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With improved survival of adults with congenital heart disease (CHD) comes a need to understand the lifelong outcomes of this population. The aim of this paper is to describe the rationale and design of Congenital Heart Disease Project to Understand Lifelong Survivor Experience (CHD PULSE), a study to determine long-term medical, neurocognitive, and psychosocial outcomes among adults with a history of intervention for CHD and to identify factors associated with those outcomes. CHD PULSE is a cross-sectional survey conducted from September 2021 to April 2023 among adults aged 18 and older with a history of at least 1 intervention for CHD at 1 of 11 participating U.S. centers in the Pediatric Cardiac Care Consortium. Participants with CHD were asked to complete a 99-question survey on a variety of topics including: demographics, surgeries, health insurance, health care, heart doctors, general health, height and weight, education and work history, reproductive health (for women only), and COVID-19. To construct a control group for the study, siblings of survey respondents were invited to complete a similar survey. Descriptive statistics for demographics, disease severity, center, and method of survey completion were computed for participants and controls. Comparisons were made between participants and non-participants to assess for response bias and between CHD participants and sibling controls to assess for baseline differences. Among the 14,322 eligible participants, there were 3,133 respondents (21.9%) from 48 U.S. states with surveys returned for inclusion in the study. Sibling contact information was provided by 691 respondents, with surveys returned by 326 siblings (47.2%). The median age of participants was 32.8 years at time of survey completion, with an interquartile range of 27.2 years to 39.7 years and an overall range of 20.1 to 82.9 years. Participants were predominantly female (55.1%) and of non-Hispanic White race/ethnicity (87.1%). There were no differences between participants and non-participants regarding severity of CHD. Compared to nonparticipants, participants were more likely to be female, of older age, and be of non-Hispanic White race/ethnicity. Enrolled siblings were more likely to be female and slightly younger than participants. With surveys from 3,133 participants from across the U.S., CHD PULSE is poised to provide keen insights into the lifelong journey of those living with CHD, extending beyond mere survival. These insights will offer opportunities for informing strategies to enhance and improve future outcomes for this population of patients. [ABSTRACT FROM AUTHOR]

The development of the e-commerce industry creates a new shopping environment for consumers. This brings both opportunities and threats. One observed problem is the low visibility and recognition of ecological products in this sales channel. This issue is becoming increasingly important in the era of growing climate threats and global warming. The aim of this study was to examine the variables influencing the attitudes, intentions, and behaviors of consumers when purchasing ecological products in online stores. A survey method was used among 250 young consumers from Poland to achieve the set assumptions. The analysis and research design were based on the Theory of Planned Behavior, with certain modifications to reach the goal better. The results obtained from statistical analysis showed that the most significant influence on the purchase intentions of ecological products online is attitude, subjective norms, and subjective control of compliance. Meanwhile, the strongest impact on consumers' attitudes is ecological labeling in online stores, and this relationship is statistically significant. These results prove that ecological labeling of products offered in e-commerce is very important in the process of purchasing these products. The results of this study should draw greater attention from retailers and decision-makers to the presentation and labeling of ecological products in e-commerce. Undoubtedly, this area will be very important in promoting sustainable consumer behavior, especially with the growth of online sales. [ABSTRACT FROM AUTHOR]

We report a 39-year-old male who presented with severe chest pain and diaphoresis who suffered from pulseless polymorphic ventricular tachycardia en route to the hospital. His initial electrocardiogram showed De Winter's Pattern (dWP). Coronary angiography revealed 100% thrombotic ostial occlusion of the left anterior descending artery. In young males presenting with chest pain and diaphoresis, dWP should be part of a clinician's differential diagnosis when analyzing the initial electrocardiogram. The medical community needs increased awareness to prevent delay of revascularization because dWP is an ST-segment elevation myocardial infarction (STEMI) equivalent and does not present like a typical STEMI on electrocardiogram. [ABSTRACT FROM AUTHOR]

We evaluated the impact of significant renal dysfunction (SRD) on listing and pediatric heart transplantation (PHT) outcomes. The United Network of Organ Sharing registry was queried. Our cohort included 11,625 children listed for PHT (2000-2020). At listing, 1494 (13%) had SRD, defined as an estimated glomerular filtration rate of <45 mL/min/1.73 m2 and/or dialysis requirement. Characteristics of children with and without SRD were compared. SRD impact on outcomes was examined. Factors associated with waiting list mortality, persistent SRD at PHT, and post-PHT survival with and without simultaneous heart-kidney transplantation were assessed. Compared with children with an estimated glomerular filtration rate >45 mL/min/1.73 m2, those with SRD had higher waiting list death (37% vs 14%, P <.01) and lower transplantation rate (51% vs 71%, P <.01). On multivariable analysis, SRD was associated with waiting list death (hazard ratio, 3.016; P <.0001). Among 767 children with SRD who received PHT, 361 (47%) had persistent SRD at the time of PHT. On multivariable analysis, factors associated with persistent SRD were older age (odds ratio [OR], 1.147 per year; 95% CI, 1.046-1.258 per year; P =.0035), bilirubin (OR, 1.127 per 1-mg/dL; 95% CI, 1.061-1.197 per 1-mg/dL; P <.0001), dialysis (OR, 1.839; 95% CI, 1.017-3.326; P =.0115), mechanical ventilation (OR, 1.972; 95% CI, 1.336-2.911; P =.0006), extracorporeal membrane oxygenation (OR, 1.747; 95% CI, 1.074-2.842; P =.0247), and not using a ventricular assist device (VAD) (OR, 0.498 [VAD use]; 95% CI, 0.277-0.895 VAD use; P =.0198). Post-PHT survival was 72%, 70%, and 56% (P <.01) at 8 years for PHT alone with improved renal function, simultaneous heart-kidney transplantation (n = 69), and PHT alone with persistent SRD, respectively. SRD is associated with high waiting list death and decreased transplantation rate. Timely proper pre-PHT support with VAD could enhance kidney recovery. Simultaneous heart-kidney transplantation neutralized persistent SRD effect on survival and might be considered in high-risk patients such as those on dialysis, mechanical ventilation, or extracorporeal membrane oxygenation support. [ABSTRACT FROM AUTHOR]

Asthma and obesity are both complex conditions characterized by chronic inflammation, and obesity-related severe asthma has been associated with differences in the microbiome. However, whether the airway microbiome and microbiota-immune response relationships differ between obese persons with or without nonsevere asthma is unestablished. We compared the airway microbiome and microbiota-immune mediator relationships between obese and nonobese subjects, with and without mild–moderate asthma. We performed cross-sectional analyses of the airway (induced sputum) microbiome and cytokine profiles from blood and sputum using 16S ribosomal RNA gene and internal transcribed spacer region sequencing to profile bacteria and fungi, and multiplex immunoassays. Analysis tools included QIIME 2, linear discriminant analysis effect size (aka LEfSe), Piphillin, and Sparse inverse covariance estimation for ecological association inference (aka SPIEC-EASI). Obesity, irrespective of asthma status, was associated with significant differences in sputum bacterial community structure and composition (unweighted UniFrac permutational analysis of variance, P =.02), including a higher relative abundance of Prevotella , Gemella, and Streptococcus species. Among subjects with asthma, additional differences in sputum bacterial composition and fungal richness were identified between obese and nonobese individuals. Correlation network analyses demonstrated differences between obese and nonobese asthma in relationships between cytokine mediators, and these together with specific airway bacteria involving blood PAI-1, sputum IL-1β, GM-CSF, IL-8, TNF-α, and several Prevotella species. Obesity itself is associated with an altered sputum microbiome, which further differs in those with mild–moderate asthma. The distinct differences in airway microbiota and immune marker relationships in obese asthma suggest potential involvement of airway microbes that may affect mechanisms or outcomes of obese asthma. [ABSTRACT FROM AUTHOR]

ABO-incompatible (ABOi) heart transplantation (HT) in infants has been used to reduce waiting list time and mortality with outcomes comparable to ABO compatible (ABOc). We sought to assess trends in ABOi listing and transplantation for infants within the United Network for Organ Sharing registry and to evaluate its influence on outcomes. We reviewed infants listed for HT in the United Network for Organ Sharing registry (2007-2018). We compared demographic and clinical characteristics, waiting list duration, graft survival, and 1-year freedom from rejection between patients listed for ABOi and ABOc. Cochran-Armitage trend test, univariate nonparametric statistical methods, and Kaplan-Meier curves were used to analyze the data. During the study period, 2787 patients were listed for HT, 53% of whom were listed for ABOi. Median waiting list time for patients in blood group O receiving an ABOi transplant was significantly shorter (P <.0001). Among the 1862 patients who received HT, 15% were ABOi. The incidence of ABOi HT also increased over time. The pretransplant anti-A and anti-B titers in the ABOi group did not significantly affect outcomes. There was no difference in the incidence of rejection in the first year after transplant and no significant difference in posttransplant survival The number of infants listed and transplanted as ABOi has gradually increased over the past decade, with a significantly decreased waiting list time for ABOi transplants in blood group O. At 1 year after transplant, rejection was comparable between the ABOi and ABOc groups and there was no significant difference in survival. [ABSTRACT FROM AUTHOR]

Historically, training in congenital heart surgery was variable and followed 1 of 3 pathways: residents identified during the primary training process were given the opportunity for a career training position within their own or other institution, residents would travel abroad for training and return to look for a faculty appointment based on their training experience, or a resident would enter a 1-year fellowship position after completing Thoracic Surgery training. These training opportunities and fellowships lacked uniformity and quality control. The purpose of an Accreditation Council of Graduate Medical Education (ACGME)-accredited residency program and an American Board of Thoracic Surgery subspecialty certificate in congenital heart surgery was to recognize and document a standard of education, operative experience, and cognitive knowledge for surgeons practicing in the field. There have been several important papers related to congenital cardiac training published over the years: (1) a manuscript by Kogon published in 2006 outlining congenital cardiac training prior to ACGME program accreditation, (2) a manuscript by Kogon et al published in 2016 outlining congenital cardiac training subsequent to ACGME accreditation with a focus on job transition and early work experience, and (3) a manuscript published in 2017 focusing primarily on job transition and early work experience. The purpose of this review is to provide an update with respect to congenital cardiac training. More importantly, in comparing survey results from these previous papers with the current survey, some interesting trends have been revealed, good and bad. [ABSTRACT FROM AUTHOR]

The combination of severe fetal mitral regurgitation diagnosed in utero, aortic stenosis, left ventricular dilatation, and dysfunction is associated with extremely poor prognosis. We report a neonate who underwent Norwood operation and left ventricular exclusion using partial left ventriculotomy and Alfieri mitral valve stitch. Left ventricular exclusion eliminated right ventricular compression and allowed survival and progression to subsequent second-stage palliation. [ABSTRACT FROM AUTHOR]

The aim of this work is to investigate the feasibility of the Jagiellonian Positron Emission Tomography (J-PET) scanner for intra-treatment proton beam range monitoring. The Monte Carlo simulation studies with GATE and PET image reconstruction with CASToR were performed in order to compare six J-PET scanner geometries. We simulated proton irradiation of a PMMA phantom with a Single Pencil Beam (SPB) and Spread-Out Bragg Peak (SOBP) of various ranges. The sensitivity and precision of each scanner were calculated, and considering the setup's cost-effectiveness, we indicated potentially optimal geometries for the J-PET scanner prototype dedicated to the proton beam range assessment. The investigations indicate that the double-layer cylindrical and triple-layer double-head configurations are the most promising for clinical application. We found that the scanner sensitivity is of the order of 10−5 coincidences per primary proton, while the precision of the range assessment for both SPB and SOBP irradiation plans was found below 1 mm. Among the scanners with the same number of detector modules, the best results are found for the triple-layer dual-head geometry. The results indicate that the double-layer cylindrical and triple-layer double-head configurations are the most promising for the clinical application, We performed simulation studies demonstrating that the feasibility of the J-PET detector for PET-based proton beam therapy range monitoring is possible with reasonable sensitivity and precision enabling its pre-clinical tests in the clinical proton therapy environment. Considering the sensitivity, precision and cost-effectiveness, the double-layer cylindrical and triple-layer dual-head J-PET geometry configurations seem promising for future clinical application. • Simulation studies of the plastic scintillator-based PET detector were performed. • The cylindrical and dual-head J-PET systems are feasible for proton range monitoring. • The J-PET sensitivity is of the order of 10−5 coincidences per primary proton. • The precision of range assessment for irradiation fields is below 1 mm. [ABSTRACT FROM AUTHOR]

Abstract Purpose The purpose of this study was to determine if a structured supervised outpatient exercise program specifically for cancer patients would be associated with improvements in insomnia and depression after attending for 10-weeks. Design Descriptive observational study. Sample and setting 75 adult subjects attended an outpatient hospital based exercise program specifically for cancer patients and coordinated by an exercise physiologist and a physical therapist. Method Two validated instruments were administered to measure insomnia (Athens Insomnia Instrument) and depression (Zung Self-Rating Depression Scale) at baseline (prior to the start of the program) and repeated after 10-weeks of exercise. Results Forty (53.3%) completed the full 10 week program. Of the 40 that completed the program, an improvement in insomnia scores was seen (p-value<0.01) as well as depression scores (p-value = 0.01). Baseline insomnia scores were not different between subjects that did not complete the program compared to those who did (p-value = 0.4401). However, baseline depression scores were higher in subjects who did not complete the program compared to subjects who did (p-value = 0.0462). Conclusions Exercise improved depression and insomnia in cancer patients. By improving these symptoms, mortality, morbidity, and costs may be improved in the oncology population. Exercise programs can provide not only the health benefits of exercise, but also give cancer populations support from their peers which may improve their overall quality of life. Highlights • A structured exercise program is associated with improved insomnia scores in oncology patients. • A structured exercise program is associated with improved depression scores in oncology patients. • Baseline depression scores can affect attrition rates in oncology patients who start a structured exercise program. [ABSTRACT FROM AUTHOR]

In this paper, we analyze single machine scheduling problems under the following minimization objectives: the maximum completion time (makespan), the total completion time and the maximum lateness, including fundamental practical aspects, which often occur in industrial or manufacturing reality: release dates, due dates, setup times, precedence constraints, deterioration (aging) of machines, as well as maintenance activities. To solve the problems, we propose an efficient representation of a solution and a fast neighborhood search technique, which calculates an approximation of criterion values in a constant time per solution in a neighborhood. On this basis, a novel approximate/exact search technique, using exact as well as approximate criterion values during search process, is introduced and used to develop efficient metaheuristic algorithms dedicated to the considered problems. Their efficiency is verified during computational experiments. [ABSTRACT FROM AUTHOR]

Background: Most patients presenting with suspected acute coronary syndrome (ACS) are admitted to telemetry units. While telemetry is an appropriate level of care, acute complications requiring a higher level of care in the intensive care unit (ICU) occur.Purpose: Among patients admitted to telemetry for suspected ACS, we determine the frequency of unplanned ICU transfer, and examine whether ECG changes indicative of myocardial ischemia, and/or symptoms preceded unplanned transfer.Method: This was a secondary analysis from a study assessing occurrence rates for transient myocardial ischemia (TMI) using a 12-lead Holter. Clinicians were blinded to Holter data as it was used in the context research; off-line analysis was performed post discharge. Hospital telemetry monitoring was maintained as per hospital protocol. TMI was defined as >1mm ST-segment ↑ or ↓, in >1 ECG lead, >1minute. Symptoms were assessed by chart review.Results: In 409 patients (64±13years), most were men (60%), Caucasian (93%), and had a history of coronary artery disease (47%). Unplanned transfer to the ICU occurred in 9 (2.2%), was equivalent by gender, and age (no transfer 64±13years vs transfer 67±11years). Four patients were transferred following unsuccessful percutaneous coronary intervention (PCI) attempt, four due to recurrent angina, and one due to renal and hepatic failure. Mean time from admission to transfer was 13±6hours, mean time to ECG detected ischemia was 6±5hours, and 8.8±5hours for symptoms prompting transfer. In two patients ECG detected ischemia and acute symptoms prompting transfer were simultaneous. In five patients, ECG detected ischemia was clinically silent. All patients eventually had symptoms that prompted transfer to the ICU. In all nine patients, there was no documentation or nursing notes regarding bedside ECG monitor changes prior to unplanned transfer. Hospital length of stay was longer in the unplanned transfer group (2days ± 2 versus 6days ± 4; p=0.018).Conclusions: In patients with suspected ACS, while unplanned transfer from telemetry to ICU is uncommon, it is associated with prolonged hospitalization. Two primary scenarios were identified; (1) following unsuccessful PCI, and (2) recurrent angina. Symptoms prompting unplanned transfer occurred, but happened on average 8.8 hours after hospital admission; whereas ECG detected ischemia preceding unplanned transfer occurred on average 6 hours after hospital admission. [ABSTRACT FROM AUTHOR]

Background: Energy drink consumption has increased significantly over the past decade and is associated with greater than 20,000 emergency department visits per year. Most often these visits are due to cardiovascular complaints ranging from palpitations to cardiac arrest.Objective: To determine if energy drinks alter; blood pressure, electrolytes, activated bleeding time (ACT), and/or cardiac responses measured with a 12-lead electrocardiographic (ECG) Holter.Methods: Continuous ECG data was collected for five hours (30 minutes baseline and 4 hours post consumption [PC]). Subjects consumed 32 ounces of energy drink within one hour and data (vital signs and blood samples) was collected throughout the study period. Paired students t-test and a corresponding non-parametric test (Wilcoxon signed rank) were used for analysis of the data.Results: Fourteen healthy young subjects were recruited (mean age 28.6 years). Systolic blood pressure (baseline=132, ±7.83; PC=151, ±11.21; P=.001); QTc interval (baseline=423, ±22.74; PC=503, ±24.56; P<.001); magnesium level (baseline 2.04, ± 0.09; PC=2.13, ±0.15; P=.05); and calcium level (baseline=9.31, ±.28; PC=9.52, ±.22; P=.018) significantly increased from baseline. While potassium and ACT fluctuated (some subjects increased their levels while others decreased) these changes were not significant. Eight of the fourteen subjects (57%) developed a QTc >500 milliseconds PC. Other T-wave changes were noted in 9/14 (64.3%) subjects PC.Conclusions: Energy drinks increased systolic blood pressure, altered electrolytes, and resulted in repolarization abnormalities. These physiological responses can lead to arrhythmias and other abnormal cardiac responses highlighting the importance that emergency room personnel assess for energy drink consumption and potential toxicity. [ABSTRACT FROM AUTHOR]

Public contracting authority may award contracts only to contractors who meet certain qualification criteria for participation in tenders. Such requirements can vary between countries; this paper therefore introduces basic legislation governing this process both in the Czech Republic and Poland. The verification of compliance of these requirements should be made individually for each public procurement procedure which is associated with the need to submit corresponding documents. The aim of the article is to analyse and compare current practice in using qualification criteria for public works contracts in both countries. Information about qualification criteria have been studied on the sample of 345 tenders for public works contracts, in particular for road structures, schools and water and sewage facilities and equipment. Analytical part focuses on the extent of qualification criteria use and discusses their application in the context of ensuring fairness of the competition with regard to non-discriminatory nature of the qualification. Research findings reveal significant disparity between the Czech Republic and Poland in the area of 1) professional and 2) economic and financial qualifications. It has been concluded that the reintroduction of economic and financial qualification criteria in the Czech Republic is justified if used appropriately and according to methodological guidelines. In Poland, the risk of inappropriate use of criteria lies especially in excessive requirements in relation to the volume and nature of contract. Contracting entity is not obliged to describe and demand all the requirements, it is crucial to require just the fulfilment of those criteria which are necessary to assess the ability of contractors to perform the contract. The criteria of an environmental nature are hardly used. [ABSTRACT FROM AUTHOR]

The paper deals with extremal problems concerning colorings of hypergraphs. By using a random recoloring algorithm we show that any n -uniform simple hypergraph H with maximum edge degree at most Δ ( H ) ≤ c ⋅ n r n − 1 , is r -colorable, where c > 0 is an absolute constant. As an application of our proof technique we establish a new lower bound for the Van der Waerden number W ( n , r ) . [ABSTRACT FROM AUTHOR]

The system of construction design completion most frequently used in Poland is the traditional one. In this system, the client describes the subject of the order by means of design documentation and technical specifications of construction and commissioning of building works. The article analyses the most frequent errors that appear in design documentation, discusses the reasons for their occurrence and specifies their possible consequences. [ABSTRACT FROM AUTHOR]

The system of construction design completion most frequently used in Poland is the traditional one. In this system, the client describes the subject of the order by means of design documentation and technical specifications of construction and commissioning of building works. The article analyses the most frequent errors that appear in design documentation, discusses the reasons for their occurrence and specifies their possible consequences. [ABSTRACT FROM AUTHOR]

Abstract: The research results of struvite reaction crystallization process from the phosphorus mineral fertilizers industry wastewater, carried out in DTM type continuous crystallizers with internal circulation of suspension driven by jet pump device fed with mother solution, are presented. The wastewater of pH < 4, contained 0.445 mass % of phosphate(V) ions and typical impurities: aluminium, calcium, copper, iron, potassium, magnesium, titanium, zinc, fluosilicate, fluoride and sulphate(VI) ions. Tests ran in three continuous jet pump DTM crystallizers of increasing working volumes: 1.2, 15 and 36 dm3, in temperature 298 K, assuming both stoichiometric conditions and 20% excess of magnesium ions in relation to phosphate(V) and ammonium ion contents. Influence of technological control parameters (pH, τ) on product crystal size distributions (CSDs) and crystals/mother liquor chemical composition were identified. Crystals of low size-homogeneity (coefficient of variation CV ca. 90%) which mean size varied from ca. 9 to ca. 33 μm were identified. Struvite crystals of the largest sizes were produced in a DTM crystallizer of working volume 36 dm3 at 20% excess of magnesium ions, at pH 9 and for elongated mean residence time 7200 s. Excess of magnesium ions in a process system influenced the struvite reaction crystallization process yield definitely advantageously. Concentration of phosphate(V) ions decreased from 0.445 mass % in a feed to 1.8 10–3 mass % in a postprocessed mother solution, what can be regarded as a very good result of their removal process. In product crystals, besides main component – struvite, also all impurities originally present in wastewater appeared in a form of hydroxides, phosphates and other salts. Aluminium, copper, iron and zinc ions were the subject of practically total co- precipitation with struvite. [Copyright &y& Elsevier]

Abstract: Experimental work concerning continuous reaction crystallization of struvite MgNH4PO4.6H2O from diluted aqueous solutions of phosphates(V) (1.0 mass % of PO4) is presented. Laboratory tests were carried out in a DT MSMPR type crystallizer in 298K assuming stoichiometric ratio of the reagents. Influence of pH (8.5 – 10) and mean residence time of suspension in a crystallizer (900 – 3600 s) on product crystal size distribution, their size homogeneity and process kinetics was identified. Struvite crystals of mean size from ca. 23 to ca. 86 m, of diverse homogeneity (CV 62 – 90%) were produced. The largest crystal sizes of acceptable homogeneity corresponded to pH 8.5 and mean residence time elongated up to 3600 s. Under these conditions struvite nucleation rate did not exceed 2.9 107 1/(s m3) according to SIG MSMPR kinetic model. Linear growth rate of struvite crystals within the parameter ranges tested varied from 4.33 10–9 to 1.75 10–8 m/s. [Copyright &y& Elsevier]

Abstract: Diagrammatic Monte Carlo (DiagMC) is a numeric technique that allows one to calculate quantities specified in terms of diagrammatic expansions, the latter being a standard tool of many-body quantum statistics. The sign problem that is typically fatal to Monte Carlo approaches, appears to be manageable with DiagMC. Starting with a general introduction to the principles of DiagMC, we present a detailed description of the DiagMC scheme for interacting fermions (Hubbard model), as well as the first illustrative results for the equations of state. [ABSTRACT FROM AUTHOR]

BACKGROUND: Many classes of medications initiated by clinicians can cause adverse events, such as cardiac disturbances. One such adverse outcome is that of acquired long QT syndrome, which can lead to arrhythmias and sudden death. When health care practitioners were surveyed about their knowledge of this condition, 20% indicated they knew very little about long QT syndromes and more than 30% failed to check on current therapy before prescribing QT-prolonging medications. METHODS: A case will be presented to illustrate the importance of understanding this syndrome. RESULTS: The causes and pathophysiology of acquired long QT syndrome are discussed, and the resources for clinicians to obtain more information and growing number of offending medications leading to acquired long QT syndrome are provided. CONCLUSIONS: On-going education is needed to heighten awareness in the health care community to prevent the deleterious outcomes associated with medication induced acquired long QT syndrome. [ABSTRACT FROM AUTHOR]

Background: Many classes of medications initiated by clinicians can cause adverse events, such as cardiac disturbances. One such adverse outcome is that of acquired long QT syndrome, which can lead to arrhythmias and sudden death. When health care practitioners were surveyed about their knowledge of this condition, 20% indicated they knew very little about long QT syndromes and more than 30% failed to check on current therapy before prescribing QT-prolonging medications. Methods: A case will be presented to illustrate the importance of understanding this syndrome. Results: The causes and pathophysiology of acquired long QT syndrome are discussed, and the resources for clinicians to obtain more information and growing number of offending medications leading to acquired long QT syndrome are provided. Conclusions: On-going education is needed to heighten awareness in the health care community to prevent the deleterious outcomes associated with medication induced acquired long QT syndrome. [Copyright &y& Elsevier]

Positron Annihilation Lifetime Spectroscopy (PALS) allows examining structure of materials at nano and sub-nanometer level. This technique is based on the lifetime and production intensity of ortho-positronium atoms in free volumes of given structures. It is mostly used for studies of organic materials. However there exist also few results, e.g. by groups of Y. C. Jean and R. Pietrzak, showing that morphology of cells is correlated with the PALS parameters. Jagiellonian Positron Emission Tomograph (J-PET) is a multi-purpose detector which will be used for investigations with positronium atoms in life-sciences as well as for medical diagnostics. Such prototype based on plastic scintillators and fully compatible with MRI is currently being developed at the Jagiellonian University in Krakow, Poland. In this talk results of the first experiments conducted by the J-PET collaboration will be presented. We performed PALS studies of well known structures such as silica and of some model micro-organisms, e.g. Saccharomyces cerevisiae both with dry and aqueous samples allowing to determine the correlation between hygroscopicity of the cell and PALS parameters. As a result, we proved that PALS can be successfully used for studies of living organisms their dynamics and its relation to the cells morphology. This result opens perspective for simultaneous determination of early and advanced stages of carcinogenesis by observing changes in biomechanical parameters between normal and tumour cells and standard PET examination. J-PET detection system combined with PALS technique will be more accurate and affordable for cancer diagnostics. Authors disclose any relationship that may bias the presentation. [ABSTRACT FROM AUTHOR]

Jagiellonian Postitron Emission Tomography (J-PET) scanner based on plastic scintillators has been developed at the Jagiellonian University. This innovative solution enables cost effective construction of PET detector with large field of view. At present we are working on the solution which would allow for the simultaneous PET and Magnetic Resonance Imaging (MRI). For that purpose we will use silicon photomultiplier (SiPM) readout which can be applied in the strong magnetic field of the MRI scanner. In this talk we will present results of the development of a novel scintillator material (referred to as the J-PET scintillator). The purpose of the development was the elaboration of scintillator with optical properties allowing for more efficient registration of photons with SiPM array with respect to the presently available plastics scintillators and at the same time with the superior timing characteristics. The novelty of the elaborated concept lies in usage of 2-(4-styrylphenylbenzoxazole) as a scintillation additive – wavelength shifter. The substance has been used for the first time as a scintillator dopant. J-PET scintillators were manufactured via bulk polymerization of styrene or vinyltoluene and the optimal concentration of the 2-(4-styrylphenylbenzoxazole) was set by maximizing the light output and timing properties. In the talk properties of J-PET scintillators will be presented and discussed in view of its application for the PET/MR imaging, and the performance of the developed material will be compared to the properties of commercially available scintillators. Authors disclose any relationship that may bias the presentation [ABSTRACT FROM AUTHOR]

In order to enhance diagnostic capabilities Positron Emission Tomography (PET) and Magnetic Resonance Imaging (MRI) devices are combined into a single hybrid device providing an access to both metabolic and morphological information during a single examination. Typically the PET detectors are placed inside the diagnostic volume of the MRI scanner, however being outside the commonly used local transmit-receiver (transceiver) coils such as head or chest coils. Coils are made of plastic parts and metal conductors on which annihilation gamma quanta may scatter before reaching the PET detectors scintillating material. This fact could cause the worsening of PET images spatial resolution and the field-of-view for the PET detectors. We propose a solution based on a novel PET tomograph concept comprising multiple detection modules, built from polymer scintillation strip ended with silicon photodetectors, arranged circumferentially inside the working volume of the MRI local transceiver coil. The adaptive of the polymer scintillators in both shape and size properties allows for a use of a standard MRI coils constructions to be combined with PET detection system without influence on the coil shape, geometry and material properties optimized so far. Current work is focused on a dedicated detection electronics development based on silicon photodetectors arrays and digital signal processing unit that will operate in high static magnetic field as well as radiofrequency waves environment of MRI scanner. The novel approach to the hybrid local coil construction would allow for using any existing MRI system extending its functionality by the PET imaging feature. Authors disclose any relationship that may bias the presentation. [ABSTRACT FROM AUTHOR]

Access to the anatomical and functional information about the body interior is possible with tomography techniques relying on the registration of radiation from the tissues. Modern medicine offers: Positron Emission Tomography, Magnetic Resonance and Computer Tomography. One of the present technological challenges is to combine the PET and MR scanners to work as single device to provide PET/MR images. Presented solution of a portable-PET scanner will allow simultaneous registration of PET and MR images utilizing existing MR scanners. The developed device is based on the strip-PET concept consisting of detection modules, each build from a plastic scintillator strip connected at both ends with silicon photomultipliers array. In the proposed solution determination of the point of annihilation along the direction of the gamma quanta flight path, is based on the time difference registered in various detection modules. It is important to stress that the utilized silicon photomultipliers are insensitive to the MR magnetic field. In order to position two tomographic images with respect to each other we will use watermarks, seen by MRI system. Since this method explicitly specify the position of the MRI with respect to PET scanner therefore it enables for synchronize both tomographic images. The advantage of this solution is to eliminate the possibility of artifacts in tomographic images hindering the identification of potentially cancerous lesions. In the talk we will present developed solution of a mobile-PET insert to MR scanners. The presentation will include the characteristics of a proposed device together with the advantages over present solutions. [ABSTRACT FROM AUTHOR]

Background & Aims: Fractionated plasma separation and adsorption (FPSA) is an extracorporeal procedure that supports liver function by removing endogenous toxins that cause complications from acute-on-chronic liver failure (AOCLF). We performed a randomized trial to investigate survival of patients with AOCLF treated with FPSA. Methods: Patients with AOCLF were randomly assigned to groups given a combination of FPSA and standard medical therapy (SMT) (FPSA group, n = 77) or only SMT (SMT group, n = 68). The Prometheus liver support system was used to provide 8 to 11 rounds of FPSA (minimum of 4 hours each) for 3 weeks. Primary end points were survival probabilities at days 28 and 90, irrespective of liver transplantation. Results: Baseline clinical parameters and number of transplant patients were similar between study arms. Serum bilirubin level decreased significantly in the FPSA group but not in the SMT group. In an intention-to-treat analysis, the probabilities of survival on day 28 were 66% in the FPSA group and 63% in the SMT group (P = .70); on day 90, they were 47% and 38%, respectively (P = .35). Baseline factors independently associated with poor prognosis were high SOFA score, bleeding, female sex, spontaneous bacterial peritonitis, intermediate increases in serum creatinine concentration, and combination of alcoholic and viral etiology of liver disease. There were no differences between the 2 groups in the incidence of side effects. Conclusions: Among all patients with AOCLF, extracorporeal liver support with FPSA does not increase the probability of survival. Further studies are needed to assess whether therapy might be beneficial in specific subsets of patients. [Copyright &y& Elsevier]

Cardiopulmonary bypass is known to trigger a global inflammatory response. Age-dependent differences in the inflammatory response, the increased susceptibility to injury of immature organ systems, and the larger extracorporeal circuit to patient size ratio results in greater susceptibility of younger and smaller patients to the damaging effects of cardiopulmonary bypass. In this review the components of the inflammatory response to cardiopulmonary bypass are reviewed with special reference to the pediatric age group, including the age-specific impact on organ systems. In addition the current and evolving strategies to prevent, limit, and treat the inflammatory response to cardiopulmonary bypass in children are examined. [Copyright &y& Elsevier]