European Society of Cardiology/European Society of Hypertension versus the American College of Cardiology/American Heart Association guidelines on the cut-off values for early hypertension: a microvascular perspective

The aim of this study was to investigate retinal and peripheral microvascular function in asymptomatic individuals that fall into different BP groups when using either the ESC/ESH or the ACC/AHA guidelines. Retinal and peripheral microvascular function was assessed in 358 participants by means of dynamic retinal vessel analysis and digital thermal monitoring, respectively. Blood pressure and lipid panel were also evaluated. Retinal vascular function measured in all groups belonging to the ACC/ASH classifications were within the normal values for age-matched normal population. Individuals classed as grade 1 hypertension according to the ESC/ESH guidelines, however, exhibited a significantly decreased artery baseline (p = 0.0004) and MC (p = 0.040), higher slope AD (p = 0.0018) and decreased vein MC (p = 0.0446) compared to age matched normal individuals. In addition, they also had significant lower artery baseline, artery BDF, MD and MC than individuals classed as stage 1 hypertension based on the ACC/ASH guidelines (p = 0.00022, p = 0.0179, p = 0.0409 and p = 0.0329 respectively). Peripheral vascular reactivity (aTR) was lower in ESC /ESH grade I compared to those graded ACC/ASH stage I hypertension (p = 0.0122). The conclusion of this study is that microvascular dysfunctions is present at multiple levels only in individuals with ESC/ESH grade 1 hypertension. This observation could be important when deciding personalised care in individuals with early hypertensive changes

Retinal Microvascular Dysfunction Occurs Early and Similarly in Mild Alzheimer’s Disease and Primary-Open Angle Glaucoma Patients

Purpose: To assess the similarities and differences in retinal microvascular function between mild Alzheimer’s disease (AD) patients, early-stage primary open angle glaucoma (POAG) patients and healthy controls. Methods: Retinal vessel reactivity to flickering light was assessed in 10 AD, 19 POAG and 20 healthy age matched control patients by means of dynamic retinal vessel analysis (DVA, IMEDOS, GmbH, Jena, Germany) according to an established protocol. All patients additionally underwent BP measurements and blood analysis for glucose and lipid metabolism markers. Results: AD and POAG patients demonstrated comparable alterations in retinal artery reactivity, in the form of an increased arterial reaction time (RT) to flicker light on the final flicker cycle (p = 0.009), which was not replicated by healthy controls (p > 0.05). Furthermore, the sequential changes in RT on progressing from flicker one to flicker three were found to differ between healthy controls and the two disease groups (p = 0.001). Conclusion: AD and POAG patients demonstrate comparable signs of vascular dysfunction in their retinal arteries at the early stages of their disease process. This provides support for the concept of a common underlying vascular aetiology in these two neurodegenerative diseases

SARS-2 COVID-19-induced immunity response, a new prognostic marker for the pregnant population correlates inversely with neonatal Apgar score

Background: The COVID-19 infection has impacted pregnancy outcomes; however, few studies have assessed the association between haematological parameters and virus-related pregnancy and neonatal outcomes. We hypothesised differences in routine haematology indices in pregnant and non-pregnant COVID-19 patients as well as COVID-19-negative pregnant subjects and observed neonatal outcomes in all pregnant populations. Further, we tested if pattern identification in the COVID-19 pregnant population would facilitate prediction of neonates with a poor Apgar score. Methods: We tested our hypothesis in 327 patients (111 COVID-19-positive pregnant females, 169 COVID-19-negative pregnant females and 47 COVID-19-positive non-pregnant females) in whom standard routine laboratory indices were collected on admission. Results: Pregnant COVID-19-positive patients exhibited higher WBC, neutrophil, monocyte counts as well as neutrophil/lymphocyte and neutrophil/eosinophil ratio compared to non-pregnant COVID-19-positive patients (p = 0.00001, p = 0.0023, p = 0.00002, p = 0.0402, p = 0.0161, p = 0.0352, respectively). Preterm delivery was more prevalent in COVID-19-positive pregnant patients accompanied with a significantly lower birth weight (2894.37 (± 67.50) g compared with 3194.16 (± 50.61) g, p = 0.02) in COVID-19-negative pregnant patients. The COVID-19-Induced Immunity Response (CIIR) was defined as (WBC × neutrophil) / eosinophil; Apgar scores were significantly and inversely correlated with the CIIR index (r =—0.162). Interpretation: Pregnancy appears to give rise to an increased immune response to COVID-19 which appears to protect the mother, however may give rise to complications during labour as well as neonatal concerns. CIIR is a simple metric that predicts neonatal distress to aid clinicians in determining the prognosis of COVID-19 and help provide early intensive intervention to reduce complications

Novel controlled-release polylactic-co-glycolic acid (PLGA) nanoparticles for sodium thiosulphate, a hydrogen sulphide donor, retains pro-angiogenic potential of hydrogen sulphide

Hydrogen sulphide (H2S) is an endogenous gaseous signalling molecule observing cardioprotective qualities in various experimental models. However, its therapeutic application is limited due to rapid release in vivo and potential toxicity. Controlled-release nanoparticles (NPs), such as polylactic-co-glycolic acid (PLGA) NPs entrapping H2S compounds may address these issues. PLGA NPs’ encapsulating sodium thiosulphate (STS), a H2S donor, were prepared by emulsification and sonication-solvent evaporation in polyvinyl alcohol (PVA). Sonication time was varied between 15 and 45 s and PVA concentration varied between 0.3 and 0.7% w/v. NPs were characterised, cellular uptake, H2S generation and encapsulated STS angiogenic potential was explored. An increase in sonication time as well as PVA concentration decreased NPs size resulting in an increase in STS release kinetics and cellular uptake over 24 h. Encapsulated STS gave a controlled release of H2S over 24 h whereas non-encapsulated STS peaked at 2 h. Finally, we observed entrapped STS maintained pro-angiogenic potential. PLGA NPs are a promising controlled-release delivery system with potential to offer sustained H2S levels. Results of this study demonstrate formulation of STS-loaded PLGA NPs provides a controlled-release of STS and therefore H2S. NPs are internalised into cells and critically, PLGA NPs are able to maintain the pro-angiogenic potential of H2S

Performing the Egyptian revolution : origins of collective restraint action in the Midan

This research was supported by a Carnegie Trust for the Universities of Scotland grant.In January/February 2011, the world watched with admiration the Egyptian revolution that toppled President Housni Mubarak. The demonstration in Midan al-Tahrir (Liberation Square in central Cairo), which was the nucleus of the revolution, highlighted a largely spontaneous, civil and peaceful political performance. However, this performance was temporary, contradicting subsequent bloody conflicts in post-revolutionary Egypt. This article examines the socio-political origins of the Midan performance. It argues that the demonstrators exercised collective restraint, which was temporary but necessary, in order to topple Mubarak. Building on Norbert Elias’ civilising process theory and social movements literature, it is argued that the origins of this performance are found in a collective knowledge of regime strategy and narrative, Egyptian socio-political values and existing repertoires of contention. Drawing on primary sources and semi-structured interviews, the article contends that the demonstrators exercised collective restraint to reframe regime narrative and draw public support for the revolution.PostprintPeer reviewe

Improving reactor safety systems using component redundancy allocation technique

This paper addresses the improvements to the reliability of the safety systems of nuclear reactors using redundancy allocation technique. The study has been carried out using the Probabilistic Safety Assessment (PSA). PSA involves, among others, the use of fault and event tree tools in the evaluation of the safety system failure probabilities and the quantification of annual occurrence probability of the accidental conditions postulated in the design of the nuclear reactors. The PSA has been presented and discussed. The Egypt Second Research Reactor, ETRR-2, has been used as a case study. The failure probability of the already existing safety systems has been reviewed. The effect of the allocation of more redundant components to the existing safety systems on the failure probability of the systems has been evaluated. The event trees for two selected initiating events, from those events postulated in the ETRR-2 design, have been studied considering the allocation of more redundant components to the safety systems. The result of the study showed that further improvement could be introduced to the reliability of the Confinement Ventilation System (CVS)