Dynamic cardiomyoplasty: clinical follow-up at 12 years

OBJECTIVE: The purpose of this study is to evaluate the long-term outcome of dynamic cardiomyoplasty. This surgical technique was conceived to assist the failing heart. The many proposed mechanisms of action of cardiomyoplasty are: (1) systolic assist; (2) limitation of ventricular dilation; (3) reduction of ventricular wall stress (sparing effect); (4) ventricular remodeling with an active girdling effect; (5) angiogenesis; and (6) a neurohumoral effect. METHODS: We investigated 95 patients in our hospital undergoing this procedure due to severe chronic heart failure, refractory to optimal medical treatment. Patients had a mean age of 51 +/- 12 years. The etiology of heart failure was ischemic 55%, idiopathic 34%, ventricular tumor 6%, and other 5%. The mean follow-up was 44 months. RESULTS: The mean New York Heart Association (NYHA) functional class improved postoperatively from 3.2 to 1.8. Average radioisotopic left ventricular (LV) ejection fraction increased from 17 +/- 5 to 27 +/- 4% (P < 0.05). Stroke volume index increased from 32 +/- 7 to 43 +/- 8 ml/beat per m2 (P < 0.05). The heart size remained stable over the long term. Following cardiomyoplasty, the number of hospitalizations due to congestive heart failure was reduced to 0.4 hospitalizations/patient per year (preoperative: 2.5, P < 0.05). Computed tomography scans showed at long term a preserved latissimus dorsi muscle structure in 84% of patients. Survival probability at 7 years is 54%. Six patients underwent heart transplant after cardiomyoplasty (mean delay: 25 months), due to the natural evolution of their underlying heart disease. There were no specific technical difficulties. CONCLUSIONS: Clinically, this procedure reverses heart failure, improves functional class and ameliorates quality of life. The latissimus dorsi muscle histological structure is maintained at long-term, when postoperative electrostimulation is performed, avoiding excessive stimulation. Cardiomyoplasty may delay or prevent the progression of heart failure and the indication of cardiac transplantation.     

Plasma-assisted co-evaporation of β-indium sulfide thin films

This paper describes the development of plasma-assisted co-evaporation (PACE) for the formation of β-In₂S₃ thin films. Indium was supplied by conventional thermal evaporation, while the chalcogen gas precursor (H₂S) was activated using an inductively coupled plasma (ICP) source. Using a combination of optical emission spectroscopy and mass spectrometry it was shown that the ICP effectively dissociated H₂S, producing atomic sulfur. Transport modeling was used to quantify the flux distributions of the co-evaporated metal and the plasma-generated species impinging the substrate. Model predictions were validated by measurements of deposition rate and film properties. Substantial improvements in both materials utilization and substrate temperature reduction were realized with respect to conventional co-evaporation. β-In₂S₃ was formed as low as 100 °C and it was observed that quality was a strong function of S/In ratio. The grain size decreased and the optical band gap increased as the substrate temperature was reduced.     

Public Sector Alternatives to Water Supply and Sewerage Privatization: Case Studies

The paper presents a consideration of public sector operations as an alternative to the privatization of water and sewerage services. Cross-country case studies of publicly owned enterprises which have succeeded in reconciling efficiency and social purposes and carrying out structural and managerial changes are compared with some experiences of privatized concessions. Overall, public enterprises appear no less efficient that private companies, while being capable of development-oriented consideration of public interests.     

Tetra-anionic porphyrin loading onto ZnO nanoneedles: A hybrid covalent/non covalent approach

A stepwise surface functionalization procedure, based on hybrid covalent and non-covalent approach is herein proposed to anchor tetra-anionic meso-tetrakis(4-sulfonatophenyl)porphyrin on ZnO nanorods. Carboxyalkylphosphonic acids have been proven effective to form stable self-assembled monolayers through the surface grafting of –PO₃H₂ headgroups. The exposed carboxylic functionalities are suitable for the successful grafting of cationic poly-l-lysine that drives, in water, the non-covalent anchoring of the anionic porphyrin. A stepwise surface characterization, provided by X-ray photoelectron spectroscopy, elucidates the multilayers deposition and surface composition after each process step, thus, giving interesting insights on the chemical speciation of the exposed functionalities. UV–vis spectroscopy confirms the role of ZnO morphology to increase the porphyrin loading onto the investigated surfaces. The proposed approach is effective to achieve deposition of anionic porphyrins on ZnO nanostructures and combines the robustness of covalent functionalization with the versatility and full reversibility of the non-covalent strategies.     

Effect of hemodiafiltration with endogenous reinfusion on overt idiopathic chronic inflammation in maintenance hemodialysis patients: A multicenter longitudinal study

Chronic inflammation is widely diffuse in maintenance hemodialysis (MHD) patients and is associated with poor survival. Hemodiafiltration with endogenous reinfusion (HFR) is a dialysis technique, highly biocompatible, able to adsorb proinflammatory cytokines and to decrease amino acids and antioxidants loss. These features could be helpful in MHD patients affected by idiopathic chronic inflammation, but this issue remains to be elucidated. We performed a multicenter longitudinal study to assess the effect of the switching from bicarbonate HD to HFR in patients with serum C‐reactive Protein (CRP) > 5 mg/L coupled with albumin <4.0 g/dL in the last 6 months. We enrolled 24/176 (14%) patients, of which 20 patients were assessed at 4 months and 18 completed the study. We excluded 11 patients with evident causes of inflammation. At baseline, serum levels of CRP (18.7[7.0–39.4] mg/L) and albumin (3.5[3.3–3.7] g/dL) were significantly correlated (r = ?0.49; P = 0.028). The effect on CRP and albumin was almost evident in the first 4 months and remained stable until to eighth month. A strict correlation (R = ?0.49; 0.040) between percentage change of CRP (?35%) and albumin (+14%) after 8 months of HFR. These effects were associated with the reduction of IL‐6, IL‐1β, and TNF‐α and the increment of pre‐albumin and leptin, whereas the serum levels of Branched Chain Amino Acid (BCAA) remained unchanged. In MHD patients affected by idiopathic chronic inflammation the switching from BHD to HFR is associated with improvement of inflammation. Whether these favorable effects may modify the outcomes of these high‐risk patients needs to be confirmed by studies ad hoc.     

Thermoluminescence solid-state nanodosimetry--the peak 5A/5 dosemeter

The shape of composite peak 5 in the glow curve of LiF:Mg,Ti (TLD-100) following (90)Sr/(90)Y beta irradiation, previously demonstrated to be dependent on the cooling rate used in the 400°C pre-irradiation anneal, is shown to be dependent on ionisation density in both naturally cooled and slow-cooled samples. Following heavy-charged particle high-ionisation density (HID) irradiation, the temperature of composite peak 5 decreases by ～5°C and the peak becomes broader. This behaviour is attributed to an increase in the relative intensity of peak 5a (a low-temperature satellite of peak 5). The relative intensity of peak 5a is estimated using a computerised glow curve deconvolution code based on first-order kinetics. The analysis uses kinetic parameters for peaks 4 and 5 determined from ancillary measurements resulting in nearly 'single-glow peak' curves for both the peaks. In the slow-cooled samples, owing to the increased relative intensity of peak 5a compared with the naturally cooled samples, the precision of the measurement of the 5a/5 intensity ratio is found to be ～15% (1 SD) compared with ～25% for the naturally cooled samples. The ratio of peak 5a/5 in the slow-cooled samples is found to increase systematically and gradually through a variety of radiation fields from a minimum value of 0.13±0.02 for (90)Sr/(90)Y low-ionisation density irradiations to a maximum value of ～0.8 for 20 MeV Cu and I ion HID irradiations. Irradiation by low-energy electrons of energy 0.1-1.5 keV results in values between 1.27 and 0.95, respectively. The increasing values of the ratio of peak 5a/5 with increasing ionisation density demonstrate the viability of the concept of the peak 5a/5 nanodosemeter and its potential in the measurement of average ionisation density in a 'nanoscopic' mass containing the trapping centre/luminescent centre spatially correlated molecule giving rise to composite peak 5.     

Self‐Assembled Conjugated Thiophene‐Based Rotaxane Architectures: Structural,Computational, and Spectroscopic Insights into Molecular Aggregation

A comparative study of the self‐assembly at a variety of surfaces of a dithiophene rotaxane 1 ?β‐CD and its corresponding dumbbell, 1, by means of atomic force microscopy (AFM) imaging and scanning tunneling microscopy (STM) imaging on the micrometer and nanometer scale, respectively. The dumbbell is found to have a greater propensity to form ordered supramolecular assemblies, as a result of π–π interactions between dithiophenes belonging to adjacent molecules, which are hindered in the rotaxane. The fine molecular structure determined by STM was compared to that obtained by molecular modelling. The optical properties of both rotaxane and dumbbell in the solid state were investigated by steady‐state and time‐resolved photoluminescence (PL) experiments on spin‐cast films and diluted solutions. The comparison between the optical features of the threaded and unthreaded systems reveals an effective role of encapsulation in reducing aggregation and exciton migration for the rotaxanes with respect to the dumbbells, thus leading to higher PL quantum efficiency and preserved single‐molecule photophysics for longer times after excitation in the threaded oligomers.     

A theoretical analysis of a buffer frame size conversion algorithm for audio applications ensuring minimum latency

In implementing digital signal processing (DSP) algorithms for audio real-time applications, one is frequently faced with problems regarding incompatibilities between the hardware buffer length (the internal buffer of a professional sound card) and the software buffer size imposed by the underlying algorithm (due to i.e. multirate or FFT constraints). This mismatch is solved by proper frame size conversion algorithms which inevitably introduce delay. In this context, this paper presents a buffering scheme together with a theoretical proof of the minimum delay property shown by it. Some examples derived from frequently encountered issues in DSP applications are reported.