Heat sensitivity shows considerable functional variability in humans and laboratory animals, and is fundamental to inflammatory and possibly neuropathic pain. In the mouse, at least, much of this ...variability is genetic because inbred strains differ robustly in their behavioral sensitivity to noxious heat. These strain differences are shown here to reflect differential responsiveness of primary afferent thermal nociceptors to heat stimuli. We further present convergent behavioral and electrophysiological evidence that the variable responses to noxious heat are due to strain-dependence of CGRP expression and sensitivity. Strain differences in behavioral response to noxious heat could be abolished by peripheral injection of CGRP, blockade of cutaneous and spinal CGRP receptors, or long-term inactivation of CGRP with a CGRP-binding Spiegelmer. Linkage mapping supports the contention that the genetic variant determining variable heat pain sensitivity across mouse strains affects the expression of the Calca gene that codes for CGRPα.
We investigated the impact of cardiopulmonary bypass pump (CPB), hematocrit, gender, age, and body weight on blood use in patients undergoing coronary artery bypass graft surgery at a major ...university hospital. Participants were 1235 consecutive patients undergoing primary coronary artery surgery over a period of 2 yr (1999 and 2000); 681 patients underwent coronary surgery with use of CPB, and 554 patients underwent off-pump coronary artery bypass surgery using a median sternotomy incision. There were 881 males and 354 females. Average packed red blood cells (PRBC) transfusion for patients on CPB was 3.4 U compared with 1.6 U for the off-pump group (P = <0.001). Patients on CPB received more frequent PRBC transfusion (72.5%) compared with 45.7% of off-pump patients (P = <0.001). Average PRBC transfusion for males was 2.2 U compared with 3.6 U for females (P = <0.001). A lower percentage of males (52.6%) than females (79.4%) received transfusion (P = <0.001). The impact of CPB, off-pump status, preoperative hematocrit <35%, gender, age >or=65 yr, and weight <or=83 kilograms using median values as cut points, on blood use was examined using logistic regression models. Use of CPB, preoperative hematocrit, (<35%) female gender, increasing age, and decreased body weight were significant predictors of transfusion (P = <0.001). Preoperative hematocrit <35% and use of CPB were the strongest predictors of PRBC transfusion.
We examined the impact of cardiopulmonary bypass, preoperative hematocrit, gender, age, and body weight on blood use in patients undergoing primary coronary artery bypass surgery at a tertiary care institution. We found that all five of these variables are significant predictors of blood use in patients undergoing coronary artery bypass surgery.
This paper describes a programmable capacitor intended for use as the reference impedance in an inductance measurement system. The capacitor is programmable from 1 pF to 39 μF with a resolution of 1 ...pF and consists of a parallel combination of commercially available capacitors with values that follow the Fibonacci series progression. This paper presents a novel calibration procedure for the programmable capacitor that uses an LCR meter performing only difference measurements and requires only three reference capacitance standards within the device's programmable range. Design details and major sources of error for the use of the capacitor in an inductance measurement system are also discussed.
Objective:
The purpose of the present study was to examine resource utilization in octogenarians undergoing coronary artery bypass grafting (CABG) and compare it with usage in their younger cohorts ...at a tertiary care heart center. The resources examined were time to extubation, packed red blood cell transfusions, intensive care unit (ICU) length of stay (LOS), and preoperative and postoperative LOS. The study also examined differences in postoperative morbidity and mortality.
Design:
Retrospective hospital follow-up study of consecutive patients undergoing CABG using a prospectively designed database.
Setting:
University teaching tertiary care referral center for cardiac surgery.
Participants:
Seventeen hundred forty-six male and female patients undergoing CABG surgery, including 155 octogenarians and 1591 patients younger than 80 years.
Interventions:
None.
Measurements and Main Results:
Demographic, mortality, morbidity, and resource utilization data were collected from the records of patients undergoing CABG at the authors’ institution over 3 years. There were 1746 patients: 155 octogenarians and 1591 nonoctogenarians. Octogenarians had a significantly higher incidence of preoperative stroke, peripheral vascular disease, chronic obstructive lung disease, congestive heart failure, and left main disease. They weighed significantly less, and had lower preoperative and postoperative hematocrit. There was a significantly higher percentage of women in the octogenarian group. Mean time from the end of surgery to endotracheal extubation was 9.3 hours for octogenarians and 6.3 hours for their younger cohorts (
p < 0.001). Blood transfusion was required in 88.4% of octogenarians compared with 58.6% of nonoctogenarians (
p < 0.001). Mean ICU LOS was 1.9 days for octogenarians and 1.4 days for nonoctogenarians (
p < 0.001). Mean postoperative LOS was 8.7 days for octogenarians and 5.8 days for nonoctogenarians (
p < 0.001). Clinical and demographic variables were correlated with age 80 years or older. Multivariate linear and logistic regression models were constructed to show the combined effects of age and comorbid conditions on outcomes. Octogenarians had a significantly higher incidence of postoperative renal failure and neurologic complications. The 30-day mortality rate was 9.0% for the octogenarian group v 1.2% for the younger group (
p < 0.001). Age 80 years or older was significantly associated with outcome, and was an independent predictor of increased resource utilization and postoperative mortality and morbidity.
Conclusions:
The results demonstrated that octogenarians undergoing CABG required increased resource utilization and had significantly higher morbidity, with increased incidence of postoperative renal failure, neurologic complications, and 30- day mortality. Age 80 years or older was an independent predictor of increased resource utilization, postoperative morbidity, and mortality.
Purpose
To evaluate prospective motion correction using the pilot tone (PT) as a quantitative respiratory motion signal with high temporal resolution for cardiac cine images during free breathing.
...Methods
Before cine data acquisition, a short prescan was performed, calibrating the PT to the respiratory‐induced heart motion using respiratory‐resolved real‐time images. The calibrated PT was then applied for nearly real‐time prospective motion correction of cine MRI through slice tracking (ie, updating the slice position before every readout). Additionally, in‐plane motion correction was performed retrospectively also based on the calibrated PT data. The proposed method was evaluated in a moving phantom and 10 healthy volunteers.
Results
The PT showed very good correlation to the phantom motion. In volunteer studies using a long‐term scan over 7.96 ± 1.40 min, the mean absolute error between registered and predicted motion from the PT was 1.44 ± 0.46 mm in head‐feet and 0.46 ± 0.07 mm in anterior‐posterior direction. Irregular breathing could also be corrected well with the PT. The PT motion correction leads to a significant improvement of contrast‐to‐noise ratio by 68% (P ≤ .01) between blood pool and myocardium and sharpness of endocardium by 24% (P = .04) in comparison to uncorrected data. The image score, which refers to the cine image quality, has improved with the utilization of the proposed PT motion correction.
Conclusion
The proposed approach provides respiratory motion‐corrected cine images of the heart with improved image quality and a high scan efficiency using the PT. The PT is independent of the MR acquisition, making this a very flexible motion‐correction approach.
Space-based remote sensing can make an important contribution toward monitoring greenhouse gas emissions and removals from the agriculture, forestry, and other land use (AFOLU) sector, and to ...understanding and addressing human-caused climate change through the UNFCCC Paris Agreement. Space agencies have begun to coordinate their efforts to identify needs, collect and harmonize available data and efforts, and plan and maintain a long-term roadmap for observations. International cooperation is crucial in developing and realizing the roadmap, and the Committee on Earth Observation Satellites (CEOS) is a key coordinating driver of this effort. Here, we first identify the data and information that will be useful to support the global stocktake (GST) of the Paris Agreement. Then, the paper explains how existing and planned space-based capabilities and products can be used and combined, particularly in the land use sector, and provides a workflow for their harmonization and contribution to greenhouse gas inventories and assessments at the national and global level.
Transesophageal echocardiogram (mid-esophageal view at 90°) noted an excluded LAA without persistent flow and a large mobile echodensity consistent with a thrombus attached to the level of the ...presumed staple line of the LAA, prolapsing through the mitral valve (Image,Online Video 1).
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