Recurrent ventricular arrhythmias and myocardial infarctions associated with cocaine induced reversible coronary vasospasm

Cocaine has become the most frequently used illicit drug among patients presenting to emergency departments worldwide. Although acute myocardial infarction is the most common reported cardiovascular manifestation in this setting, there are many other potential cardiotoxic effects of cocaine use including coronary artery spasm, arrhythmia, and sudden death. We report the case of a 54 year-old male with angiographically documented reversible coronary arterial spasm leading to severe life-threatening recurrent ventricular arrhythmias and electrocardiographic changes suggesting acute myocardial infarction secondary to cocaine use. Recurrent ventricular arrhythmias of this patient required implantation of a cardioverter-defibrillator which successfully treated following arrhythmia episodes. (Cardiol J 2010; 17, 5: 512-517

Optimal boundary control of dynamics responses of piezo actuating micro-beams

AbstractOptimal control theory is formulated and applied to damp out the vibrations of micro-beams where the control action is implemented using piezoceramic actuators. The use of piezoceramic actuators such as PZT in vibration control is preferable because of their large bandwidth, their mechanical simplicity and their mechanical power to produce controlling forces. The objective function is specified as a weighted quadratic functional of the dynamic responses of the micro-beam which is to be minimized at a specified terminal time using continuous piezoelectric actuators. The expenditure of the control forces is included in the objective function as a penalty term. The optimal control law for the micro-beam is derived using a maximum principle developed by Sloss et al. [J.M. Sloss, J.C. Bruch Jr., I.S. Sadek, S. Adali, Maximum principle for optimal boundary control of vibrating structures with applications to beams, Dynamics and Control: An International Journal 8 (1998) 355–375; J.M. Sloss, I.S. Sadek, J.C. Bruch Jr., S. Adali, Optimal control of structural dynamic systems in one space dimension using a maximum principle, Journal of Vibration and Control 11 (2005) 245–261] for one-dimensional structures where the control functions appear in the boundary conditions in the form of moments. The derived maximum principle involves a Hamiltonian expressed in terms of an adjoint variable as well as admissible control functions. The state and adjoint variables are linked by terminal conditions leading to a boundary-initial-terminal value problem. The explicit solution of the problem is developed for the micro-beam using eigenfunction expansions of the state and adjoint variables. The numerical results are given to assess the effectiveness and the capabilities of piezo actuation by means of moments to damp out the vibration of the micro-beam with a minimum level of voltage applied on the piezo actuators

Lycopene Prevents Development of Steatohepatitis in Experimental Nonalcoholic Steatohepatitis Model Induced by High-Fat Diet

We investigated the preventive effect of lycopene on nonalcoholic steatohepatitis-induced by high-fat diet in rats. Forty male Sprague-Dawley rats were divided into 4 groups. They were fed standard diet, high-fat diet (HFD), high-fat diet plus lycopene at a dose of 2 mg/kg body weight and the high-fat diet lycopene at a dose of 4 mg/kg BW for a period of 6 weeks. Inflammation, steatosis, α-smooth muscle actin (α-SMA), and cytochrome P450 2E1 (CYP 2E1) expression increased significantly in the rats fed HFD and decreased in the rats administered by lycopene. Significantly elevated levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), tumor necrosis factor (TNF α), and serum and liver malondialdehyde (MDA) were observed in rats fed the high-fat diet as compared to the control rats (P < .01). Supplementation with lycopene lowered serum MDA and tumor necrosis factor (TNF-α) levels and elevated liver GSH level (P < .001). Insulin resistance was higher in the rats fed HFD than in rats supplemented with lycopene. The data indicate that supplementation with lycopene can reduce high-fat diet-induced oxidative stress to the cells

Robust Optimal Design of Beams Subject to Uncertain Loads

Optimality conditions are derived for the robust optimal design of beams subject to a combination of uncertain and deterministic transverse and boundary loads using a variational min-max approach. The potential energy of the beam is maximized to compute the worst case loading and minimized to determine the optimal cross-sectional shape which results in coupled nonlinear differential equations for the unknown functions except for the case of a variable width beam. The uncertain component of the transverse load acting on the beam is not known a priori resulting in load uncertainty subject only to an norm constraint. Similarly the optimal area function is subject to a volume constraint leading to an isoperimetric variational problem. The min-max approach leads to robust optimal designs which are not susceptible to unexpected load variations as it occurs under operational conditions. The solution methodology is illustrated for the variable width beam by obtaining analytical results for several cases. The efficiency of the optimal designs is computed with respect to a uniform beam under worst case loading taking the maximum deflection as the quantity for comparison. It is observed that the optimal shapes are more than 70% efficient for the examples given in this study

Variational Principles for Multiwalled Carbon Nanotubes Undergoing Vibrations Based on Nonlocal Timoshenko Beam Theory

Variational principles are derived for multiwalled carbon nanotubes undergoing linear vibrations using the semi-inverse method with the governing equations based on nonlocal Timoshenko beam theory which takes small scale effects and shear deformation into account. Physical models based on the nonlocal theory approximate the nanoscale phenomenon more accurately than the local theories by taking small scale phenomenon into account. Variational formulation is used to derive the natural and geometric boundary conditions which give a set of coupled boundary conditions in the case of free boundaries which become uncoupled in the case of the local theory. Hamilton's principle applicable to this case is also given

Comparison of estimated continuous cardiac output with echocardiography in patients with systolic heart failure

Background: Cardiac output (CO) is an important hemodynamic parameter in the management of heart failure. The aim of this study was to compare CO measurements obtained from the bedside monitor specialized for CO measurement, which is known as estimated continuous CO (esCCO), and  transthorasic echocardiography (echoCO) in patients with ejection fraction (EF) <40%.Methods: A total of 49 patients (36 male) with EF <40% were studied in this study. CO was measured using esCCO and transthorasic echocardiography (TTE). Measurements of CO were compared using Bland-Altman statistical method.Results: Mean ejection fraction was 27.11 ± 7.31%. Measurements of CO using esCCO and echoCO were found to be different (5.44±1.10 L/min vs. 5.08±1.08 L/min, respectively, p=0.004). CO was higher in esCCO compared to TTE. Bland-Altman analysis showed that the bias between esCCO and echoCO was -0.36 L/min [95% CI: -0.60 – (-0.13)], 95% limits of agreement were ranged from -1.77 to 1.05 L/min, and percentage errors of measurements of CO was 13%. A significant positive correlation was found between esCCO and echoCO (r = 0.785, p< 0.001).Conclusions: esCCO was well correlated with echoCO in patients with low EF. The esCCO may be useful for non-cardiologist such as specialist for anaesthesiology and thorasic disease. Also, it may be used in the patients with HF having poor echocardiographic image quality due to co-morbidities including chronic obstructive pulmonary disease

Astronomical Site Selection for Turkey Using GIS Techniques

A site selection of potential observatory locations in Turkey have been carried out by using Multi-Criteria Decision Analysis (MCDA) coupled with Geographical Information Systems (GIS) and satellite imagery which in turn reduced cost and time and increased the accuracy of the final outcome. The layers of cloud cover, digital elevation model, artificial lights, precipitable water vapor, aerosol optical thickness and wind speed were studied in the GIS system. In conclusion of MCDA, the most suitable regions were found to be located in a strip crossing from southwest to northeast including also a diverted region in southeast of Turkey. These regions are thus our prime candidate locations for future on-site testing. In addition to this major outcome, this study has also been applied to locations of major observatories sites. Since no goal is set for \textit{the best}, the results of this study is limited with a list of positions. Therefore, the list has to be further confirmed with on-site tests. A national funding has been awarded to produce a prototype of an on-site test unit (to measure both astronomical and meteorological parameters) which might be used in this list of locations.Comment: 17 pages, 10 figures, accepted by Experimental Astronom

Clinical spectrum and features of activated phosphoinositide 3-kinase δ syndrome: A large patient cohort study.

BACKGROUND: Activated phosphoinositide 3-kinase δ syndrome (APDS) is a recently described combined immunodeficiency resulting from gain-of-function mutations in PIK3CD, the gene encoding the catalytic subunit of phosphoinositide 3-kinase δ (PI3Kδ). OBJECTIVE: We sought to review the clinical, immunologic, histopathologic, and radiologic features of APDS in a large genetically defined international cohort. METHODS: We applied a clinical questionnaire and performed review of medical notes, radiology, histopathology, and laboratory investigations of 53 patients with APDS. RESULTS: Recurrent sinopulmonary infections (98%) and nonneoplastic lymphoproliferation (75%) were common, often from childhood. Other significant complications included herpesvirus infections (49%), autoinflammatory disease (34%), and lymphoma (13%). Unexpectedly, neurodevelopmental delay occurred in 19% of the cohort, suggesting a role for PI3Kδ in the central nervous system; consistent with this, PI3Kδ is broadly expressed in the developing murine central nervous system. Thoracic imaging revealed high rates of mosaic attenuation (90%) and bronchiectasis (60%). Increased IgM levels (78%), IgG deficiency (43%), and CD4 lymphopenia (84%) were significant immunologic features. No immunologic marker reliably predicted clinical severity, which ranged from asymptomatic to death in early childhood. The majority of patients received immunoglobulin replacement and antibiotic prophylaxis, and 5 patients underwent hematopoietic stem cell transplantation. Five patients died from complications of APDS. CONCLUSION: APDS is a combined immunodeficiency with multiple clinical manifestations, many with incomplete penetrance and others with variable expressivity. The severity of complications in some patients supports consideration of hematopoietic stem cell transplantation for severe childhood disease. Clinical trials of selective PI3Kδ inhibitors offer new prospects for APDS treatment.T.C. is supported by National Children’s Research Centre, Our Lady’s Children’s Hospital Crumlin, Dublin, Ireland. A.C. has a Wellcome Trust Postdoctoral Training Fellowship for Clinicians (103413/Z/13/Z). K.O. is supported by funding from BBSRC, MRC, Wellcome Trust and GSK. R.D. and D.S.K are funded by National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre, Cambridge, UK. C.S. and S.E. are supported by the German Federal Ministry of Education and Research (BMBF 01 EO 0803 grant to the Center of Chronic immunodeficiency and BMBF 01GM1111B grant to the PID-NET initiative). S.N.F is supported in part by the Southampton UK National Institute for Health Research (NIHR) Wellcome Trust Clinical Research Facility and NIHR Respiratory Biomedical Research Unit. M.A.A.I. is funded by NHS Innovation London and King’s College Hospital Charitable Trust. A.F., S.L., A.D., F.R-L and S.K. are supported by the European Union’s 7th RTD Framework Programme (ERC advanced grant PID-IMMUNE contract 249816) and a government grant managed by the French Agence Nationale de la Recherche as part of the "Investments for the Future" program (ANR-10-IAHU-01). S.L. is supported by the Agence Nationale de la Recherche (ANR) (ANR-14-CE14-0028-01), the Foundation ARC pour la Recherche sur le Cancer (France), the Rare Diseases Foundation (France) and François Aupetit Association (France). S.L. is a senior scientist and S.K is a researcher at the Centre National de la Recherche Scientifique-CNRS (France). A.D. and S.K. are supported by the “Institut National de la Santé et de la Recherche Médicale". S.K. also supported by the Fondation pour la Recherche Médicale (grant number: ING20130526624), la Ligue Contre le Cancer (Comité de Paris) and the Centre de Référence Déficits Immunitaires Héréditaires (CEREDIH). S.O.B is supported by the Higher Education Funding Council for England. B.V. is supported by the UK Biotechnology and Biological Sciences Research Council [BB/I007806/1], Cancer Research UK [C23338/A15965) and the National Institute for Health Research (NIHR) University College London Hospitals Biomedical Research Centre. B.V. is consultant to Karus Therapeutics (Oxford, UK). S.N. is a Wellcome Trust Senior Research Fellow in Basic Biomedical Science (095198/Z/10/Z). S.N. is also supported by the European Research Council Starting grant 260477, the EU FP7 collaborative grant 261441 (PEVNET project) and the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre, UK. A.M.C. is funded by the Medical Research Council, British Lung Foundation, University of Sheffield and Cambridge NIHR-BRC. Research in A.M.C. laboratory has received non-commercial grant support from GSK, Novartis, and MedImmune.This is the author accepted manuscript. The final version is available from Elsevier via http://dx.doi.org/10.1016/j.jaci.2016.06.02