Effective control of pulmonary vascular resistance with inhaled nitric oxide after cardiac operation

AbstractIncreased pulmonary vascular resistance may greatly complicate the perioperative management of cardiac surgical patients. Inhaled nitric oxide may be a promising new therapy to selectively lower pulmonary vascular resistance. The purpose of this study was to examine the effects of inhaled nitric oxide on pulmonary and systemic hemodynamics in cardiac surgical patients. Twenty patients (age 57 ± 6 years) were studied in the operating room after weaning from cardiopulmonary bypass. Mean pulmonary artery pressure, pulmonary vascular resistance, systemic vascular resistance, and mean aortic pressure were determined at four points of data collection: before nitric oxide, with 20 ppm nitric oxide, with 40 ppm nitric oxide, and after nitric oxide. Statistical analysis was by analysis of variance; significance was accepted for p < 0.05. Inhaled nitric oxide produced selective pulmonary vasorelaxation. Pulmonary vascular resistance was lowered from 343 ± 30 before nitric oxide to 233 ± 25 dynes · sec -1 · cm -5 with 20 ppm nitric oxide. Pulmonary vascular resistance was not further lowered by 40 ppm nitric oxide ( p < 0.05). Mean pulmonary arterial pressure was 29 ± 1 mm Hg before nitric oxide and was lowered to 22 ± 1 mm Hg by 20 ppm nitric oxide and 21 ± 1 mm Hg by 40 ppm nitric oxide ( p < 0.05). Both pulmonary vascular resistance and mean pulmonary arterial pressure returned to baseline after withdrawal of inhaled nitric oxide. Inhaled nitric oxide produced no changes in either systemic vascular resistance or mean aortic pressure. We conclude that nitric oxide may be used as an effective pulmonary vasodilator after cardiac operations. It may be particularly valuable for selectively lowering right ventricular afterload in patients with right ventricular dysfunction. (J THORAC CARDIOVASC SURG 1996;111:753-63

Associations of physical activity and quality of life in parapneumonic effusion patients

Introduction Little is known about activity behaviours and quality of life (QoL) of patients with parapneumonic pleural effusions (PPE) after hospital discharge. This study is a secondary analysis of a randomised trial (dexamethasone versus placebo) for hospitalised patients with PPE. We: 1) described the patients’ activity behaviour patterns and QoL measured at discharge and at 30 days post-discharge; and 2) examined the association between activity behaviours and QoL scores. Methods Activity behaviour (7-day accelerometry; Actigraph GT3X+) and QoL (Medical Outcomes Study Short-Form 36) were assessed. Repeated measures analysis of covariance controlling for baseline values and a series of linear regression models were undertaken. Results 36 out of 53 eligible participants completed accelerometry assessments. Despite modest increases in light physical activity (+7.5%) and some domains of QoL ( \u3e 2 points) from discharge to 30 days post-discharge, patients had persistently high levels of sedentary behaviour ( \u3e 65% of waking wear time) and poor QoL ( ⩽ 50 out of 100 points) irrespective of treatment group ( p=0.135–0.903). Increasing moderate-to-vigorous physical activity was associated with higher scores on most QoL domains ( p=0.006–0.037). Linear regression indicates that a clinically important difference of 5 points in physical composite QoL score can be achieved by reallocating 16.1 min·day−1 of sedentary time to moderate-to-vigorous physical activity. Conclusion Patients with PPE had low levels of physical activity and QoL at discharge and 30 days post-discharge irrespective of treatment. Moderate-to-vigorous physical activity participation was associated with higher QoL scores. Increasing moderate-to-vigorous physical activity following discharge from the hospital may be associated with improvements in QoL. © The authors 2023

Exploiting proteomic data for genome annotation and gene model validation in Aspergillus niger

<p>Abstract</p> <p>Background</p> <p>Proteomic data is a potentially rich, but arguably unexploited, data source for genome annotation. Peptide identifications from tandem mass spectrometry provide <it>prima facie </it>evidence for gene predictions and can discriminate over a set of candidate gene models. Here we apply this to the recently sequenced <it>Aspergillus niger </it>fungal genome from the Joint Genome Institutes (JGI) and another predicted protein set from another <it>A.niger </it>sequence. Tandem mass spectra (MS/MS) were acquired from 1d gel electrophoresis bands and searched against all available gene models using Average Peptide Scoring (APS) and reverse database searching to produce confident identifications at an acceptable false discovery rate (FDR).</p> <p>Results</p> <p>405 identified peptide sequences were mapped to 214 different <it>A.niger </it>genomic <it>loci </it>to which 4093 predicted gene models clustered, 2872 of which contained the mapped peptides. Interestingly, 13 (6%) of these <it>loci </it>either had no preferred predicted gene model or the genome annotators' chosen "best" model for that genomic locus was not found to be the most parsimonious match to the identified peptides. The peptides identified also boosted confidence in predicted gene structures spanning 54 introns from different gene models.</p> <p>Conclusion</p> <p>This work highlights the potential of integrating experimental proteomics data into genomic annotation pipelines much as expressed sequence tag (EST) data has been. A comparison of the published genome from another strain of <it>A.niger </it>sequenced by DSM showed that a number of the gene models or proteins with proteomics evidence did not occur in both genomes, further highlighting the utility of the method.</p

Phase 1b study of AVB-500 in combination with paclitaxel or pegylated liposomal doxorubicin platinum-resistant recurrent ovarian cancer

OBJECTIVE: GAS6 and AXL are expressed in high-grade serous ovarian cancer but not in normal ovarian tissue. AVB-500, a novel high affinity Fc-sAXL fusion protein, binds GAS6 preventing AXL signaling. This Phase 1b study (NCT03639246) evaluated safety, efficacy, and exploratory predictive markers of AVB-500 combined with paclitaxel (PAC) or pegylated liposomal doxorubicin (PLD) in patients with platinum-resistant ovarian cancer (PROC), and used a model informed drug development (MIDD) approach for identification of the recommended phase 2 dose (RP2D). METHODS: Eligible patients received AVB-500 at 10, 15, or 20 mg/kg IV q2wk combined with PAC (n = 23) or PLD (n = 30). Patients were treated until progression or unacceptable toxicity. All were followed for survival. RESULTS: No dose limiting toxicities were observed and serum GAS6 was completely suppressed across the three dose levels evaluated. AVB-500 + PAC yielded better clinical activity than AVB-500 + PLD with an ORR of 34.8% (8/23, 2 complete responses) and median DoR, PFS, and OS of 7.0, 3.1, and 10.3 months, respectively. Subgroup analyses showed AVB-500 + PAC patients who had no prior bevacizumab or whose AVB-500 trough levels were \u3e13.8 mg/L exhibited the best clinical response. The ORR and median PFS and OS in patients with these characteristics were ≥50%, ≥7.5 months, and ≥19 months, respectively. Given AVB-500 nor the combination with chemotherapy was expected to cause DLTs, the RP2D of AVB-500 was 15 mg/kg identified using an MIDD approach. CONCLUSION: AVB-500 was well-tolerated in combination with PAC or PLD and contributed to the clinical activity of PAC in PROC patients. Subgroup analyses identified a population of PROC patients who may benefit the most from AVB-500 treatment, which will be further assessed in an ongoing Phase 3 PROC trial

Sea surface temperature changes in the southern California borderlands during the last glacial-interglacial cycle

A variety of evidence suggests that average sea surface temperatures (SSTs) during the last glacial maximum in the California Borderlands region were significantly colder than during the Holocene. Planktonic foraminiferal δ18O evidence and average SST estimates derived by the modern analog technique indicate that temperatures were 6°-10°C cooler during the last glacial relative to the present. The glacial plankton assemblage is dominated by the planktonic foraminifer Neogloboquadrina pachyderma (sinistral coiling) and the coccolith Coccolithus pelagicus, both of which are currently restricted to subpolar regions of the North Pacific. The glacial-interglacial average SST change determined in this study is considerably larger than the 2°C change estimated by Climate: Long-Range Investigation, Mapping, and Prediction (CLIMAP) [1981]. We propose that a strengthened California Current flow was associated with the advance of subpolar surface waters into the Borderlands region during the last glacial

Imaging Lipid Distributions in Model Monolayers by ToF-SIMS with Selectively Deuterated Components and Principal Components Analysis

Abstract Time of Flight Secondary Ion Mass Spectrometry (ToF-SIMS) provides the capability to image the distribution of molecular ions and their associated fragments that are emitted from monolayer films. ToF-SIMS can be applied to the analysis of monolayers of complex lipid mixtures that act as a model to understand the organization of cell membranes into solid-like domains called lipid rafts. The ability to determine the molecular distribution of lipids using ToF-SIMS in monolayer films is also important in studies of the function of pulmonary surfactant. One of the limitations of the use of ToF-SIMS to studies of complex lipid mixtures found in biological systems, arises from the similarity of the mass fragments that are emitted from the components of the lipid mixture. The use of selectively deuterated components in a mixture overcomes this limitation and results in an unambiguous assignment of specific lipids to particular surface domains. The use of deuterium labeling to identify specific lipids in a multi-component mixture can be done by the deuteration of a single lipid or by the addition of more than one lipid with selectively deuterated components. The incorporation of deuterium into the lipid chains does not alter the miscibility or phase behavior of these systems. The use of deuterium labeling to identify lipids and determine their distribution in monolayer films will be demonstrated using two biological systems. Principal components analysis (PCA) is used to further analyze these deuterated systems checking for the origin of the various mass fragments present

TEARS: a longitudinal investigation of the prevalence, psychological associations and trajectory of poststroke emotionalism

Objective: There are few longitudinal studies of poststroke emotionalism (PSE) and our understanding of the psychological associations of PSE is limited, constraining assessment of existing interventions and the development of new therapies. This study aimed to assess the prevalence and course of PSE over the first year poststroke, and its psychological associations. Methods: Consenting stroke survivors who were physically and cognitively able to participate were assessed within 2 weeks, 6 and 12 months of stroke to determine PSE point prevalence using a diagnostic, semistructured PSE interview (Testing Emotionalism After Recent Stroke-Diagnostic Interview). At the same assessments, neuropsychological and disability status were determined using Hospital Anxiety and Depression Scale, Abbreviated Mental Test, National Institute of Health Stroke Scale, Barthel Index and Euro-Qol. Results: Two hundred and seventy seven stroke survivors were recruited between 1 October 2015 and 30 September 2018. Diagnostic data were available at baseline for 228 of 277 cohort participants. Point prevalence for PSE was 27.2% at 2 weeks; estimated prevalence at 6 months adjusted for baseline was 19.9% and at 12 months 22.3%. PSE was associated with symptoms of anxiety and event-related distress. Interpretation: PSE affects at least one in five stroke patients acutely following their stroke, and continues to affect one in eight longer term. PSE is associated with anxiety and event-related distress but is not simply a manifestation of mood disorder over time. Such psychological correlates may have implications for longer term social rehabilitation

Association between energy balance-related factors and clinical outcomes in patients with ovarian cancer: A systematic review and meta-analysis

Background: This systematic review and meta-analysis synthesized evidence in patients with ovarian cancer at diagnosis and/or during first-line treatment on; (i) the association of body weight, body composition, diet, exercise, sedentary behavior, or physical fitness with clinical outcomes; and (ii) the effect of exercise and/or dietary interventions. Methods: Risk of bias assessments and best-evidence syntheses were completed. Meta-analyses were performed when ≥ 3 papers presented point estimates and variability measures of associations or effects. Results: Body mass index (BMI) at diagnosis was not significantly associated with survival. Although the following trends were not supported by the best-evidence syntheses, the meta-analyses revealed that a higher BMI was associated with a higher risk of post-surgical complications (n = 5, HR: 1.63, 95 % CI: 1.06 – 2.51, p = 0.030), a higher muscle mass was associated with a better progression-free survival (n = 3, HR: 1.41, 95 % CI: 1.04 – 1.91, p = 0.030) and a higher muscle density was associated with a better overall survival (n = 3, HR: 2.12, 95 % CI: 1.62 – 2.79, p \u3c 0.001). Muscle measures were not significantly associated with surgical or chemotherapy-related outcomes. Conclusions: The prognostic value of baseline BMI for clinical outcomes is limited, but muscle mass and density may have more prognostic potential. High-quality studies with comprehensive reporting of results are required to improve our understanding of the prognostic value of body composition measures for clinical outcomes. Systematic review registration number: PROSPERO identifier CRD42020163058