17.2 Cardiac resynchronization: Multicenter experience with a new coronary sinus lead

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Strength asymmetries are muscle-specific and metric-dependent

We investigated if dominance affected upper limbs muscle function, and we calculated the level of agreement in asymmetry direction across various muscle-function metrics of two heterologous muscle groups. We recorded elbow flexors and extensors isometric strength of the dominant and non-dominant limb of 55 healthy adults. Participants performed a series of explosive contractions of maximal and submaximal amplitudes to record three metrics of muscle performance: maximal voluntary force (MVF), rate of force development (RFDpeak), and RFD-Scaling Factor (RFD-SF). At the population level, the MVF was the only muscle function that showed a difference between the dominant and non-dominant sides, being on average slightly (3-6%) higher on the non-dominant side. At the individual level, the direction agreement among heterologous muscles was poor for all metrics (Kappa values ≤ 0.15). When considering the homologous muscles, the direction agreement was moderate between MVF and RFDpeak (Kappa = 0.37) and low between MVF and RFD-SF (Kappa = 0.01). The asymmetries are muscle-specific and rarely favour the same side across different muscle-performance metrics. At the individual level, no one side is more performative than the other: each limb is favoured depending on muscle group and performance metric. The present findings can be used by practitioners that want to decrease the asymmetry levels as they should prescribe specific exercise training for each muscle

A Multi-Disciplinary Approach to the Study of Large Rock Avalanches Combining Remote Sensing, GIS and Field Surveys: The Case of the Scanno Landslide, Italy

This is the final version. Available from MDPI via the DOI in this record.This research aims to highlight the importance of adopting a multi-disciplinary approach to understanding the factors controlling large rock avalanches using the Scanno landslide, Italy, as a case study. The study area is the Mount Genzana, Abruzzi Central Apennines, characterized by the regional Difesa-Mount Genzana-Vallone delle Masserie fault zone. The Scanno landslide is famous for its role in the formation of the Scanno Lake. The landslide is characterized by a wide exposed scar, which was interpreted in previous studies as the intersection of high-angle joints and an outcropping bedding plane on which the landslide failed sometime between the Upper Pleistocene and the Holocene. In this study, the Scanno landslide was investigated through the integration of geological, geomechanical and geomorphological surveys. Remote sensing techniques were used to enrich the conventionally gathered datasets, while Geographic Information Systems (GIS) were used to integrate, manage and investigate the data. The results of the authors investigation show that the outcropping landslide scar can be interpreted as a low-angle fault, associated with the Difesa-Mount Genzana-Vallone delle Masserie fault zone, which di ers from previous investigations and interpretations of the area. The low-angle fault provides the basal failure surface of the landslide, with two systematic high-angle joint sets acting as lateral release and back scarp surfaces, respectively. In light of these new findings, pre- and post-failure models of the area have been created. The models were generated in GIS by combining LiDAR (Light Detection and Ranging) and geophysics data acquired on the landslide body and through bathymetric survey data of the Scanno Lake. Using the pre- and post-failure models it was possible to estimate the approximate volume of the landslide. Finally, back-analyses using static and dynamic limit equilibrium methods is also used to show the possible influence of medium-to-high magnitude seismic events in triggering the Scanno landslide

Overlapping redox zones control arsenic pollution in Pleistocene multi-layer aquifers, the Po Plain (Italy)

Understanding the factors that control As concentrations in groundwater is vital for supplying safe groundwater in regions with As-polluted aquifers. Despite much research, mainly addressing Holocene aquifers hosting young (12,000 yrs) groundwaters are not yet fully understood and so are assessed here through an evaluation of the redox properties of the system in a type locality, the Po Plain (Italy). Analyses of redox-sensitive species and major ions on 22 groundwater samples from the Pleistocene arsenic-affected aquifer in the Po Plain shows that groundwater concentrations of As are controlled by the simultaneous operation of several terminal electron accepters. Organic matter, present as peat, is abundant in the aquifer, allowing groundwater to reach a quasi-steady-state of highly reducing conditions close to thermodynamic equilibrium. In this system, simultaneous reduction of Fe-oxide and sulfate results in low concentrations of As (median 7 μg/L) whereas As reaches higher concentrations (median of 82 μg/L) during simultaneous methanogenesis and Fe-reduction. The position of well-screens is an additional controlling factor on groundwater As: short screens that overlap confining aquitards generate higher As concentrations than long screens placed away from them. A conceptual model for groundwater As, applicable worldwide in other Pleistocene aquifers with reducible Fe-oxides and abundant organic matter is proposed: As may have two concentration peaks, the first after prolonged Fe-oxide reduction and until sulfate reduction takes place, the second during simultaneous Fe-reduction and methanogenesis

ROLE OF 5-LIPOXYGENASE IN THE MULTIPLE ORGAN FAILURE INDUCED BY ZYMOSAN.

Objective: This study investigated the role of 5-lipoxygenase in the pathogenesis of multiple organ failure (MOF) induced by zymosan. Design: Male mice with a targeted disruption of the 5-lipoxygenase gene (5-LOKO) and littermate wild-type (WT) controls (5-LOWT) were used to evaluate the role of 5-lipoxygenase (5-LO) in the pathogenesis of MOF. Setting: University research laboratory. Interventions and measurements: MOF was induced by peritoneal injection of zymosan (500 mg/kg i.p. as a suspension in saline) in 5-LOWT and in 5-LOKO mice. MOF was assessed 18 h after administration of zymosan and monitored for 12 days (for loss of body weight and mortality). Results: A severe inflammatory process induced by zymosan administration in WT mice coincided with the damage of lung and small intestine, as assessed by histological examination. Myeloperoxidase activity indicative of neutrophil infiltration and lipid peroxidation were significantly increased in zymosan-treated WT mice. Zymosan in the WT mice also induced a significant increase in the plasma level of nitrite/nitrate. Immunohistochemical examination demonstrated a marked increase in the immunoreactivity to ICAM-1 and P-selectin in the lung and intestine of zymosan-treated WT mice. In contrast, the degree of (a) peritoneal inflammation and tissue injury, (b) upregulation/expression of P-selectin and ICAM-1, and (c) neutrophil infiltration were markedly reduced in intestine and lung tissue obtained from zymosan-treated 5-LO deficient mice. Zymosan-treated 5-LOKO showed also a significantly decreased mortality. Conclusions: These findings clearly demonstrate that 5-LO exerts a role in zymosan-induced nonseptic shock

Hemodynamic changes, plasma catecholamine responses, and echocardiographically detected contractile reserve during two different dobutamine-infusion protocols

We studied hemodynamic changes, catecholamine responses, and the occurrence of improved wall thickening by echocardiography during two different dobutamine-infusion protocols. Forty-three patients were studied by using a stepwise incremental dobutamine dose-infusion protocol (10-40 μg/kg/min, 3-min intervals); a subgroup of 11 patients also underwent a continuous dobutamine-infusion protocol (10 μg/kg/min for 12 min) in random order. No patient used β-blockers. At 3-min intervals, blood pressure, heart rate, and plasma concentrations of dobutamine, epinephrine, and norepinephrine were measured. The echocardiographic improvement of wall thickening was analyzed only in paired protocols by visual assessment in left ventricular regions with normal wall motion at rest. The mean heart rate increased in the continuous and stepwise protocols from 73 to 99 and 74 to 132 beats/min. There was no significant change in blood pressure response between the two protocols. The mean plasma dobutamine concentrations during the continuous and stepwise protocols at 0, 3, 6, 9, and 12 min were 0/0; 31/38; 80/203; 106/448; and 120/692 ng/ml, respectively. In each patient, a response curve was constructed for the plasma dobutamine concentration versus heart rate. The heart rate increment and dobutamine concentration at which wall thickening was detected were similar with both protocols (14 ± 5 vs. 12 ± 7 beats/min) and (8) ± 40 vs. 92 ± 48 ng/ml; mean ± SD). Wall thickening was noted in two of 11 patients b

The association of impaired semen quality and pregnancy rates in assisted reproduction technology cycles: Systematic review and meta-analysis

Some studies suggest a relationship between semen quality and pregnancy rates of assisted reproduction technologies (ART). Others have questioned the utility of semen quality as proxy for fertility in couples attempting to conceive with or without assistance. We aimed to investigate the current body of evidence which correlates semen parameters and clinical pregnancy among couples utilizing ART (i.e. in vitro fertilization [IVF], intracytoplasmic sperm injection [ICSI]) through a systematic review and meta-analysis of cross-sectional and retrospective cohort studies. Pooled Odd Ratio (OR) for oligo-, astheno- and teratospermic compared to normospermic number of ART cycles were calculated among. Meta-regression and sub-group analysis were implemented to model the contribution of clinical/demographic and laboratory standards differences among the studies. Overall, 17 studies were analysed representing 17,348 cycles were analysed. Pooled OR for impaired sperm concentration, motility and morphology was 1 (95%Confidence Interval [CI]: 0.97-1.03), 0.88 (95%CI: 0.73-1.03) and 0.88 (95%CI: 0.75-1) respectively. Further analysis on sperm morphology showed no differences with regard of IVF versus ICSI (p = 0.14) nor a significant correlation with rising reference thresholds (Coeff: -0.02, p = 0.38). A temporal trend towards a null association between semen parameters and clinical pregnancy was observed over the 20-year observation period (Coeff: 0.01, p = 0.014). The current analysis found no association between semen quality (as measured by concentration, motility or morphology) and clinical pregnancy rates utilizing ART. Future investigations are necessary to explore the association between semen parameters and other ART outcomes (e.g. fertilization, implantation, birth and perinatal health)

Morphophenotypic changes in human multistep hepatocarcinogenesis with translational implications

BACKGROUND & AIMS: Human hepatocarcinogenesis in cirrhosis is thought to be multistep and characterized by a spectrum of nodular lesions, ranging from low to high grade dysplastic nodules (LGDN and HGDN) to early and progressed hepatocellular carcinoma (eHCC and pHCC). Aim of this study was to investigate the morpho-phenotypical changes of this sequence and their potential translational significance. METHODS: We scored the vascular profile, ductular reaction/stromal invasion and overexpression of 5 biomarkers (GPC3, HSP70, GS, CHC, and EZH2), in a series of 100 resected nodules (13 LGDN, 16 HGDN, 42 eHCC and 29 small pHCC). RESULTS: The score separated the 4 groups of nodules as individual entities (p<0.01). In the sequence, biomarkers overexpression progressively increased with parallel decrease of ductular reaction; the vascular remodeling started very early (LGDN) but did not further develop in a proportion of HCC. eHCC was the most heterogeneous entity, with marginal overlap with HGDN and pHCC. Liver environment (fibrosis, etiology) did not impact on the phenotype of the different nodules. A subclass of eHCC (16/42) without evidence of stromal invasion was identified, suggesting a "preinvasive stage" (p<0.05). For diagnosis, the application of 4 and 5 biomarkers (rather than the usual 3) improved the sensitivity of the assay for the detection of eHCC (76% and 93% vs. 52%); biomarkers in alternative combinations also increased the sensitivity of the assay (GS+CHC+EZH2: 76%; GS+CHC+EZH2+HSP70: 90%). CONCLUSIONS: This study supports the multistep nature of human hepatocarcinogenesis, suggests that eHCC is more heterogeneous than previously thought and provides information of potential translational significance into the clinical practice