Pre-eclampsia is associated with a twofold increase in diabetes : a systematic review and meta-analysis

CSK and RH are funded by National Institute for Health Research Academic Clinical Fellowships. This study was supported by a grant from the North Staffs Heart Committee.Peer reviewedPublisher PD

Cardiac toxicities in oncology: Elucidating the dark box in the era of precision medicine

Despite current advancements in chemotherapy, immunotherapy and targeted treatments, the potential for major adverse cardiovascular events, regardless of previous cardiac history, persists. Scoring systems, such as the Heart Failure Association-International Cardio-Oncology Society (HFA-ICOS) risk assessment tool, can be utilized to evaluate several factors including prior cardiac history, risk factors and cardiac biomarkers to categorize patients into low, moderate, high, and very high-risk groups. Common cardiotoxicity complications include new or worsening left ventricular ejection fraction (LVEF), QT interval prolongation, myocardial ischaemia, hypertension, thromboembolic disease, cardiac device malfunction and valve disease. Baseline electrocardiogram (ECG) and transthoracic echocardiogram (TTE) are routinely performed for all patients commenced on cardiotoxic treatment, while other imaging modalities and biochemical markers have proven useful for monitoring. Management mainly includes early risk stratification and prompt identification of cardiovascular complications, with patient-specific surveillance throughout treatment. A multidisciplinary approach is crucial in determining the relationship between potential treatment benefits and cardiotoxicity, and whether the continuation of treatment is appropriate on a case-by-case basis. Early risk stratification, optimizing the patient's cardiovascular status prior to treatment, and prompt identification of suspected cardiotoxicity are key in significantly reducing risk. This article provides a comprehensive review of the various types of treatment-related cardiotoxicity, offering guidance on identifying high-risk patients, recognizing early signs of cardiotoxicity, and outlining appropriate treatment approaches and follow-up care for such cases

Preeclampsia and Future Cardiovascular Health

Background—Preeclampsia is a pregnancy-specific disorder resulting in hypertension and multiorgan dysfunction. There is growing evidence that these effects persist after pregnancy. We aimed to systematically evaluate and quantify the evidence on the relationship between preeclampsia and the future risk of cardiovascular diseases.Methods and Results—We studied the future risk of heart failure, coronary heart disease, composite cardiovascular disease, death because of coronary heart or cardiovascular disease, stroke, and stroke death after preeclampsia. A systematic search of MEDLINE and EMBASE was performed to identify relevant studies. We used random-effects meta-analysis to determine the risk. Twenty-two studies were identified with >6.4 million women including >258?000 women with preeclampsia. Meta-analysis of studies that adjusted for potential confounders demonstrated that preeclampsia was independently associated with an increased risk of future heart failure (risk ratio [RR], 4.19; 95% confidence interval [CI], 2.09–8.38), coronary heart disease (RR, 2.50; 95% CI, 1.43–4.37), cardiovascular disease death (RR, 2.21; 95% CI, 1.83–2.66), and stroke (RR, 1.81; 95% CI, 1.29–2.55). Sensitivity analyses showed that preeclampsia continued to be associated with an increased risk of future coronary heart disease, heart failure, and stroke after adjusting for age (RR, 3.89; 95% CI, 1.83–8.26), body mass index (RR, 3.16; 95% CI, 1.41–7.07), and diabetes mellitus (RR, 4.19; 95% CI, 2.09–8.38).Conclusions—Preeclampsia is associated with a 4-fold increase in future incident heart failure and a 2-fold increased risk in coronary heart disease, stroke, and death because of coronary heart or cardiovascular disease. Our study highlights the importance of lifelong monitoring of cardiovascular risk factors in women with a history of preeclampsia

Metamaterial inspired re-configurable monopole antenna for RF energy harvesting

A meta-material inspired re-configurable monopole antenna for RF energy harvesting is proposed in this thesis. The antenna structure consists of a Coplanar Waveguide (CPW) feed which is connected to a rectangular monopole antenna, which is loaded with thin inductor strip and interdigital capacitive (IDC) slot. This introduces metamaterial property in the antenna. Two different antennas are proposed namely one with two IDCs and the other with four IDCs. The goal is to design an antenna for energy harvesting, which requires omnidirectional radiation pattern, and should be functional at wideband/multiband. Hence to be specific the objective is to design, fabricate and test frequency reconfigurable widebandAnultiband antenna. Frequency re-configurability is bought in by switching the introduced diodes at T-IDC slotjunctions which connects and disconnects the IDC slot with the T slot based on the voltage across the diodes, hi case of antenna with two IDCs, it radiates as wideband antenna when IDC slot is connected to the ‘1’ slot, whereas if one is connected and the other is disconnected then it radiates as multiband antenna. In case of antenna with four IDCs different switching combinations give rise to radiation at different frequencies hence leading to frequency re-configurability. The proposed antenna is studied under different switching combinations. Computer Simulation Technology (CST) software was used to design and simulate the proposed antenna. Parametric study was done for optimizing all the important parameters and to understand the working of the antenna. Results were measured and compared with the simulated results and found it to be as expected, except for few cases that were found to be due to fabrication errors. The antenna with two IDCs radiates omnidirectionally between 4.5GHz to 5.5GHz, at 5.35GHz Sn is measured as -8.55dB and the maximum simulated realized gain is 1.939dB when both slots are connected. In the other case antenna radiates as multiband antenna with Sn measured as -11.78dB at 2.1GHz, -10.53dB at 4.36GHz and -16.87dB at 6.9GHz. The maximum simulated realized gain at 4.13GHz was 1.780dB. Whereas in case of antenna with fours IDCs the maximum simulated realized gain with omnidirectional characteristics was found as 1.866dB at 6.97GHz and whereas overall maximum gain was 3.534dB In conclusion a frequency reconfigurable antenna was proposed, simulated and designed. Their reconfigurable property was tested under various switching conditions. The simulated results were compared with the measured results and were found to reasonably comparable and met the design specification for RF energy harvesting, where this antenna can be used in RF energy harvesting system for charging the battery or even for direct power supply to very low power devices.Master of Science (Communications Engineering

Principles of transcriptional regulation and evolution of the metabolic system in E. coli

Organisms must adapt to make optimal use of the metabolic system in response to environmental changes. In the long-term, this involves evolution of the genomic repertoire of enzymes; in the short-term, transcriptional control ensures that appropriate enzymes are expressed in response to transitory extracellular conditions. Unicellular organisms are particularly susceptible to environmental changes; however, genome-scale impact of these modulatory effects has not been explored so far in bacteria. Here, we integrate genome-scale data to investigate the evolutionary trends and transcriptional control of metabolism in Escherichia coli K12. Globally, the regulatory system is organized in a clear hierarchy of general and specific transcription factors (TFs) that control differing ranges of metabolic functions. Further, catabolic, anabolic, and central metabolic pathways are targeted by distinct combinations of these TFs. Locally, enzymes catalyzing sequential reactions in a metabolic pathway are co-regulated by the same TFs. Regulation is more complex at junctions: General TFs control the overall activity of all connecting reactions, whereas specific TFs control individual enzymes. Divergent junctions play a special role in delineating metabolic pathways and decouple the regulation of incoming and outgoing reactions. We find little evidence for differential usage of isozymes, which are generally co-expressed in similar conditions, and thus are likely to reinforce the metabolic system through redundancy. Finally, we show that enzymes controlled by the same TFs have a strong tendency to co-evolve, suggesting a significant constraint to maintain similar regulatory regimes during evolution. Catabolic, anabolic, and central energy pathways evolve differently, emphasizing the role of the environment in shaping the metabolic system. Many of the observations also occur in yeast, and our findings may apply across large evolutionary distances