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Cardiac remodeling following reperfused acute myocardial infarction is linked to the concomitant evolution of vascular function as assessed by cardiovascular magnetic resonance
No full textAbstract
Background
Left ventricular (LV) remodeling following acute myocardial infarction (MI) is difficult to predict at an individual level although a possible interfering role of vascular function has yet to be considered to date. This study aimed to determine the extent to which this LV remodeling is influenced by the concomitant evolution of vascular function and LV loading conditions, as assessed by phase-contrast Cardiovascular Magnetic Resonance (CMR) of the ascending aorta.
Methods
CMR was performed in 121 patients, 2\u20134\ua0days after reperfusion of a first ST-segment elevation myocardial infarction and 6\ua0months thereafter. LV remodeling was: (i) assessed by the 6-month increase in end-diastolic volume (EDV) and/or ejection fraction (EF) and (ii) correlated with the indexed aortic stroke volume (mL.m
\u22122
), determined by a CMR phase-contrast sequence, along with derived functional vascular parameters (total peripheral vascular resistance (TPVR), total arterial compliance index, effective arterial elastance).
Results
At 6\ua0months, most patients were under angiotensin enzyme converting inhibitors (86%) and beta-blockers (84%) and, on average, all functional vascular parameters were improved whereas blood pressure levels were not. An increase in EDV only (EDV+/EF-) was documented in 17% of patients at 6\ua0months, in EF only (EDV-/EF+) in 31%, in both EDV and EF (EDV+/EF+) in 12% and neither EDV nor EF (EDV-/EF-) in 40%. The increase in EF was mainly and independently linked to a concomitant decline in TPVR (6-month change in mmHg.min.m
2
.L
\u22121
, EDV-/EF-: +1\u2009\ub1\u20098, EDV+/EF-: +3\u2009\ub1\u20099, EDV-/EF+: -7\u2009\ub1\u20096, EDV+/EF+: -15\u2009\ub1\u200920, p \u2009<\u20090.001) while the absence of any EF improvement was associated with high persisting rates of abnormally high TPVR at 6\ua0months (EDV-/EF-: 31%, EDV+/EF-: 38%, EDV-/EF+: 5%, EDV+/EF+: 13%, p \u2009=\u20090.007). By contrast, the 6\u2013month increase in EDV was mainly dependent on cardiac as opposed to vascular parameters and particularly on the presence of microvascular ..
QFT-Plus: a plus in variability? \u2013 Evaluation of new generation IGRA in serial testing of students with a migration background in Germany
No full textAbstract
Background
Currently available Interferon-gamma release assays (IGRAs) show a considerable variability in serial testing for latent tuberculosis infection (LTBI).
This study offers first results for the new generation IGRA QuantiFERON-TB Gold Plus (QFT-Plus) introduced in 2015 in comparison with its predecessor QuantiFERON-TB Gold In-Tube (QFT-GIT) from serial testing of students with a migration background at German universities.
Methods
Forty-one students were selected from a previous study. All students with a positive IGRA were asked and 11 agreed to participate in this cohort study. Additionally 30 students with negative IGRA results were selected by chance. Weekly testing with QFT-Plus and QFT-GIT was performed in all individuals over a 4-week period. IGRA variability was evaluated by calculating conversion and reversion rates.
Results
From 41 participants a total number of 163 serial measurements were analyzed for each IGRA, leading to 122 possible IGRA changes each. QFT-Plus had four conversions and two reversions leading to a conversion rate of 4.3% (4 of 93 possible conversions, 95% CI 1.4\u201311.3%) and reversion rate of 6.9% (2 of 29 possible reversions, 95% CI 1.2\u201324.2%). QFT-GIT had 2 conversions and 1 reversion causing slightly lower rates with 2.2% conversions (2 of 91, 95% CI 0.4\u20138.5%) and 3.2% reversions (1 of 31, 95% CI 0.2\u201318.5%). Inconsistent IGRA results occurred in 4 subjects for QFT-Plus (8 stable positives, 29 stable negatives) and in 2 subjects for QFT-GIT (9 stable positives, 30 stable negatives). Agreement between the two IGRAs was 95.1% ( \u3ba = 0.89). Variance attributed to the individuals was low (QFT-Plus: ICC = 0.88).
Conclusion
This study confirms occurrence of conversions and reversions for the new QFT-Plus in serial testing of a high-risk cohort in a low-incidence setting with improbable new TB contact during the study. QFT-Plus conversion and reversion rates were slightly higher than for the QFT-GIT but overall they were lower for both IGRAs than in other studies that investigated IGRA variability
Factors that influence early breastfeeding of singletons and twins in Korea: a retrospective study
No full textAbstract
Background
This study aimed to evaluate the factors that influence breastfeeding throughout the hospital stay, including prenatal preparation, early skin-to-skin contact directly after delivery, rooming-in, feeding before the first breastfeed, time to first breastfeed, and postpartum support. This study also aimed to verify whether these factors were significant after adjusting for the mother\u2019s characteristics, the newborn\u2019s characteristics, and the delivery characteristics.
Methods
A retrospective survey was used to collect the data. Factors that influenced breastfeeding throughout the hospital stay, and differences between the types of newborns were analyzed.
Results
Among twins, a higher likelihood of breastfeeding throughout the hospital stay was associated with not feeding before the first breastfeeding and an earlier start time for the first breastfeeding. Among singletons, a higher likelihood of breastfeeding throughout the hospital stay was associated with early skin-to-skin contact, no other feeding before the first breastfeed, and an earlier commencement of the first breastfeed.
Conclusions
Effort should encourage early breastfeeding, without restriction, to improve the breastfeeding rate among mothers of twins. Moreover, an individualized approach that addresses the factors that influence breastfeeding for each type of newborn may help improve the corresponding rates of breastfeeding throughout the hospital stay
Childcare workers\u2019 experiences of supporting exclusive breastfeeding in Kuala Muda District, Malaysia: a qualitative study
No full textAbstract
Background
The role of childcare workers at registered nurseries in supporting exclusive breastfeeding practice is important, as many newborn babies are placed in nurseries during working hours. To increase exclusive breastfeeding rates among working mothers, understanding childcare workers\u2019 experiences and needs relating to supporting these mothers is crucial. This study aimed to explore childcare workers\u2019 experiences of supporting breastfeeding at registered nurseries.
Methods
We used a qualitative design to conduct in-depth, semi-structured interviews with ten childcare workers at seven registered nursery centres in Kuala Muda District, Malaysia. Attitudes towards exclusive breastfeeding practice, experiences of breastfeeding training and information, and experiences supporting exclusive breastfeeding at the nursery were explored. Participants were asked to suggest improvements for exclusive breastfeeding practice at their nursery. All interviews were audio recorded, transcribed verbatim, and translated before analysis.
Results
All participants demonstrated a positive attitude in supporting and promoting exclusive breastfeeding practice, mainly centred on the advantages of breastfeeding. Various supports have been found such as labelling bottled breastmilk, allowing the mother to come to the nursery during breaks, and providing reading materials. However, several issues emerged that include parents\u2019 choice on infant feeding practice, insufficient content on breastfeeding topics during training, and adherence to the (not recommended) practice of bottle feeding expressed breastmilk. Recommendations to enhance breastfeeding were also suggested by participants.
Conclusion
Childcare workers may serve as another potential resource for sustaining exclusive breastfeeding at registered nurseries
Process evaluation of the data-driven quality improvement in primary care (DQIP) trial: active and less active ingredients of a multi-component complex intervention to reduce high-risk primary care prescribing
No full textAbstract
Background
Two to 4% of emergency hospital admissions are caused by preventable adverse drug events. The estimated costs of such avoidable admissions in England were \ua3530 million in 2015. The data-driven quality improvement in primary care (DQIP) intervention was designed to prompt review of patients vulnerable from currently prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and anti-platelets and was found to be effective at reducing this prescribing. A process evaluation was conducted parallel to the trial, and this paper reports the analysis which aimed to explore response to the intervention delivered to clusters in relation to participants\u2019 perceptions about which intervention elements were active in changing their practice.
Methods
Data generation was by in-depth interview with key staff exploring participant\u2019s perceptions of the intervention components. Analysis was iterative using the framework technique and drawing on normalisation process theory.
Results
All the primary components of the intervention were perceived as active, but at different stages of implementation: financial incentives primarily supported recruitment; education motivated the GPs to initiate implementation; the informatics tool facilitated sustained implementation. Participants perceived the primary components as interdependent. Intervention subcomponents also varied in whether and when they were active. For example, run charts providing feedback of change in prescribing over time were ignored in the informatics tool, but were motivating in some practices in the regular e-mailed newsletter. The high-risk NSAID and anti-platelet prescribing targeted was accepted as important by all interviewees, and this shared understanding was a key wider context underlying intervention effectiveness.
Conclusions
This was a novel use of process evaluation data which examined whether and how the individual intervention components were effective from the perspective of the professionals delivering changed care to patients. These findings are important for reproducibility and roll-out of the intervention.
Trial registration
ClinicalTrials.gov, NCT01425502
Cellulolytic RoboLector \u2013 towards an automated high-throughput screening platform for recombinant cellulase expression
No full textAbstract
Background
Cellulases are key player in the hydrolyzation of cellulose. Unfortunately, this reaction is slow and a bottleneck in the process chain from biomass to intermediates and biofuels due to low activities of the enzymes. To overcome this draw back, a lot of effort is put into the area of protein engineering, to modify these enzymes by directed evolution or rational design. Huge clone libraries are constructed and have to be screened for improved variants. High-throughput screening is the method of choice to tackle this experimental effort, but up to now only a few process steps are adapted to automated platforms and little attention has been turned to the reproducibility of clone rankings.
Results
In this study, an extended robotic platform is presented to conduct automated high-throughput screenings of clone libraries including preculture synchronization and biomass specific induction. Automated upstream, downstream and analytical process steps are described and evaluated using E. coli and K. lactis as model organisms. Conventional protocols for media preparation, cell lysis, Azo-CMC assay and PAHBAH assay are successfully adapted to automatable high-throughput protocols. Finally, a recombinant E. coli celA2 clone library was screened and a reliable clone ranking could be realized.
Conclusion
The RoboLector device is a suitable platform to perform all process steps of an automated high-throughput clone library screening for improved cellulases. On-line biomass growth measurement controlling liquid handling actions enables fair comparison of clone variants
Using flow technologies to direct the synthesis and assembly of materials in solution
No full textAbstract
In the pursuit of materials with structure-related function, directing the assembly of materials is paramount. The resultant structure can be controlled by ordering of reactants, spatial confinement and control over the reaction/crystallisation times and stoichiometries. These conditions can be administered through the use of flow technologies as evidenced by the growing widespread application of microfluidics for the production of nanomaterials; the function of which is often dictated or circumscribed by size. In this review a range of flow technologies is explored for use in the control of self-assembled systems: including techniques for reagent ordering, mixing control and high-throughput optimisation. The examples given encompass organic, inorganic and biological systems and focus on control of shape, function, composition and size.
Graphical abstract
SLC11A1 polymorphisms and host susceptibility to cutaneous leishmaniasis in Pakistan
No full textAbstract
Background
The vector-borne cutaneous leishmaniasis (CL) is endemic in several regions of Pakistan mainly affecting poor populations. Host genetic factors, particularly SLC11A1 (solute carrier transmembrane protein) within macrophages, play a crucial role in disease pathology and susceptibility. Association of SLC11A1 with cutaneous leishmaniasis, a neglected tropical disease, is not well established. Inconsistencies have been observed within different populations worldwide with respect to genetic susceptibility. This study was designed to investigate genetic variation(s) in SLC11A1 and to assess possible association with cutaneous leishmaniasis in Pakistan.
Results
Eight polymorphisms (rs2276631, rs3731864, rs2290708, rs2695342, rs201565523, rs17215556, rs17235409, rs17235416) were genotyped across SLC11A1 in 274 patients and 119 healthy controls. Six polymorphisms were studied by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and sequencing. Two single nucleotide polymorphisms were analyzed with newly designed semi-nested PCR assays. Case-control analysis showed no association between selected polymorphisms in SLC11A1 and cutaneous leishmaniasis. No significant difference was observed in the distribution of alleles between leishmaniasis patients and healthy individuals. Strong pairwise linkage disequilibrium was observed between rs2276631 and rs2290708 ( r
2
\u2009=\u200964); and rs17235409 and rs17235416 ( r
2
\u2009=\u200978).
Conclusions
This study shows that genetic variations in the candidate gene SLC11A1 do not affect susceptibility to cutaneous leishmaniasis in the sample population from Pakistan
Evaluations of dual attractant toxic sugar baits for surveillance and control of Aedes aegypti and Aedes albopictus in Florida
No full textAbstract
Background
Dual attractant toxic sugar baits (D-ATSB) containing two host kairomones, L-lactic (LA) and 1-octen-3-ol (O), and fruit-based attractants were evaluated through olfactory, consumption and mortality, and semi-field experiments to determine if host kairomones could first, enhance attraction of a fruit-based (attractant) toxic sugar bait (ATSB), and second, increase the efficacy of a fruit based attractive toxic sugar bait (ATSB).
Methods
Four combinations of LA and O were incorporated into the ATSB and evaluated in an olfactometer to determine if these combinations could enhance attraction of Aedes aegypti (L.) to the bait. Ae. albopictus (Skuse) and Ae. aegypti were used to determine bait consumption through excrement droplet counts and percent mortality, of the most attractive D-ATSB (1% LA and 1% O) from the olfactory study. Semi-field evaluations were conducted in screened portable field cages to determine if the D-ATSB applied to non-flowering plants controlled more mosquitoes than the fruit-based ATSB, and ASB. Mosquitoes were exposed to D-ATSB and the two controls for 48\ua0h and collected with BGS traps. The catch rates of the BGS traps were compared to determine efficacy of the D-ATSB.
Results
During olfactometer evaluations of D-ATSB, Ae. aegypti mosquitoes were more attracted to 1% LA and 1% O compared to the fruit-based toxic sugar bait alone. Both species of mosquito consumed more fruit-based non-toxic bait (ASB) and ATSB than the D-ATSB. For both species, percent mortality bioassays indicated D-ATSB controlled mosquitoes, as compared to non-toxic control, but not more than the fruit based ATSB. Semi-field evaluations, BioGents sentinel traps at 48\ua0h confirmed that ATSB (positive control) controlled Ae. albopictus , but there was no statistical difference between ASB (negative control) and the D-ATSB. No differences were observed between the mosquitoes caught in any of the experimental formulations for Ae. aegypti .
Conclusions
L-lactic (1%) and 1-octen-3-ol (1%) added to a fruit-based sugar bait increased attraction of Ae. aegypti and may have future implications in mosquito trapping devices. The addition of the host kairomones did not enhance the consumption and efficacy of the ATSB in laboratory or semi-field evaluations for both mosquito species. We attribute to the absence of other host cues leading to lack of alighting onto bait surfaces to imbibe the toxic bait, as well as a possible decrease in ..
Diagnostic value of microRNA-143 in predicting in-stent restenosis for patients with lower extremity arterial occlusive disease
No full textAbstract
Purpose
This study was conducted to explore the diagnostic value of microRNA-143 (miRNA-143) in predicting in-stent restenosis (ISR) of lower extremity arterial occlusive disease (LEAOD).
Methods
From February 2012 to March 2015, 165 patients (112 males and 53 females) with LEAOD undergoing interventional treatment were enrolled in this study. Serum miRNA-143 expression was detected using quantitative real-time polymerase chain reaction (qRT-PCR). Patients were assigned into the restenosis and non-restenosis groups according to routine surveillance postoperative angiography. A logistic regression analysis was conducted to analyze the risk factors for ISR in LEAOD patients. A receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of miRNA-143 in predicting ISR for LEAOD patients.
Results
There were 74 and 91 patients in the restenosis and non-restenosis groups, respectively. Before the treatment, there were significant differences in history of diabetes, smoking status, blood sugar level (BSL) at admission, low-density lipoprotein cholesterol (LDL-C) level, and stent diameter between the restenosis and non-restenosis groups (all P \ua0<\ua00.05). Serum miRNA-143 expression was lower in the restenosis group than in the non-restenosis group ( P \ua0<\ua00.05). Serum miRNA-143 expression in the restenosis group was correlated with smoking status, history of diabetes, BSL, and LDL-C (all P \ua0<\ua00.05). Logistic regression analysis demonstrated that miRNA-143, LDL-C, and smoking status were correlated with the postoperative ISR (all P \ua0<\ua00.05). ROC curve analysis revealed that the area under the curve (AUC) of miRNA-143 in predicting ISR for LEAOD patients was 0.866.
Conclusion
Our results indicate that miRNA-143 can be a promising tool for predicting the ISR in LEAOD patients