bluuebunny/crossref_metadata_2025 huggingface dataset:
Low skeletal muscle density combined with muscle dysfunction predicts adverse events after adult cardiovascular surgery
Authors: Yamashita M , Kamiya K , Matsunaga A , Kitamura T , Hamazaki N , Nozaki K , Ichikawa T , Maekawa E , Meguro K , Yamaoka-Tojo M , Miyaji K
Published: May 2021

Funding Acknowledgements

Type of funding sources: Other. Main funding source(s): This study was supported by the Grant for Japan Society for the Promotion of Science (JSPS) KAKENHI.

Introduction

Although muscle dysfunction is widely known as a poor prognostic factor in patients with cardiovascular disease, no study has examined whether the addition of low skeletal muscle density (SMD) assessed by computed tomography (CT) to muscle dysfunction is useful.

Purpose

The present study aimed to examine whether SMDs can strengthen the predictive ability of muscle dysfunction for adverse events in patients who underwent cardiovascular surgery.

Methods

We retrospectively reviewed 853 patients (median age: 69 years, 65.1% male) aged ≥40 years who had preoperative CT for risk management purposes and muscle dysfunctions measured during postoperative cardiac rehabilitation. Muscle dysfunctions were determined from weakness (low grip strength) and slowness (slow gait speed) based on the Asia Working Group for Sarcopenia. Low SMD based on transverse abdominal CT images was defined as a mean Hounsfield unit of the psoas muscle <45. To examine the complementary prognostic value for all-cause deaths, all-cause events, and cardiovascular-related events when low SMDs were added to four patterns of muscle dysfunction (weakness only, slowness only, weakness or slowness, and weakness and slowness), the continuous net reclassification improvement (cNRI) and integrated discrimination improvement (IDI) index were calculated.

Results

For all definitions of muscle dysfunction, the addition of SMDs was shown to significantly improve the cNRI (estimates: 0.377 to 0.468 for all-cause death, 0.220 to 0.248 for all-cause events, 0.308 to 0.322 for cardiovascular-related events) and IDI (estimates: 0.005 to 0.011 for all-cause death, 0.005 to 0.010 for all-cause events, 0.009 to 0.012 for cardiovascular-related events) in all analyses. Low SMDs combined with muscle dysfunctions were associated with the highest risk of all-cause death (Figure 1: A-D). Patients with neither low SMDs nor muscle dysfunction had the lowest risk of all-cause events and cardiovascular-related events (Figure1: E-L).

Conclusion

The predictive ability of muscle dysfunction for adverse events was consistently increased by addition of SMDs in patients who underwent cardiovascular surgery. Our results suggest that when CT is performed for any clinical investigation, the addition of the organic assessment of skeletal muscle can strengthen the diagnostic accuracy of muscle wasting.

Abstract Figure 1
The underrepresentation of female participants in studies assessing the impact of high-dose exercise on cardiovascular outcomes: a scoping review
Authors: Pallikadavath S , Patel R , Kemp CL , Hafejee M , Peckham N , Jain V , Mccann GP
Published: May 2021

Funding Acknowledgements

Type of funding sources: None.

Introduction

Cardiovascular adaptations as a result of exercise conducted at high-intensity and high-volume are often termed the ‘Athlete’s heart’. Studies have shown that these cardiovascular adaptations vary between sexes. It is important that both sexes are well represented in this literature. However, many studies assessing the impact of high-dose exercise on cardiovascular outcomes under-recruit female participants.

Purpose

This scoping review aimed to evaluate the representation of females in studies assessing the impact of high-dose exercise on cardiovascular outcomes and demonstrate how this has changed over time.

Methods

The scoping review protocol as outlined by Arksey and O’Malley was used. OVID and EMBASE databases were searched and studies independently reviewed by two reviewers. Studies must have investigated the effects of high-dose exercise on cardiovascular outcomes. To assess how the recruitment of females has changed over time, two methods were used. One, the median study date was used to categorise studies into two groups. Two, studies were divided into deciles to form ten equal groups over the study period. Mean percentage of female recruitment and percentage of studies that failed to include females were calculated.

Results

Overall, 250 studies were included. Over half the studies (50.8%, n = 127) did not include female participants. Only 3.2% (n = 8) did not include male participants. Overall, mean percentage recruitment was 18.2%. The mean percentage of recruitment was 14.5% before 2011 and 21.8% after 2011. The most recent decile of studies demonstrated the highest mean percentage of female recruitment (29.3%) and lowest number of studies that did not include female participants (26.9%).

Conclusion

Female participants are significantly underrepresented in studies assessing cardiovascular outcomes caused by high-dose exercise. The most recent studies show that female recruitment may be improving, however, this still falls significantly short for equal representation. Risk factors, progression and management of cardiovascular diseases vary between sexes, hence, translating findings from male dominated data is not appropriate. Future investigators should aim to establish barriers and strategies to optimise fair recruitment.

Mean percentage females recruited per study (%) Percentage studies that do not include women (%) Overall (n = 250) 18.2 50.8 (n = 127) Studies before 2011 (n = 121) 14.5 59.5 (n = 72) Studies after 2011 (n = 129) 21.8 42.6 (n = 55) Table 1: Female recruitment characteristics. The year 2011 (median study year) was chosen as this divides all included studies into two equal groups.
Nursing management of anxiety and sleep disorders in patients hospitalized in a cardiac intensive care unit
Authors: Mzoughi K , Mansouri S , Aissa I , Ben Mrad I , Zairi I , Kraiem S
Published: May 2021

Funding Acknowledgements

Type of funding sources: None.

Introduction

Cardiac intensive care unit is an environment that induces a high rate of stress, anxiety and sleep disorders in hospitalized patients. All these elements can create an obstacle in the continuity of care and increase cardiovascular risk.

Purpose

The purpose of our study was to evaluate the anxiety and sleep disorders in patients admitted to the ICUU and to evaluate nurses’ behavior to these disorders.

Materials and methods

We conducted a descriptive, transversal, observational, prospective study in the cardiology department of Habib Thameur Hospital, which included 37 patients admitted to the ICU and 11 nurses practicing in the department. A questionnaire including two validated scales (HADS-A for anxiety and RCSQ for sleep) was submitted to patients and a self-questionnaire was administered to nurses.

Results

Patients mean age was 61.24 ± 13.41 years with a sex ratio of 2.36. Eight patients (22%) admitted to the ICU had anxiety disorder. In univariate analysis, female gender and mean hospital stay were significantly associated with anxiety among patients admitted to the ICU. In multivariate analysis, female gender was the only independent factor associated with anxiety at ICU hospitalization (relative risk = 3, 95% confidence interval 2.25-3.37, p = 0.005). Seventeen patients (40%) were afraid of death. The majority of patients (92%, n = 34) felt safe with the health care team. Most patients (92%, n = 34) responded to their visitors (through the window), 97% of whom were family members.

Seven patients (19%) had poor sleep. The item with the lowest average was the quality of sleep (53.86 ± 15.65). In univariate analysis, urban living and the average number of sleep hours were significantly associated with poor sleep. Surveillance of vital signs, noise and monitor alarms were the main factors of sleep disturbance.

Eleven nurses were included in our study. Seven nurses considered the management of anxiety as not important, and six answered that the management of sleep disorders was not important. The most used medication by nurses to relieve both symptoms was Hydroxyzine tablets. The most common non-medical way to relieve anxiety was privacy. The most common non-medication way to improve sleep was brightness reduction.

Conclusion

Our study shows that despite the prevalence of anxiety and sleep disorders in patients admitted to the ICU, their care by nurses was not adequate.

Specific training on assessment and coping with these disorders could improve nursing care.
Sex-based differences in program completion and clinical outcomes in patients following outpatient cardiac rehabilitation
Authors: Chan E , Chirico D , Arena R , Feng Y , Liang Z , Ahmed SB , Colbert J , Aggarwal S
Published: May 2021

Funding Acknowledgements

Type of funding sources: None.

Background

Females have greater reduction in mortality compared to males, following completion of a cardiac rehabilitation (CR) program, yet they continue to have lower referral rates and program completion. Since 1996, a local rehabilitation program has been the main provider of CR in our health zone. A standardized rapid referral program was implemented in 2008 to improve referral rates of hospitalized patients. Since then, the relationship between sex and CR completion is unknown.

Purpose

To evaluate the relationship between sex and CR completion and to evaluate the association between CR completion and clinical outcomes, stratified by sex.

Methods: We included consecutive patients who were referred to CR and who

1) were hospitalized for an acute coronary syndrome (ACS) or stable angina between 2008 and 2016; 2) had angiographic evidence of at least one-vessel coronary disease; and 3) had revascularization with percutaneous intervention, coronary artery bypass or medical management. The outcomes of interest were CR completion, anxiety and depression categories, exercise capacity, death, and need for revascularization. Logistics regression models were used to determine the association between sex and CR completion. The association between sex, CR completion, and the outcomes of interest were assessed using multivariable cox proportional hazards models.

Results

A total of 726 females and 2645 males were included in this study. The rate of CR completion was lower in females compared to males (64.6% vs 69.98%, p = 0.006). Following adjustment for baseline characteristics, female sex independently predicted lower rates of CR completion, OR 0.81 (95%CI 0.67-0.97).

Both sexes displayed improvements in peak metabolic equivalents (METs) achieved during exercise testing (W: initial 5.99 ± 1.93; 12-week 7.22 ± 1.92; M: initial 7.62 ± 2.04; 12-week 8.81 ± 1.93, p = 0.001). Amongst CR completers, one-year mortality was similar between sex (W: 1.84% vs M: 3.27%, p = 0.118), as was revascularization (W: 14.29% vs M: 11.97%, p = 0.193), however both sexes had higher one-year mortality in CR non-completers.

Conclusion

Despite a standardized CR referral protocol, a sex-difference in CR completion remains. In CR completers, one-year mortality and revascularization was similar in both sexes, however mortality was higher in CR non-completers. Our study suggests that addressing the causes of female CR non-completion following ACS or stable angina may improve outcomes.

Outcomes by CR Completion and Sex All NC (n = 1051) W-NC (n = 257) M-NC (n = 794) p-value All C (n = 2320) W-C (n = 469) M-C (n = 1851) p-value Revascularization-1 year (%) 146 (14.94) 28 (11.72) 118 (15.59) 0.107 267 (12.44) 62 (14.29) 205 (11.97) 0.193 Death-1 year (%) 67 (6.86) 19 (7.95) 48 (6.50) 0.442 64 (2.98) 8 (1.84) 56 (3.27) 0.118 W = Women;M = Men;NC = Non-Completers;C = Completers
Assessment of vascular function in formerly pre-eclamptic women as a novel marker of future cardiovascular risk
Authors: Faes E , Mannaerts D , Witvrouwen I , Van Berendoncks A , Jacquemyn Y , Van Craenenbroeck EM
Published: May 2021

Funding Acknowledgements

Type of funding sources: None.

Background

Women with a history of pre-eclampsia (PE) are at increased risk of cardiovascular disease (CVD). The association between PE and CVD in later life may be explained by vascular dysfunction, either pre-existing or elicited by PE.  Several small studies have shown that vascular dysfunction may persist for years in some patients, indicator of future CVD risk, while other studies could not confirm these findings.

Purpose

In this longitudinal prospective cohort study, we aim to comprehensively assess vascular function in previously pre-eclamptic women (early (<34 weeks) and late (>34 weeks)) and healthy controls. We hypothesize that vascular dysfunction is both more persistent and pronounced in early PE compared to late PE since different pathophysiologic mechanisms underlie both subtypes of PE.

Methods

For this first analysis, 63 PE patients were compared to 16 non-pregnant healthy controls.  Endothelial function was determined by flow-mediated dilatation (FMD), modified FMD (mFMD) and low-flow mediated constriction (L-FMC). Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV) and augmentation index using pulse wave analysis of the brachial artery, and corrected for heart-rate (Aix75).

Results

Average post-partum period was 11 months (1.4-111.5 months). Thirty-five presented with early PE, 28 with late PE.

In the total PE group, FMD was significantly decreased compared to healthy controls (7.1 ± 2.8 vs 8.9 ± 3.8; p = 0.037), but no difference between early and late PE was observed. Likewise, Aix75 remained elevated after PE (16.5 ± 11.5 vs 5.8 ± 10.1; p < 0.001), again, without difference between early and late PE.  cfPWV was not different after PE compared to healthy controls (p > 0.05) but was significantly higher in the early PE group compared to the late PE group (6.9 ± 1.0 vs 6.4 ± 1.0;  p = 0.045).

Conclusion

Even in the postpartum, PE is characterized by overt and persisting endothelial dysfunction and arterial stiffness. Arterial stiffness is more pronounced in early PE compared to late PE.

This reaffirms that PE has consequences beyond placental impairment and that the persisting vascular impairment in the postpartum could reflect the risk of CVD later in life.
The most common cardiovascular diseases in an outpatient cardiology office with online patient support
Authors: Podgorodetskaya N , Demkina AE
Published: May 2021

Funding Acknowledgements

Type of funding sources: None.

Purpose. To study cardiovascular diseases diagnosed in the cardiology office with online patient support on the basis at Korolev Family Outpatient Clinic No. 4

Methods. The Clinic has created a cardiology room with online patient support. A special feature of the online office is that after a full-time appointment, patients are tracked through our Instagram account. Patient support is provided in the form of posts and video lectures lasting up to 60 minutes in the period from 01.01.2020 to 01.12.2020.

Results. 1,938 people (35% men; average age 55.7 years) were treated, including 980 patients with cardiovascular diseases (56% men; average age 56.7 years). The most common cardiovascular diseases were arterial hypertension (72%), cardiac arrhythmia (15.6%) and coronary heart disease (11.6%). The second stage of treatment was carried out online through the medical blog Instagram account (online). The average monthly reach of an online consultation room is 15,100 users; 11.8% of them are men; the main age group from 24 to 45 years is 37.4% of users. The highest participation over 11 months was achieved by posts about hypertension (27,058) and cardiac arrhythmia (100,681).

Conclusions. Cardiovascular diseases are the most common reason for visiting the therapeutic department. Analysis of the work shows that hypertension (72%), cardiac arrhythmia (15.6%) and coronary heart disease (11.6%) are the most common cardiovascular diseases. This corresponds to epidemiological data on the prevalence of cardiovascular diseases among the Russian population. Online support is a popular form of interaction between healthcare professionals and patients. The average annual and monthly coverage of the online consultation room is 165,000 and 15,000 people, respectively. The most popular topics in the online consultation are hypertension and cardiac arrhythmia. Further research is needed to combine face-to-face meetings and online patient support to ensure patient compliance, build trust in healthcare professionals, and improve patient quality of life.
COVID-19 pandemic stresses trigger ST-elevation and non-ST-elevation acute myocardial infarction in Middle Eastern individuals not infected with the virus
Authors: Hammoudeh A , Mdanat E , Tabbalat R , Jarrah M , Alhaddad IA
Published: May 2021

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): Abdul Hameed Showman Foundation

OnBehalf

The Jordan COVID-19 AtheRosclerotic Cardiovascular Events (JoCORE) Study Investigators

Background. The vicarious stresses associated with the covid-19 pandemic have been reported to cause psychosocial behavioral changes in individuals not infected with the virus. No reports have evaluated the effect of these stresses on triggering acute ST-segment elevation and non-ST-segment elevation myocardial infarction (STEMI and NSTEMI, respectively) in such individuals. Purpose. We sought to study the nature of MI triggers and clinical profiles in non covid-19 individuals during the pandemic. Methods: Patients not infected with the covid-19 virus admitted to 9 hospitals with STEMI and NSTEMI during the pandemic crisis in Jordan from February through December 2020 were evaluated for pre-MI exposure to psychosocial and economic triggers related to the pandemic, lockdown and shutdown. Results: Of 144 patients enrolled, 58 (40.3%) had STEMI and 86 (59.7%) had NSTEMI. Compared with the NSTEMI group, the STEMI group tended to be younger (59.0 + 13.8 vs. 62.3 + 12.7 years, p = 0.14), had significantly more men than women (94.9% vs. 75.6%, p = 0.005), were more likely to be smokers (75.9% vs. 55.8, p = 0.02) and had lower prevalence of prior coronary revascularization (17.2% vs. 45.3%, p = 0.001). In-hospital mortality among the 133 patients who were alive upon hospital arrival was 1.5%. All patients reported exposure to at least one psychosocial stressful trigger, including lockdown and loneliness stress (65.3%), fear of contacting covid-19 infection or of uncertainty (26.4%), anger (18.8%), and death of a significant person during the pandemic (4.2%) Financial hardship and volatile income were reported by 42.4% of patients. STEMI and NSTEMI patients did not have significant differences in the frequency of psychosocial (100% vs. 99.9%, respectively, p = NS) or economic triggers (34.5% vs. 47.7%, respectively, p = NS). Conclusions. Exposure to psychosocial and financial stresses related to the covid-19 pandemic and its related lockdown can trigger acute MI. An increase in the number of these events may become a potentially serious health issue with longer duration of the unremitting pandemic.
Effects of COVID-19 pandemic on physical activity: Results of the Russian online survey on spring 2020
Authors: Kontsevaya A , Mukaneeva D , Myrzamatova A , Khudyakov M , Drapkina O
Published: May 2021

Funding Acknowledgements

Type of funding sources: None.

Introduction

The Russian Federation reported one of the largest number of COVID-19 infections. In spring 2020 social distancing, travel bans, the cancellation of sporting and other mass participation events, and changes to work practices have dramatically affected daily life throughout the country. Major restrictions were introduced on the 28th March 2020 with the level of restrictions varied depending on the epidemiology of the virus from region to region. Cities with a large number of cases had the most strict restrictions such as limitations on any outdoor activities. In cities with a smaller number of cases limitations were less strict, especially with outdoor activities. Indoor sport activities were limited across the country and outdoor sports were restricted – depending on the situation in the region.

The aim of this study is to estimate the impact of COVID-19 on the levels of physical activity among adults in Russia.

Methods

Cross-sectional data were collected during the period of tightest restrictions between 26 April 2020 and 6 June 2020. The link on the on-line survey was distributed through the regional centers of public health. Eligible participants included all Russian adults aged 18 years and over. Participants reported frequency and duration of walking, moderate- and vigorous-intensity physical activity, and muscle strengthening activities before COVID-19 and during the past seven days.

Results

A convenience sample of 2432 adults from 62 regions of Russia completed a 15-min self-report questionnaire. Participants were primarily female (83%). Compared with before COVID-19, physical activity was adversely affected during COVID-19. The average time spent in MPA and VPA each declined by around 12 minutes per day (42.43 ± 37.57 to 30.44 ± 35.35 and 37.79 ± 37.80 to 26.56 ± 34.69, respectively [all P < 0.001]). The number of minutes per day spent walking decreased by around 20 minutes from 60.5 ± 38.66 to 40.83 ± 38.6 (P < 0.001). The proportion of participants who met the WHO Guidelines for physical activity declined from 68% to 49% (P < 0.001). The proportion who participated in muscle strengthening activities for 2 or more days per week declined from 53% to 45% (P < 0.001). Compared with those who did not use online PA resources, those who did were 1.4 (95%CI 1.3, 1.5) and 1.9 (95%CI 1.8, 2.1) times more likely to meet the recommendations for PA and for muscle-strengthening activities, respectively.

Conclusion

Effective health promotion strategies directed at adopting or maintain positive health-related behaviors such as targeted social media messaging and balanced media reporting, should be used to increase the physical activity during these unprecedented times.
Modelling the impact of compliance with WHO salt recommendations on cardiovascular mortality in Russia
Authors: Mukaneeva D , Kontsevaya A , Balanova YU , Khudyakov M , Drapkina O
Published: May 2021

Funding Acknowledgements

Type of funding sources: None.

Introduction

High salt intake is considered the primary diet-related risk factor (being responsible for 3 million deaths and 70 million DALYs), because of its association with NCDs, such as cardiovascular diseases (ischemic heart disease, stroke, and hypertension). The World Health Organization (WHO) recommended daily salt intake is known to be <5 g / day (2 g sodium per day). Despite strong evidence indicating that high salt intake relates to chronic diseases and mortality, most adults do not comply with dietary recommendations. The average amount of salt consumed per day is significantly higher and amounts to 11.35 g/day among Russian adults (2018).

The purpose of this study is to model the impact of following the national salt consumption recommendations in decreasing N of death  attributable to excessive salt consumption.

Methods

This study provides a health impact evaluation, which models the effect of sodium reduction on mortality associated with blood pressure and CVD in 2018 in Russia. Cardiovascular disease included coronary heart disease, stroke, hypertensive disease, heart failure, aortic aneurysm, pulmonary embolism and rheumatic heart disease. The observed salt intake from the Russian National Health Survey of 2018 was used to determine the reference (baseline) scenario and the counterfactual scenario considered that average salt consumption was reduced to 5g/day. A comparative risk assessment model, the Preventable Risk Integrated ModEl (PRIME) was used to estimate the deaths from cardiovascular diseases that could be averted or postponed based on the sodium recommendation scenario compared to the baseline scenario. The sensitivity of the model to the results from the meta-analyses was assessed with Monte Carlo simulations.

Results

In 2018, an estimated 104 602 (95%: 46 832, 154 233) deaths from CVDs could have been prevented if the average salt consumption had been reduced to 5 g/day in Russia. Coronary heart disease (CHD), stroke and hypertensive disease accounted for 97% of these deaths. The modelled reduction in deaths for coronary heart disease was 59 454, for stroke 37 306 and for hypertensive disease 4 833.

Conclusion

A considerable number of lives could be saved if Russians adhered to the national salt intake recommendations.
A comprehensive, contemporary assessment of the association between the presence of hepatosteatosis and the incidence of coronary artery disease on CT coronary angiography
Authors: Heseltine T , Hughes E , Packer M , Dunne T , Jones R , Murray SW , Ruzsics B
Published: May 2021

Funding Acknowledgements

Type of funding sources: None.

Background

The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing exponentially. The overall prevalence of NAFLD in the United States is predicted to increase to 33.5% of the adult population by 2030. Hepatosteatosis (HS) has been previously shown to be an independent risk factor for cardiovascular disease events. We sought to investigate the association of clinical covariates and the presence of HS and coronary artery disease (CAD) in patients referred for computed tomography coronary angiography (CTCA).

Methods

We performed a retrospective, observational analysis at a high-volume cardiac CT centre analysing consecutive CTCA studies. All patients referred for investigation of chest pain over a 28-month period (June 2014 to November 2016) were included. Covariates in those with CAD and patients without CAD were compared using compared using student"s t-test for continuous variables and chi-squared test for categorical variables. Logistic regression models were constructed for the multivariate analysis.

Results

In total there were 1499 patients referred for CTCA without prior evidence of CAD. Age, male sex, presence of hypertension and diabetes were significantly higher in those with CAD (table 1). HS evaluation was assessed in 1195 (79.7%). In the multivariate analysis significant predictors of CAD were male sex (OR 3.40, p < 0.001), family history (OR 1.90, p = 0.003), current smoking (OR 1.80, p = 0.03) and increasing age (OR 1.12, p < 0.001). The presence of HS was not associated with CAD when adjusted for risk factors (OR 1.05 CI:0.70-1.60, p = 0.80).

Conclusion

We found a significant association between the increasing age, presence of hypertension, male sex, diabetes and current smoking with presence of CAD as detected by CTCA. In contrast to recent evidence HS may not be an independent risk factor for the development of the development of CAD.

Summary statistics of the cohort No CAD (n = 881) CAD (n = 618) P Age (mean (SD)) 48.86 (±12.1) 57.9(±10.6) <0.005* Male Sex (%) 343 (38.6%) 326 (51.1%) <0.005* Hypertension (%) 193(21.9%) 239 (38.7%) <0.005* Diabetes (%) 59 (6.7%) 86 (13.9%) <0.005* Current Smoking (%) 139 (15.8%) 108 (17.5%) 0.423 FHx (%) 239 (27.1%) 167 (27%) 1 HS (%) 291 (33%) 247 (40%) 0.007* A comparison of clinical covariates for the cohort stratified by the presence of coronary artery disease. Statistical significance was assumed when p < 0.05 and is denoted with *.
Cardiorespiratory fitness and electroanatomical remodelling in patients with atrial fibrillation
Authors: Mishima RS , Elliott AD , Ariyaratnam JP , Jones D , Nguyen O , Martin L , Noubiap JJ , Malik V , Mahajan R , Lau DH , Sanders P
Published: May 2021

Funding Acknowledgements

Type of funding sources: None.

Introduction

Atrial fibrillation (AF) is the most common clinically-relevant arrhythmia. Its initiation and maintenance is linked to the presence cardiovascular risk factors such as hypertension and obesity. Higher cardiorespiratory fitness (CRF) has been associated with a better prognosis. However, specific electroanatomical features associated with baseline CRF have not been described. 

Purpose

Compare electroanatomical substrate across exercise capacity levels in patients with AF

Methods

Patients referred for de novo AF radiofrequency ablation at the Centre for Heart Rhythm Disorders from August 2017 until June 2020 were screened for inclusion and CRF was evaluated in metabolic equivalents (METs) by a symptom-limited maximal treadmill exercise test using the standard Bruce protocol prior to ablation. Predicted CRF was calculated based on established equations and patients were categorized according to the percentage of predicted CRF achieved; low (<85%), adequate (85-100%) and high (>100%). Total mean and regional peak-to-peak bipolar voltages, percent of low voltage areas (% LVA), conduction velocity (CV) and percent of complex fractionated electrograms (% CFE) in sinus rhythm were compared across groups. 

Results

There were no between-group differences in baseline characteristics, medication use or echocardiographic features. Total mean voltage was significantly lower in the low CRF group compared to both adequate and high CRF. Compared to the high CRF group, roof (3.25 ± 1.2 mV vs 1.9 ± 1.3 mV, p < 0.05), posterior (3.8 ± 1.8 mV vs 1.7 ± 0.9 mV, p < 0.001) and inferior mean voltages (3.4 ± 2 mV vs 1.6 ± 0.7 mV, p < 0.05) were significantly lower in the low CRF group (figure 1A). Furthermore, compared with the adequate CRF group, mean voltages were significantly lower in the posterior (3.7 ± 1.5 mV vs 1.7 ± 0.9 mV, p < 0.001), inferior (3.4 ± 1 mV vs 1.6 ± 0.7 mV, p < 0.001) and lateral (4.2 ± 2.2 mV vs 2.1 ± 1.4 mV, p < 0.05) walls of the low CRF group. Anterior and septal mean voltages were not significantly different across CRF groups (P for trend = 0.07, 0.3 and 0.15, respectively). Conduction velocities were not significantly different across groups. The inferior %LVA was significantly higher in the low CRF (5.6 ± 6%) compared to adequate CRF group (23 ± 18%) (p < 0.05) (figure 1B). Total and regional % CFE was higher in the low CRF compared to adequate and high CRF.

Conclusion

Participants in the lower baseline CRF category showed significant reductions in regional voltages along with higher fractionation with preserved conduction velocities. Research on the effect of physical activity and CRF on left atrial arrhythmogenic substrate is required.

Abstract Figure. Global and regional mV and % LVA by CRF
Understanding the differences in 2G ethanol fermentative scales through omics data integration
Authors: Carvalho Lucas M , Carvalho-Netto Osmar V , Calderón Luige L , Gutierrez Milena , de Assis Michelle A , Mofatto Luciana S , Camargo Antonio P , dos Santos Leandro V , Borelli Guilherme , Temer Beatriz , Araujo Guido , Pereira Gonçalo A G , Carazzolle Marcelo F
Published: May 2021

In this work, we evaluated the fermentative performance and metabolism modifications of a second generation (2G) industrial yeast by comparing an industrial condition during laboratory and industrial scale fermentations. Fermentations were done using industrial lignocellulosic hydrolysate and a synthetic medium containing inhibitors and analyses were carried out through transcriptomics and proteomics of these experimental conditions. We found that fermentation profiles were very similar, but there was an increase in xylose consumption rate during fermentations using synthetic medium when compared to lignocellulosic hydrolysate, likely due to the presence of unknown growth inhibitors contained in the hydrolysate. We also evaluated the bacterial community composition of the industrial fermentation setting and found that the presence of homofermentative and heterofermentative bacteria did not significantly change the performance of yeast fermentation. In parallel, temporal differentially expressed genes (tDEG) showed differences in gene expression profiles between compared conditions, including heat shocks and the presence of up-regulated genes from the TCA cycle during anaerobic xylose fermentation. Thus, we indicate HMF as a possible electron acceptor in this rapid respiratory process performed by yeast, in addition to demonstrating the importance of culture medium for the performance of yeast within industrial fermentation processes, highlighting the uniquenesses according to scales.
Important role of melanin for fertility in the fungus Podospora anserina
Authors: Gautier Valérie , Levert Emilie , Giraud Tatiana , Silar Philippe
Published: May 2021

Melanins are pigments used by fungi to withstand various stresses and to strengthen vegetative and reproductive structures. In Sordariales fungi, their biosynthesis starts with a condensation step catalyzed by an evolutionary-conserved polyketide synthase. Here we show that complete inactivation of this enzyme in the model ascomycete Podospora anserina through targeted deletion of the PaPks1 gene results in reduced female fertility, in contrast to a previously analyzed nonsense mutation in the same gene that retains full fertility. We also show the utility of PaPks1 mutants for detecting rare genetic events in P. anserina, such as parasexuality and possible fertilization and/or apomixis of nuclei devoid of mating-type gene.
Genome-wide analysis of the soybean root transcriptome reveals the impact of nitrate on alternative splicing
Authors: Guo Binhui , Dai Yi , Chen Lin , Pan Zhenzhi , Song Li
Published: May 2021

In plants, nitrate acts not only as a signaling molecule that affects plant development but also as a nutrient. The development of plant roots, which directly absorb nutrients, is greatly affected by nitrate supply. Alternative gene splicing plays a crucial role in the plant stress response by increasing transcriptome diversity. The effects of nitrate supply on alternative splicing (AS), however, have not been investigated in soybean roots. We used high-quality high-throughput RNA-sequencing data to investigate genome-wide AS events in soybean roots in response to various levels of nitrate supply. In total, we identified 355 nitrate-responsive AS events between optimal and high nitrate levels (NH), 335 nitrate-responsive AS events between optimal and low nitrate levels (NL), and 588 nitrate-responsive AS events between low and high nitrate levels (NLH). RI and A3SS were the most common AS types; in particular, they accounted for 67% of all AS events under all conditions. This increased complex and diversity of AS events regulation might be associated with the soybean response to nitrate. Functional ontology enrichment analysis suggested that the differentially splicing genes were associated with several pathways, including spliceosome, base excision repair, mRNA surveillance pathway and so on. Finally, we validated several AS events using reverse transcription–polymerase chain reaction to confirm our RNA-seq results. In summary, we characterized the features and patterns of genome-wide AS in the soybean root exposed to different nitrate levels, and our results revealed that AS is an important mechanism of nitrate-response regulation in the soybean root.
Healthy Aging-Relevant Goals: The Role of Person–Context Co-construction
Authors: Wahl Hans-Werner , Hoppmann Christiane A , Ram Nilam , Gerstorf Denis
Published: May 2021

Objectives

This article considers how individuals’ motivation for healthy aging manifests within the myriad of different contexts that older adults are embedded in as they move through later life.

Methods

Drawing on the concept of co-construction, we argue that persons and contexts both contribute to the emergence, maintenance, and disengagement from healthy aging relevant goals in adulthood and old age.

Results

To promote the understanding of such co-constructive dynamics, we propose four conceptual refinements of previous healthy aging models. First, we outline various different, often multidirectional, ways in which persons and contexts conjointly contribute to how people set, pursue, and disengage from health goals. Second, we promote consideration of context as involving unique, shared, and interactive effects of socio-economic, social, physical, care/service, and technology dimensions. Third, we highlight how the relevance, utility, and nature of these context dimensions and their role in co-constructing health goals change as individuals move through the Third Age, the Fourth Age, and a terminal stages of life. Finally, we suggest that these conceptual refinements be linked to established (motivational) theories of lifespan development and aging.

Discussions

In closing, we outline a set of research questions that promise to advance our understanding of the mechanisms by which contexts and aging persons co-construct healthy aging relevant goals and elaborate on the applied significance of this approach for common public health practices.
The multiple roles of RAB GTPases in female and male meiosis
Authors: Shan Meng-Meng , Sun Shao-Chen
Published: May 2021

BACKGROUND

RAB GTPases constitute the largest family of small GTPases and are found in all eukaryotes. RAB GTPases regulate components of the endomembrane system, the nucleus and the plasma membrane, and are involved in intracellular actin/tubulin-dependent vesicle movement, membrane fusion and cell growth in mitosis.

OBJECTIVE AND RATIONALE

RAB GTPases play multiple critical roles during both female and male meiosis. This review summarizes the progress made in our understanding of the role of RAB GTPases in female and male meiosis in different species. We also discuss the potential relationship between RAB GTPases and oocyte/sperm quality, which may help in understanding the mechanisms underlying oogenesis and spermatogenesis and potential genetic causes of infertility.

SEARCH METHODS

The PubMed database was searched for articles published between 1991 and 2020 using the following terms: ‘RAB’, ‘RAB oocyte’, ‘RAB sperm’ and ‘RAB meiosis’.

OUTCOMES

An analysis of 126 relevant articles indicated that RAB GTPases are present in all eukaryotes, and ten subfamilies (almost 70 members) are expressed in human cells. The roles of 25 RAB proteins and orthologues in female meiosis and 12 in male meiosis have been reported. RAB proteins are essential for the accurate continuity of genetic material, successful fertilization and the normal growth of offspring. Distinct and crucial functions of RAB GTPases in meiosis have been reported. In oocytes, RAB GTPases are involved in spindle organization, kinetochore–microtubule attachment, chromosome alignment, actin filament-mediated spindle migration, cytokinesis, cell cycle and oocyte–embryo transition. RAB GTPases function in mitochondrial processes and Golgi-mediated vesicular transport during female meiosis, and are critical for cortical granule transport during fertilization and oocyte–embryo transition. In sperm, RAB GTPases are vital for cytoskeletal organization and successful cytokinesis, and are associated with Golgi-mediated acrosome formation, membrane trafficking and morphological changes of sperm cells, as well as the exocytosis-related acrosome reaction and zona reaction during fertilization.

WIDER IMPLICATIONS

Abnormal expression of RAB GTPases disrupts intracellular systems, which may induce diverse diseases. The roles of RAB proteins in female and male reproductive systems, thus, need to be considered. The mechanisms underlying the function of RAB GTPases and the binding specificity of their effectors during oogenesis, spermatogenesis and fertilization remain to be studied. This review should contribute to our understanding of the molecular mechanisms of oogenesis and spermatogenesis and potential genetic causes of infertility.
Wage Equalization and Regional Misallocation: Evidence from Italian and German Provinces
Authors: Boeri Tito , Ichino Andrea , Moretti Enrico , Posch Johanna
Published: May 2021

Italy and Germany have similar geographical differences in firm productivity—with the North more productive than the South in Italy and the West more productive than the East in Germany—but have adopted different models of wage bargaining. Italy sets wages based on nationwide contracts that allow for limited local wage adjustments, while Germany has moved toward a more flexible system that allows for local bargaining. We find that Italy exhibits limited geographical wage differences in nominal terms and almost no relationship between local productivity and local nominal wages, while Germany has larger geographic wage differences and a tighter link between local wages and local productivity. As a consequence, in Italy, low-productivity provinces have higher non-employment rates than high-productivity provinces, because employers cannot lower wages, while in Germany the relationship between non-employment and productivity is significantly weaker. We conclude that the Italian system has significant costs in terms of forgone aggregate earnings and employment because it generates a spatial equilibrium where workers queue for jobs in the South and remain unemployed while waiting. If Italy adopted the German system, aggregate employment and earnings would increase by 11.04% and 7.45%, respectively. Our findings are relevant for other European countries.
Chlamydomonas reinhardtii cellular compartments and their contribution to intracellular calcium signalling
Authors: Pivato Matteo , Ballottari Matteo
Published: May 2021

Calcium (Ca2+)-dependent signalling plays a well-characterized role in the response to different environmental stimuli, in both plant and animal cells. In the model organism for green algae, Chlamydomonas reinhardtii, Ca2+ signals were reported to have a crucial role in different physiological processes, such as stress responses, photosynthesis, and flagella functions. Recent reports identified the underlying components of the Ca2+ signalling machinery at the level of specific subcellular compartments and reported in vivo imaging of cytosolic Ca2+ concentration in response to environmental stimuli. The characterization of these Ca2+-related mechanisms and proteins in C. reinhardtii is providing knowledge on how microalgae can perceive and respond to environmental stimuli, but also on how this Ca2+ signalling machinery has evolved. Here, we review current knowledge on the cellular mechanisms underlying the generation, shaping, and decoding of Ca2+ signals in C. reinhardtii, providing an overview of the known and possible molecular players involved in the Ca2+ signalling of its different subcellular compartments. The advanced toolkits recently developed to measure time-resolved Ca2+ signalling in living C. reinhardtii cells are also discussed, suggesting how they can improve the study of the role of Ca2+ signals in the cellular response of microalgae to environmental stimuli.
ATOMS: ALMA three-millimeter observations of massive star-forming regions – III. Catalogues of candidate hot molecular cores and hyper/ultra compact H ii regions
Authors: Liu Hong-Li , Liu Tie , Evans II Neal J , Wang Ke , Garay Guido , Qin Sheng-Li , Li Shanghuo , Stutz Amelia , Goldsmith Paul F , Liu Sheng-Yuan , Tej Anandmayee , Zhang Qizhou , Juvela Mika , Li Di , Wang Jun-Zhi , Bronfman Leonardo , Ren Zhiyuan , Wu Yue-Fang , Kim Kee-Tae , Lee Chang Won , Tatematsu Ken’ichi , Cunningham Maria R , Liu Xun-Chuan , Wu Jing-Wen , Hirota Tomoya , Lee Jeong-Eun , Li Pak-Shing , Kang Sung-Ju , Mardones Diego , Ristorcelli Isabelle , Zhang Yong , Luo Qiu-Yi , Toth L Viktor , Yi Hee-weon , Yun Hyeong-Sik , Peng Ya-Ping , Li Juan , Zhu Feng-Yao , Shen Zhi-Qiang , Baug Tapas , Dewangan L K , Chakali Eswaraiah , Liu Rong , Xu Feng-Wei , Wang Yu , Zhang Chao , Li Jinzeng , Zhang Chao , Zhou Jianwen , Tang Mengyao , Xue Qiaowei , Issac Namitha , Soam Archana , Álvarez-Gutiérrez Rodrigo H
Published: May 2021

We have identified 453 compact dense cores in 3 mm continuum emission maps in the ALMA Three-millimetre Observations of Massive Star-forming regions survey, and compiled three catalogues of high-mass star-forming cores. One catalogue, referred to as hyper/ultra compact (H/UC)-H ii catalogue, includes 89 cores that enshroud H/UC H ii regions as characterized by associated compact H40α emission. A second catalogue, referred to as pure s-cHMC, includes 32 candidate hot molecular cores (HMCs) showing rich spectra (N ≥ 20 lines) of complex organic molecules (COMs) and not associated with H/UC-H ii regions. The third catalogue, referred to as pure w-cHMC, includes 58 candidate HMCs with relatively low levels of COM richness and not associated with H/UC-H ii regions. These three catalogues of dense cores provide an important foundation for future studies of the early stages of high-mass star formation across the Milky Way. We also find that nearly half of H/UC-H ii cores are candidate HMCs. From the number counts of COM-containing and H/UC-H ii cores, we suggest that the duration of high-mass protostellar cores showing chemically rich features is at least comparable to the lifetime of H/UC-H ii regions. For cores in the H/UC-H ii catalogue, the width of the H40α line increases as the core size decreases, suggesting that the non-thermal dynamical and/or pressure line-broadening mechanisms dominate on the smaller scales of the H/UC-H ii cores.
BET inhibitors repress expression of interferon-stimulated genes and synergize with HDAC inhibitors in glioblastoma
Authors: Gusyatiner Olga , Bady Pierre , Pham Minh D T , Lei Yvonne , Park Jungyeon , Daniel Roy T , Delorenzi Mauro , Hegi Monika E
Published: May 2021

Background

The development of rational combination therapies is key to overcome inherent treatment resistance of glioblastoma (GBM). We aim at identifying new druggable targets by disturbing GBM cells with inhibitors of bromodomain and extra-terminal motif (BET) proteins to reveal cancer-relevant vulnerabilities that may sensitize to a second drug. BET proteins are epigenetic modulators and have been associated with proto-oncogene overexpression in cancer.

Methods

A GBM-derived sphere-line was treated with the BET inhibitor (BETi) JQ1 over a time-course of 48 hours, followed by RNA-sequencing. Four chromatin marks were investigated by chromatin immunoprecipitation followed by sequencing (ChIP-seq). Signatures of interest were functionally validated in vitro and in orthotopic xenografts. Combination therapies were evaluated for synergistic effects.

Results

Cancer-relevant pathways significantly modulated by JQ1 comprised interferon alpha (IFN-α) response genes and response signatures to histone deacetylase inhibitors (HDACi). The IFN-signature was reminiscent of a GBM-derived IFN-signature comprising CD274 (PD-L1). Functional pathway analysis suggested that JQ1 was acting directly on the transcriptional level of IFN-response genes and not via the canonical JAK/STAT pathway. This was in line with JQ1 modulated expression and BRD4 and Pol II occupancy at IFN-signature genes, supporting a direct mechanistic interaction. Finally, we showed that combining HDACi with JQ1 acts synergistically in reducing cell viability of GS-lines.

Conclusions

Our approach identified BETi-induced vulnerabilities in cancer-relevant pathways, potentially amenable to synergistic combinatorial therapy, such as combination with HDACi. The direct inhibitory effect of BETi on IFN-responsive genes in GBM cells, including CD274, indicates modulation of the tumor immune landscape and warrants further studies.