Superconductivity in SrNi2As2 Single Crystals

The electrical resistivity \rho(T) and heat capacity C(T) on single crystals of SrNi2As2 and EuNi2As2 are reported. While there is no evidence for a structural transition in either compound, SrNi2As2 is found to be a bulk superconductor at T_c=0.62 K with a Sommerfeld coefficient of \gamma= 8.7 mJ/mol K^2 and a small upper critical field H_{c2} \sim 200 Oe. No superconductivity was found in EuNi2As2 above 0.4 K, but anomalies in \rho and C reveal that magnetic order associated with the Eu^{2+} magnetic moments occurs at T_m = 14 K.Comment: 8 pages, 5 figure

Range of normal values for left and right ventricular ejection fraction at rest and during exercise assessed by radionuclide angiocardiography

In order to reach a world-wide consensus on the normal range of left (LV) and right ventricular (RV) ejection fraction (EF) at rest and during exercise, pooled data of 1200 normal subjects from 28 leading centres in the field of nuclear cardiology (68% of those contacted) was analysed. Weighted mean normal values for LVEF at rest were 62.3±6.1% (1SD) with a lower limit of normal of 50% and for RVEF 52.3±6.2% (N=365) with a lower limit of normal of 40%. During exercise, LVEF increased in 475 subjects by +8.0 EF% (range 3-15%), a normal increase being accepted to be ≥5% over a normal resting value for both LVEF and RVEF. Subgroup analysis of results at rest revealed no significant differences regarding selection of normal subjects (based on normal catheterization findings vs. normal volunteers with low probability of disease), age or sex. During exercise, however, significantly larger increases in LVEF measurements were noted for men versus women (P<0.01), for normal volunteers versus subjects selected as ‘normals' based on a normal coronary angiogram (P<0.001) and for younger versus older subjects (P<0.001). Data on reproducibility and variability showed that radionuclide angiocardiography can be considered to be a reliable method today. No consensus was found for measurements of regional LV function or wall motion mainly because of differences in methodology used. These normal values may serve as general guidelines for future applications of these techniques but factors which may influence the normal range as defined and discussed in this study should be recognize

The role of narrow-angle forward surface scatter and particulate scatter in exoplanet exploration

It is often thought that because of the very small solid angle subtended by the field-of-view of the coronagraph, scattered light from optical surfaces will have no effect on images recorded for terrestrial exoplanet spectroscopy. In this paper, we examine mirror surface scatter and particulate contamination scatter as sources of background light or noise signal in large aperture terrestrial exoplanet telescope/coronagraph systems. Scattered light control to one part in 10^(+10) or better is required for exoplanet exploration. We will discuss the optical fabrication tolerances necessary to minimize narrowangle forward scatter and their relative effects upon direct imaging coronagraph instruments used to characterize terrestrial exoplanets

Coronary artery disease and depression

Coronary artery disease (CAD) as well as depression are both highly prevalent diseases. Both cause a significant decrease in quality of life for the patient and impose a significant economic burden on society. There are several factors that seem to link depression with the development of CAD and with a worse outcome in patients with established CAD: worse adherence to prescribed medication and life style modifications in depressive patients, as well as higher rates in abnormal platelet function, endothelial dysfunction and lowered heart rate variability. The evidence is growing that depression per se is an independent risk factor for cardiac events in a patient population without known CAD and also in patients with established diagnosis of CAD, particularly after myocardial infarction. Treatment of depression has been shown to improve patients' quality of life. However, it did not improve cardiovascular prognosis in depressed patients even though there is open discussion about the trend to better outcome in treated patients. Large scale clinical trials are needed to answer this question. Selective serotonin reuptake inhibitors seem to be preferable to tricyclic antidepressants for treatment of depressive patients with comorbid CAD because of their good tolerability and absence of significant cardiovascular side effects. Hypericum perforatum (St. John's wort), an increasingly used herbal antidepressant drug should be used with caution due to severe and possibly dangerous interaction with cardioactive drug

Effect of 3d-doping on the electronic structure of BaFe2As2

The electronic structure of BaFe2As2 doped with Co, Ni, and Cu has been studied by a variety of experimental and theoretical methods, but a clear picture of the dopant 3d states has not yet emerged. Herein we provide experimental evidence of the distribution of Co, Ni, and Cu 3d states in the valence band. We conclude that the Co and Ni 3d states provide additional free carriers to the Fermi level, while the Cu 3d states are found at the bottom of the valence band in a localized 3d10 shell. These findings help shed light on why superconductivity can occur in BaFe2As2 doped with Co and Ni but not Cu.Comment: 18 pages, 8 figure

Emergency revascularization in patients with cardiogenic shock on admission: a report from the SHOCK trial and registry

Aims To determine clinical correlates and optimal treatment strategy in patients with cardiogenic shock (CS) on admission. Methods and results In SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK? (SHOCK) trial and registry patients with left ventricular (LV) dysfunction (n=1053), CS on admission occurred in 26% of directly admitted patients (n=166/627). Time from myocardial infarction to CS was shorter, initial haemodynamic profile poorer, and aggressive treatment less frequent in CS on admission than in delayed CS patients. CS on admission patients constituted a smaller relative proportion (11%) of the transferred (n=48/426) when compared with the directly admitted cohort (P<0.001). In-hospital mortality was higher (75 vs. 56%; P<0.001) with more rapid death (24-h mortality 40 vs. 17%; P<0.001) in CS on admission than in delayed CS patients. Emergency revascularization reduced in-hospital mortality in CS on admission (60 vs. 82%; P=0.001) and in delayed CS patients similarly (46 vs. 62%; P<0.001; interaction P=0.25). After adjustment for clinical differences, CS on admission was an independent predictor of in-hospital mortality (P=0.008). Conclusion CS on admission patients have a worse outcome but benefit equally from emergency revascularization as delayed CS patients, emphasizing the need for rapid and direct access of CS on admission patients to facilities providing this car

Structure stability in the simple element sodium under pressure

The simple alkali metal Na, that crystallizes in a body-centred cubic structure at ambient pressure, exhibits a wealth of complex phases at extreme conditions as found by experimental studies. The analysis of the mechanism of stabilization of some of these phases, namely, the low-temperature Sm-type phase and the high-pressure cI16 and oP8 phases, shows that they satisfy the criteria for the Hume-Rothery mechanism. These phases appear to be stabilized due to a formation of numerous planes in a Brillouin-Jones zone in the vicinity of the Fermi sphere of Na, which leads to the reduction of the overall electronic energy. For the oP8 phase, this mechanism seems to be working if one assumes that Na becomes divalent metal at this density. The oP8 phase of Na is analysed in comparison with the MnP-type oP8 phases known in binary compounds, as well as in relation to the hP4 structure of the NiAs-type

End-of-life preferences of elderly patients with chronic heart failure

Aims Elderly heart failure (HF) patients are assumed to prefer improved quality of life over longevity, but sufficient data are lacking. Therefore, we assessed the willingness to trade survival time for quality-of-life (QoL) and the preferences for resuscitation. Methods and results At baseline and after 12 and 18 months, 622 HF patients aged ≥60 years (77 ± 8 years, 74% NYHA-class ≥III) participating in the Trial of Intensified vs. standard Medical therapy in Elderly patients with Congestive Heart Failure had prospective evaluation of end-of-life preferences by answering trade-off questions (willingness to accept a shorter life span in return for living without symptoms) and preferences for resuscitation if necessary. The time trade-off question was answered by 555 patients (89%), 74% of whom were not willing to trade survival time for improved QoL. This proportion increased over time (Month 12: 85%, Month 18: 87%, P < 0.001). In multivariable analysis, willingness to trade survival time increased with age, female sex, a reduced Duke Activity Status Index, Geriatric Depression Score, and history of gout, exercise intolerance, constipation and oedema, but even combining these variables did not result in reliable prediction. Of 603 (97%) patients expressing their resuscitation preference, 51% wished resuscitation, 39% did not, and 10% were undecided, with little changes over time. In 430 patients resuscitation orders were known; they differed from patients' preferences 32% of the time. End-of-life preferences were not correlated to 18-month outcome. Conclusion Elderly HF patients are willing to address their end-of-life preferences. The majority prefers longevity over QoL and half wished resuscitation if necessary. Prediction of individual preferences was inaccurate. Trial Registration: isrctn.org Identifier: ISRCTN4359647

Prognostic relevance of symptoms versus objective evidence of coronary artery disease in diabetic patients

Aim Little is known about the prognostic significance of silent versus symptomatic coronary artery disease (CAD) in diabetic patients. We therefore assessed the incidence of scintigraphic evidence of CAD in diabetic patients without known CAD and the impact of symptoms and scintigraphic findings on prognosis. Methods and results A consecutive series of 1737 diabetic patients without known CAD underwent dual-isotope myocardial perfusion SPECT (MPS) and 1430 were followed-up for a median of 2 (1-8.5) years. Critical events were defined as myocardial infarction or cardiac death. Objective evidence of CAD was found in 39% of 826 asymptomatic diabetic patients, in 51% of 151 diabetic patients with shortness of breath (SOB), and in 44% of 760 diabetic patients with angina. During follow-up, 98 critical events occurred. Annual critical event rates were 2.2% in asymptomatic, 3.2% in angina, and 7.7% in diabetic patients with shortness of breath (\batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} $p{<}0.001$ \end{document} versus other groups). With MPS evidence of CAD, critical event rates increased to 3.4% (asymptomatic), 5.6% (angina), and 13.2% (SOB) (\batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} $p{\leqslant}0.009$ \end{document} versus no evidence of CAD). Age, hypertension, shortness of breath, scarring and ischaemia were independent predictors of critical events. MPS findings added incremental information to prescan information regarding outcome prediction. Conclusions In asymptomatic diabetic patients, the rate of objective evidence of CAD and annual critical events were similar to those found in diabetic patients with angina. The outcome was three times worse in diabetic patients with shortness of breath. MPS findings were strongly predictive of outcome and proved valuable for risk stratificatio

International variation in invasive care of the elderly with acute coronary syndromes

Aims To explore variations in invasive care of the elderly with acute coronary syndromes across international practice. Methods and results Using combined populations from the SYMPHONY and 2nd SYMPHONY trials, we describe 30-day cardiac catheterization in elderly (≥75 years; n=1794) vs. younger patients (<75 years; n=14 043) after multivariable adjustment and by region of enrolment. The use of cardiac catheterization and revascularization were not protocol-specified. Elderly patients (median age 78 years) were more often female and more frequently had hypertension, diabetes, prior myocardial infarction, and prior coronary bypass surgery. Overall, they underwent less cardiac catheterization than younger patients [53 vs. 63%; adjusted OR 0.53 (0.46, 0.60)]. The absolute rate of cardiac catheterization in the elderly varied from 77% (vs. 91% in younger patients) in the US cohort to 27% (vs. 41% in younger patients) in the non-US cohort. Revascularization of elderly who underwent cardiac catheterization was also higher in US than non-US cohorts (71.3 vs. 53.6%). There was a significant interaction between the patient age and the use of catheterization across US and non-US regions of enrolment, as well as differences in the predictors of catheterization in the elderly. Despite these findings, after adjustment, 90-day rates of death and death or myocardial infarction (MI) were not significantly different in elderly who underwent catheterization compared with those who did not. Conclusion Although older age is universally predictive of lower use of cardiac catheterization, marked variation in catheterization of the elderly exists across international practice. Demonstrated differences in patterns of use suggest a lack of consensus regarding optimal use of an invasive strategy in the elderl