Electrocardiogram Analysis Reveals Ionic Current Dysregulation Relevant for Atrial Fibrillation

Antiarrhythmic drug choice for atrial fibrillation (AF) neglects the individual ionic current profile of the patient, even though it determines drug safety and efficacy. We hypothesize that the electrocardiogram (ECG) might contain information critical for pharmacological treatment personalization. Thus, this study aims to identify the extent of atrial ionic information embedded in the ECG, using multi-scale modeling and simulation. A dataset of 1,000 simulated ECGs was computed using a population of human-based whole-atria models with 200 individual ionic profiles and 5 different torso-atria orientations. A regression neural network was built to predict key atrial ionic conductances based on P- and T$_a$ -wave biomarkers. The neural network predicted, with >80% precision, the density of seven ionic currents relevant for AF, namely, ultra-rapid (I$_{Kur}$ ), rapid (I$_{Kr}$ ), outward transient (I$_{to}$ ), inward rectifier K$^+$ (I$_{K1}$ ), L-type Ca$^{2+}$ (I$_{CaL}$ ), Na$^+$ /K$^+$ pump (I$_{NaK}$ ) and fast Na$^+$ (I$_{Na}$) currents. These ionic densities were identified through the P- (i.e., I$_{Na}$), Ta - (i.e., I$_{K1}$ , I$_{NaK}$) or both waves (i.e., I$_{Kur}$ , I$_{Kr}$ , I$_{to}$ , I$_{CaL}$), providing a non- invasive characterization of the atrial electrophysiology. This could improve patient stratification and cardiac safety and the efficacy of AF pharmacological treatment

Prognosis of patients with hepatocellular carcinoma. Validation and ranking of established staging-systems in a large western HCC-cohort.

HCC is diagnosed in approximately half a million people per year, worldwide. Staging is a more complex issue than in most other cancer entities and, mainly due to unique geographic characteristics of the disease, no universally accepted staging system exists to date. Focusing on survival rates we analyzed demographic, etiological, clinical, laboratory and tumor characteristics of HCC-patients in our institution and applied the common staging systems. Furthermore we aimed at identifying the most suitable of the current staging systems for predicting survival. Overall, 405 patients with HCC were identified from an electronic medical record database. The following seven staging systems were applied and ranked according to their ability to predict survival by using the Akaike information criterion (AIC) and the concordance-index (c-index): BCLC, CLIP, GETCH, JIS, Okuda, TNM and Child-Pugh. Separately, every single variable of each staging system was tested for prognostic meaning in uni- and multivariate analysis. Alcoholic cirrhosis (44.4%) was the leading etiological factor followed by viral hepatitis C (18.8%). Median survival was 18.1 months (95%-CI: 15.2-22.2). Ascites, bilirubin, alkaline phosphatase, AFP, number of tumor nodes and the BCLC tumor extension remained independent prognostic factors in multivariate analysis. Overall, all of the tested staging systems showed a reasonable discriminatory ability. CLIP (closely followed by JIS) was the top-ranked score in terms of prognostic capability with the best values of the AIC and c-index (AIC 2286, c-index 0.71), surpassing other established staging systems like BCLC (AIC 2343, c-index 0.66). The unidimensional scores TNM (AIC 2342, c-index 0.64) and Child-Pugh (AIC 2369, c-index 0.63) performed in an inferior fashion. Compared with six other staging systems, the CLIP-score was identified as the most suitable staging system for predicting prognosis in a large German cohort of predominantly non-surgical HCC-patients

Social integration of immigrant adolescents and young adults in Swiss sports clubs

There are a high proportion of young immigrants in Switzerland as a consequence of past and present migratory movements in Europe. Switzerland is subsequently faced with the task of integrating immigrants into society. Sports clubs foster social integration in a more effective way than other voluntary organizations, and are considered important institutions in this context (Østerlund & Seippel, 2013). However, young immigrants are under represented in sports clubs in comparison with their Swiss counterparts (Lamprecht et al., 2014). The question then arises: What is the extent of social integration by young immigrants participating in sports clubs and what are the club structures that effectively work towards integration? Our study focuses on relevant aspects of social integration in sports clubs at an individual and organizational level. Based on a multi-level research design that includes Esser’s (2004) concepts of social action and integration, data was collected via written questionnaire in 20 sports clubs. 346 members (♀ 27 %; aged 16-30, M = 20.3, SD = 3.9) and chair (wo)men were surveyed. Findings reveal a similar quality of integration among immigrant and non-immigrant members in terms of identity, participation in general meetings and existing knowledge within the club; but members differ in their depth of friendships. The clubs - with a high respectively low immigrant member share - have similar assimilative or pluralistic attitudes (aside from the expectation of speaking German) and goals such as support of integration, openness for all. Esser, H. (2004). Does the “New” Immigration Require a “New” Theory of Intergenerational Integration? International Migration Report (38) 3, 1126-1159. Lamprecht, M., Fischer, A., & Stamm, H.P. (2014). Sport Schweiz 2014. Magglingen: BASPO. Østerlund, K. & Seippel, Ø. (2013). Does membership in civil society organizations foster social integration? The case of Danish voluntary sport organizations. Journal of Civil Society (9) 4, 391-413

Bovine macrophages responses to the infection with virulent and attenuated Leptospira interrogans serovar Pomona

Leptospirosis is a zoonosis, caused by pathogenic spirochetes of the genus Leptospira. Although cattle are usually the maintenance hosts of serovar Hardjo, Pomona is the most frequent serovar circulating in Argentina. The understanding of bovine innate immune response and the virulence of this serovar is important for future control measures. This work compares infection of bovine macrophages with the virulent L. interrogans sv Pomona strain AKRFB (P1) and its attenuated counterpart (P19). First, we confirmed attenuation in the hamster model. Mortality and lung hemorrhages occurred after P1 inoculation, while the survival rate was 100% in P19-infected animals. Cells infected with both strains showed statistically upregulated gene expression of pro-inflammatory cytokines, IL-1β, IL-6 and TNFα. The level of expression of anti-inflammatory cytokine IL-10 was statistically different between strains. Increased expression of IL-10 was observed only in P1-infected cells. For the first time, we describe macrophages extracellular traps induced by infection of bovine macrophages (bMETs) with both, the virulent and attenuated Leptospira interrogans Pomona strains. P1 was found higher internalized when the phagocytosis was inhibited, suggesting a cell entrance of this strain also by an independent-phagocytosis pathway. Furthermore, P1 was higher colocalized with acidic and late endosomal compartments compared with P19. This data emphasizes the importance to deepen in Leptospira bovine macrophages particular invasion mechanisms and, furthermore, underline the value of studying the main hosts.Fil: Nagel, Ariel Gastón. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Agrobiotecnología y Biología Molecular. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Agrobiotecnología y Biología Molecular; ArgentinaFil: Vázquez, Cristina Lourdes. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Agrobiotecnología y Biología Molecular. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Agrobiotecnología y Biología Molecular; ArgentinaFil: Etulain, Julia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Blanco, Federico Carlos. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Agrobiotecnología y Biología Molecular. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Agrobiotecnología y Biología Molecular; ArgentinaFil: Gravisaco, Maria José. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Agrobiotecnología y Biología Molecular. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Agrobiotecnología y Biología Molecular; ArgentinaFil: Gómez, Ricardo Martín. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Biotecnología y Biología Molecular. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Biotecnología y Biología Molecular; ArgentinaFil: Caimi, Karina Cynthia. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Agrobiotecnología y Biología Molecular. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Agrobiotecnología y Biología Molecular; Argentin

A comprehensive microarray-based DNA methylation study of 367 hematological neoplasms

Background: Alterations in the DNA methylation pattern are a hallmark of leukemias and lymphomas. However, most epigenetic studies in hematologic neoplasms (HNs) have focused either on the analysis of few candidate genes or many genes and few HN entities, and comprehensive studies are required. Methodology/Principal Findings: Here, we report for the first time a microarray-based DNA methylation study of 767 genes in 367 HNs diagnosed with 16 of the most representative B-cell (n = 203), T-cell (n = 30), and myeloid (n = 134) neoplasias, as well as 37 samples from different cell types of the hematopoietic system. Using appropriate controls of B-, T-, or myeloid cellular origin, we identified a total of 220 genes hypermethylated in at least one HN entity. In general, promoter hypermethylation was more frequent in lymphoid malignancies than in myeloid malignancies, being germinal center mature B-cell lymphomas as well as B and T precursor lymphoid neoplasias those entities with highest frequency of gene-associated DNA hypermethylation. We also observed a significant correlation between the number of hypermethylated and hypomethylated genes in several mature B-cell neoplasias, but not in precursor B- and T-cell leukemias. Most of the genes becoming hypermethylated contained promoters with high CpG content, and a significant fraction of them are targets of the polycomb repressor complex. Interestingly, T-cell prolymphocytic leukemias show low levels of DNA hypermethylation and a comparatively large number of hypomethylated genes, many of them showing an increased gene expression. Conclusions/Significance: We have characterized the DNA methylation profile of a wide range of different HNs entities. As well as identifying genes showing aberrant DNA methylation in certain HN subtypes, we also detected six genes—DBC1, DIO3, FZD9, HS3ST2, MOS, and MYOD1—that were significantly hypermethylated in B-cell, T-cell, and myeloid malignancies. These might therefore play an important role in the development of different HNs

Safety and Healthcare Resource Utilization in Patients Undergoing Left Atrial Appendage Closure—A Nationwide Analysis

Percutaneous left atrial appendage closure (LAAC) has emerged as a non-pharmacological alternative for stroke prevention in patients with atrial fibrillation (AF) not suitable for anticoagulation therapy. Real-world data on peri-procedural outcomes are limited. The aim of this study was to analyze outcomes of peri-procedural safety and healthcare resource utilization in 11,240 adult patients undergoing LAAC in the United States between 2016 and 2019. Primary outcomes (safety) were in-hospital ischemic stroke or systemic embolism (SE), pericardial effusion (PE), major bleeding, device embolization and mortality. Secondary outcomes (resource utilization) were adverse discharge disposition, hospital length of stay (LOS) and costs. Logistic and Poisson regression models were used to analyze outcomes by adjusting for 10 confounders. SE decreased by 97% between 2016 and 2019 [95% Confidence Interval (CI) 0-0.24] (p = 0.003), while a trend to lower numbers of other peri-procedural complications was determined. In-hospital mortality (0.14%) remained stable. Hospital LOS decreased by 17% (0.78-0.87, p < 0.001) and adverse discharge rate by 41% (95% CI 0.41-0.86, p = 0.005) between 2016 and 2019, while hospital costs did not significantly change (p = 0.2). Female patients had a higher risk of PE (OR 2.86 [95% CI 2.41-6.39]) and SE (OR 5.0 [95% CI 1.28-43.6]) while multi-morbid patients had higher risks of major bleeding (p < 0.001) and mortality (p = 0.031), longer hospital LOS (p < 0.001) and increased treatment costs (p = 0.073). Significant differences in all outcomes were observed between male and female patients across US regions. In conclusion, LAAC has become a safer and more efficient procedure. Significant sex differences existed across US regions. Careful considerations should be taken when performing LAAC in female and comorbid patients

Comparison between USEPA and IPCC methodologies for theoretical estimation of biogas production in landfill

Resumo: O aproveitamento energético do biogás de aterros sanitários é uma alternativa sustentável para a disposição final de gases residuais. A estimativa teórica da produção desse biogás torna-se uma ferramenta muito útil para a avaliação de viabilidade e dimensionamento de sistemas de coleta de gás. Os modelos de geração de biogás de aterro mais utilizados atualmente são os baseados em equações de decaimento de primeira ordem. Os modelos LandGEM e IPCC foram utilizados neste trabalho para a estimativa da geração de gases no aterro municipal de Guarapuava (PR, Brasil), onde os principais parâmetros foram escolhidos com base nos dados frequentemente aplicados para cada modelo: valores default sugeridos para as condições locais específicas, para a aplicação do software LandGEM; e cálculo do potencial de geração de metano (L0) a partir da análise gravimétrica dos resíduos, para a aplicação da equação sugerida pelo IPCC. Estimou-se uma produção total de biogás de 44.466.711 Nm3.ano-1 aplicando LandGEM e 60.080.906 Nm3.ano-1 aplicando IPCC, onde os picos de produção foram observados nos anos de 2021 e 2020, respectivamente. A escolha do modelo mais adequado dependerá dos dados disponíveis e, para maior aproximação de resultados reais, os parâmetros adotados devem ser analisados com cautela, considerando as diferentes condições climáticas e operacionais de cada caso.Abstract: The energetic use of landfill biogas is a sustainable alternative for the final disposal of waste gases. The theoretical estimation of the production of this biogas becomes a very useful tool for evaluating the feasibility and design of gas collection systems sizing. The most widely used landfill biogas generation models are those based on first-order-decay equations. LandGEM and IPCC models were used in this work to estimate the generation of gases in the municipal landfill of Guarapuava (PR), and the main parameters were chosen based on the frequently applied data for each model: default values suggested for the specific local conditions,for the application of LandGEM software; and calculating the methane generation potential (L0) from the gravimetric analysis of the residues, for the application of the equation suggested by the IPCC. A total biogas production of 44,466,711 Nm³.ano-1 was estimated by applying LandGEM and 60,080,906 Nm³.ano-1 using IPCC, whose production peaks were observed in the years 2021 and 2020, respectively. The choice of the most appropriate model will depend on the available data and, for better approximation to real results, the parameters adopted should be analyzed with caution, considering the difference in climatic and operational conditions of each case