Prognostic Cardiovascular Markers in Chronic Kidney Disease

Chronic kidney disease (CKD), including end-stage renal disease (ESRD), is a public health issue worldwide, and is associated with high rates of morbidity and mortality. In addition, cardiovascular disease is a major cause of mortality in these patients. Both traditional and nontraditional risk factors associated with CKD can lead to remodeling of the myocardium and blood vessels, thereby resulting in cardiomyopathy, atherosclerosis and arterial stiffness. This can subsequently lead to ischemic heart disease, heart failure, cardiovascular death, rapid renal progression and progression to ESRD. Identifying these risk factors to allow for aggressive preventive and interventional strategies is important for the management of patients with CKD. This aim of this review was to survey the clinical outcomes of CKD using cardiac and vascular markers including echocardiographic parameters, systolic time intervals, electrocardiography, heart rate variability, ankle-brachial index, pulse wave velocity, differences between interarm and interankle blood pressure, and vascular calcification

Association of Female Menopause With Atrioventricular Mechanics and Outcomes

BACKGROUND: Despite known sex differences in cardiac structure and function, little is known about how menopause and estrogen associate with atrioventricular mechanics and outcomes. OBJECTIVE: To study how, sex differences, loss of estrogen in menopause and duration of menopause, relate to atrioventricular mechanics and outcomes. METHODS: Among 4051 asymptomatic adults (49.8 ± 10.8 years, 35%women), left ventricular (LV) and left atrial (LA) mechanics were assessed using speckle-tracking. RESULTS: Post-menopausal (vs. pre-menopausal) women had similar LV ejection fraction but reduced GLS, reduced PALS, increased LA stiffness, higher LV sphericity and LV torsion (all p < 0.001). Multivariable analysis showed menopause to be associated with greater LV sphericity (0.02, 95%CI 0.01, 0.03), higher indexed LV mass (LVMi), lower mitral e’, lower LV GLS (0.37, 95%CI 0.04–0.70), higher LV torsion, larger LA volume, worse PALS (∼2.4-fold) and greater LA stiffness (0.028, 95%CI 0.01–0.05). Increasing years of menopause was associated with further reduction in GLS, markedly worse LA mechanics despite greater LV sphericity and higher torsion. Lower estradiol levels correlated with more impaired LV diastolic function, impaired LV GLS, greater LA stiffness, and increased LV sphericity and LV torsion (all p < 0.05). Approximately 5.5% (37/669) of post-menopausal women incident HF over 2.9 years of follow-up. Greater LV sphericity [adjusted hazard ratio (aHR) 1.04, 95%CI 1.00–1.07], impaired GLS (aHR 0.87, 95%CI 0.78–0.97), reduced peak left atrial longitudinal strain (PALS, aHR 0.94, 95%CI 0.90–0.99) and higher LA stiffness (aHR 10.5, 95%CI 1.69–64.6) were independently associated with the primary outcome of HF hospitalizations in post-menopause. Both PALS < 23% (aHR:1.32, 95%CI 1.01–3.49) and GLS < 16% (aHR:5.80, 95%CI 1.79–18.8) remained prognostic for the incidence of HF in post-menopausal women in dichotomous analyses, even after adjusting for confounders. Results were consistent with composite outcomes of HF hospitalizations and 1-year all-cause mortality as well. CONCLUSION: Menopause was associated with greater LV/LA remodeling and reduced LV longitudinal and LA function in women. The cardiac functional deficit with menopause and lower estradiol levels, along with their independent prognostic value post-menopause, may elucidate sex differences in heart failure further

Energetic Electrons Below the Inner Radiation Belt

International audienceEnergetic electrons have occasionally been observed with high intensity in the low-latitude quasi-trapping region, below the inner radiation belt, where their intensity is normally low. During magnetic storms in November 2004 and July 2006, electrons reached magnetic drift shells with L<1.1. Data from the IDP electron spectrometer on the DEMETER satellite provide high energy resolution, while multiple NOAA/POES satellites provide local time coverage. After accounting for instrumental effects caused by the high intensity, electron kinetic energy is shown to reach at least 200 keV with generally softer spectra than are normally found in the stable trapping region. Electron injection from the inner belt by an enhanced convection electric field ∼5 mV/m may explain the observations. This could provide remote testing for models of global electrodynamics

Grouping of RFID Tags via Strongly Selective Families

This letter proposes a novel scheme for grouping of radio-frequency identification (RFID) tags, based on strongly selective families (SSFs). Grouping of RFID tags allows verifying the integrity of groups of objects without external systems such as databases or verifiers, and can be extended to identify missing objects. The existing scheme is based on Gallager's low-density parity-check (LDPC) codes and, as such, it cannot easily achieve designated decoding guarantees due to its pseudo-random nature. Motivated by the strongly selective property of SSFs, this study proposes grouping of RFID tags via SSFs, such that designated decoding guarantees are more easily achieved. Simulation and theoretical results are presented, demonstrating that the proposed scheme can greatly improve the performance of the existing one.</p

Diagnosing and prognosticating the quality movement - a review on the 25 years quality literature (1987-2011)

The purpose of this article is to create a snapshot of 25 years quality movement. The creation process of the snapshot, as well as the result of the study, aims to help in diagnosing the current status of quality management (QM) and further contribute in understanding and shaping its future direction. For this purpose, all published articles during the last 25 years period (1987-2011) under the subject of Total Quality Management (TQM), Business Excellence (BE), quality tools, techniques as well as core values/principles have been collected through the ABI/INFORM complete periodical database. The collected data were analysed and reflected in order to show the current status, evolution trends of the past, and the predicted future directions. The results show that the total number of articles under the subject of TQM has been decreasing after having reached its peak in 1995. However, papers focusing on techniques and tools within the QM framework in terms of Lean, Just-in-Time/Toyota Production System, Benchmarking, and Six-Sigma Quality have been increasing. In addition, papers focusing on core values/key principles needed to build a quality culture in terms of leadership, people-based management, continuous improvements, management based on facts, and focus on the customer have been slightly increasing during the last decade. The findings indicate that QM is now at a more mature stage where focuses have shifted from being initially on TQM to tools, techniques, and core values which are needed for building a quality and BE culture. Based on its evolution, it is concluded that TQM can be understood as a management innovation, if not a management revolution