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Left atrial congestion results from backward failure in dilated cardiomyopathy. We aimed to evaluate feasibility and efficacy of percutaneous atrioseptostomy to create a restrictive atrial septum defect in management of dilated cardiomyopathy.
Methods and results
From June 2009 to December 2016, 27 interventions comprised left atria decompressions in 22 dilated cardiomyopathy patients; 9 females; age: 24 days to 36.9 years; weight: 3–50 kg; NYHA-/Ross class IV (n=16). Mean left ventricular ejection fraction was 21.5±9.7% and brain natriuretic peptide was 2291±1992 pg/ml. Dilated cardiomyopathy was classified as chronic (n=9); acute (n=1) myocarditis; idiopathic (n=5); left ventricular non-compaction (n=4); mitochondriopathy, pacemaker induced, and arrhythmogenic (n=3). Atrioseptostomy was concomitantly performed with myocardial biopsies 6.5 days (±11.7) after admission (n=11). Trans-septal puncture was used in 18 patients; foramen ovale dilatation was done in four patients. Mean balloon size was 11 mm (range 7–14 mm); total procedure time was 133±38 minutes. No procedural complications were observed. Mean left atrial pressure decreased from 15.8±6.8 to 12.2±4.8 mmHg (p=0.005), left/right atrial pressure gradient from 9.6±5.6 to 5±3.5 mmHg; brain natriuretic peptide (n=18) decreased from 1968±1606 to 830±1083 pg/ml (p=0.01). One patient unsuitable for heart transplantation died at home despite additionally performed pulmonary artery banding and three further left atrial decompressions; five patients were bridged to transplantation, two died afterwards. Functional recovery occurred in the remaining 14 patients and in six after additional pulmonary artery banding. No patient required assist device.
Percutaneous left atrial decompression is an age-independent, effective palliation treating patients with dilated cardiomyopathy.
Słomiński (9), as well as the author (8), gave a descriptive, i.e., noncategory-theoretic, definition of the direct sum of partial algebras, i.e., the co-product in the category of partial algebras (A,ƒ), where ƒ = (ƒi)i∈I, ƒi: dom ƒi ⟶ A, dom ƒi ⊂ AKi, of fixed type A = (Ki)i∈I.
The two high-pressure water-retaining dams at the Ibbenbüren coalmine in Münsterland (Germany) have to perform reliably under the induced tension caused by further exploitation of the current mining area. The load-bearing and the sealing functions of the new barriers were separated and new sealing materials were developed. An innovative multilayer sealing system of bentonite and sandwiched equipotential layers (SANDWICH) supporting homogeneous swelling and sealing, independent of formation water (Nüesch et al., 2002), was applied in this project. A testing program of strain-controlled swelling pressure tests on compacted bentonite specimens and on a bentonite/sand mixture was conducted to ensure an adequate potential for swelling-pressure development.
The measurements under constant volume for dry densities between 1.45 g/cm3 and 1.67 g/cm3 showed an evolving swelling pressure between 1.04 and 1.8 MPa for 100% bentonite samples. Straincontrolled oedometer tests for zero strain and step-wise applied strain up to 2% revealed that a sufficient magnitude of swelling pressure existed at maximum applied strain.
Dilated cardiomyopathy is a leading cause of cardiac death in children. Approximately 30% of children die or need cardiac transplantation in the first year after establishing the diagnosis. New strategies are needed to improve the outcome in this high-risk patient population.
Method and results
We present our experience in 38 patients below the age of three years, who were diagnosed with dilated cardiomyopathy and who were treated at our institution between 2006 and 2012. The treatment strategy involved institution of β-blockers and angiotensin-converting enzyme inhibitors as soon as feasible. In selected cases, pulmonary artery banding or intracoronary autologous bone marrow-derived cell therapy was performed. The median age at presentation was six months (range 1–26 months). The median follow-up age was 16 months (range 2–80 months). Kaplan–Meier analysis of survival after dilated cardiomyopathy diagnosis revealed a one-year survival of 97% and a five-year survival of 86%. The rate of freedom from death or heart transplantation was 82% at one year and 69% at five years. Surviving patients who were free of transplantation, at the follow-up at 25 months (3–80 months), showed a significant improvement in left ventricular ejection fraction (from 19±11 to 46±16%) and left ventricular end-diastolic diameter (z-score from 4.6±2.4 to 1.4±1.6). In addition, the levels of B-type natriuretic peptide improved significantly (from 3330±3840 to 171±825 pg/ml).
Our data suggest that the clinical approach described here may result in a markedly improved medium-term outcome in young children with dilated cardiomyopathy. Further studies are required to evaluate whether these approaches reduce end-points such as transplantation or death.
How can a modern concept like Amartya Sen's capability approach be introduced in historical studies? One possibility is to ask how public services were implemented in municipal policy and how these services open up capabilities for the individuals of a city. This article uses Sen's theoretical framework as an analytical tool to explore two Prussian towns, Erfurt and Frankfurt am Main, and their public services (job centres and tramway systems) as examples of social policy at the local level.
Radar sensors are used widely in modern driver assistance systems. Available sensors nowadays often operate in the 77 GHz band and can accurately provide distance, velocity, and angle information about remote objects. Increasing the operation frequency allows improving the angular resolution and accuracy. In this paper, the technical feasibility to move the operation frequency beyond 100 GHz is discussed, by investigating dielectric properties of radome materials, the attenuation of rain and atmosphere, radar cross-section behavior, active circuits technology, and frequency regulation issues. Moreover, a miniaturized antenna at 150 GHz is presented to demonstrate the possibilities of high-resolution radar for cars.
(Bi,Sb)2Te3 + 4 mol%PbTe was quenched in water and on a rotating copper wheel (melt spinning). It was found that PbTe was immiscible in (Bi,Sb)2Te3 when the material is quenched in water and that the thermoelectric figure of merit increases by annealing. Natural nanostructures (nns) were found in melt-spun (Bi,Sb)2Te3, whereas they were hard to detect in (Bi,Sb)2Te3 alloyed with PbTe. There is a correlation between the orientation of the strain field and the nns. Within the grains of melt-spun (Bi,Sb)2Te3 alloyed with PbTe, the chemical composition was homogeneous. An enrichment of Pb was found at the grain boundaries. Quenched (Bi,Sb)2Te3 alloyed with 0.3 wt%PbTe have been spark plasma sintered (SPS). After optimization, the Seebeck coefficients of the melt-spun SPS (MS-SPS) materials were larger than for materials quenched in water and sintered (QW-SPS) materials. In addition, the mobility increases with the carrier concentration in MS-SPS materials, whereas it decreases in QW-SPS materials.
The melt spinning technique (MST) combined with post annealing processes is evaluated for the development of thermoelectric nanocomposites. The evaluated ones are based on two components almost immiscible in solid state but with crystallographic correlation. One is taken from the V-VI-components system and the other one from the IV-VI-components system. This concept was applied to p-(Bi0,2Sb0,8)2Te3 and to p-[(Bi0,2Sb0,8)2Te3]1-xPbTex composites. MST samples of all types were characterised for some structural and thermoelectric properties. All V-VI materials are clearly textured after MST and show no deterioration concerning the thermoelectric properties even after subsequent annealing processes. Structural analysis of p-[(Bi0,2Sb0,8)2Te3]1-xPbTex composites gave significant hints for oriented precipitates of a IV-VI-rich phase incorporated into the V-VI-rich matrix. The thermoelectric figure of merit of the evaluated composites could be enhanced by suitable annealing procedures of both the quenched bulk materials and the melt spin material.
We report here a procedure for the functioalization of SiO2-coated, SiONx waveguides for biological assays. Surface functionalization occurs by self-assembly of an amine-terminated silane monolayer on the waveguide, followed by partial chemical modification with functionalized polyethylene glycol (PEG) groups. Functionalized surfaces were characterized by atomic force microscopy and contact angle measurements. When combined with a BSA blocking step, these functional PEG surfaces significantly reduced non-specific binding and allowed for specific binding to occur. An antibody sandwich assay for detection of Bacillus anthracis protective antigen was used to validate these surfaces for sensing applications.
The development of new optimized photoinitiators for the two-photon induced photopolymerization (TPIP) is essential in order to obtain high resolutions in this solid freeform fabrication process. Herein, we present the syntheses and characterizations of a series of efficient photoinitiators, comprising of a cross conjugated D-π-A-π-D system. The different donor- and acceptor functionalities of the investigated photoinitiators as well as the synthesis of targeted derivatives containing double and triple bonds in the conjugated backbone allowed the evaluation of structure-activity relationships. The basic photophysical properties as well as the activity and ideal processing window under TPIP conditions were investigated for each initiator and compared with typical commercially available one-photon initiator and with two highly potential initiators well known from literature. These tests figured out that the new chromophores are highly potential even at concentrations down to 0.05 wt%.
Two photon photopolymerization (2PP) is a new and modern method in solid freeform fabrication. 2PP allows the fabrication of sub-micron structures from a photopolymerizable resin. By the use of near-infrared (NIR) lasers it is possible to produce 3D structures with a spatial feature resolution as good as 200 nm. This technique can be used in polymer-based photonic and micro-electromechanical systems (MEMS), for 3D optical data storage or for the inscription of optical waveguides based on a local refractive index change upon laser exposure. Since the 2PP only takes place inside the focus of the laser beam, complex 3D-structures can be in-scri-bed into a suitable matrix material.
In the presented work, 2PP is used to write optical waveguides into a prefabricated mechanically flexible polydimethylsiloxane matrix. The waveguides were structured by selectively irradiating a polymer network, which was swollen by a monomer mixture. The monomer was polymerized by two photon photopolymerization and the uncured monomer was removed by evaporation at elevated temperatures. This treatment led to a local change in refractive index in the order of Δn = 0.02, which was significantly above the industrial requirement of Δn = 0.003. The measured optical losses were around 2.3dB/cm. Since all unreacted monomers were removed by eva-po-ration, the final waveguide was stable up to temperatures of more than 200°C.
In a second approach highly porous sol-gel materials (based on tetramethoxysilane (TMOS) as precursor and the surfactant cetylpyridinium chloride monohydrate as structural temp-late) were utilized as matrix materials. The precursor was organically modified with poly(ethylene glycol) spacers in order to increase the toughness and thus facilitate the fabrication of transparent porous monoliths and flexible films. The pores of the sol-gel-derived matrix were filled with acrylate-based monomers of high refractive index and after selective irradiation using 2PP waveguides (Δn = 0.015) could be written into the material.
The suitability of two commercial dry diets for rearing Coregonus lavaretus larvae was tested in a 58-day experiment. A diet of live zooplankton was used for comparison. The trials were conducted at water temperature of 12 °C in 800 l tanks, with a stocking density of 10 000-25 000 larvae per tank. Diets were evaluated by means of growth and liver histological analysis. Best growth was obtained with zooplankton, but one of the two dry diets (TetraWerke Az 20) also resulted in satisfactory gowth. Examination of liver structure using light and electron microscopy revealed no nutritional pathology for larvae fed with dry diet Az 20. Histological diagnosis presented evidence for a close association between hepatic protein synthesis and larval growth. From the data of the present study it can be concluded that a large-scale rearing of larvae of Coregonus lavaretus exclusively on dry food, is feasible.
The main result of this paper is the theorem in the title. Only special cases of it seem to be known so far. As an application, we obtain a result on the unique extension of Galois connexions. As a matter of fact, it is only by the use of Galois connexions that we obtain the main result, in its present generality.