Epidural electrical spinal cord stimulation of the thoracic segments (T2-T5) facilitates respiratory function in patients with complete spinal cord injury

Introduction: Patients with high cervical Spinal Cord Injury (SCI) usually require mechanical ventilation support. Phrenic Nerve Stimulation (PNS) both direct and indirect is the main alternative for these patients to wean off ventilator although PNS has several limitations and phrenic nerve could be also damaged after cervical spinal cord injury.Objective: In this study, we assessed if the spinal cord Epidural Electrical Stimulation (EES) at the segments T2-T5, related to intercostal muscles, can facilitate respiratory function and particularly inspired tidal volume during mechanic ventilation.Methods: Two patients with a high cervical injury were selected for this study with ethical committee permission and under review board supervision. A phrenic nerve conduction study with diaphragm electromyography (DEMG) was performed before and after trial of EES.Results: Results demonstrate that EES at T2-T5 substantially increase the inspired volume. The results of this study also demonstrate that EES at spinal segments T2-T5 can bring patients dependent from mechanical ventilation to pressure support (on CPAP), preventing Baro-trauma and other complications related to mechanical ventilation.Conclusion: These findings suggest that tested approach applied alone or in combination with the phrenic nerve stimulation could help to reduce time on mechanical ventilation and related complications

N-acetyl cysteine: A tool to perturb SARS-CoV-2 spike protein conformation

The infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) resulted in a pandemic with huge death toll and economic consequences. The virus attaches itself to the human epithelial cells through noncovalent bonding of its spike protein with the angiotensin-converting enzyme-2 (ACE2) receptor on the host cell. We hypothesized that perturbing the functionally active conformation of spike protein through reduction of its solvent accessible disulfide bond, thereby disintegrating its structural architecture, may be a feasible strategy to prevent infection. Proteomics data showed that N-acetyl cysteine (NAC), an antioxidant and mucolytic agent been widely in use in clinical medicine, forms covalent conjugates with solvent accessible cysteine residues of spike protein that were disulfide bonded in the native state. In silico analysis indicated that this covalent conjugation perturbed the stereo specific orientations of the interacting key residues of spike protein that resulted in threefold weakening in the binding affinity of spike protein with ACE2 receptor. Antiviral assay using VeroE6 cells showed that NAC caused 54.3% inhibition in SARS-CoV-2 replication. Interestingly, almost all SARS-Cov-2 variants conserved cystine residues in the spike protein. Our observed results open avenues for exploring in vivo pharmaco-preventive and therapeutic potential of NAC for Coronavirus Disease 2019 (COVID-19).</p

Characterising the nickel isotopic composition of organic-rich marine sediments

New Ni stable isotope data (δ60Ni) determined by double-spike MC-ICP-MS for two geologically distinct suites of organic-rich marine sediments from the Sinemurian-Pliensbachian (S-P) Global Stratotype Section and Point (GSSP; Robin Hood's Bay, UK) and the Devonian-Mississippian Exshaw Formation (West Canada Sedimentary Basin) is presented herein. These sediments yield δ60Ni values of between 0.2‰ and 2.5‰, and predominantly have Ni isotopic compositions that are heavier than those of abiotic terrestrial and extraterrestrial samples (0.15‰ and 0.27‰), and in some cases present-day seawater (1.44‰) and dissolved Ni from riverine input (0.80‰). In addition, the observed degree of isotopic fractionation in the marine sediments is far greater than that of these other sample matrices. However, a strong similarity is exhibited between the δ60Ni values of the organic-rich sediments studied here and those of ferromanganese crusts (0.9-2.5‰), suggesting that factors ubiquitous to the marine environment are likely to play a key role in the heightened level of isotopic fractionation in these sample matrices.A lack of correlation between the Ni stable isotope compositions of the organic-rich sediments and Ni abundance suggests that isotopic fractionation in these sediments is not controlled by incorporation or enrichment of Ni during sediment accumulation. Further, no relationship is observed between δ60Ni and TOC concentrations or bottom-water redox conditions, indicating that the organic carbon reservoir and levels of oxygenation at the sediment-water interface do not exert a primary control on Ni isotope fractionation in marine sediments. Following examination of these relationships, it is therefore more likely that the heavy Ni isotope compositions of marine sediments are controlled by the weathering environment and the dominant sources of dissolved Ni into the global ocean reservoir.</p