Insecticide resistance enhances male reproductive success in a beetle

peer reviewe

Impaired contractile function of the supraspinatus in the acute period following a rotator cuff tear

Background: Rotator cuff (RTC) tears are a common clinical problem resulting in adverse changes to the muscle, but there is limited information comparing histopathology to contractile function. This study assessed supraspinatus force and susceptibility to injury in the rat model of RTC tear, and compared these functional changes to histopathology of the muscle. Methods: Unilateral RTC tears were induced in male rats via tenotomy of the supraspinatus and infraspinatus. Maximal tetanic force and susceptibility to injury of the supraspinatus muscle were measured in vivo at day 2 and day 15 after tenotomy. Supraspinatus muscles were weighed and harvested for histologic analysis of the neuromuscular junction (NMJ), intramuscular lipid, and collagen. Results: Tenotomy resulted in eventual atrophy and weakness. Despite no loss in muscle mass at day 2 there was a 30% reduction in contractile force, and a decrease in NMJ continuity and size. Reduced force persisted at day 15, a time point when muscle atrophy was evident but NMJ morphology was restored. At day 15, torn muscles had decreased collagen-packing density and were also more susceptible to contraction-induced injury. Conclusion: Muscle size and histopathology are not direct indicators of overall RTC contractile health. Changes in NMJ morphology and collagen organization were associated with changes in contractile function and thus may play a role in response to injury. Although our findings are limited to the acute phase after a RTC tear, the most salient finding is that RTC tenotomy results in increased susceptibility to injury of the supraspinatus

Abstract 77: Pilot Outcomes Of A Multi-component Support Intervention For Caregivers Of Persons With Heart Failure

Background: Caregivers of persons with heart failure must manage high levels of patient health care utilization, treatment complexity and often unpredictable stressors associated with intermittent symptom exacerbations and mortality. Interventions have often focused on the needs of the person with HF, not the caregiver. Therefore, we developed an intervention using human-centered design to provide caregiver-targeted support for this population. Objective: Pilot test the feasibility and gauge initial effect size of the Caregiver Support intervention to improve quality of life (mental and physical), caregiver burden, and self-efficacy among family caregivers from baseline to 16 weeks. Methods: The intervention includes five individualized, nurse-led sessions over 10 weeks conducted remotely (due to COVID-19). Intervention components focus on 1) nature of caregiving, 2) life purpose, 3) co-development of an action plan to address caregiver goals to reduce caregiver burden and improve caregiver well-being, 4) exploration of social and community resources to support unmet needs, and 5) building a sustainability plan for addressing future caregiver needs. We tested our approach in a randomized waitlist control pilot trial (N=35) from August 2020 through March 2022. We calculated enrollment and retention rates, described acceptability, and computed intervention effect sizes from baseline to 16 weeks. Results: 35 out of 101 (35%) eligible caregivers enrolled and were majority female (93.3%), White (60%) and spousal caregivers (63.3%). Average age was 59.4 ± 16.6 years. Overall retention was 69%. All intervention participants completed the five core components, reporting high levels of satisfaction and acceptability of activities. Between-group effect sizes (n=21) at 16 weeks suggest improvement in the mental health component of quality of life, caregiver burden, and self-efficacy (effect sizes 0.88, 0.31, and 0.63, respectively). Conclusion: Caregivers found Caregiver Support acceptable and study methods were feasible, despite challenges to engaging during the COVID-19 pandemic. Findings provide foundational evidence that this person-centered behavioral intervention can contribute to enhanced caregiver outcomes. </jats:p

Impact of socioeconomic factors on patient desire for LVAD therapy

Purpose: While increased heart failure (HF) severity and poor quality of life (QOL) have been associated with the decision to receive a left ventricular assist device (LVAD), we examined if socioeconomic factors were associated with patient willingness to accept an LVAD. Methods: We studied ambulatory patients with advanced HF (n= 400) from the REVIVAL Registry. Subjects were classified into 3 groups based on their responses after receiving basic information about benefits and risks of LVAD therapy: 1-wanting LVAD, 2-unsure, 3-not wanting LVAD to treat their current level ofHF. Logistic regression analysis was performed to identify clinical and demographic predictors of wanting an LVAD. Results: Patient characteristics are shown in Table 1. Lower education level, lower income, worse QOL and higher NYHA class were significant univariable predictors of patients wanting LVAD (p\u3c 0.05 for all). In the multivariable model, higher NYHA class and lower income remained significant independent predictors (p= 0.003 and 0.041, respectively). Every unit increase in NYHA class was associated with a 1.79 times higher odds of wanting LVAD vs. combined unsure and not wanting LVAD. Compared to those with income \u3e $80K, patients with income \u3c$40K and those with income $40K-80K were 2.28 and 2.17 times more likely to want LVAD vs. combined unsure and not wanting LVAD(Table 2). Conclusion: Patients preference for LVAD is influenced by level of income independently of severity ofHF, with greater preference for LVAD among lower and middle tier income groups. Understanding impact ofsocioeconomic factors on patients desire to accept LVADmay help tailor discussion to individual needs (Table presented)