Cardiac magnetic resonance predicts ventricular arrhythmias in scleroderma: The Scleroderma Arrhythmia Clinical Utility Study (SAnCtUS)

Objectives: Cardiac rhythm disturbances constitute the most frequent cardiovascular cause of death in SSc. However, electrocardiographic findings are not a part of risk stratification in SSc. We aimed to translate 24 h Holter findings into a tangible risk prediction score using cardiovascular magnetic resonance. Methods: The Scleroderma Arrhythmia Clinical Utility Study (SAnCtUS) was a prospective multicentre study including 150 consecutive SSc patients from eight European centres, assessed with 24 h Holter and cardiovascular magnetic resonance, including ventricular function, oedema (T2 ratio) and late gadolinium enhancement (%LGE). Laboratory/clinical parameters were included in multivariable corrections. A combined endpoint of sustained ventricular tachycardia requiring hospitalization and sudden cardiac death at a median (interquartile range) follow-up of 1 (1.0-1.4) year was generated. Results: Only T2 ratio and %LGE were significant predictors of ventricular rhythm disturbances, but not of supraventricular rhythm disturbances, after multivariable correction and adjustment for multiple comparisons. Using decision-tree analysis, we created the SAnCtUS score, a four-category scoring system based on T2 ratio and %LGE, for identifying SSc patients at high risk of experiencing ventricular rhythm disturbance at baseline. Increasing SAnCtUS scores were associated with a greater disease and arrhythmic burden. All cases of non-sustained ventricular tachycardia (n = 7) occurred in patients with the highest SAnCtUS score (=4). Having a score of 4 conveyed a higher risk of reaching the combined endpoint in multivariable Cox regression compared with scores 1/2/3 [hazard ratio (95% CI): 3.86 (1.14, 13.04), P = 0.029] independently of left ventricular ejection fraction and baseline ventricular tachycardia occurrence. Conclusion: T2 ratio and %LGE had the greatest utility as independent predictors of rhythm disturbances in SSc patients

Computational modelling of full interaction between crystal plasticity and oxygen diffusion at a crack tip

Oxidation-promoted crack growth, one of the major concerns for nickel-based superalloys, is closely linked to the diffusion of oxygen into the crack tip. The phenomenon is still not well understood yet, especially the full interaction between oxygen diffusion and severe near-tip mechanical deformation. This work aimed at the development of a robust numerical strategy to model the full coupling of crystal plasticity and oxygen diffusion in a single crystal nickel-based superalloy. In order to accomplish this, finite element package ABAQUS is used as a platform to develop a series of user-defined subroutines to model the fully coupled process of deformation and diffusion. The formulation allowed easy incorporation of nonlinear material behaviour, various loading conditions and arbitrary model geometries. Using this method, finite element analyses of oxygen diffusion, coupled with crystal plastic deformation, were carried out to simulate oxygen penetration at a crack tip and associated change of near-tip stress field, which has significance in understanding crack growth acceleration in oxidation environment. Based on fully coupled diffusion-deformation analyses, a case study was carried out to predict crack growth rate in oxidation environment and under dwell-fatigue loading conditions, for which a two-parameter failure criterion, in terms of accumulated inelastic strain and oxygen concentration at the crack tip, has been utilized

Static and dynamic mechanics of the murine lung after intratracheal bleomycin

<p>Abstract</p> <p>Background</p> <p>Despite its widespread use in pulmonary fibrosis research, the bleomycin mouse model has not been thoroughly validated from a pulmonary functional standpoint using new technologies. Purpose of this study was to systematically assess the functional alterations induced in murine lungs by fibrogenic agent bleomycin and to compare the forced oscillation technique with quasi-static pressure-volume curves in mice following bleomycin exposure.</p> <p>Methods</p> <p>Single intratracheal injections of saline (50 μL) or bleomycin (2 mg/Kg in 50 μL saline) were administered to C57BL/6 (<it>n </it>= 40) and Balb/c (<it>n </it>= 32) mice. Injury/fibrosis score, tissue volume density (TVD), collagen content, airway resistance (<it>R_N</it>), tissue damping (<it>G</it>) and elastance coefficient (<it>H</it>), hysteresivity (<it>η</it>), and area of pressure-volume curve (PV-A) were determined after 7 and 21 days (inflammation and fibrosis stage, respectively). Statistical hypothesis testing was performed using one-way ANOVA with LSD <it>post hoc </it>tests.</p> <p>Results</p> <p>Both C57BL/6 and Balb/c mice developed weight loss and lung inflammation after bleomycin. However, only C57BL/6 mice displayed cachexia and fibrosis, evidenced by increased fibrosis score, TVD, and collagen. At day 7, PV-A increased significantly and <it>G </it>and <it>H </it>non-significantly in bleomycin-exposed C57BL/6 mice compared to saline controls and further increase in all parameters was documented at day 21. <it>G </it>and <it>H</it>, but not PV-A, correlated well with the presence of fibrosis based on histology, TVD and collagen. In Balb/c mice, no change in collagen content, histology score, TVD, <it>H </it>and <it>G </it>was noted following bleomycin exposure, yet PV-A increased significantly compared to saline controls.</p> <p>Conclusions</p> <p>Lung dysfunction in the bleomycin model is more pronounced during the fibrosis stage rather than the inflammation stage. Forced oscillation mechanics are accurate indicators of experimental bleomycin-induced lung fibrosis. Quasi-static PV-curves may be more sensitive than forced oscillations at detecting inflammation and fibrosis.</p

In vivo expression of innate immunity markers in patients with mycobacterium tuberculosis infection

<p>Abstract</p> <p>Background</p> <p>Toll-like receptors (TLRs), Coronin-1 and Sp110 are essential factors for the containment of <it>Mycobacterium tuberculosis </it>infection. The purpose of this study was to investigate the <it>in vivo </it>expression of these molecules at different stages of the infection and uncover possible relationships between these markers and the state of the disease.</p> <p>Methods</p> <p>Twenty-two patients with active tuberculosis, 15 close contacts of subjects with latent disease, 17 close contacts of subjects negative for mycobacterium antigens and 10 healthy, unrelated to patients, subjects were studied. Quantitative mRNA expression of Coronin-1, Sp110, TLRs-1,-2,-4 and -6 was analysed in total blood cells <it>vs </it>an endogenous house-keeping gene.</p> <p>Results</p> <p>The mRNA expression of Coronin-1, Sp110 and TLR-2 was significantly higher in patients with active tuberculosis and subjects with latent disease compared to the uninfected ones. Positive linear correlation for the expression of those factors was only found in the infected populations.</p> <p>Conclusions</p> <p>Our results suggest that the up-regulation of Coronin-1 and Sp110, through a pathway that also includes TLR-2 up-regulation may be involved in the process of tuberculous infection in humans. However, further studies are needed, in order to elucidate whether the selective upregulation of these factors in the infected patients could serve as a specific molecular marker of tuberculosis.</p

Low cycle fatigue of a directionally solidified nickel-based superalloy: Testing, characterisation and modelling

Low cycle fatigue (LCF) of a low-carbon (LC) directionally-solidified (DS) nickel-base superalloy, CM247 LC DS, was investigated using both experimental and computational methods. Strain-controlled LCF tests were conducted at 850°C, with a loading direction either parallel or perpendicular to the solidification direction. Trapezoidal loading-waveforms with 2 s and 200 s dwell times imposed at the minimum and the maximum strains were adopted for the testing. A constant strain range of 2% was maintained throughout the fully-reversed loading conditions (strain ratio R = −1). The observed fatigue life was shorter when the loading direction was perpendicular to the solidification one, indicating an anisotropic material response. It was found that the stress amplitude remained almost constant until final fracture, suggesting limited cyclic hardening/softening. Also, stress relaxation was clearly observed during the dwell period. Scanning Electron Microscopy fractographic analyses showed evidence of similar failure modes in all the specimens. To understand deformation at grain level, crystal plasticity finite element modelling was carried out based on grain textures measured with EBSD. The model simulated the full history of cyclic stress-strain responses. It was particularly revealed that the misorientations between columnar grains resulted in heterogeneous deformation and localised stress concentrations, which became more severe when the loading direction was normal to a solidification direction, explaining the shorter fatigue life observed

Inborn errors of type I IFN immunity in patients with life-threatening COVID-19.

Clinical outcome upon infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ranges from silent infection to lethal coronavirus disease 2019 (COVID-19). We have found an enrichment in rare variants predicted to be loss-of-function (LOF) at the 13 human loci known to govern Toll-like receptor 3 (TLR3)- and interferon regulatory factor 7 (IRF7)-dependent type I interferon (IFN) immunity to influenza virus in 659 patients with life-threatening COVID-19 pneumonia relative to 534 subjects with asymptomatic or benign infection. By testing these and other rare variants at these 13 loci, we experimentally defined LOF variants underlying autosomal-recessive or autosomal-dominant deficiencies in 23 patients (3.5%) 17 to 77 years of age. We show that human fibroblasts with mutations affecting this circuit are vulnerable to SARS-CoV-2. Inborn errors of TLR3- and IRF7-dependent type I IFN immunity can underlie life-threatening COVID-19 pneumonia in patients with no prior severe infection

The use of various methods for the study of metal pollution in marine sediments, the case of Euvoikos Gulf, Greece

This study presents the results on heavy metal (Mn, Fe, Cu, Zn) analyses of sediments taken from Euvoikos Gulf, Greece, which is a semi-enclosed system receiving pollution loads from several urban and industrial sources and is affected by a strong tidal current. A sequential extraction schema and two single-step methods were used for the determination of trace metals. The data of the 1997 period are compared with data from previous studies carried out in the authors&apos; laboratory in the area (1980, 1993) using various analytical techniques, in an attempt to evaluate both the evolution of pollution in the area and the effectiveness of analytical methods. It has been confirmed that a significant part of the pollution load remains in coastal localities in the vicinity of the land based pollution sources, whereas there are also some more remote sites where small polluted particles are transported, deposited and accumulated. The sedimentology regime of the area affects the concentration of metals in a rather complex way depending also on its content of carbonates, organic C and clay minerals. The study of sediment cores has indicated elevated metal concentrations in recent surface sediments. On the other hand, some environmentally positive trends were also observed (i.e. the reduction of mobile metals). A systematic monitoring is needed in the marine environment coupled with some reduction in pollution inputs and integrated management on the coastal zone because the overall hydrological characteristics of the area favour its rapid self-restoration. © 2002 Elsevier Science Ltd. All rights reserved