Inflammation modulatory effect of perioperative high-dose statin in prevention of post-operative atrial fibrillation in patients undergoing coronary artery bypass grafting

Background: Atrial fibrillation (AF) is one of the most common complications after coronary artery bypass grafting (CABG), occurring in 20% to 40% of patients. Statins exert pleiotropic effects which are largely independent from their lipid-lowering properties.  The objective of this study was based on to affirm the evidence that perioperative statins have a significant role in preventing early postoperative AF in patients undergoing CABG.Methods: A prospective, randomized, cohort study of all consecutive patients who underwent primary isolated on pump CABG surgery was performed. Patients were divided into two groups -statin and non-statin groups - to examine the influence of statins on early postoperative prevention of AF.Results: In total, 127 patients who underwent isolated CABG were included in the study and were analysed. There were no significant differences in age, gender, history of cardiac infarction, concomitant diseases (hypertension, smoking, PPCI, hyperlipidaemia), cardiac functional grading (NYHA III-IV), electro- cardiograms, and preoperative medication. There were no significant differences in the average number of grafts where the left internal mammary artery was used as a bypass conduit, the surgical procedure or total cardiopulmonary bypass time, or aortic cross-clamping (ACC) time. In addition, there were no significant differences in the postoperative mechanical ventilation duration time, length of ICU stays or length of hospitalization between the two groups. The incidence of AF following CABG in the statin group was significantly lower than that in the non-statin group.Conclusions: Oral atorvastatin 40 mg/d, initiated at least 1 week before the scheduled CABG and continued in the early postoperative period, significantly decreases the risk of post-operative AF

Shell-model study of β+\beta^+/EC-decay half-lives for Z=21−30Z = 21-30 nuclei

In the present work, we have reported $\beta^+$/EC-decay half-lives for $Z = 21 -30$ nuclei using large-scale shell-model. %and N $\leq$ A recent study shows that some proton-rich nuclei in this region belong to the island of inversion. We have performed calculations for these nuclei using KB3G effective interaction, while for Ni, Cu, and Zn nuclei we have used JUN45 effective interaction in the $f_{5/2}pg_{9/2}$ model space. The calculated quenching factors for $fp$ and $f_{5/2}pg_{9/2}$ space using KB3G and JUN45 effective interactions are also reported. Shell-model results of $\beta$-decay half-lives, excitation energies, log$ft$ values, and branching fractions are discussed and compared with the available experimental data. We have obtained a reasonable agreement with the available data.Comment: 12 pages, 4 figures, 4 Tables, The European Physical Journal A : Hadrons and Nuclei (2023

Epidemiology of carbapenem-resistant Enterobacteriaceae colonization in ICU: a pilot study from a tertiary care hospital in Western Rajasthan, India

Background: Carbapenem-resistant Enterobacteriaceae (CRE) is a serious global public health threat. Antibiotic overuse, improper sanitation and unhygienic practices lead to large scale carriage and rapid spread.Methods: This is a prospective hospital based study planned for a period of 3 months including all patients admitted to 14 bedded Trauma ICU of a tertiary care hospital in Rajasthan. Rectal swabs were collected from admitted patients and carriage of carbapenem resistant Enterobacteriaceae looked for as per CDC guidelines. Screening of the Enterobacteriaceae colonies for carbapenemase production was done by Modified Hodge test. Carbapenem-resistant isolates were also tested for Metallo beta lactamase production by phenotypic disc confirmatory test.Results: A total of 73 patients were screened and 27 CRE isolates were obtained, carriage rate being 37%. A high level of resistance was seen to aminoglycosides, fluoroquinolones and cephalosporins. 100% sensitivity was however seen to Colistin, Tigecycline and Fosfomycin. 5 out of 27 strains showed a positive MHT test. Metallo beta lactamase (MBL) production was seen in 21/25 strains as tested by meropenem and Meropenem-EDTA discs.Conclusions: The current pilot study finds out the prevalence of CRE carriage among critically ill patients and stresses upon strong need for stringent infection control measures

Wave propagation in a hygrothermoelastic half-space along with non-local variable

This particular work is an effort to investigate the propagation of wave in hygrothermoelastic medium in the light of Eringen’s nonlocal theory of elasticity. The coupled wave equations in terms of displacement, temperature and moisture concentration are solved in an analytical way. The phase velocities of longitudinal displacement wave, transverse displacement wave, diffusion wave and thermal wave, under the influence of nonlocal variable, moisture concentration, and diffusion coefficient, in the medium are obtained analytically and presented graphically to show the effect of these parameters on the wave velocities

Studies on morpho-physiological characters of different Avena species under stress conditions

Seven species of oat (Avena) were evaluated for their relative drought tolerance under soil moisture stress. The plant height, leaf area production and biomass yield reduced under soil moisture stress. Among the species tested, minimum reduction in height was recorded in Avena vaviloviana, Avena abyssinica and Avena sterilis at vegetative and flowering stages. Significant decrease in leaf area production was recorded at vegetative stage, whereas at flowering stage, the decrease in leaf area production was marginal in A. sterilis followed by A. abyssinica predicting their more adaption to stress environment. The increase in specific leaf weight (SLW) of all the species of Avena showed increase in leaf thickness, exhibiting high water retention capacity under soil moisture stress condition which is a requisite trait for drought tolerance. Soil moisture stress imposed at vegetative and flowering stages reduced fresh biomass yield in all the species. Minimum reduction in dry biomass accumulation under stress environment at vegetative stage was recorded in A. sterilis followed by A. strigosa and A. sativa, exhibiting their tolerance to drought at early stages of growth. However, at flowering stage, minimum decrease in dry biomass production was recorded in A. sterilis (3.47%) followed by A. marocana (12.56%) indicating their relative drought tolerance at flowering stage of crop growth. A  significant positive correlation between total leaf area and dry biomass (r2=0.738) under stress environment indicates that dry biomass accumulation was governed by total leaf area production. A. sterilis accumulated maximum fresh and dry biomass under soil moisture stress with minimum reduction over the non stress environment, indicating its drought tolerance potential as compared to other genotypes tested.Keywords: Avena, biomass, flowering stage, leaf area, soil moisture stress, vegetative stage

WNT signaling pathway contributes to Dectin-1-dependent inhibition of TLR-induced inflammatory signature

Macrophages regulate cell fate decisions during microbial challenges by carefully titrating signaling events activated by innate receptors such as dectin-1 or Toll-like receptors (TLRs). Here, we demonstrate that dectin-1 activation robustly dampens TLR-induced proinflammatory signature in macrophages. Dectin-1 induced the stabilization of β-catenin via spleen tyrosine kinase (Syk)-reactive oxygen species (ROS) signals, contributing to the expression of WNT5A. Subsequently, WNT5A-responsive protein inhibitors of activated STAT (PIAS-1) and suppressor of cytokine signaling 1 (SOCS-1) mediate the downregulation of IRAK-1, IRAK-4, and MyD88, resulting in decreased expression of interleukin 12 (IL-12), IL-1β and tumor necrosis factor alpha (TNF-α). In vivo activation of dectin-1 with pathogenic fungi or ligand resulted in an increased bacterial burden of Mycobacteria, Klebsiella, Staphylococcus, or Escherichia, with a concomitant decrease in TLR-triggered proinflammatory cytokines. All together, our study establishes a new role for dectin-1-responsive inhibitory mechanisms employed by virulent fungi to limit the proinflammatory environment of the host

Case Report: Successful treatment of late-onset immune checkpoint inhibitor-associated membranous nephropathy in a patient with advanced renal cell carcinoma

BackgroundDiagnosing immune checkpoint inhibitor (ICI)-associated nephritis can be challenging since it is a rare complication of therapy, associated with a spectrum of immune-mediated pathologies, and can present months after ICI therapy discontinuation (i.e., late-onset). ICIs are increasingly administered in combination with other cancer therapies with associated nephrotoxicity, further obfuscating the diagnosis of ICI-associated nephritis. In this report, we describe the first suspected case of late-onset ICI-associated membranous nephropathy (MN) in a patient with metastatic clear cell renal cell carcinoma (RCC) who had discontinued ICI therapy 6 months prior to presentation. Prompt recognition of the suspected late-onset immune-related adverse event (irAE) resulted in the successful treatment of MN and continuation of RCC therapy.Case presentationA 57-year-old man with metastatic clear cell RCC was responsive to third-line RCC therapy with lenvatinib (oral TKI) and everolimus (oral mTOR inhibitor) when he presented with nephrotic range proteinuria and acute kidney injury (AKI). His kidney biopsy revealed probable secondary MN with subendothelial and mesangial immune complex deposits and negative staining for both phospholipase A2 receptor (PLA2R) and thrombospondin type-1 domain-containing 7A (THSD7A). While a diagnosis of paraneoplastic MN could not be excluded, the patient was responding to cancer therapy and had tumor regression. However, 6 months prior to presentation, the patient had received pembrolizumab, an ICI, with his first-line RCC treatment. Due to concern that the patient may be presenting with late-onset ICI-associated MN, he was effectively treated with rituximab, which allowed for his continued RCC therapy.ConclusionThis report highlights the first case of suspected late-onset ICI-associated MN and the increasing complexity of recognizing renal irAEs. With the growing indications for the use of ICIs in combination with other cancer therapies, recognizing the various presentations of ICI-immune nephritis can help guide patient management and treatment

Breakthrough SARS-CoV-2 infections among patients with cancer following two and three doses of COVID-19 mRNA vaccines: a retrospective observational study from the COVID-19 and Cancer Consortium

BACKGROUND: Breakthrough SARS-CoV-2 infections following vaccination against COVID-19 are of international concern. Patients with cancer have been observed to have worse outcomes associated with COVID-19 during the pandemic. We sought to evaluate the clinical characteristics and outcomes of patients with cancer who developed breakthrough SARS-CoV-2 infections after 2 or 3 doses of mRNA vaccines. METHODS: We evaluated the clinical characteristics of patients with cancer who developed breakthrough infections using data from the multi-institutional COVID-19 and Cancer Consortium (CCC19; NCT04354701). Analysis was restricted to patients with laboratory-confirmed SARS-CoV-2 diagnosed in 2021 or 2022, to allow for a contemporary unvaccinated control population; potential differences were evaluated using a multivariable logistic regression model after inverse probability of treatment weighting to adjust for potential baseline confounding variables. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) are reported. The primary endpoint was 30-day mortality, with key secondary endpoints of hospitalization and ICU and/or mechanical ventilation (ICU/MV). FINDINGS: The analysis included 2486 patients, of which 564 and 385 had received 2 or 3 doses of an mRNA vaccine prior to infection, respectively. Hematologic malignancies and recent receipt of systemic anti-neoplastic therapy were more frequent among vaccinated patients. Vaccination was associated with improved outcomes: in the primary analysis, 2 doses (aOR: 0.62, 95% CI: 0.44-0.88) and 3 doses (aOR: 0.20, 95% CI: 0.11-0.36) were associated with decreased 30-day mortality. There were similar findings for the key secondary endpoints of ICU/MV (aOR: 0.60, 95% CI: 0.45-0.82 and 0.37, 95% CI: 0.24-0.58) and hospitalization (aOR: 0.60, 95% CI: 0.48-0.75 and 0.35, 95% CI: 0.26-0.46) for 2 and 3 doses, respectively. Importantly, Black patients had higher rates of hospitalization (aOR: 1.47, 95% CI: 1.12-1.92), and Hispanic patients presented with higher rates of ICU/MV (aOR: 1.61, 95% CI: 1.06-2.44). INTERPRETATION: Vaccination against COVID-19, especially with additional doses, is a fundamental strategy in the prevention of adverse outcomes including death, among patients with cancer. FUNDING: This study was partly supported by grants from the National Cancer Institute grant number P30 CA068485 to C-YH, YS, SM, JLW; T32-CA236621 and P30-CA046592 to C.R.F; CTSA 2UL1TR001425-05A1 to TMW-D; ACS/FHI Real-World Data Impact Award, P50 MD017341-01, R21 CA242044-01A1, Susan G. Komen Leadership Grant Hunt to MKA. REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS/NIH)