Clinical course and prognosis of dilated cardiomyopathy in children

Background: Epidemiology and clinical course of dilated cardiomyopathy (DCM) in children and infants are not well established. Thus, this study aims to investigate the clinical course and prognosis of DCM in childrenMethods: This was a single-center, prospective, observational study conducted at a tertiary-care center in India between February 2011 and September 2012. A total of 31 patients admitted to the paediatric department diagnosed with DCM were included in the study. Patients were divided into three groups based on the age at the time of diagnosis: 0-3 years, >3-12 years and >12-16 years. Among the study population, 28 patients were followed up for a mean period of 1.44 years and three patients were lost to follow-up.Results: Of the 31 patients, 11 patients were male with a mean age of 8.9±6 years and 20 patients were female with a mean age of 8.3±6 years. All patients were presented with same characteristics of New York heart association (NYHA) class III-IV dyspnoea and fatigue. Among 28 patients who were followed-up for a mean period of 1.44 years, 20(71.4%) patients died and eight patients were on follow up. Of the eight patients, five patients were with NYHA class III symptoms and three patients were with NYHA class I-II symptoms.Conclusions: Dilated cardiomyopathy in children is a very serious disease with a grave prognosis. Patients with NYHA III-IV symptoms have a very high mortality rate and potential use of other therapies remains to be fully evaluated in paediatric population

Intercropping of medicinal and aromatic plants in coconut gardens

A field study was conducted at Horticulture Research Station, Arsikere, Karnataka during 2006-07 to 2008-09 to identify suitable medicinal and aromatic plants for intercropping in coconut gardens of maidan tract of Karnataka. The experiment consisted of 14 medicinal and aromatic crops viz., Kalmegh (Andrographis paniculata), Makoi (Solanum nigrum), Coleus (Coleus forskohlii), Garden rue (Ruta graveolens), Lepidium (Lepidium sativum), Tulsi (Ocimum sanctum), Arrow root (Maranta arundinaceae), Kacholam (Kaemferia galanga), Cowhage (Mucuna pruriens), Roselle (Hibiscus sabdariffa), Ambrette (Abelmoschus moschatus), Citronella (Cymbopogon winteranus), Lemon grass (Cymbopogon flexuosus) and Vetiver grass (Vetiveria zizanoides). The yield of all the medicinal and aromatic crops grown as intercrop in coconut garden were reduced compared to their sole crop yields. The reduction in yield was less in lemon grass (6.4 %), tulsi (23.5 %), arrow root (23.9 %), vetiver grass (25.1 %), kalmegh (25.7 %), makoi (29.1 %), citronella (30.2 %) and garden rue (30.5 %). The nut yield of coconut was improved with intercropping of medicinal and aromatic crops. The andrographolide content in kalmegh (4.40 to 3.20 %), rutin alkaloids in garden rue (1.68 to 1.40 %) and oil content in lepidium (19.60 to 17.23 %) were significantly reduced when grown as intercrops in coconut garden as compared to sole crop. However, the forskohlin content in coleus (0.43 to 0.61 %) and essential oil content in ambrette (0.24 to 0.29 %) were significantly increased by intercropping. In other medicinal and aromatic crops, the quality parameters were not significantly influenced by intercropping. The intercropping system of growing lemon grass under coconut recorded the highest net income (Rs. 91,561/ha) and B:C ratio (2.89) followed by garden rue (Rs. 81,865/ha and 2.79), tulsi (Rs. 77,472/ha and 2.71), kalmegh (Rs. 75,163/ha and 2.56), arrow root (Rs. 72,211/ha and 2.28) and makoi (Rs. 67,058/ha and 2.68). Hence, intercropping of lemon grass, garden rue, tulsi, kalmegh, arrow root and makoi with coconut can be recommended for maidan tract of Karnataka

Predicted Changes in Climatic Niche and Climate Refugia of Conservation Priority Salamander Species in the Northeastern United States

Global climate change represents one of the most extensive and pervasive threats to wildlife populations. Amphibians, specifically salamanders, are particularly susceptible to the effects of changing climates due to their restrictive physiological requirements and low vagility; however, little is known about which landscapes and species are vulnerable to climate change. Our study objectives included, (1) evaluating species-specific predictions (based on 2050 climate projections) and vulnerabilities to climate change and (2) using collective species responses to identify areas of climate refugia for conservation priority salamanders in the northeastern United States. All evaluated salamander species were projected to lose a portion of their climatic niche. Averaged projected losses ranged from 3%–100% for individual species, with the Cow Knob Salamander (Plethodon punctatus), Cheat Mountain Salamander (Plethodon nettingi), Shenandoah Mountain Salamander (Plethodon virginia), Mabee’s Salamander (Ambystoma mabeei), and Streamside Salamander (Ambystoma barbouri) predicted to lose at least 97% of their landscape-scale climatic niche. The Western Allegheny Plateau was predicted to lose the greatest salamander climate refugia richness (i.e., number of species with a climatically-suitable niche in a landscape patch), whereas the Central Appalachians provided refugia for the greatest number of species during current and projected climate scenarios. Our results can be used to identify species and landscapes that are likely to be further affected by climate change and potentially resilient habitats that will provide consistent climatic conditions in the face of environmental change

A Bioinformatics Resource for TWEAK-Fn14 Signaling Pathway

TNF-related weak inducer of apoptosis (TWEAK) is a new member of the TNF superfamily. It signals through TNFRSF12A, commonly known as Fn14. The TWEAK-Fn14 interaction regulates cellular activities including proliferation, migration, differentiation, apoptosis, angiogenesis, tissue remodeling and inflammation. Although TWEAK has been reported to be associated with autoimmune diseases, cancers, stroke, and kidney-related disorders, the downstream molecular events of TWEAK-Fn14 signaling are yet not available in any signaling pathway repository. In this paper, we manually compiled from the literature, in particular those reported in human systems, the downstream reactions stimulated by TWEAK-Fn14 interactions. Our manual amassment of the TWEAK-Fn14 pathway has resulted in cataloging of 46 proteins involved in various biochemical reactions and TWEAK-Fn14 induced expression of 28 genes. We have enabled the availability of data in various standard exchange formats from NetPath, a repository for signaling pathways. We believe that this composite molecular interaction pathway will enable identification of new signaling components in TWEAK signaling pathway. This in turn may lead to the identification of potential therapeutic targets in TWEAK-associated disorders

A proteomic approach for the rapid, multi-informative and reliable identification of blood

Blood evidence is frequently encountered at the scene of violent crimes and can provide valuable intelligence in the forensic investigation of serious offences. Because many of the current enhancement methods used by crime scene investigators are presumptive, the visualisation of blood is not always reliable nor does it bear additional information. In the work presented here, two methods employing a shotgun bottom up proteomic approach for the detection of blood are reported; the developed protocols employ both an in solution digestion method and a recently proposed procedure involving immobilization of trypsin on hydrophobin Vmh2 coated MALDI sample plate. The methods are complementary as whilst one yields more identifiable proteins (as biomolecular signatures), the other is extremely rapid (5 minutes). Additionally, data demonstrate the opportunity to discriminate blood provenance even when two different blood sources are present in a mixture. This approach is also suitable for old bloodstains which had been previously chemically enhanced, as experiments conducted on a 9-year-old bloodstain deposited on a ceramic tile demonstrate

A theory led narrative review of one-to-one health interventions:the influence of attachment style and client-provider relationship on client adherence

A theory-led narrative approach was used to unpack the complexities of the factors that enable successful client adherence following one-to-one health interventions. Understanding this could prepare the provider to anticipate different adherence behaviours by clients, allowing them to tailor their interventions to increase the likelihood of adherence. The review was done in two stages. A theoretical formulation was proposed to explore factors which influence the effectiveness of one-to-one interventions to result in client adherence. The second stage tested this theory using a narrative synthesis approach. Eleven studies across the health care arena were included in the synthesis and explored the interplay between client attachment style, client–provider interaction and client adherence with health interventions. It emerged that adherence results substantially because of the relationship that the client has with the provider, which is amplified or diminished by the client’s own attachment style. This occurs because the client’s attachment style shapes how they perceive and behave in relationships with the health-care providers, who become the ‘secure base’ from which the client accepts, assimilates and adheres with the recommended health intervention. The pathway from one-to-one interventions to adherence is explained using moderated mediation and mediated moderation models

Yoga-Based Cardiac Rehabilitation After Acute Myocardial Infarction: A Randomized Trial

Background: Given the shortage of cardiac rehabilitation (CR) programs in India and poor uptake worldwide, there is an urgent need to find alternative models of CR that are inexpensive and may offer choice to subgroups with poor uptake (e.g., women and elderly). Objectives: This study sought to evaluate the effects of yoga-based CR (Yoga-CaRe) on major cardiovascular events and self-rated health in a multicenter randomized controlled trial. Methods: The trial was conducted in 24 medical centers across India. This study recruited 3,959 patients with acute myocardial infarction with a median and minimum follow-up of 22 and 6 months. Patients were individually randomized to receive either a Yoga-CaRe program (n = 1,970) or enhanced standard care involving educational advice (n = 1,989). The co-primary outcomes were: 1) first occurrence of major adverse cardiovascular events (MACE) (composite of all-cause mortality, myocardial infarction, stroke, or emergency cardiovascular hospitalization); and 2) self-rated health on the European Quality of Life–5 Dimensions–5 Level visual analogue scale at 12 weeks. Results: MACE occurred in 131 (6.7%) patients in the Yoga-CaRe group and 146 (7.4%) patients in the enhanced standard care group (hazard ratio with Yoga-CaRe: 0.90; 95% confidence interval [CI]: 0.71 to 1.15; p = 0.41). Self-rated health was 77 in Yoga-CaRe and 75.7 in the enhanced standard care group (baseline-adjusted mean difference in favor of Yoga-CaRe: 1.5; 95% CI: 0.5 to 2.5; p = 0.002). The Yoga-CaRe group had greater return to pre-infarct activities, but there was no difference in tobacco cessation or medication adherence between the treatment groups (secondary outcomes). Conclusions: Yoga-CaRe improved self-rated health and return to pre-infarct activities after acute myocardial infarction, but the trial lacked statistical power to show a difference in MACE. Yoga-CaRe may be an option when conventional CR is unavailable or unacceptable to individuals. (A study on effectiveness of YOGA based cardiac rehabilitation programme in India and United Kingdom; CTRI/2012/02/002408)

A comprehensive manually curated reaction map of RANKL/RANK-signaling pathway

Receptor activator of nuclear factor-kappa B ligand (RANKL) is a member of tumor necrosis factor (TNF) superfamily that plays a key role in the regulation of differentiation, activation and survival of osteoclasts and also in tumor cell migration and bone metastasis. Osteoclast activation induced by RANKL regulates hematopoietic stem cell mobilization as part of homeostasis and host defense mechanisms thereby linking regulation of hematopoiesis with bone remodeling. Binding of RANKL to its receptor, Receptor activator of nuclear factor-kappa B (RANK) activates molecules such as NF-kappa B, mitogen activated protein kinase (MAPK), nuclear factor of activated T cells (NFAT) and phosphatidyl 3-kinase (PI3K). Although the molecular and cellular roles of these molecules have been reported previously, a systematic cataloging of the molecular events induced by RANKL/RANK interaction has not been attempted. Here, we present a comprehensive reaction map of the RANKL/RANK-signaling pathway based on an extensive manual curation of the published literature. We hope that the curated RANKL/RANK-signaling pathway model would enable new biomedical discoveries, which can provide novel insights into disease processes and development of novel therapeutic interventions