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A long period grating (LPG) modified with a mesoporous film infused with a calixarene as a functional compound was employed for the detection of individual volatile organic compounds (VOCs) and their mixtures. The mesoporous film consisted of an inorganic part, SiO2 nanoparticles (NPs), along with an organic moiety of poly(allylamine hydrochloride) polycation PAH, which was finally infused with the functional compound, p-sulphanato calix[4]arene (CA[4]) or p-sulphanato calix[8]arene (CA[8]). The LPG sensor was designed to operate at the phase matching turning point to provide the highest sensitivity. The sensing mechanism is based on the measurement of the refractive index (RI) change induced by a complex of the VOCs with calixarene. The LPG, modified with a coating of 5 cycles of (SiO2 NPs/PAH) and infused with CA[4] or CA[8], was exposed to chloroform, benzene, toluene and acetone vapours. The British Standards test of the VOCs emissions from material (BS EN ISO 16000-9:2006) was used to test the LPG sensor performance.

This work focuses on the development of fibre optic long period grating (LPG) based chemical sensors and the fabrication and evaluation of the appropriate sensitive coatings. Fibre-optic sensing platforms have been considered as a promising platform for the development of new sensors. The current progress in the field of LPG based chemical sensors is provided. The proof of concept of LPG based metal organic framework (MOF) sensors for the detection of organic vapours and carbon dioxide is presented. The inappropriate indoor air quality negatively affects human health. Nutrients growth in aquatic environments causes eutrophication and thus changes in the chemistry of the whole ecosystem. The practical use of LPG based ammonia and VOCs sensors is demonstrated in the fields of seawater and indoor air quality monitoring. Real-time monitoring and development of new sensors are highly needed in these areas. An array of three LPGs was created in a single optical fibre, multiplexed in the wavelength domain. Sensors were calibrated in the laboratory and the simultaneous measurement of the key indoor air quality elements was undertaken. In conclusion the project has successfully demonstrated the use of novel fibre optic sensors in laboratory and real conditions that are in a good agreement with commercially used techniques.

Patients with acute myocardial infarction (AMI) who have concomitant peripheral artery disease (PAD) represent a subgroup at high risk of subsequent ischaemic events. This post hoc analysis of PRAGUE-18, a multicenter, randomised trial comparing prasugrel versus ticagrelor in primary PCI, analysed the effect of symptomatic PAD and intensity of antithrombotic therapy on the prognosis of AMI patients treated with primary percutaneous coronary intervention (PCI). During 12-month follow-up, de-escalation from intensive antiplatelet therapy to clopidogrel was allowed with the permission of the treating physician for economic reasons. Symptomatic PAD was present in 2.9% of the study population (n = 1230). The presence of PAD did not significantly affect short-term outcome. At one year, the risk of death was higher in patients with concomitant PAD, 49 (4.1%) vs. 6(16.7%), HR 4.211 (1.803–9.830); p = 0,001. All-cause mortality significantly increased only in subgroup of patients who de-escalated to clopidogrel [6.37 (2.16–18.84), p = 0.001] as opposed to those who did not [3.02 (0.72–12.61), p = 0.13]. These findings suggest that long-term intensive antithrombotic therapy may be particularly important for post-AMI patients with concomitant symptomatic PAD and warrant further investigation.

The prevalence of left-sided valvular heart disease (VHD) increases with age, but data on the impact of pre-existing VHD in patients with acute myocardial infarction (AMI) are limited. We aimed to define the clinical characteristics and outcomes of AMI patients with pre-existing left VHD. The analysis is based on data from three merged national registries. The dataset included 47,436 patients admitted with AMI over a 5year period at all Cath Labs nationwide. Pre-existing VHD was diagnosed in 1,445 patients (3.0%), moderate-to-severe mitral regurgitation (MR) in 510 patients (35.3%), and moderate-to-severe aortic stenosis (AS) in 869 patients (60.1%). Patients with VHD had worse baseline characteristics, pre-existing coronary artery disease, more complicated in-hospital course with higher Killip class, lower left ventricular ejection fraction, and more comorbidities. Angiographically more frequent left main stenosis, TIMI flow 3 before PCI, less frequent stent implantation. Patients with pre-existing VHD had significantly higher 7-day (10.1% vs. 4.5%, p  < 0.001), 30-day (16.0% vs. 7.0%, p  < 0.001) and 1-year mortality (28.7 vs. 12.7%, p  < 0.001) compared to patients without. Conclusions. Patients with pre-existing VHD and AMI are characterized by complicated in-hospital course with higher Killip class, lower ejection fraction, angiographically less severe stenosis, TIMI flow 3 prior to PCI, and less frequent stent implantation. This is a high-risk group with higher short – and long-term mortality and earlier intervention should be considered.

Background Immediate initiation of extracorporeal membrane oxygenation (ECMO) has not demonstrated benefit in individuals diagnosed with cardiogenic shock based on the presence of hypotension. The relationship between other hemodynamic or metabolic parameters and clinical outcomes, with or without ECMO, is not fully understood. Methods The Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shock (ECMO-CS) trial randomly assigned 117 patients diagnosed with cardiogenic shock to 2 groups: immediate initiation of ECMO or early conservative strategy. The present post-hoc analysis investigated the clinical efficacy of immediate ECMO therapy in subgroups with cardiogenic shock-more specific characteristics: low cardiac index, low venous oxygen saturation (SvO 2 ) and high partial carbon dioxide pressure (pCO 2 ) gap. The primary endpoint for this analysis was 1-year all-cause mortality; the secondary endpoint was a composite of mortality or hemodynamic worsening requiring ECMO. Results Data regarding cardiac index were available for 58 patients. In the subgroup with cardiac index < 2.2 L/min/m 2 , immediate ECMO initiation was associated with a reduced risk for all-cause death (hazard ratio [HR] 0.48 [95% confidence interval (CI) 0.23–0.99]; p  = 0.049; number needed to treat to prevent one death [NNT] 3.6) and composite of all-cause death or hemodynamic worsening (HR 0.30 [95% CI 0.15–0.65]; p  = 0.003). Data regarding pCO 2 gap were available for 54 patients and, in the subgroup with pCO 2 gap > 0.8 kPa, initiation of ECMO was associated with a lower risk for all-cause death (HR 0.43 [95% CI 0.20–0.91]; p  = 0.028; NNT 3.5) and the composite endpoint (HR 0.29 [95% CI 0.13–0.62]; p  = 0.001). Finally, data regarding SvO 2 were available for 95 patients. In the subgroup with SvO 2  < 60%, initiation of ECMO was associated with lower risk for all-cause mortality (HR 0.34 [95% CI 0.17–0.67]; p  = 0.002; NNT 2.8) and the composite endpoint (HR 0.28 [95% CI 0.14–0.57]; p  < 0.001). Conclusions Measurement of cardiac index, pCO 2 gap and SvO 2 could improve the management of cardiogenic shock. The presence of any of the following criteria - low cardiac index, high pCO 2 gap and low SvO 2 - may indicate a poor prognosis with conservative therapy and a substantial mortality benefit from mechanical circulatory support. Trial registration NCT02301819. Retrospectively registered 26 November 2014.

Aim. This study was designed to evaluate the relationship between microRNAs (miRNAs), miR-126-3p and miR-223-3p, as new biomarkers of platelet activation, and predicting recurrent thrombotic events after acute myocardial infarction (AMI). Methods and Results. The analysis included 598 patients randomized in the PRAGUE-18 study (ticagrelor vs. prasugrel in AMI). The measurements of miRNAs were performed by using a novel miRNA immunoassay method. The association of miRNAs with the occurrence of the ischemic endpoint (EP) (cardiovascular death, nonfatal MI, or stroke) and bleeding were analyzed. The miR-223-3p level was significantly related to an increased risk of occurrence of the ischemic EP within 30 days (odds ratio (OR) = 15.74, 95% confidence interval (CI): 2.07–119.93, p = 0.008) and one year (OR = 3.18, 95% CI: 1.40–7.19, p = 0.006), respectively. The miR-126-3p to miR-223-3p ratio was related to a decreased risk of occurrence of EP within 30 days (OR = 0.14, 95% CI: 0.03–0.61, p = 0.009) and one year (OR = 0.37, 95% CI: 0.17–0.82, p = 0.014), respectively. MiRNAs were identified as independent predictors of EP even after adjustment for confounding clinical predictors. Adding miR-223-3p and miR-126-3p to miR-223-3p ratios as predictors into the model calculating the ischemic risk significantly increased the predictive accuracy for combined ischemic EP within one year more than using only clinical ischemic risk parameters. No associations between miRNAs and bleeding complications were identified. Conclusion. The miR-223-3p and the miR-126-3p are promising independent predictors of thrombotic events and can be used for ischemic risk stratification after AMI.

This paper describes the phenomenon of reliability of power plants. It gives an explanation of the terms connected with this topic as their proper understanding is important for understanding the relations and equations which model the possible real situations. The reliability phenomenon is analysed using both the exponential distribution and the Weibull distribution. The results of our analysis are specific equations giving information about the characteristics of the power plants, the mean time of operations and the probability of failure-free operation. Equations solved for the Weibull distribution respect the failures as well as the actual operating hours. Thanks to our results, we are able to create a model of dynamic reliability for prediction of future states. It can be useful for improving the current situation of the unit as well as for creating the optimal plan of maintenance and thus have an impact on the overall economics of the operation of these power plants.

Purpose: To investigate the prognostic significance of diabetes mellitus (DM) in patients with high risk acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (pPCI) in the era of potent antithrombotics. Methods: Data from 1230 ST-segment elevation myocardial infarction (STEMI) patients enrolled in the PRAGUE-18 (prasugrel vs. ticagrelor in pPCI) study were analyzed. Ischemic and bleeding event rates were calculated for patients with and without diabetes. The independent impact of diabetes on outcomes was evaluated after adjustment for outcome predictors. Results: The prevalence of DM was 20% (N = 250). Diabetics were older and more often female. They were more likely to have hypertension, hyperlipoproteinemia, multivessel coronary disease and left main disease, and be obese. The primary net-clinical endpoint (EP) containing death, spontaneous nonfatal MI, stroke, severe bleeding, and revascularization at day 7 occurred in 6.1% of patients with, and in 3.5% of patients without DM (HR 1.8; 95% CI 0.978–3.315; P = 0.055). At one year, the key secondary endpoint defined as cardiovascular death, spontaneous MI, or stroke occurred in 8.8% with, and 5.5% without DM (HR 1.621; 95% CI 0.987–2.661; P = 0.054). In those with DM the risk of total one-year mortality (6.8% vs. 3.9% (HR 1.773; 95% CI 1.001–3.141; P = 0.047)) and the risk of nonfatal reinfarction (4.8% vs. 2.2% (HR 2.177; 95% CI 1.077–4.398; P = 0.026)) were significantly higher compared to in those without DM. There was no risk of major bleeding associated with DM (HR 0.861; 95% CI 0.554–1.339; P = 0.506). In the multivariate analysis, diabetes was independently associated with the one-year risk of reinfarction (HR 2.176; 95% Confidence Interval, 1.055–4.489; p = 0.035). Conclusion: Despite best practices STEMI treatment, diabetes is still associated with significantly worse prognoses, which highlights the importance of further improvements in the management of this high-risk population.

Immediate initiation of extracorporeal membrane oxygenation (ECMO) has not demonstrated benefit in individuals diagnosed with cardiogenic shock based on the presence of hypotension. The relationship between other hemodynamic or metabolic parameters and clinical outcomes, with or without ECMO, is not fully understood. The Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shock (ECMO-CS) trial randomly assigned 117 patients diagnosed with cardiogenic shock to 2 groups: immediate initiation of ECMO or early conservative strategy. The present post-hoc analysis investigated the clinical efficacy of immediate ECMO therapy in subgroups with cardiogenic shock-more specific characteristics: low cardiac index, low venous oxygen saturation (SvO ) and high partial carbon dioxide pressure (pCO ) gap. The primary endpoint for this analysis was 1-year all-cause mortality; the secondary endpoint was a composite of mortality or hemodynamic worsening requiring ECMO. Data regarding cardiac index were available for 58 patients. In the subgroup with cardiac index < 2.2 L/min/m , immediate ECMO initiation was associated with a reduced risk for all-cause death (hazard ratio [HR] 0.48 [95% confidence interval (CI) 0.23-0.99]; p = 0.049; number needed to treat to prevent one death [NNT] 3.6) and composite of all-cause death or hemodynamic worsening (HR 0.30 [95% CI 0.15-0.65]; p = 0.003). Data regarding pCO gap were available for 54 patients and, in the subgroup with pCO gap > 0.8 kPa, initiation of ECMO was associated with a lower risk for all-cause death (HR 0.43 [95% CI 0.20-0.91]; p = 0.028; NNT 3.5) and the composite endpoint (HR 0.29 [95% CI 0.13-0.62]; p = 0.001). Finally, data regarding SvO were available for 95 patients. In the subgroup with SvO  < 60%, initiation of ECMO was associated with lower risk for all-cause mortality (HR 0.34 [95% CI 0.17-0.67]; p = 0.002; NNT 2.8) and the composite endpoint (HR 0.28 [95% CI 0.14-0.57]; p < 0.001). Measurement of cardiac index, pCO gap and SvO could improve the management of cardiogenic shock. The presence of any of the following criteria - low cardiac index, high pCO gap and low SvO - may indicate a poor prognosis with conservative therapy and a substantial mortality benefit from mechanical circulatory support. NCT02301819. Retrospectively registered 26 November 2014.