Effect of dietary fatty acid composition on depot fat and exercise performance in a migrating songbird, the red-eyed vireo

Most migrating birds accumulate lipid stores as their primary source of energy for fueling long distance flights. Lipid stores of birds during migration are composed of mostly unsaturated fatty acids; whether such a fatty acid composition enhances exercise performance of birds is unknown. We tested this hypothesis by measuring metabolic rate at rest and during intense exercise in two groups of red-eyed vireos, a long-distance migratory passerine, fed either a diet containing 82% unsaturated fat (82%U), or one containing 58% unsaturated fat (58%U). Vireos fed the 82%U diet had fat stores containing (77%) unsaturated fatty acids, whereas vireos fed the 58% U diet had fat stores containing less (66%) unsaturated fatty acids. Blood metabolites measured prior to and immediately following exercise confirmed that vireos were metabolizing endogenous fat during intense exercise. Mass-specific resting metabolic rate (RMR) was similar for vireos fed the 58%U diet (2.75±0.32 ml O2 g–1 h–1) and for vireos fed the 82%U diet (2.30±0.30 ml O2 g–1 h–1). However, mass-specific peak metabolic rate (MRpeak) was 25% higher in vireos fed the 58%U diet (28.55±1.47 ml O2 g–1 h–1) than in vireos fed the 82%U diet (21.50±1.76 ml O2 g–1 h–1). Such whole-animal energetic effects of fatty acid composition of birds suggest that the energetic cost of migration in birds may be affected by the fatty acid composition of the diet

COVID-19 Severity and Cardiovascular Outcomes in SARS-CoV-2-Infected Patients With Cancer and Cardiovascular Disease

BACKGROUND: Data regarding outcomes among patients with cancer and co-morbid cardiovascular disease (CVD)/cardiovascular risk factors (CVRF) after SARS-CoV-2 infection are limited. OBJECTIVES: To compare Coronavirus disease 2019 (COVID-19) related complications among cancer patients with and without co-morbid CVD/CVRF. METHODS: Retrospective cohort study of patients with cancer and laboratory-confirmed SARS-CoV-2, reported to the COVID-19 and Cancer Consortium (CCC19) registry from 03/17/2020 to 12/31/2021. CVD/CVRF was defined as established CVD RESULTS: Among 10,876 SARS-CoV-2 infected patients with cancer (median age 65 [IQR 54-74] years, 53% female, 52% White), 6253 patients (57%) had co-morbid CVD/CVRF. Co-morbid CVD/CVRF was associated with higher COVID-19 severity (adjusted OR: 1.25 [95% CI 1.11-1.40]). Adverse CV events were significantly higher in patients with CVD/CVRF (all CONCLUSIONS: Co-morbid CVD/CVRF is associated with higher COVID-19 severity among patients with cancer, particularly those not receiving active cancer therapy. While infrequent, COVID-19 related CV complications were higher in patients with comorbid CVD/CVRF. (COVID-19 and Cancer Consortium Registry [CCC19]; NCT04354701)

Arteriovenous fistula patency in the 3 years following vonapanitase and placebo treatment

OBJECTIVE: This study explored the long-term outcomes of arteriovenous fistulas treated with vonapanitase (recombinant human elastase) at the time of surgical creation. METHODS: This was a randomized, double-blind, placebo-controlled trial of 151 patients undergoing radiocephalic or brachiocephalic arteriovenous fistula creation who were randomized equally to placebo, vonapanitase 10 mug, or vonapanitase 30 mug. The results after 1 year of follow-up were previously reported. The current analysis occurred when the last patient treated was observed for 3 years. For the current analysis, the primary end point was primary patency; the secondary end points included secondary patency, use of the fistula for hemodialysis, and rate of procedures to restore or to maintain patency. RESULTS: There was no significant difference in the risk of primary patency loss with vonapanitase 10 mug or 30 mug vs placebo. When seven initial patency loss events related to cephalic arch and central vein balloon angioplasty were excluded, the risk of patency loss was reduced with vonapanitase overall (hazard ratio [HR], 0.63; P = .049) and 30 mug (HR, 0.51; P = .03). In patients with radiocephalic fistulas (n = 67), the risks of primary and secondary patency loss were reduced with 30 mug (HR, 0.37 [P = .02] and 0.24 [P = .046], respectively). The rate of procedures to restore or to maintain fistula patency was reduced with 30 mug vs placebo (0.23 vs 0.72 procedure days/patient/year; P = .03) and also reduced in patients with radiocephalic fistulas with 30 mug vs placebo (0.17 vs 0.85 procedure days/patient/year; P = .048). CONCLUSIONS: In this study, vonapanitase did not significantly improve primary patency in the primary analysis but did significantly improve primary patency in an analysis that excluded patency loss due to cephalic arch and central vein balloon angioplasty. In patients with radiocephalic fistulas, 30 mug significantly improved primary and secondary patency. Vonapanitase 30 mug decreased the rate of procedures to restore or to maintain patency in the analysis that included all patients and in the subset with radiocephalic fistulas

Team Decision-Making In Crisis: How Affect Asymmetry and Team Process Norms Affect Decision-Making

Purpose: Teams in extreme and disruptive contexts face unique challenges that can undermine coordination and decision-making. In this study, we evaluated how affective differences between team members and team process norms affected the team\u27s decision-making effectiveness. Approach: Teams were placed in a survival simulation where they evaluated how best to maximize the team\u27s survival prospects given scarce resources. We incorporated multisource and multirater (i.e., team, observer, and archival) data to ascertain the impacts of affect asymmetry and team process norms on decision-making effectiveness. Findings: Results suggest that teams with low positive affect asymmetry and low process norms generate the most effective decisions. The least effective team decision performance occurred in teams characterized by high variance in team positive affectivity (high positive affect asymmetry) and low process norms. We found no similar effect for teams with high process norms and no effect for negative affect asymmetry, however, irrespective of team process norms. Originality: These findings support the affect infusion model and extend cognitive resource theory, by highlighting how affect infusion processes and situational constraints influence team decision-making in extreme and disruptive contexts

Effects of cardiorespiratory fitness on aging: glucose trajectory in a cohort of healthy men

PURPOSE: We modeled the age-related trajectory of glucose and determined if cardiorespiratory fitness altered the trajectory in a cohort of men from the Aerobics Center Longitudinal Study. METHODS: 10,092 men free of diagnosed diabetes, CVD, and cancer, aged 20 to 90 years, completed from 2 to 21 health examinations between 1977 and 2005. Cardiorespiratory fitness was measured by a maximal treadmill exercise test and normalized for age. The covariates included waist circumference, hypertension, elevated cholesterol, smoking behavior and physical activity. RESULTS: Linear mixed models regression analysis showed that fasting glucose increased at a linear rate with aging. Glucose increased at a yearly rate of 0.17 mg/dL (95% confidence interval: 0.16, 0.19). Fitness had little influence on the aging glucose trajectory below age 35, but significantly influenced the trend after age 35 (P for interaction <0.001). The aging-related glucose increases in low fit men (0.25 mg/dL per year) was higher than average fit (0.15 mg/dL per year) and high fit (0.13 mg/dL per year) men. CONCLUSIONS: The aging-related glucose increases in low fit men was nearly double that of high fit men. Our results may suggest that it is possible to delay the age-related glucose impairment through increasing one’s fitness

Longitudinal cardiorespiratory fitness algorithms for clinical settings

BACKGROUND: Non-exercise algorithms are cost-effective methods to estimate cardiorespiratory fitness (CRF) in healthcare settings. The limitation of current non-exercise models is that they were developed with cross-sectional data. PURPOSE: To extend the non-exercise research by developing algorithms for men and women using longitudinal data on indicators available in healthcare settings. METHODS: The sample included 1325 women (aged 20–78 years) and 10,040 men (aged 20–86 years) who completed from two to 21 maximal treadmill tests between 1977 and 2005. The data were analyzed in 2011 and 2012. The dependent variable was CRF measured by treadmill test. The independent variables were age, body composition (percentage fat or BMI); waist circumference, self-reported physical activity; resting heart rate; and smoking behavior. RESULTS: Linear mixed-models regression showed that all variables were independently related to CRF. There was a positive association between CRF and physical activity. Higher levels of body composition were linked to lower CRF. High resting heart rate and smoking resulted in lower estimates of CRF. The error estimates of the percentage fat algorithms were: women, 1.41 METs (95% CI=1.35, 1.47); and men, METs 1.54 (95% CI=1.51, 1.55). The BMI models were somewhat less accurate: women, METs 1.51 (95% CI=1.45, 1.58); and men, 1.66 METs (95% CI=1.63, 1.68). CONCLUSIONS: These results showed that the CRF of women and men can be estimated from easily obtained health indicators. The longitudinal non-exercise algorithms provide models to accurately estimate CRF changes associated with aging and provide cost-effective algorithms to track CRF over time with health indicators available in healthcare settings

Systolic and diastolic mechanics in stress cardiomyopathy

BACKGROUND: Stress cardiomyopathy (SCM) is a peculiar form of reversible left ventricular dysfunction seen predominantly in women and occurs in response to emotional or physical stress. Because dysfunction in SCM is reversible and that of acute myocardial infarction (MI) is not, we hypothesized that these fundamental mechanistic differences between SCM and MI would be associated with different systolic and diastolic properties. METHODS AND RESULTS: We examined 3 groups, all women: patients with SCM (n=24; mean age, 63+/-12 years), those with left anterior (LAD) ST-segment-elevation MI (n=36; mean age, 63+/-10 years), and referent control subjects (n=30; mean age, 62+/-8 years). All underwent angiography, ventriculography, and pressure measurements within 48 hours of presentation. Left ventricular volumes, diastolic pressures, and diastolic stiffness were higher in SCM and LAD MI patients than in control subjects but no different from each other. Similarly, left ventricular diastolic pressures and diastolic stiffness were elevated in the SCM and LAD MI groups compared with the control group. Left ventricular ejection fraction in SCM and LAD MI were 40.8+/-12.3% and 49.6+/-5.6%, respectively, versus 70.4+/-9.4% in control subjects (P \u3c 0.001), and stroke work less than half the value of control subjects. Indexes of contractility and ventricular-arterial coupling were similarly abnormal in SCM and LAD MI. CONCLUSIONS: SCM and LAD MI show severe diastolic dysfunction. At similar left ventricular volumes, their diastolic pressures are more than twice as high as in control subjects, and systolic dysfunction is equally reduced in SCM and LAD MI. Despite a completely different pathophysiology in terms of systolic and diastolic function, SCM is indistinguishable from acute LAD-territory MI

Human type I pancreatic elastase treatment of arteriovenous fistulas in patients with chronic kidney disease

OBJECTIVE: This study explored the safety and efficacy of recombinant type I pancreatic elastase (PRT-201) topically applied once to the external surface of an arteriovenous fistula. METHODS: This was a randomized, double-blind, placebo-controlled trial. Adults with kidney disease undergoing creation of a radiocephalic fistula (RCF) or brachiocephalic fistula were randomized to treatment with placebo (n = 51), PRT-201 at 10 mug (n = 51), or PRT-201 at 30 mug (n = 49). The primary efficacy measure was unassisted primary patency (PP) over 1 year. Secondary efficacy measures were secondary patency (SP), unassisted maturation by ultrasound interrogation, use for hemodialysis, and hemodynamically significant lumen stenosis. RESULTS: Median PP was 224 days for placebo and \u3e 365 days for the PRT-201 groups. At 1 year, 45%, 54%, and 53% of placebo, 10-mug, and 30-mug patients retained PP. The risk of PP loss was nonsignificantly reduced for 10 mug (hazard ratio [HR], 0.69; P = .19) and 30 mug (HR, 0.67; P = .17) vs placebo. In the subset (44% of patients) with a RCF, the median PP was 125 days for placebo and \u3e 365 days for the PRT-201 groups. At 1 year, 31%, 50%, and 63% of placebo, 10-mug, and 30-mug RCFs retained PP. The risk of RCF PP loss was nonsignificantly reduced by 10 mug (HR, 0.59; P = .18) and significantly reduced by 30 mug (HR, 0.37; P = .02) vs placebo. At 1 year, 77%, 81%, and 83% of placebo, 10-mug, and 30-mug patients retained SP. The risk of SP loss was nonsignificantly reduced for 10 mug (HR, 0.79; P = .61) and 30 mug (HR, 0.76; P = .55) vs placebo. In the subset with RCFs, 65%, 82%, and 90% of placebo, 10-mug, and 30-mug patients retained SP at 1 year. The risk of RCF SP loss was nonsignificantly reduced for 10 mug (HR, 0.45; P = .19) and 30 mug (HR, 0.27; P = .08) vs placebo. At month 3, 67%, 87% (P = .03), and 92% (P \u3c .01) of the placebo, 10-mug, and 30-mug group fistulas had unassisted maturation by ultrasound interrogation. At month 3 in the subset with an RCF, 47%, 74% (P = .17), and 93% (P \u3c .01) of placebo, 10-mug, and 30-mug group fistulas had unassisted maturation by ultrasound interrogation. Adverse event reports were not meaningfully different between groups. CONCLUSIONS: PRT-201 appeared safe. The primary efficacy end point was not met. However, both PRT-201 doses were associated with improved unassisted maturation. The 30-mug dose was associated with increased PP in the subset with RCF