Recent progress with the vortex stabilized arc

Vortex stabilized plasma arc used to obtain spectral energy distribution dat

Baseline characteristics of patients in the reduction of events with darbepoetin alfa in heart failure trial (RED-HF)

<p>Aims: This report describes the baseline characteristics of patients in the Reduction of Events with Darbepoetin alfa in Heart Failure trial (RED-HF) which is testing the hypothesis that anaemia correction with darbepoetin alfa will reduce the composite endpoint of death from any cause or hospital admission for worsening heart failure, and improve other outcomes.</p> <p>Methods and results: Key demographic, clinical, and laboratory findings, along with baseline treatment, are reported and compared with those of patients in other recent clinical trials in heart failure. Compared with other recent trials, RED-HF enrolled more elderly [mean age 70 (SD 11.4) years], female (41%), and black (9%) patients. RED-HF patients more often had diabetes (46%) and renal impairment (72% had an estimated glomerular filtration rate <60 mL/min/1.73 m2). Patients in RED-HF had heart failure of longer duration [5.3 (5.4) years], worse NYHA class (35% II, 63% III, and 2% IV), and more signs of congestion. Mean EF was 30% (6.8%). RED-HF patients were well treated at randomization, and pharmacological therapy at baseline was broadly similar to that of other recent trials, taking account of study-specific inclusion/exclusion criteria. Median (interquartile range) haemoglobin at baseline was 112 (106–117) g/L.</p> <p>Conclusion: The anaemic patients enrolled in RED-HF were older, moderately to markedly symptomatic, and had extensive co-morbidity.</p&gt

Implications of serial measurements of natriuretic peptides in heart failure: insights from BIOSTAT‐CHF

No abstract available

Performance assessment for low-level radioactive waste management and disposal at DOE facilities: Requirements, review process, and lessons learned

Department of Energy (DOE) facilities, located at sites across the nation, generate large quantities and a wide variety of low-level radioactive waste (LLRW) from nuclear defense production and research and development activities. All DOE-generated LLRW is disposed of at DOE disposal sites. Most DOE waste generating sites do not have disposal facilities on site and so must ship their LLRW to one of six currently active DOE disposal locations. Four disposal sites are located in generally arid regions: the Hanford Reservation (HANF) in the state of Washington, the Nevada Test Site (NTS), the Idaho National Engineering Laboratory (INEL), and the Los Alamos National Laboratory (LANL) in New Mexico. The other two disposal sites are located in the humid southeast: The Savannah River Plant (SRP) in South Carolina and the Oak Ridge National Laboratory (ORNL) in Tennessee

Intruder Dose Pathway Analysis for the Onsite Disposal of Radioactive Wastes: The ONSITE/MAXI1 Computer Program

Because of uncertainties associated with assessing the potential risks from onsite burials of radioactive waste, the US Nuclear Regulatory Commission (NRC) has amended its regulations to provide greater assurance that buried radioactive material will not present a hazard to public health and safety. The amended regulations now require licensees to apply for approval of proposed procedures for onsite disposal pursuant to 10 CFR 20.302. The NRC technically reviews these requests on a case-by-case basis. These technical reviews require modeling potential pathways to man and projecting radiation dose commitments. This document contains a summary of our efforts to develop human-intrusion scenarios and to modify a version of the MAXI computer program for potential use by the NRC in reviewing applications for onsite radioactive waste disposal. The documentation of the ONSITE/MAXI computer program is written for two audiences. The first (Audience A) includes persons concerned with the mathematical models and computer algorithms. The second (Audience B) includes persons concerned with exercising the computer program and scenarios for specific onsite disposal applications. Five sample problems are presented and discussed to assist the user in operating the computer program. Summaries of the input and output for the sample problems are included along with a discussion of the hand calculations performed to verify the correct operation of the computer program. Computer listings of the ONSITE/MAXI1 computer program with an abbreviated data base listing are included as Appendix 1 to this document. Finally, complete listings of the data base with listings of the special codes used to create the data base are included in Appendix 2 as a microfiche attachment to this document

Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial

AimsThe objective of the Aliskiren Trial on Acute Heart Failure Outcomes (ASTRONAUT) was to determine whether aliskiren, a direct renin inhibitor, would improve post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction. Pre-specified subgroup analyses suggested potential heterogeneity in post-discharge outcomes with aliskiren in patients with and without baseline diabetes mellitus (DM).Methods and resultsASTRONAUT included 953 patients without DM (aliskiren 489; placebo 464) and 662 patients with DM (aliskiren 319; placebo 343) (as reported by study investigators). Study endpoints included the first occurrence of cardiovascular death or HHF within 6 and 12 months, all-cause death within 6 and 12 months, and change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 1, 6, and 12 months. Data regarding risk of hyperkalaemia, renal impairment, and hypotension, and changes in additional serum biomarkers were collected. The effect of aliskiren on cardiovascular death or HHF within 6 months (primary endpoint) did not significantly differ by baseline DM status (P = 0.08 for interaction), but reached statistical significance at 12 months (non-DM: HR: 0.80, 95% CI: 0.64-0.99; DM: HR: 1.16, 95% CI: 0.91-1.47; P = 0.03 for interaction). Risk of 12-month all-cause death with aliskiren significantly differed by the presence of baseline DM (non-DM: HR: 0.69, 95% CI: 0.50-0.94; DM: HR: 1.64, 95% CI: 1.15-2.33; P < 0.01 for interaction). Among non-diabetics, aliskiren significantly reduced NT-proBNP through 6 months and plasma troponin I and aldosterone through 12 months, as compared to placebo. Among diabetic patients, aliskiren reduced plasma troponin I and aldosterone relative to placebo through 1 month only. There was a trend towards differing risk of post-baseline potassium ≥6 mmol/L with aliskiren by underlying DM status (non-DM: HR: 1.17, 95% CI: 0.71-1.93; DM: HR: 2.39, 95% CI: 1.30-4.42; P = 0.07 for interaction).ConclusionThis pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard HHF therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of HHF patients without DM