Blood pressure response to renal denervation is correlated with baseline blood pressure variability: a patient-level meta-analysis

Background: Sympathetic tone is one of the main determinants of blood pressure (BP) variability and treatment-resistant hypertension. The aim of our study was to assess changes in BP variability after renal denervation (RDN). In addition, on an exploratory basis, we investigated whether baseline BP variability predicted the BP changes after RDN. Methods: We analyzed 24-h BP recordings obtained at baseline and 6 months after RDN in 167 treatmentresistant hypertension patients (40% women; age, 56.7 years; mean 24-h BP, 152/90 mmHg) recruited at 11 expert centers. BP variability was assessed by weighted SD [SD over time weighted for the time interval between consecutive readings (SDiw)], average real variability (ARV), coefficient of variation, and variability independent of the mean (VIM). Results: Mean office and 24-h BP fell by 15.4/6.6 and 5.5/ 3.7 mmHg, respectively (P < 0.001). In multivariable-adjusted analyses, systolic/diastolic SDiw and VIM for 24-h SBP/DBP decreased by 1.18/0.63 mmHg (P 0.01) and 0.86/0.42 mmHg (P 0.05), respectively, whereas no significant changes in ARV or coefficient of variation occurred. Furthermore, baseline SDiw (P ¼ 0.0006), ARV (P ¼ 0.01), and VIM (P ¼ 0.04) predicted the decrease in 24-h DBP but not 24-h SBP after RDN. Conclusion: RDN was associated with a decrease in BP variability independent of the BP level, suggesting that responders may derive benefits from the reduction in BP variability as well. Furthermore, baseline DBP variability estimates significantly correlated with mean DBP decrease after RDN. If confirmed in younger patients with less arterial damage, in the absence of the confounding effect of drugs and drug adherence, baseline BP variability may prove a good predictor of BP response to RDN

Origin of the Breno and Esino dolomites in the western Southern Alps (Italy): Implications for a volcanic influence

The Esino Limestone of the western Southern Alps represents a differentiated Ladinian-Lower Carnian (?) carbonate platform comprised of margin, slope and peritidal inner platform facies up to 1000 m thick. A major regional subaerial exposure event lead to coverage by another peritidal Lower Carnian carbonate platform (Breno Formation). Multiphase dolomitization affected the carbonate sediments. Petrographic examinations identified at least three main generations of dolomites (D1, D2, and D3) that occur as both replacement and fracture-filling cements. These phases have crystal-size ranges of 3e35 mm (dolomicrite D1), 40e600 mm (eu-to subhedral crystals D2), and 200 mm to 5 mm (cavity- and fracture-filling anhedral to subhedral saddle dolomite D3), respectively. The fabric retentive near-micritic grain size coupled with low mean Sr concentration (76 \ub1 37 ppm) and estimated d18O of the parent dolomitizing fluids of D1 suggest formation in shallow burial setting at temperature ~ 45e50 C with possible contributions from volcanic-related fluids (basinal fluids circulated in volcaniclastics or related to volcanic activity), which is consistent with its abnormally high Fe (4438 \ub1 4393 ppm) and Mn (1219 \ub1 1418 ppm) contents. The larger crystal sizes, homogenization temperatures (D2, 108 \ub1 9 C; D3, 111 \ub1 14 C) of primary two-phase fluid inclusions, and calculated salinity estimates (D2, 23 \ub1 2 eq wt% NaCl; D3, 20 \ub1 4 eq wt% NaCl) of D2 and D3 suggest that they formed at later stages under mid-to deeper burial settings at higher temperatures from dolomitizing fluids of higher salinity, which is supported by higher estimated d18O values of their parent dolomitizing fluids. This is also consistent with their high Fe (4462 \ub1 4888 ppm; and 1091 \ub1 1183 ppm, respectively) and Mn (556 \ub1 289 ppm and 1091 \ub1 1183 ppm) contents, and low Sr concentrations (53 \ub1 31 ppm and 57 \ub1 24 ppm, respectively). The similarity in shale-normalized (SN) REE patterns and Ce (Ce/Ce*)SN and La (Pr/Pr*)SN anomalies of the investigated carbonates support the genetic relationship between the dolomite generations and their calcite precursor. Positive Eu anomalies, coupled with fluid-inclusion gas ratios (N2/Ar, CO2/CH4, Ar/He), high F concentration, high F/Cl and high Cl/Br molar ratios suggest an origin from diagenetic fluids circulated through volcanic rocks, which is consistent with the co-occurrence of volcaniclastic lenses in the investigated sequence

SPECTRORADIOMETRY IN THE VISIBLE AND NEAR INFRARED REGION ON A STAND OF Eucalyptus grandis Hill ex Maiden

Leituras de reflect\ue2ncia em folhas de \ue1rvores de bordadura e de interior de um povoamento florestal de Eucalyptus grandis , no munic\uedpio de S\ue3o Pedro das Miss\uf5es - RS, foram analisadas nas regi\uf5es do espectro eletromagn\ue9tico vis\uedvel e do infravermelho pr\uf3ximo, utilizando-se espectrorradiometria. A \ue1rea foi dividida em duas partes: bordadura e centro do povoamento. Para a coleta de material, a copa das \ue1rvores foi dividida em tr\ueas partes (superior, m\ue9dia e inferior), de forma a diferenciar as posi\ue7\uf5es de coleta de folhas, em cada uma das \ue1reas. Foram amostradas tr\ueas \ue1rvores em cada \ue1rea, totalizando seis \ue1rvores, sendo que para cada \ue1rvore foram coletadas 60 folhas isoladas, 20 em cada posi\ue7\ue3o. As leituras de reflect\ue2ncia foram realizadas atrav\ue9s do espectrorradi\uf4metro FieldSpec\uae3 e os resultados finais foram segmentados nas bandas espectrais do vis\uedvel e do infravermelho pr\uf3ximo. A an\ue1lise estat\uedstica valeu-se do teste Tukey HSD, para compara\ue7\ue3o das m\ue9dias da regi\ue3o do vis\uedvel, que de acordo com a ANOVA apresentaram diferen\ue7as significativas. Conclui-se que as classes indicadas de coleta de folhas para an\ue1lise espectrorradiom\ue9trica na regi\ue3o do vis\uedvel s\ue3o preferencialmente a 5 (\ue1rvore de centro, leitura na parte mediana) e a 3 (\ue1rvore de bordadura, leitura parte superior).Reflectance readings in border and inner tree leaves in a Eucalyptus grandis stand, in S\ue3o Pedro das Miss\uf5es, Rio Grande do Sul state, were analyzed in the regions of the visible electromagnetic spectrum and the nearby infrared, by using spectrum radiometry. The area was divided in two parts: border and center stands. In order to collect the material, the crown was divided in three parts (superior, medium and inferior), so that it would be possible to differentiate the positions of leaf collections in each area. Three trees were sampled in each area, adding up to six trees, for each tree, 60 isolated leaves were collected, 20 in each position. The reflectance readings were carried out through FieldSpec\uae3 spectrum radiometer and the final results were segmented in the visible and nearby infrared spectral bands. The statistical analysis was made on the basis of several tests, among them Tukey HSD test, in order to compare the averages of the visible region, which, according to ANOVA, present significant differences. It is concluded that the collecting indicating class of leaves for the spectrum radiometric analysis in the visible region are preferably the 5 one (tree in the center, reading in the medium part) and #3 one (border tree, reading superior part)

Diamond-Based Thin Film Bulk Acoustic Wave Resonator for Biomedical Applications

Nowadays it is in constant growing the development of thin film bulk acoustic resonators. If the piezoelectric material is going to be implanted in the human body, an important requirement is the biocompatibility of the implant. In this regard, Aluminum Nitride (AlN) has emerged as an attractive alternative for use in biomedical MicroElectroMechanical Systems. Ultrananocrystalline Diamond (UNCD) is a promising material to be used in biomedical applications, due to its extraordinary mulifunctionality; it is exceptional for implantable medical devices requiring stringent biological performance. Since both UNCD and AlN films can be processed via photolithography processes used in microfabrication, the integration of UNCD and AlN films provides the bases for developing a new generation of biocompatible Bio-MEMS/NEMS. Research and development was conducted to produce implantable MEMS devices: Pt/piezoelectric AlN/Pt layer heterostructure was grown and patterned on the UNCD membrane with a Ti adhesion layer. By applying voltages between the top and bottom Pt electrodes layers the piezoelectric AlN layer is energized. The feasibility of the fabrication of biocompatible AlN/diamond-based FBAR structure has been demonstrated.Fil: Zalazar, Martin. Universidad Nacional de Entre Rios. Facultad de Ingenieria. Departamento de Bioingenieria; ArgentinaFil: Guarnieri, Fabio Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico. Centro de Investigación de Métodos Computacionales; Argentina. Universidad Nacional de Entre Rios. Facultad de Ingenieria. Departamento de Bioingenieria; Argentin

Association of Accelerometry-Measured Physical Activity and Cardiovascular Events in Mobility-Limited Older Adults: The LIFE (Lifestyle Interventions and Independence for Elders) Study.

BACKGROUND:Data are sparse regarding the value of physical activity (PA) surveillance among older adults-particularly among those with mobility limitations. The objective of this study was to examine longitudinal associations between objectively measured daily PA and the incidence of cardiovascular events among older adults in the LIFE (Lifestyle Interventions and Independence for Elders) study. METHODS AND RESULTS:Cardiovascular events were adjudicated based on medical records review, and cardiovascular risk factors were controlled for in the analysis. Home-based activity data were collected by hip-worn accelerometers at baseline and at 6, 12, and 24 months postrandomization to either a physical activity or health education intervention. LIFE study participants (n=1590; age 78.9±5.2 [SD] years; 67.2% women) at baseline had an 11% lower incidence of experiencing a subsequent cardiovascular event per 500 steps taken per day based on activity data (hazard ratio, 0.89; 95% confidence interval, 0.84-0.96; P=0.001). At baseline, every 30 minutes spent performing activities ≥500 counts per minute (hazard ratio, 0.75; confidence interval, 0.65-0.89 [P=0.001]) were also associated with a lower incidence of cardiovascular events. Throughout follow-up (6, 12, and 24 months), both the number of steps per day (per 500 steps; hazard ratio, 0.90, confidence interval, 0.85-0.96 [P=0.001]) and duration of activity ≥500 counts per minute (per 30 minutes; hazard ratio, 0.76; confidence interval, 0.63-0.90 [P=0.002]) were significantly associated with lower cardiovascular event rates. CONCLUSIONS:Objective measurements of physical activity via accelerometry were associated with cardiovascular events among older adults with limited mobility (summary score >10 on the Short Physical Performance Battery) both using baseline and longitudinal data. CLINICAL TRIAL REGISTRATION:URL: http://www.clinicaltrials.gov. Unique identifier: NCT01072500

Structural Analysis to Determine the Core of Hypoxia Response Network

The advent of sophisticated molecular biology techniques allows to deduce the structure of complex biological networks. However, networks tend to be huge and impose computational challenges on traditional mathematical analysis due to their high dimension and lack of reliable kinetic data. To overcome this problem, complex biological networks are decomposed into modules that are assumed to capture essential aspects of the full network's dynamics. The question that begs for an answer is how to identify the core that is representative of a network's dynamics, its function and robustness. One of the powerful methods to probe into the structure of a network is Petri net analysis. Petri nets support network visualization and execution. They are also equipped with sound mathematical and formal reasoning based on which a network can be decomposed into modules. The structural analysis provides insight into the robustness and facilitates the identification of fragile nodes. The application of these techniques to a previously proposed hypoxia control network reveals three functional modules responsible for degrading the hypoxia-inducible factor (HIF). Interestingly, the structural analysis identifies superfluous network parts and suggests that the reversibility of the reactions are not important for the essential functionality. The core network is determined to be the union of the three reduced individual modules. The structural analysis results are confirmed by numerical integration of the differential equations induced by the individual modules as well as their composition. The structural analysis leads also to a coarse network structure highlighting the structural principles inherent in the three functional modules. Importantly, our analysis identifies the fragile node in this robust network without which the switch-like behavior is shown to be completely absent

Molecular Analysis of Microbial Communities in Endotracheal Tube Biofilms

Ventilator-associated pneumonia is the most prevalent acquired infection of patients on intensive care units and is associated with considerable morbidity and mortality. Evidence suggests that an improved understanding of the composition of the biofilm communities that form on endotracheal tubes may result in the development of improved preventative strategies for ventilator-associated pneumonia. (n = 5). DGGE profiling of the endotracheal biofilms revealed complex banding patterns containing between 3 and 22 (mean 6) bands per tube, thus demonstrating the marked complexity of the constituent biofilms. Significant inter-patient diversity was evident. The number of DGGE bands detected was not related to total viable microbial counts or the duration of intubation.Molecular profiling using DGGE demonstrated considerable biofilm compositional complexity and inter-patient diversity and provides a rapid method for the further study of biofilm composition in longitudinal and interventional studies. The presence of oral microorganisms in endotracheal tube biofilms suggests that these may be important in biofilm development and may provide a therapeutic target for the prevention of ventilator-associated pneumonia

Oxygen Tension Regulates Pancreatic β-Cell Differentiation Through Hypoxia-Inducible Factor 1α

International audienceThese data demonstrate that beta-cell differentiation is controlled by pO2 through HIF1alpha. Modifying pO2 should now be tested in protocols aiming to differentiate beta-cells from embryonic stem cells