Left atrial volume predicts adverse cardiac and cerebrovascular events in patients with hypertrophic cardiomyopathy

<p>Abstract</p> <p>Aims</p> <p>To prospectively evaluate the relationship between left atrial volume (LAV) and the risk of clinical events in patients with hypertrophic cardiomyopathy (HCM).</p> <p>Methods</p> <p>We enrolled a total of 141 HCM patients with sinus rhythm and normal pump function, and 102 patients (73 men; mean age, 61 ± 13 years) who met inclusion criteria were followed for 30.8 ± 10.0 months. The patients were divided into two groups with or without major adverse cardiac and cerebrovascular events (MACCE), a composite of stroke, sudden death, and congestive heart failure. Detailed clinical and echocardiographic data were obtained.</p> <p>Results</p> <p>MACCE occurred in 24 patients (18 strokes, 4 congestive heart failure and 2 sudden deaths). Maximum LAV, minimum LAV, and LAV index (LAVI) corrected for body surface area (BSA) were significantly greater in patients with MACCE than those without MACCE (maximum LAV: 64.3 ± 25.0 vs. 51.9 ± 16.0 ml, p = 0.005; minimum LAV: 33.9 ± 15.1 vs. 26.2 ± 10.9 ml, p = 0.008; LAVI: 40.1 ± 15.4 vs. 31.5 ± 8.7 ml/mm², p = 0.0009), while there were no differences in the other echocardiographic parameters.</p> <p>LAV/BSA of ≥ 40.4 ml/m²to identify patients with cardiovascular complications with a sensitivity of 73% and a specificity of 88%.</p> <p>Conclusion</p> <p>LAVI may be an effective marker for detecting the risk of MACCE in patients with HCM and normal pump function.</p

Essential versus accessory aspects of cell death: recommendations of the NCCD 2015

Cells exposed to extreme physicochemical or mechanical stimuli die in an uncontrollable manner, as a result of their immediate structural breakdown. Such an unavoidable variant of cellular demise is generally referred to as ‘accidental cell death’ (ACD). In most settings, however, cell death is initiated by a genetically encoded apparatus, correlating with the fact that its course can be altered by pharmacologic or genetic interventions. ‘Regulated cell death’ (RCD) can occur as part of physiologic programs or can be activated once adaptive responses to perturbations of the extracellular or intracellular microenvironment fail. The biochemical phenomena that accompany RCD may be harnessed to classify it into a few subtypes, which often (but not always) exhibit stereotyped morphologic features. Nonetheless, efficiently inhibiting the processes that are commonly thought to cause RCD, such as the activation of executioner caspases in the course of apoptosis, does not exert true cytoprotective effects in the mammalian system, but simply alters the kinetics of cellular demise as it shifts its morphologic and biochemical correlates. Conversely, bona fide cytoprotection can be achieved by inhibiting the transduction of lethal signals in the early phases of the process, when adaptive responses are still operational. Thus, the mechanisms that truly execute RCD may be less understood, less inhibitable and perhaps more homogeneous than previously thought. Here, the Nomenclature Committee on Cell Death formulates a set of recommendations to help scientists and researchers to discriminate between essential and accessory aspects of cell death

Effects of a mechanical engineering design course on students’ motivational features

Diverse learning opportunities and deep engagement are needed to support development of engineering competencies and expertise. Deep engagement evolves from productive and high-quality motivation that derives from both internal and external sources. Motivation to learn is lacking in many fields, like engineering, because it is too often assumed or ignored, rather than explicitly built into course instruction. While the lack of motivation in engineering education is clear in data-like attrition, there is little relevant research that informs the necessary changes for the field. The purpose of this study is to present a systematic approach that explicitly considers motivational elements in engineering courses. First a comprehensive set of motivational characteristics and the interrelationships for productive motivation of mechanical engineering students are identified. Students’ motivational characteristics and profiles of change over time are assessed using a multipoint predictive correlational design. This information is then used to strategically redesign motivational elements of a senior-level mechanical engineering design course. The SUCCESS framework has been used to redesign motivational features of the existing course. This paper reports results of the study, including implications for redesign of other engineering courses. Analysis of the data demonstrates the complexity of motivation in the engineering classroom, which includes addressing implicit and explicit, intrinsic and extrinsic, individual and team interaction and instruction. These elements extend not only to direct communication and interactions of instructor with students but into the full scope of the learning environment, peer-to-peer interactions, grading, (a)synchronous activities, face to face, and virtual communications. Key features of engineering students’ productive (learning and engagement-related) motivational profiles consisted of clusters of perceptual and experiential variables that were strongly correlated with motivational and learning outcomes. Tracking these factors demonstrated that they changed over time. These changes corresponded to perceptions of instructor and peer interactions, which were amenable to instructional intervention and responsive to social modeling. This study also revealed links among engineering students’ perceptions of their field of study, their own development of self-efficacy, and success expectations in both the design course and for their careers. This work revealed important distinctions between engineering students’ self-efficacy for, and engagement in, the course generally and for group tasks more specifically. These newly revealed relationships offer the opportunity to improve engineering instruction and the design of dynamic learning environments that support adaptive skill development.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

The effect of extended post-mortem ageing on the Warner–Brazler shear force of longissimus thoracis from beef heifers from two sire breeds, slaughtered at 20 or 25 mo of age

peer-reviewedwere examined. Spring-born Angus × Holstein-Friesian heifers (n = 48) and Belgian Blue × Holstein-Friesian heifers (n = 48) were slaughtered, within sire breed, at 20 or 25 mo of age. Approximately 48 h post-mortem, LT steaks (2.5 cm) were removed, and either stored at −20°C for chemical analysis or vacuum-packed, stored at 2°C for 7, 14 or 28 d post-mortem and then at −20°C pending Warner–Bratzler shear force (WBSF) analysis. Muscle from Angus-sired heifers had higher (P < 0.001) intramuscular fat (IMF) concentration, lower (P < 0.001) proportion of type IIX muscle fibres and higher (P < 0.001) proportion of type IIA and type I muscle fibres compared to muscle from Belgian Blue-sired heifers. Collagen characteristics did not differ between sire breeds. Later slaughter increased (P < 0.001) IMF concentration and decreased (P < 0.001) total and insoluble concentrations and collagen solubility. There were no interactions between the main effects for WBSF and no difference between sire breeds. Later slaughter and increasing the duration of ageing decreased (P < 0.05) WBSF. Based on threshold WBSF values in the literature, all samples would be considered tender (<39 N) after 7 d ageing. Untrained consumers are likely to detect the decrease in WBSF from 7 to 14 d ageing but not due to further ageing. Within the production system examined and based on WBSF data, extending LT ageing to 28 d is not necessary to ensure consumer satisfaction

Additional file 3 of Costunolide is a dual inhibitor of MEK1 and AKT1/2 that overcomes osimertinib resistance in lung cancer

Supplementary Material