‘PAPER WAR’ – OR THE LESSER-KNOWN ASPECTS OF A CERTAIN WELL-KNOWN FAILURE OF WARTIME PROPAGANDA
The article presents examples of the construction of a war narrative aimed not so much at accurately ...informing the public about key decisions for the state, but at ways of constructing messages to achieve strategic objectives, which do not necessarily prove to be effective.
The PZL-11: Construction and Re-constructions of How an Aeronautical Symbol is Remembered
The PZL-11 fighter plane, almost immediately after its creation in the early 30s of the 20th century, became ...recognized in Poland to be one of the greatest achievements of native technological know-how; evidence that in a very short period of time it had attained a world-class level. In September 1939, a little dated, it fought the Luftwaffe. After WW2 it was exploited by the historical politics of the ruling communist party: presented as evidence of the failure of the preceding capitalist system. Over time, however, it has become a symbol of persistent struggle against foreign aggression and of heroic resistance, becoming a significant element of Polish cultural heritage.
Minor-destructive (MDT) and non-destructive (NDT) techniques are not commonly used for masonry as they are complex and difficult to perform. This paper describes validation of the following methods: ...semi-non-destructive, non-destructive, and ultrasonic technique for autoclaved aerated concrete (AAC). The subject of this study covers the compressive strength of AAC test elements with declared various density classes of: 400, 500, 600, and 700 (kg/m³), at various moisture levels. Empirical data including the shape and size of specimens, were established from tests on 494 cylindrical and cuboid specimens, and standard cube specimens 100 mm × 100 mm × 100 mm using the general relationship for ordinary concrete (Neville's curve). The effect of moisture on AAC was taken into account while determining the strength
for 127 standard specimens tested at different levels of water content (
= 100%, 67%, 33%, 23%, and 10%). Defined empirical relations were suitable to correct the compressive strength of dry specimens. For 91 specimens 100 mm × 100 mm × 100 mm, the P-wave velocity
was tested with the transmission method using the ultrasonic pulse velocity method with exponential transducers. The curve (
⁻
) for determining the compressive strength of AAC elements with any moisture level (
) was established. The developed methods turned out to be statistically significant and can be successfully applied during in-situ tests. Semi-non-destructive testing can be used independently, whereas the non-destructive technique can be only applied when the developed curve
⁻
is scaled.
This article presents results from non-destructive testing (NDT) that referred to the location and diameter or rebars in beam and slab members. The aim of paper was to demonstrate that the accuracy ...and deviations of the NDT methods could be higher than the allowable execution or standard deviations. Tests were conducted on autoclaved aerated concrete beam and nine specimens that were specially prepared from lightweight concrete. The most advanced instruments that were available on the market were used to perform tests. They included two electromagnetic scanners and one ground penetrating radar (GPR). The testing equipment was used to analyse how the rebar (cover) location affected the detection of their diameters and how their mutual spacing influenced the detected quantity of rebars. The considerations included the impact of rebar depth on cover measurements and the spread of obtained results. Tests indicated that the measurement error was clearly greater when the rebars were located at very low or high depths. It could lead to the improper interpretation of test results, and consequently to the incorrect estimation of the structure safety based on the design resistance analysis. Electromagnetic and radar devices were unreliable while detecting the reinforcement of small (8 and 10 mm) diameters at close spacing (up to 20 mm) and of large (20 mm) diameters at a close spacing and greater depths. Recommendations for practical applications were developed to facilitate the evaluation of a structure.
To determine the differences in left atrial (LA) function and geometry assessed by cardiac magnetic resonance (CMR) between transthyretin (ATTR) and immunoglobulin light chain (AL) cardiac ...amyloidosis (CA). We performed a retrospective analysis of 54 consecutive patients (68.5% male, mean age 67 ± 11 years) with confirmed CA (24 ATTR, 30 AL) who underwent comprehensive CMR examinations. LA structural and functional assessment including LA volume, LA sphericity index, and LA strain parameters were compared between both subtypes. In addition, 15 age-matched controls were compared to all groups. Patients with ATTR-CA were older (73 ± 9 vs. 62 ± 10 years, p < 0.001) and more likely to be male (83.3% vs. 56.7%, p = 0.036) when compared to AL-CA. No significant difference existed in LA maximum volume and LA sphericity index between ATTR-CA and AL-CA. LA minimum volumes were larger in ATTR-CA when compared with AL-CA. There was a significant difference in LA function with worse strain values in ATTR vs AL: left atrial reservoir 7.4 (6.3-12.8) in ATTR vs. 13.8 (6.90-24.8) in AL, p = 0.017 and booster strains 3.6 (2.6-5.5) in ATTR vs. 5.2 (3.6-12.1) in AL, p = 0.039. After adjusting for age, LA reservoir remained significantly lower in ATTR-CA compared to AL-CA (p = 0.03), but not LA booster (p = 0.16). We demonstrate novel differences in LA function between ATTR-CA and AL-CA despite similar LA geometry. Our findings of more impaired LA function in ATTR may offer insight into higher AF burden in these patients.
Adults with obesity and type 2 diabetes mellitus (T2DM) related to obesity are at increased risk of heart failure with preserved ejection fraction (HFpEF). Whether left ventricular (LV) diastolic ...function abnormalities related to obesity and T2DM start in adolescence and early adulthood is unknown. We non-invasively evaluated the differences seen in LV diastolic and left atrial (LA) function in adolescents and young adults with obesity and T2DM.
We analyzed echocardiographic measures of LV diastolic function in patients with structurally normal hearts which were divided into 3 groups (normal weight, obese, and T2DM). Spectral and tissue Doppler and 2-D speckle tracking measurements of diastolic function were obtained. Logistic regression was performed to compare the prevalence of abnormalities in diastolic function based on the worst 25th percentile for each measure to determine the prevalence of diastolic and LA function abnormalities in obese and T2DM patients.
331 teenagers and young adults (median age 22.1 years) were analyzed (101 normal weight, 114 obese, 116 T2DM). Obese and T2DM group had lower E/A and higher E/e'. Obese and T2DM patients had significantly lower atrial reservoir, conduit, and booster strain and worse reservoir and conduit strain rate compared to normal patients (p < 0.001 for all measures). All patients had normal LA volumes. On multivariable analysis, conduit strain and reservoir and conduit strain rate were independently associated with having below the 25th percentile e'. Conduit strain rate was independently associated with having below the 25th percentile for mitral E/A ratio on multivariable analysis.
Abnormal indices of LV diastolic function are detected in adolescents and young adults with obesity and T2DM. LA function and strain analysis were able to detect evidence of decreased reservoir, conduit, and booster strain in these patients although LA volume was normal. The use of LA function strain may increase our ability to detect early diastolic function abnormalities in this population.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Summary Background Cardiomyopathy is a leading cause of death in patients with Duchenne muscular dystrophy and myocardial damage precedes decline in left ventricular systolic function. We tested the ...efficacy of eplerenone on top of background therapy in patients with Duchenne muscular dystrophy with early myocardial disease. Methods In this randomised, double-blind, placebo-controlled trial, boys from three centres in the USA aged 7 years or older with Duchenne muscular dystrophy, myocardial damage by late gadolinium enhancement cardiac MRI and preserved ejection fraction received either eplerenone 25 mg or placebo orally, every other day for the first month and once daily thereafter, in addition to background clinician-directed therapy with either angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB). Computer-generated randomisation was done centrally using block sizes of four and six, and only the study statistician and the investigational pharmacy had the preset randomisation assignments. The primary outcome was change in left ventricular circumferential strain (Ecc) at 12 months, a measure of contractile dysfunction. Safety was established through serial serum potassium levels and measurement of cystatin C, a non-creatinine measure of kidney function. This trial is registered with ClinicalTrials.gov , number NCT01521546. Findings Between Jan 26, 2012, and July 3, 2013, 188 boys were screened and 42 were enrolled. 20 were randomly assigned to receive eplerenone and 22 to receive placebo, of whom 20 in the eplerenone group and 20 in the placebo group completed baseline, 6-month, and 12-month visits. After 12 months, decline in left ventricular circumferential strain was less in those who received eplerenone than in those who received placebo (median ΔEcc 1·0 IQR 0·3–2·2 vs 2·2 1·3–3·1; p=0·020). Cystatin C concentrations remained normal in both groups, and all non-haemolysed blood samples showed normal potassium concentrations. One 23-year-old patient in the placebo group died of fat embolism, and another patient in the placebo group withdrew from the trial to address long-standing digestive issues. All other adverse events were mild: short-lived headaches coincident with seasonal allergies occurred in one patient given eplerenone, flushing occurred in one patient given placebo, and anxiety occurred in another patient given placebo. Interpretation In boys with Duchenne muscular dystrophy and preserved ejection fraction, addition of eplerenone to background ACEI or ARB therapy attenuates the progressive decline in left ventricular systolic function. Early use of available drugs warrants consideration in this population at high risk of cardiac death, but further studies are needed to determine the effect of combination cardioprotective therapy on event-free survival in Duchenne muscular dystrophy. Funding BallouSkies, Parent Project for Muscular Dystrophy, US National Center for Advancing Translational Sciences, and US National Institutes of Health.
Speckle tracking echocardiography (STE), and more recently, cardiovascular magnetic resonance myocardial feature tracking (CMR-FT) provides insight into all phases of atrial function. The aim of our ...study was to compare all phases of RA strain using CMR-FT and STE and also assess the relationship between RA and LA strain. A total of 61 healthy volunteers with mean age of 45 ± 13 years had adequate tracking for analysis on CMR-FT and 2D-STE. Females had larger RA reservoir strain (39 ± 15% vs. 32 ± 13%, p = 0.046) and conduit strain (26 ± 12% vs. 20 ± 9%, p = 0.03) when compared to males, but was not the case with booster strain (14 ± 7% vs. 12 ± 6%, p = 0.45). In comparison with STE derived strain, the RA reservoir and conduit strain were not significantly different between CMR-FT and the three echocardiography gating methods (p > 0.05 for all). Noticeably, there were no significant differences in strain and strain rate between RA and LA function using CMR-FT (p > 0.05 for all). RA strain and strain rate using CMR-FT had fair and good intra- and inter-observer reproducibility and had superior reproducibility compared to STE derived strain.
Background
Limited data exist regarding left ventricular remodeling patterns observed in adult survivors of childhood cancer after therapy.
Methods
Among 1190 adult survivors diagnosed with childhood ...cancer (median age at diagnosis, 9 years interquartile range (IQR), 3.8‐14.4 years; age at evaluation, 35.6 years IQR, 29.5‐42.8 years), treatment exposures included anthracyclines (n = 346), chest radiotherapy (n = 174), both (n = 245), or neither (n = 425). Prospective echocardiographic assessment compared survivors with 449 noncancer controls classified according to left ventricle geometric patterns. Associations between left ventricle geometric patterns and decreased exercise tolerance were assessed.
Results
Overall, 28.2% of survivors (95% confidence interval CI, 25.6%‐30.8%) exhibited concentric remodeling, 2.4% (95% CI, 1.6%‐3.5%) exhibited eccentric hypertrophy, and 1.1% (95% CI, 0.6%‐1.9%) exhibited concentric hypertrophy. A greater proportion of survivors who received only chest radiotherapy (41%) had concentric remodeling compared with those who received only anthracyclines (24%), both (27%), or neither (27%; all P < .001), and all were greater than the proportions in noncancer controls (18%; all P < .05). Concentric remodeling was associated with radiation exposure, but not with anthracycline exposure, in multivariable models. Survivors who had concentric remodeling were more likely to have a maximal oxygen uptake peak <85% compared with those who had normal geometry (81.0% vs 66.3%; odds ratio, 1.75; 95% CI, 1.15‐2.68).
Conclusions
Chest radiation therapy, but not anthracycline therapy, increased the risk for concentric remodeling in survivors of childhood cancer. The presence of concentric remodeling was associated with increased exercise intolerance.
Chest radiation therapy increases the risk of concentric left ventricular remodeling as assessed by echocardiography, but anthracycline therapy does not increase the risk of concentric remodeling. Adult survivors of childhood cancer who have concentric remodeling are more likely to have a relative peak oxygen uptake <85% compared with survivors who have normal left ventricular geometry.
Left ventricular noncompaction (LVNC) is a genetically and phenotypically heterogeneous disease and, although increasingly recognized in clinical practice, there is a lack of widely accepted ...diagnostic criteria. We sought to identify novel genetic causes of LVNC and describe genotype-phenotype correlations.
A total of 190 patients from 174 families with left ventricular hypertrabeculation (LVHT) or LVNC were referred for cardiac magnetic resonance and whole-exome sequencing. A total of 425 control individuals were included to identify variants of interest (VOIs). We found an excess of 138 VOIs in 102 (59%) unrelated patients in 54 previously identified LVNC or other known cardiomyopathy genes. VOIs were found in 68 of 90 probands with LVNC and 34 of 84 probands with LVHT (76% and 40%, respectively;
<0.001). We identified 0, 1, and ≥2 VOIs in 72, 74, and 28 probands, respectively. We found increasing number of VOIs in a patient strongly correlated with several markers of disease severity, including ratio of noncompacted to compacted myocardium (
<0.001) and left ventricular ejection fraction (
=0.01). The presence of sarcomeric gene mutations was associated with increased occurrence of late gadolinium enhancement (
=0.004).
LVHT and LVNC likely represent a continuum of genotypic disease with differences in severity and variable phenotype explained, in part, by the number of VOIs and whether mutations are present in sarcomeric or nonsarcomeric genes. Presence of VOIs is common in patients with LVHT. Our findings expand the current clinical and genetic diagnostic approaches for patients with LVHT and LVNC.
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