The prothrombotic state in atrial fibrillation – observations on fibrin clot structure and the relationship to renal dysfunction

Atrial fibrillation (AF) is the most common arrhythmia and is closely associated with chronic kidney disease. The mainstay pharmacological agent to prevent AF-related stroke and thromboembolism is the use of oral anticoagulants, but may result in an increased risk of haemorrhage. Therefore, this MD research thesis is a comprehensive study of the changes in thrombogenesis and fibrin clot structure related to AF and CKD, as well as the potential impact of exposure to different classes of oral anticoagulant

Nutritional composition and antioxidant properties of Canarium odontophyllum Miq. (dabai) fruits.

The present study sought to determine the nutritional composition and antioxidant properties of Canarium odontophyllum Miq. (dabai) fruits from different districts in Malaysia, namely Kanowit, Sarikei, Kapit and Song in Sarawak. Two varieties of the fruits were investigated. Lipid (21.16 ± 4.71 to 25.76 ± 3.03 g/100 g FW) was the major macronutrient in dabai fruits, while the predominant minerals were calcium, sodium and potassium. The fruit protein was rich in aspartic and glutamic acids which accounted for 45–49% of total amino acids. Purple dabai fruits from Kapit were found to contain the highest total phenolic levels, flavonoids and anthocyanin contents (p < 0.01) and to exhibit the most significant antioxidant activities (p < 0.01), using trolox equivalent antioxidant capacity (TEAC) and ferric reducing ability (FRAP) assays. Antioxidant activities were highly correlated with total phenolic and flavonoid contents of dabai fruits

Analysis of phenolic compounds of dabai (Canarium odontophyllum Miq.) fruits by high-performance liquid chromatography.

Dabai (Canarium odontophyllum Miq.) fruit is a popular seasonal indigenous fruit of Sarawak, Malaysia that is always appreciated as an exotic fruit by the local community. The present study was designed to identify and quantify the phenolic compounds of dabai fruits from different divisions of Sarawak. Difference between the purple and red varieties of the fruits was also investigated. Analysis of phenolic compounds was performed by reversed phase high-performance liquid chromatography coupled with diode array detector. Three detection wavelengths (280, 254 and 329 nm) were used to monitor all phenolic compounds (except for anthocyanidins) since they display absorbance maxima at different wavelengths. Characteristic spectra of eluted peaks provide useful information in confirming the identities of peaks. Hydrolysis of phenolic compounds of dabai fruits was insufficient under the milder conditions (30 °C, 2 h) employed thus resulted in unidentified peaks. Two phenolic acids (ellagic and vanillic acids), five flavonoids (catechin, epicatechin, epicatechin gallate, epigallocatechin gallate, apigenin) and ethyl gallate were detected in the fruits. Furthermore, three anthocyanidins (cyanidin, pelargonidin and delphinidin) and four anthocyanins (malvidin-3,5-di-O-glucoside, cyanidin-3-O-glucoside, cyanidin-3-O-rutinoside and peonidin-3-O-glucoside) were detected. All these phenolic compounds were reported in dabai fruits for the first time. The fruit variety affected the anthocyanidins and anthocyanins profile (p < 0.01) but had little or no effect on the phenolic acids and flavonoids profile of the fruits. Within the same variety, diversity in environmental conditions had an impact on the quantitative differences of phenolic compounds (p < 0.05)

Habitual Sleep Quality Moderated the Effects of Sleep Deprivation on EmotionRegulation by Third-Person Self Talk: Event-Related Potential (ERP) andBehavioral Findings

The current study investigated the impact of sleep deprivation (SD) on the use of third-person self-talk, a relatively effort-less strategy, to regulate emotion. Twenty-four participants (age = 22.75 2.68, 54.17% male, 33.33% good sleepers) com-pleted a cue-picture ERP paradigm after normal sleep and SD conditions, in which they viewed negative or neutral stimuliand reflected on their feelings using either the pronoun I or their name (third-person). We calculated post-instruction latepositive potential (LPP) that has been found sensitive to emotion regulation strategies and closely related to amygdalaactivity. While poor sleepers showed greater LPP amplitudes overall, F(1,7) = 17.50, p = .004, SD only increased the LPPfor negative picture trials among good sleepers but not poor sleepers, F(1,7) = 5.37, p = .054, suggesting that the effect ofSD on emotion regulation using third-person self talk was moderated by habitual sleep quality

Singaporean mothers' perception of their three-year-old child's weight status: A cross-sectional study

Singapore National Research FoundationFull Author List as below: Cheng T.S.; Cheng T.; Loy S.; Cheung Y.; Chan J.; Tint M.; Godfrey K.; Gluckman P.; Kwek K.; Saw S.; Chong Y.; Lee Y.; Yap F.; Lek N.; Sheppard A.; Chinnadurai A.; Goh A.; Rifkin-Graboi A.; Qiu A.; Biswas A.; Lee B.; Broekman B.; Quah B.; Shuter B.; Chng C.; Ngo C.; Hsu S.; Bong C.; Henry C.; Chee C.; Fok D.; Yeo G.; Inskip H.; Chen H.; Van Bever H.; Magiati I.; Wong I.; Lau I.; Kapur J.; Richmond J.; Holbrook J.; Gooley J.; Tan K.; Niduvaje K.; Singh L.; Su L.; Daniel L.; Shek L.; Fortier M.; Hanson M.; Chong M.; Rauff M.; Chua M.; Meaney M.; Teoh O.; Wong P.; Agarwal P.; Van Dam R.; Rebello S.; Chong S.; Cai S.; Soh S.; Lim S.; Rajadurai V.; Stunkel W.; Han W.; Pang W.; Goh Y.; Chan Y.</p

Relationship between renal function and circulating microparticles, soluble P-selectin and E-selectin levels in atrial fibrillation

Atrial fibrillation (AF) and chronic kidney disease are closely related, and any associated risk of stroke and thromboembolism due to AF is increased by concurrent renal dysfunction. The mechanism(s) for this include abnormalities in platelets and endothelial cells. We hypothesized relationships between levels of circulating platelet microparticles (PMPs, defined by CD42b), soluble P selectin (both reflecting platelet activation), soluble E-selectin (reflecting endothelial activation) and endothelial/platelet microparticles (EPMPs, defined by CD31) with progressive renal dysfunction. Blood samples were obtained from 160 anticoagulated AF patients. Microparticles were measured by flow cytometry, soluble E and P selectin levels by ELISA. Renal function was determined by estimated glomerular filtration rate (eGFR). EPMP levels demonstrated a linear increased trend across quartiles of eGFR (p = 0.034) and CKD stage (p < 0.001), and correlated with eGFR and serum creatinine (p < 0.01). PMPs, P-selectin and E-selectin levels were not significantly different across groupings of renal dysfunction, and no significant correlations with eGFR were evident (p = 0.186, p = 0.561, p = 0.746 respectively). Stepwise multivariable regression analysis demonstrated that worsening renal function was an independent predictor of EPMP levels (p < 0.001). In well-anticoagulated AF patients, there is potential relationship between endothelial function (as judged by elevated EPMP levels, with no change in PMPs) and renal function. Other markers of prothombotic state or cellular activation (PMP, P-selectin and E-selectin levels) were not significantly different across the various degree of renal dysfunction. Renal function must be addressed when measuring EPMP levels

Effects of non-vitamin K antagonist oral anticoagulants on fibrin clot and whole blood clot formation, integrity and thrombolysis in patients with atrial fibrillation

Non-vitamin K antagonist oral anticoagulants (NOACs) are replacing warfarin and heparins in several clinical situations. With varying modes of action, the effects of NOACs on thrombus formation, integrity, and lysis is unknown. To determine whether two techniques of thrombelastography (TEG) and a micro-plate assay (MPA) provide novel data on thrombus formation, integrity and lysis in those taking a NOACs compared to warfarin and a control group taking aspirin. We assessed thrombogenesis, clot integrity and fibrinolysis in blood (TEG) and plasma (MPA) from 182 atrial fibrillation patients—50 on aspirin, 50 on warfarin, and 82 on a NOAC (17 apixaban, 19 dabigatran and 46 rivaroxaban). Eleven of 16 TEG indices and 4 of 5 MPA indices differed (p ≤ 0.01) between those on aspirin, warfarin or a NOAC. Three TEG indices and 4 MPA indices differed (p < 0.01) between the NOACs. Time to initiation of clot formation was most rapid on apixaban, then rivaroxaban and slowest on dabigatran. The rate of clot formation was most rapid on dabigatran, then apixaban, and slowest on rivaroxaban. Clot density was greatest on rivaroxaban, then apixaban, but weakest on dabigatran. The rate of clot dissolution was most rapid in apixaban, then dabigatran, and slowest on rivaroxaban. The TEG and MPA identify major differences in thrombogenesis and fibrinolysis in different NOACs. These techniques may have value in investigating the effects of these drugs on haemostasis in a clinical setting, and in identifying those in need of targeted therapy

Nutritional constituents and antioxidant properties of indigenous kembayau (Dacryodes rostrata (Blume) H. J. Lam) fruits.

The nutritional and antioxidant properties of peels, pulp and seeds of kembayau (Dacryodes rostrata) fruits were evaluated. Kembayau seeds and pulp were rich in fat, while peels had the highest ash contents. Potassium was the most prevalent mineral in peels (380.72-1112.00mg/100g). In kembayau fruits, total flavonoid content (1012.74-28,022.28mg rutin equivalent/100g) was higher than total phenolic and total monomeric anthocyanin contents. Kembayau seeds exhibited high flavonoid and phenolic contents compared to the contents in peels and pulp. Antioxidant capacities were also higher in seeds as typified by trolox equivalent antioxidant capacity assay (51.39-74.59mmol TE/100g), ferric reducing antioxidant power assay (530.05-556.98mmol Fe2+/100g) and by 1,1-diphenyl-2-picryl hydrazyl radical scavenging activity (92.18-92.19%) when compared to peels and pulp. Pulp and peels of kembayau fruit may be an important source of energy and minerals for human consumption, while seeds have a good potential as antioxidants

Handgrip strength assessment at baseline in addition to bone parameters could potentially predict the risk of curve progression in adolescent idiopathic scoliosis

IntroductionAdolescent idiopathic scoliosis (AIS) is characterized by deranged bone and muscle qualities, which are important prognostic factors for curve progression. This retrospective case–control study aims to investigate whether the baseline muscle parameters, in addition to the bone parameters, could predict curve progression in AIS.MethodsThe study included a cohort of 126 female patients diagnosed with AIS who were between the ages of 12 and 14 years old at their initial clinical visit. These patients were longitudinally followed up every 6 months (average 4.08 years) until they reached skeletal maturity. The records of these patients were thoroughly reviewed as part of the study. The participants were categorized into two sub-groups: the progressive AIS group (increase in Cobb angle of ≥6°) and the stable AIS group (increase in Cobb angle &lt;6°). Clinical and radiological assessments were conducted on each group.ResultsCobb angle increase of ≥6° was observed in 44 AIS patients (34.9%) prior to skeletal maturity. A progressive AIS was associated with decreased skeletal maturity and weight, lower trunk lean mass (5.7%, p = 0.027) and arm lean mass (8.9%, p &lt; 0.050), weaker dominant handgrip strength (8.8%, p = 0.027), deranged cortical compartment [lower volumetric bone mineral density (vBMD) by 6.5%, p = 0.002], and lower bone mechanical properties [stiffness and estimated failure load lowered by 13.2% (p = 0.005) and 12.5% (p = 0.004)]. The best cut-off threshold of maximum dominant handgrip strength is 19.75 kg for distinguishing progressive AIS from stable AIS (75% sensitivity and 52.4% specificity, p = 0.011).DiscussionPatients with progressive AIS had poorer muscle and bone parameters than patients with stable AIS. The implementation of a cut-off threshold in the baseline dominant handgrip strength could potentially be used as an additional predictor, in addition to bone parameters, for identifying individuals with AIS who are at higher risk of experiencing curve progression