bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of originally coloured wools with garlic stem extracts and zinc chloride to ensure anti‐bacterial properties with limited colour changes
Authors: Yılmaz Fazlıhan , Aydınlıoğlu Ömer , Benli Hüseyin , Kahraman Gamze , Bahtiyari Muhammed İbrahim
Published: October 2019

In this study, the objective was to ensure anti‐bacterial properties for originally coloured wools with naturally sourced garlic stem extracts. In addition, zinc chloride‐based treatment was also carried out. The aim was to retain the original colours of the wool fibres during these treatments. The effects of both treatments were evaluated in terms of colour changes in the wool fibres. It was found that the colour changes caused by the treatments were high in white/ecru fibres but more limited in black fibres. The colour differences between the treated and untreated black fibres were near 1; they were also quite high in white/ecru fibres. The anti‐bacterial properties of the treated wool fibres against two bacteria species, one gram‐negative and one gram‐positive, were also investigated. It was observed that zinc chloride‐based treatment ensured significant anti‐bacterial efficiencies against the bacteria tested and 99.9% bacterial reduction in all cases. However, the anti‐bacterial effects of garlic stem extract‐based treated wool fibres were limited. It was observed that treatment of wool fibres with garlic stem extracts resulted in no anti‐bacterial efficiency against Escherichia coli but did provide some anti‐bacterial capability against Staphylococcus aureus. The highest bacterial reduction of S. aureus was 80.7% in originally brown‐coloured wool fibre.
Looking back on 25 years of the PSAD study group
Authors: Snoek F. J.
Published: October 2019

The year 2020 marks the 25th anniversary of the Psychosocial Aspects of Diabetes (PSAD) study group of the European Association for the Study of Diabetes. At the time, psychosocial diabetes research in Europe was steadily growing, but not well recognized. By establishing an official European Association for the Study of Diabetes study group, PSAD, for which purpose some hurdles had to be overcome, diabetes psychology became more visible and accessible to the scientific diabetes community. Over the years the PSAD study group has been successful in promoting the quality of research in the field through scientific meetings, mentoring, postgraduate education and publications. Looking back we can conclude that starting the PSAD study group signified an important moment in time, where researchers were joining forces to further the quality of the science, raise awareness of the importance of psychosocial aspects and promote the dissemination of psychological interventions in diabetes care.
Echocardiographic features of Fabry cardiomyopathy—Comparison with hypertrophy‐matched sarcomeric hypertrophic cardiomyopathy
Authors: Militaru Sebastian , Jurcuț Ruxandra , Adam Robert , Roşca Monica , Ginghina Carmen , Popescu Bogdan A.
Published: October 2019

Background

The concept of “red flags” has been particularly useful in the etiologic diagnosis of cardiomyopathies such as Fabry disease, as early detection is often essential for treatment response and outcomes. The present study sought to describe the echocardiographic features that may differentiate Fabry cardiomyopathy from sarcomeric hypertrophic cardiomyopathy (HCM).

Methods

Forty patients with left ventricular (LV) hypertrophy were prospectively included and divided into two groups: the Fabry group (20) and the sarcomeric HCM group (20). The two groups were matched for LV hypertrophy (similar maximum wall thickness and indexed LV mass) and age. All patients underwent full echocardiographic evaluation including ventricular strain analysis.

Results

The Fabry group had significantly lower LV ejection fraction (63 ± 7 vs 72 ± 7%, P = .001) and higher LV end‐systolic diameter (28 ± 7 vs 22 ± 5 mm, P = .004). LV hypertrophy in Fabry patients was more often concentric, with a significantly lower interventricular septum/posterior wall ratio (1.22 ± 0.63 vs 1.55 ± 0.66, P = .001). Fabry patients had more reduced regional longitudinal strain in the inferolateral part of the LV (−9 ± 5 vs –16 ± 7%), and RV free wall longitudinal strain was also worse in Fabry patients (−23 ± 6 vs –28 ± 5%, P = .027).

Conclusion

These parameters are promising echocardiographic features to identify patients with Fabry cardiomyopathy and may help for the detection and subsequent management of these patients.
Platform Urbanism, Creativity, and the New Educational Futurism
Authors: Means Alexander J.
Published: October 2019

This essay examines speculative narratives reflective of Silicon Valley and corporate technology culture that project creative scenarios and sociotechnical futures for cities and citizens, whereby learning and creativity become global imperatives to defer future risk within a new digital urbanism. Taking inspiration from Fredric Jameson's transhistorical dialectics, Alexander J. Means assembles a cognitive map of emerging sociotechnical projections of urbanity and education through three frames — solutionism, collaborationism, and techno‐realism — linking each to specific conceptualizations of creativity and learning. Means argues that these projections are subsumed within an ontology of the present, and they therefore fail to index the complexities that drive historical and technological change, particularly the deep structure of power and conflict immanent to late capitalism as a world‐historical system. Such an ontology is ultimately rooted in imaginative displacement, a futurism without futurity, where time is rendered a static feedback loop of present systems and processes.
The Rise of the Creative Underclass
Authors: Denmead Tyler
Published: October 2019

In this article, Tyler Denmead draws upon critical race theory to argue that the creative city discourse reproduces racial injustice for youth. In particular, the creative city invests in the property rights and profitability of whiteness by inscribing creative superiority on the bodies of young people who are more likely to be privileged by virtue of their race and class. Through evidence collected by both autoethnographic and ethnographic methods, Denmead discusses how his history as an arts educator has been entangled in the manifestation of this racist reconfiguration of urban space in one particular American city, Providence, Rhode Island. He discovered that the racial dynamics of the creative city discourse have productive power over how young people construct their identities and make life choices in this city and, further, that those dynamics operate in and through artist partnerships between those positioned as creatives and those positioned as troubled youth. As a result, Denmead argues that white arts educators, in particular, must disinvest themselves from notions of creativity that enhance the profitability and power of whiteness. This move requires advocating ceding land and resources that have been acquired through the creative city discourse and committing to reframing culture‐led urban renewal in terms of the economic and creative flourishing of communities of color.
Unforgetting Place in Urban Education through Creative Participatory Visual Methods
Authors: Tuck Eve , Habtom Sefanit
Published: October 2019

In this article, Eve Tuck and Sefanit Habtom first consider the consequences of the erasure of the importance of place in the field of urban education and then describe a new youth participatory action research project in Toronto called Making Sense of Movements (MSOM). MSOM is a youth participatory visual research project that engages Black and Indigenous youth in thinking about the influence of social movements such as Black Lives Matter and Idle No More in their relationships to Toronto as a place, and also in their postsecondary planning.
Transfusion strategies in patients with cirrhosis
Authors: Liu Patricia , Hum Justine , Jou Janice , Scanlan Richard M. , Shatzel Joseph
Published: October 2019

Bleeding related to portal hypertension and coagulopathy is a common complication in patients with cirrhosis. Complications and management of bleeding is a significant source of healthcare cost and utilization, as well as morbidity and mortality. Due to the scarcity of evidence surrounding transfusion strategies and hemostatic interventions in patients with cirrhosis, there has been significant debate regarding the best practice. Emerging data suggest that evidence supporting transfusion of packed red blood cells to a hemoglobin threshold of 7‐8 g/dL is strong. thrombopoietin (TPO) receptor agonists have shown promise in increasing platelet levels and reducing transfusions preprocedurally, although have not specifically been found to reduce bleeding risk. Data for viscoelastic testing (VET)‐guided transfusions appear favorable for reducing blood transfusion requirements prior to minor procedures and during orthotopic liver transplantation. Hemostatic agents such as recombinant factor VIIa, prothrombin complex concentrates, and tranexamic acid have been examined but their role in cirrhotic patients is unclear. Other areas of growing interest include balanced ratio and whole blood transfusion. In the following manuscript, we summarize the most up to date evidence for threshold‐guided, VET‐guided, balanced‐ratio, and whole blood transfusions as well as the use of hemostatic agents in cirrhotic patients to provide practice guidance to clinicians.
The effects of early life adversity on growth, maturation, and steroid hormones in male and female rats
Authors: Eck Samantha R. , Ardekani Cory S. , Salvatore Madeleine , Luz Sandra , Kim Eric D. , Rogers Charleanne M. , Hall Arron , Lee Demetrius E. , Famularo Sydney T. , Bhatnagar Seema , Bangasser Debra A.
Published: October 2019

Early life adversity is a risk factor for psychiatric disorders, yet the mechanisms by which adversity increases this risk are still being delineated. Here, we used a limited bedding and nesting (LBN) manipulation in rats that models a low resource environment to examine effects on growth, developmental milestones, and endocrine endpoints. In LBN, dams and pups, from pups’ postnatal days 2–9, are exposed to an environment where dams lack proper materials to build a nest. This manipulation is compared to control housing conditions, where rat dams have access to ample nesting materials and enrichment throughout pups’ development. We found that the LBN condition altered maternal care, increasing pup‐directed behaviors while reducing self‐care. This, perhaps compensatory, increase in nursing and attention to pups did not mitigate against changes in metabolism, as LBN reduced weight gain in both sexes and this effect persisted into adulthood. Although adult stress hormone levels in both sexes and vaginal opening and estrous cycle length in females were not disrupted, there was other evidence of endocrine dysregulation. Compared to controls, LBN rats of both sexes had shortened anogenital distances, indicating reduced androgen exposure. LBN males also had higher plasma estradiol levels in adulthood. This combination of results suggests that LBN causes a demasculinizing effect in males that could contribute to lasting changes in the brain and behavior. Importantly, alterations in metabolic and endocrine systems due to early life adversity could be one mechanism by which stress early in life increases risk for later disease.
Effect of genetic liability to migraine on coronary artery disease and atrial fibrillation: a Mendelian randomization study
Authors: Daghlas I. , Guo Y. , Chasman D. I.
Published: October 2019

Background and purpose

Observational studies have implicated migraine as a risk factor for coronary artery disease (CAD) and atrial fibrillation (AF); however, it is unclear whether migraine is causal in this relationship. Potential causality between genetically instrumented liability to migraine and cardiovascular disease outcomes was investigated using two‐sample Mendelian randomization.

Methods

The exposure comprised 35 independent, genome‐wide significant genetic variants identified in the largest published genome‐wide association study of migraine (Ncases = 59 674/Ncontrols = 316 078). The outcome datasets included genome‐wide association studies of CAD (76 014/264 785), myocardial infarction (43 676/128 199), angina (10 618/326 065) and AF (60 620/970 216). Mendelian randomization estimates were calculated using inverse‐variance weighted regression, and were further assessed with conventional Mendelian randomization sensitivity analyses.

Results

Evidence was found for a protective effect of migraine liability on CAD (odds ratio 0.86, 95% confidence interval 0.76–0.96, P = 0.003), myocardial infarction (0.86, 0.74–0.96, P = 0.01) and angina (0.86, 0.75–0.99, P = 0.04), but not on AF (1.00, 0.95–1.05, P = 0.88). Analyses by migraine subtype showed an effect of liability to migraine without aura on CAD risk (0.91, 0.84–0.99, P = 0.014), but not of migraine with aura (1.00, 0.97–1.03, P = 0.89). Sensitivity analyses indicated minimal bias by horizontal pleiotropy, outliers, reverse causality or sample overlap.

Conclusions

A potentially protective effect of genetically instrumented liability to migraine on CAD risk was identified. Mechanistic research investigating this link is warranted.
Traumatic injury to the parotid salivary gland or duct and the subsequent development of ipsilateral severe peripheral dental caries in two horses
Authors: Jackson K. , McConnell E. , Kelty E. , Tennant M.
Published: October 2019

This report describes two cases of unilateral traumatic injury to the parotid salivary gland or duct and the subsequent development of severe ipsilateral peripheral dental caries. Ultrasonographic examination of the parotid salivary gland and duct was indicative of parotid glandular atrophy in one case and demonstrated parotid duct obstruction in the second case. To the authors’ knowledge, the effects of the loss of function of the parotid salivary gland on the horse's dentition has not been documented and should be considered as a potential side effect of surgical ablation of the parotid salivary gland.
Tracking intra‐ and inter‐organelle signaling of mitochondria
Authors: Madreiter‐Sokolowski Corina T. , Ramadani‐Muja Jeta , Ziomek Gabriela , Burgstaller Sandra , Bischof Helmut , Koshenov Zhanat , Gottschalk Benjamin , Malli Roland , Graier Wolfgang F.
Published: October 2019

Mitochondria are as highly specialized organelles and masters of the cellular energy metabolism in a constant and dynamic interplay with their cellular environment, providing adenosine triphosphate, buffering Ca2+ and fundamentally contributing to various signaling pathways. Hence, such broad field of action within eukaryotic cells requires a high level of structural and functional adaptation. Therefore, mitochondria are constantly moving and undergoing fusion and fission processes, changing their shape and their interaction with other organelles. Moreover, mitochondrial activity gets fine‐tuned by intra‐ and interorganelle H+, K+, Na+, and Ca2+ signaling. In this review, we provide an up‐to‐date overview on mitochondrial strategies to adapt and respond to, as well as affect, their cellular environment. We also present cutting‐edge technologies used to track and investigate subcellular signaling, essential to the understanding of various physiological and pathophysiological processes.
Safety and efficacy of lenvatinib in elderly patients with unresectable hepatocellular carcinoma: A multicenter analysis with propensity score matching
Authors: Tada Toshifumi , Kumada Takashi , Hiraoka Atsushi , Michitaka Kojiro , Atsukawa Masanori , Hirooka Masashi , Tsuji Kunihiko , Ishikawa Toru , Takaguchi Koichi , Kariyama Kazuya , Itobayashi Ei , Tajiri Kazuto , Shimada Noritomo , Shibata Hiroshi , Ochi Hironori , Toyoda Hidenori , Nouso Kazuhiro , Tsutsui Akemi , Nagano Takuya , Itokawa Norio , Hayama Korenobu , Imai Michitaka , Joko Kouji , Koizumi Yohei , Hiasa Yoichi
Published: October 2019

Aim

Lenvatinib has become available as first‐line therapy for patients with unresectable hepatocellular carcinoma (HCC). However, the safety and efficacy of lenvatinib in elderly patients with HCC has not been sufficiently investigated. We compared the frequency of adverse events and prognosis between elderly and non‐elderly patients with HCC who received lenvatinib.

Methods

A total of 100 patients with HCC who received lenvatinib were selected using propensity score matching: 50 patients were elderly (age ≥75 years) and 50 patients were non‐elderly.

Results

In the elderly group, >20% of patients experienced fatigue (36.0%), decreased appetite (26.0%), hypothyroidism (24.0%), proteinuria (22.0%), palmar‐plantar erythrodysesthesia (22.0%), and hypertension (20.0%) of any grade as treatment‐related adverse events. In addition, >10% of patients experienced grade ≥3 treatment‐related fatigue (12.0%). In the non‐elderly group, >20% of patients experienced palmar‐plantar erythrodysesthesia (42.0%), fatigue (28.0%), decreased appetite (22.0%), and diarrhea (20.0%) of any grade as treatment‐related adverse events. In addition, >10% of patients experienced grade ≥3 treatment‐related proteinuria (10.0%). There were no significant differences between the elderly and non‐elderly groups in the frequency of adverse events. Regarding overall and progression‐free survival, there were no significant differences between the elderly and non‐elderly groups (hazard ratio 0.972, 95% confidence interval 0.374–2.529; and hazard ratio 1.362, 95% confidence interval 0.687–2.700, respectively). Palmar‐plantar erythrodysesthesia (hazard ratio 0.117, 95% confidence interval 0.015–0.916) was independently associated with overall survival in a multivariate analysis.

Conclusions

Lenvatinib can be used safely and efficaciously regardless of age in patients with HCC.
Providing palliative care closer to home: a retrospective analysis from a remote Australian hospital
Authors: Watson Benjamin J. , Budd Richard , Waran Eswaran , Scott Ian , Quilty Simon
Published: October 2019

Background

Rural and remote patients have reduced access to palliative care, often resulting in inter‐hospital transfers and death a long way from home and family. Katherine Hospital (KH), a 50‐bed hospital services a population with high Aboriginality who experience this issue.

Aims

To characterise trends in mortality and transfers at a remote hospital in reference to increasing capacity to provide palliative care.

Methods

Retrospective analysis of deaths in patients over 18 years of age, admitted between 2008 and 2018 at KH, Northern Territory. Outcome measures include number of deaths, aeromedical transfers to tertiary facility, palliative care episodes, demographics including Aboriginality, admission data and comorbidity. Statistical analysis included unpaired t‐test, chi‐square test and regression analysis.

Results

The number of deaths in KH increased from 23 (0.88% of inpatient admissions) in 2011 to 52 in 2018 (1.7%). During the same period, the proportion of all deaths classified as palliative increased from 51.4 to 66.0% (P = 0.001), with fewer deaths occurring in the emergency department (17.2–1.4% for the last 3 years, R = 0.75, P = 0.008). The number of aeromedical transfers of patients from KH to tertiary centres decreased from 769 (10.4% of all admissions) in 2011 to 434 (3.4%) in 2018 (P = 0.006).

Conclusions

Increasing the capacity of a remote hospital to provide palliative care allowed more patients to die closer to home and decreased inappropriate aeromedical retrievals. An increased in‐hospital mortality rate should not be misinterpreted as reflecting suboptimal care if palliative intent, patients' wishes and non‐clinical risk factors have not been ascertained.
Decreasing the problematic use of an information system: An empirical investigation of smartphone game players
Authors: Chen Chongyang , Zhang Kem Z.K. , Gong Xiang , Lee Matthew K.O. , Wang Yaoyu
Published: October 2019

Based on protection motivation theory, this study aims to identify factors that influence the intention to decrease problematic smartphone game use, including the effects of a gaming habit and subjective norms. The research model is tested with a scenario‐based survey method. Players' perceived threat refers to the negative consequences (eg, reduced performance or social isolation) that are caused by problematic smartphone game use. The findings indicate that under high fear appeals, threat appraisal creates fearful emotions about suffering from the negative consequences, which further reduces the gaming habit and activates the intention to decrease use. Self‐efficacy in decreasing game playing, the response efficacy of decreasing usage in avoiding the threat and subjective norms effectively promote users' intention to decrease use. Moreover, response costs reduce the intention to decrease use. The findings provide insights into how to activate users' intention to decrease problematic use, and the resulting implications are discussed.
Use of concentrate growth factors gel or membrane in chronic wound healing: Description of 18 cases
Authors: Kao Chao‐Hsing
Published: October 2019

Treating chronic skin wounds in patients with diabetes, bed sores, or stasis dermatitis is typically a time‐consuming and costly process, and the outcome is not always promising. Concentrated growth factor (CGF) obtained from the autologous venous blood of patients via fractional centrifugation is employed for producing a CGF gel or membrane that can be applied to expedite self‐regeneration of skin wounds. In this case report, we presented the results from 18 patients with chronic skin wounds treated with a CGF gel or membrane produced from autologous venous blood. Noticeable granulation tissue and regenerated epidermal coverage were observed in 16 patients who received CGF treatment over various time courses, thereby demonstrating the significant therapeutic effects of CGF treatment in overall wound healing. The other two patients with stasis ulcers in their calves failed to respond to the treatment because of the comorbidity of iliac vein thrombosis. In addition, by culturing HaCaT keratinocytes using CGF membrane as the foundation, we observed that HaCaT cells attached to the CGF membrane migrated and proliferated to form an epithelium‐like structure. Comprehensively, the clinical results infer that CGF gel can expedite the regeneration of the soft tissue at the wound, whereas CGF membrane may facilitate its marginal re‐epithelialisation. The combination of the two can promote autologous regeneration of both deep and superficial wounds effectively and safely.
Oxidative damage in forage rape (Brassica napus L.) seeds following heat stress during seed development
Authors: Rashid Muhammad , Hampton John G. , Shaw Martin L. , Rolston M. Philip , Khan Khan Mir , Saville Dave J.
Published: October 2019

A short period (240°C hr; Tb = 25°C) of heat stress (30°C day/25°C night) during forage rape (Brassica napus L.) seed development or at seed physiological maturity can reduce seed vigour, but the extent of oxidative damage associated with this short heat stress was not known. Heat‐stressed seeds were assessed for malondialdehyde (MDA) content, hydrogen peroxide (H2O2) accumulation, antioxidant enzyme activity, adenylate energy charge and seed ultrastructural integrity, and compared with that of non‐heat‐stressed seeds. Heat stress increased both MDA content and H2O2 accumulation by 35%–50%, reduced antioxidant enzyme activity by between 12% and 67%, and significantly reduced adenosine energy charge. Transmission electron microscope images showed clear evidence of seed deterioration in heat‐stressed seeds, including ruptures in cell wall and plasma membranes, fused lipid bodies and damaged mitochondria. Heat stress at physiological maturity caused more oxidative damage than the same heat stress during seed development. Seed vigour decreased as H2O2 accumulation increased and antioxidant enzyme activity decreased, but no direct relationship between lipid peroxidation and seed vigour was established. The extent of damage resulting from even shorter periods of heat stress (<240°C hr) before or at seed physiological maturity requires investigation.
A randomized comparison of manual pressure versus figure‐of‐eight suture for hemostasis after cryoballoon ablation for atrial fibrillation
Authors: Kumar Vineet , Wish Marc , Venkataraman Ganesh , Bliden Kevin , Jindal Manila , Strickberger Adam
Published: October 2019

Introduction

Cryoballoon ablation is commonly used to treat atrial fibrillation (AF). Femoral vein hemostasis after cryoballoon ablation for AF is routinely achieved with manual pressure (MP) after reversal of heparin and reassessment of the activated clotting time, or with a figure‐of‐eight suture (F8). The purpose of this randomized trial was to compare these two techniques for femoral vein hemostasis after cryoballoon ablation for AF in a patient population predominantly on novel anticoagulants (NOAC).

Methods and Results

Seventy consecutive patients who underwent cryoballoon ablation were randomized to either the MP or F8 for femoral vein hemostasis. Clinical and procedural characteristics were similar between the groups with the majority of patients treated with a NOAC. The total time in the electrophysiology laboratory for the MP group and the F8 group (197 ± 37 minutes vs 167 ± 36 minutes, respectively; P = .02), and the time from sheath removal until the patient left the laboratory (28 ± 9 minutes vs 20 ± 5 minutes, respectively; P < .0001) were significantly less in the F8 group. Additional pressure for hemostasis in the recovery suite was required more often in the MP Group, as opposed to the F8 group (29% vs 3%; P = .003). No major bleeding occurred and the rate of minor hematomas was statistically similar.

Conclusions

Hemostasis obtained with a F8 suture after cryoballoon ablation for AF is associated with significantly less patient time in the electrophysiology laboratory, and an improved safety profile, compared with manual hemostasis, even amongst patients treated with a NOAC.
Impact of multipoint pacing on projected battery longevity in cardiac resynchronization therapy. An IRON‐MPP study sub‐analysis
Authors: Forleo Giovanni B. , Gasperetti Alessio , Ricciardi Danilo , Curnis Antonio , Bertaglia Emanuele , Calò Leonardo , Pignalberi Carlo , Calzolari Vittorio , Ribatti Valentina , Lavalle Carlo , Potenza Domenico , Tondi Lara , Natale Veronica , Notarstefano Pasquale , Viecca Maurizio , Morani Giovanni , Biffi Mauro , Giammaria Massimo , Zanon Francesco , Santini Luca
Published: October 2019

Background

Multipoint pacing (MPP) may improve clinical outcomes in patients with cardiac resynchronization therapy defibrillators (CRT‐D), but its impact on battery longevity in a real‐world population has not been investigated in large trials.

Objective

Compare projected battery longevity in CRT‐D patients with and without MPP during long‐term follow‐up.

Methods

The Italian registry on multipoint left ventricular pacing (IRON‐MPP) is a prospective, multicenter registry of patients implanted with MPP‐capable CRT‐D devices. Projected battery longevity during follow‐up was compared for patients with MPP (MPP ON) vs single‐site (MPP OFF) left ventricular pacing at CRT‐D implantation. A sub‐analysis excluded crossover patients with MPP activation or deactivation occurring after implantation. A second sub‐analysis excluded patients with a right or left ventricular pacing amplitude >2.5 V.

Results

Out of 237 CRT‐D patients (71 ± 9 years, 81% male) followed for 1.9 ± 0.8 years, 102 (43%) had MPP ON at implantation. Programmed atrial and ventricular outputs and percentage of pacing were similar between groups. MPP was associated with a 0.44 years reduction in projected battery longevity (P = .03) during long‐term follow‐up. Results were similar for the first and second sub‐analyses, with a 0.57 years (P < .001) and 0.71 years (P < .001) reduction in projected longevity, respectively.

Conclusion

In this long‐term real‐world registry, early MPP activation is associated with less than a 1‐year reduction in projected battery life compared to single‐site biventricular pacing.
Imaging of subendocardial adipose tissue and fiber orientation distributions in the human left atrium using optical coherence tomography
Authors: Lye Theresa H. , Marboe Charles C. , Hendon Christine P.
Published: October 2019

Background

Optical coherence tomography (OCT) has the potential to provide real‐time imaging guidance for atrial fibrillation ablation, with promising results for lesion monitoring. OCT can also offer high‐resolution imaging of tissue composition, but there is insufficient cardiac OCT data to inform the use of OCT to reveal important tissue architecture of the human left atrium. Thus, the objective of this study was to define OCT imaging data throughout the human left atrium, focusing on the distribution of adipose tissue and fiber orientation as seen from the endocardium.

Methods and Results

Human hearts (n = 7) were acquired for imaging the left atrium with OCT. A spectral‐domain OCT system with 1325 nm center wavelength, 6.5 μm axial resolution, 15 μm lateral resolution, and a maximum imaging depth of 2.51 mm in the air was used. Large‐scale OCT image maps of human left atrial tissue were developed, with adipose thickness and fiber orientation extracted from the imaging data. OCT imaging showed scattered distributions of adipose tissue around the septal and pulmonary vein regions, up to a depth of about 0.43 mm from the endocardial surface. The total volume of adipose tissue detected by OCT over one left atrium ranged from 1.42 to 28.74 mm3. Limited fiber orientation information primarily around the pulmonary veins and the septum could be identified.

Conclusion

OCT imaging could provide adjunctive information on the distribution of subendocardial adipose tissue, particularly around thin areas around the pulmonary veins and septal regions. Variations in OCT‐detected tissue composition could potentially assist ablation guidance.
Blood pressure in relation to frailty in older adults: A population‐based study
Authors: Anker Daniela , Santos‐Eggimann Brigitte , Zwahlen Marcel , Santschi Valérie , Rodondi Nicolas , Wolfson Christina , Chiolero Arnaud
Published: October 2019

In frail older adults, low blood pressure (BP) might be associated with worse health outcomes and hypertension management in this population is highly debated. Using data from a population‐based study of older adults, we assessed the association between frailty and BP. We used data collected between 2014 and 2016 from 3157 participants aged between 67 and 80 years in the Lausanne cohort Lc65+. BP was measured three times at one visit, and frailty status was assessed based on Fried's phenotype model. We analyzed the cross‐sectional association between BP and frailty by computing mean systolic and diastolic BP stratified by sex, age, and frailty and by fitting regression models. The average age of the participants was 73.3 (standard deviation [SD]: 4.1) years, and 59.1% were women. 34.1% were pre‐frail, and 3.3% were frail. Mean BP was 135.1/76.3 mm Hg (SD 18.5/11.0). Age‐ and sex‐adjusted systolic BP was on average lower by 2.8 mm Hg (95% confidence interval [CI]: 1.4‐4.2) and 6.7 mm Hg (95% CI: 3.2‐10.3) among pre‐frail and frail compared to non‐frail participants. Similar differences in mean diastolic BP across frailty status were found. Upon adjustment for antihypertensive treatment, the associations between frailty status and BP did not change substantially. Frail individuals had a substantially lower BP compared with non‐frail older adults. Because low BP could be detrimental among frail older patients, our findings raise questions about hypertension management in this population and stress the need for additional evidence.
Body fat change and 8‐year incidence of hypertension: Korean Genome and Epidemiology Study
Authors: Lee Sung‐Bum , Cho A‐Ra , Kwon Yu‐Jin , Jung Dong‐Hyuk
Published: October 2019

Hypertension is strongly correlated with an increased risk of cardiovascular events. Recent studies have demonstrated that body fat percentage (BF%) is associated with cardiometabolic risk factors. The aim of this study was to investigate the association between a change in BF% and body mass index (BMI) and the incidence of new‐onset hypertension in a normotensive Korean cohort. At baseline (2001‐2002), 8848 participants aged 40‐70 years were recruited for the study; follow‐up surveys were completed in the year 2012. A total of 3902 adults (1866 men and 2036 women) were included in the final analysis. These subjects were divided into quartile groups according to changes in BF% and were followed for 8.4 years to monitor for the development of hypertension. A Poisson regression model was used to evaluate the relative risk (RR) for hypertension according to BF% change quartile. Additionally, we also stratified participants into four groups according to BMI change levels and body fat change levels. Finally, we compared two factors, BF% change, and BMI change, to determine which is more predictive of incident hypertension. In an adjusted model, compared with the lowest BF% quartile group, the risk of new‐onset hypertension significantly increased with BF% change: Changes in risk were 0%‐2.0% for quartile 3 subjects (RR: 1.32 [1.06‐1.63]) and 2.0%‐8.9% for quartile 4 participants (RR: 1.78 [1.43‐2.19]). We also revealed that the RR for new‐onset hypertension was 1.81 (95% CI: 1.47‐2.21) for quartile 4 group subjects, compared with subjects in quartile 1 (change in BMI −6.80 to −0.86% [kg/m2]). Body fat gain and BMI increase were predictors of hypertension in this community‐based Korean cohort.
Macrophage autophagy regulates mitochondria‐mediated apoptosis and inhibits necrotic core formation in vulnerable plaques
Authors: Xiao Qingqing , Che Xinyu , Cai Bin , Tao Zhenyu , Zhang Hengyuan , Shao Qin , Pu Jun
Published: October 2019

The vulnerable plaque is a key distinguishing feature of atherosclerotic lesions that can cause acute atherothrombotic vascular disease. This study was designed to explore the effect of autophagy on mitochondria‐mediated macrophage apoptosis and vulnerable plaques. Here, we generated the mouse model of vulnerable carotid plaque in ApoE−/− mice. Application of ApoE−/− mice with rapamycin (an autophagy inducer) inhibited necrotic core formation in vulnerable plaques by decreasing macrophage apoptosis. However, 3‐methyladenine (an autophagy inhibitor) promoted plaque vulnerability through deteriorating these indexes. To further explore the mechanism of autophagy on macrophage apoptosis, we used macrophage apoptosis model in vitro and found that 7‐ketocholesterol (7‐KC, one of the primary oxysterols in oxLDL) caused macrophage apoptosis with concomitant impairment of mitochondria, characterized by the impairment of mitochondrial ultrastructure, cytochrome c release, mitochondrial potential dissipation, mitochondrial fragmentation, excessive ROS generation and both caspase‐9 and caspase‐3 activation. Interestingly, such mitochondrial apoptotic responses were ameliorated by autophagy activator, but exacerbated by autophagy inhibitor. Finally, we found that MAPK‐NF‐κB signalling pathway was involved in autophagy modulation of 7‐KC–induced macrophage apoptosis. So, we provide strong evidence for the potential therapeutic benefit of macrophage autophagy in regulating mitochondria‐mediated apoptosis and inhibiting necrotic core formation in vulnerable plaques.
Standard medical nutrition therapy of 25 kcal/kg ideal bodyweight/day often does not reach even resting energy expenditure for patients with type 2 diabetes
Authors: Fukuda Takuya , Tanaka Muhei , Yamazaki Masahiro , Marunaka Yoshinori , Fukui Michiaki
Published: October 2019

Aims/Introduction

In Japan, an ideal bodyweight (IBW) calculated by 22 × height (m)2 has commonly been used in the planning of medical nutrition therapy (MNT). However, there have been concerns regarding calorie deficits in fulfilling resting energy expenditure (REE) for patients with type 2 diabetes undergoing MNT as defined by 25 kcal/kg IBW/day. The objective of the present study was to measure REE in patients with type 2 diabetes and verify the validity of MNT with 25 kcal/kg IBW/day.

Materials and Methods

A retrospective cross‐sectional study was carried out in 52 patients with type 2 diabetes (mean age was 65.9 ± 7.3 years, bodyweight 65.0 ± 11.3 kg, body mass index 24.9 ± 3.8 kg/m2). REE was measured by indirect calorimetry.

Results

The mean REE was 1,601.0 ± 253.1 kcal/day. Assuming that all patients strictly observed daily energy intake as 25 kcal/kg IBW/day, 41 of 52 patients (78.9%) did not reach their REE. The greater the bodyweight, the greater the difference between assumed energy intake as 25 kcal/kg IBW and REE.

Conclusions

We call attention to the potential risk of total dietary energy intake set to 25 kcal/kg IBW/day. Clinicians should carefully plan MNT to not fall below a patient’s REE to prevent sarcopenia and ensure MNT continuity.
Zoon balanitis—does it exist?
Authors: Bunker C.B.
Published: October 2019

Linked article: S. Piaserico et al. J Eur Acad Dermatol Venereol 2020; 34: e117–e118. https://doi.org/10.1111/jdv.16032.
Extraction of Brazil nut kernel oil using green solvents: Effects of the process variables in the oil yield and composition
Authors: Cornelio‐Santiago Heber P. , Mazalli Mônica R. , Rodrigues Christianne E. C. , de Oliveira Alessandra L.
Published: October 2019

The extraction efficiency of isopropyl alcohol and ethyl alcohol was studied, and the effects of the process variables, static time (St), solvent‐to‐feed (S/F) ratio, and temperature (T) in the oil extraction yield (X0), free fatty acids (FFA) content, total phenolic content (TPC), and β‐sitosterol content were statistically investigated. The amount of solvent used (S/F) did not influence theX0, but St andTsignificantly influenced (p< .05) theX0. The condition that maximized theX0(60.40%) occurred when a St of 9 min and aTof 86°C were used, and low level of FFA were observed in all oils obtained. The process variables studied did not significantly influence (p> .05) in the content of FFA (0.25–0.28%), TPC (29.10–38.47 mg GAE/kg oil), and β‐sitosterol content (9.51–40.32 mg/100 g oil). Its oil is a high source of unsaturated fatty acid. Pressurized liquid extraction is a promising technique for rapid extraction of oil including Brazil nut kernel. Its process recovered 90.58% of oil in 27 min (3 cycles for 9 min of static time).

Practical Applications

The optimization of pressurized green solvent extraction has been studied in order to demonstrate that this technology, even employing polar solvents, provides high yields in oil extraction. It is a technology under study that leaves no residue of toxic solvents on vegetable oils. In this study, the use of pressurized liquid extraction with isopropyl alcohol (IPA) and ethyl alcohol (EtOH) as solvents was employed to extract oil from Brazil nut kernel, focusing on the oil rapid recovery as an alternative process to increase the oil yield and improve the use of non‐timber forest product of Amazon biome.
Formation and gastrointestinal digestion of β‐carotene emulsion stabilized by milk fat globule membrane
Authors: He Shenghua , Ye Aiqian
Published: October 2019

In the present study, milk fat globule membrane (MFGM) was used to prepare β‐carotene emulsion. The physicochemical and microstructure changes of MFGM‐prepared emulsions were investigated upon exposure to gastrointestinal (GI) digestion fluid. The average droplet size significantly reduced (p < .05) from 18.29 μm to 0.91 μm with the addition of MFGM concentrations from 0.25 wt% to 4.0 wt%. The emulsion exposure to the simulated gastric fluid showed a significant increase in droplet sizes (p < .05) and partial droplet aggregation in microstructure compared to initial emulsion. There was a notable increase (p < .05) in particle sizes and decrease in the number of oil droplets when β‐carotene emulsion was exposed to simulated intestinal fluid after 60, 120, and 180 min digestion time. In the simulated intestinal fluid, about 200 μmol/L free fatty acid and 60% β‐carotene were released when β‐carotene emulsion was exposed to simulated intestinal fluid after 60 min digestion time.

Practical applications

Milk fat globule membrane (MFGM) is an ideal material used for the preparation of β‐carotene emulsions because of not only its fascinating structure and special compositions but also its nutritional and health benefits. In this work, MFGM stabilizes the oil phase, as well as controlling and triggering the release of β‐carotene when the emulsions are exposed to GI tract. Therefore, these results demonstrate that MFGM as a natural emulsifier can be used to deliver hydrophobic bioactivities.
Interaction and inactivation of Listeria and Lactobacillus cells in single and mixed species biofilms exposed to different disinfectants
Authors: Kocot Aleksandra M. , Olszewska Magdalena A.
Published: October 2019

Listeria spp. are ubiquitously found in both the natural and the food processing environment, of which Listeria monocytogenes is of an important health risk. Here, we report on the formation of single and mixed species biofilms of L. monocytogenes/Listeria innocua and Lactobacillus plantarum strains in 24‐well polystyrene microtiter plates and on the inactivation of 24‐hr and 72‐hr biofilms using quaternary ammonium compound‐, tertiary alkyl amine‐, and chlorine‐based disinfectants. Fluorescent in situ hybridization (FISH) and LIVE/DEAD BacLight staining were applied for 72‐hr L. innocua–L. plantarum mixed biofilms in the LabTek system for the species identification and the reaction of biofilm cells to disinfectants, respectively. L. monocytogenes/L. innocua were more resistant to disinfectants in 72‐hr than in 24‐hr biofilms, whereas L. plantarum strains did not show any significant differences between 72‐hr and 24‐hr biofilms. Furthermore, L. innocua when grown with L. plantarum was more resistant to all disinfection treatments, indicating a protective effect from lactobacilli in the mixed species biofilm. The biofilm formation and reaction to disinfectants, microscopically verified using fluorescence in situ hybridization and LIVE/DEAD staining, showed that L. innocua and L. plantarum form a dense mixed biofilm and also suggested the shielding effect of L. plantarum on L. innocua in the mixed species biofilm.
Depression‐linked beliefs in older adults with depression
Authors: Tanaka Koji
Published: October 2019

Aims and objectives

To clarify beliefs linked with depression among older adults with depression in Japan.

Background

As a result of global population ageing, caring for older adults with depression has become an important issue worldwide. In this paper, the concept of “beliefs” pertains to phenomena that lead to distress about disease and can be alleviated through talk therapy. While previous studies focused on illness beliefs in people with mental illness and depression, no studies have yet focused on such beliefs among older adults with depression.

Design

Qualitative, narrative‐research‐based method.

Methods

Observation and 1–5 narrative interviews lasting 60–90 min were conducted with each of 19 older adults with depression in a Japanese psychiatric ward. The resulting narratives were thematically analysed to derive relevant themes and subthemes. Reporting of this research adheres to COREQ guidelines.

Results

Four themes and twelve subthemes were revealed. Depression‐linked beliefs among older adults with depression were (1) “guilt and regret,” (2) “pessimism,” (3) “futility of treatment” and (4) “desire to be needed by loved ones and society.”

Conclusion

Depression‐linked beliefs among older adults with depression constituted spiritual pain reflecting character tendencies, including experiences of loss and developmental challenges related to ageing as well as subjects' natural diligence and consideration for others.

Relevance to clinical practice

(1) Helping nurses better understand distress experienced by older adults with depression, who are prone to feel guilt and regret when reflecting on the past and to alleviate distress through dialogue and providing positive affirmation for patients. (2) To understand and assuage distress over experiences of loss in old age. (3) To help older adults with depression form a more relaxed attitude towards life, so that even if they have experienced loss as a result of old age, they can maintain their self‐esteem and existential sense of self‐worth.
The hospital frailty risk score in patients with heart failure is strongly associated with outcomes but less so with pharmacotherapy
Authors: McAlister F. A. , Savu A. , Ezekowitz J. A. , Armstrong P. W. , Kaul P.
Published: October 2019

Background

Although frailty is known to be an important prognostic factor in heart failure (HF), HF risk‐adjustment models do not incorporate frailty measures and the interplay between frailty, age and pharmacotherapy is unclear.

Objectives

To explore the relationships between frailty, pharmacotherapy and outcomes in heart failure (HF).

Methods

Retrospective cohort study of all adults in Alberta, Canada hospitalized for the first time for HF between 2004 and 2016. Frailty was defined using the Hospital Frailty Risk Score (HFRS).

Results

In 26 626 patients (mean age 77.4 years), the 8887 (33.4%) defined as frail (HFRS ≥ 5) were older, had higher Charlson scores and more prior emergency department visits or hospitalizations. The HFRS and the Charlson Score were only weakly correlated (r = 0.35). Whilst more common in older patients (41.4% of patients 80 or older), frailty was present in 22.4% of patients younger than 65. Frail patients had longer lengths of stay and worse outcomes postdischarge, but adding the HFRS to age, sex and Charlson score did not improve prediction of events (c‐statistics 0.69 for 30‐day mortality after admission, and 0.54 for 30‐day readmission/ED visit/or death after discharge). Frail patients younger than 65 were significantly more likely than nonfrail patients 80 or older to be prescribed high‐dose evidence‐based HF therapies (27.1% vs. 22.2%, P = 0.003).

Conclusion

Although the HFRS reflects aspects of frailty that patient age and Charlson scores do not, the addition of the HFRS to standard risk prediction equations provides little additional information. Prescribing practices correlate more with patient age than frailty status.
Clinical FDG‐PET Findings in Patients with Temporal Lobe Epilepsy: Concordance with EEG and MRI
Authors: Jaisani Zeenat , Miletich Robert S. , Ramanathan Murali , Weinstock Arie L.
Published: October 2019

BACKGROUND AND PURPOSE

We aimed to study the yield of PET in temporal lobe epilepsy (TLE) by analyzing the correlation of PET findings with MRI, and interictal and ictal EEG findings, in a single‐center cohort of patients with TLE. Predictors of PET thalamic changes and its role in predicting postsurgical outcome were also studied.

METHODS

This was a retrospective study of 39 patients with TLE who underwent MRI, PET, and scalp video EEG monitoring at the University at Buffalo, New York from 2001 to 2011 during presurgical evaluation. PET‐defined metabolism of the temporal lobes was evaluated using a 4‐point ordinal rating scale.

RESULTS

PET hypometabolism was associated with a variation in ictal (P = .034) and interictal (P < .001) foci in both lesional (by MRI) and nonlesional patients. Nonlesional MRI scans were associated with none to mild temporal PET hypometabolism (71% of patients) while lesional MRI scans were associated with moderate to severe hypometabolism (82% of patients) (P = .006). The odds of thalamic hypometabolism were 5.36 times higher when there was moderate to severe temporal hypometabolism (P = .039).

CONCLUSION

This study underscores the utility of PET in localizing ictal foci in TLE patients even in those with normal MRI. The degree of PET hypometabolism corresponds to presence of MRI pathology. Coexistent thalamic hypometabolism with temporal hypometabolism suggests a secondary effect of distant temporal network disruption. Extratemporal metabolism is a predictor of poor postsurgical seizure outcome in TLE patients.