Studies of the Response of the Prototype CMS Hadron Calorimeter, Including Magnetic Field Effects, to Pion, Electron, and Muon Beams

We report on the response of a prototype CMS hadron calorimeter module to charged particle beams of pions, muons, and electrons with momenta up to 375 GeV/c. The data were taken at the H2 and H4 beamlines at CERN in 1995 and 1996. The prototype sampling calorimeter used copper absorber plates and scintillator tiles with wavelength shifting fibers for readout. The effects of a magnetic field of up to 3 Tesla on the response of the calorimeter to muons, electrons, and pions are presented, and the effects of an upstream lead tungstate crystal electromagnetic calorimeter on the linearity and energy resolution of the combined calorimetric system to hadrons are evaluated. The results are compared with Monte Carlo simulations and are used to optimize the choice of total absorber depth, sampling frequency, and longitudinal readout segmentation.Comment: 89 pages, 41 figures, to be published in NIM, corresponding author: P de Barbaro, [email protected]

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

Mass-spectrometric study on

The present study continues the 2015–2016 research project on biological characteristics of stable isotopes fractionation in grapes taking into account the agro-climatic growth conditions of this representative of the C3-pathway of photosynthesis group of plants in different geographical Black Sea regions. The first parts of the project were presented at the 39th and 40th Congresses of OIV in Bento Gonçalves (Brazil) and Sofia (Bulgaria). The scientific data on compositions of 13C/12C carbon and 18O/16O oxygen stable isotopes in carbohydrates, organic acids, and intracellular water were obtained for grapes of 2015–2016 growing seasons in the four areas of the Crimean peninsula as well as in several areas of the Don Basin and the Western Caspian region. This report presents the results of the 2017 season study of 13C/12C carbon and 18O/16O oxygen stable isotopes in carbohydrates and intracellular water of 12 red and white grape varieties (Aligote, Rkatsiteli, Sauvignon Zeleny, Chardonnay, Cabernet Sauvignon, Sauvignon Blanc, Merlot, Risling, Pinot Noir, Cabernet Franc, Sira, Krasnostop) as well as in ethanol of wines made from corresponding grapes from the Crimean Peninsula and South-West Coast of the Greater Caucasus. To measure the ratio of carbon isotopes 13C/12C in grape (must) carbohydrates and wine ethanol the Flash-Combustion technique (FC-IRMS/SIRA) has been used, while the method of isotopic equilibration (EQ-IRMS/SIRA) has been used for the measurement of 18O/16O oxygen isotopes ratio in the intracellular water of grapes (must) and in the water fraction of wine. The GC-Combustion technique (GC-IRMS/SIRA) has been used for the first time to measure the carbon isotopes 13C/12C distribution in ethanol of studied wines. It has been found that the δ13CVPDB values for carbohydrates of red and white grape varieties as a result of biological fractionation of carbon isotopes in the agro-climatic conditions of plant growth (2017 season) for the studied geographical areas formed the following quantitative ranges: from − 26.72 to − 23.35‰ (the Crimean Peninsula) and from − 25.92 to − 23.87‰ (South-West Coast of the Greater Caucasus). The δ13CVPDB values for wine ethanol are in the following ranges: from − 28.15 to − 24.47‰ (the Crimean Peninsula) and from − 27.29 to − 25.78‰ (South-West Coast of the Greater Caucasus). The δ18OVSMOW values in intracellular water of grapes of the 2017 season range from − 1.24 to 2.17‰ (the Crimean Peninsula) and from 1.08 to 4.09‰ (South-West Coast of the Greater Caucasus). The results of this study show, in comparison with the results of studies of the 2015 and 2016 seasons, a decrease in the δ13CVPDB values for carbohydrates of grapes and ethanol of wine, which is explained by the changed climatic conditions of grapes growing in the vegetation period of 2017

Mass-spectrometric study on13C/12C carbon and18O/16O oxygenstable isotopes distributions in grapes and wines from the BlackSea regions

The present study continues the 2015–2016 research project on biological characteristics of stableisotopes fractionation in grapes taking into account the agro-climatic growth conditions of this representativeof the C3-pathway of photosynthesis group of plants in different geographical Black Sea regions. The firstparts of the project were presented at the 39th and 40th Congresses of OIV in Bento Gonc ̧alves (Brazil) andSofia (Bulgaria). The scientific data on compositions of13C/12C carbon and18O/16O oxygen stable isotopes incarbohydrates, organic acids, and intracellular water were obtained for grapes of 2015–2016 growing seasonsin the four areas of the Crimean peninsula as well as in several areas of the Don Basin and the Western Caspianregion. This report presents the results of the 2017 season study of13C/12C carbon and18O/16O oxygen stableisotopes in carbohydrates and intracellular water of 12 red and white grape varieties (Aligote, Rkatsiteli,Sauvignon Zeleny, Chardonnay, Cabernet Sauvignon, Sauvignon Blanc, Merlot, Risling, Pinot Noir, CabernetFranc, Sira, Krasnostop) as well as in ethanol of wines made from corresponding grapes from the CrimeanPeninsula and South-West Coast of the Greater Caucasus. To measure the ratio of carbon isotopes13C/12Cin grape (must) carbohydrates and wine ethanol the Flash-Combustion technique (FC-IRMS/SIRA) has beenused, while the method of isotopic equilibration (EQ-IRMS/SIRA) has been used for the measurement of18O/16O oxygen isotopes ratio in the intracellular water of grapes (must) and in the water fraction of wine. TheGC-Combustion technique (GC-IRMS/SIRA) has been used for the first time to measure the carbon isotopes13C/12C distribution in ethanol of studied wines. It has been found that theδ13CVPDBvalues for carbohydratesof red and white grape varieties as a result of biological fractionation of carbon isotopes in the agro-climaticconditions of plant growth (2017 season) for the studied geographical areas formed the following quantitativeranges: from−26.72 to−23.35‰ (the Crimean Peninsula) and from−25.92 to−23.87‰ (South-West Coastof the Greater Caucasus). Theδ13CVPDBvalues for wine ethanol are in the following ranges: from−28.15to−24.47‰ (the Crimean Peninsula) and from−27.29 to−25.78‰ (South-West Coast of the GreaterCaucasus). Theδ18OVSMOWvalues in intracellular water of grapes of the 2017 season range from−1.24to 2.17‰ (the Crimean Peninsula) and from 1.08 to 4.09‰ (South-West Coast of the Greater Caucasus). Theresults of this study show, in comparison with the results of studies of the 2015 and 2016 seasons, a decreasein theδ13CVPDBvalues for carbohydrates of grapes and ethanol of wine, which is explained by the changedclimatic conditions of grapes growing in the vegetation period of 201

Peculiarities of hemodynamic status of healthy newborns in early neonatal period

The study is devoted to the assessment of hemodynamic parameters in healthy newborns in the early neonatal period. The authors examined 76 healthy newborns aged up to 7 days. 12 (15.7%) of 76 children were diagnosed with intrauterine growth retardation of hypotrophic type and 14 children (18.49%) were premature. The authors evaluated the diameter of the outgoing tract of the left ventricle, pulmonary artery trunk, mitral and tricuspid valve rings. The disc method was used to determine the final diastolic volume of the left ventricle. The pulse Doppler was used to determine the integrated flow rate in the outflow tract of the left ventricle, the pulmonary artery trunk, on the mitral and tricuspid valves. After US there were calculated the stroke volume index, cardiac index, total peripheral vascular resistance and oxygen delivery index.The results. It integral flow rate was found to be a key indicator of central hemodynamics, which determines the magnitude of the stroke volume. Body weight and the presence of functioning fetal communications do not have a significant impact on the indexed systemic blood flow in healthy newborns. There is a direct correlation between the integral blood flow velocity and the stroke volume index, which is characteristic of all intracardiac anatomical structures

Edoxaban versus warfarin in patients with atrial fibrillation

Contains fulltext : 125374.pdf (publisher's version ) (Open Access)BACKGROUND: Edoxaban is a direct oral factor Xa inhibitor with proven antithrombotic effects. The long-term efficacy and safety of edoxaban as compared with warfarin in patients with atrial fibrillation is not known. METHODS: We conducted a randomized, double-blind, double-dummy trial comparing two once-daily regimens of edoxaban with warfarin in 21,105 patients with moderate-to-high-risk atrial fibrillation (median follow-up, 2.8 years). The primary efficacy end point was stroke or systemic embolism. Each edoxaban regimen was tested for noninferiority to warfarin during the treatment period. The principal safety end point was major bleeding. RESULTS: The annualized rate of the primary end point during treatment was 1.50% with warfarin (median time in the therapeutic range, 68.4%), as compared with 1.18% with high-dose edoxaban (hazard ratio, 0.79; 97.5% confidence interval [CI], 0.63 to 0.99; P<0.001 for noninferiority) and 1.61% with low-dose edoxaban (hazard ratio, 1.07; 97.5% CI, 0.87 to 1.31; P=0.005 for noninferiority). In the intention-to-treat analysis, there was a trend favoring high-dose edoxaban versus warfarin (hazard ratio, 0.87; 97.5% CI, 0.73 to 1.04; P=0.08) and an unfavorable trend with low-dose edoxaban versus warfarin (hazard ratio, 1.13; 97.5% CI, 0.96 to 1.34; P=0.10). The annualized rate of major bleeding was 3.43% with warfarin versus 2.75% with high-dose edoxaban (hazard ratio, 0.80; 95% CI, 0.71 to 0.91; P<0.001) and 1.61% with low-dose edoxaban (hazard ratio, 0.47; 95% CI, 0.41 to 0.55; P<0.001). The corresponding annualized rates of death from cardiovascular causes were 3.17% versus 2.74% (hazard ratio, 0.86; 95% CI, 0.77 to 0.97; P=0.01), and 2.71% (hazard ratio, 0.85; 95% CI, 0.76 to 0.96; P=0.008), and the corresponding rates of the key secondary end point (a composite of stroke, systemic embolism, or death from cardiovascular causes) were 4.43% versus 3.85% (hazard ratio, 0.87; 95% CI, 0.78 to 0.96; P=0.005), and 4.23% (hazard ratio, 0.95; 95% CI, 0.86 to 1.05; P=0.32). CONCLUSIONS: Both once-daily regimens of edoxaban were noninferior to warfarin with respect to the prevention of stroke or systemic embolism and were associated with significantly lower rates of bleeding and death from cardiovascular causes. (Funded by Daiichi Sankyo Pharma Development; ENGAGE AF-TIMI 48 ClinicalTrials.gov number, NCT00781391.)

Evolocumab and clinical outcomes in patients with cardiovascular disease

peer reviewedBACKGROUND Evolocumab is a monoclonal antibody that inhibits proprotein convertase subtilisin-kexin type 9 (PCSK9) and lowers low-density lipoprotein (LDL) cholesterol levels by approximately 60%. Whether it prevents cardiovascular events is uncertain. METHODS We conducted a randomized, double-blind, placebo-controlled trial involving 27,564 patients with atherosclerotic cardiovascular disease and LDL cholesterol levels of 70 mg per deciliter (1.8 mmol per liter) or higher who were receiving statin therapy. Patients were randomly assigned to receive evolocumab (either 140 mg every 2 weeks or 420 mg monthly) or matching placebo as subcutaneous injections. The primary efficacy end point was the composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. The key secondary efficacy end point was the composite of cardiovascular death, myocardial infarction, or stroke. The median duration of follow-up was 2.2 years. RESULTS At 48 weeks, the least-squares mean percentage reduction in LDL cholesterol levels with evolocumab, as compared with placebo, was 59%, from a median baseline value of 92 mg per deciliter (2.4 mmol per liter) to 30 mg per deciliter (0.78 mmol per liter) (P<0.001). Relative to placebo, evolocumab treatment significantly reduced the risk of the primary end point (1344 patients [9.8%] vs. 1563 patients [11.3%]; hazard ratio, 0.85; 95% confidence interval [CI], 0.79 to 0.92; P<0.001) and the key secondary end point (816 [5.9%] vs. 1013 [7.4%]; hazard ratio, 0.80; 95% CI, 0.73 to 0.88; P<0.001). The results were consistent across key subgroups, including the subgroup of patients in the lowest quartile for baseline LDL cholesterol levels (median, 74 mg per deciliter [1.9 mmol per liter]). There was no significant difference between the study groups with regard to adverse events (including new-onset diabetes and neurocognitive events), with the exception of injection-site reactions, which were more common with evolocumab (2.1% vs. 1.6%). CONCLUSIONS In our trial, inhibition of PCSK9 with evolocumab on a background of statin therapy lowered LDL cholesterol levels to a median of 30 mg per deciliter (0.78 mmol per liter) and reduced the risk of cardiovascular events. These findings show that patients with atherosclerotic cardiovascular disease benefit from lowering of LDL cholesterol levels below current targets. © 2017 Massachusetts Medical Society

Treatment of Anemia with Darbepoetin Alfa in Systolic Heart Failure

<p>BACKGROUND</p><p>Patients with systolic heart failure and anemia have worse symptoms, functional capacity, and outcomes than those without anemia. We evaluated the effects of darbepoetin alfa on clinical outcomes in patients with systolic heart failure and anemia.</p><p>METHODS</p><p>In this randomized, double-blind trial, we assigned 2278 patients with systolic heart failure and mild-to-moderate anemia (hemoglobin level, 9.0 to 12.0 g per deciliter) to receive either darbepoetin alfa (to achieve a hemoglobin target of 13 g per deciliter) or placebo. The primary outcome was a composite of death from any cause or hospitalization for worsening heart failure.</p><p>RESULTS</p><p>The primary outcome occurred in 576 of 1136 patients (50.7%) in the darbepoetin alfa group and 565 of 1142 patients (49.5%) in the placebo group (hazard ratio in the darbepoetin alfa group, 1.01; 95% confidence interval, 0.90 to 1.13; P = 0.87). There was no significant between-group difference in any of the secondary outcomes. The neutral effect of darbepoetin alfa was consistent across all prespecified subgroups. Fatal or nonfatal stroke occurred in 42 patients (3.7%) in the darbepoetin alfa group and 31 patients (2.7%) in the placebo group (P = 0.23). Thromboembolic adverse events were reported in 153 patients (13.5%) in the darbepoetin alfa group and 114 patients (10.0%) in the placebo group (P = 0.01). Cancer-related adverse events were similar in the two study groups.</p><p>CONCLUSIONS</p><p>Treatment with darbepoetin alfa did not improve clinical outcomes in patients with systolic heart failure and mild-to-moderate anemia. Our findings do not support the use of darbepoetin alfa in these patients. (Funded by Amgen; RED-HF ClinicalTrials.gov number, NCT00358215.)</p>