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1. Actively Controlled Components

Author

Horn, W, Hiller, S.-J, Pfoertner, H, Schadow, K, Rosenfeld, T, and Garg, S

Subjects
Aircraft Propulsion And Power
Abstract

Active Control can help to meet future engine requirements by an active improvement of the component characteristics. The concept is based on an intelligent control logic, which senses actual operating conditions and reacts with adequate actuator action. This approach can directly improve engine characteristics as performance, operability, durability and emissions on the one hand. On the other hand active control addresses the design constrains imposed by unsteady phenomena like inlet distortion, compressor surge, combustion instability, flow separations, vibration and noise, which only occur during exceptional operating conditions. The feasibility and effectiveness of active control technologies have been demonstrated in lab-scale tests. This chapter describes a broad range of promising applications for each engine component. Significant efforts in research and development remain to implement these technologies in engine rig and finally production engines and to demonstrate today s engine generation airworthiness, safety, reliability, and durability requirements. Active control applications are in particular limited by the gap between available and advanced sensors and actuators, which allow an operation in the harsh environment in an aero engine. The operating and performance requirements for actuators and sensors are outlined for each of the gas turbine sections from inlet to nozzle.

Published
2009

7. A virtual aged care system: When health informatics and spatial science intersect

Author

Hamish Robertson, Nicholas N, Rosenfeld T, Georgiou A, Johnson J, and Travaglia J

Subjects
User-Computer Interface, Health Information Systems, Spatio-Temporal Analysis, Information Dissemination, Health Services for the Aged, Geographic Information Systems, Medical Informatics, Needs Assessment
Abstract

© 2014 The authors and IOS Press. Healthcare systems are increasingly adapting to address the issues associated with population ageing. The shift to chronic diseases and a rise in neuroepidemiological conditions, associated with rising life expectancies, means that continued change and accommodation will be required of our health and social support systems. Current social policy environments developed out of early approaches to state-supported health and welfare service provision, most now a century or more old. A feature of these systems has often been a formal separation between them, into silos, that does not and cannot effectively address the issues raised by a growing population of older people. This is especially true in the context of community-based care where the majority of older people currently live and where governments hope to keep more elderly people living into the future. This objective will require a far more sophisticated and responsive approach to the health information environment than is currently the case. One strategy for improving this scenario is the development of augmented and virtual environments that collect and analyse real-time data on which health professionals and support staff can act in a timely manner. In this paper we explore some aspects of a virtualised aged care system and provide some examples of how this would enhance our current strategies for aged care.

Published
2014

10. Materiality, health informatics and the limits of knowledge production

Author

Robertson, H, Nicholas, N, Rosenfeld, T, Travaglia, JF, Robertson, H, Nicholas, N, Rosenfeld, T, and Travaglia, JF

Abstract

© IFIP International Federation for Information Processing 2014 Contemporary societies increasingly rely on complex and sophisticated information systems for a wide variety of tasks and, ultimately, knowledge about the world in which we live. Those systems are central to the kinds of problems our systems and sub-systems face such as health and medical diagnosis, treatment and care. While health information systems represent a continuously expanding field of knowledge production, we suggest that they carry forward significant limitations, particularly in their claims to represent human beings as living creatures and in their capacity to critically reflect on the social, cultural and political origins of many forms of data ‘representation’. In this paper we take these ideas and explore them in relation to the way we see healthcare information systems currently functioning. We offer some examples from our own experience in healthcare settings to illustrate how unexamined ideas about individuals, groups and social categories of people continue to influence health information systems and practices as well as their resulting knowledge production. We suggest some ideas for better understanding how and why this still happens and look to a future where the reflexivity of healthcare administration, the healthcare professions and the information sciences might better engage with these issues. There is no denying the role of health informatics in contemporary healthcare systems but their capacity to represent people in those datascapes has a long way to go if the categories they use to describe and analyse human beings are to produce meaningful knowledge about the social world and not simply to replicate past ideologies of those same categories.

Published
2014

11. A virtual aged care system: When health informatics and spatial science intersect

Author

Robertson, H, Nicholas, N, Rosenfeld, T, Georgiou, A, Johnson, J, Travaglia, J, Robertson, H, Nicholas, N, Rosenfeld, T, Georgiou, A, Johnson, J, and Travaglia, J

Abstract

© 2014 The authors and IOS Press. Healthcare systems are increasingly adapting to address the issues associated with population ageing. The shift to chronic diseases and a rise in neuroepidemiological conditions, associated with rising life expectancies, means that continued change and accommodation will be required of our health and social support systems. Current social policy environments developed out of early approaches to state-supported health and welfare service provision, most now a century or more old. A feature of these systems has often been a formal separation between them, into silos, that does not and cannot effectively address the issues raised by a growing population of older people. This is especially true in the context of community-based care where the majority of older people currently live and where governments hope to keep more elderly people living into the future. This objective will require a far more sophisticated and responsive approach to the health information environment than is currently the case. One strategy for improving this scenario is the development of augmented and virtual environments that collect and analyse real-time data on which health professionals and support staff can act in a timely manner. In this paper we explore some aspects of a virtualised aged care system and provide some examples of how this would enhance our current strategies for aged care.

Published
2014

18. The subvalvular apparatus in rheumatic mitral stenosis: methods of assessment and therapeutic implications.

Author

Turgeman Y, Atar S, Rosenfeld T, Turgeman, Yoav, Atar, Shaul, and Rosenfeld, Tiberio

Abstract

The assessment of the structure and function of the subvalvular apparatus (SVA) in patients with rheumatic mitral stenosis (MS) is complex, yet is of major importance prior to therapeutic decision making. Currently available methods of assessment are neither sufficiently accurate nor feasible. We review anatomic and functional aspects of the SVA and define SVA involvement in rheumatic MS. The role of various noninvasive and invasive methods for evaluating the integrity and function of SVA in rheumatic MS, as well as clinical implications and pitfalls in assessment of SVA are also discussed. [ABSTRACT FROM AUTHOR]

Published
2003
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19. Stents in Total Occlusion for restenosis Prevention. The multicentre randomized STOP study.

Author

Lotan, C, Rozenman, Y, Hendler, A, Turgeman, Y, Ayzenberg, O, Beyar, R, Krakover, R, Rosenfeld, T, and Gotsman, M.S

Abstract

Aims This multicentre randomized study set out to evaluate whether coronary stenting improves the results of successful balloon angioplasty for chronic total occlusion. Balloon angioplasty for chronic total occlusion has a high restenosis rate. Several reports have suggested that coronary stenting may decrease the likelihood of restenosis and reocclusion.Methods and Results Patients with total coronary artery occlusions who had an optimal PTCA result were randomized either to no further treatment or additional stent implantation. The AVE microstent was used and all patients were scheduled for a 1-, 3-, and 6-month clinical follow-up. Repeat coronary angiography to assess the rate and pattern of restenosis was performed at 6 months or earlier if clinically indicated. Ninety-six patients were enrolled in this study. The mean age was 59·3±10·3 years and 15 were females. Forty-eight patients were randomized to the stent arm, receiving 52 stents (lengths 18–39mm). Stent implantation was successful in all and there were no major procedure-related complications. Sixty-nine patients (72%) were restudied after 6 months. The binary restenosis rates (50%), in the PTCA arm were 70·9% with a minimal lumen diameter of 1·01±0·79mm compared to 42·1% in the stent arm with a minimal lumen diameter of 1·63±1·02mm (P=0·034). Reocclusion occurred in 7·9% in the stent group compared to 16·1% in the PTCA group. Restenosis in the PTCA group was focal in 88% of patients and occurred at the point of total obstruction (within 5mm), compared to diffuse instent restenosis, which occurred in 54% of the patients in the stent group.Conclusion Coronary stenting can significantly decrease the rate of restenosis and reocclusion of total occlusions. As restenosis in the stent group was more diffuse, care should be taken to implant short stents at the site of occlusion. [ABSTRACT FROM PUBLISHER]

Published
2000
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23. Serum Antioxidant Capacity and the Risk of Contrast Medium Nephropathy

Author

Elias, M., Swae’ed, S., Shneor, A., Turgman, Y., Saliba, W., Goldstein, L.H., and Rosenfeld, T.

Abstract

AbstractIntroduction: The use of contrast medium can result in an acute reduction in renal function. The exact mechanism of this side effect is not yet fully understood. There is accumulating evidence that reactive oxygen species have a role in renal damage. Prophylactic administration of antioxidant drugs could prevent this reduction in renal function. We examined whether there is a correlation between the antioxidant capacity of the serum and the risk of contrast medium nephropathy. Methods: We studied prospectively 193 patients with normal renal function who underwent cardiac catheterization. Serum haptoglobin, uric acid, albumin and the total antioxidant capacity were measured before the injection of contrast media. Serum urea and creatinine concentrations were measured before angiography and on days 3 and 7 following the procedure. Results: Eleven patients developed mild renal failure. We compared the serum levels of antioxidant compounds of this group with the serum levels of these compounds in patients who did not develop renal damage. No statistical significant difference in the baseline levels of antioxidant species was found between the two groups. Conclusions: These prospective data indicate that among low-risk patients with normal renal function, baseline levels of antioxidant material did not predict the possible development of contrast medium nephropathy.Copyright © 2005 S. Karger AG, Basel

Published
2005

26. The clopidogrel in unstable angina to prevent Recurrent Events (CURE) trial programme - Rationale, design and baseline characteristics including a meta-analysis of the effects of thienopyridines in vascular disease

Author

Yusuf, S., Mehta, S., Anand, S., Avezum, A., Awan, N., Bertrand, M., Blumenthal, M., Bouthier, J., Budaj, A., Ceremuzynski, L., Chrolavicius, S., Col, J., Commerford, P., Diaz, R., Flather, M., Fox, K., Franzosi, Mg, Gaudin, C., Gersh, B., Grossman, W., Halon, D., Hess, T., Hunt, D., Joyner, C., Karatzas, N., Keltai, M., Khurmi, N., Kopecky, S., Lewis, B., Maggioni, A., Malmberg, K., Moccetti, T., Morais, J., Paolasso, E., Peters, R., Piegas, L., Pipilis, A., Ramos-Corrales, Ma, Rupprecht, Hj, Ryden, L., Sitkei, E., Sotty, M., Tognoni, G., Valentin, V., Varigos, J., Widimsky, P., Wittlinger, T., Pogue, J., Copland, I., Cracknell, B., Demers, C., Eikelboom, J., Hall, K., Keys, J., Mcqueen, M., Montague, P., Morris, B., Ounpuu, S., Wright, C., Yacyshyn, V., Zhao, F., Lewis, Bs, Commerford, Pj, Wyse, G., Cairns, J., Hart, R., Hirsh, J., Gent, M., Ryan, T., Wittes, J., Auger, P., Basart, Dcg, Chan, Y., Raedt, H., Den Hartoog, M., Galli, M., Garcia-Guerrero, Jj, Marquis, Jf, Mauri, F., Mayosi, B., Natarajan, M., Nieminen, M., Norris, J., Panju, A., Peters, Rj, Renkin, J., Rihal, C., Szymanski, P., Wasek, W., Allende, G., Bono, Jo, Caccavo, A., Fernandez, Aa, Fuselli, Jj, Gambarte, Aj, Guerrero, Raa, Hasbani, Eg, Liprandi, As, Marzetti, E., Mon, G., Nordaby, R., Nul, D., Quijano, G., Salvati, A., San Martin, E., Sokn, F., Torre, H., Trivi, M., Tuero, E., Amerena, J., Bailey, N., Bett, Jhn, Buncle, A., Careless, D., Desilva, S., Ewart, A., Fitzpatrick, D., Garrahy, P., Gunawardane, K., Hamer, A., Hill, A., Jackson, B., Lane, G., Nelson, G., Owensby, D., Rees, D., Rosen, D., Sampson, J., Singh, B., Taylor, R., Thomson, A., Walsh, W., Watson, B., Glogar, H., Steinbach, K., Geutjens, L., Ledune, J., Lescot, C., Popeye, R., Vermeulen, J., Abrantes, Ja, Baruzzi, Ac, Bassan, R., Bodanese, Lc, Carvalho, Ac, Mario Coutinho, Albuquerque, Dc, Dutra, O., Esteves, Jp, Leaes, Pe, Marino, Rl, Neto, Jam, Nicolau, Jc, Rabelo, A., Timerman, A., Xavier, Ss, Bata, I., Bhargava, Rk, Bogaty, P., Bolduc, P., Boyne, T., Chan, Yk, D Astous, M., Davies, T., Dhingra, S., Desjardins, L., Douglas, Jg, Fortin, C., Fung, A., Gangbar, E., Gebhardt, V., Gervais, Pb, Giannoccaro, Jp, Gossard, D., Gosselin, G., Grandmont, D., Grover, A., Gupta, M., Hiscock, Jg, Hynd, Jwh, Hussain, M., Iless, A., Kitching, A., Kostuk, W., Kouz, S., Kwok, K., Lee, H., Lefkowitz, C., Lenis, J., Lubelsky, B., Ma, P., May, B., Mercier, M., Montigny, M., Morris, A., Nawaz, S., Pallie, S., Parekh, P., Pesant, Y., Pilon, C., Pistawka, K., Rajakumar, Arj, Rebane, T., Ricci, J., Ruel, M., Schuld, R., Starra, R., Sussex, B., Talbot, P., Theroux, P., Venkatesh, G., Weeks, As, Winkler, Lh, Wisenberg, G., Woo, K., Yu, E., Zadra, R., Bocek, P., Branny, M., Cepelak, V., Drapalik, V., Gregor, P., Groch, L., Jansky, P., Kalslerova, M., Starek, A., Svitil, P., Vaclavicek, A., Husted, S., Rasmussen, Lh, Nielsen, Hk, Hamalainen, T., Majamas-Voltti, K., Mustonen, J., Peuhkurinen, K., Raasakka, T., Ylitalo, A., Adam, Mc, Agraou, B., Amat, G., Bessede, G., Boulenc, Jm, Boureux, C., Dambrine, P., Decoulx, E., Delarche, N., Desjoyaux, E., D Hautefeuille, B., Dubois-Rande, Jl, Fadel, N., Fouche, R., Fournier, P., Haftel, Y., Kahn, Jc, Ketelers, Jy, Lallemant, R., Lang, M., Lelguen, C., Leroy, F., Montalescot, G., Poulard, Je, Richard, M., Wittenberg, O., Beythien, Rd, Dippold, Wg, Harenberg, J., Hasslacher, C., Hauptmann, Ke, Hempel, G., Horacek, T., Kaulhausen, A., Kohler, B., Kurz, C., Lengfelder, W., Liebau, G., Loos, U., Neuss, H., Ochs, Hr, Pollock, B., Post, G., Reismann, K., Sauer, M., Schmidt, A., Schmitt, H., Schuster, P., Trenkwalder, P., Uebis, R., Leitner, Er, Vossbeck, G., Christakos, S., Karidis, K., Kelesidis, K., Papadopoulos, K., Tirologos, A., Tsaknakis, T., Gesztesi, T., Herczeg, B., Janosi, A., Kalo, E., Karpati, P., Mesko, E., Mezofi, M., Poor, F., Regos, L., Rudas, L., Soltesz, P., Szaboki, F., Timar, S., Valyi, P., Zamolyi, K., Daly, Km, Meany, Bt, Sugrue, D., Caspi, A., David, D., Marmor, A., Nazzal, D., Omary, M., Reisin, L., Rosenfeld, T., Shasha, S., Vered, Z., Zimlichman, R., Bellet, C., Bernardi, D., Branzi, A., Ceci, V., Celegon, L., Cernigliaro, C., Corsini, G., Croce, A., Caterina, R., Servi, S., Di Biase, G., Di Chiara, A., Di Pasquale, G., Filorizzo, G., Fiorentini, C., Ignone, G., Lombardi, F., Mafrici, A., Margonato, A., Maurea, N., Meneghetti, P., Meniconi, L., Mennuni, M., Mininni, N., Murrone, A., Notaristefan, A., Pettinati, G., Pinelli, G., Rossi, R., Sanna, A., Scabbia, E., Terrosu, P., Trinchero, R., Ruiz, Ra, Diaz, Ac, Santamaria, Ih, Pons, Jll, Diaz, Cjs, Castro, Jat, Morales, Ev, Bronzwaer, Pna, Haan, Hpj, Grosfeld, Mjw, Heijmeriks, Ja, Jochemsen, Gm, Klomps, Hc, Landsaat, Pm, Michels, Hr, Peters, Jrm, Beek, Gj, Hiejden, R., Verheul, Ja, Viergever, Ep, Audeau, M., Bopitiya, U., Hills, M., Ikram, H., Erikssen, J., Morstel, T., Vik-Mo, H., Haerem, Jw, Achremczyk, P., Banasiak, W., Burduk, P., Danielewicz, H., Demczuk, M., Dworzanski, W., Frycz, J., Gessek, J., Gorny, J., Janik, K., Jedrzejowski, A., Kawka-Urbanek, T., Kozlowski, A., Krasowski, W., Maciejewicz, J., Majcher, Z., Malinowski, S., Marczyk, T., Miekus, P., Ogorek, M., Piepiorka, M., Religa, K., Reszka, Z., Smielak-Korombel, W., Susol, D., Szpajer, M., Ujda, M., Waszyrowski, T., Zebrowski, A., Zielinski, Z., Cardoso, P., Carrageta, M., Correia, A., Cunha, D., Ferreira, L., Ferreira, R., Ribeiro, Vg, Tuna, Jl, Gomes, Mv, Aboo, A., Bobak, L., Brown, B., Cassim, S., King, J., Manga, P., Maritz, F., Marx, Jd, Mekel, J., Myburgh, Dp, Routier, R., Orcajo, Na, Asin, E., Colomina, F., Del Nogal, F., Echanove, I., Ferriz, J., Alcantara, Ag, Guerrero, Jjg, Juanatey, Jrg, Jodar, L., Lekuona, I., Miralles, L., Llorian, Ar, Rovira, A., San Jose, Jm, Valle, V., Abdon, Nj, Bartholdson, B., Fredholm, O., Kristensson, Be, Messner, T., Moller, Bh, Rasmanis, G., Stjerna, A., Strandberg, Le, Tolhagen, K., Caduff, B., Christen, S., Gallino, A., Haller, A., Noseda, G., Schmidt, D., Weber, A., Allen, M., Allison, W., Berk, M., Blankenship, D., Browne, K., Bryg, Rj, Caputo, C., Carr, K., Chandrashekhar, Y., Chelliah, N., Courtney, Dl, Deedwania, P., Detrano, R., Dixon, Ew, Dzwonczyk, T., Egbujiobi, L., Erenrich, Nh, Frazier, R., Funai, J., Gammon, Rs, Geer, Vr, Ghali, J., Goldberg, Mc, Goldman, S., Grainer, S., Grewal, G., Hanley, P., Haronian, H., Hermany, R., Karlsberg, R., Kesselbrenner, M., Krantzler, J., Lader, Ew, Lakkis, N., Levites, R., Lewis, Wr, Losordo, Dw, Magorien, R., Minisi, A., Minor, St, Newton, Cm, Nisar, A., Pacheco, Tr, Papuchis, G., Promisloff, S., Puma, J., Rokey, R., Sacco, J., Saeian, K., Schlesinger, R., Sharma, Sc, Shettigar, R., Smith, K., Thadani, U., Thomas, I., Urban, Pl, Vallenkaran, G., Whitaker, J., Yellen, Lg, Zarich, S., Zaroff, J., Adgey, Yja, Brack, M., Bridges, A., Cohen, A., Currie, P., Dwight, Jf, Findlay, I., Foale, R., Gemmill, J., Goodfellow, J., Gray, Ke, Holdright, D., Jennings, K., Keeling, P., Ludman, P., Murphy, C., Oliver, Rm, Rodrigues, E., Smith, Rh, Sprigings, D., Stephens, J., Swan, J., Timmis, A., Vincent, R., Yusuf, S, Mehta, S, Anand, S, Avezum, A, Awan, N, Bertrand, M, Blumenthal, M, Bouthier, J, Budaj, A, Ceremuzynski, L, Chrolavicius, S, Col, J, Commerford, P, Diaz, R, Flather, M, Fox, K, Franzosi, Mg, Gaudin, C, Gersh, B, Grossman, W, Halon, D, Hess, T, Hunt, D, Joyner, C, Karatzas, N, Keltai, M, Khurmi, N, Kopecky, S, Lewis, B, Maggioni, A, Malmberg, K, Moccetti, T, Morais, J, Paolasso, E, Peters, R, Piegas, L, Pipilis, A, Ramos Corrales, Ma, Rupprecht, Hj, Ryden, L, Sitkei, E, Sotty, M, Tognoni, G, Valentin, V, Varigos, J, Widimsky, P, Wittlinger, T, Pogue, J, Copland, I, Cracknell, B, Demers, C, Eikelboom, J, Hall, K, Keys, J, Mcqueen, M, Montague, P, Morris, B, Ounpuu, S, Wright, C, Yacyshyn, V, Zhao, F, Commerford, Pj, Wyse, G, Cairns, J, Hart, R, Hirsh, J, Gent, M, Ryan, T, Wittes, J, Auger, P, Basart, Dcg, Chan, Y, De Raedt, H, den Hartoog, M, Galli, M, Garcia Guerrero, Jj, Marquis, Jf, Mauri, F, Mayosi, B, Natarajan, M, Nieminen, M, Norris, J, Panju, A, Peters, Rj, Renkin, J, Rihal, C, Szymanski, P, Wasek, W, Allende, G, Bono, Jo, Caccavo, A, Fernandez, Aa, Fuselli, Jj, Gambarte, Aj, Guerrero, Raa, Hasbani, Eg, Liprandi, A, Marzetti, E, Mon, G, Nordaby, R, Nul, D, Quijano, G, Salvati, A, San Martin, E, Sokn, F, Torre, H, Trivi, M, Tuero, E, Amerena, J, Bailey, N, Bett, Jhn, Buncle, A, Careless, D, Desilva, S, Ewart, A, Fitzpatrick, D, Garrahy, P, Gunawardane, K, Hamer, A, Hill, A, Jackson, B, Lane, G, Nelson, G, Owensby, D, Rees, D, Rosen, D, Sampson, J, Singh, B, Taylor, R, Thomson, A, Walsh, W, Watson, B, Glogar, H, Steinbach, K, Geutjens, L, Ledune, J, Lescot, C, Popeye, R, Vermeulen, J, Abrantes, Ja, Baruzzi, Ac, Bassan, R, Bodanese, Lc, Carvalho, Ac, Coutinho, M, de Albuquerque, Dc, Dutra, O, Esteves, Jp, Leaes, Pe, Marino, Rl, Neto, Jam, Nicolau, Jc, Rabelo, A, Timerman, A, Xavier, S, Bata, I, Bhargava, Rk, Bogaty, P, Bolduc, P, Boyne, T, Chan, Yk, D'Astous, M, Davies, T, Dhingra, S, Desjardins, L, Douglas, Jg, Fortin, C, Fung, A, Gangbar, E, Gebhardt, V, Gervais, Pb, Giannoccaro, Jp, Gossard, D, Gosselin, G, Grandmont, D, Grover, A, Gupta, M, Hiscock, Jg, Hynd, Jwh, Hussain, M, Iless, A, Kitching, A, Kostuk, W, Kouz, S, Kwok, K, Lee, H, Lefkowitz, C, Lenis, J, Lubelsky, B, Ma, P, May, B, Mercier, M, Montigny, M, Morris, A, Nawaz, S, Pallie, S, Parekh, P, Pesant, Y, Pilon, C, Pistawka, K, Rajakumar, Arj, Rebane, T, Ricci, J, Ruel, M, Schuld, R, Starra, R, Sussex, B, Talbot, P, Theroux, P, Venkatesh, G, Weeks, A, Winkler, Lh, Wisenberg, G, Woo, K, Yu, E, Zadra, R, Bocek, P, Branny, M, Cepelak, V, Drapalik, V, Gregor, P, Groch, L, Jansky, P, Kalslerova, M, Starek, A, Svitil, P, Vaclavicek, A, Husted, S, Rasmussen, Lh, Nielsen, Hk, Hamalainen, T, Majamas Voltti, K, Mustonen, J, Peuhkurinen, K, Raasakka, T, Ylitalo, A, Adam, Mc, Agraou, B, Amat, G, Bessede, G, Boulenc, Jm, Boureux, C, Dambrine, P, Decoulx, E, Delarche, N, Desjoyaux, E, D'Hautefeuille, B, Dubois Rande, Jl, Fadel, N, Fouche, R, Fournier, P, Haftel, Y, Kahn, Jc, Ketelers, Jy, Lallemant, R, Lang, M, Lelguen, C, Leroy, F, Montalescot, G, Poulard, Je, Richard, M, Wittenberg, O, Beythien, Rd, Dippold, Wg, Harenberg, J, Hasslacher, C, Hauptmann, Ke, Hempel, G, Horacek, T, Kaulhausen, A, Kohler, B, Kurz, C, Lengfelder, W, Liebau, G, Loos, U, Neuss, H, Ochs, Hr, Pollock, B, Post, G, Reismann, K, Sauer, M, Schmidt, A, Schmitt, H, Schuster, P, Trenkwalder, P, Uebis, R, von Leitner, Er, Vossbeck, G, Christakos, S, Karidis, K, Kelesidis, K, Papadopoulos, K, Tirologos, A, Tsaknakis, T, Gesztesi, T, Herczeg, B, Janosi, A, Kalo, E, Karpati, P, Mesko, E, Mezofi, M, Poor, F, Regos, L, Rudas, L, Soltesz, P, Szaboki, F, Timar, S, Valyi, P, Zamolyi, K, Daly, Km, Meany, Bt, Sugrue, D, Caspi, A, David, D, Marmor, A, Nazzal, D, Omary, M, Reisin, L, Rosenfeld, T, Shasha, S, Vered, Z, Zimlichman, R, Bellet, C, Bernardi, D, Branzi, A, Ceci, V, Celegon, L, Cernigliaro, C, Corsini, G, Croce, A, De Caterina, R, De Servi, S, Di Biase, G, Di Chiara, A, Di Pasquale, G, Filorizzo, G, Fiorentini, C, Ignone, G, Lombardi, F, Mafrici, A, Margonato, Alberto, Maurea, N, Meneghetti, P, Meniconi, L, Mennuni, M, Mininni, N, Murrone, A, Notaristefan, A, Pettinati, G, Pinelli, G, Rossi, R, Sanna, A, Scabbia, E, Terrosu, P, Trinchero, R, Ruiz, Ra, Diaz, Ac, Santamaria, Ih, Pons, Jll, Diaz, Cj, Castro, Jat, Morales, Ev, Bronzwaer, Pna, de Haan, Hpj, Grosfeld, Mjw, Heijmeriks, Ja, Jochemsen, Gm, Klomps, Hc, Landsaat, Pm, Michels, Hr, Peters, Jrm, van Beek, Gj, van der Hiejden, R, Verheul, Ja, Viergever, Ep, Audeau, M, Bopitiya, U, Hills, M, Ikram, H, Erikssen, J, Morstel, T, Vik Mo, H, Haerem, Jw, Achremczyk, P, Banasiak, W, Burduk, P, Danielewicz, H, Demczuk, M, Dworzanski, W, Frycz, J, Gessek, J, Gorny, J, Janik, K, Jedrzejowski, A, Kawka Urbanek, T, Kozlowski, A, Krasowski, W, Maciejewicz, J, Majcher, Z, Malinowski, S, Marczyk, T, Miekus, P, Ogorek, M, Piepiorka, M, Religa, K, Reszka, Z, Smielak Korombel, W, Susol, D, Szpajer, M, Ujda, M, Waszyrowski, T, Zebrowski, A, Zielinski, Z, Cardoso, P, Carrageta, M, Correia, A, Cunha, D, Ferreira, L, Ferreira, R, Ribeiro, Vg, Tuna, Jl, Gomes, Mv, Aboo, A, Bobak, L, Brown, B, Cassim, S, King, J, Manga, P, Maritz, F, Marx, Jd, Mekel, J, Myburgh, Dp, Routier, R, Orcajo, Na, Asin, E, Colomina, F, del Nogal, F, Echanove, I, Ferriz, J, Alcantara, Ag, Guerrero, Jjg, Juanatey, Jrg, Jodar, L, Lekuona, I, Miralles, L, Llorian, Ar, Rovira, A, San Jose, Jm, Valle, V, Abdon, Nj, Bartholdson, B, Fredholm, O, Kristensson, Be, Messner, T, Moller, Bh, Rasmanis, G, Stjerna, A, Strandberg, Le, Tolhagen, K, Caduff, B, Christen, S, Gallino, A, Haller, A, Noseda, G, Schmidt, D, Weber, A, Allen, M, Allison, W, Berk, M, Blankenship, D, Browne, K, Bryg, Rj, Caputo, C, Carr, K, Chandrashekhar, Y, Chelliah, N, Courtney, Dl, Deedwania, P, Detrano, R, Dixon, Ew, Dzwonczyk, T, Egbujiobi, L, Erenrich, Nh, Frazier, R, Funai, J, Gammon, R, Geer, Vr, Ghali, J, Goldberg, Mc, Goldman, S, Grainer, S, Grewal, G, Hanley, P, Haronian, H, Hermany, R, Karlsberg, R, Kesselbrenner, M, Krantzler, J, Lader, Ew, Lakkis, N, Levites, R, Lewis, Wr, Losordo, Dw, Magorien, R, Minisi, A, Minor, St, Newton, Cm, Nisar, A, Pacheco, Tr, Papuchis, G, Promisloff, S, Puma, J, Rokey, R, Sacco, J, Saeian, K, Schlesinger, R, Sharma, Sc, Shettigar, R, Smith, K, Thadani, U, Thomas, I, Urban, Pl, Vallenkaran, G, Whitaker, J, Yellen, Lg, Zarich, S, Zaroff, J, Adgey, Yja, Brack, M, Bridges, A, Cohen, A, Currie, P, Dwight, Jf, Findlay, I, Foale, R, Gemmill, J, Goodfellow, J, Gray, Ke, Holdright, D, Jennings, K, Keeling, P, Ludman, P, Murphy, C, Oliver, Rm, Rodrigues, E, Smith, Rh, Sprigings, D, Stephens, J, Swan, J, Timmis, A, and Vincent, R.

Abstract

Background Other than aspirin, there are few oral antithrombotic treatments with proven efficacy in patients with acute coronary syndrome. In this report, we present the rationale, design and baseline characteristics of the Clopidogrel in Unstable angina to prevent Recurrent ischaemic Events (CURE) trial, which includes a meta-analysis of the effects of thienopyridines in patients with vascular disease. Methods and Results Combined data from randomized trials of thienopyrindines in patients with atherosclerotic disease demonstrated a 29% reduction in vascular events when compared with placebo/control (n=2392) (OR 0.71, 95% CI 0.58-0.86, P=0.0006) and a 10% reduction in vascular events when compared with aspirin (n=22 254) (OR 0.91, 95% Cl 0.84-0.99, P=0.039). Similarly, randomized trials of aspirin plus thienopyridines in patients undergoing intracoronary stenting, demonstrated marked benefit of aspirin plus ticlopidine in reducing death or myocardial infarction compared with aspirin alone (OR 0.23, 95% CI 0.11-0.49, P=0.0001) or aspirin plus warfarin (OR 0.51, 95% CI 0.33-0.78, P=0.002). Whether these benefits extend to the much larger population of patients with acute coronary syndrome is unknown. CURE is an international, randomized, double-blind trial, in which patients with acute coronary syndrome will be randomized to receive either a bolus dose of clopidogrel (300 mg) followed by 75 mg per day for 3-12 months, or matching placebo. Both groups will receive aspirin. The co-primary efficacy end-points of CURE are: (1) the composite of cardiovascular death, myocardial infarction or stroke; and (2) the composite of cardiovascular death, myocardial infarction, stroke or refractory ischaemia. CURE will recruit approximately 12 500 patients with acute coronary syndrome (from 28 countries) and its power to detect moderate treatment benefits will be in the region of 80-90%, while maintaining an overall type I error (a) of 0.05. The baseline characteristics of the study population are consistent with at least a moderate risk group of patients with acute coronary syndrome. Conclusions Randomized trials of thienopyridines in patients with vascular disease demonstrate that thienopyridines are effective in reducing vascular events when compared with placebo/control or aspirin, as well as when used in combination with aspirin in patients undergoing intracoronary stent implantation. The CURE trial is a large international study to determine if acute and longterm treatment with the combination of clopidogrel and aspirin is superior to aspirin alone in patients with acute coronary syndrome. (C) 2000 The European Society of Cardiology. RI Nicolau, Jose/E-1487-2012

28. Variant angina induced by biliary colic.

Author

Antonelli, D and Rosenfeld, T

Abstract

A 65 year old woman with gall stones presented with crushing chest pain after an attack of biliary colic. The electrocardiogram showed ST segment elevation in leads I, aVL, and V1-V3 while leads II, III, and aVF showed ST segment depression. Cardiac enzyme activity remained within the normal range. During the next three weeks attacks of epigastric and right hypochondrial pain preceded by crushing chest pain with identical electrocardiogram changes occurred with decreasing frequency. Coronary arteriography showed 60% obstruction of the left anterior descending coronary artery and good left ventricular function. During the next three years the patient complained both of mild abdominal pain, probably biliary colic, and mild effort related angina pectoris without a relation between the two symptoms. It is suggested that the attack of variant angina was triggered by biliary colic through sympathoadrenal discharge causing vasospasm. [ABSTRACT FROM PUBLISHER]

Published
1987
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29. Long term survival and late repair of massive cardiac pseudoaneurysm.

Author

Turgeman, Y, Rosenfeld, T, and Halon, D A

Abstract

Myocardial rupture of the left ventricle after an acute myocardial infarction resulted in the formation of a massive pseudoaneurysm in a middle aged man. Cross sectional echocardiography was useful in identifying the defect which was successfully closed at operation nine years after its formation. [ABSTRACT FROM PUBLISHER]

Published
1987
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31. Assessing testamentary and decision-making capacity: Approaches and models

Author

Kelly Purser and Rosenfeld, T.

Subjects
Models for assessment, Capacity assessment, Substitute decision making, 180100 LAW, Testamentary capacity, Financial capacity
Abstract

The need for better and more accurate assessments of testamentary and decision-making capacity grows as Australian society ages and incidences of mentally disabling conditions increase. Capacity is a legal determination, but one on which medical opinion is increasingly being sought. The difficulties inherent within capacity assessments are exacerbated by the ad hoc approaches adopted by legal and medical professionals based on individual knowledge and skill, as well as the numerous assessment paradigms that exist. This can negatively affect the quality of assessments, and results in confusion as to the best way to assess capacity. This article begins by assessing the nature of capacity. The most common general assessment models used in Australia are then discussed, as are the practical challenges associated with capacity assessment. The article concludes by suggesting a way forward to satisfactorily assess legal capacity given the significant ramifications of getting it wrong.

41. Massive transient pulmonary air embolism during pacemaker implantation under mild sedation: an unrecognized hazard of snoring.

Author

Turgeman Y, Antonelli D, Atar S, and Rosenfeld T

Abstract

We present a case of a massive pulmonary air embolism during permanent pacemaker lead implantation under mild sedation in a 73-year-old woman. We used a peel-away sheath that is devoid of a hemostatic valve. The air embolism occurred after deep inspiration associated with loud snoring sounds and resolved after short chest massage and administration of adrenaline. Temporary closure of the intravenous entrance route of the peel-away sheath before inserting the lead may prevent this potentially lethal complication. [ABSTRACT FROM AUTHOR]

Published
2004
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42. IMAGES IN CARDIOLOGY........: "Myxomatous" mitral stenosis.

Author

Atar, S., Bloch, L., and Rosenfeld, T.

Subjects
MITRAL stenosis, OLDER men, HEART beat, ATRIAL fibrillation, ELECTROCARDIOGRAPHY, CARDIAC imaging
Abstract

The article focuses on mitral stenosis. A 78 year old man was admitted because of a sudden appearance of stupor, dysarthria, and left sided hemiplegia. Physical examination revealed an irregular heart rate, an accentuated first heart sound, an "opening snap", and a long apical mid diastolic rumbling murmur. The ECG showed atrial fibrillation. A presumptive diagnosis of mitral stenosis was made on admission. Transoesophageal echocardiography revealed a large left atrial (LA) highly mobile mass attached to the inter-atrial septum and confined to the left atrium in systole.

Published
2004
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45. Looking for the skeleton in the closet-rare genetic diagnoses in patients with diabetes and skeletal manifestations.

Author

Brener A, Zeitlin L, Wilnai Y, Birk OS, Rosenfeld T, Chorna E, and Lebenthal Y

Subjects
Adolescent, Bone and Bones, Child, Humans, Insulin therapeutic use, Male, Methyltransferases genetics, Methyltransferases therapeutic use, Mutation, Pain, Camurati-Engelmann Syndrome drug therapy, Camurati-Engelmann Syndrome genetics, Diabetes Mellitus
Abstract

Aims: The precision medicine approach of tailoring treatment to the individual characteristics of each patient has been a great success in monogenic diabetes subtypes, highlighting the importance of accurate clinical and genetic diagnoses of the type of diabetes. We sought to describe three unique cases of childhood-onset diabetes in whom skeletal manifestations led to the revelation of a rare type of diabetes. METHODS : Case-scenarios and review of the literature., Results: Case 1: A homozygous mutation in TRMT10A, a tRNA methyltransferase, was identified in a 15-year-old boy with new-onset diabetes, developmental delay, microcephaly, dysmorphism, short stature and central obesity. The progressive apoptosis of pancreatic beta cells required insulin replacement therapy, with increased demand due to an unfavorable body composition. Case 2: Congenital generalized lipodystrophy type 1 was suspected in an adolescent male with an acromegaloid facial appearance, muscular habitus, and diabetes who presented with a pathological fracture in a cystic bone lesion. A homozygous mutation in AGPAT2, an acyl transferase which mediates the formation of phospholipid precursors, was identified. Leptin replacement therapy initiation resulted in a remarkable improvement in clinical parameters. Case 3: A 12-year-old boy with progressive lower limb weakness and pain was diagnosed with diabetic ketoacidosis. Diffuse diaphyseal osteosclerosis compatible with the diagnosis of Camurati-Engelmann disease and a heterozygous mutation in TGFβ1 were identified. Preservation of euglycemia by insulin replacement relieved pain, suggesting that the diabetic milieu may have augmented TGFβ1 overexpression., Conclusion: Unraveling the precise genetic cause for the clinical manifestations led to the prediction of phenotypic manifestations, and enhanced the clinical outcomes., (© 2022. Springer-Verlag Italia S.r.l., part of Springer Nature.)

Published
2022
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46. The heritability of body composition.

Author

Brener A, Waksman Y, Rosenfeld T, Levy S, Peleg I, Raviv A, Interator H, and Lebenthal Y

Subjects
Adolescent, Body Height, Body Mass Index, Body Weight, Child, Child, Preschool, Female, Humans, Male, Sex Characteristics, Body Composition, Obesity
Abstract

Background: Physical growth during childhood and adolescence is influenced by both genetic and environmental factors. Heritability, the proportion of phenotypic variance explained by genetic factors, has been demonstrated for stature and weight status. The aim of this study was to explore the heritability of body composition., Methods: A real-life, observational study of the children and adolescents referred to the Endocrine Unit in a tertiary medical center. In January 2018, body composition by means of bioimpedance analysis (BIA) was implemented as part of the standard intake assessment of subjects referred for endocrine consultation. The clinic BIA database was searched for subjects with the term "observation of growth" as the sole reason for referral. BIA of 114 triads of healthy subjects aged 5-18 years and their parents were analyzed. The BIA report included the following data: fat mass, fat percentage, truncal fat percentage and muscle mass. Calculated variables included: appendicular skeletal muscle mass (ASMM = the sum of muscle mass of four limbs), muscle-to-fat ratio [MFR = ASMM (kg)/fat mass (kg)] and sarcopenic index [(SI = ASMM(kg)/height (meter)²]. Data collection from medical files included pubertal stage and home address for socioeconomic position grading., Results: There were sex differences in body composition parameters in both the prepubertal and pubertal subjects. The boys among the prepubertal subjects had a lower fat percentage on average than girls (p = 0.020). Among the adolescents, boys on average had lower fat percentage (p = 0.011), higher sarcopenic index (p = 0.021), and higher muscle-to-fat ratio (p < 0.001), than adolescent girls. Correlation analyses between body composition parameters of all participants revealed significant correlations in the sarcopenic index of prepubertal children and their parents (boys-fathers: r = 0.380, p = 0.050; boys-mothers: r = 0.435, p = 0.026; girls-fathers: r = 0.462, p = 0.012; girls-mothers: r = 0.365, p = 0.050) and adiposity indices (fat percentage, truncal fat percentage and muscle-to-fat ratio) of prepubertal boys and their mothers (r = 0.438, p = 0.025; r = 0.420, p = 0.033, and r = 0.478, p = 0.014, respectively). There were no associations between body composition parameters of adolescents and their parents. Socioeconomic position adversely affected fat percentage in adolescent girls and mothers., Conclusions: Heritable body composition traits were demonstrated in childhood but not in adolescence, suggesting that environmental influence has a more telling effect during teenage years.

Published
2021
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47. Beyond Body Mass Index - Body Composition Assessment by Bioimpedance in Routine Endocrine Practice.

Author

Brener A, Peleg I, Rosenfeld T, Kern S, Uretzky A, Elkon-Tamir E, Rosen G, Levinson H, Israeli G, Interator H, and Lebenthal Y

Subjects
Adolescent, Anthropometry, Body Mass Index, Body Weight, Child, Child, Preschool, Electric Impedance, Female, Humans, Male, Body Composition, Obesity epidemiology
Abstract

Objective: To explore the body composition of pediatric patients referred for endocrine evaluation., Methods: This real-life observational study conducted between January 2018 and January 2020 included 10 001 clinic visits of 3500 children and adolescents; first visits of 5 to 18-year-old patients were included. Anthropometric data, blood pressure levels, pubertal status, and bioelectrical impedance analysis (BIA, Tanita MC-780 MA) were extracted from medical files. Excluded from the analysis were patients participating in other studies., Results: A total of 1001 patients (48% boys, mean age 11.3 ± 3.4 years, 33.5% prepubertal) were included. Mean anthropometric z-scores were normal and similar for boys and girls. Sex differences in body composition were as follows: boys had lower fat percentage, lower truncal fat percentage, higher appendicular skeletal muscle mass, and a higher muscle-to-fat ratio (MFR) than girls (P < .001 for all). MFR correlated with body mass index-standard deviation scores (BMI-SDS) in overweight/obese patients (r = -0.558, P < .001), although not in underweight patients. Systolic blood pressure (SBP) correlated with BMI-SDS in overweight/obese patients (r = 0.262, P < .001), although not in underweight patients. Diastolic blood pressure (DBP) did not correlate with BMI-SDS in either group of extreme weight status. MFR correlated with SBP and DBP in overweight/obese patients (r = -0.230, P < .001 and r = -0.141, P = .018, respectively) as well as in underweight patients (r = 0.331, P < .001 and r = 0.264, P = .005, respectively)., Conclusions: Our findings support BIA for a more refined characterization of patients referred for endocrine evaluation than BMI-SDS. MFR may be a better surrogate marker of blood pressure levels than BMI-SDS in both underweight and overweight/obese pediatric patients., (Copyright © 2020 AACE. Published by Elsevier Inc. All rights reserved.)

Published
2021
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48. Dynamic control of capillary flow in porous media by electroosmotic pumping.

Author

Rosenfeld T and Bercovici M

Abstract

Microfluidic paper-based analytical devices (μPADs) rely on capillary flow to achieve filling, mixing and delivery of liquids. We investigate the use of electroosmotic (EO) pumping as a mechanism for dynamic control of capillary flow in paper-based devices. The applied voltage can accelerate or decelerate the baseline capillary-driven velocity, as well as be used to create a tunable valve that reversibly switches the flow on and off in an electrically controlled manner. The method relies on simple fabrication and allows repeated actuation, providing a high degree of flexibility for automation of liquid delivery. We adapt the Lucas-Washburn model to account for EO pumping and provide an experimentally validated analytical model for the distance penetrated by the liquid as a function of time and the applied voltage. We show that the EO-pump can reduce filling time by 6.5-fold for channels spanning several cm in length, relative to capillary filling alone. We demonstrate the utilization of the EO-pump for a tunable and dynamic flow control that accelerates, decelerates and stops the flow on demand. Finally, we present the use of the EO-pump for fluid flow sequencing on a paper-based device.

Published
2019
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49. Maternal and neonatal irisin precursor gene FNDC5 polymorphism is associated with preterm birth.

Author

Salem H, Yatchenko Y, Anosov M, Rosenfeld T, Altarescu G, Grisaru-Granovsky S, and Birk R

Subjects
Adult, Alleles, Cohort Studies, Female, Fibronectins blood, Fibronectins metabolism, Gene Frequency genetics, Genetic Association Studies methods, Genetic Predisposition to Disease genetics, Humans, Infant, Newborn, Israel, Male, Neuropeptides genetics, Polymorphism, Single Nucleotide genetics, Fibronectins genetics, Premature Birth genetics
Abstract

Irisin is a novel secreted myokine, encoded by the fibronectin type III domain-containing protein 5 (FNDC5) precursor gene. Irisin plays a role in the female reproductive system in pregnancy and in embryonic development, and is associated with fetal size. It is expressed in the ovary, placenta and neonatal cord serum. We studied whether maternal and neonatal FNDC5 genetic polymorphisms are associated with preterm birth (PTB). Blood for DNA analysis was collected from Israeli mothers (n = 315) and from umbilical veins of their respected idiopathic preterm (24-36 weeks) and control term (>37 weeks) newborns (n = 161). Genotypes of maternal and neonatal FNDC5 polymorphisms (rs726344 and rs1746661) were determined by restriction fragment length polymorphism analysis. Genotype-phenotype associations were analyzed using SPSS program. The Frequency of FNCD5 rs726344 G alleles in the Israeli cohort is 82%. We found significant FNCD5 rs726344 genotype frequencies control and PTB groups. Women bearing the FNDC5 rs726344 GG genotype had 2.18 fold ([CI] 1.193-4.008, p = 0.01) higher chance to deliver at term compared to both AG and AA genotypes (adjusting to age, gravidity, parity, weight percentile per gestational age and gender of newborn). Neonates carrying the FNDC5 rs726344 GG genotype had 2.24 fold ([CI] 0.979-5.134, p = 0.05) higher chance to be born at term compared to either AG or AA genotypes (adjusting to parity, previous abortions and weight percentile per gestational age). There was no significant association of the rs1746661 polymorphism with PTB. Thus, we determined FNDC5 polymorphisms frequencies in the Israeli population and demonstrated that maternal and neonatal FNDC5 rs726344 polymorphism is significantly associated with increased risk for PTB., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Published
2018
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50. Amplification-free detection of DNA in a paper-based microfluidic device using electroosmotically balanced isotachophoresis.

Author

Rosenfeld T and Bercovici M

Subjects
Collodion chemistry, DNA analysis, Electroosmosis instrumentation, Isotachophoresis instrumentation, Microfluidic Analytical Techniques instrumentation, Paper
Abstract

We present a novel microfluidic paper-based analytical device (μPAD) which utilizes the native high electroosmotic flow (EOF) in nitrocellulose to achieve stationary isotachophoresis (ITP) focusing. This approach decouples sample accumulation from the length of the channel, resulting in significant focusing over short channel lengths. We provide a brief theory for EOF-balanced ITP focusing under continuous injection from a depleting reservoir and present the design of a short (7 mm) paper-based microfluidic channel, which allows a 200 μL sample to be processed in approximately 6 min, resulting in a 20 000-fold increase in concentration - a full order of magnitude improvement compared to previous paper-based ITP devices. We show the stability of the assay over longer (40 min) durations of time, and using Morpholino probes, we present the applicability of the device for amplification-free detection of nucleic acids, with a limit-of-detection (LoD) of 5 pM in 10 min. Finally, we utilize the small footprint of the channel and show a multiplexed platform in which 12 assays operate in parallel in a 24-well plate format.

Published
2018
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