , 14.6±1 in these three areas. The present average of sodium alginate at Sargassum in Autumn season in three areas (Chabahar, Tang and Pasabandar) Respectively: 31.5±4.3, 31.6±4.8, 29.4±4.8 present, the present average of sodium alginate at Cystoseira in Autumn in three areas at above mentioned goes in this way: 23±2.7, 21.4±2.8, 21.4±2.7 present and the present average of sodium alginate at Nizimuddinia in Autumn were 25.8±2.2, 26.4±2.1 , 23.4±1.9 in these three areas. The present average of calacium alginate at Sargassum in Autumn season in three areas (Chabahar, Tang and Pasabandar): 43.3±1.6, 42.8±2.7, 41.7±2.9 present, the present average of calacium alginate at Cystoseira in Autumn in three areas at above mentioned goes in this way: 34.3±5.9, 32.4±5.5, 30.9±5.2 present and the present average of calacium alginate at Nizimuddinia in Autumn were 50±7.1, 50.2±7.5, 45.6±5.2 in these three areas. The present average of Alginic acid at Sargassum in Autumn season in three areas (Chabahar, Tang and Pasabandar): 28±3.8, 28±3.5, 26±3.9 present, the present average of Alginic acid at Cystoseira in Autumn in three areas at above mentioned goes in this way: 20.2±1.8, 19.2±2.1, 18.7±1.6 present and the present average of Alginic acid at Nizimuddinia in Autumn were 25.9±3, 26.1±2.9, 24.6±3.6 in these three areas. The present average of sodium alginate at Sargassum in Winter season in three areas (Chabahar, Tang and Pasabandar) Respectively: 35±1.6, 35.2±1.8 , 33.8±1.9 present, the present average of sodium alginate at Cystoseira in Winter in three areas at above mentioned goes in this way: 24.1±2, 22.9±1.2, 23.3±0.7 present and the present average of sodium alginate at Nizimuddinia in Winter were 28.2±1.3, 29.2±1.7, 26.2±1.8 in these three areas. The present average of calacium alginate at Sargassum in Winter season in three areas (Chabahar, Tang and Pasabandar): 45.6±1.9, 45±2, 44.6±2.5 present, the present average of calacium alginate at Cystoseira in Winter in three areas at above mentioned goes in this way: 38.2±2.8, 35.9±3.4, 35.6±3.5 present and the present average of calacium alginate at Nizimuddinia in Winter were 56.4±3.5, 56±3.5, 51.8±2.5 in these three areas. The present average of Alginic acid at Sargassum in winter season in three areas (Chabahar, Tang and Pasabandar): 31.8±1.2, 32.1±0.9, 30.9±1.2 present, the present average of Alginic acid at Cystoseira in Winter in three areas at above mentioned goes in this way: 21.1±1.2, 20.4±1.4, 19.3±1.4 present and the present average of Alginic acid at Nizimuddinia in Winter were 26.4±2.1, 27±2.2, 24.6±2.2 in these three areas. The more amount of calacium alginate in Autumn can be found at Nizimuddinia in Tang area , wite amount of 50.2 present and the lates amount of Alginic acid at Cystoseira can be found in Summer with 11.1 present. If the Alginic acid become more than 20 present, it can be economical, that it can be showed more than 20 present in Autumn and Winter. According to this results, One way ANOVA showed that average of Alginates were not similar and significant differences ( P<0.05 ) between species

Can prodromal symptoms predict recurrence of vasovagal syncope?

Background: Vasovagal syncope (VVS) is a common symptom with empirical therapy and high recurrence rate. Our goal was to determine whether the pattern of presyncopal prodromal symptoms can predict the recurrence probability of vasovagal syncope. Methods: Seventy-nine consecutive patients (male/female: 53/26) with history of VVS and positive tilt table test (TTT) were enrolled in the study and completed the follow-up time for one year. They all had normal electrocardiograms and cardiac echocardiography without underlying disease. All of them were evaluated meticulously for prodromal symptoms (diaphoresis, nausea, palpitation and blurred vision) and frequency of syncopal spells in their past medical history. They received metoprolol at maximum tolerated dose and were taught tilt training as an empirical therapy after TTT. Results: Fifty-four patients (68.4) reported at least one of the four main prodromal symptoms. Median syncopal ± presyncopal spells were 4 episodes. Forty-two patients (53.2) experienced recurrence of syncope or presyncope during the follow-up period. In recurrent symptomatic patients, diaphoresis had been more significantly reported in their past medical history (p = 0.018) and they had more syncopal spells before TTT (p = 0.001). Age, gender and type of TTT response did not have any effect on the recurrence of VVS. Conclusions: Patients with a history of diaphoresis as a prodromal symptom and more pre-tilt syncopal attacks experience more syncopal or presyncopal spells during follow-up. Copyright © 2008 Via Medica

Fisebility study of collection and rearing of proleus stage of lobster (Panolirus homarus) in the cement tanks

The present study was carried out from late October2010 to end of June 2011. Executive operations were done in two stages; proleus catching from the sea and stocking/rearing them in a control conditions. Totally, it took 8 months from start to finish. The research objectives were; - Proleus catching techniques achievement. -Proleus keeping, stoking and rearing achievement. 32 pieces of proleus and post-proleus were collected by special installed collectors at the beneath of the sea. They were stocked after adaptation and initially biometry. In order to stocking, two 4th-tone tanks (one for proleus stage and another one for post-proleus stage) were applied. 0.77 gram and 11.8 gram was recorded as average weighted for proleus and post- proleus, respectively. Four stations were chosen for collecting of require samples. They were starched from west side of Ramin’s Jetty toward east. 84% of the samples were caught from the station two, using sandwich collectors. Collector’s efficiencies were compared to each others, in this study. A significant difference was observed between the sandwich collectors efficiency with the other collectors (p0.05). Comparison of the proleus abundance between stations showed a significant difference between station 2 and other stations, but there wasn’t any sig. difference between the stations number 2, 3 and 4, together (p>0.05). The samples were fed by fish waste, bivalves and squid. The amount of larval requirement food was calculated based on 15% of their body weight. During breading period, 50% of the rearing tanks water was exchanged, daily. Total weight, total length and carapace length was measured, monthly. 0.6 gram, 5.5 mm and 1 mm was recorded for mean total weight, mean total length and mean carapace length for proleus and 18.3 gram, 25.4 mm and 8 mm was recorded for mean total weight, mean total length and mean carapace length for post-proleus. According to the results, can be realized that growth rate in post-proleus was much faster than the growth rate of proleus. Finally, comparison of the total weight, total length and carapace length between proleus and post-proleus were showed a sig. differences between the two reared groups (p>0.05)

The global, regional, and national burden of adult lip, oral, and pharyngeal cancer in 204 countries and territories:A systematic analysis for the Global Burden of Disease Study 2019

Importance Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning.Objective To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates.Evidence Review The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019.Findings In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia.Conclusions and Relevance In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere