Exercise training reduces the acute physiological severity of post-menopausal hot flushes.

A hot-flush is characterised by feelings of intense heat, profuse elevations in cutaneous vasodilation and sweating, and reduced brain blood flow. Exercise training reduces self-reported hot-flush severity, but underpinning physiological data are lacking. We hypothesised that exercise training attenuates the changes in cutaneous vasodilation, sweat rate and cerebral blood flow during a hot flush. In a preference trial, 18 symptomatic post-menopausal women underwent a passive heat stress to induce hot-flushes at baseline and follow-up. Fourteen participants opted for a 16-week moderate intensity supervised exercise intervention, while 7 participants opted for control. Sweat rate, cutaneous vasodilation, blood pressure, heart rate and middle cerebral artery velocity (MCAv) were measured during the hot-flushes. Data were binned into eight equal segments, each representing 12.5% of hot flush duration. Weekly self-reported frequency and severity of hot flushes were also recorded at baseline and follow-up. Following training, mean hot-flush sweat rate decreased by 0.04 mg·cm2 ·min-1 at the chest (95% CI: 0.02-0.06, P = 0.01) and by 0.03 mg·cm2 ·min-1 (0.02-0.05, P = 0.03) at the forearm, compared with negligible changes in control. Training also mediated reductions in cutaneous vasodilation by 9% (6-12) at the chest and by 7% (4-9) at forearm (P≤0.05). Training attenuated hot flush MCAv by 3.4 cm/s (0.7-5.1, P = 0.04) compared with negligible changes in control. Exercise training reduced the self-reported severity of hot-flush by 109 arbitrary units (80-121, P<0.001). These data indicate that exercise training leads to parallel reductions in hot-flush severity and within-flush changes in cutaneous vasodilation, sweating and cerebral blood flo

Heart failure in COVID-19: the multicentre, multinational PCHF-COVICAV registry.

AIMS: We assessed the outcome of hospitalized coronavirus disease 2019 (COVID-19) patients with heart failure (HF) compared with patients with other cardiovascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia). We further wanted to determine the incidence of HF events and its consequences in these patient populations. METHODS AND RESULTS: International retrospective Postgraduate Course in Heart Failure registry for patients hospitalized with COVID-19 and CArdioVascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia) was performed in 28 centres from 15 countries (PCHF-COVICAV). The primary endpoint was in-hospital mortality. Of 1974 patients hospitalized with COVID-19, 1282 had cardiovascular disease and/or risk factors (median age: 72 [interquartile range: 62-81] years, 58% male), with HF being present in 256 [20%] patients. Overall in-hospital mortality was 25% (n = 323/1282 deaths). In-hospital mortality was higher in patients with a history of HF (36%, n = 92) compared with non-HF patients (23%, n = 231, odds ratio [OR] 1.93 [95% confidence interval: 1.44-2.59], P < 0.001). After adjusting, HF remained associated with in-hospital mortality (OR 1.45 [95% confidence interval: 1.01-2.06], P = 0.041). Importantly, 186 of 1282 [15%] patients had an acute HF event during hospitalization (76 [40%] with de novo HF), which was associated with higher in-hospital mortality (89 [48%] vs. 220 [23%]) than in patients without HF event (OR 3.10 [2.24-4.29], P < 0.001). CONCLUSIONS: Hospitalized COVID-19 patients with HF are at increased risk for in-hospital death. In-hospital worsening of HF or acute HF de novo are common and associated with a further increase in in-hospital mortality

Image Based Visual Servoing for Floating Base Mobile Manipulator Systems with Prescribed Performance under Operational Constraints

This paper presents a novel Image-Based Visual Servoing (IBVS) control approach for Floating Base Mobile Manipulator Systems (FBMMSs) that imposes prescribed transient and steady-state response on the image feature coordinate errors while satisfying the visibility constraints that arise owing to the camera’s limited field of view. The proposed control strategy does not incorporate any knowledge on either the FBMMS dynamic model, the exogenous disturbances, or the inevitable camera calibration and depth measurement errors. More specifically, it guarantees: (i) predefined behavior in terms of overshoot, convergence rate, and maximum steady-state error value of the image features and system velocities tracking errors; (ii) satisfaction of camera field of view constraints; (iii) bounded closed-loop control signals, and (iv) reduced design and implementation complexity. Additionally, the performance of the developed scheme is solely determined by certain designer-specified performance functions/parameters, and it is fully decoupled by the control gains selection. The efficiency of the proposed scheme is demonstrated via a realistic simulation study, using an eye-in-hand Underwater Vehicle Manipulator System (UVMS) as a test-bed FBMMS platform. Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland

Premature ovarian failure, endothelial dysfunction and estrogen-progestogen replacement

Cardiovascular disease, including coronary artery disease, stroke and peripheral vascular disease, is the leading cause of death among women. Vascular endothelial dysfunction is an early marker of atherosclerosis. Women with premature ovarian failure (or premature menopause) present an increased risk for cardiovascular disease, which might be attributed to the early onset of vascular endothelial dysfunction, associated with sex steroid deficiency. Cyclical estrogen and progestogen therapy has been shown to restore endothelial function in these young women. Further research is required to assess primarily the long-term effects of hormone replacement therapy on cardiovascular and overall prognosis in young women with premature ovarian failure, as well as the effects of different doses, duration and routes of hormone administration in these women

Effect of the insulin sensitizers metformin and pioglitazone on endothelial function in young women with polycystic ovary syndrome: A prospective randomized study

Objective: To compare the effect of two different insulin sensitizers, metformin and pioglitazone, on endothelial function in women with polycystic ovary syndrome (PCOS). Design: Prospective randomized study. Setting: University Hospital endocrinology outpatient clinic. Patient(s): Young women with PCOS (aged 23.3 ± 4.9 years). Intervention(s): Patients were assigned randomly to no treatment (n = 14), metformin 850 mg two times per day (n = 15), and pioglitazone 30 mg daily (n = 14) for 6 months. Healthy age- and body mass index-matched women served as controls (n = 14). Main Outcome Measure(s): Brachial artery flow-mediated dilation was studied at baseline and 6 months. Result(s): Women with PCOS had higher insulin resistance and hyperandrogenism indices and lower flow-mediated dilation compared with controls. The three groups of women with PCOS did not differ at baseline. No differences were observed at follow-up in women who received no treatment. Metformin and pioglitazone improved flow-mediated dilation to a similar extent, restoring it to normal values at 6 months. Both insulin sensitizers induced favorable changes in insulin resistance and hyperandrogenism indices in women with PCOS. Independent predictors of flow-mediated dilation improvement at 6 months were treatment with insulin sensitizers and reduction in insulin resistance. Conclusion(s): In young women with PCOS, treatment with metformin or pioglitazone for 6 months induces a similar beneficial effect on endothelial function; this may be partially attributed to an improvement in insulin resistance. Further research is needed to investigate whether treatment with insulin sensitizers in women with PCOS also reduces cardiovascular risk. © 2011 American Society for Reproductive Medicine, Published by Elsevier Inc

KardiaSoft Architecture -A Software Supporting Diagnosis and Therapy Monitoring of Heart Failure Patients Exploiting Saliva Biomarkers

The aim of this work is to present the architecture of the KardiaSoft software, a clinical decision support tool allowing the healthcare professionals to monitor patients with heart failure by providing useful information and suggestions in terms of the estimation of the presence of heart failure (heart failure diagnosis), stratification-patient profiling, long term patient condition evaluation and therapy response monitoring. KardiaSoft is based on predictive modeling techniques that analyze data that correspond to four saliva biomarkers, measured by a point-of-care device, along with other patient's data. The KardiaSoft is designed based on the results of a user requirements elicitation process. A small clinical scale study with 135 subjects and an early clinical study with 90 subjects will take place in order to build and validate the predictive models, respectively