Morphine Analgesia Pre-PPCI Is Associated with Prothrombotic State, Reduced Spontaneous Reperfusion and Greater Infarct Size

Schattauer GmbH Stuttgart.The emergency management of ST-elevation myocardial infarction (STEMI) involves treatment with dual-antiplatelet therapy (DAPT) and primary percutaneous coronary intervention (PPCI). Pain is generally treated with opiates, which may delay gastric transit and reduce DAPT absorption. We sought to assess the effect of morphine on reperfusion, infarct size and thrombotic status in 300 patients presenting for PPCI. Morphine was given in a non-randomized fashion as required by emergency teams en route to the heart attack centre. All patients received DAPT and PPCI according to standard care, with optional glycoprotein IIb/IIIa inhibitor (GPI) use. Patients were assessed for ST-segment resolution, coronary flow, thrombotic status and peak troponin. Patients receiving morphine (n = 218; 72.7%) experienced less spontaneous ST-segment resolution pre-PPCI, lower rate of TIMI 2/3 flow in the infarct-related artery pre-PPCI and higher peak troponin level post-PPCI (median [interquartile range]; 1,906 [1,002-4,398] vs. 1,268 [249-2,920] ng/L; p = 0.016) than those who did not. Patients receiving morphine exhibited significantly enhanced platelet reactivity and impaired endogenous fibrinolysis on arrival, compared with no-morphine patients. Morphine administration was an independent predictor of failure of spontaneous ST-segment resolution after adjustment for other variables (odds ratio: 0.26; confidence interval: 0.08-0.84; p = 0.025). Among patients receiving GPI, there was no difference in pre-PPCI flow or peak troponin according to morphine use, suggesting that the adverse effects of morphine relate to delayed DAPT absorption, which may be overcome by GPI. Our hypothesis-generating data suggest that morphine use in STEMI is associated with enhanced platelet reactivity, reduced spontaneous myocardial reperfusion (pre-PPCI) and larger infarct size, and these adverse effects may be influenced by GPI use. CLINICAL TRIAL REGISTRATION:  URL: http://www.clinicaltrials.gov. Unique identifier: NCT02562690.Peer reviewedFinal Accepted Versio

Biodegradation of lignocellulosic residues of water hyacinth (Eichhornia crassipes) and response surface methodological approach to optimize bioethanol production using fermenting yeast Pachysolen tannophilus NRRL Y-2460

The objective of this research was to investigate biodegradation of water hyacinth (Eichhornia crassipes) to produce bioethanol using dilute-acid pretreatment (1 % sulfuric acid) results in high hemicellulose decomposition and using yeast (Pachysolen tannophilus) as bioethanol producing strain. A maximum ethanol yield of 1.14 g/L with coefficient, 0.24 g g-1; productivity, 0.015 g l-1h-1 was comparable to predicted value 32.05 g/L obtained by Central Composite Design (CCD). Maximum ethanol yield coefficient was comparable to those obtained through enzymatic saccharification and fermentation of acid hydrolysate using fully equipped fermentor. Although maximum ethanol concentration was low in lab scale, the improvement of lignocellulosic ethanol yield is necessary for large scale production

Magnetic properties of Hydrogenated Li and Co doped ZnO nanoparticles

The effect of hydrogenation on magnetic properties of Zn0.85Co0.05Li0.10O nanoparticles is presented. It was found that the sample hydrided at room temperature (RT) showed weak ferromagnetism (FM) while that hydrided at 400oC showed robust ferromagnetism at room temperature. In both cases reheating the sample at 400oC in air converts it back into paramagnetic state (P) completely. The characterization of samples by X-ray and electron diffraction (ED) showed that room temperature ferromagnetism observed in the samples hydrogenated at RT is intrinsic in nature whereas that observed in the samples hydrogenated at 400oC is partly due to the cobalt metal clusters.Comment: 10 pages, 3 figure

Rationale and design of "Can Very Low Dose Rivaroxaban (VLDR) in addition to dual antiplatelet therapy improve thrombotic status in acute coronary syndrome (VaLiDate-R)" study : A randomised trial modulating endogenous fibrinolysis in patients with acute coronary syndrome

© The Author(s) 2019. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.Impaired endogenous fibrinolysis is novel biomarker that can identify patients with ACS at increased cardiovascular risk. The addition of Very Low Dose Rivaroxaban (VLDR) to dual antiplatelet therapy has been shown to reduce cardiovascular events but at a cost of increased bleeding and is therefore not suitable for all-comers. Targeted additional pharmacotherapy with VLDR to improve endogenous fibrinolysis may improve outcomes in high-risk patients, whilst avoiding unnecessary bleeding in low-risk individuals. The VaLiDate-R study (ClinicalTrials.gov Identifier: NCT03775746, EudraCT: 2018-003299-11) is an investigator-initiated, randomised, open-label, single centre trial comparing the effect of 3 antithrombotic regimens on endogenous fibrinolysis in 150 patients with ACS. Subjects whose screening blood test shows impaired fibrinolytic status (lysis time > 2000s), will be randomised to one of 3 treatment arms in a 1:1:1 ratio: clopidogrel 75 mg daily (Group 1); clopidogrel 75 mg daily plus rivaroxaban 2.5 mg twice daily (Group 2); ticagrelor 90 mg twice daily (Group 3), in addition to aspirin 75 mg daily. Rivaroxaban will be given for 30 days. Fibrinolytic status will be assessed during admission and at 2, 4 and 8 weeks. The primary outcome measure is the change in fibrinolysis time from admission to 4 weeks follow-up, using the Global Thrombosis Test. If VLDR can improve endogenous fibrinolysis in ACS, future large-scale studies would be required to assess whether targeted use of VLDR in patients with ACS and impaired fibrinolysis can translate into improved clinical outcomes, with reduction in major adverse cardiovascular events in this high-risk cohort.Peer reviewedFinal Published versio

Assessment of variability and association for seed yield and yield attributing traits among the interspecific derivatives of greengram x blackgram cross

The present investigation was carried out with 24 progenies in F4 generation of interspecific cross derivatives of Vigna radiata cv. VBN(Gg)2 x Vigna mungo cv. Mash 114 to study the variability and association among the yield and the yield component traits. A set of 24 F4 progenies from the interspecific cross between greengram (VBN(Gg)2) and blackgram (Mash 114) formed the basic genetic material for the present investigation. Variability studies recorded high Phenotypic Coefficient of Variation (PCV) and Genotypic Coefficient of Variation (GCV) for the traits viz., number of branches/ plant, number of clusters/ plant, number of pods/ plant and seed yield /plant. High heritability (h2) along with high genetic advance as per cent of mean (GAM) were recorded for the traits, plant height, number of clusters/ plant, number of pods/ plant and seed yield/ plant. Association studies revealed that the trait number of pods/ plant alone recorded high direct positive effect on seed yield/ plant. The results indicated that high magnitude of variability was present among the interspecific progenies for these traits. The high heritability and genetic advance might be due to presence of additive gene action. Hence selection based on these traits might be effective for genetic improvement among the interspecific progenies of Vigna radiata x Vigna mungo. The study indicates that the trait, number of pods / plant should be given due importance in selection programme for seed yield improvement in the interspecific progenies of greengram and blackgram

Callus induction and regeneration of elite Indian maize inbreds

Five elite Indian maize inbreds namely; HKI1105, HKI1105, HKI335, CM300 and LM5 were evaluated for callus induction and regeneration. Immature embryos obtained 14 days after pollination were used as explants. Genotype, medium, type of auxin and their concentrations influenced callus induction. N6 medium supplemented with different concentration of 2,4-D (1, 2 and 3 mg/l) and Dicamba (1, 2 and 3 mg/l) were used for callus induction. N6 supplemented with 2 mg/l of 2,4-D has shown highest percentage of embryogenic callus induction. Among the five genotypes tested, CM300 gave highest percentage of embryogenic calli. CM300 and LM5 both have shown higher regeneration percentage of 12.22%.Key words: Maize, in-vitro culture and regeneration

Use of bioresorbable vascular scaffold : a meta-analysis of patients with coronary artery disease

BACKGROUND: Differences in outcomes between bioresorbable vascular scaffold (BVS) systems and drug-eluting metal stents (DES) have not been fully evaluated. We aimed to compare clinical and angiographic outcomes in randomised studies of patients with coronary artery disease (CAD), with a secondary analysis performed among registry studies. METHODS: A meta-analysis comparing outcomes between BVS and DES in patients with CAD. Overall estimates of treatment effect were calculated with random-effects model and fixed-effects model. RESULTS: In 6 randomised trials (3818 patients), BVS increased the risk of subacute stent thrombosis (ST) over and above DES (OR 2.14; CI 1.01 to 4.53; p=0.05), with a trend towards an increase in the risk of myocardial infarction (MI) (125 events in those assigned to BVS and 50 to DES; OR 1.36; CI 0.97 to 1.91; p=0.07). The risk of in-device late lumen loss (LLL) was higher with BVS than DES (mean difference 0.08 mm; CI 0.03 to 0.13; p=0.004). There was no difference in the risk of death or target vessel revascularisation (TVR) between the two devices. In 6 registry studies (1845 patients), there was no difference in the risk of death, MI, TVR or subacute ST between the two stents. Final BVS dilation pressures were higher in registry than in randomised studies (18.7±4.6 vs 15.2±3.3 atm; p<0.001). CONCLUSIONS: Patients treated with BVS had an increased risk of subacute ST and slightly higher LLL compared with those with DES, but this might be related to inadequate implantation techniques, in particular device underexpansion.Peer reviewedFinal Published versio

Graphene-Enabled Electrodes for Electrocardiogram Monitoring

The unique parameters of Graphene (GN), notably its considerable electron mobility, high surface area and electrical conductivity are bringing extensive attention into the wearable technologies. This work presents a novel Graphene-based electrode for acquisition of electrocardiogram (ECG). The proposed electrode was fabricated by coating GN on top of metallic layer of Ag/AgCl electrode using chemical vapor deposition (CVD) technique. To investigate the performance of the fabricated GN-based electrode, two types of electrodes were fabricated with different sizes to conduct the signal qualities and the skin-electrode contact impedance measurements. Performances of the GN-enabled electrodes were compared to the conventional Ag/AgCl electrodes in terms of ECG signal quality, skin-electrode contact impedance, signal-to-noise ratio (SNR) and response time. Experimental results showed the proposed GN-based electrodes produced better ECG signals, higher SNR (improved by 8%) and lower contact impedance (improved by 78%) values than conventional ECG electrodes