‘Hearts and minds’: association, causation and implication of cognitive impairment in heart failure

The clinical syndrome of heart failure is one of the leading causes of hospitalisation and mortality in older adults. An association between cognitive impairment and heart failure is well described but our understanding of the relationship between the two conditions remains limited. In this review we provide a synthesis of available evidence, focussing on epidemiology, the potential pathogenesis, and treatment implications of cognitive decline in heart failure. Most evidence available relates to heart failure with reduced ejection fraction and the syndromes of chronic cognitive decline or dementia. These conditions are only part of a complex heart failure-cognition paradigm. Associations between cognition and heart failure with preserved ejection fraction and between acute delirium and heart failure also seem evident and where data are available we will discuss these syndromes. Many questions remain unanswered regarding heart failure and cognition. Much of the observational evidence on the association is confounded by study design, comorbidity and insensitive cognitive assessment tools. If a causal link exists, there are several potential pathophysiological explanations. Plausible underlying mechanisms relating to cerebral hypoperfusion or occult cerebrovascular disease have been described and it seems likely that these may coexist and exert synergistic effects. Despite the prevalence of the two conditions, when cognitive impairment coexists with heart failure there is no specific guidance on treatment. Institution of evidence-based heart failure therapies that reduce mortality and hospitalisations seems intuitive and there is no signal that these interventions have an adverse effect on cognition. However, cognitive impairment will present a further barrier to the often complex medication self-management that is required in contemporary heart failure treatment

Composite Fermions and quantum Hall systems: Role of the Coulomb pseudopotential

The mean field composite Fermion (CF) picture successfully predicts angular momenta of multiplets forming the lowest energy band in fractional quantum Hall (FQH) systems. This success cannot be attributed to a cancellation between Coulomb and Chern-Simons interactions beyond the mean field, because these interactions have totally different energy scales. Rather, it results from the behavior of the Coulomb pseudopotential V(L) (pair energy as a function of pair angular momentum) in the lowest Landau level (LL). The class of short range repulsive pseudopotentials is defined that lead to short range Laughlin like correlations in many body systems and to which the CF model can be applied. These Laughlin correlations are described quantitatively using the formalism of fractional parentage. The discussion is illustrated with an analysis of the energy spectra obtained in numerical diagonalization of up to eleven electrons in the lowest and excited LL's. The qualitative difference in the behavior of V(L) is shown to sometimes invalidate the mean field CF picture when applied to higher LL's. For example, the nu=7/3 state is not a Laughlin nu=1/3 state in the first excited LL. The analysis of the involved pseudopotentials also explains the success or failure of the CF picture when applied to other systems of charged Fermions with Coulomb repulsion, such as the Laughlin quasiparticles in the FQH hierarchy or charged excitons in an electron-hole plasma.Comment: 27 pages, 23 figures, revised version (significant changes in text and figures), submitted to Phil. Mag.

Effects of magnesium with or without boron on headshaking behavior in horses with trigeminal-mediated headshaking.

BackgroundOral administration of magnesium and boron might have a beneficial effect on headshaking behavior in horses.ObjectiveEvaluate the effects of oral magnesium alone or in combination with boron on headshaking behavior in affected horses.AnimalsTwelve geldings (6 healthy controls and 6 affected).MethodsProspective randomized controlled dietary trial over 42 days in 12 horses (6 horses diagnosed with trigeminal-mediated headshaking and 6 unaffected healthy controls). All horses received a hay diet and were randomized into 3 treatment groups: pelleted feed combination (PF), pelleted feed combination with magnesium (M), and pelleted feed combination with magnesium-boron (MB) with a week washout of hay only between treatments. Headshaking behavior and biochemical blood variables were assessed at baseline (hay only) and then after each week of supplementation.ResultsAll 3 diet interventions increased blood ionized and total magnesium. Groups M and MB further increased Mg2+ when compared to PF. Horses receiving treatments had a significant reduction in headshaking behavior, as measured by incidence rate ratio (IRR), when compared to unsupplemented hay diet (44% for PF, IRR, 0.558; CI, 0.44, 0.72; P < .001; 52% for M, IRR, 0.476; CI, 0.37, 0.62; P < .001; and 64% for MB, IRR, 0.358; CI, 0.27, 0.48; P < .001).Conclusions and clinical importanceMagnesium in combination with boron had the greatest decrease in headshaking. Oral supplementation with magnesium or magnesium in combination with boron should be considered in horses affected with headshaking

Intravenous infusion of magnesium sulfate and its effect on horses with trigeminal-mediated headshaking.

BackgroundTrigeminal-mediated headshaking results from low-threshold firing of the trigeminal nerve resulting in apparent facial pain. Magnesium may have neuroprotective effects on nerve firing that potentially dampen signs of neuropathic pain. This hypothesis has not been investigated in horses with trigeminal-mediated headshaking.ObjectiveTo investigate head-shaking behavior in affected horses after IV magnesium sulfate infusion.AnimalsSix geldings with trigeminal-mediated headshaking.MethodsProspective randomized crossover study. Horses were controlled for diet and infused IV with 5% dextrose solution (DS; control solution at 2 mL/kg body weight [BW]) and MgSO4 50% solution (MSS at 40 mg/kg BW). Head-shaking behavior was recorded at times T0 (baseline, before infusion) and T15, T30, T60, and T120 minutes post-infusion. Venous blood variables such as pH, HCO3 - , standard base excess (SBE), Na+ , Cl- , K+ , Ca2+ , Mg2+ , total magnesium (tMg), glucose, and lactate were measured; strong ion difference (SID) and anion gap (AG) were calculated for each time point.ResultsBlood variables including pH, Na+ , Cl- , K+ , SID, AG, lactate, Ca2+ , tMg, and Mg2+ had significant changes with MSS as compared to DS treatment. Glucose, SBE, and HCO3 - did not have significant changes. A 29% reduction in head-shaking rate occurred after MSS treatment but no change occurred after DS treatment.Conclusions and clinical importanceAdministration of MSS IV increased plasma total and ionized magnesium concentrations and significantly decreased head-shaking behavior in horses with trigeminal-mediated headshaking

Scale and Turbulence Effects on the Lift and Drag Characteristics of the NACA 65(Sub 3)-418, A=1.0 Airfoil Section

Wind-tunnel tests, investigating low drag wing performance in small-scale tests, showed a large increase in minimum drag coefficient, and a decrease of maximum lift coefficient occurred with decreasing Reynolds Number above certain designated values. The lift-curve slope varied up to 6% between high and low turbulence levels. Low Reynolds Number test data are unreliable for low drag airfoils either to estimate full-scale characteristics or to determine merits of airfoils for higher Reynolds numbers

Effects of contaminants of emerging concern on Megaselia scalaris (Lowe, Diptera: Phoridae) and its microbial community.

Drought, rising temperatures, and expanding human populations are increasing water demands. Many countries are extending potable water supplies by irrigating crops with wastewater. Unfortunately, wastewater contains biologically active, long-lived pharmaceuticals, even after treatment. Run-off from farms and wastewater treatment plant overflows contribute high concentrations of pharmaceuticals to the environment. This study assessed the effects of common pharmaceuticals on a cosmopolitan saprophagous insect, Megaselia scalaris (Diptera: Phoridae). Larvae were reared on artificial diets spiked with contaminants of emerging concern (CECs) at environmentally relevant concentrations. Female flies showed no oviposition preference for treated or untreated diets. Larvae exposed to caffeine in diets showed increased mortality, and larvae fed antibiotics and hormones showed signs of slowed development, especially in females. The normal sex ratio observed in M. scalaris from control diets was affected by exposure to caffeine and pharmaceutical mixture treatments. There was an overall effect of treatment on the flies' microbial communities; notably, caffeine fed insects displayed higher microbial variability. Eight bacterial families accounted for approximately 95% of the total microbes in diet and insects. Our results suggest that CECs at environmentally relevant concentrations can affect the biology and microbial communities of an insect of ecological and medical importance