Improving Postdischarge Outcomes in Acute Heart Failure

The global burden that acute heart failure (AHF) carries has remained unchanged over the past several decades (1). European registries (2–5) showed that 1-year outcome rates remain unacceptably high (Table 1) and confirm that hospitalization for AHF represents a change in the natural history of the disease process(6). As patients hospitalized for HF have a bad prognosis, it is crucial to utilize hospitalization as an opportunity to: 1) assess the individual components of the cardiac substrate; 2) identify and treat comorbidities; 3) identify early, safe endpoints of therapy to facilitate timely hospital discharge and outpatient follow-up; and 4) implement and begin optimization guideline-directed medical therapies (GDMTs). As outcomes are influenced by many factors, many of which are incompletely understood, a systematic approach is proposed that should start with admission and continues through post-discharge (7)

Cryogenic Ion Trapping Systems with Surface-Electrode Traps

We present two simple cryogenic RF ion trap systems in which cryogenic temperatures and ultra high vacuum pressures can be reached in as little as 12 hours. The ion traps are operated either in a liquid helium bath cryostat or in a low vibration closed cycle cryostat. The fast turn around time and availability of buffer gas cooling made the systems ideal for testing surface-electrode ion traps. The vibration amplitude of the closed cycled cryostat was found to be below 106 nm. We evaluated the systems by loading surface-electrode ion traps with $^{88}$Sr$^+$ ions using laser ablation, which is compatible with the cryogenic environment. Using Doppler cooling we observed small ion crystals in which optically resolved ions have a trapped lifetime over 2500 minutes.Comment: 10 pages, 13 EPS figure

Laser ablation loading of a surface-electrode ion trap

We demonstrate loading by laser ablation of $^{88}$Sr$^+$ ions into a mm-scale surface-electrode ion trap. The laser used for ablation is a pulsed, frequency-tripled Nd:YAG with pulse energies of 1-10 mJ and durations of 3-5 ns. An additional laser is not required to photoionize the ablated material. The efficiency and lifetime of several candidate materials for the laser ablation target are characterized by measuring the trapped ion fluorescence signal for a number of consecutive loads. Additionally, laser ablation is used to load traps with a trap depth (40 meV) below where electron impact ionization loading is typically successful ($\gtrsim$ 500 meV).Comment: 4 pages, 4 figure

Time-separated entangled light pulses from a single-atom emitter

The controlled interaction between a single, trapped, laser-driven atom and the mode of a high-finesse optical cavity allows for the generation of temporally separated, entangled light pulses. Entanglement between the photon-number fluctuations of the pulses is created and mediated via the atomic center-of-mass motion, which is interfaced with light through the mechanical effect of atom-photon interaction. By means of a quantum noise analysis we determine the correlation matrix which characterizes the entanglement, as a function of the system parameters. The scheme is feasible in experimentally accessible parameter regimes. It may be easily extended to the generation of entangled pulses at different frequencies, even at vastly different wavelengths.Comment: 17 pages, 5 figures. Modified version, to appear in the New Journal of Physic

Renewable energy strategy analysis in relation to environmental pollution for BRICS, G7, and EU countries by using a machine learning framework and panel data analysis

The present research uses machine learning, panel data and time series prediction and forecasting techniques to establish a framework between a series of renewable energy and environmental pollution parameters, considering data for BRICS, G7, and EU countries, which can serve as a tool for optimizing the policy strategy in the sustainable energy production sector. The results indicates that XGBoost model for predicting the renewable energy production capacity reveals the highest feature importance among independent variables is associated with the gas consumption parameter in the case of G7, oil consumption for EU block and GHG emissions for BRICS, respectively. Furthermore, the generalized additive model (GAM) predictions for the EU block reveal the scenario of relatively constant renewable energy capacity if gas consumption increases, while oil consumption increases determine an increase in renewable energy capacity until a kick point, followed by a decrease. The GAM models for G7 revealed the scenario of an upward trend of renewable energy production capacity, as gas consumption increases and renewable energy production capacity decreases while oil consumption increases. In the case of the BRICS geopolitical block, the prediction scenario reveals that, in time, an increase in gas consumption generates an increase in renewable energy production capacity. The PCA emphasizes that renewable energy production capacity and GHG, respectively CO2 emissions, are highly correlated and are integrated into the first component, which explains more than 60% of the variance. The resulting models represent a good prediction capacity and reveal specific peculiarities for each analyzed geopolitical block. The prediction models conclude that the EU economic growth scenario is based on fossil fuel energy sources during the first development stage, followed by a shift to renewable energy sources once it reaches a kick point, during the second development stage. The decrease in renewable energy production capacity when oil consumption increases indicates that fossil fuels are in trend within the G7 economy. In the case of BRICS, it is assumed that gas consumption appears because of increasing the industrial capacity, followed by the increase of economic sustainability, respectively. In addition, the generalized additive models emphasize evolution scenarios with different peculiarities, specific for each analyzed geopolitical block

On the importance of grain size in luminescence dating using quartz

There are two major problems commonly encountered when applying Optically Stimulated Luminescence (OSL) dating in the high dose range: (i) age discrepancy between different grain sizes, and (ii) age underestimation. A marked and systematic discrepancy between fine-grain (4–11 μm) and coarse-grain (63–90 μm) quartz single aliquot regeneration protocol (SAR) ages has been reported previously for Romanian and Serbian loess >40 ka (De of ∼100 Gy), generally with fine-grain ages underestimating the depositional age. In this paper, we show a similar age pattern for two grain size fractions from Chinese loess, thus pointing to a potential worldwide phenomenon. While age underestimation is often attributed to signal saturation problems, this is not the case for fine grain material, which saturates at higher doses than coarse grains, yet begins to underestimate true ages earlier. Here we examine the dose response curves of quartz from different sedimentary contexts around the world, using a range of grain sizes (diameters of 4–11 μm, 11–30 μm, 35–50 μm, 63–90 μm, 90–125 μm, 125–180 μm, and 180–250 μm). All dose response curves can be adequately described by a sum of two saturating exponential functions, whose saturation characteristics (D0 values) are clearly anticorrelated with grain diameter (φ) through an inverse square root relationship, D0 = A/√φ, where A is a scaling factor. While the mechanism behind this grain-size dependency of saturation characteristics still needs to be understood, our results show that the observation of an extended SAR laboratory dose response curve does not necessarily enable high doses to be recorded accurately, or provide a corresponding extended age range

About the causes of evolution of the “operated ear`s disease”

Summary It doesn’t matter that ear surgery improved a lot for last 30 years, because radical mastoidectomy didn’t lose its importance. A type of illness named the “operated year disease” often appears and the signs of the chronic medial otitis recur (headache, hearinglos, otorea, vertigo). We studied causes of “operated year disease” appearance in 77 patients and concluded that the illness is caused by the long duration of the sickness, the volume of the operations, technical mistakes in radical mastoidectomy, microflora. After the studies of operated ear we accomplished that one more operation for stopping the illness should be made repetitive.Rezumat Cu toate că dezvoltarea otochirurgiei a progresat în ultimii 30 ani, evidarea petromastoidiană totală a rămas la fel de actuală. Dar frecvent apare aşa numita “maladia urechii operate” şi simptomatica otitei medii cronice apare din nou ( otoreea, hipoacuzia, cefaleea, vertijul ). Pe exemplu a 77 de pacienţi care au fost studiaţi noi am determinat cauzele principale a apariţiei „maladiei urechii operate”. Am ajuns la concluzia că apariţia ei este cauzată de următorii factori: - durata bolii, - volumul cavităţii postoperatorii, încălcarea tehnicii de efectuare a evidării petromastoidiene totale. Cercetările efectuate de noi au adus la concluzia că cea mai bună metodă de tratament a urechii operate este reoperaţia urechii

Heart failure during the COVID-19 pandemic: clinical, diagnostic, management, and organizational dilemmas

The coronavirus 2019 (COVID-19) infection pandemic has affected the care of patients with heart failure (HF). Several consensus documents describe the appropriate diagnostic algorithm and treatment approach for patients with HF and associated COVID-19 infection. However, few questions about the mechanisms by which COVID can exacerbate HF in patients with high-risk (Stage B) or symptomatic HF (Stage C) remain unanswered. Therefore, the type of HF occurring during infection is poorly investigated. The diagnostic differentiation and management should be focused on the identification of the HF phenotype, underlying causes, and subsequent tailored therapy. In this framework, the relationship existing between COVID and onset of acute decompensated HF, isolated right HF, and cardiogenic shock is questioned, and the specific management is mainly based on local hospital organization rather than a standardized model. Similarly, some specific populations such as advanced HF, heart transplant, patients with left ventricular assist device (LVAD), or valve disease remain under investigated. In this systematic review, we examine recent advances regarding the relationships between HF and COVID-19 pandemic with respect to epidemiology, pathogenetic mechanisms, and differential diagnosis. Also, according to the recent HF guidelines definition, we highlight different clinical profile identification, pointing out the main concerns in understudied HF populations.© 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology

Trapped electron coupled to superconducting devices

We propose to couple a trapped single electron to superconducting structures located at a variable distance from the electron. The electron is captured in a cryogenic Penning trap using electric fields and a static magnetic field in the Tesla range. Measurements on the electron will allow investigating the properties of the superconductor such as vortex structure, damping and decoherence. We propose to couple a superconducting microwave resonator to the electron in order to realize a circuit QED-like experiment, as well as to couple superconducting Josephson junctions or superconducting quantum interferometers (SQUIDs) to the electron. The electron may also be coupled to a vortex which is situated in a double well potential, realized by nearby pinning centers in the superconductor, acting as a quantum mechanical two level system that can be controlled by a transport current tilting the double well potential. When the vortex is trapped in the interferometer arms of a SQUID, this would allow its detection both by the SQUID and by the electron.Comment: 13 pages, 5 figure

Therapeutic Advances in the Management of Cardiogenic Shock

Background: Cardiogenic shock (CS) is a life-threatening state of tissue hypoperfusion, associated with a very high risk of mortality, despite intensive monitoring and modern treatment modalities. The present review aimed at describing the therapeutic advances in the management of CS. Areas of uncertainty: Many uncertainties about CS management remain in clinical practice, and these relate to the intensity of invasive monitoring, the type and timing of vasoactive therapies, the risk-benefit ratio of mechanical circulatory support (MCS) therapy, and optimal ventilation mode. Furthermore, most of the data are obtained from CS in the setting of acute myocardial infarction (AMI), although for non-AMI-CS patients, there are very few evidences for etiological or MCS therapies. Data sources: The prospective multicentric acute heart failure registries that specifically presented characteristics of patients with CS, distinct to other phenotypes, were included in the present review. Relevant clinical trials investigating therapeutic strategies in post-AMI-CS patients were added as source information. Several trials investigating vasoactive medications and meta-analysis providing information about benefits and risks of MCS devices were reviewed in this study. Therapeutic advances: Early revascularization remains the most important intervention for CS in settings of AMI, and in patients with multivessel disease, recent trial data recommend revascularization on a "culprit-lesion-only" strategy. Although diverse types of MCS devices improve hemodynamics and organ perfusion in patients with CS, results from almost all randomized trials incorporating clinical end points were inconclusive. However, development of new algorithms for utilization of MCS devices and progresses in technology showed benefit in selected patients. A major advance in the management of CS is development of concept of regional CS centers based on the level of facilities and expertise. The modern systems of care with CS centers used as hubs integrated with emergency medical systems and other referee hospitals have the potential to improve patient outcomes. Conclusions: Additional research is needed to establish new triage algorithms and to clarify intensity and timing of pharmacological and mechanical therapies