Myocardial contractile reserve as a predictor of response to cardiac = resyinchronization therapy

Uvod: Broj bolesnika sa srčanom slabošću i širokim QRS-kompleksom, kod kojih izostaje efekat srčane resinhronizacione terapije (CRT) je i dalje visok, uprkos skorašnjem napretu u selekciji bolensika za ovaj vid lečenja. U ovom doktoratu ispitujemo prediktivnu vrednost kontraktile rezerve miokarda, određene pomoću dobutaminske stres-ehokardiografije (DSE), na efekat srčane resinhronizacione terapije u bolesnka sa srčanom slabošću i širokim QRS kompleksom. Metodologija: U studiju se uključuju bolesnici sa neishemijskom kadiomiopatijom, i konvencionalnom indikacijom za ugradnju CRT-pejsmejkera. DSE se izvodi kod svih bolesnika pre implantacije pejsmejkera, sa maksimalnom dozom dobutamina od 20mcg/kg/min. Ispituje se uticaj indeksa kontraktilne rezerve miokarda – promena ejekcione frakcije leve komore (ΔEF) i promene u indeksu pokretljivosti zidova leve komore (ΔWMSI), kao i različitih drugih demografskih, klinickih, elektrokardiografskih i ehokardiografskih parametara, uključujući i parametre asinhronije, na efekat CRT. Pozitivan ukupni klinički odgovor na CRT je definisan kao poboljsanje NYHA klase za 1 klasu, 10% poboljšanje 6-minutnog testa hodanja, 10% poboljšanje vrednosti Kanzas skora, odsustvo hospitalizacija zbog pogoršanja srčane slabosti tokom jednogodišnjeg praćenja nakon imlantacije CRT pejsmejekra, i pojava reverznog remodelovanja leve komore , definisano kao redukcija endsistolnog dijametra leve komore za 15% i povećanje ejekcione frakcije leve komore za 10%-ih poena. Super-responderima se smatraju bolesnici u kojih je došlo do popravljanja ejekcione frakcije na preko 50%. Rezultati: Multivarijantna analiza je pokazala da su ΔEF (OR 2,013 95% CI 1,168- 3,469 p<0,05), EF pre implantatcije CRT pejsmejkera (OR 1,206, 95%CI 1,011- 1,439, p<0,05) i promena širine QRS komleksa pre i nakon CRT-pejsinga (ΔQRS ) (OR 1,079, 95%CI 1,012-1,159 p<0,05) nezavisni prediktori ukupnog kliničkog odgovora na CRT...Introduction: Despite the recent advances in selection of patients for cardiac resynchronization therapy (CRT) the rate of nonresponders to it remains high. In this study we evaluate the predictive role of myocardial contractile reserve assesed by dobutamine stress echocardiography (DSE) in candidates for CRT. Methods: In this study we included 55 patients with non-ischaemic cardiomyopathy and conventional indication for CRT. Low dose DSE was performed with the maximum dose of 20mcg/kg/min. Indices of CR such as change in LVEF (ΔEF) and change in wall motion score index (ΔWMSI), as well as various other clinical, electrocardiographic and echocardiographic data, including parameters of asynchrony were assesed. Positive total clinical response to CRT was defined as improvement in NYHA class for 1 point, 10% improvement in 6 minute walking test, absence of hospitalization for worsening of heart failure 1 year after CRT implantation, and presence of reverse remodeling of left ventricle defined as reduction of LVESD for 15% and imporvement of LVEF for 10%. Super-response to CRT was defined as improvement of LVEF to >50%. Results: Multivariate analysis showed ΔEF (OR 2,013 95% CI 1,168-3,469 p<0,05), baseline EF (OR 1,206, 95%CI 1,011-1,439, p<0,05) and a change in QRS complex duration before and after pacemaker implantation (ΔQRS) (OR 1,079, 95%CI 1,012- 1,159 p<0,05) to be independent predictors of positive total clinical CRT repsonse. Similarly, baseline LVEF (OR 1,452, 95% CI:1,027-1,053; p<0,05), ΔQRS (OR 1,153, 95%CI:1009-1,317; p<0,05), and ΔEF (OR 2,525, 95% CI 0,996-6,405; p=0,51) were predictors of reverse remodeling. ΔEF (OR=1,441, 95%CI:0,366-5,682; p=0.047) and baseline QRS complex duration (OR=1,007, 95%CI:0,694-1,463; p=0.047) were independent predictors of super-response to CRT. Patients with ΔEF>8.5% and ΔWMSI>0,27 have better survival free of rehospitalization for heart failure (Log rank =13,423 p<0,001, and 9,952 p=0.003, respectively) ..

Osetljivost na niske temperature Plodia interpunctella, Sitophilus oryzae i Sitophilus zeamais - dominantnih štetočina uskladištenog kukuruza u Srbiji

Insect's bionomics and development are highly dependent on the environmental temperature. For centuries, this fact has been used for the control of storage pests. However, the temperature threshold depends on the species, life stage, acclimation and exposure period. This work assessed the effects of low temperatures (4,-4,-10,-15 and-18°C) and exposure period (10, 30, 60, 120 and 180 min) on the survival and development of Plodia interpunctella larvae, and adults of Sitophilus oryzae and S. zeamais, the prevalent maize pests in Serbia. Data were analysed using one-way and two-way ANOVA. Additionally, Probyt analysis was performed to determine the LT 50 and LT 99. The first significant effects were recorded at-4°C for S. oryzae when the mortality was 41% after 120 and 52% after 180 min of exposure. At-10°C, the mortality of S. zeamais was significant after 180 min (52.5%) and increased with the exposure period. The significant mortality of P. interpunctella larvae was at-15°C after 10 min (55.5%). At-18°C, P. interpunctella larvae were the most susceptible and 98% of mortality was recorded after 10 min, while 77.5% of S. oryzae and 68% of S. zeamais was recorded after 10 min. Two-way ANOVA showed that both factors (temperature and exposure) significantly affected the mortality of tested species, but the first factor was the most influential. These results indicate that temperature and exposure period should be adjusted to specific pest, while in combined infestations the temperature should be adjusted to the most tolerant one.Razviće insekata je visoko uslovljeno temperaturom životne sredine. Vekovima je ova činjenica korišćena u kontroli brojnosti skladišnih štetočina. Međutim, temperaturni pragovi zavise od vrste, životnog stadijuma, aklimatizacije i trajanja ekspozicije. U ovom radu ispitivani su uticaji niskih temperatura (4, -4, -10, -15 i -18°C) i trajanja ekspozicionog perioda (10, 30, 60, 120 i 180 min) na nivo preživljavanja i razviće larvi Plodia interpunctella i imaga Sitophilus oryzae i S. zeamais, dominantnih štetočina uskladištenog kukuruza u Srbiji. Dobijeni podaci su analizirani korišćenjem one-way i two-way ANOVA. Dodatno, urađena je i Probyt analysis radi utvrđivanja LT50 i LT99. Prvi značajni efekti niskih temperature registrovani su na -4°C za imaga S. oryzae sa registrovanim uginućem od 41% posle 120 i 52% posle 180 min ekspozicije. Na -10°C uginuće imaga S. zeamais bilo je značajno posle ekpozicije od 180 min (52,5%) i raslo je sa trajanjem ekspozicionog perioda. Značajna smrtnost larvi P. interpunctella registrovana je na -15°C posle 10 min (55,5%). Na -18°C larve P. interpunctella bile su osetljivije i 98% smrtnost registrovana je posle 10 min, a u istim uslovima 77,5% kod imaga S. oryzae i 68% kod S. zeamais. Two-way ANOVA ukazuje da oba faktora (temperatura i ekspozicija) značajno utiču na smrtnost testiranih štetočina, ali je temperatura uticajniji faktor. Dobijeni rezultati pokazuju da temperatura i ekspozicija predstavljaju manipulativne faktore koje treba prilagoditi vrsti, dok u kombinovanim infestacijama treba ih prilagoditi najtolerantnijoj štetočini

Host and ovipositional preference of rice weevil (sitophilus oryzae) depending on feeding experience

Rice weevil, Sitophilus oryzae is one of the most devastating primary pests of stored grains. Adults feed mainly on endosperm, while larvae feed on germ, resulting in reduced germination and nutritional value of kernels. The influence of a commodity condition on the food preferences of S. oryzae has been well documented, but the influence of previous feeding experience ("natal habitat preference induction" - NHPI theory) has not yet been confirmed. This research aims to test the NHPI theory, to study the behavioural responses of S. oryzae virgin males and females to different grains (maize, wheat and barley) depending on rearing substrate and feeding history and to test host, feeding and oviposition preference. In a "Choice test", the host preference was determined based on the adult distribution on specific grains, feeding preferences based on grain damage (%) and grain loss (%), and ovipositional preference based on the progeny production. The results indicate that host, feeding and ovipositional preference of S. oryzae was not dependent on the previous feeding experience. Maize was the most preferential grain, regardless on the rearing substrate, for both male and female weevils. Grain damage, weight loss and progeny production were higher on maize, regardless on the rearing history

Efficacy of Echium spp. water extracts as post-harvest grain protectants against Plodia interpunctella

Water extracts of three plant species of the genus Echium (E. italicum L., E. vulgare L. and E. rubrum Jacq.) were tested under laboratory conditions for their activity as potential post-harvest grain protectants against Plodia interpunctella (Hubner, 1813) (Lepidoptera: Pyralidae) larvae. Antioxidative activity and total phenolic, flavonoid and tannin contents in plant extracts were determined. The larvicidal assays were conducted with the local population of P. interpunctella from Central Serbia on kernels of Takovoanka winter wheat cultivar. The experiment was set as factorial 3x3x3x3 block design type. Three groups of larvae of different maturity were used. The larvae were exposed to three different concentrations of water extracts (1%, 2% and 5%) of three listed plant species. Mortality was registered daily during 96 hours and the efficacy was calculated using Schneider-Orelli's formula. The largest number of dead larvae was recorded in the treatment of 1% extract of E. italicum on youngest group, after 72 and 96 h. Extracts of E. vulgare and E. rubrum did not show high larvicidal effect

Biološka aktivnost nekih korovskih vrsta prema skladišnim štetočinama – pregled istraživanja

Ograničenje i zabrana primene pojedinih insekticida za tretiranje semena inicirala su intenzivnija istraživanja u oblasti ne-hemijskih načina suzbijanja štetočina semena. Posebno su u ekspanziji biološki preparati, kao bioracionalna zamena hemijski sintetisanim insekticidma. Poznato je da su biljke bogat izvor biološki aktivnih supstanci i da neke vrste poseduju insekticidno delovanje. Međutim, komercijalno je dostupan mali broj botaničkih preparata na biljnoj bazi, što ukazuje na potrebu za ispitivanjem novih biljnih vrsta kao potencijalnih insekticida i/ili repelenata. Posebno su interesante korovske vrste, zbog prirodne tolerantnosti na herbivorne insekte, ali i potencijalnog iskorišćavanja korovske biljne mase. Ne sme se zaboraviti da pojedine korovske vrste poseduju alergena svojstva, te je u tom slučaju potrebno uskladiti protokol istraživanja (odabrati deo biljke koji nije alergen) i razmotriti praktičnu primenu. Rad sumira dosadašnje rezultate autora koji se odnose na biološku aktivnost korovskih vrsta prema polifagnim štetočinama semena. Od nadzemne mase repušnjače (Erigeron canadensis L.), divlje mrkve (Daucus carota L.), pepeljuge obične (Chenopodium album L.), štira običnog (Amaranthus retroflexus L.), ambrozije pelenaste (Ambrosia artemisiifolia L.) i listova halačije (Halascya sendtneri (Boiss.) Dörfl.), pripremljeni su etanolni ekstrakti (0,5, 1 i 2%). Biološka aktivnost je ispitana prema pirinčanom žišku (Sitophilus oryzae) i žitnom kukuljičaru (Rhyzopertha dominica) i to u testovima fumigantnog, kontaktnog (površinski nanos na staklo), kontaktno-digestivnog (nanošenje na zrno pšenice), antifeeding tj. ometanje ishrane (u “No-choice“ testu, izraženo preko AFI vrednosti [ AFI ≥ 20 - slaba antifiding aktivnost; 70 > AFI ≥ 50 - srednja antifeeding aktivnost; ≥ 70 - jaka antifiding aktivnost]) i repelentnog delovanja (u Y-tube olfaktometru iskazano preko Indeksa repelentnosti [IR -1,0 do -0,1 repelent; -0,1 do +0,1 neutralno; +0,1 do +1,0 atraktant]). U dosadašnjim istraživanjima, pomenuti ekstrakti nisu imali fumigantno delovanje na žitnog kukuljičara i pirinčanog žiška

Coronary Artery Occlusion Detection Using 3-Lead ECG System Suitable for Credit Card-Size Personal Device Integration

Background Early coronary occlusion detection by portable personal device with limited number of electrocardiographic (ECG) leads might shorten symptom-to-balloon time in acute coronary syndromes. Objectives The purpose of this study was to compare the accuracy of coronary occlusion detection using vectorcardgiographic analysis of a near-orthogonal 3-lead ECG configuration suitable for credit card-size personal device integration with automated and human 12 lead ECG interpretation. Methods The 12-lead ECGs with 3 additional leads (“abc”) using 2 arm and 2 left parasternal electrodes were recorded in 66 patients undergoing percutaneous coronary intervention prior to (“baseline”, n = 66), immediately before (“preinflation”, n = 66), and after 90-second balloon coronary occlusion (“inflation”, n = 120). Performance of computer-measured ST-segment shift on vectorcardgiographic loops constructed from “abc” and 12 leads, standard 12-lead ECG, and consensus human interpretation in coronary occlusion detection were compared in “comparative” and “spot” modes (with/without reference to “baseline”) using areas under ROC curves (AUC), reliability, and sensitivity/specificity analysis. Results Comparative “abc”-derived ST-segment shift was similar to two 12-lead methods (vector/traditional) in detecting balloon coronary occlusion (AUC = 0.95, 0.96, and 0.97, respectively, P = NS). Spot “abc” and 12-lead measurements (AUC = 0.72, 0.77, 0.68, respectively, P = NS) demonstrated poorer performance (P < 0.01 vs comparative measurements). Reliability analysis demonstrated comparative automated measurements in “good” agreement with reference (preinflation/inflation), while comparative human interpretation was in “moderate” range. Spot automated and human reading showed “poor” agreement. Conclusions Vectorcardiographic ST-segment analysis using baseline comparison of 3-lead ECG system suitable for credit card-size personal device integration is similar to established 12-lead ECG methods in detecting balloon coronary occlusion

Are trypsin inhibitors responsible for the suitability of different legumes for Acanthocelides obtectus development?

Legumes represent a valuable source of proteins in human and animal nutrition, as well as of different nutrients. Also, they enable diversification of agroecosystems and can be considered climate smart crops. Therefore, they are gaining importance in both developed and developing countries. The most important, and often limiting factor in legume production is the presence of the bean weevil (Acanthoscelides obtectus). This work tested the suitability of three different legume species, i. e. common bean, grass pea and faba bean (two accessions of each species) with growing interest in human nutrition, for the development and population growth of this pest, with special emphasis on the levels of anti-nutritive compounds – trypsin inhibitors. The suitability was assessed based on the progeny production after each month. The development and progeny production were significantly affected by the legume species, but also by the accessions. The highest number of emerged adults was on common bean, while the lowest regardless on observation period, was on faba bean, indicating its low suitability for weevil development. Correlation analysis detected significant influence of the level of trypsin inhibitors on progeny production.This work was done as a part of activities of the Centre of Excellence for Innovations in Breeding of Climate Resilient Crops – Climate Crops, Institute of Field and Vegetable Crops, Serbia

Implantable cardioverter-defibrillator oversensing due to electric shock

Introduction. We described the first case of oversensing due to electric shock in Serbia, in a 54-year-old man who had implantable cardioverter-defibrillator (ICD). Case Outline. In July 2002, the patient had acute anteroseptal myocardial infarction and ventricular fibrillation (VF) which was terminated with six defibrillation shocks of 360 J. Coronary angiography revealed 30% stenosis of circumflex artery, the left anterior descending coronary artery was recanalized and the right coronary artery was without stenosis. Left ventricular ejection fraction was 20%. In December 2003, an electrophysiology study was performed and ventricular tachycardia (VT) was induced and terminated with 200 J defibrillation shock. Single chamber ICD Medtronic Gem III VR was implanted in January 2004 and defibrillation threshold was 12 J. The patient was followed up during three years every three months and there were no VT/VF episodes and VT/VF therapies. In December 2007, the patient experienced electric shock through the fork while he was making barbecue on the electric grill. ICD recognized this event in VF zone (oversensing) and delivered defibrillation shock of 18 J. The electrogram of the episode showed ventricular sensing - intrinsic sinus rhythm with electric shock potentials which were misidentified as VF. After charge time of 3.16 seconds, ICD delivered defibrillation shock and sinus rhythm was still present. Conclusion. Oversensing of ICD has different aetiology and the most common cause is supraventricular tachyarrhythmia

Life history of Plodia interpunctella Hubner on sunflower seeds: Effects of seed qualitative traits and the initial seed damage

Sunflower seeds are regularly infested by Plodia interpunctella during storage. Although this pest prefers damaged seeds, in practice it can infest undamaged seeds as well. This research assessed the influence of the sunflower seed type (oil, protein for human consumption and bird-feed) and the initial seed damage during post-harvest processing (dehulled kernels, 10, 20, 30% of damaged seeds and undamaged seeds) on development of P. interpunctella (larval mortality, larval development, mean developmental duration, adult emergence and fecundity). Biochemical analysis of seeds, kernels and hulls detected the highest content of phenols in the seed and hull and tocopherols in the kernel of the oil type hybrid. The anti oxidative activity was the highest in the seed, kernel and hull of the protein type for bird feed. The shortest development (39.5 days) and the highest fecundity (91.3) were on the oil type seeds, while the longest development (42.1 days) and the lowest fecundity (68.1) were on the seeds of the protein type for bird feed. The highest mortality of larvae was on the undamaged seeds of the protein type for bird feed and human consumption (21.3% and 14.0%, respectively). The type of sunflower and the level of initial damage affected larval mortality, developmental duration and fecundity. The mean developmental duration and the number of emerged adults were dependent only on the initial seed damage. Principal component analysis detected strong positive correlation between mortality and development with the tocopherol content on the undamaged seeds while fecundity was associated with the state of kernel and the amount of tannins, proteins and oil content in the seed. The undamaged seeds of the protein type for the bird feed were the least suitable for the development of this pest, while the oil type kernels were the most suitable

Accurate Reconstruction of the 12-Lead Electrocardiogram From a 3-Lead Electrocardiogram Measured by a Mobile Device

Clinical outcomes of several acute conditions, including myocardial infarction (MI), the most common cause of death, can be improved by timely diagnostics based on electrocardiography (ECG). However, current diagnostic technologies include a large number of wired ECG electrodes, which require accurate placement by trained personnel. The ideal ECG device would be suitable for self-measurement, i.e., would have a small number of electrodes, be mobile or portable, and provide an accurate diagnosis. However, these aims have not been met using the same device. A recently developed handheld ECG device with three quasi-orthogonal leads opened the door for mobile assessment of the three-dimensional cardiac vector by self-measurement. We hypothesize that the information provided is sufficient for accurate reconstruction of the 12-lead ECG. We propose a reconstruction algorithm based on the segment-by-segment 4-matrix (4M) transformation applied to the P wave, QRS complex, ST segment, and T wave. The accuracy of the 4M method was tested using data obtained from 64 healthy volunteers. The 4M method reconstructed the standard 12-lead ECG with a 0.96 mean cross-correlation for all leads and provided meaningful clinical results. A back-to-back comparative study demonstrated the superiority of the proposed method over the traditional EASI method. In addition, the results provide evidence of the capability of the 3-lead 4M technology to accurately reconstruct the full cardiac vector from a single measurement, which distinguishes it from competition. Although further clinical investigation is necessary, wireless operation and high accuracy make the proposed method potentially suitable for remote monitoring and self-assessment