Simulation of dilated heart failure with continuous flow circulatory support

Lumped parameter models have been employed for decades to simulate important hemodynamic couplings between a left ventricular assist device (LVAD) and the native circulation. However, these studies seldom consider the pathological descending limb of the Frank-Starling response of the overloaded ventricle. This study introduces a dilated heart failure model featuring a unimodal end systolic pressure-volume relationship (ESPVR) to address this critical shortcoming. The resulting hemodynamic response to mechanical circulatory support are illustrated through numerical simulations of a rotodynamic, continuous flow ventricular assist device (cfVAD) coupled to systemic and pulmonary circulations with baroreflex control. The model further incorporated septal interaction to capture the influence of left ventricular (LV) unloading on right ventricular function. Four heart failure conditions were simulated (LV and bi-ventricular failure with/ without pulmonary hypertension) in addition to normal baseline. Several metrics of LV function, including cardiac output and stroke work, exhibited a unimodal response whereby initial unloading improved function, and further unloading depleted preload reserve thereby reducing ventricular output. The concept of extremal loading was introduced to reflect the loading condition in which the intrinsic LV stroke work is maximized. Simulation of bi-ventricular failure with pulmonary hypertension revealed inadequacy of LV support alone. These simulations motivate the implementation of an extremum tracking feedback controller to potentially optimize ventricular recovery. © 2014 Wang et al

Cardiac oxygen supply is compromised during the night in hypertensive patients

The enhanced heart rate and blood pressure soon after awaking increases cardiac oxygen demand, and has been associated with the high incidence of acute myocardial infarction in the morning. The behavior of cardiac oxygen supply is unknown. We hypothesized that oxygen supply decreases in the morning and to that purpose investigated cardiac oxygen demand and oxygen supply at night and after awaking. We compared hypertensive to normotensive subjects and furthermore assessed whether pressures measured non-invasively and intra-arterially give similar results. Aortic pressure was reconstructed from 24-h intra-brachial and simultaneously obtained non-invasive finger pressure in 14 hypertensives and 8 normotensives. Supply was assessed by Diastolic Time Fraction (DTF, ratio of diastolic and heart period), demand by Rate-Pressure Product (RPP, systolic pressure times heart rate, HR) and supply/demand ratio by Adia/Asys, with Adia and Asys diastolic and systolic areas under the aortic pressure curve. Hypertensives had lower supply by DTF and higher demand by RPP than normotensives during the night. DTF decreased and RPP increased in both groups after awaking. The DTF of hypertensives decreased less becoming similar to the DTF of normotensives in the morning; the RPP remained higher. Adia/Asys followed the pattern of DTF. Findings from invasively and non-invasively determined pressure were similar. The cardiac oxygen supply/demand ratio in hypertensive patients is lower than in normotensives at night. With a smaller night-day differences, the hypertensives’ risk for cardiovascular events may be more evenly spread over the 24 h. This information can be obtained noninvasively

Law in social work education: reviewing the evidence on teaching, learning and assessment

This paper presents the findings from a systemic review of knowledge relating to current practice in the teaching, learning and assessment of law in social work education. The research comprised an internationally conducted systematic review of the literature, together with a survey of current education practice in the four countries of the UK. Two consultation events sought the views of a range of stakeholders, including the perspectives of service users and carers. Set in the context of debates about the relationship between law and social work practice, this paper identifies the common themes emerging from the review and offers an analysis of key findings, together with priorities for future directions in education practice

Low-energy Calibration of XENON1T with an Internal 37^{37}Ar Source

A low-energy electronic recoil calibration of XENON1T, a dual-phase xenontime projection chamber, with an internal $^{37}$Ar source was performed. Thiscalibration source features a 35-day half-life and provides two mono-energeticlines at 2.82 keV and 0.27 keV. The photon yield and electron yield at 2.82 keVare measured to be (32.3$\pm$0.3) photons/keV and (40.6$\pm$0.5) electrons/keV,respectively, in agreement with other measurements and with NEST predictions.The electron yield at 0.27 keV is also measured and it is(68.0$^{+6.3}_{-3.7}$) electrons/keV. The $^{37}$Ar calibration confirms thatthe detector is well-understood in the energy region close to the detectionthreshold, with the 2.82 keV line reconstructed at (2.83$\pm$0.02) keV, whichfurther validates the model used to interpret the low-energy electronic recoilexcess previously reported by XENON1T. The ability to efficiently remove argonwith cryogenic distillation after the calibration proves that $^{37}$Ar can beconsidered as a regular calibration source for multi-tonne xenon detectors.<br

Effective Field Theory and Inelastic Dark Matter Results from XENON1T

In this work, we expand on the XENON1T nuclear recoil searches to study theindividual signals of dark matter interactions from operators up todimension-eight in a Chiral Effective Field Theory (ChEFT) and a model ofinelastic dark matter (iDM). We analyze data from two science runs of theXENON1T detector totaling 1\,tonne$\times$year exposure. For these analyses, weextended the region of interest from [4.9, 40.9]$\,$keV$_{\text{NR}}$ to [4.9,54.4]$\,$keV$_{\text{NR}}$ to enhance our sensitivity for signals that peak atnonzero energies. We show that the data is consistent with the background-onlyhypothesis, with a small background over-fluctuation observed peaking between20 and 50$\,$keV$_{\text{NR}}$, resulting in a maximum local discoverysignificance of 1.7\,$\sigma$ for the Vector$\otimes$Vector$_{\text{strange}}$($VV_s$) ChEFT channel for a dark matter particle of 70$\,$GeV/c$^2$, and$1.8\,\sigma$ for an iDM particle of 50$\,$GeV/c$^2$ with a mass splitting of100$\,$keV/c$^2$. For each model, we report 90\,\% confidence level (CL) upperlimits. We also report upper limits on three benchmark models of dark matterinteraction using ChEFT where we investigate the effect of isospin-breakinginteractions. We observe rate-driven cancellations in regions of theisospin-breaking couplings, leading to up to 6 orders of magnitude weaker upperlimits with respect to the isospin-conserving case.<br

Emission of single and few electrons in XENON1T and limits on light dark matter

Delayed single- and few-electron emissions plague dual-phase time projection chambers, limiting their potential to search for light-mass dark matter. This paper examines the origins of these events in the XENON1T experiment. Characterization of the intensity of delayed electron backgrounds shows that the resulting emissions are correlated, in time and position, with high-energy events and can effectively be vetoed. In this work we extend previous S2-only analyses down to a single electron. From this analysis, after removing the correlated backgrounds, we observe rates <30 events/(electron×kg×day) in the region of interest spanning 1 to 5 electrons. We derive 90% confidence upper limits for dark matter-electron scattering, first direct limits on the electric dipole, magnetic dipole, and anapole interactions, and bosonic dark matter models, where we exclude new parameter space for dark photons and solar dark photons

The Triggerless Data Acquisition System of the XENONnT Experiment

The XENONnT detector uses the latest and largest liquid xenon-based timeprojection chamber (TPC) operated by the XENON Collaboration, aimed atdetecting Weakly Interacting Massive Particles and conducting other rare eventsearches. The XENONnT data acquisition (DAQ) system constitutes an upgraded andexpanded version of the XENON1T DAQ system. For its operation, it reliespredominantly on commercially available hardware accompanied by open-source andcustom-developed software. The three constituent subsystems of the XENONnTdetector, the TPC (main detector), muon veto, and the newly introduced neutronveto, are integrated into a single DAQ, and can be operated both independentlyand as a unified system. In total, the DAQ digitizes the signals of 698photomultiplier tubes (PMTs), of which 253 from the top PMT array of the TPCare digitized twice, at $\times10$ and $\times0.5$ gain. The DAQ for the mostpart is a triggerless system, reading out and storing every signal that exceedsthe digitization thresholds. Custom-developed software is used to process theacquired data, making it available within $\mathcal{O}\left(10\text{ s}\right)$for live data quality monitoring and online analyses. The entire system withall the three subsystems was successfully commissioned and has been operatingcontinuously, comfortably withstanding readout rates that exceed $\sim500$ MB/sduring calibration. Livetime during normal operation exceeds $99\%$ and is$\sim90\%$ during most high-rate calibrations. The combined DAQ system hascollected more than 2 PB of both calibration and science data during thecommissioning of XENONnT and the first science run.<br

Searching for Heavy Dark Matter near the Planck Mass with XENON1T

Multiple viable theoretical models predict heavy dark matter particles with a mass close to the Planck mass, a range relatively unexplored by current experimental measurements. We use 219.4 days of data collected with the XENON1T experiment to conduct a blind search for signals from multiply interacting massive particles (MIMPs). Their unique track signature allows a targeted analysis with only 0.05 expected background events from muons. Following unblinding, we observe no signal candidate events. This Letter places strong constraints on spin-independent interactions of dark matter particles with a mass between 1×10$^{12}$ and 2×10$^{17}$  GeV/c$^2$. In addition, we present the first exclusion limits on spin-dependent MIMP-neutron and MIMP-proton cross sections for dark matter particles with masses close to the Planck scale

Low-energy calibration of XENON1T with an internal 37^{{\textbf {37}}}Ar source

A low-energy electronic recoil calibration of XENON1T, a dual-phase xenon time projection chamber, with an internal 37Ar source was performed. This calibration source features a 35-day half-life and provides two mono-energetic lines at 2.82 keV and 0.27 keV. The photon yield and electron yield at 2.82 keV are measured to be (32.3±0.3) photons/keV and (40.6±0.5) electrons/keV, respectively, in agreement with other measurements and with NEST predictions. The electron yield at 0.27 keV is also measured and it is (68.0+6.3−3.7) electrons/keV. The 37Ar calibration confirms that the detector is well-understood in the energy region close to the detection threshold, with the 2.82 keV line reconstructed at (2.83±0.02) keV, which further validates the model used to interpret the low-energy electronic recoil excess previously reported by XENON1T. The ability to efficiently remove argon with cryogenic distillation after the calibration proves that 37Ar can be considered as a regular calibration source for multi-tonne xenon detectors