Long-term cardiac follow-up of athletes infected with SARS-CoV-2 after resumption of elite-level sports

OBJECTIVE: Longitudinal consequences and potential interactions of COVID-19 and elite-level sports and exercise are unclear. Therefore, we determined the long-term detrimental cardiac effects of the interaction between SARS-CoV-2 infection and the highest level of sports and exercise.METHODS: This prospective controlled study included elite athletes from the Evaluation of Lifetime participation in Intensive Top-level sports and Exercise cohort. Athletes infected with SARS-CoV-2were offered structured, additional cardiovascular screenings, including cardiovascular MRI (CMR). We compared ventricular volumes and function, late gadolinium enhancement (LGE) and T1 relaxation times, between infected and non-infected elite athletes, and collected follow-up data on cardiac adverse events, ventricular arrhythmia burden and the cessation of sports careers.RESULTS: We included 259 elite athletes (mean age 26±5 years; 40% women), of whom 123 were infected (9% cardiovascular symptoms) and 136 were controls. We found no differences in function and volumetric CMR parameters. Four infected athletes (3%) demonstrated LGE (one reversible), compared with none of the controls. During the 26.7 (±5.8) months follow-up, all four athletes resumed elite-level sports, without an increase in ventricular arrhythmias or adverse cardiac remodelling. None of the infected athletes reported new cardiac symptoms or events. The majority (n=118; 96%) still participated in elite-level sports; no sports careers were terminated due to SARS-CoV-2.CONCLUSIONS: This prospective study demonstrates the safety of resuming elite-level sports after SARS-CoV-2 infection. The medium-term risks associated with SARS-CoV-2 infection and elite-level sports appear low, as the resumption of elite sports did not lead to detrimental cardiac effects or increases in clinical events, even in the four elite athletes with SARS-CoV-2 associated myocardial involvement.</p

Emissies uit mestdroogsystemen op leghennenbedrijven bij dagontmesting en versneld drogen = Emissions from manure drying systems on layer farms using 24-h manure removal and rapid drying

In dit onderzoek is de hypothese getoetst dat met het dagelijks afdraaien van alle stalmest naar een mestdroogsysteem (dagontmesting), gevolgd door snelle indroging, de extra ammoniakemissie uit deze droogsystemen aanzienlijk kan worden beperkt. Deze hypothese is bevestigd door het onderzoek. Daarnaast is gebleken dat de aangepaste manier van drogen nog steeds een aanzienlijke fijnstofreductie bewerkstelligt

Maatregelen ter vermindering van fijnstofemissie uit de pluimveehouderij: validatie van een oliefilmrobot op een leghennenbedrijf = Measures to reduce fine dust emission from poultry houses: validation of an oil spraying robot on a layer farm

In this study, the emission reduction of an oil film robot was determined through validation measurements on a layer farm with houses with floor housing

Mesozoic Paleo-Pacific Subduction Beneath SW Borneo: U-Pb Geochronology of the Schwaner Granitoids and the Pinoh Metamorphic Group

The Schwaner Mountains in southwestern Borneo form a large igneous province with a complex magmatic history and poorly known tectonic history. Previously it was known that Cretaceous granitoids intruded metamorphic rocks of the Pinoh Metamorphic Group assumed to be of Paleozoic age. Jurassic granitoids had been reported from the southern Schwaner Mountains. Most ages were based on K-Ar dating. We present new geochemistry, zircon U-Pb and 40Ar/39Ar age data from igneous and metamorphic rocks from the Schwaner Mountains to investigate their tectono-magmatic histories. We subdivide the Schwaner Mountains into three different zones which record rifting, subduction-related and post-collisional magmatism. The Northwest Schwaner Zone (NWSZ) is part of the West Borneo Block which in the Triassic was within the Sundaland margin. It records Triassic to Jurassic magmatism during early Paleo-Pacific subduction. In contrast, the North Schwaner Zone (NSZ) and South Schwaner Zone (SSZ) are part of the SW Borneo (Banda) Block that separated from NW Australia in the Jurassic. Jurassic granitoids in the SSZ are within-plate (A-type) granites interpreted to have formed during rifting. The SW Borneo (Banda) Block collided with eastern Sundaland at c. 135 Ma. Following this, large I-type granitoid plutons and arc volcanics formed in the NWSZ and NSZ between c. 90 and 132 Ma, associated with Cretaceous Paleo-Pacific subduction. The largest intrusion is the c. 110 to 120 Ma Sepauk Tonalite. After collision of the East Java-West Sulawesi (Argo) Block, subduction ceased and post-collisional magmatism produced the c. 78 to 85 Ma Sukadana Granite and the A-type 72 Ma Sangiyang Granite in the SSZ. Rocks of the Pinoh Metamorphic Group mainly exposed in the NSZ, previously assumed to represent Paleozoic basement, contain abundant Early Cretaceous (110 to 135 Ma) zircons. They are interpreted as volcaniclastic sediments that formed contemporaneously with subduction-related volcanic rocks of the NSZ subsequently metamorphosed during intrusion of Cretaceous granitoids. There are no igneous rocks older than Cretaceous in the NSZ and older than Jurassic in the SSZ and there is no evidence for a continuation of a Triassic volcanic arc crossing Borneo from Sundaland to the east.This project was funded by the SE Asia Research Group of Royal Holloway University of London, which is supported by a consortium of oil companies

Interferon alfa for chronic hepatitis B infection: Increased efficacy of prolonged treatment

Interferon alfa (IFN-a) is the primary treatment for chronic hepatitis B. The standard duration of IFN-a therapy is considered 16 weeks; however, the optimal treatment length is still poorly defined. We evaluated the efficacy and acceptability of prolonged IFN-a treatment in patients with chronic hepatitis B. To investigate whether treatment prolongation could enhance the rate of hepatitis B e antigen (HBeAg) seroconversion, we conducted a prospective, controlled, multicenter trial in wh

No topoisomerase I alteration in a neuroblastoma model with in vivo acquired resistance to irinotecan

CPT-11 (irinotecan) is a DNA-topoisomerase I inhibitor with preclinical activity against neuroblastoma (NB) xenografts. The aim was to establish in vivo an NB xenograft resistant to CPT-11 in order to study the resistance mechanisms acquired in a therapeutic setting. IGR-NB8 is an immature NB xenograft with MYCN amplification and 1p deletion, which is sensitive to CPT-11. Athymic mice bearing advanced-stage subcutaneous tumours were treated with CPT-11 (27 mg kg−1 day−1 × 5) every 21 days (1 cycle) for a maximum of four cycles. After tumour regrowth, a new in vivo passage was performed and the CPT-11 treatment was repeated. After the third passage, a resistant xenograft was obtained (IGRNB8-R). The tumour growth delay (TGD) was reduced from 115 at passage 1 to 40 at passage 4 and no complete or partial regression was observed. After further exposure to the drug, up to 28 passages, the resistant xenograft was definitively established with a TGD from 17 at passage 28. Resistant tumours reverted to sensitive tumours after 15 passages without treatment. IGR-NB8-R remained sensitive to cyclophosphamide and cisplatin and cross-resistance was observed with the topoisomerase I inhibitor topotecan. No quantitative or qualitative topoisomerase I modifications were observed. The level of expression of multidrug resistance 1 (MDR1), MDR-associated protein 1 (MRP1) and, breast cancer resistance protein, three members of the ATP-binding cassette transporter family was not modified over passages. Our results suggest a novel resistance mechanism, probably not involving the mechanisms usually observed in vitro

Induction of breast cancer resistance protein by the camptothecin derivative DX-8951f is associated with minor reduction of antitumour activity

DX-8951f (exatecan mesylate), a new water-soluble derivative of camptothecin, is currently being evaluated in phase II clinical trials. Resistance may be acquired when treating cancer patients with DX-8951f. Therefore, we selected a subline of the human ovarian cancer cell line A2780 for resistance against DX-8951f to investigate possible mechanisms of resistance. This DX-8951f-resistant subline, designated 2780DX8 (resistance factor=9.3), displayed a typical cross-resistance pattern including compounds, such as topotecan (resistance factor =34), SN-38 (resistance factor =47), mitoxantrone (resistance factor =59) and doxorubicin (resistance factor =2.9), which have previously been associated with the expression of breast cancer resistance protein. 2780DX8 cells did not show changes in the topoisomerase I gene, in topoisomerase I protein levels or catalytic activity. Overexpression of breast cancer resistance protein could be detected, both at the mRNA and protein level, while staining for Pgp, MRP1, or LRP was negative. GF120918, an inhibitor of breast cancer resistance protein, was able to reverse the DX-8951f-induced resistance in 2780DX8 cells. In vivo experiments in well-established 2780DX8 human tumour xenografts demonstrated that the growth inhibition induced by CPT-11 was more affected by breast cancer resistance protein expression than that of DX-8951f. These data indicate for the first time that DX-8951f is able to induce breast cancer resistance protein as a mechanism of resistance. Breast cancer resistance protein, however, results in only minor reduction of antitumour activity of DX-8951f which is an advantage over topotecan and CPT-11/SN-38

Prevalence and diagnostic significance of de-novo 12-lead ECG changes after COVID-19 infection in elite soccer players.

BACKGROUND AND AIM: The efficacy of pre-COVID-19 and post-COVID-19 infection 12-lead ECGs for identifying athletes with myopericarditis has never been reported. We aimed to assess the prevalence and significance of de-novo ECG changes following COVID-19 infection. METHODS: In this multicentre observational study, between March 2020 and May 2022, we evaluated consecutive athletes with COVID-19 infection. Athletes exhibiting de-novo ECG changes underwent cardiovascular magnetic resonance (CMR) scans. One club mandated CMR scans for all players (n=30) following COVID-19 infection, despite the absence of cardiac symptoms or de-novo ECG changes. RESULTS: 511 soccer players (median age 21 years, IQR 18-26 years) were included. 17 (3%) athletes demonstrated de-novo ECG changes, which included reduction in T-wave amplitude in the inferior and lateral leads (n=5), inferior leads (n=4) and lateral leads (n=4); inferior T-wave inversion (n=7); and ST-segment depression (n=2). 15 (88%) athletes with de-novo ECG changes revealed evidence of inflammatory cardiac sequelae. All 30 athletes who underwent a mandatory CMR scan had normal findings. Athletes revealing de-novo ECG changes had a higher prevalence of cardiac symptoms (71% vs 12%, p<0.0001) and longer median symptom duration (5 days, IQR 3-10) compared with athletes without de-novo ECG changes (2 days, IQR 1-3, p<0.001). Among athletes without cardiac symptoms, the additional yield of de-novo ECG changes to detect cardiac inflammation was 20%. CONCLUSIONS: 3% of athletes demonstrated de-novo ECG changes post COVID-19 infection, of which 88% were diagnosed with cardiac inflammation. Most affected athletes exhibited cardiac symptoms; however, de-novo ECG changes contributed to a diagnosis of cardiac inflammation in 20% of athletes without cardiac symptoms