“Background: Survival after out-of-hospital cardiac arrest


“Background: Survival after out-of-hospital cardiac arrest (OHCA) has increased in recent years, and new data are therefore needed to avoid unsubstantiated statements when debating futility of resuscitation attempts following OHCA in nursing

home (NH)-residents. We aimed to investigate the outcome and prognosis after OHCA in NH.

Methods: Consecutive Emergency Medical Service (EMS) attended OHCA-patients in Copenhagen during 2007-2011 were included. Utstein-criteria for pre-hospital data and review of individual patient charts for in-hospital post-resuscitation care were collected.

Results: A total of 2541 consecutive OHCA-patients were recorded, 245 (10%) of who JQ-EZ-05 order were current NH-residents. NH-patients were older, more frequently female, had more witnessed arrests, fewer shockable primary rhythm and assumed cardiac aetiology, but shorter time to the return of spontaneous circulation (ROSC) compared to OHCA in non-nursing homes (non-NH). Overall 30-day survival

rate was 9% in NH and 18% in non-NH, p<0.001. Of the 245 NH-arrests 79 (32%) patients were admitted to hospital compared to 937 (41%) from non-NH (p<0.001). Thirty-day survival rate in patients admitted to hospital were 27% for NH- and 42% for non-NH-patients, p<0.001. OHCA in NH was, however, not associated with a significantly worse prognosis (HR = 0.88 (0.64-1.21), p=0.4) after adjustment for known prognostic factors including co-morbidity.

Conclusions: Nursing home residents ARN-509 manufacturer resuscitated from CUDC-907 OHCA and admitted to hospital have similar survival rates as non-NH-patients when adjusting for known prognostic factors and pre-existing comorbidity. A policy of not attempting resuscitation in nursing homes at all may therefore not be justified. (C) 2013 Elsevier Ireland Ltd. All rights reserved.”
“Background and Purpose: Mini-PCNL was developed to reduce the morbidity of PCNL

by using smaller tract sizes. Most mini-techniques, however, require specialized instruments and use ureteroscopes as surrogates for nephroscopes, resulting in decreased visualization, poor irrigation, and difficult fragment extraction. We describe our modified technique (mPCNL) that allows for the use of standard PCNL equipment through a tract that is smaller than standard PCNL (sPCNL) but larger than previously reported for mini-PCNL.

Technique: After ureteral access with a coaxial anti-retropulsion device, the patient is placed in the prone position. After percutaneous access under fluoroscopic guidance, a 24F balloon dilating catheter is used to place a 24F Amplatz sheath. A standard 26F rigid nephroscope is used to complete the entire procedure, with the modification of selectively removing the outer sheath to allow the scope to fit in the smaller tract. Standard lithotripters and graspers are used, as necessary.

In the second step, the oligomer was reacted with 4 a m by grad

In the second step, the oligomer was reacted with 4 a. m. by gradually dropping the oligomer into 4 a. m. solution with the mole ratio 4 : 5. By reacting chiral compounds, mandelic acid, menthyl chloroformate, and menthyl glyoxylate GW4064 in vitro hydrate using condensation reaction with amine groups along polyimide molecules, the novel polyimides can be synthesized. Their chemical structures were confirmed by fourier transform infrared spectroscopy and nuclear magnetic resonance spectroscopy ((1)H-NMR). The coated glass slides pairs were coated with PI4 a. m. and with

each Polyimide/chiral. The liquid crystals (LCs) were inserted between two coated glass slides at above the nematic temperature under the polarized light microscope to observe the alignment of LCs. The results showed the alignment of LCs in some certain direction under Polyimide/chiral pair, regardless of the type of the chiral

molecule. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 120: 3265-3277, 2011″
“Study Design. Retrospective, case-control study.

Objective. Determine risk factors for postoperative wound infections after surgery for neuromuscular scoliosis as well as the causative organisms and the results of treatment.

Summary of Background Data. Wound infection after surgery for neuromuscular scoliosis is more common than that for idiopathic scoliosis. A variety of potential risk factors have been identified, but few have demonstrated statistical significance.

Methods. The Pediatric Orthopedic Spine Database identified 151 patients with neuromuscular scoliosis find more who underwent surgery and had a follow-up of minimum of 2 years. A to

tal of eight patients (5.3% prevalence) developed a postoperative wound infection. Nine patients without an infection selleck inhibitor were matched by year and type of surgery, for each patient with an infection and selected as controls (n = 72). Preoperative, intraoperative, and postoperative factors were analyzed for an association with wound infection by using stepwise logistic regression. In addition, causative organisms as well as the methods and results of treatment were recorded for each patient.

Results. The control group consisted of 32 males and 40 females with a mean age of 13.3 years (range, 7-21 years) and a mean follow-up of 4.6 years (range, 2.0-20.9 years) at surgery. The infection group (n = 8) consisted of four males and four females with a mean age of 12.5 years (range, 11-14 years) and a mean follow-up of 5.1 year (range, 2.0-12.3 years) at surgery. There were five early and three late wound infections. The presence of a ventriculoperitoneal shunt before surgery was the only factor statistically associated with an increased risk for wound infection (P < 0.01). In addition, infection was associated with pseudarthrosis (P < 0.01) and an increased length of hospitalization (P < 0.01).

Twenty minutes after injection, mean headache severity decreased

Twenty minutes after injection, mean headache severity decreased by 3.2 points in group A (p < 0.01) and by 3.1 points in group B (p < 0.01). Mean neck pain severity decreased by 1.5 points in group A (p < 0.01) and by 1.7 points in group B (p < 0.01). Mean duration of being headache-free was 2.7 +/- 3.8 days in group A and 1.0 +/- 1.1 days in group B (p = 0.67). None of

the outcome measures differed significantly between the two groups. Both treatments were full tolerated. In our study, adding Entinostat concentration triamcinolone to local anaesthetic when perfoming GONB and TPIs was not associated with improved outcome in the sample of patients with TM. In both groups, the procedure Selleck NVP-AUY922 resulted in significant and rapid relief of headache, neck pain, photophobia and phonofobia.”
“A series of carbon black filled SBR 1500 compounds (without curatives)

were prepared in carefully controlled lab-mixing conditions so that filler content ranged from 0 to 50 phr, with the usual compounding ingredients. Carbon Black agglomeration and dispersion quality were assessed through an advanced microscopic technique with automated data treatment. Linear and nonlinear viscoelastic properties were evaluated using a closed cavity torsional rheometer, equipped for Fourier Transform rheometry experiments. In the linear viscoelastic regime, dynamic moduli mastercurves were derived from experiments in the 60-160 degrees C temperature range. In the nonlinear viscoelastic regime, complex modulus and torque harmonics variation with strain amplitude were investigated at 100 degrees C and frequency 0.5 and 1.0 Hz. Relationships between dispersion quality, carbon black loading and mixing parameters were investigated so that dispersion appears better when the filler loading is above a critical level that to some extent (but not exactly)

corresponds to the theoretical percolation threshold (around 13%). Linear and nonlinear viscoelastic measurements demonstrate and quantify the role played by plasticizing compounding ingredients, that CAL-101 price is, processing oil, stearic acid and other chemicals, with nearly no significant effect of mixing energy. At least 10-15 phr carbon black are necessary to recover the modulus loss associated with this plasticizing effect. Nonlinear results and particularly the torque harmonics reveal a number of details as to how the compounding ingredients do affect the viscoelastic behavior, with expectedly the carbon black playing the major role. By fitting results with mathematically simple models, all of the observed effects can be summarized in a rather limited number of parameters so that the effects of compounding ingredients can be studied in details. (C) 2011 Wiley Periodicals, Inc.

However, it reduced significantly DNA damage and blood MDA levels

However, it reduced significantly DNA damage and blood MDA levels in STZ-induced diabetic rats compared to the control group. Plasma levels of TNF-a however did not show any significant changes

in STZ-induced diabetic rats fed with CV. Antioxidant enzyme SOD showed no significant changes in all groups but CAT activity was reduced in STZ-induced diabetic rats compared to the control.

Conclusions: CV did not have hypoglycaemic effect but it has a protective role in STZ-induced diabetic rats by reducing oxidative DNA damage, and lipid peroxidation.”
“Extant epidemiologic results for pediatric congenital heart disease PRIMA-1MET manufacturer (CHD) are dated. Given the degree of variability in previous prevalence estimates and the rapid changes in LEE011 order pediatric cardiology diagnostic and treatment procedures, a reexamination of these rates represents a potentially important update in this area of inquiry. This report characterizes the prevalence rates of children with CHD in one state’s treated pediatric population by type of lesion and in comparison with published rates from previous studies. Two 15-year data sets (1996-2010) are analyzed. The inclusion criteria for the study required the participants to be 17 years or younger, enrollees in the South Carolina State Medicaid or State Health Plan, and recipients of a CHD diagnosis on one or more service

visits to a pediatrician or pediatric cardiologist. A 15-year accrued prevalence rate for pediatric CHD of 16.7 per 1,000 was found among 1,145,364 unduplicated children served. The annual incidence rates varied from 6.3 to 8.6 per 1,000, selleck kinase inhibitor with an initial downward trend from 1996 to 2002 followed by an upward trend from 2003 to 2008. A higher prevalence of atrioventricular canal/endocardial cushion

defects, common/single ventricle, double-outlet right ventricle, tetralogy of Fallot, and truncus arteriosus and a lower prevalence of dextro-transposition of the great arteries were diagnosed in South Carolina than in other states and countries according to published results. The study results underscore the need for periodic updating of prevalence data for pediatric CHD, both in total and for specific lesions, to anticipate and provide more specialized care to young patients with CHD, especially in the more rare and complex cases.”
“Purpose: We lesioned the hypothalamic paraventricular nucleus (PVN) of male Wistar rats using two different doses (8 mu g/3 mu l and 16 mu g/3 mu l) of 5,7-dihydroxytryptamine (5,7-DHT) and then animals were subjected to a battery of behavioral tests designed to assess anxiety and memory formation. Further, we were interested to know whether this lesion would result in neuronal oxidative stress and also if there is a correlation between the behavioral response to this lesion and brain oxidative stress.

Summary of Background Data As the population ages, the incidence

Summary of Background Data. As the population ages, the incidence of degenerative spine conditions increases. More patients are being diagnosed with and treated for spinal deformities, including scoliosis.

Methods. We examined dual-energy x-ray absorptiometry lumbar spine images of 3185 individuals >= 40 years old (average, 60.8 years; range, 40-97 years), obtained July 2002 to

June 2005, to determine the presence of scoliosis (i.e., a curvature of >= 11.0 degrees) by digitally buy OSI-744 measuring Cobb angles. Patients with a history of previous lumbar spinal surgery were excluded, leaving 2973 individuals for final evaluation. We used SAS system software, version 9.1 (SAS Institute, Inc., Cary, NC) to investigate the relationship between the prevalence of scoliosis BAY 11-7821 and the variables of age, race, and gender, we then examined for any effect that these variables had on curve severity.

Results. We identified scoliosis (i.e., a Cobb angle of >= 11 degrees) in 263 of 2973 patients. Age was associated with an increased prevalence of scoliosis, e.g., 40 to 50 years old, 3.14%; >= 90 years old, 50%. Prevalence rates differed among races (e.g., 11.1% for whites and 6.5% for African Americans) but were similar for men and women. Most patients had mild curves (80.6%), there was no difference in the

distribution of curve severity by gender or age, and African Americans were more likely to have mild curves (94.3%) than were other races.

Conclusion. The prevalence of scoliosis in our patients >= 40 years old was 8.85% and was associated with age and race,

but not with gender. Most curves in our population were mild; curve severity was associated with race but not with age or gender.”
“A novel see more toughening modifier, styrene-isoprene-butadiene rubber (SIBR), was used to improve the impact resistance and toughness of acrylonitrile-butadiene-styrene (ABS) resin via bulk polymerization. For comparison, two kinds of ABS samples were prepared: ABS-1 was toughened by a conventional modifier (a low-cis polybutadiene rubber/styrene-butadiene block copolymer), and ABS-2 was toughened by SIBR. The mechanical properties, microstructures of the as-prepared materials, and fracture surface morphology of the specimens after impact were studied by instrumented notched Izod impact tests and tensile tests, transmission electron microscopy, and scanning electron microscopy, respectively. The mechanical test results show that ABS-2 had a much higher impact strength and elongation at break than ABS-1. The microscopic results suggested that fracture resistance of ABS-1 only depended on voids, shear yielding, and few crazing, which resulted in less ductile fracture behavior.

Methods: The medical records of patients

admitted to Well

Methods: The medical records of patients

admitted to Wellington Hospital with AECOPD during a 12-month period from June 2006 were reviewed. Logistic regression was used to determine the strength of the association between the CRB65 score and death at three measurement times: in-hospital, 30 days and 12 months.

Results: Complete data VX-770 purchase were available in 133/174 patient admissions. In-hospital and 30-day mortality increased progressively with increasing CRB65 score and was markedly higher in the CRB 3-4 group (3%, 5%, 29%, and 4%, 9%, 43% for CRB65 scores 0-1, 2, 3-4 for in-hospital and 30-day mortality, respectively). Differences in 1-year mortality were less apparent (24%, 25%, 57% for CRB65 scores 0-1, 2, 3-4, respectively). The CRB65 score demonstrated a modest value for predicting in-hospital and 30-day mortality with a c statistic of 0.68 at both time points.

Conclusions: The CRB65 score shows similar characteristics for predicting short-term mortality in

AECOPD as its use in community-acquired pneumonia. We recommend its use in clinical practice, particularly in patients with a score >= 3, which is associated with a high risk of early mortality, and need for intensive hospital management.”
“It has been proposed that laparoscopic adjustable gastric banding (LAGB) procedure might play a role in modulation of fundic ghrelin production. To test this hypothesis, we examined plasma and tissue concentrations of acylated ghrelin in morbidly obese patients before buy MK-8776 and 6 months after LAGB. Baseline levels of acylated ghrelin in morbidly obese patients were also compared with those in age-matched, healthy,

non-obese controls.

We studied 21 patients who had been operated on for morbid obesity (M/F = 9/12, BMI = 49.3 +/- 5.3 kg/m(2)) and 16 healthy, non-obese persons (M/F = 7/9, BMI = 23.0 +/- 1.7 kg/m(2)). Fasting blood samples were collected once selleck kinase inhibitor from the non-obese controls as well as the morbidly obese patients before and 6 months after the LAGB. The morbidly obese patients and their respective controls underwent gastroscopy for fundic biopsy. The plasma and fundic acylated ghrelin levels were evaluated in these groups by enzyme-linked immunosorbent assay.

The plasma and fundic acylated ghrelin concentrations were significantly lower in obese patients than in non-obese controls (2.8 +/- 1.0 ng/ml, 727 +/- 171.7 ng/g tissue, respectively; p = 0.000). These parameters were significantly increased in morbidly obese patients 6 months after LAGB (4.1 +/- 1.2 ng/ml and p = 0.001; 999 +/- 292.1 ng/g tissue and p = 0.003, respectively).

We showed that fundic production of acylated ghrelin was significantly increased in morbidly obese patients 6 months after LAGB. Moreover, the weight loss after LAGB occurred in spite of the significant increase in the plasma and fundic acylated ghrelin levels.

At M6, the mean air conduction PTA with transcutaneous BCD was 28

At M6, the mean air conduction PTA with transcutaneous BCD was 28.45 +/- 1.68 dB, the mean gain 43 +/- 6.96 dB, and the mean SRT gain 33.33

+/- 10.75 dB. Using speech-in-noise tests in real-life conditions, the mean SRT was statistically improved with the transcutaneous BCD (-8 +/- 2.83 dB, p = 0.0313). Both children and parents reported being satisfied or very satisfied.

Conclusion: These preliminary results selleck products show satisfactory functional gain, cutaneous tolerance, and patients’ satisfaction with the new transcutaneous BCD.”
“Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can result in left-ventricular distension and the development of pulmonary edema. We present the case of a 13-year-old girl who presented with cardiogenic shock. VA-ECMO was

initiated, but after 6 days, severe left-ventricular distension resulted in decreased VA-ECMO flows. With guidance by bedside transesophageal echocardiography, a percutaneous VS-6063 purchase atrial transseptal cannula was placed and connected to the venous circuit, thus decompressing the left ventricle. The patient improved, was weaned from VA-ECMO 5 days later, and was discharged from the hospital. Bedside transseptal catheter insertion is an effective method of left-ventricular decompression.”
“This study aimed to characterize the profiles of suicide attempts that were attended to in the Hospital of Alagoas in the year 2010. Four hundred sixty-one charts and service bulletins were analyzed. Patients attempting suicide were predominately female. There were significant difference for suicide attempts

(SAs) among men and women in the age of 10 to 19 years and 60 to 69 years. Women have tried more suicide aged between 10 and 19 years and men between 60 and 69 years. The ingestion of drugs was the most frequent method buy BB-94 for women; and poisoning, use of sharp objects and hanging for men. The results of this study may contribute to elaboration, planning and implementation of preventive measures to reduce cases of SAs.”
“Elevated plasma homocysteine (Hcy) is one of the suggested risk factors for endothelial dysfunction. There is evidence of association between raised plasma Hcy and an increased risk of developing peripheral arterial disease. A causal relationship, however, has not been established. In this report, a 37-year old male patient with the complaints of intermittent hand pain is presented. Brachial artery aneurysm accompanying a homozygous methylenetetrahydrofolate reductase mutation was detected.”
“Objective: Mobility is crucial to maintain a sufficient quality of life. Posturography should be therefore focused on the investigation of daily-life activities (“”mobile posturography”"). Nowadays, postural control is often estimated by stance tasks on a force plate under different sensorimotor conditions. This technique applies an indirect approximation of the center of body mass and is not related to tasks required for mobility.


“Background: Fire eater’s lung (FEL) is a distinct form of


“Background: Fire eater’s lung (FEL) is a distinct form of acute chemical toxic pneumonitis, which is click here caused by aspiration of flammable petrochemical derivatives used by street performers for ‘fire eating’. The optimal management of this condition has not yet been determined. Objective: The aim of this study was to investigate patient characteristics, clinical features, treatment, and outcome of FEL. Methods: A single-center retrospective review of consecutive cases of FEL in children and adults reported to a national poison center (the Swiss Toxicological Information Center) between 1995 and 2012. Results: 123 cases (83.7% males, mean age 21.9 years) were included.

The most frequently reported symptom was cough (50.4%), followed by chest pain (45.5%), and fever (35.8%). Dyspnea was reported by 23.6%. Cough (p = 0.002) and chest pain (p = 0.02) were significantly more prevalent in subjects reporting to have aspirated the fuel compared to those who have swallowed it or who did not perceive poison exposure. A pulmonary infiltrate was detected in 83% of the cases in whom chest X-ray was performed. Overall, 22% were treated with an antibiotic agent for a mean duration of 10.4 days. Corticosteroids were administered in 4.9%. All showed complete recovery irrespective of the therapeutic

management. Conclusion: The combination of intense pleuritic chest pain, cough, dyspnea, and fever, or any of these symptoms after ‘fire eating’

or erroneous swallowing of a petroleum distillate Doramapimod should alert the clinician to the diagnosis of FEL. Early antibiotic Epigenetics inhibitor treatment of severe cases seems justified, considering that clinical, laboratory, and radiologic findings of FEL are overlapping with bacterial superinfection. Copyright (C) 2013 S. Karger AG, Basel”
“Low-frequency (1/f) noise is studied in N-channel furnace solid phase crystallized (FSPC) and in laser solid phase crystallized (LSPC) polysilicon thin film transistors (TFTs) biased from weak to strong inversion. Noise analysis is supported by the theory of charge carrier trapping/detrapping at the interface tunneling into gate oxide traps. The distribution of interface trap states (N-T) is deduced from the number of carriers trapped into the oxide. Noise measurements for devices biased from weak to moderate inversion allow the determination of the distribution of deep level trap states associated with dangling bond-type defects (N-Tdb), whereas measurements from moderate to strong inversion give the distribution of shallow level trap states (N-Tts) associated with strained bond defects. The noise analysis clearly shows that the slope of both exponential distributions equals to the reverse of the Meyer Neldel energy E-MN (0.035 and 0.055 eV for FSPC and LSPC TFTs, respectively).

Results: During 4-10 y of follow-up, 5249 coronary events and 215

Results: During 4-10 y of follow-up, 5249 coronary events and 2155 coronary

deaths occurred among 344,696 persons. For a 5% lower energy intake from SFAs and a concomitant higher energy intake from PUFAs, there was a significant inverse association between PUFAs and risk of coronary events (hazard ratio: 0.87; 95% CI: 0.77, 0.97); the hazard ratio for coronary deaths was 0.74 SCH772984 (95% CI: 0.61, 0.89). For a 5% lower energy intake from SFAs and a concomitant higher energy intake from carbohydrates, there was a modest significant direct association between carbohydrates and coronary events (hazard ratio: 1.07; 95% CI: 1.01, 1.14); the hazard ratio for coronary deaths was 0.96 (95% CI: 0.82, 1.13). MUFA intake was not associated with CHD. No effect modification by sex or age was found.

Conclusion: The associations suggest that replacing SFAs with PUFAs rather than MUFAs or carbohydrates prevents CHD over a wide range of intakes. Am J Clin Nutr 2009;89:1425-32.”
“Graphite nanosheets (GNs) modified with sodium dodecyl benzene sulfonate (SDBS)

selleck chemicals llc was prepared and then incorporated into high-density polyethylene The GNs/HDPE nanocomposites displayed pronounced enhancements of the mechanical properties. With a load of 10 wt % of the modified GNs, the nanocomposites exhibited all increase of about 290% in the elongation at break as well as all increase of about 14% in the elastic modulus in comparison with neat HDPE. Scanning electron microscopy (SEM) shows a notable microscopic orientation of the matrix

and GNs in the strained nanocomposite specimen, which may play an important role in the dramatic increase in the elongation at break. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 116: 2029-2034, 2010″
“The magnetic noise of a frozen ferrofluid made RepSox mouse of maghemite nanoparticles dispersed in glycerin is measured using a two-dimensional electron gas based quantum well Hall sensor (QWHS) with the spinning current technique. The frozen ferrofluid shows a superspin glass transition at 67 K. Below this glass transition temperature, the relation between the imaginary part of the ac susceptibility of a bulk ferrofluid sample and the magnetic noise measured with the QWHS gives an indication of a violation of the fluctuation dissipation theorem. (C) 2010 American Institute of Physics. [doi:10.1063/1.3366613]“
“Background Abdominal aortic aneurysm (AAA) is a common cardiovascular disease among older people and demonstrates significant heritability. In contrast to similar complex diseases, relatively few genetic associations with AAA have been confirmed. We reanalyzed our genome-wide study and carried through to replication suggestive discovery associations at a lower level of significance.

Two types of nano-diamond seed powders of similar grain sizes but

Two types of nano-diamond seed powders of similar grain sizes but with different zeta potentials were also compared. The pretreated substrate surface and the synthesized UNCD film were characterized by near edge x-ray absorption fine structure, FTIR, AFM, high-resolution

scanning electron microscope, HR-TEM, and Raman spectroscopy. The electrophoretic light scattering spectroscopy was adopted to characterize the zeta potentials of the seeding suspensions and that of the substrates, respectively. Contrary to the previous report, the pretreatments deteriorated the seed density relative to that of the non-treated substrate. By contrast, the seed density was drastically SHP099 solubility dmso improved by using

a proper type of the nano-diamond seed powder. The seed density variation according to the substrate pretreatments and the type of the seed powders was attributed to the relative values of the zeta potentials of the substrates and that of the seed powders, which indicated the electrostatic nature of the seeding process. The variation of the substrate surface zeta potentials was attributed to the variation in the surface terminations induced by the respective pretreatments. The present DC-PACVD environment ensured that the secondary nucleation was also active enough to generate the densely packed UNCD grains in the growth stage. Consequently, the ultrathin, mirror-smooth S63845 and void-free UNCD film of 30 nm in thickness was enabled. (C) 2011 American Institute of Physics. [doi:10.1063/1.3652752]“
“Mechanical circulatory support (MCS) devices are a guideline-recommended treatment option for a small subset of advanced heart failure patients. MCS has the potential to become more prominent in the management of Navitoclax Acute Heart Failure Syndromes (AHFS) as device technology advances and as clinical trials consistently discover neutral or harmful effects with pharmacologic therapies hypothesized to be beneficial in this population.

While it is now possible to identify AHFS patients who are at high risk of death, the therapeutic options available to improve their long-term outcomes are limited. MCS therapy in this population offers a “”bridge to recovery”" strategy; these patients may have viable myocardium that responds favorably to the influence of MCS on neurohormones, cytokines, and/or reverse remodeling. Patients at high risk for mortality who have a substantial likelihood of benefiting from MCS can be easily identified using standard clinical criteria developed from large observational databases. MCS technology is rapidly evolving, and risks related to implantation are declining.