Effects of steady state free precession parameters on cardiac mass, function, and volumes

G0400444/Medical Research Council/United Kingdom Wellcome Trust/United Kingdo

Optimisation of assessment of maximal rate of heart rate increase for tracking training-induced changes in endurance exercise performance

The maximal rate of heart rate (HR) increase (rHRI), a marker of HR acceleration during transition from rest to submaximal exercise, correlates with exercise performance. In this cohort study, whether rHRI tracked performance better when evaluated over shorter time-periods which include a greater proportion of HR acceleration and less steady-state HR was evaluated. rHRI and five-km treadmill running time-trial performance (5TTT) were assessed in 15 runners following one week of light training (LT), two weeks of heavy training (HT) and 10-day taper (T). rHRI was the first derivative maximum of a sigmoidal curve fit to one, two, three and four minutes of R-R data during transition from rest to running at 8 km/h (rHRI8 km/h), 10.5 km/h, 13 km/h and transition from 8 to 13 km/h (rHRI8-13km/h). 5TTT time increased from LT to HT (effect size [ES] 1.0, p < 0.001) then decreased from HT to T (ES -1.7, p < 0.001). 5TTT time was inversely related to rHRI8 km/h assessed over two (B = -5.54, p = 0.04) three (B = -5.34, p = 0.04) and four (B = -5.37, p = 0.04) minutes, and rHRI8-13km/h over one (B = -11.62, p = 0.006) and three (B = -11.44, p = 0.03) minutes. 5TTT correlated most consistently with rHRI8 km/h. rHRI8 km/h assessed over two to four minutes may be suitable for evaluating athlete responses to training.Maximillian J. Nelson, Clint R. Bellenger, Rebecca L. Thomson, Eileen Y. Robertson, Kade Davison, Daniela Schäfer Olstad, Jonathan D. Buckle

Targeting Infectious Agents as a Therapeutic Strategy in Alzheimer’s Disease

Alzheimer’s disease (AD) is the most prevalent dementia in the world. Its cause(s) are presently largely unknown. The most common explanation for AD, now, is the amyloid cascade hypothesis, which states that the cause of AD is senile plaque forma- tion by the amyloid β peptide, and the formation of neurofibrillary tangles by hyperphosphorylated tau. A second, burgeoning theory by which to explain AD is based on the infection hypothesis. Much experimental and epidemiological data support the involvement of infections in the development of dementia. According to this mechanism, the infection either directly or via microbial virulence factors precedes the formation of amyloid β plaques. The amyloid β peptide, possessing antimicrobial properties, may be beneficial at an early stage of AD, but becomes detrimental with the progression of the disease, concomi- tantly with alterations to the innate immune system at both the peripheral and central levels. Infection results in neuroinflam- mation, leading to, and sustained by, systemic inflammation, causing eventual neurodegeneration, and the senescence of the immune cells. The sources of AD-involved microbes are various body microbiome communities from the gut, mouth, nose, and skin. The infection hypothesis of AD opens a vista to new therapeutic approaches, either by treating the infection itself or modulating the immune system, its senescence, or the body’s metabolism, either separately, in parallel, or in a multi-step way.Basque Government under the grant “Artificial Intelligence in BCAM number EXP. 2019/00432

The propensity to bargain while on a vacation

This article assesses how tourists' bargaining motivations and attitudes moderate their willingness to return to Italy, where bargaining is perceived as one of the best ways to deal with sellers. A non-probability quota sampling technique was used to survey domestic tourists in Italy through an online questionnaire which encompassed 26 bargaining values and one item to measure the likelihood that the tourists would bargain at the same destination in the future. The data comprised a total of 812 observations. An order probit model and marginal effects were estimated to measure the tourists' propensity to return to Italy for bargaining purposes. The study findings indicate that tourists' propensity to return for bargaining purposes is taken with the awareness that they will not obtain what they expected; as a matter of fact, they are unlikely to care about the final result but instead engage in this behaviour to have fun.FCT - National Funding Agency for Science, Research and Technology [UID/ECO/04007/2013 CEFAGE

Hyperactivation of monocytes and macrophages in MCI patients contributes to the progression of Alzheimer's disease

Background: Alzheimer’s disease (AD) is the most common neurodegenerative disease ultimately manifesting as clinical dementia. Despite considerable effort and ample experimental data, the role of neuroinflammation related to systemic inflammation is still unsettled. While the implication of microglia is well recognized, the exact contribution of peripheral monocytes/macrophages is still largely unknown, especially concerning their role in the various stages of AD. Objectives: AD develops over decades and its clinical manifestation is preceded by subjective memory complaints (SMC) and mild cognitive impairment (MCI); thus, the question arises how the peripheral innate immune response changes with the progression of the disease. Therefore, to further investigate the roles of monocytes/macrophages in the progression of AD we assessed their phenotypes and functions in patients at SMC, MCI and AD stages and compared them with cognitively healthy controls. We also conceptualised an idealised mathematical model to explain the functionality of monocytes/macrophages along the progression of the disease. Results: We show that there are distinct phenotypic and functional changes in monocyte and macrophage populations as the disease progresses. Higher free radical production upon stimulation could already be observed for the monocytes of SMC patients. The most striking results show that activation of peripheral monocytes (hyperactivation) is the strongest in the MCI group, at the prodromal stage of the disease. Monocytes exhibit significantly increased chemotaxis, free radical production, and cytokine production in response to TLR2 and TLR4 stimulation. Conclusion: Our data suggest that the peripheral innate immune system is activated during the progression from SMC through MCI to AD, with the highest levels of activation being in MCI subjects and the lowest in AD patients. Some of these parameters may be used as biomarkers, but more holistic immune studies are needed to find the best period of the disease for clinical intervention

Understanding the town centre customer experience (TCCE)

This research enhances the understanding of consumer behaviour and customer experience in the context of town centres. First, it defines town centre customer experience (TCCE) as a multifaceted journey that combines interactions with a diverse range of public and private organisations, including retailers and social and community elements; this results in a unique experience co-created with the consumer across a series of functional and experiential touchpoints. Second, combining qualitative and quantitative insights, this research reveals a series of specific functional and experiential TCCE touchpoints, which underpin the consumer internal response (motivation to visit) and outward behaviour (desire to stay and revisit intentions) in the town centre. In addition to enhancing town centre and customer experience knowledge, these findings offer important new insights to those managing town centres and seeking to retain customer loyalty in the high street. Above all, these findings can help identify the touchpoints that need to be reinforced and/or improved to differentiate a town from its competing centres and to create tailored marketing strategies. Taken together, such initiatives have the potential to positively impact the revitalisation of the high street and the town centre economy

Prevalence and prognosis of myocardial scar in patients with known or suspected coronary artery disease and normal wall motion

<p>Abstract</p> <p>Background</p> <p>Some patients may have normal wall motion after myocardial infarction. The aim of this study was to determine the prevalence and prognosis of patients with myocardial scar in the absence of abnormal wall motion. We studied patients with suspected or known coronary artery disease (CAD) who were referred for cardiovascular magnetic resonance (CMR) for the assessment of global and regional cardiac function and late gadolinium enhancement (LGE) and had normal left ventricular wall motion. Prognostic value was determined by the occurrence of hard endpoints (cardiac death and nonfatal myocardial infarction) and major adverse cardiac events (MACE) which also included hospitalization due to unstable angina or heart failure or life threatening ventricular arrhythmia.</p> <p>Results</p> <p>A total 1148 patients (70.3%) were studied. LGE was detected in 104 patients (9.1%). Prevalence of LGE increased in patients with increased left ventricular mass. Average follow-up time was 955 ± 542 days. LGE was the strongest predictor for hard endpoints and MACE.</p> <p>Conclusion</p> <p>LGE was detected in 9.1% of patients with suspected or known CAD and normal wall motion. LGE was the strongest predictor of significant cardiac events.</p

Age and gender specific normal values of left ventricular mass, volume and function for gradient echo magnetic resonance imaging: a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Knowledge about age-specific normal values for left ventricular mass (LVM), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF) by cardiac magnetic resonance imaging (CMR) is of importance to differentiate between health and disease and to assess the severity of disease. The aims of the study were to determine age and gender specific normal reference values and to explore the normal physiological variation of these parameters from adolescence to late adulthood, in a cross sectional study.</p> <p>Methods</p> <p>Gradient echo CMR was performed at 1.5 T in 96 healthy volunteers (11–81 years, 50 male). Gender-specific analysis of parameters was undertaken in both absolute values and adjusted for body surface area (BSA).</p> <p>Results</p> <p>Age and gender specific normal ranges for LV volumes, mass and function are presented from the second through the eighth decade of life. LVM, ESV and EDV rose during adolescence and declined in adulthood. SV and EF decreased with age. Compared to adult females, adult males had higher BSA-adjusted values of EDV (p = 0.006) and ESV (p < 0.001), similar SV (p = 0.51) and lower EF (p = 0.014). No gender differences were seen in the youngest, 11–15 year, age range.</p> <p>Conclusion</p> <p>LV volumes, mass and function vary over a broad age range in healthy individuals. LV volumes and mass both rise in adolescence and decline with age. EF showed a rapid decline in adolescence compared to changes throughout adulthood. These findings demonstrate the need for age and gender specific normal ranges for clinical use.</p