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ESC Heart Failure May 2024This study aimed to investigate the prevalence, risk factors and prognostic implications of cognitive impairment in young and middle-aged patients with acute heart...
AIMS
This study aimed to investigate the prevalence, risk factors and prognostic implications of cognitive impairment in young and middle-aged patients with acute heart failure (HF).
METHODS
In a prospective cohort of patients with acute HF, we assessed cognitive function by the Mini-Cog, predictors of the cognitive impairment and its associations with 30 day and 1 year cardiovascular death or HF rehospitalization among young and middle-aged patients (<65 years old).
RESULTS
Among 1958 young and middle-aged patients, the prevalence of cognitive impairment was 19.6%. Predictors of cognitive impairment included older age, females, lower education levels and prior strokes. Compared with patients having normal cognitive function, cognitive impairment was associated with a higher risk of 30 day cardiovascular death or HF rehospitalization [hazard ratio (HR), 1.52, 95% confidence interval (CI), 1.07-2.17, P = 0.02], but not for 1 year cardiovascular death or HF rehospitalization (HR, 1.06, 95% CI, 0.87-1.30, P = 0.55).
CONCLUSIONS
Cognitive impairment is present in a notable proportion of young and middle-aged patients with acute HF and is associated with an increased risk of short-term adverse outcomes. Strategies for screening and intervention for cognitive impairment at a younger age are necessary, particularly for those at high risk.
PubMed: 38816208
DOI: 10.1002/ehf2.14885 -
Turkish Journal of Medical Sciences 2023Despite advancements in valve technology and increased clinical experience, complications related to conduction defects after transcatheter aortic valve implantation...
BACKGROUND/AIM
Despite advancements in valve technology and increased clinical experience, complications related to conduction defects after transcatheter aortic valve implantation (TAVR) have not improved as rapidly as expected. In this study, we aimed to predict the development of complete atrioventricular (AV) block and bundle branch block during and after the TAVR procedure and to investigate any changes in the cardiac conduction system before and after the procedure using electrophysiological study.
MATERIALS AND METHODS
A total of 30 patients who were scheduled for TAVR at our cardiovascular council were planned to be included in the study. TAVR was performed on patients at Erciyes University Medical Faculty Hospital as a single center between May 2019 and August 2020 Diagnostic electrophysiological study was performed before the TAVR procedure and after its completion. Changes in the cardiac conduction system during the preprocedure, intra-procedure, and postprocedure periods were recorded.
RESULTS
Significant increases in baseline cycle length, atrial-His (AH) interval, his-ventricular (HV) interval and atrioventricular (AV) distance were observed before and after the TAVR procedure (p = 0.039, p < 0.001, p = 0.018, p < 0.001, respectively). During the TAVR procedure, the preprocedural HV interval was longer in patients who developed AV block and bundle branch block compared to those who did not and this difference was statistically significant (p = 0.024). ROC curve analysis revealed that a TAVR preprocedure HV value >59.5 ms had 86% specificity and 75% sensitivity in detecting AV block and bundle branch block (AUC = 0.83, 95% CI: 0.664-0.996, p = 0.013). The preprocedure HV distance was 98 ± 10.55ms in the group with permanent pacemaker implantation and the mean value in the group without permanent pacemaker implantation was 66.27 ± 15.55 ms, showing a borderline significant difference (p = 0.049).
CONCLUSION
The prolongation of HV interval in patients with AV block and bundle branch block suggests that the block predominantly occurs at the infra-hisian level. Patients with longer preprocedural HV intervals should be closely monitored for the need for permanent pacemaker implantation after the TAVR procedure.
Topics: Humans; Transcatheter Aortic Valve Replacement; Male; Female; Pacemaker, Artificial; Aged; Aged, 80 and over; Atrioventricular Block; Bundle-Branch Block; Aortic Valve Stenosis; Electrocardiography; Postoperative Complications; Heart Conduction System
PubMed: 38813482
DOI: 10.55730/1300-0144.5750 -
F1000Research 2023Electrocardiography (ECG) findings in acute pulmonary embolism (PE) are known to be related to various right ventricular (RV) alterations. These abnormalities are not...
Electrocardiography (ECG) findings in acute pulmonary embolism (PE) are known to be related to various right ventricular (RV) alterations. These abnormalities are not included in risk stratification algorithms despite emerging evidence of their association with patient outcomes. We aimed to analyze the impact of right bundle branch block (RBBB) and/or SIQIII patterns as indicators for determining the level of risk in patients with PE. We performed a retrospective cohort study including all patients with confirmed acute PE hospitalized from January 2008 to December 2019 in two tertiary care cardiology departments. The first ECG taken at admission was selected and the analysis focused on the presence of a complete or an incomplete RBBB and SIQIII-type patterns. A total of 255 patients were divided into two groups: Group I (47.8%, n=122) included patients with PE without RBBB nor SIQIII patterns, and Group II (52.2%, n=133) included patients with RBBB and/or SIQIII patterns. Patients in group II presented significantly more frequently with acute right heart symptoms (45.1% 18%, p<0.001) and cardiogenic shock at admission (31.6 4.1%, p<0.001). Echocardiographic parameters indicating right heart injury also occurred more significantly in group II patients (p<0.001). By univariate analysis, patients in group II were found to be significantly associated with in-hospital mortality (22.6 6.1%, p=0.002) and major cardiovascular events (MACEs) during hospitalization (43.3 13.7%, p<0.001). Multivariate logistic regression analysis identified five independent factors predictive of MACEs: SIQIII and/or RBBB, renal failure, positive troponin levels, RV dysfunction and right heart failure symptoms during initial presentation. Kaplan-Meier survival analysis identified the inclusion in Group II and the presence of SIQIII pattern as predictors of overall mortality (p<0.001). Our study suggests an important and independent prognostic value of RBBB and SIQIII patterns and their usefulness in determining the outcome of PE patients.
Topics: Humans; Pulmonary Embolism; Female; Male; Bundle-Branch Block; Retrospective Studies; Aged; Electrocardiography; Middle Aged; Acute Disease; Risk Assessment; Risk Factors; Aged, 80 and over
PubMed: 38813350
DOI: 10.12688/f1000research.131758.1 -
Research and Practice in Thrombosis and... Mar 2024Assessment of platelet function is key in diagnosing bleeding disorders and evaluating antiplatelet drug efficacy. However, there is a prevailing "one-size-fits-all"...
BACKGROUND
Assessment of platelet function is key in diagnosing bleeding disorders and evaluating antiplatelet drug efficacy. However, there is a prevailing "one-size-fits-all" approach in the interpretation of measures of platelet reactivity, with arbitrary cutoffs often derived from healthy volunteer responses.
OBJECTIVES
Our aim was to compare well-used platelet reactivity assays.
METHODS
Blood and platelet-rich plasma obtained from the Framingham Heart Study ( = 3429) were assayed using a range of agonists in 5 platelet assays: light transmission aggregometry, Optimul aggregometry, Multiplate impedance aggregometry (Roche Diagnostics), Total Thrombus-Formation Analysis System, and flow cytometry. Using linear mixed-effect models, we determined the contribution of preanalytical and technical factors that modulated platelet reactivity traits.
RESULTS
A strong intra-assay correlation of platelet traits was seen in all assays, particularly Multiplate velocity ( = 0.740; ristocetin vs arachidonic acid). In contrast, only moderate interassay correlations were observed ( = 0.375; adenosine diphosphate Optimul E vs light transmission aggregometry large area under the curve). As expected, antiplatelet drugs strongly reduced platelet responses, with aspirin use primarily targeting arachidonic acid-induced aggregation, and explained substantial variance (β = -1.735; = 4.59 × 10; variance proportion = 46.2%) and P2Y antagonists blocking adenosine diphosphate responses (β = -1.612; = 6.75 × 10; variance proportion = 2.1%). Notably, female sex and older age were associated with enhanced platelet reactivity. Fasting status and deviations from standard venipuncture practices did not alter platelet reactivity significantly. Finally, the agonist batch, phlebotomist, and assay technician (more so for assays that require additional sample manipulation) had a moderate to large effect on measured platelet reactivity.
CONCLUSION
Caution must be exercised when extrapolating findings between assays, and the use of standard ranges must be medication-specific and sex-specific at a minimum. Researchers should also consider preanalytical and technical variables when designing experiments and interpreting platelet reactivity measures.
PubMed: 38813256
DOI: 10.1016/j.rpth.2024.102406 -
Heliyon May 2024The AgBr and WO nanoparticles (NPs) were synthesized and coupled, and the coupled AgBr-WO binary catalyst, as well as the individual AgBr and WO NPs, were then...
The AgBr and WO nanoparticles (NPs) were synthesized and coupled, and the coupled AgBr-WO binary catalyst, as well as the individual AgBr and WO NPs, were then characterized by XRD, FTIR, DRS, and SEM-EDX. XRD results showed the formation of orthorhombic WO cubic AgBr crystals. The crystallite sizes of 45, 28, and 45 nm were estimated by the Scherrer formula for the as-prepared AgBr, WO and AgBr-WO catalysts, respectively. The DRS study estimated band gap energies using both absorption edge wavelengths and the Kubelka-Munk model. The band gap energies of 2.72, 3.06, and 2.92 eV were obtained for the direct electronic transitions of AgBr, WO, and AgBr-WO. The E (potential position) of AgBr and WO were estimated to be 0.01 and 0.52 V, while their E values were 2.60 and 3.55 V, respectively. Typical FTIR absorption bands of W‒OH, the W‒O‒W, and AgBr bonds have appeared at 1637 cm, 823 (and 766) cm, and 1384 cm respectively. The pHpzc of 4 was estimated for the individual and coupled catalysts. In studying the photocatalytic activity of the catalysts in the photodegradation of metronidazole (MNZ) a boosted activity was achieved for the coupled system. This increased activity depends on the maximum AgBr:WO mole ratio in a 1:3 mol ratio. Grinding time applied to prepare the coupled catalyst has also varied the photocatalytic activity.
PubMed: 38813214
DOI: 10.1016/j.heliyon.2024.e31353 -
Heliyon May 2024In this study, the proton-induced reactions of Zn and Ga aimed at generating Ga were simulated and modeled using Talys code and neural network software. In the first...
In this study, the proton-induced reactions of Zn and Ga aimed at generating Ga were simulated and modeled using Talys code and neural network software. In the first step, both targets were simulated under different proton energies and at different bombardments times to generate a total of six thousand data. Then, the obtained data from the Talys, including the various cross-sections, contaminations, the main product i.e. Ga, and other options were completely saved in the output file. Afterwards, the inputs of the neural network were selected from the output of the Talys by analyzing and considering most of the key features. A total of four inputs, two of which are different energies related to the reaction, the other is the process sequence and the fourth input is the bombardment time, were recognized as suitable inputs and the model was trained differently depending on the type of target. The selected model was a feed-forward neural network with 5 nodes in a middle layer, which was able to estimate the output of Talys code by changing the input parameters with extremely high accuracy. Two different models including the main model for estimating the output of the main sample (product) and the sub-model for estimating process pollution or impurity were trained, and then the trained model was tested on the deduced process data. The implementation results fully demonstrated the high accuracy of the method. The neural network model is much easier to implement than the Talys code, and its execution speed is very high. In addition, it can be used appropriately as a system alternative for optimization and different structures in medical and biological engineering.
PubMed: 38813197
DOI: 10.1016/j.heliyon.2024.e31499 -
Optimization of off-grid renewable energy systems using a hybrid version of golden search algorithm.Heliyon May 2024Currently, the development of HRESs (hybrid renewable energy systems) in remote areas is of great importance and popularity. However, measuring and optimizing the...
Currently, the development of HRESs (hybrid renewable energy systems) in remote areas is of great importance and popularity. However, measuring and optimizing the capacity of these systems faces a difficult challenge. Multiple works had been reported in the literature to optimize such systems, all of which aim to achieve an optimal configuration with minimum annual net cost. Therefore, the significance of providing off-grid electrification to remote areas through HRESs can be highlighted as a crucial case for sustainable growth. Accordingly, the study proposes a modified metaheuristic approach, known as the Hybrid Golden Search Algorithm (HGSA), for long-term application planning and optimization of the off-grid HRES. The aim of this algorithm is to minimize the amount of net cost which is used annually; to reduce the probability of power supply interruption. In order to assess the effectiveness of the proposed algorithm, a simulation study over a long period on a remote area was conducted. From the results, increasing the reliability level from 1 % to 3 % causes a decrease in the total net annual cost by around 7.3 % under the proposed HGSA and also results in a reduction in component size (around 6 % and 21 % reductions for the wind turbine area and storage tanks, respectively). Further, the HGSA technique obtains the lowest value of fitness function for the hybrid system at a reliability level of 3 %, which is 31,539,810$. This result demonstrates that the efficiency of HGSA outperforms Fuzzy Logic and Optimization, Artificial Bee Colony (ABC), and GSA techniques. Based on this, the proposed HGSA could lead to more promising results than the other comparative algorithms. Hence, the proposed HGSA can be a valuable tool for long-term application planning and optimization of off-grid HRES, which can contribute significantly to achieving sustainable development goals.
PubMed: 38813192
DOI: 10.1016/j.heliyon.2024.e30990 -
Heliyon May 2024The current study was carried out at Nuclear Institute of Agriculture, Tandojam to assess ten mungbean mutants together with one check cultivar in two separate cropping...
The current study was carried out at Nuclear Institute of Agriculture, Tandojam to assess ten mungbean mutants together with one check cultivar in two separate cropping seasons. The findings revealed that all mutants, with the exception of the branches per plant, had significantly different examined traits. By characterizing ten variables, including plant height (cm), number of branches/plant, number of seeds per pod, grain yield per plot (g/plot), grain weight per plant, pod length (cm), pods per plant, days to flowering, above ground biological weight per plot (g/plot) and days to maturity, the results could considerably differentiate between low and high producing mutants. Discriminant analysis was used to choose high-yielding genotypes. The discriminant score demonstrated a significant canonical correlation of 0.994** and could account for 98.8 % of differences in mungbean production. According to the results of discriminant function analysis, the most significant features are pod length, days to flowering, plant height and above ground biological weight. The highest discriminant scores were displayed by the genotypes AEM66, AEM27, AEM25 and AEM14, identified as high yielding mutants. The low yielding mungbean mutants, designated Viz, AEM20, AEM30, AEM35, AEM-96, AEM29, AEM40 and AEM32 are those that exhibit the lowest values of the discriminant score. Mungbean cultivation is more successful in the summer than it is in the spring.
PubMed: 38813169
DOI: 10.1016/j.heliyon.2024.e31331 -
Frontiers in Nutrition 2024Previous animal experiments have demonstrated the potential of spermidine to mitigate glucose intolerance, insulin resistance, and hyperinsulinemia. However, there...
BACKGROUND
Previous animal experiments have demonstrated the potential of spermidine to mitigate glucose intolerance, insulin resistance, and hyperinsulinemia. However, there remains a scarcity of epidemiological evidence supporting these findings. Therefore, we aimed to elucidate the associations of serum spermidine with T2DM and FPG.
MATERIALS AND METHODS
The cross-sectional study was conducted from June to August 2019 in the rural areas of Fuxin County, Liaoning Province, China. A total of 4,437 participants were included in the study. The serum spermidine was detected using high-performance liquid chromatography with a fluorescence detector. FPG was measured using the hexokinase method. T2DM was defined as participants with a FPG level of 7.0 mmol/L or greater, or self-reported diagnosis of diabetes by a doctor. Restricted cubic spline model and piecewise linear regression model were used to explore the associations of serum spermidine with T2DM and FPG, respectively.
RESULTS
The mean (SD) age of the participants was 59.3 (10.0) years, with 622 out of 4,437 participants being defined as T2DM. The serum spermidine in participants stratified by age and BMI categories was significantly different, with values of 0.006 and 0.001, respectively. Among all the participants, the association of serum spermidine with T2DM was J-shaped. The log (spermidine) was negatively associated with T2DM (OR = 0.68, 95% CI: 0.52 to 0.92, = 0.01) below the inflection point, while log (spermidine) was not significantly associated with T2DM (OR = 1.97, 95% CI: 0.93 to 4.15, = 0.07) above the inflection point. Among the participants without T2DM, the association of serum spermidine with FPG was inverted J-shaped. The log (spermidine) was positively associated with FPG ( = 0.13, 95% CI: 0.05 to 0.21, = 0.001) below the inflection point, while log (spermidine) was negatively associated with FPG ( = -0.29, 95% CI: -0.42 to -0.16, < 0.001) above the inflection point.
CONCLUSION
In conclusion, non-linear associations of serum spermidine with T2DM and FPG were found in the cross-sectional study in Chinese rural adults. This provided insights into the use of spermidine for the prevention of T2DM, highlighting the potential role in public health prevention strategies of spermidine.
PubMed: 38812932
DOI: 10.3389/fnut.2024.1393552 -
Journal of Ophthalmology 2024The reference range for the preoperative anterior chamber angle width for ICL surgery is unclear. Our objective was to assess the clinical effect and the range of...
Clinical Observation of Posterior-Chamber Phakic Implantable Collamer Lens V4c Implantation in Myopic Patients with Shallow Anterior Chamber Depth: A Retrospective, Consecutive Observational Study.
PURPOSE
The reference range for the preoperative anterior chamber angle width for ICL surgery is unclear. Our objective was to assess the clinical effect and the range of anterior chamber angle width of posterior-chamber implantable collamer lens V4c (ICL V4c) implantation in patients with anterior chamber depth (ACD) < 2.8 mm.
METHODS
Patients who underwent ICL V4c implantation with shallow ACD were included in this retrospective study. The patients' uncorrected and corrected distance visual acuity, angle of trabecular-iris (TIA), angle-opening distance (AOD500), trabecular-iris space area (TISA500), corneal endothelial cell density, vault, retinal nerve fiber layer thickness, intraocular pressure, visual field, and complications were analyzed.
RESULTS
Forty-one patients (68 eyes) completed at least 12 months of follow-up (median follow-up, 30 months). The effectiveness and safety indices were 1.09 ± 0.13 and 1.04 ± 0.21, respectively. The preoperative TIA values on the nasal and temporal sides were 39.78 ± 7.68 degree (range, 25.8-65.1 degree) and 41.54 ± 8.03 degree (range, 28.5-63.00 degree). Forty-seven eyes had uncorrected distance visual acuity ≥1.0, and 55 had corrected distance visual acuity ≥1.0 at the last follow-up visit. The TIA, AOD500, and TISA500 on the nasal and temporal sides were significantly reduced compared to those before surgery (all < 0.01); no eye had an angle closure or elevated intraocular pressure. The ICL V4c vault was 290.88 ± 153.36 m (range, 60.0-880.0 m). No severe complications occurred in any patient.
CONCLUSIONS
In patients with myopia with shallow ACD (2.55-2.79 mm), a preoperative TIA >25.8° is safe and effective for a relatively long time after surgery; however, an extended long-term close follow-up is needed.
PubMed: 38812725
DOI: 10.1155/2024/3181569