QT peak prolongation predicts cardiac death following stroke

Cardiac death has been linked in many populations to prolongation of the QT interval (QTe). However, basic science research suggested that the best estimate of the time point when repolarisation begins is near the T-wave peak. We found QT peak (QTp) was longer in hypertensive subjects with LVH. A prolonged “depolarisation” phase, rather than “repolarisation” (T peak to T end) might therefore account for the higher incidence of cardiac death linked to long QT. Hypothesis: We have tested the hypothesis that QT peak (QTp) prolongation predicts cardiac death in stroke survivors. Methods and Results: ECGs were recorded from 296 stroke survivors (152 male), mean age 67.2 (SD 11.6) approximately 1 year after the event. Their mean blood pressure was 152/88 mmHg (SD 29/15mmHg). These ECGs were digitised by one observer who was blinded to patient outcome. The patients were followed up for a median of 3.3 years. The primary endpoint was cardiac death. A prolonged heart rate corrected QT peak (QTpc) of lead I carried the highest relative risk of death from all cause as well as cardiac death, when compared with the other more conventional QT indices. In multivariate analyses, when adjusted for conventional risk factors of atherosclerosis, a prolonged QTpc of lead I was still associated with a 3-fold increased risk of cardiac death. (adjusted relative risk 3.0 [95% CI 1.1 - 8.5], p=0.037). Conclusion: QT peak prolongation in lead I predicts cardiac death after strok

Towards understanding the clinical significance of QT peak prolongation: a novel marker of myocardial ischemia independently demonstrated in two prospective studies

Background: QT peak prolongation identified patients at risk of death or non-fatal MI. We tested the hypothesis that QT peak prolongation might be associated with significant myocardial ischaemia in two separate cohorts to see how widely applicable the concept was. Methods and Results: In the first study, 134 stroke survivors were prospectively recruited and had 12-lead ECGs and Nuclear myocardial perfusion scanning. QT peak was measured in lead I of a 12-lead ECG and heart rate corrected by Bazett’s formula (QTpc). QTpc prolongation to 360ms or more was 92% specific at diagnosing severe myocardial ischaemia. This hypothesis-generating study led us to perform a second prospective study in a different cohort of patients who were referred for dobutamine stress echocardiography. 13 of 102 patients had significant myocardial ischaemia. Significant myocardial ischaemia was associated with QT peak prolongation at rest (mean 354ms, 95% CI 341-367ms, compared with mean 332ms, 95% CI 327-337ms in those without significant ischaemia; p=0.002). QT peak prolongation to 360ms or more was 88% specific at diagnosing significant myocardial ischaemia in the stress echocardiography study. QT peak prolongation to 360ms or more was associated with over 4-fold increase odds ratio of significant myocardial ischaemia. The Mantel- Haenszel Common Odds Ratio Estimate=4.4, 95% CI=1.2-16.0, p=0.023. Conclusion: QT peak (QTpc) prolongation to 360ms or more should make us suspect the presence of significant myocardial ischaemia. Such patients merit further investigations for potentially treatable ischaemic heart disease to reduce their risk of subsequent death or non-fatal MI

How tidal processes impact the transfer of sediment from source to sink : Mekong River collaborative studies

Author Posting. © Oceanography Society, 2017. This article is posted here by permission of Oceanography Society for personal use, not for redistribution. The definitive version was published in Oceanography 30, no. 3 (2017): 22–33, doi:10.5670/oceanog.2017.311.Significant sediment transformation and trapping occur along the tidal and estuarine reaches of large rivers, complicating sediment source signals transmitted to the coastal ocean. The collaborative Mekong Tropical Delta Study explored the tidally influenced portion of the Mekong River to investigate processes that impact mud- and sand-sized sediment transport and deposition associated with varying fluvial and marine influences. Researchers participating in this 2014–2015 project found that as sand and mud progress down the tidal portion of the river, sands in suspension can settle during reduced or slack flows as river discharge becomes progressively more affected by tides in the seaward direction. Consequently, deposits on the tidal river bed are connected to sand transport in the channel. In contrast, fine mud particles remain in suspension until they reach an interface zone where waters are still fresh, but the downstream saline estuary nonetheless impacts the flows. In this interface zone, as within the estuary, fine particles tend to settle, draping the sand beds with mud and limiting the connection between the bed and suspended sand. In the Mekong system, the interface and estuarine zones migrate along the distributary channels seasonally, resulting in variable trapping dynamics and channel bed texture. Therefore, the signature of fluvial-sediment discharge is altered on its path to the coastal ocean, and the disconnected mud and sand supply functions at the river mouth should result in distinct offshore depositional signatures.This research was funded by the US Office of Naval Research (grant numbers: N00014-15-1-2011, N00014- 13-1-0127, N00014-13-1-0781, N00014-14-1-0145)

Sediment dynamics in the lower Mekong River : transition from tidal river to estuary

Author Posting. © American Geophysical Union, 2015. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research: Oceans 120 (2015): 6363–6383, doi:10.1002/2015JC010754.A better understanding of flow and sediment dynamics in the lowermost portions of large-tropical rivers is essential to constraining estimates of worldwide sediment delivery to the ocean. Flow velocity, salinity, and suspended-sediment concentration were measured for 25 h at three cross sections in the tidal Song Hau distributary of the Mekong River, Vietnam. Two campaigns took place during comparatively high-seasonal and low-seasonal discharge, and estuarine conditions varied dramatically between them. The system transitioned from a tidal river with ephemeral presence of a salt wedge during high flow to a partially mixed estuary during low flow. The changing freshwater input, sediment sources, and estuarine characteristics resulted in seaward sediment export during high flow and landward import during low flow. The Dinh An channel of the Song Hau distributary exported sediment to the coast at a rate of about 1 t s−1 during high flow and imported sediment in a spatially varying manner at approximately 0.3 t s−1 during low flow. Scaling these values results in a yearly Mekong sediment discharge estimate about 65% smaller than a generally accepted estimate of 110 Mt yr−1, although the limited temporal and spatial nature of this study implies a relatively high degree of uncertainty for the new estimate. Fluvial advection of sediment was primarily responsible for the high-flow sediment export. Exchange-flow and tidal processes, including local resuspension, were principally responsible for the low-flow import. The resulting bed-sediment grain size was coarser and more variable during high flow and finer during low, and the residual flow patterns support the maintenance of mid-channel islands.Office of Naval Research Grant Numbers: N00014-12-1-0181 , N00014-13-1-0127 , N00014-13-1-0781, and National Defense Science and Engineering2016-03-2

Determining the neurotransmitter concentration profile at active synapses

Establishing the temporal and concentration profiles of neurotransmitters during synaptic release is an essential step towards understanding the basic properties of inter-neuronal communication in the central nervous system. A variety of ingenious attempts has been made to gain insights into this process, but the general inaccessibility of central synapses, intrinsic limitations of the techniques used, and natural variety of different synaptic environments have hindered a comprehensive description of this fundamental phenomenon. Here, we describe a number of experimental and theoretical findings that has been instrumental for advancing our knowledge of various features of neurotransmitter release, as well as newly developed tools that could overcome some limits of traditional pharmacological approaches and bring new impetus to the description of the complex mechanisms of synaptic transmission

Production of D∗+(2010)D^{*+}(2010) mesons by high energy neutrinos from the Tevatron

Charged vector $D^{*+}(2010)$ meson production is studied in a high energy neutrino bubble chamber experiment with mean neutrino energy of 141 GeV. The $D^{*+}$ are produced in $(5.6 \pm 1.8)\%$ of the neutrino charged current interactions, indicating a steep increase of cross section with energy. The mean fractional hadronic energy of the $D^{*+}$ meson is $0.55 \pm 0.06$

Pathological complete response and residual DCIS following neoadjuvant chemotherapy for breast carcinoma

Patients who have no residual invasive cancer following neoadjuvant chemotherapy for breast carcinoma have a better overall survival than those with residual disease. Many classification systems assessing pathological response to neoadjuvant chemotherapy include residual ductal carcinoma in situ (DCIS) only in the definition of pathological complete response. The purpose of this study was to investigate whether patients with residual DCIS only have the same prognosis as those with no residual invasive or in situ disease. A retrospective analysis of a prospectively maintained database identified 435 patients, who received neoadjuvant chemotherapy for operable breast cancer between February 1985 and February 2003. Of these, 30 (7%; 95% CI 5–9%) had no residual invasive disease or DCIS and 20 (5%; CI 3–7%) had residual DCIS only. With a median follow-up of 61 months, there was no statistical difference in disease-free survival, 80% (95% CI 60–90%) in those with no residual invasive or in situ disease and 61% (95% CI 35–80%) in those with DCIS only (P=0.4). No significant difference in 5-year overall survival was observed, 93% (95% CI 75–98%) in those with no residual invasive or in situ disease and 82% (95% CI 52–94%) in those with DCIS only (P=0.3). Due to the small number of patients and limited number of events in each group, it is not possible to draw definitive conclusions from this study. Further analyses of other databases are required to confirm our finding of no difference in disease-free and overall survival between patients with residual DCIS and those with no invasive or in situ disease following neoadjuvant chemotherapy for breast cancer

Antibacterial and dermal toxicological profiles of ethyl acetate extract from Crassocephalum bauchiense (Hutch.) Milne-Redh (Asteraceae)

<p>Abstract</p> <p>Background</p> <p>The emergence in recent years of numerous resistant strains of pathogenic bacteria to a range of formerly efficient antibiotics constitutes a serious threat to public health. <it>Crassocephalum bauchiense</it>, a medicinal herb found in the West Region of Cameroon is used to treat gastrointestinal infections as well as liver disorders. The ethyl acetate extract from the leaves of <it>C. bauchiense </it>was evaluated for its antibacterial activity as well as acute and sub-acute toxicities.</p> <p>Methods</p> <p>The plant extract was prepared by maceration in ethyl acetate. Its phytochemical screening was done by standard methods. The broth microdilution method was used to evaluate the <it>in vitro </it>antibacterial activity. The <it>in vivo </it>antibacterial activity of a gel formulation (0.05, 1 and 2% w/v) of this extract was evaluated using a <it>Staphylococcus aureus</it>-induced dermatitis in a murine model. Selected haematological and biochemical parameters were used to evaluate the dermal sub-acute toxicity of the extract in rats.</p> <p>Results</p> <p>Phytochemical screening of the <it>C. bauchiense </it>extract revealed the presence of alkaloids, phenols, tannins and sterols. <it>In vitro </it>antibacterial activities were observed against all the tested microorganisms (MIC = 0.04-6.25 mg/ml). Formulated extract-gel (2% w/v) and gentamycin (reference drug) eradicated the microbial infection after five days of treatment. A single dermal dose of this extract up to 32 g/kg body weight (bw) did not produce any visible sign of toxicity. Also, daily dermal application of the <it>C. bauchiense </it>extract gel formulation for 28 days did not show any negative effect, instead some biochemical parameters such as alanine aminotransferase (ALT and AST), low density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides were significantly (p < 0.05) affected positively.</p> <p>Conclusion</p> <p>These results indicate that the <it>C. bauchiense </it>ethyl acetate extract can be used safely for the treatment of some bacterial infections.</p