240 research outputs found

    Coronary angiography and angioplasty in diabetic patients

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    Screening, diagnosis and revascularization of coronary artery disease (CAD) in type 2 diabetes mellitus are major challenges for current clinical practice. Diagnostic (angiography) and therapeutic (angioplasty) cardiac catheterization are important resources for the clinical assessment and management of coronary atherosclerosis. Anatomic peculiarities of CAD in diabetics can be well characterized by angiography, associated or not by intravascular ultrasound. The worse outcome following coronary revascularization procedures, either angioplasty or surgery, in diabetic is one of the main fields of clinical research. In spite of controversies, about one quarter of angioplasty and one third of surgical revascularization procedures are performed in diabetics. Two ongoing, large, randomized, multicentric trials are investigating the best management of CAD in diabetics. The BARI 2D trial is randomizing asymptomatic or mildly symptomatic patients with CAD for either medical therapy or revascularization (angioplasty or surgery, according to the best clinical judgment). The FREEDOM trial is randomizing stable patients with multivessel CAD for either angioplasty with drug eluting stents or surgery, with or without extracorporeal circulation. While the evidences are not available, in order to decide on the best revascularization procedure for individual patients, medical practice has been balanced according to a number of variables. Conditions that favor angioplasty: short lesions, lesions in large vessels, absence of left anterior descending artery disease, previous coronary bypass surgery and high surgical risk due to co-morbidities. Conditions that favor surgery: long lesions, lesions in small vessels, presence of left anterior descending artery disease and need for associated valve surgery.O rastreamento, o diagnóstico e a revascularização da doença arterial coronária (DAC) no diabetes tipo 2 representam enormes desafios para a prática médica. Neste contexto, o cateterismo cardíaco diagnóstico (angiografia) e terapêutico (angioplastia) são recursos fundamentais na avaliação clínica e manejo da aterosclerose coronária. Avaliações das particularidades anatômicas da DAC no diabetes são detalhadamente caracterizadas pela angiografia coronária, associada ou não ao ultra-som intracoronário. Por outro lado, a resposta pior aos procedimentos de revascularização (angioplastia e cirurgia) da DAC nos diabéticos representa umas das áreas de maior investigação clínica contemporânea. A despeito das controvérsias, cerca de um quarto dos pacientes submetidos a angioplastia e um terço dos pacientes submetidos a cirurgia são diabéticos. Dois grandes estudos multicêntricos randomizados, em andamento, investigam o melhor manejo da DAC nos diabéticos. O BARI 2D está randomizando pacientes com DAC assintomáticos ou com sintomas leves para tratamento clínico ou revascularização (angioplastia ou cirurgia, conforme melhor julgamento clínico). O FREEDOM está randomizando pacientes diabéticos estáveis com DAC multiarterial, para angioplastia com stent farmacológico ou cirurgia, com ou sem uso de circulação extra-corpórea. Enquanto as evidências não estão disponíveis, a prática médica atual é balanceada por um conjunto de variáveis na decisão sobre a melhor alternativa de revascularização. Condições que favorecem a angioplastia: estenoses curtas, vasos grandes, ausência de estenose na artéria descendente anterior (ADA), cirurgia de revascularização prévia e risco cirúrgico elevado. Condições que favorecem a indicação de cirurgia: estenoses longas, vasos pequenos, presença de estenose da ADA e cirurgia valvar associada.UNIFESP-EPMSPDM Hospital São Paulo Serviço de Hemodinâmica e Cardiologia IntervencionistaFOR Hospital do Rim e HipertensãoUNIFESP, EPMSPDM Hospital São Paulo Serviço de Hemodinâmica e Cardiologia IntervencionistaSciEL

    Biologically inspired simulation of livor mortis

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    We present a biologically motivated livor mortis simulation that is capable of modelling the colouration changes in skin caused by blood pooling after death. Our approach consists of a simulation of post mortem blood dynamics and a layered skin shader that is controlled by the haemoglobin and oxygen levels in blood. The object is represented by a layered data structure made of a triangle mesh for the skin and a tetrahedral mesh on which the blood dynamics are simulated. This allows us to simulate the skin discolouration caused by livor mortis, including early patchy appearance, fixation of hypostasis and pressure induced blanching. We demonstrate our approach on two different models and scenarios and compare the results to real world livor mortis photographic examples

    Charged-particle distributions at low transverse momentum in √s=13 13 TeV pp interactions measured with the ATLAS detector at the LHC

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    Measurements of distributions of charged particles produced in proton–proton collisions with a centre-of-mass energy of 13 TeV are presented. The data were recorded by the ATLAS detector at the LHC and correspond to an integrated luminosity of 151 μb −1 μb−1 . The particles are required to have a transverse momentum greater than 100 MeV and an absolute pseudorapidity less than 2.5. The charged-particle multiplicity, its dependence on transverse momentum and pseudorapidity and the dependence of the mean transverse momentum on multiplicity are measured in events containing at least two charged particles satisfying the above kinematic criteria. The results are corrected for detector effects and compared to the predictions from several Monte Carlo event generators

    Searches for Higgs boson pair production in the hh→bbττ, γγWW∗, γγbb, bbbb channels with the ATLAS detector

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    Searches for both resonant and nonresonant Higgs boson pair production are performed in the hh→bbττ, γγWW∗ final states using 20.3  fb−1 of pp collision data at a center-of-mass energy of 8 TeV recorded with the ATLAS detector at the Large Hadron Collider. No evidence of their production is observed and 95% confidence-level upper limits on the production cross sections are set. These results are then combined with the published results of the hh→γγbb, bbbb analyses. An upper limit of 0.69 (0.47) pb on the nonresonant hh production is observed (expected), corresponding to 70 (48) times the SM gg→hh cross section. For production via narrow resonances, cross-section limits of hh production from a heavy Higgs boson decay are set as a function of the heavy Higgs boson mass. The observed (expected) limits range from 2.1 (1.1) pb at 260 GeV to 0.011 (0.018) pb at 1000 GeV. These results are interpreted in the context of two simplified scenarios of the Minimal Supersymmetric Standard Model

    Measurements of the top quark branching ratios into channels with leptons and quarks with the ATLAS detector

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    We thank CERN for the very successful operation of the LHC, as well as the support staff from our institutions without whom ATLAS could not be operated efficiently. We acknowledge the support of ANPCyT, Argentina; YerPhI, Armenia; ARC, Australia; BMWFW and FWF, Austria; ANAS, Azerbaijan; SSTC, Belarus; CNPq and FAPESP, Brazil; NSERC, NRC and CFI, Canada; CERN; CONICYT, Chile; CAS, MOST and NSFC, China; COLCIENCIAS, Colombia; MSMT CR, MPO CR and VSC CR, Czech Republic; DNRF, DNSRC and Lundbeck Foundation, Denmark; EPLANET, ERC and NSRF, European Union; IN2P3-CNRS, CEA-DSM/IRFU, France; GNSF, Georgia; BMBF, DFG, HGF Helmholtz Association, MPG and AvH Foundation, Germany; GSRT and NSRF, Greece; RGC, Hong Kong SAR, China; ISF, MINERVA, GIF, I-CORE and Benoziyo Center, Israel; INFN, Italy; MEXT and JSPS, Japan; CNRST, Morocco; FOM and NWO, Netherlands; BRF and RCN, Norway; MNiSW and NCN, Poland; GRICES and FCT, Portugal; MNE/IFA, Romania; MES of Russia and NRC KI, Russian Federation; JINR; MSTD, Serbia; MSSR, Slovakia; ARRS and MIZŠ, Slovenia; DST/NRF, South Africa; MINECO, Spain; SRC and Wallenberg Foundation, Sweden; SER, SNSF and Cantons of Bern and Geneva, Switzerland; NSC, Taiwan; TAEK, Turkey; STFC, the Royal Society and Leverhulme Trust, United Kingdom; DOE and NSF, United States of America. The crucial computing support from all WLCG partners is acknowledged gratefully, in particular from CERN and the ATLAS Tier-1 facilities at TRIUMF (Canada), NDGF (Denmark, Norway, Sweden), CC-IN2P3 (France), KIT/GridKA (Germany), INFN-CNAF (Italy), NL-T1 (Netherlands), PIC (Spain), ASGC (Taiwan), RAL (UK) and BNL (USA) and in the Tier-2 facilities worldwide

    Search for dark matter at √s=13 TeV in final states containing an energetic photon and large missing transverse momentum with the ATLAS detector

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    Results of a search for physics beyond the Standard Model in events containing an energetic photon and large missing transverse momentum with the ATLAS detector at the Large Hadron Collider are reported. As the number of events observed in data, corresponding to an integrated luminosity of 36.1 fb−1 of proton–proton collisions at a centre-of-mass energy of 13 TeV, is in agreement with the Standard Model expectations, model-independent limits are set on the fiducial cross section for the production of events in this final state. Exclusion limits are also placed in models where dark-matter candidates are pair-produced. For dark-matter production via an axial-vector or a vector mediator in the s-channel, this search excludes mediator masses below 750–1200 GeV for dark-matter candidate masses below 230–480 GeV at 95% confidence level, depending on the couplings. In an effective theory of dark-matter production, the limits restrict the value of the suppression scale M∗ to be above 790 GeV at 95% confidence level. A limit is also reported on the production of a high-mass scalar resonance by processes beyond the Standard Model, in which the resonance decays to Zγ and the Z boson subsequently decays into neutrinos

    Search for excited electrons singly produced in proton–proton collisions at \sqrt{s} = 13 TeV with the ALAS experiment at the LHC

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    A search for excited electrons produced in pp collisions at s√ = 13 TeV via a contact interaction qq¯→ee∗ is presented. The search uses 36.1 fb −1 of data collected in 2015 and 2016 by the ATLAS experiment at the Large Hadron Collider. Decays of the excited electron into an electron and a pair of quarks ( eqq¯ ) are targeted in final states with two electrons and two hadronic jets, and decays via a gauge interaction into a neutrino and a W boson ( νW ) are probed in final states with an electron, missing transverse momentum, and a large-radius jet consistent with a hadronically decaying W boson. No significant excess is observed over the expected backgrounds. Upper limits are calculated for the pp→ee∗→eeqq¯ and pp→ee∗→eνW production cross sections as a function of the excited electron mass me∗ at 95% confidence level. The limits are translated into lower bounds on the compositeness scale parameter Λ of the model as a function of me∗ . For me∗<0.5 TeV , the lower bound for Λ is 11 TeV . In the special case of me∗=Λ , the values of me∗<4.8 TeV are excluded. The presented limits on Λ are more stringent than those obtained in previous searches

    Measurements of differential cross-sections in top-quark pair events with a high transverse momentum top quark and limits on beyond the Standard Model contributions to top-quark pair production with the ATLAS detector at √s = 13 TeV

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    Cross-section measurements of top-quark pair production where the hadronically decaying top quark has transverse momentum greater than 355 GeV and the other top quark decays into ℓνb are presented using 139 fb−1 of data collected by the ATLAS experiment during proton-proton collisions at the LHC. The fiducial cross-section at s = 13 TeV is measured to be σ = 1.267 ± 0.005 ± 0.053 pb, where the uncertainties reflect the limited number of data events and the systematic uncertainties, giving a total uncertainty of 4.2%. The cross-section is measured differentially as a function of variables characterising the tt¯ system and additional radiation in the events. The results are compared with various Monte Carlo generators, including comparisons where the generators are reweighted to match a parton-level calculation at next-to-next-to-leading order. The reweighting improves the agreement between data and theory. The measured distribution of the top-quark transverse momentum is used to search for new physics in the context of the effective field theory framework. No significant deviation from the Standard Model is observed and limits are set on the Wilson coefficients of the dimension-six operators OtG and Otq(8), where the limits on the latter are the most stringent to date. [Figure not available: see fulltext.]

    Measurement of the associated production of a Higgs boson decaying into b-quarks with a vector boson at high transverse momentum in pp collisions at s=13\sqrt{s}=13 TeV with the ATLAS detector

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    The associated production of a Higgs boson with a W or Z boson decaying into leptons and where the Higgs boson decays to a pair is measured in the high vector-boson transverse momentum regime, above 250 GeV, with the ATLAS detector. The analysed data, corresponding to an integrated luminosity of , were collected in proton–proton collisions at the Large Hadron Collider between 2015 and 2018 at a centre-of-mass energy of . The measured signal strength, defined as the ratio of the measured signal yield to that predicted by the Standard Model, is corresponding to an observed (expected) significance of 2.1 (2.7) standard deviations. Cross-sections of associated production of a Higgs boson decaying into b quark pairs with a W or Z gauge boson, decaying into leptons, are measured in two exclusive vector boson transverse momentum regions, 250–400 GeV and above 400 GeV, and interpreted as constraints on anomalous couplings in the framework of a Standard Model effective field theory

    Electron reconstruction and identification efficiency measurements with the ATLAS detector using the 2011 LHC proton–proton collision data

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    Many of the interesting physics processes to be measured at the LHC have a signature involving one or more isolated electrons. The electron reconstruction and identification efficiencies of the ATLAS detector at the LHC have been evaluated using proton–proton collision data collected in 2011 at s√=7 TeV and corresponding to an integrated luminosity of 4.7 fb −1. Tag-and-probe methods using events with leptonic decays of W and Z bosons and J/ψ mesons are employed to benchmark these performance parameters. The combination of all measurements results in identification efficiencies determined with an accuracy at the few per mil level for electron transverse energy greater than 30 GeV
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