Optical bonding agents for severe environments

Test results and applications of elastors (General Electric RTV 665, Dow Corning (DC) XR-63-488, DC 93-500, DC 182, and DC 184) considered for use as optical bonding agents in aerospace environments are presented

Study of spin-scan imaging for outer planets missions

The constraints that are imposed on the Outer Planet Missions (OPM) imager design are of critical importance. Imager system modeling analyses define important parameters and systematic means for trade-offs applied to specific Jupiter orbiter missions. Possible image sequence plans for Jupiter missions are discussed in detail. Considered is a series of orbits that allow repeated near encounters with three of the Jovian satellites. The data handling involved in the image processing is discussed, and it is shown that only minimal processing is required for the majority of images for a Jupiter orbiter mission

Study of spin-scan imaging for outer planets missions: Executive summary

The development and characteristics of spin-scan imagers for interplanetary exploration are discussed. The spin-scan imaging photopolarimeter instruments of Pioneer 10 and 11 are described. In addition to the imaging function, the instruments are also used in a faint-light mode to take sky maps in both radiance and polarization. The performance of a visible-infrared spin-scan radiometer (VISSR), which operates in both visible and infrared wavelengths, is reported

Cardiac Dysfunction, Congestion and Loop Diuretics: their Relationship to Prognosis in Heart Failure

Background: Diuretics are the mainstay of treatment for congestion but concerns exist that they adversely affect prognosis. We explored whether the relationship between loop diuretic use and outcome is explained by the underlying severity of congestion amongst patients referred with suspected heart failure. Method and Results: Of 1190 patients, 712 had a left ventricular ejection fraction (LVEF) ≤50 %, 267 had LVEF >50 % with raised plasma NTproBNP (>400 ng/L) and 211 had LVEF >50 % with NTproBNP ≤400 ng/L; respectively, 72 %, 68 % and 37 % of these groups were treated with loop diuretics including 28 %, 29 % and 10 % in doses ≥80 mg furosemide equivalent/day. Compared to patients with cardiac dysfunction (either LVEF ≤50 % or NT-proBNP >400 ng/L) but not taking a loop diuretic, those taking a loop diuretic were older and had more clinical evidence of congestion, renal dysfunction, anaemia and hyponatraemia. During a median follow-up of 934 (IQR: 513–1425) days, 450 patients were hospitalized for HF or died. Patients prescribed loop diuretics had a worse outcome. However, in multi-variable models, clinical, echocardiographic (inferior vena cava diameter), and biochemical (NTproBNP) measures of congestion were strongly associated with an adverse outcome but not the use, or dose, of loop diuretics. Conclusions: Prescription of loop diuretics identifies patients with more advanced features of heart failure and congestion, which may account for their worse prognosis. Further research is needed to clarify the relationship between loop diuretic agents and outcome; imaging and biochemical measures of congestion might be better guides to diuretic dose than symptoms or clinical signs

Multiple cardiac biomarkers to improve prediction of cardiovascular events:Findings from the Generation Scotland Scottish Family Health Study

Background: Many studies have investigated whether single cardiac biomarkers improve cardiovascular risk prediction for primary prevention but whether a combined approach could further improve risk prediction is unclear. We aimed to test a sex-specific combined cardiac biomarker approach for cardiovascular risk prediction. Methods: In the Generation Scotland Scottish Family Health Study, N-terminal pro-B-type natriuretic peptide (NT-proBNP), growth differentiation factor-15 (GDF-15), cardiac troponin I (cTnI), cardiac troponin T (cTnT), and C-reactive protein (CRP) were measured in stored serum using automated immunoassays. Sex-specific Cox models that included SCORE2 risk factors evaluated addition of single and combined biomarkers for prediction of major adverse cardiovascular events (MACE). Combined biomarker models were compared to a baseline model that included SCORE2 factors.Results: The study population comprised 18,383 individuals (58.9% women, median age of 48 years [25th-75th percentile, 35-58 years]). During the median follow up of 11.6 (25th-75th percentile, 10.8-13.0) years, MACE occurred in 942 (5.1%) individuals. The greatest increase in discrimination with addition of individual biomarkers to base model was for women GDF-15 and for men NT-proBNP (change in c-index: +0.010 for women and +0.005 for men). For women, combined biomarker models that included GDF-15 and NT-proBNP (+0.012) or GDF-15 and cTnI (+0.013), but not CRP or cTnT, further improved discrimination. For men, combined biomarker models that included NT-proBNP and GDF-15 (+0.007), NT-proBNP and cTnI (+0.006), or NT-proBNP and CRP (+0.008), but not cTnT, further improved discrimination. Conclusions: A combined biomarker approach, particularly the use of GDF-15, NT-proBNP and cTnI, further refined cardiovascular risk estimates.<br/

Detection of Extended Red Emisson in the Diffuse Interstellar Medium

Extended Red Emission (ERE) has been detected in many dusty astrophysical objects and this raises the question: Is ERE present only in discrete objects or is it an observational feature of all dust, i.e. present in the diffuse interstellar medium? In order to answer this question, we determined the blue and red intensities of the radiation from the diffuse interstellar medium (ISM) and examined the red intensity for the presence of an excess above that expected for scattered light. The diffuse ISM blue and red intensities were obtained by subtracting the integrated star and galaxy intensities from the blue and red measurements made by the Imaging Photopolarimeter (IPP) aboard the Pioneer 10 and 11 spacecraft. The color of the diffuse ISM was found to be redder than the Pioneer intensities, contrary to that expected for scattered light (Diffuse Galactic Light [DGL]). The red DGL was calculated using the blue diffuse ISM intensities and the approximately invariant color of the DGL calculated with the DGL model. Subtracting the calculated red DGL from the red diffuse ISM intensities resulted in the detection of an excess red intensity. This represents the likely detection of ERE in the diffuse ISM since H-alpha emission cannot account for the strength of this excess and the only other known emission process applicable to the diffuse ISM is ERE. Thus, ERE appears to be a general characteristic of dust. From the correlation between N_HI and ERE intensity the ERE photon conversion efficiency was estimated at 10 +/- 3%.Comment: 44 pages (41 figures included), to be published in the ApJ, new version corrected for small error in fig. 2

Prevalence, predictors and prognostic implications of PR interval prolongation in patients with heart failure

Aims: To determine the prevalence, incidence, predictors and prognostic implications of PR interval prolongation in patients referred with suspected heart failure. Methods and Results: Consecutive patients referred with suspected heart failure were prospectively enrolled. After excluding patients with implantable cardiac devices and atrial fibrillation, 1420 patients with heart failure and reduced ejection fraction (HeFREF) [age: median 71 (interquartile range IQR: 63-78) years; men: 71%; NT-ProBNP: 1319 (583-3378) ng/L], 1094 with heart failure and normal ejection fraction (HeFNEF) [age: 76 (70-82) years; men: 47%; NT-ProBNP: 547 (321-1171) ng/L], and 1150 without heart failure [age: 68 (60-75) years; men: 51%; NT-ProBNP: 86 (46-140) ng/L] were included. The prevalence of first degree heart block [heart-rate corrected PR interval (PRc) >200 ms] was higher in patients with heart failure (21% HeFREF, 20% HeFNEF, 9% without heart failure). In patients with HeFREF or HeFNEF, longer baseline PRc was associated with greater age, male sex, and longer QRS duration and, in those with HeFREF, treatment with amiodarone or digoxin. Patients with heart failure in the longest PRc quartile had worse survival compared to shorter PRc quartiles but PRc was not independently associated with survival in multivariable analysis. For patients without heart failure, shorter baseline PRc was independently associated with worse survival. Conclusion: PRc prolongation is common in patients with HeFREF or HeFNEF and associated with worse survival, although not an independent predictor of outcome. The results of clinical trials investigating the therapeutic potential of shortening the PR interval by pacing are awaited

Prognostic value of simple frailty and malnutrition screening tools in patients with acute heart failure due to left ventricular systolic dysfunction

Background: Frailty and malnutrition are common in patients with heart failure (HF), and are associated with adverse outcomes. We studied the prognostic value of three malnutrition and three frailty indices in patients admitted acutely to hospital with HF. Methods: 265 consecutive patients [62% males, median age 80 (interquartile range (IQR): 72–86) years, median NTproBNP 3633 (IQR: 2025–6407) ng/l] admitted with HF between 2013 and 2014 were enrolled. Patients were screened for frailty using the Derby frailty index (DFI), acute frailty network (AFN) frailty criteria, and clinical frailty scale (CFS) and for malnutrition using the geriatric nutritional risk index (GNRI), controlling nutritional status (CONUT) score and prognostic nutritional index (PNI). Results: According to the CFS (> 4), DFI, and AFN, 53, 50, and 53% were frail, respectively. According to the GNRI (≤ 98), CONUT score (> 4), and PNI (≤ 38), 46, 46, and 42% patients were malnourished, respectively. During a median follow-up of 598 days (IQR 319–807 days), 113 patients died. One year mortality was 1% for those who were neither frail nor malnourished; 15% for those who were either malnourished or frail; and 65% for those who were both malnourished and frail. Amongst the malnutrition scores, PNI, and amongst the frailty scores, CFS increased model performance most compared with base model. A final model, including CFS and PNI, increased c-statistic for mortality prediction from 0.68 to 0.84. Conclusion: Worsening frailty and malnutrition indices are strongly related to worse outcome in patients hospitalised with HF