Statins in Heart Failure-Where Do We Stand?

HMG Co-A reductase inhibitors (statins) are a group of drugs which lower cholesterol by inhibiting the conversion of HMG Co-A to mevalonate early in the cholesterol synthetic pathway. They are used in the primary and secondary prevention of cardiovascular events in patients deemed to be at increased risk and their benefit in patients with ischaemic heart disease is well supported. Their use in patients with heart failure (HF) however, is controversial. Evidence from observational and mechanistic studies suggests that statins should benefit patients with HF. However, larger randomised controlled trials have failed to demonstrate these expected benefits. The aim of this review article is to summarise the data from trials of statin use in patients with HF and attempt to explain the apparent conflict between recent placebo controlled trials and earlier observational and mechanistic studies.

Boost radiosurgery as a strategy after failure of initial management of pediatric primitive neuroectodermal tumors Clinical article

The aim in this study was to determine the outcomes of boost stereotactic radiosurgery, specifically Gamma Knife surgery (GKS), for recurrent primitive neuroectodermal tumors (PNETs) in children in whom initial multimodality management had failed.

Cement mantle fatigue failure in total hip replacement: Experimental and computational testing

One possible loosening mechanism of the femoral component in total hip replacement is fatigue cracking of the cement mantle. A computational method capable of simulating this process may therefore be a useful tool in the preclinical evaluation of prospective implants. In this study, we investigated the ability of a computational method to predict fatigue cracking in experimental models of the implanted femur construct. Experimental specimens were fabricated such that cement mantle visualisation was possible throughout the test. Two different implant surface finishes were considered: grit blasted and polished. Loading was applied to represent level gait for two million cycles. Computational (finite element) models were generated to the same geometry as the experimental specimens, with residual stress and porosity simulated in the cement mantle. Cement fatigue and creep were modelled over a simulated two million cycles. For the polished stem surface finish, the predicted fracture locations in the finite element models closely matched those on the experimental specimens, and the recorded stem displacements were also comparable. For the grit blasted stem surface finish, no cement mantle fractures were predicted by the computational method, which was again in agreement with the experimental results. It was concluded that the computational method was capable of predicting cement mantle fracture and subsequent stem displacement for the structure considered. (C) 2006 Elsevier Ltd. All rights reserved.

The experience of individuals with renal failure participating in home haemodialysis: An interpretative phenomenological analysis.

This study explored the experience of individuals with renal failure undertaking home haemodialysis (HHD). Semi-structured interviews were conducted with six participants who were active HHD users in a UK region. Participants’ accounts were transcribed verbatim and analysed using an interpretative phenomenological approach. Three main themes were identified: (1) embracing treatment and lifestyle freedom and flexibility; (2) re-establishing a sense of self and preferred self-identity; and (3) integrating aspects of active engagement and aspects of supported, life-sustaining dependence. A ‘good fit’ between the HHD user (an independent, self-determined health participant) and the healthcare provision (personalized, enabling) is proposed.

Scaling in the time-dependent failure of a fiber bundle with local load sharing

We study the scaling behaviors of a time-dependent fiber-bundle model with local load sharing. Upon approaching the complete failure of the bundle, the breaking rate of fibers diverges according to r(t)proportional to(T-f-t)(-xi) where T-f is the lifetime of the bundle and xi approximate to 1.0 is a universal scaling exponent. The average lifetime of the bundle [T-f] scales with the system size as N-delta, where delta depends on the distribution of individual fiber as well as the breakdown rule. [S1063-651X(99)13902-3].

Failure of fiber bundles with local load sharing

We develop a recursion-relation approach for calculating the failure probabilities of a fiber bundle with local load sharing. This recursion relation is exact, so it provides a way to test the validity of the various approximate methods. Applying the exact calculation to uniform and Weibull threshold distributions, we find that the most probable failure load coincides with the average strength as the size of the system N --> infinity.

Propagating Wave Phenomena Detected in Observations and Simulations of the Lower Solar Atmosphere

We present high-cadence observations and simulations of the solar photosphere, obtained using the Rapid Oscillations in the Solar Atmosphere imaging system and the MuRAM magnetohydrodynamic (MHD) code, respectively. Each data set demonstrates a wealth of magnetoacoustic oscillatory behavior, visible as periodic intensity fluctuations with periods in the range 110–600 s. Almost no propagating waves with periods less than 140 s and 110 s are detected in the observational and simulated data sets, respectively. High concentrations of power are found in highly magnetized regions, such as magnetic bright points and intergranular lanes. Radiative diagnostics of the photospheric simulations replicate our observational results, confirming that the current breed of MHD simulations are able to accurately represent the lower solar atmosphere. All observed oscillations are generated as a result of naturally occurring magnetoconvective processes, with no specific input driver present. Using contribution functions extracted from our numerical simulations, we estimate minimum G-band and 4170 Å continuum formation heights of 100 km and 25 km, respectively. Detected magnetoacoustic oscillations exhibit a dominant phase delay of −8◦ between the G-band and 4170 Å continuum observations, suggesting the presence of upwardly propagating waves.More than 73% of MBPs (73% from observations and 96% from simulations) display upwardly propagating wave phenomena, suggesting the abundant nature of oscillatory behavior detected higher in the solar atmosphere may be traced back to magnetoconvective processes occurring in the upper layers of the Sun’s convection zone.