Vagal nerve stimulation started just prior to reperfusion limits infarct size and no-reflow

Vagal nerve stimulation (VNS) started prior to, or during, ischemia has been shown to reduce infarct size. Here, we investigated the effect of VNS when started just prior to, and continued during early, reperfusion on infarct size and no-reflow and studied the underlying mechanisms. For this purpose, swine (13 VNS, 10 sham) underwent 45 min mid-LAD occlusion followed by 120 min of reperfusion. VNS was started 5 min prior to reperfusion and continued until 15 min of reperfusion. Area at risk, area of no-reflow (% of infarct area) and infarct size (% of area at risk), circulating cytokines, and regional myocardial leukocyte influx were assessed after 120 min of reperfusion. VNS significantly reduced infarct size from 67 ± 2 % in sham to 54 ± 5 % and area of no-reflow from 54 ± 6 % in sham to 32 ± 6 %. These effects were accompanied by reductions in neutrophil (~40 %) and macrophage (~60 %) infiltration in the infarct area (all p < 0.05), whereas systemic circulating plasma levels of TNFα and IL6 were not affected. The degree of cardioprotection could not be explained by the VNS-induced bradycardia or the VNS-induced decrease in the double product of heart rate and left ventricular systolic pressure. In the presence of NO-synthase inhibitor LNNA, VNS no longer attenuated infarct size and area of no-reflow, which was paralleled by similarly unaffected regional leukocyte infiltration. In conclusion, VNS is a promising novel adjunctive therapy that limits reperfusion injury in a large animal model of acute myocardial infarction

Characterization of dry-stack interlocking compressed earth blocks

Earth has been a traditional building material to construct houses in Africa. One of the most common techniques is the use of sun dried or kiln fired adobe bricks with mud mortar. Fired bricks are the main cause for deforestation in countries like Malawi. Although this technique is low-cost, the bricks vary largely in shape, strength and durability. This leads to weak houses which suffer considerable damage during floods and seismic events. One solution is the use of dry-stack masonry with stabilized interlocking compressed earth blocks (ICEB). This technology has the potential of substituting the current bricks by a more sustainable kind of block. This study was made in the context of the HiLoTec project, which focuses on houses in rural areas of developing countries. For this study, Malawi was chosen for a case study. This paper presents the experimental results of tests made with dry-stack ICEBs. Soil samples from Malawi were taken and studied. Since the experimental campaign could not be carried out in Malawi, a homogenization process of Portuguese soil was made to produce ICEBs at the University of Minho, Portugal. Then, the compression and tensile strength of the materials was determined via small cylinder samples. Subsequently, the compression and flexural strength of units were determined. Finally, tests to determine the compressive strength of both prisms and masonry wallets and to determine the initial shear strength of the dry interfaces were carried out. This work provides valuable data for low-cost eco-efficient housingThis work was carried out under the research project HiLoTec - Development of a Sustainable Self-Construction System for Developing Countries. The authors wish to thank Mota-Engil Constructing Group for supporting this project

Current discharge management of acute coronary syndromes: Data from the Rijnmond Collective Cardiology Research (CCR) study

Background Medical discharge management of acute coronary syndromes (ACS) remains suboptimal outside randomised trials and constitutes an essential quality benchmark for ACS. We sought to evaluate the rates of key guideline-recommended pharmacological agents after ACS and characteristics associated with optimal treatment at discharge. Methods The Rijnmond Collective Cardiology Research (CCR) registry is an ongoing prospective, observational study in the Netherlands that aims to enrol 4000 patients with ACS. We examined discharge and 1-month follow-up medication use among the first 1000 patients enrolled in the CCR registry. Logistic regression was performed to identify patient and hospital characteristics associated with collective guidelinerecommended pharmacotherapy at hospital discharge. Results At discharge, 94%of patients received aspirin, 100% thienopyridines, 80 % angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers, 87 % β-blockers, 96 % statins, and 65 % the combination of all 5 agents. STsegment elevation myocardial infarction, hypertension, hypercholesterolaemia, and enrolment in an interventional centre were positive independent predictors of 5-drug combination therapy at discharge. Negative independent predictors were unstable angina and advanced age. Conclusion Current data from the CCR registry reflect a high quality of care for ACS discharge management in the Rotterdam-Rijnmond region. However, potential still remains for further optimisation

Current discharge management of acute coronary syndromes: data from the Rijnmond Collective Cardiology Research (CCR) study

BACKGROUND: Medical discharge management of acute coronary syndromes (ACS) remains suboptimal outside randomised trials and constitutes an essential quality benchmark for ACS. We sought to evaluate the rates of key guideline-recommended pharmacological agents after ACS and characteristics associated with optimal treatment at discharge. METHODS: The Rijnmond Collective Cardiology Research (CCR) registry is an ongoing prospective, observational study in the Netherlands that aims to enrol 4000 patients with ACS. We examined discharge and 1-month follow-up medication use among the first 1000 patients enrolled in the CCR registry. Logistic regression was performed to identify patient and hospital characteristics associated with collective guideline-recommended pharmacotherapy at hospital discharge. RESULTS: At discharge, 94 % of patients received aspirin, 100 % thienopyridines, 80 % angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers, 87 % β-blockers, 96 % statins, and 65 % the combination of all 5 agents. ST-segment elevation myocardial infarction, hypertension, hypercholesterolaemia, and enrolment in an interventional centre were positive independent predictors of 5-drug combination therapy at discharge. Negative independent predictors were unstable angina and advanced age. CONCLUSION: Current data from the CCR registry reflect a high quality of care for ACS discharge management in the Rotterdam-Rijnmond region. However, potential still remains for further optimisation

The effect of vitamin D3 on CD34 progenitor cells in vitamin D deficiency rickets

Vitamin D metabolites have multiple functions not only in calcium homeostasis, but also in hematopoiesis. To detect the effect of vitamin D on hematopoiesis with a surface glycoprotein marker, the proportions of the CD34+ cells were measured in bone marrow, peripheral blood and spleen prior to and after vitamin D3 treatment in an infant with severe rickets, myelofibrosis and myeloid metaplasia. CD34+ cells measured 0.4% in bone marrow, 8.0% in peripheral blood and 8.7% in splenic aspirate. The detection of a high and comparable level of CD34+ cells in both peripheral blood and splenic aspirate on admission and the decline in the level of CD34+ cells (2%) following treatment support that CD34+ cells were from extramedullary hematopoiesis in spleen. The improvement of rickets and hematological findings with treatment at the same time raises the possibility of vitamin D3 acting directly upon the same target or upon different targets at the same time or of the presence of interaction between two targets. Our findings may also show a relation between vitamin D3 and its metabolites to bone marrow stem cells

Distinct cardioprotective mechanisms of immediate, early and delayed ischaemic postconditioning

Cardioprotection against ischaemia/reperfusion injury in mice can be achieved by delayed ischaemic postconditioning (IPost) applied as late as 30 min after the onset of reperfusion. We determined the efficacy of delayed IPost in a rat model of myocardial infarction (MI) and investigated potential underlying mechanisms of this phenomenon. Rats were subjected to 20, 30 or 45 min of coronary artery occlusion followed by 120 min of reperfusion (I/R). Immediate and early IPost included six cycles of I/R (10/10 s) applied 10 s or 10 min after reperfusion onset. In the second series of experiments, the rats were subjected to 30 min of coronary occlusion followed by IPost applied 10 s, 10, 30, 45 or 60 min after the onset of reperfusion. Immediate and early IPost (applied 10 s or 10 min of reperfusion) established cardioprotection only when applied after a period of myocardial ischaemia lasting 30 min. Delayed IPost applied after 30 or 45 min of reperfusion reduced infarct sizes by 36 and 41 %, respectively (both P < 0.01). IPost applied 60 min after reperfusion onset was ineffective. Inhibition of RISK pathway (administration of ERK1/2 inhibitor PD-98059 or PI3K inhibitor LY-294002) abolished cardioprotection established by immediate IPost but had no effect on cardioprotection conferred by early IPost. Blockade of SAFE pathway using JAK/STAT inhibitor AG490 had no effect on the immediate or early IPost cardioprotection. Blockade of mitochondrial KATP (mitoKATP) channels (with 5-Hydroxydecanoate) abolished cardioprotection achieved by immediate and early IPost, but had no effect on cardioprotection when IPost was applied 30 or 45 min into the reperfusion period. Immediate IPost increased phosphorylation of PI3K-AKT and ERK1/2. Early or delayed IPost had no effect on phosphorylation of PI3K-AKT, ERK1/2 or STAT3. These data show that in the rat model, delayed IPost confers significant cardioprotection even if applied 45 min after onset of reperfusion. Cardioprotection induced by immediate and early postconditioning involves recruitment of RISK pathway and/or mitoKATP channels, while delayed postconditioning appears to rely on a different mechanism

Karbon Elyaf Dolgulu Pa6 Polimer Kompozitlerinin Aşınma Özellikleri Üzerine Uygulanan Yük ve Kayma Hızının Etkisi

Bu çalışmada, karbon elyaf (KE) dolgulu poliamit 6 (PA6) polimer kompozitlerinin sürtünme ve aşınma davranışları üzerine kayma hızı ve yükün etkileri incelenmiştir. PA6 polimeri ve PA6 kompozitlerinin sürtünme ve aşınma testleri 1040 çelik diske karşı kuru ortamda pim-disk sistemi ile gerçekleştirilmiştir. Tribolojik testler oda sıcaklığında, farklı yük (10-40N) ve kayma hızı (0.4-1.2m/s) şartlarında yapılmıştır. Deneysel çalışmalar sonucunda, tüm polimer numuneler için yükün ve kayma hızının artmasıyla sürtünme katsayısı artmıştır. PA6 kompozitleri için aşınma oranı 10-10 mm3/Nm civarında elde edilmiştir. PA6 polimer kompozitlerinin aşınma oranını etkileyen en önemli parametrenin uygulanan kayma hızı olduğu belirlenmiştir

Twin-Component Near-Pareto Routing Optimization for AANETs in the North-Atlantic Region Relying on Real Flight Statistics

Integrated ground-air-space (IGAS) networks intrinsically amalgamate terrestrial and non-terrestrial communication techniques in support of universal connectivity across the globe. Multi-hop routing over the IGAS networks has the potential to provide long-distance highly directional connections in the sky. For meeting the latency and reliability requirements of in-flight connectivity, we formulate a multi-objective multi-hop routing problem in aeronautical ad hoc networks (AANETs) for concurrently optimizing multiple end-to-end performance metrics in terms of the total delay and the throughput. In contrast to single-objective optimization problems that may have a unique optimal solution, the problem formulated is a multi-objective combinatorial optimization problem (MOCOP), which generally has a set of trade-off solutions, called the Pareto optimal set. Due to the discrete structure of the MOCOP formulated, finding the Pareto optimal set becomes excessively complex for large-scale networks. Therefore, we employ a multi-objective evolutionary algorithm (MOEA), namely the classic NSGA-II for generating an approximation of the Pareto optimal set. Explicitly, with the intrinsic parallelism of MOEAs, the MOEA employed starts with a set of candidate solutions for creating and reproducing new solutions via genetic operators. Finally, we evaluate the MOCOP formulated for different networks generated both from simulated data as well as from real historical flight data. Our simulation results demonstrate that the utilized MOEA has the potential of finding the Pareto optimal solutions for small-scale networks, while also finding a set of high-performance nondominated solutions for large-scale networks

Minimum-Delay Routing for Integrated Aeronautical Ad Hoc Networks Relying on Real Flight Data in the North-Atlantic Region

Relying on multi-hop communication techniques, aeronautical ad hoc networks (AANETs) seamlessly integrate ground base stations (BSs) and satellites into aircraft communications for enhancing the on-demand connectivity of planes in the air. The goal of the paper is to assess the performance of the classic shortest-path routing algorithm in the context of the real flight data collected in the North-Atlantic Region. Specifically, in this integrated AANET context we investigate the shortest-path routing problem with the objective of minimizing the total delay of the in-flight connection from the ground BS subject to certain minimum-rate constraints for all selected links in support of lowlatency and high-speed services. Inspired by the best-first search and priority queue concepts, we model the problem formulated by a weighted digraph and find the optimal route based on the shortest-path algorithm. Our simulation results demonstrate that aircraft-aided multi-hop communications are capable of reducing the total delay of satellite communications, when relying on real historical flight data

The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials

Objectives To investigate whether statins reduce all cause mortality and major coronary and cerebrovascular events in people without established cardiovascular disease but with cardiovascular risk factors, and whether these effects are similar in men and women, in young and older (>65 years) people, and in people with diabetes mellitus