Newly shaped intra-aortic balloons improve the performance of counterpulsation at the semirecumbent position: an In Vitro study

The major hemodynamic benefits of intra‐aortic balloon pump (IABP) counterpulsation are augmentation in diastolic aortic pressure (Paug) during inflation, and decrease in end‐diastolic aortic pressure (ΔedP) during deflation. When the patient is nursed in the semirecumbent position these benefits are diminished. Attempts to change the shape of the IAB in order to limit or prevent this deterioration have been scarce. The aim of the present study was to investigate the hemodynamic performance of six new IAB shapes, and compare it to that of a traditional cylindrical IAB. A mock circulation system, featuring an artificial left ventricle and an aortic model with 11 branches and physiological resistance and compliance, was used to test one cylindrical and six newly shaped IABs at angles 0, 10, 20, 30, and 40°. Pressure was measured continuously at the aortic root during 1:1 and 1:4 IABP support. Shape 2 was found to consistently achieve, in terms of absolute magnitude, larger ΔedP at angles than the cylindrical IAB. Although ΔedP was gradually diminished with angle, it did so to a lesser degree than the cylindrical IAB; this diminishment was only 53% (with frequency 1:1) and 40% (with frequency 1:4) of that of the cylindrical IAB, when angle increased from 0 to 40°. During inflation Shape 1 displayed a more stable behavior with increasing angle compared to the cylindrical IAB; with an increase in angle from 0 to 40°, diastolic aortic pressure augmentation dropped only by 45% (with frequency 1:1) and by 33% (with frequency 1:4) of the drop reached with the cylindrical IAB. After compensating for differences in nominal IAB volume, Shape 1 generally achieved higher Paug over most angles. Newly shaped IABs could allow for IABP therapy to become more efficient for patients nursed at the semirecumbent position. The findings promote the idea of personalized rather than generalized patient therapy for the achievement of higher IABP therapeutic efficiency, with a choice of IAB shape that prioritizes the recovery of those hemodynamic indices that are more in need of support in the unassisted circulation

The KELT-South Telescope

The Kilodegree Extremely Little Telescope (KELT) project is a survey for new transiting planets around bright stars. KELT-South is a small-aperture, wide-field automated telescope located at Sutherland, South Africa. The telescope surveys a set of 26 degree by 26 degree fields around the southern sky, and targets stars in the range of 8 < V < 10 mag, searching for transits by Hot Jupiters. This paper describes the KELT-South system hardware and software and discusses the quality of the observations. We show that KELT-South is able to achieve the necessary photometric precision to detect transits of Hot Jupiters around solar-type main-sequence stars.Comment: 26 pages, 13 figure

Possible evidence of a spontaneous spin-polarization in mesoscopic 2D electron systems

We have experimentally studied the non-equilibrium transport in low-density clean 2D electron systems at mesoscopic length scales. At zero magnetic field (B), a double-peak structure in the non-linear conductance was observed close to the Fermi energy in the localized regime. From the behavior of these peaks at non-zero B, we could associate them to the opposite spin states of the system, indicating a spontaneous spin polarization at B = 0. Detailed temperature and disorder dependence of the structure shows that such a splitting is a ground state property of the low-density 2D systems.Comment: 7 pages, 5 figure

On the Period Distribution of Close-In Extrasolar Giant Planets

Transit (TR) surveys for extrasolar planets have recently uncovered a population of ``very hot Jupiters,'' planets with orbital periods of P< 3 d. At first sight this may seem surprising, given that radial velocity (RV) surveys have found a dearth of such planets, despite the fact that their sensitivity increases with decreasing P. We examine the confrontation between RV and TR survey results, paying particular attention to selection biases that favor short-period planets in transit surveys. We demonstrate that, when such biases and small-number statistics are properly taken into account, the period distribution of planets found by RV and TR surveys are consistent at better than the 1-sigma level. This consistency holds for a large range of reasonable assumptions. In other words, there are not enough planets detected to robustly conclude that the RV and TR short-period planet results are inconsistent. Assuming a logarithmic distribution of periods, we find that the relative frequency of very hot Jupiters (VHJ: P=1-3 d) to hot Jupiters (HJ: P=3-9 d) is 10-20%. Given an absolute frequency of HJ of ~1%, this implies that approximately one star in ~500-1000 has a VHJ. We also note that VHJ and HJ appear to be distinct in terms of their upper mass limit. We discuss the implications of our results for planetary migration theories, as well as present and future TR and RV surveys.Comment: 11 pages, 4 figures, 2 tables. Minor changes. Accepted to ApJ, to appear in the April 20, 2005 issue (v623

Does conventional intra-aortic balloon pump trigger timing produce optimal hemodynamic effects in vivo?

Purpose The intra-aortic balloon pump (IABP) provides circulatory support through counterpulsation. The hemodynamic effects of the IABP may vary with assisting frequency and depend on IAB inflation/deflation timing. We aimed to assess in vivo the IABP benefits on coronary, aortic, and left ventricular hemodynamics at different assistance frequencies and trigger timings. Methods Six healthy, anesthetized, open-chest sheep received IABP support at 5 timing modes (EC, LC, CC, CE, CL, corresponding to early/late/conventional/conventional/conventional inflation and conventional/conventional/conventional/early/late deflation, respectively) with frequency 1:3 and 1:1. Aortic (Qao) and coronary (Qcor) flow, and aortic (Pao) and left ventricular (PLV) pressure were recorded simultaneously, with and without IABP support. Integrating systolic Qao yielded stroke volume (SV). Results EC at 1:1 produced the lowest end-diastolic Pao (59.5 ± 7.8 mmHg [EC], 63.4 ± 11.1 mmHg [CC]), CC at 1:1 the lowest systolic PLV (69.1 ± 6.5 mmHg [CC], 76.4 ± 6.5 mmHg [control]), CC at 1:1 the highest SV (88.5 ± 34.4 ml [CC], 76.6 ± 31.9 ml [control]) and CC at 1:3 the highest diastolic Qcor (187.2 ± 25.0 ml/min [CC], 149.9 ± 16.6 ml/min [control]). Diastolic Pao augmentation was enhanced by both assistance frequencies alike, and optimal timings were EC for 1:3 (10.4 ± 2.8 mmHg [EC], 6.7 ± 3.8 mmHg [CC]) and CC for 1:1 (10.8 ± 6.7 mmHg [CC], −3.0 ± 3.8 mmHg [control]). Conclusions In our experiments, neither a single frequency nor a single inflation/deflation timing, including conventional IAB timing, has shown superiority by uniformly benefiting all studied hemodynamic parameters. A choice of optimal frequency and IAB timing might need to be made based on individual patient hemodynamic needs rather than as a generalized protocol