Under pressure: pulmonary hypertension associated with left heart disease.

© ERS 2015.Pulmonary hypertension (PH) associated with left heart disease (PH-LHD) is the most common type of PH, but its natural history is not well understood. PH-LHD is diagnosed by right heart catheterisation with a mean pulmonary arterial pressure ⩾25 mmHg and a pulmonary capillary wedge pressure >15 mmHg. The primary causes of PH-LHD are left ventricular dysfunction of systolic and diastolic origin, and valvular disease. Prognosis is poor and survival rates are low. Limited progress has been made towards specific therapies for PH-LHD, and management focuses on addressing the underlying cause of the disease with supportive therapies, surgery and pharmacological treatments. Clinical trials of therapies for pulmonary arterial hypertension in patients with PH-LHD have thus far been limited and have provided disappointing or conflicting results. Robust, long-term clinical studies in appropriate target populations have the potential to improve the outlook for patients with PH-LHD. Herein, we discuss the knowledge gaps in our understanding of PH-LHD, and describe the current unmet needs and challenges that are faced by clinicians when identifying and managing patients with this disease

Pion Charge Exchange on Deuterium

We investigate quantum corrections to a classical intranuclear cascade simulation of pion single charge exchange on the deuteron. In order to separate various effects the orders of scattering need to be distinguished and, to that end, we develop signals for each order of scattering corresponding to quasi-free conditions. Quantum corrections are evaluated for double scattering and are found to be large. Global agreement with the data is good.Comment: 30 pages, 12 figure

The evaluation of waste tyre pulverised fuel for NOx reduction by reburning

The combustion of coal for power generation will continue to play a major role in the future, however, this must be achieved using cleaner technologies than we use at present. Scrap tyre arisings in the UK are 400,000 tonnes per year amounting to 30 million tyres and in the EU as a whole, more than 2.5 million tonnes of tyres per year are scrapped. The recent EC Waste Landfill Directive (1999) sets a deadline for the banning of whole and shredded tyres from landfill sites by 2006. Consequently, there is an urgent need to find a mass disposal route for tyres. We describe, in this paper, a novel use for tyre rubber pulverised fuel in a NOx reburning process which may have an application in power station boilers. This method of disposal could represent a way of combining waste disposal, energy recovery and pollution control within one process. A preliminary study of micronised tyre combustion was undertaken to identify the suitable size ranges for application in NOx reduction by reburning. Tests were performed in a down-fired, pulverised fuel combustor (PFC) operating at about 80 kW. Superior combustion characteristics, i.e. burnout were achieved with particle sizes less than 250 μm. A South African coal was used as the primary fuel in the reburn tests and the tyre was fed pneumatically via a separate feed system. Parameters studied, were, reburn zone stoichiometry and reburn fuel fraction. Additionally, the carbon content of the ash was carefully monitored for any effect on burnout at the fuel rich reburn stoichiometries. The NOx reductions achieved with tyres are compared with reburning with coal. NOx reductions up to 80% were achieved with tyres at half of the reburn fuel feed rate required to achieve the same reductions by coal. The results have been evaluated within the context of other studies available in the literature on NOx reburning by bituminous coal, brown coal, gas and biomass

Mesospheric scatter and its microstructure

The difference in character between mesospheric returns from about 70 and about 80 km was noted. The 69-km echo is characterized by a single return with about .1 Hz width, while the 82.5 km return extends over more than 3 Hz bandwidth; this difference is also perceptible, but to a lesser degree, on the fading curves. The conclusion seems inescapable that internal random velocities of a few m/s are present within the scattering volume for the 82.5-km echo. The most likely source for these rather large velocities is convective instability arising from deformations of the temperature profile by breaking gravity waves. The distinction between the two types of scatter at these altitudes probably accounts for the behavior with frequency of the nightime fading period at low and very low frequencies. The fading period of D-region reflections at night was constant at about 7 min from 16 to 43 kHz, but that at frequencies of 70 kHz and above, the fading period decreased in such a way as to indicate the presence of irregularities smaller than about 1 km in size. This suggests that frequencies of 48 kHz and above, the fading period decreased in such a way as to indicate the presence of irregularities smaller than about 1 km in size. This suggests that frequencies of 48 kHz and below were reflected primarily from the region below 80 km where the narrow spectral irregularities dominate

Struggling and juggling: a comparison of assessment loads in research and teaching-intensive universities

In spite of the rising tide of metrics in UK higher education, there has been scant attention paid to assessment loads, when evidence demonstrates that heavy demands lead to surface learning. Our study seeks to redress the situation by defining assessment loads and comparing them across research-and teaching intensive universities. We clarify the concept of ‘assessment load’ in response to findings about high volumes of summative assessment on modular degrees. We define assessment load across whole undergraduate degrees, according to four measures: the volume of summative assessment; volume of formative assessment; proportion of examinations to coursework; number of different varieties of assessment. All four factors contribute to the weight of an assessment load, and influence students’ approaches to learning. Our research compares programme assessment data from 73 programmes in 14 UK universities, across two institutional categories. Research-intensives have higher summative assessment loads and a greater proportion of examinations; teaching-intensives have higher varieties of assessment. Formative assessment does not differ significantly across both university groups. These findings pose particular challenges for students in different parts of the sector. Our study questions the wisdom that ‘more’ is always better, proposing that lighter assessment loads may make room for ‘slow’ and deep learning

Pion double charge exchange on 4He

The doubly differential cross sections for the $^4$He$(\pi^+,\pi^-) 4p$ reaction were calculated using both a two-nucleon sequential single charge exchange model and an intranuclear cascade code. Final state interactions between the two final protons which were the initial neutrons were included in both methods. At incident pion energies of 240 and 270 MeV the low-energy peak observed experimentally in the energy spectrum of the final pions can be understood only if the contribution of pion production is included. The calculated cross sections are compared with data.Comment: 25 pages, 9 figure

Crucial involvement of xanthine oxidase in the intracellular signalling networks associated with human myeloid cell function

Xanthine oxidase (XOD) is an enzyme which plays a central role in purine catabolism by converting hypoxanthine into xanthine and then further into uric acid. Here we report that XOD is activated in THP-1 human myeloid cells in response to pro-inflammatory and growth factor stimulation. This effect occurred following stimulation of THP-1 cells with ligands of plasma membrane associated TLRs 2 and 4, endosomal TLRs 7 and 8 as well as stem cell growth factor (SCF). Hypoxia-inducible factor 1 (HIF-1) and activator protein 1 (AP-1) transcription complexes were found to be responsible for XOD upregulation. Importantly, the mammalian target of rapamycin (mTOR), a major myeloid cell translation regulator, was also found to be essential for XOD activation. Specific inhibition of XOD by allopurinol and sodium tungstate led to an increase in intracellular AMP levels triggering downregulation of mTOR activation by phosphorylation of its T2446 residue. Taken together, our results demonstrate for the first time that XOD is not only activated by pro-inflammatory stimuli or SCF but also plays an important role in maintaining mTOR-dependent translational control during the biological responses of human myeloid cells

An intermediate state between the kagome-ice and the fully polarized state in Dy2_2Ti2_2O7_7

Dy$_2$Ti$_2$O$_7$ is at present the cleanest example of a spin-ice material. Previous theoretical and experimental work on the first-order transition between the kagome-ice and the fully polarized state has been taken as a validation for the dipolar spin-ice model. Here we investigate in further depth this phase transition using ac-susceptibility and dc-magnetization, and compare this results with Monte-Carlo simulations and previous magnetization and specific heat measurements. We find signatures of an intermediate state between the kagome-ice and full polarization. This signatures are absent in current theoretical models used to describe spin-ice materials.Comment: 7 pages, 4 figure