Une chaîne d'applications intégrées

Dans leurs phases d'étude, d'installation, de maintenance et de suivi technico-financier des contrats d'appui, les activités du groupe électricité sont largement basées sur l'utilisation d'applications informatiques. Couplées à des bases de données, ces applications CERN étroitement interconnectées, sont développées autour de noyaux informatiques industriels. Toutes les phases d'un projet, tel que le LHC, bénéficient de ces bases de données enrichies par le personnel du CERN et par ses partenaires industriels. Ce document présente le maquettage virtuel des ouvrages du génie-civil et des équipements du CERN. Il traite également de la gestion de ces équipements, de leur câblage, de leur maintenance et du suivi des contrats de sous-traitance

Zunehmende Augentrübung bei Trisomie13

peer reviewedThe power transfer efficiency of energy harvesting systems is strongly dependent on the power conditioning circuits, especially rectifiers. The voltage drop across rectifier and its leakage current can drastically influence the efficiency. The hybrid energy harvesters impose even more severe constraints on the rectifier. The low Vth transistors and bulk regulation technique are used in this work to mitigated the voltage drop and leakage current, respectively. It has been shown that the bulk regulation stops the current leakage through body of PMOS transistor. A near zero threshold cross connected CMOS rectifier is presented in this work using the standard 180nm UMC technology and experimental analysis are carried out to evaluate the circuit performance. © 2015 ICST

Reduced incidence of atrial fibrillation after cardiac surgery by continuous wireless monitoring of oxygen saturation on the normal ward and resultant oxygen therapy for hypoxia

Objective: Monitoring of cardiac surgical patients after transfer from the intensive care unit to the normal ward is incomplete. Undetected hypoxia, however, is known to be a risk factor for occurrence of atrial fibrillation. We have utilized Auricall® for continuous wireless monitoring of oxygen saturation and heart rate until discharge. The object of the study was to analyze if oxygen therapy as a result of Auricall® alerts of hypoxia can decrease the incidence of postoperative atrial fibrillation. Methods: Auricall® is a wireless portable pulse oximeter. An alert is generated depending on preset threshold values (heart rate, oxygen saturation). Over a period of 6 months, 119 patients were monitored with the Auricall® following coronary artery bypass graft and/or valve surgery. Oxygen therapy was started subsequent to an oxygen saturation below 90%. These patients were compared with a cohort of 238 patients from the time period before availability of Auricall®. The patient characteristics were comparable in both groups. In a retrospective study, the incidence of atrial fibrillation was measured in both groups. Results: The postoperative AF was observed in 22/119 patients (18%) in group I and in 66/238 patients (28%) in group II. This difference between the two groups approached significance (p=0.056). In the subgroup of patients with coronary artery bypass graft with our without simultaneous valve surgery (n=312), Auricall® monitoring resulted in a significantly reduced incidence of atrial fibrillation (14% vs 26%, p=0.016). Conclusions: Continuous monitoring of oxygen saturation on the normal ward and subsequent oxygen therapy for hypoxia can reduce the incidence of atrial fibrillation in a subgroup of patients after cardiac surgery. Prospective randomized trials are warranted to confirm these dat

Cortisol levels and history of depression in acute coronary syndrome patients

Background Depressed mood following an acute coronary syndrome (ACS) is a risk factor for future cardiac morbidity. Hypothalamic-pituitary-adrenal (HPA) axis dysregulation is associated with depression, and may be a process through which depressive symptoms influence later cardiac health. Additionally, a history of depression predicts depressive symptoms in the weeks following ACS. The purpose of this study was to determine whether a history of depression and/or current depression are associated with the HPA axis dysregulation following ACS. Method A total of 152 cardiac patients completed a structured diagnostic interview, a standardized depression questionnaire and a cortisol profile over the day, 3 weeks after an ACS. Cortisol was analysed using: the cortisol awakening response (CAR), total cortisol output estimated using the area under the curve method, and the slope of cortisol decline over the day. Results Total cortisol output was positively associated with history of depression, after adjustment for age, gender, marital status, ethnicity, smoking status, body mass index (BMI), Global Registry of Acute Cardiac Events (GRACE) risk score, days in hospital, medication with statins and antiplatelet compounds, and current depression score. Men with clinically diagnosed depression after ACS showed a blunted CAR, but the CAR was not related to a history of depression. Conclusions Patients with a history of depression showed increased total cortisol output, but this is unlikely to be responsible for associations between depression after ACS and later cardiac morbidity. However, the blunted CAR in patients with severe depression following ACS indicates that HPA dysregulation is presen

Disproportional decrease in office blood pressure compared with 24-hour ambulatory blood pressure with antihypertensive treatment: dependency on pretreatment blood pressure levels

The long-term relationship between 24-hour ambulatory blood pressure (ABP) and office BP in patients on therapy is not well documented. From a registry we included all patients in whom antihypertensive therapy needed to be uptitrated. Drug treatment included the direct renin inhibitor aliskiren or an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker or drugs not blocking the renin-angiotensin system, alone or on top of an existing drug regimen. In all patients, office BP and 24-hour ABP were obtained at baseline and after 1 year with validated devices. In the study population of 2722 patients, there was a good correlation between the change in office BP and 24-hour ABP (systolic: r=0.39; P<0.001; diastolic: r=0.34; P<0.001). However, the numeric decrease in office BP did not correspond to the decrease in ABP in a 1:1 fashion, for example, a decrease of 10, 20, and 30 mm Hg corresponded to a decrease of ~7.2, 10.5, and 13.9 mm Hg in systolic ABP, respectively. The disproportionally greater decrease in systolic office BP compared with ABP was dependent on the level of the pretreatment BP, which was consistently higher for office BP than ABP. The white coat effect (difference between office BP and ABP) was on average 10/5 mm Hg lower 1 year after intensifying treatment and the magnitude of that was also dependent on pretreatment BP. There was a disproportionally greater decrease in systolic office BP than in ABP, which for both office BP and ABP seemed to depend on the pretreatment BP level

68Ga-PSMA-11 PET/MR Can Be False Positive in Normal Prostatic Tissue

Prostate-specific membrane antigen (PSMA) is a transmembrane glycoprotein expressed in the cytosol of normal prostate tissue and highly overexpressed on the membrane of prostate cancer, therefore increasingly used to image prostate cancer. We report a case of a 65-year-old man with two focal PSMA-positive areas on a Ga-PSMA-11 PET/MR, one corresponding to a prostate carcinoma (Gleason score 4 + 3) and another region without any evidence of malignancy, but with corresponding high PSMA-expression on immunohistochemistry

Effects of Verapamil SR and Atenolol on 24-Hour Blood Pressure and Heart Rate in Hypertension Patients with Coronary Artery Disease...

Elevated night-time blood pressure (BP) and heart rate (HR), increased BP and HR variability, and altered diurnal variations of BP and HR (nighttime dipping and morning surge) in patients with systemic hypertension are each associated with increased adverse cardiovascular events. However, there are no reports on the effect of hypertension treatment on these important hemodynamic parameters in the growing population of hypertensive patients with atherosclerotic coronary artery disease (CAD). This was a pre-specified subgroup analysis of the INternational VErapamil SR-Trandolapril STudy (INVEST), which involved 22,576 clinically stable patients aged ≥50 years with hypertension and CAD randomized to either verapamil SR- or atenolol-based hypertension treatment strategies. The subgroup consisted of 117 patients undergoing 24-hour ambulatory monitoring at baseline and after 1 year of treatment. Hourly systolic and diastolic BP (SBP and DBP) decreased after 1 year for both verapamil SR- and atenolol-based treatment strategies compared with baseline (P<0.0001). Atenolol also decreased hourly HR (P<0.0001). Both treatment strategies decreased SBP variability (weighted standard deviation: P = 0.012 and 0.021, respectively). Compared with verapamil SR, atenolol also increased the prevalence of BP and HR night-time dipping among prior non-dippers (BP: OR = 3.37; 95% CI: 1.26 – 8.97; P = 0.015; HR: OR = 4.06; 95% CI: 1.35-12.17;P = 0.012) and blunted HR morning surge (+2.8 vs. +4.5 beats/min/hr; P = 0.019). Both verapamil SR- and especially atenolol-based strategies resulted in favorable changes in ambulatory monitoring parameters that have been previously associated with increased adverse cardiovascular events

Fear of dying and inflammation following acute coronary syndrome

Aims Many patients are afraid of dying during acute coronary syndrome (ACS), but the origins and biological correlates of these emotional responses are poorly understood. This study evaluated the prevalence of fear of dying, associations with inflammatory responses during ACS, and later heart rate variability (HRV) and cortisol secretion. Methods and results Two hundred and eight patients admitted with clinically verified ACS rated their fear of dying on interview in hospital. Plasma tumour necrosis factor (TNF)α was recorded on admission, and HRV and salivary cortisol were assessed 3 weeks later. Intense distress and fear of dying was experienced by 21.7%, with moderate levels in 66.1% patients. Fear of dying was more common in younger, lower socioeconomic status, and unmarried patients. It was positively associated with plasma TNFα on admission after controlling for sociodemographic factors, clinical risk, and pain intensity (adjusted odds = 4.67, 95% C.I. 1.66-12.65). TNFα was associated with reduced HRV 3 weeks later, adjusting for clinical and sociodemographic factors and medication (P = 0.019), while fear of dying was associated with reduced cortisol output (P = 0.004). Conclusions Intense distress and fear of dying and heightened inflammation may be related manifestations of an acute biobehavioural response to severe cardiac injury, and have implications for prognostically significant biological risk processe

Effects of Verapamil SR and Atenolol on 24-Hour Blood Pressure and Heart Rate in Hypertension Patients with Coronary Artery Disease...

Elevated night-time blood pressure (BP) and heart rate (HR), increased BP and HR variability, and altered diurnal variations of BP and HR (nighttime dipping and morning surge) in patients with systemic hypertension are each associated with increased adverse cardiovascular events. However, there are no reports on the effect of hypertension treatment on these important hemodynamic parameters in the growing population of hypertensive patients with atherosclerotic coronary artery disease (CAD). This was a pre-specified subgroup analysis of the INternational VErapamil SR-Trandolapril STudy (INVEST), which involved 22,576 clinically stable patients aged ≥50 years with hypertension and CAD randomized to either verapamil SR- or atenolol-based hypertension treatment strategies. The subgroup consisted of 117 patients undergoing 24-hour ambulatory monitoring at baseline and after 1 year of treatment. Hourly systolic and diastolic BP (SBP and DBP) decreased after 1 year for both verapamil SR- and atenolol-based treatment strategies compared with baseline (P<0.0001). Atenolol also decreased hourly HR (P<0.0001). Both treatment strategies decreased SBP variability (weighted standard deviation: P = 0.012 and 0.021, respectively). Compared with verapamil SR, atenolol also increased the prevalence of BP and HR night-time dipping among prior non-dippers (BP: OR = 3.37; 95% CI: 1.26 – 8.97; P = 0.015; HR: OR = 4.06; 95% CI: 1.35-12.17;P = 0.012) and blunted HR morning surge (+2.8 vs. +4.5 beats/min/hr; P = 0.019). Both verapamil SR- and especially atenolol-based strategies resulted in favorable changes in ambulatory monitoring parameters that have been previously associated with increased adverse cardiovascular events