736 research outputs found
Macroscopic effects in attosecond pulse generation
We examine how the generation and propagation of high-order harmonics in a
partly ionized gas medium affect their strength and synchronization. The
temporal properties of the resulting attosecond pulses generated in long gas
targets can be significantly influenced by macroscopic effects, in particular
by the intensity in the medium and the degree of ionization. Under some
conditions, the use of gas targets longer than the absorption length can lead
to the generation of self-compressed attosecond pulses. We show this effect
experimentally, using long argon-filled gas cells as generating medium.Comment: 5 pages 4 figure
Probing single-photon ionization on the attosecond time scale
We study photoionization of argon atoms excited by attosecond pulses using an
interferometric measurement technique. We measure the difference in time delays
between electrons emitted from the and from the shell, at
different excitation energies ranging from 32 to 42 eV. The determination of
single photoemission time delays requires to take into account the measurement
process, involving the interaction with a probing infrared field. This
contribution can be estimated using an universal formula and is found to
account for a substantial fraction of the measured delay.Comment: 4 pages, 4 figures, under consideratio
Imaging, biomarker and invasive assessment of diffuse left ventricular myocardial fibrosis in atrial fibrillation
Background
Using cardiovascular magnetic resonance imaging (CMR), it is possible to detect diffuse fibrosis of the left ventricle (LV) in patients with atrial fibrillation (AF), which may be independently associated with recurrence of AF after ablation. By conducting CMR, clinical, electrophysiology and biomarker assessment we planned to investigate LV myocardial fibrosis in patients undergoing AF ablation.
Methods
LV fibrosis was assessed by T1 mapping in 31 patients undergoing percutaneous ablation for AF. Galectin-3, coronary sinus type I collagen C terminal telopeptide (ICTP), and type III procollagen N terminal peptide were measured with ELISA. Comparison was made between groups above and below the median for LV extracellular volume fraction (ECV), followed by regression analysis.
Results
On linear regression analysis LV ECV had significant associations with invasive left atrial pressure (Beta 0.49, P = 0.008) and coronary sinus ICTP (Beta 0.75, P < 0.001), which remained significant on multivariable regression.
Conclusion
LV fibrosis in patients with AF is associated with left atrial pressure and invasively measured levels of ICTP turnover biomarker
Early Geometrical Thinking in the Environment of Patterns, Mosaics and Isometries
This book discusses the learning and teaching of geometry, with a special focus on kindergarten and primary education. It examines important new trends and developments in research and practice, and emphasizes theoretical, empirical and developmental issues. Further, it discusses various topics, including curriculum studies and implementation, spatial abilities and geometric reasoning, as well as the psychological roots of geometrical thinking and teacher preparation in geometry education. It considers these issues from historical, epistemological, cognitive semiotic and educational points of view in the context of students' difficulties and the design of teaching and curricula
A novel and practical screening tool for the detection of silent myocardial infarction in patients with type 2 diabetes
Silent myocardial infarction (MI) is a prevalent finding in patients with type 2 diabetes and is associated with significant mortality and morbidity. Late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR) is the most validated technique for detection of silent MI but is time consuming, costly and requires administration of intravenous contrast. We therefore planned to develop a simple and low cost population screening tool to identify those at highest risk of silent MI validated against the CMR reference standard.100 asymptomatic patients with type 2 diabetes underwent electrocardiogram (ECG), echocardiography, biomarker assessment and CMR at 3.0T including assessment of left ventricular ejection fraction and LGE. Global longitudinal strain (GLS) from 2 and 4 chamber cines was measured using feature tracking.17/100 patients with no history of cardiovascular disease had silent MI defined by LGE in an infarct pattern on CMR. Only 4 silent MI patients had Q waves on ECG. Patients with silent MI were older (65 vs 60, p=0.05), had lower E/A ratio (0.75 vs 0.89, p=0.004), lower GLS (-15.2% vs -17.7%, p=0.004) and higher NT-proBNP (106ng/L vs 52ng/L, p=0.003). A combined risk score derived from these 4 factors had an area under the receiver operating characteristic (ROC) curve of 0.823 (0.734-0.892), P<0.0001. A score of ?3/5 had 82% sensitivity and 72% specificity for silent MI.Using measures that can be derived in an outpatient clinic setting, we have developed a novel screening tool for the detection of silent MI in type 2 diabetes. The screening tool had significantly superior diagnostic accuracy than current ECG criteria for the detection of silent MI in asymptomatic patients
Trayectorias laborales de jóvenes trabajadores de la actividad vitivinÃcola : departamento Maipú, Mendoza
La presente investigación tuvo como eje los vÃnculos entre educación y trabajo en la vitivinicultura mendocina desde 1990 . El objetivo general fue comprender los procesos de incorporación de jóvenes de ambos sexos al mundo del trabajo y su vÃnculo con las estrategias de formación y los esquemas de percepción en el mercado vitivinÃcola mendocino desde los 90. Se analizaron e identificaron los tipos de trayectorias educativas, laborales y transiciones existentes en los jóvenes. También los condicionantes de género que operan desde la perspectiva de las mujeres jóvenes. Se buscó comprender las formas que adquieren, cómo se manifiestan y varÃan las perspectivas acerca del trabajo, de las exigencias laborales y las condiciones del mercado de trabajo a lo largo de las trayectorias educativas y laborales y cuáles son los principales elementos constitutivos de las trayectorias de inserción, qué factores están asociados a sus variaciones y cómo se vinculan con las expectativas y estrategias de formación de inserción laboral.Fil: MartÃn, MarÃa Eugenia.
CONICET (Consejo Nacional de Investigaciones CientÃficas y Técnicas) - Universidad Nacional de CuyoFil: Zamarbide, Gabriela.
Universidad Nacional de Cuy
The role of left ventricular deformation in the assessment of microvascular obstruction and intramyocardial haemorrhage
In the setting of acute ST-elevation myocardial infarction (STEMI), it remains unclear which strain parameter most strongly correlates with microvascular obstruction (MVO) or intramyocardial haemorrhage (IMH). We aimed to investigate the association of MVO, IMH and convalescent left ventricular (LV) remodelling with strain parameters measured with cardiovascular magnetic resonance (CMR). Forty-three patients with reperfused STEMI and 10 age and gender matched healthy controls underwent CMR within 3-days and at 3-months following reperfused STEMI. Cine, T2-weighted, T2*-imaging and late gadolinium enhancement (LGE) imaging were performed. Infarct size, MVO and IMH were quantified. Peak global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS) and their strain rates were derived by feature tracking analysis of LV short-axis, 4-chamber and 2-chamber cines. All 43 patients and ten controls completed the baseline scan and 34 patients completed 3-month scans. In multivariate regression, GLS demonstrated the strongest association with MVO or IMH (beta = 0.53, p 20%). Baseline GLS also demonstrated the strongest diagnostic performance in predicting adverse LV remodelling (AUC = 0.79; 95% CI 0.60–0.98; p = 0.03). Post-reperfused STEMI, baseline GLS was most closely associated with the presence of MVO or IMH. Baseline GLS was more strongly associated with adverse LV remodelling than other CMR parameters
SMA CARNI-VAL TRIAL PART II: A Prospective, Single-Armed Trial of L-Carnitine and Valproic Acid in Ambulatory Children with Spinal Muscular Atrophy
Multiple lines of evidence have suggested that valproic acid (VPA) might benefit patients with spinal muscular atrophy (SMA). The SMA CARNIVAL TRIAL was a two part prospective trial to evaluate oral VPA and l-carnitine in SMA children. Part 1 targeted non-ambulatory children ages 2–8 in a 12 month cross over design. We report here Part 2, a twelve month prospective, open-label trial of VPA and L-carnitine in ambulatory SMA children.This study involved 33 genetically proven type 3 SMA subjects ages 3–17 years. Subjects underwent two baseline assessments over 4–6 weeks and then were placed on VPA and L-carnitine for 12 months. Assessments were performed at baseline, 3, 6 and 12 months. Primary outcomes included safety, adverse events and the change at 6 and 12 months in motor function assessed using the Modified Hammersmith Functional Motor Scale Extend (MHFMS-Extend), timed motor tests and fine motor modules. Secondary outcomes included changes in ulnar compound muscle action potential amplitudes (CMAP), handheld dynamometry, pulmonary function, and Pediatric Quality of Life Inventory scores.Twenty-eight subjects completed the study. VPA and carnitine were generally well tolerated. Although adverse events occurred in 85% of subjects, they were usually mild and transient. Weight gain of 20% above body weight occurred in 17% of subjects. There was no significant change in any primary outcome at six or 12 months. Some pulmonary function measures showed improvement at one year as expected with normal growth. CMAP significantly improved suggesting a modest biologic effect not clinically meaningful.This study, coupled with the CARNIVAL Part 1 study, indicate that VPA is not effective in improving strength or function in SMA children. The outcomes used in this study are feasible and reliable, and can be employed in future trials in SMA
Practice of ALARA in the pediatric interventional suite
As interventional procedures have become progressively more sophisticated and lengthy, the potential for high patient radiation dose has increased. Staff exposure arises from patient scatter, so steps to minimize patient dose will in turn reduce operator and staff dose. The practice of ALARA in an interventional radiology (IR) suite, therefore, requires careful attention to technical detail in order to reduce patient dose. The choice of imaging modality should minimize radiation when and where possible. In this paper practical steps are outlined to reduce patient dose. Further details are included that specifically reduce operator exposure. Challenges unique to pediatric intervention are reviewed. Reference is made to experience from modern pediatric interventional suites. Given the potential for high exposures, the practice of ALARA is a team responsibility. Various measures are outlined for consideration when implementing a quality assurance (QA) program for an IR service
Phase II Open Label Study of Valproic Acid in Spinal Muscular Atrophy
UNLABELLED:Preliminary in vitro and in vivo studies with valproic acid (VPA) in cell lines and patients with spinal muscular atrophy (SMA) demonstrate increased expression of SMN, supporting the possibility of therapeutic benefit. We performed an open label trial of VPA in 42 subjects with SMA to assess safety and explore potential outcome measures to help guide design of future controlled clinical trials. Subjects included 2 SMA type I ages 2-3 years, 29 SMA type II ages 2-14 years and 11 type III ages 2-31 years, recruited from a natural history study. VPA was well-tolerated and without evident hepatotoxicity. Carnitine depletion was frequent and temporally associated with increased weakness in two subjects. Exploratory outcome measures included assessment of gross motor function via the modified Hammersmith Functional Motor Scale (MHFMS), electrophysiologic measures of innervation including maximum ulnar compound muscle action potential (CMAP) amplitudes and motor unit number estimation (MUNE), body composition and bone density via dual-energy X-ray absorptiometry (DEXA), and quantitative blood SMN mRNA levels. Clear decline in motor function occurred in several subjects in association with weight gain; mean fat mass increased without a corresponding increase in lean mass. We observed an increased mean score on the MHFMS scale in 27 subjects with SMA type II (p<or=0.001); however, significant improvement was almost entirely restricted to participants <5 years of age. Full length SMN levels were unchanged and Delta7SMN levels were significantly reduced for 2 of 3 treatment visits. In contrast, bone mineral density (p<or=0.0036) and maximum ulnar CMAP scores (p<or=0.0001) increased significantly. CONCLUSIONS:While VPA appears safe and well-tolerated in this initial pilot trial, these data suggest that weight gain and carnitine depletion are likely to be significant confounding factors in clinical trials. This study highlights potential strengths and limitations of various candidate outcome measures and underscores the need for additional controlled clinical trials with VPA targeting more restricted cohorts of subjects. TRIAL REGISTRATION:ClinicalTrials.gov
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