The effects of lower-body compression garments on walking performance and perceived exertion in adults with CVD risk factors

Objectives Compression garments are used by athletes in attempts to enhance performance and recovery, although evidence to support their use is equivocal. Reducing the exertion experienced during exercise may encourage sedentary individuals to increase physical activity. The aim of this study was to assess the effect of compression garments on walking performance (self-paced and enforced pace) and rate of perceived exertion (RPE) in adults who presented with two or more CVD risk factors. Participants (n = 15, 10 female, 58.9 ± 11.5 years, BMI 27.5 ± 4.5 kg m2) were recruited. Design A repeated measures design. Methods Participants were randomised to Modified Bruce Protocol (enforced pace), or the 6 min walk test (self-paced), and completed the test wearing compression garments or normal exercise clothes (Control). Outcome measures included stage completed, gross efficiency (%) and RPE in Modified Bruce Protocol, and distance walked (m) and RPE in 6 min walk test. Results In the Modified Bruce Protcol participants had a higher RPE (15.5 ± 2.5 vs 14.3 ± 2.2) and a lower efficiency (19.1 ± 5.9 vs 21.1 ± 6.7) in the compression garment condition compared with control, p < 0.05. In the 6 min walk test participants walked 9% less in the compression garment condition (p < 0.05) but did not have a lower RPE. Conclusions Compared with previous studies reporting enhanced or no effects of compression garments on performance or RPE, this study shows adverse effects of such clothing in untrained individuals with CVD risk factors. The mechanisms underlying this negative effect require further exploration. Use of garments designed for the athletic individuals may not be suitable for the wider population

Succinate Dehydrogenase Supports Metabolic Repurposing of Mitochondria to Drive Inflammatory Macrophages.

Activated macrophages undergo metabolic reprogramming, which drives their pro-inflammatory phenotype, but the mechanistic basis for this remains obscure. Here, we demonstrate that upon lipopolysaccharide (LPS) stimulation, macrophages shift from producing ATP by oxidative phosphorylation to glycolysis while also increasing succinate levels. We show that increased mitochondrial oxidation of succinate via succinate dehydrogenase (SDH) and an elevation of mitochondrial membrane potential combine to drive mitochondrial reactive oxygen species (ROS) production. RNA sequencing reveals that this combination induces a pro-inflammatory gene expression profile, while an inhibitor of succinate oxidation, dimethyl malonate (DMM), promotes an anti-inflammatory outcome. Blocking ROS production with rotenone by uncoupling mitochondria or by expressing the alternative oxidase (AOX) inhibits this inflammatory phenotype, with AOX protecting mice from LPS lethality. The metabolic alterations that occur upon activation of macrophages therefore repurpose mitochondria from ATP synthesis to ROS production in order to promote a pro-inflammatory state

Risk of Malignant Progression in Barrett’s Esophagus Patients: Results from a Large Population-Based Study

BACKGROUND: Barrett’s esophagus (BE) is a premalignant lesion that predisposes to esophageal adenocarcinoma. However, the reported incidence of esophageal adenocarcinoma in patients with BE varies widely. We examined the risk of malignant progression in patients with BE using data from the Northern Ireland Barrett’s esophagus Register (NIBR), one of the largest population-based registries of BE worldwide, which includes every adult diagnosed with BE in Northern Ireland between 1993 and 2005. SUBJECTS AND METHODS: We followed 8522 patients with BE, defined as columnar lined epithelium of the esophagus with or without specialized intestinal metaplasia (SIM), until the end of 2008. Patients with incident adenocarcinomas of the esophagus or gastric cardia or with high-grade dysplasia of the esophagus were identified by matching the NIBR with the Northern Ireland Cancer Registry, and deaths were identified by matching with records from the Registrar General’s Office. Incidence of cancer outcomes or high-grade dysplasia was calculated as events per 100 person-years (% per year) of follow-up, and Cox proportional hazard models were used to determine incidence by age, sex, length of BE segment, presence of SIM, macroscopic BE, or low-grade dysplasia. All P values were from two-sided tests. RESULTS: After a mean of 7.0 years of follow-up, 79 patients were diagnosed with esophageal cancer, 16 with cancer of the gastric cardia, and 36 with high-grade dysplasia. In the entire cohort, incidence of esophageal or gastric cardia cancer or high-grade dysplasia combined was 0.22% per year (95% confidence interval [CI] = 0.19% to 0.26%). SIM was found in 46.0% of patients. In patients with SIM, the combined incidence was 0.38% per year (95% CI = 0.31 to 0.46%). The risk of cancer was statistically significantly elevated in patients with vs without SIM at index biopsy (0.38% per year vs 0.07% per year; hazard ratio [HR] = 3.54, 95% CI = 2.09 to 6.00, P < .001), in men compared with women (0.28% per year vs 0.13% per year; HR = 2.11, 95% CI = 1.41 to 3.16, P < .001), and in patients with low-grade dysplasia compared with no dysplasia (1.40% per year vs 0.17% per year; HR = 5.67, 95% CI = 3.77 to 8.53, P < .001). CONCLUSION: We found the risk of malignant progression among patients with BE to be lower than previously reported, suggesting that currently recommended surveillance strategies may not be cost-effective

Geochemical response of the mid-depth Northeast Atlantic Ocean to freshwater input during Heinrich events 1 to 4

PublishedArticleHeinrich events are intervals of rapid iceberg-sourced freshwater release to the high latitude North Atlantic Ocean that punctuate late Pleistocene glacials. Delivery of fresh water to the main North Atlantic sites of deep water formation during Heinrich events may result in major disruption to the Atlantic Meridional Overturning Circulation (AMOC), however, the simple concept of an AMOC shutdown in response to each freshwater input has recently been shown to be overly simplistic. Here we present a new multi-proxy dataset spanning the last 41,000 years that resolves four Heinrich events at a classic mid-depth North Atlantic drill site, employing four independent geochemical tracers of water mass properties: boron/calcium, carbon and oxygen isotopes in foraminiferal calcite and neodymium isotopes in multiple substrates. We also report rare earth element distributions to investigate the fidelity by which neodymium isotopes record changes in water mass distribution in the northeast North Atlantic. Our data reveal distinct geochemical signatures for each Heinrich event, suggesting that the sites of fresh water delivery and/or rates of input played at least as important a role as the stage of the glacial cycle in which the fresh water was released. At no time during the last 41 kyr was the mid-depth northeast North Atlantic dominantly ventilated by southern-sourced water. Instead, we document persistent ventilation by Glacial North Atlantic Intermediate Water (GNAIW), albeit with variable properties signifying changes in supply from multiple contributing northern sources.This research used samples provided by the Integrated Ocean Drilling (Discovery) Program IODP, which is sponsored by the US National Science Foundation and participating countries under management of Joint Oceanographic Institutions, Inc. We thank Walter Hale and Alex Wülbers for help with sampling, Kirsty Crocket for providing additional samples and Matt Cooper, Andy Milton, Mike Bolshaw and Dave Spanner for analytical support. Heiko Pälike, David Thornalley and Rachel Mills are thanked for productive discussions and comments on earlier versions of this work. We also thank three anonymous reviewers for their constructive feedback, which greatly improved the manuscript. Funding for this project was provided by NERC studentships to A.J.C. (grant NE/D005728/2) and T.B.C. (NE/I528626/1), with additional funding support from a Royal Society Wolfson Research Merit Award and NERC grants NE/F00141X/1 and NE/I006168/1 to P.A.W. and NE/D00876X/2 to G.L.F

Common variants at the MHC locus and at chromosome 16q24.1 predispose to Barrett's esophagus

Barrett’s Esophagus is an increasingly common disease that is strongly associated with reflux of stomach acid and usually a hiatus hernia. Barrett’s Esophagus strongly predisposes to esophageal adenocarcinoma (EAC), a tumour with a very poor prognosis. We have undertaken the first genome-wide association study on Barrett’s Esophagus, comprising 1,852 UK cases and 5,172 UK controls in discovery and 5,986 cases and 12,825 controls in the replication. Two regions were associated with disease risk: chromosome 6p21, rs9257809 (Pcombined=4.09×10−9, OR(95%CI) =1.21(1.13-1.28)) and chromosome 16q24, rs9936833 (Pcombined=2.74×10−10, OR(95%CI) =1.14(1.10-1.19)). The top SNP on chromosome 6p21 is within the major histocompatibility complex, and the closest protein-coding gene to rs9936833 on chromosome 16q24 is FOXF1, which is implicated in esophageal development and structure. We found evidence that the genetic component of Barrett’s Esophagus is mediated by many common variants of small effect and that SNP alleles predisposing to obesity also increase risk for Barrett’s Esophagus