Guidelines for reporting statistics in journals published by the American Physiological Society

Hemorrhage at high altitude: impact of sustained hypobaric hypoxia on cerebral blood flow, tissue oxygenation, and tolerance to simulated hemorrhage in humans

With ascent to high altitude (HA), compensatory increases in cerebral blood flow and oxygen delivery must occur to preserve cerebral metabolism and consciousness. We hypothesized that this compensation in cerebral blood flow and oxygen delivery preserves tolerance to simulated hemorrhage (via lower body negative pressure, LBNP), such that tolerance is similar during sustained exposure to HA vs. low altitude (LA). Healthy humans (4F/4 M) participated in LBNP protocols to presyncope at LA (1130 m) and 5-7 days following ascent to HA (3800 m). Internal carotid artery (ICA) blood flow, cerebral delivery of oxygen (CDO2) through the ICA, and cerebral tissue oxygen saturation (ScO2) were determined. LBNP tolerance was similar between conditions (LA: 1276 ± 304 s vs. HA: 1208 ± 306 s; P = 0.58). Overall, ICA blood flow and CDO2 were elevated at HA vs. LA (P ≤ 0.01) and decreased with LBNP under both conditions (P < 0.0001), but there was no effect of altitude on ScO2 responses (P = 0.59). Thus, sustained exposure to hypobaric hypoxia did not negatively impact tolerance to simulated hemorrhage. These data demonstrate the robustness of compensatory physiological mechanisms that preserve human cerebral blood flow and oxygen delivery during sustained hypoxia, ensuring cerebral tissue metabolism and neuronal function is maintained.

Effects of aerobic exercise training on cerebral pulsatile hemodynamics in middle-aged adults with elevated blood pressure/stage 1 hypertension

Mechanisms behind the protective effects of aerobic exercise on brain health remain elusive but may be vascular in origin and relate to cerebral pulsatility. This pilot study investigated the effects of 12-wk aerobic exercise training on cerebral pulsatility and its vascular contributors (large artery stiffness, characteristic impedance) in at-risk middle-aged adults. Twenty-eight inactive middle-aged adults with elevated blood pressure or stage 1 hypertension were assigned to either moderate/vigorous aerobic exercise training (AET) for 3 days/wk or no-exercise control (CON) group. Middle cerebral artery (MCA) pulsatility index (PI), large artery (i.e., aorta, carotid) stiffness, and characteristic impedance were assessed via Doppler and tonometry at baseline, 6, and 12 wk, whereas cardiorespiratory fitness (V̇o2peak) was assessed via incremental exercise test and cognitive function via computerized battery at baseline and 12 wk. V̇o2peak increased 6% in AET and decreased 4% in CON (P < 0.05). Proximal aortic compliance increased (P = 0.04, partial η2 = 0.14) and aortic characteristic impedance decreased (P = 0.02, partial η2 = 0.17) with AET but not CON. Cerebral pulsatility showed a medium-to-large effect size increase with AET, although not statistically significant (P = 0.07, partial η2 = 0.11) compared with CON. Working memory reaction time improved with AET but not CON (P = 0.02, partial η2 = 0.20). Our data suggest 12-wk AET elicited improvements in central vascular hemodynamics (e.g., proximal aortic compliance and characteristic impedance) along with apparent, paradoxical increases in cerebral pulsatile hemodynamics.NEW & NOTEWORTHY We identify differential central versus cerebrovascular responses to 12 wk of aerobic exercise training in middle-aged adults. Although proximal aortic compliance and characteristic impedance improved after 12 wk of exercise, cerebral pulsatility tended to unexpectedly increase. These data suggest short-term aerobic exercise training may lead to more immediate benefits in the central vasculature, whereas longer duration exercise training may be required for beneficial changes in pulsatility within the cerebrovasculature.

Poor statistical reporting, inadequate data presentation and spin persist despite Journal awareness and updated Information for Authors

Sound reporting of research results is fundamental to good science. Unfortunately, poor reporting is common and does not improve with editorial educational strategies. We investigated whether publicly highlighting poor reporting at a journal can lead to improved reporting practices. We also investigated whether reporting practices that are required or strongly encouraged in journal Information for Authors are enforced by journal editors and staff. A 2016 audit highlighted poor reporting practices in the Journal of Neurophysiology. In August 2016 and 2018, the American Physiological Society updated the Information for Authors, which included the introduction of several required or strongly encouraged reporting practices. We audited Journal of Neurophysiology papers published in 2019 and 2020 (downloaded through the library of the University of New South Wales) on reporting items selected from the 2016 audit, the newly introduced reporting practices, and items from previous audits. Summary statistics (means, counts) were used to summarize audit results. In total, 580 papers were audited. Compared to results from the 2016 audit, several reporting practices remained unchanged or worsened. For example, 60% of papers erroneously reported standard errors of the mean, 23% of papers included undefined measures of variability, 40% of papers failed to define a statistical threshold for their tests, and when present, 64% of papers with p-values between 0.05 and 0.1 misinterpreted them as statistical trends. As for the newly introduced reporting practices, required practices were consistently adhered to by 34 to 37% of papers, while strongly encouraged practices were consistently adhered to by 9 to 26% of papers. Adherence to the other audited reporting practices was comparable to our previous audits. Publicly highlighting poor reporting practices did little to improve research reporting. Similarly, requiring or strongly encouraging reporting practices was only partly effective. Although the present audit focused on a single journal, this is likely not an isolated case. Stronger, more strategic measures are required to improve poor research reporting.

The reciprocal relationship between cardiac baroreceptor sensitivity and cerebral autoregulation during simulated hemorrhage in humans

A reciprocal relationship between the baroreflex and cerebral autoregulation (CA) has been demonstrated at rest and in response to acute hypotension. We hypothesized that the reciprocal relationship between cardiac baroreflex sensitivity (BRS) and CA would be maintained during sustained central hypovolemia induced by lower body negative pressure (LBNP), and that the strength of this relationship would be greater in subjects with higher tolerance to this stress. Healthy young adults (n = 51; 23F/28M) completed a LBNP protocol to presyncope. Subjects were classified as high tolerant (HT; completion of -60 mmHg LBNP stage, ≥20-min) or low tolerant (LT; did not complete -60 mmHg LBNP stage, <20-min). R-R intervals (RRI), systolic arterial pressure (SAP), mean arterial pressure (MAP), and middle cerebral artery velocity (MCAv) were measured continuously. Cardiac BRS was calculated in the time domain (ΔHR/ΔSAP) and frequency domain (RRI-SAP low frequency (LF) transfer function gain), and CA was calculated in the time domain (ΔMCAv/ΔMAP) and frequency domain (MAP-mean MCAv LF transfer function gain). There was a moderate relationship between cardiac BRS and CA for the group of 51 subjects in both the time (R = -0.54, P < 0.0001) and frequency (R = 0.61, P < 0.001) domains; there was a stronger relationship in the HT group (R = 0.73) compared to the LT group (R = 0.31) in the frequency domain (P = 0.08), but no difference between groups in the time domain (HT: R = -0.73 vs. LT: R = -0.63; P = 0.27). These findings suggest that an interaction between BRS and CA may be an important compensatory mechanism that contributes to tolerance to simulated hemorrhage in young healthy adults.

Integrated analysis of miRNA-mRNA interaction in pediatric dilated cardiomyopathy

BACKGROUND

MicroRNAs (miRNAs) are short single-stranded nucleotides that can regulate gene expression. Although we previously evaluated the expression of miRNAs in pediatric dilated cardiomyopathy (DCM) by miRNA array, pathway prediction based on changes in mRNA expression has not been previously analyzed in this population. The current study aimed to determine the regulation of miRNA expression by miRNA-sequencing (miRNA-seq) and, through miRNA-sequencing (mRNA-seq), analyze their putative target genes and altered pathways in pediatric DCM hearts.

METHODS

miRNA expression was determined by miRNA-seq [n = 10 non-failing (NF), n = 20 DCM]. Expression of a subset of miRNAs was evaluated in adult DCM patients (n = 11 NF, n = 13 DCM). miRNA-mRNA prediction analysis was performed using mRNA-seq data (n = 7 NF, n = 7 DCM) from matched samples.

RESULTS

Expression of 393 miRNAs was significantly different (p < 0.05) in pediatric DCM patients compared to NF controls. TargetScan-based miRNA-mRNA analysis revealed 808 significantly inversely expressed genes. Functional analysis suggests upregulated pathways related to the regulation of stem cell differentiation and cardiac muscle contraction, and downregulated pathways related to the regulation of protein phosphorylation, signal transduction, and cell communication.

CONCLUSIONS

Our results demonstrated a unique age-dependent regulation of miRNAs and their putative target genes, which may contribute to distinctive phenotypic characteristics of DCM in children.

IMPACT

This is the first study to compare miRNA expression in the heart of pediatric DCM patients to age-matched healthy controls by RNA sequencing. Expression of a subset of miRNAs is uniquely dysregulated in children. Using mRNA-seq and miRNA-seq from matched samples, target prediction was performed. This study underscores the importance of pediatric-focused studies.

Intake Duration of Anthocyanin-Rich New Zealand Blackcurrant Extract Affects Cardiovascular Responses during Moderate-Intensity Walking But Not at Rest

We examined effects of intake duration of New Zealand blackcurrant (NZBC) extract on cardiovascular responses during supine rest and moderate-intensity walking. Recreationally active men (n = 15, age: 24 ± 6 yr, BMI: 24.7 ± 4.3 kg·m^-2) volunteered in a randomized, cross-over design. One metabolic equivalent (1-MET) was measured (3.97 ± 0.66 mL·kg^-1·min^-1) and an incremental walking test was performed to individualize speed at 4 (n = 3) or 5 (n = 12) METs for the 30-min walk (5.7 ± 0.7 km·hr^-1). NZBC extract (210 mg of anthocyanins) was taken with breakfast for 7 and 14 days, with a 14-days washout. The final dose was ingested 2-hr before recording of the cardiovascular responses (Portapres Model-2). At rest, %changes at 7- and 14-days intake were observed for stroke volume (+6.8% (trend), p = 0.065; +8.5%, p = 0.012), cardiac output (+10.1%, p = 0.007; +8.5%, p = 0.013), total peripheral resistance (-12.0%, p = 0.004; -13.1%, p = 0.011), diastolic (-5.7%, p = 0.045; -9.7%, p = 0.015) and mean arterial pressure (-4.4%, p = 0.040; -7.2%, p = 0.029), but without intake duration effect. During walking, %changes at 7- and 14-days intake were observed for stroke volume (+7.7% (trend), p = 0.063; +9.9%, p = 0.006), cardiac output (+8.7%, p = 0.037; +10.1%, p = 0.007), diastolic blood pressure (-6.2%, p = 0.042; -10.6%, p = 0.001), and total peripheral resistance (-9.6%, p = 0.042; -13.5%, p = 0.005) but without intake duration effect. During walking, %changes at 14-days were observed only for mean arterial pressure (-6.4%, p = 0.018) and arterio-venous oxygen difference (-7.9%, p = 0.019). NZBC extract affects cardiovascular responses at rest and during moderate-intensity exercise with 7- and 14-day intake. Only during moderate-intensity exercise, a longer intake of NZBC extract was required for an effect on some cardiovascular responses.

The impact of acute central hypovolemia on cerebral hemodynamics: does sex matter?

Trauma-induced hemorrhage is a leading cause of disability and death due, in part, to impaired perfusion and oxygenation of the brain. It is unknown if cerebrovascular responses to blood loss are differentiated based on sex. We hypothesized that compared to males, females would have reduced tolerance to simulated hemorrhage induced by maximal lower body negative pressure (LBNP), and this would be associated with an earlier reduction in cerebral blood flow and cerebral oxygenation. Healthy young males (n = 29, 26 ± 4 yr) and females (n = 23, 27 ± 5 yr) completed a step-wise LBNP protocol to presyncope. Mean arterial pressure (MAP), stroke volume (SV), middle cerebral artery velocity (MCAv), end-tidal CO₂ (etCO₂), and cerebral oxygen saturation (ScO₂) were measured continuously. Unexpectedly, tolerance to LBNP was similar between the sexes (males, 1,604 ± 68 s vs. females, 1,453 ± 78 s; P = 0.15). Accordingly, decreases (%Δ) in MAP, SV, MCAv, and ScO₂ were similar between males and females throughout LBNP and at presyncope (P ≥ 0.20). Interestingly, although decreases in etCO₂ were similar between the sexes throughout LBNP (P = 0.16), at presyncope, the %Δ etCO₂ from baseline was greater in males compared to females (-30.8 ± 2.6% vs. -21.3 ± 3.0%; P = 0.02). Contrary to our hypothesis, sex does not influence tolerance, or the central or cerebral hemodynamic responses to simulated hemorrhage. However, the etCO₂ responses at presyncope do suggest potential sex differences in cerebral vascular sensitivity to CO₂ during central hypovolemia.NEW & NOTEWORTHY Tolerance and cerebral blood velocity responses to simulated hemorrhage (elicited by lower body negative pressure) were similar between male and female subjects. Interestingly, the change in etCO₂ from baseline was greater in males compared to females at presyncope, suggesting potential sex differences in cerebral vascular sensitivity to CO₂ during simulated hemorrhage. These findings may facilitate development of individualized therapeutic interventions to improve survival from hemorrhagic injuries in both men and women.

Intake of New Zealand Blackcurrant Powder Affects Skin-Borne Volatile Organic Compounds in Middle-Aged and Older Adults

Skin volatile organic compounds (VOCs) can cause body odor or reveal human disease and may result from lipid peroxidation or activity by skin bacteria. We examined the effect of intake of New Zealand blackcurrant (NZBC) powder for 77 skin VOCs in middle-aged and older adults in a crossover design. Fourteen adults (nine males, age: 55 ± 5 yrs) consumed NZBC powder for 7 days (6 g·day^-1 with 138.6 mg anthocyanins). Two hours after the last intake, a passive flux sampler with trapping media was applied in the base of the neck for 1 hour. Gas chromatography-mass spectrometry was used for media analysis. Habitual anthocyanin intake was quantified using a food frequency questionnaire. Compared to control (i.e., no intake of NZBC powder), emission of six skin VOCs (i.e., 2-nonenal, acetic acid, 2-hexanone, 6-methyl-5-hepten-2-one, benzaldehyde, allyl methyl sulfide) were lower by more than 25%. Increases were observed for γ-octanolactone (+184%) and γ-decanolactone (+89%). A trend for a decrease for isovaleraldehyde, hexanal, and 2-pentanone, and an increase for heptanoic acid and γ-nonanolactone was observed. There was a significant correlation with daily habitual dietary anthocyanin intake for control values of hexanal and percentage change of γ-octanolactone. NZBC powder can change emanation of some VOCs in human skin. Analysis of skin VOCs following specific polyphenol intake may address the impact of dietary components to affect internal metabolic processes, body odor, and health.

The right ventricular transcriptome signature in Ossabaw swine with cardiometabolic heart failure: implications for the coronary vasculature

Heart failure (HF) patients with deteriorating right ventricular (RV) structure and function have a nearly twofold increased risk of death compared with those without. Despite the well-established clinical risk, few studies have examined the molecular signature associated with this HF condition. The purpose of this study was to integrate morphological, molecular, and functional data with the transcriptome data set in the RV of a preclinical model of cardiometabolic HF. Ossabaw swine were fed either normal diet without surgery (lean control, n = 5) or Western diet and aortic-banding (WD-AB; n = 4). Postmortem RV weight was increased and positively correlated with lung weight in the WD-AB group compared with CON. Total RNA-seq was performed and gene expression profiles were compared and analyzed using principal component analysis, weighted gene co-expression network analysis, module enrichment analysis, and ingenuity pathway analysis. Gene networks specifically associated with RV hypertrophic remodeling identified a hub gene in MAPK8 (or JNK1) that was associated with the selective induction of the extracellular matrix (ECM) component fibronectin. JNK1 and fibronectin protein were increased in the right coronary artery (RCA) of WD-AB animals and associated with a decrease in matrix metalloproteinase 14 protein, which specifically degrades fibronectin. RCA fibronectin content was correlated with increased vascular stiffness evident as a decreased elastin elastic modulus in WD-AB animals. In conclusion, this study establishes a molecular and transcriptome signature in the RV using Ossabaw swine with cardiometabolic HF. This signature was associated with altered ECM regulation and increased vascular stiffness in the RCA, with selective dysregulation of fibronectin.

A comparison of protocols for simulating hemorrhage in humans: step versus ramp lower body negative pressure

Lower body negative pressure (LBNP) elicits central hypovolemia, and it has been used to simulate the cardiovascular and cerebrovascular responses to hemorrhage in humans. LBNP protocols commonly use progressive stepwise reductions in chamber pressure for specific time periods. However, continuous ramp LBNP protocols have also been utilized to simulate the continuous nature of most bleeding injuries. The aim of this study was to compare tolerance and hemodynamic responses between these two LBNP profiles. Healthy human subjects (N = 19; age, 27 ± 4 y; 7 female/12 male) completed a 1) step LBNP protocol (5-min steps) and 2) continuous ramp LBNP protocol (3 mmHg/min), both to presyncope. Heart rate (HR), mean arterial pressure (MAP), stroke volume (SV), middle and posterior cerebral artery velocity (MCAv and PCAv), cerebral oxygen saturation (ScO₂), and end-tidal CO₂ (etCO₂) were measured. LBNP tolerance, via the cumulative stress index (CSI, summation of chamber pressure × time at each pressure), and hemodynamic responses were compared between the two protocols. The CSI (step: 911 ± 97 mmHg/min vs. ramp: 823 ± 83 mmHg/min; P = 0.12) and the magnitude of central hypovolemia (%Δ SV, step: -54.6% ± 2.6% vs. ramp: -52.1% ± 2.8%; P = 0.32) were similar between protocols. Although there were no differences between protocols for the maximal %Δ HR (P = 0.88), the %Δ MAP during the step protocol was attenuated (P = 0.05), and the reductions in MCAv, PCAv, ScO₂, and etCO₂ were greater (P ≤ 0.08) when compared with the ramp protocol at presyncope. These results indicate that when comparing cardiovascular responses to LBNP across different laboratories, the specific pressure profile must be considered as a potential confounding factor.NEW & NOTEWORTHY Ramp lower body negative pressure (LBNP) protocols have been utilized to simulate the continuous nature of bleeding injuries. However, it unknown if tolerance or the physiological responses to ramp LBNP are similar to the more common stepwise LBNP protocol. We report similar tolerance between the two protocols, but the step protocol elicited a greater increase in cerebral oxygen extraction in the presence of reduced blood flow, presumably facilitating the matching of metabolic supply and demand.

Effect of New Zealand Blackcurrant Extract on Isometric Contraction-Induced Fatigue and Recovery: Potential Muscle-Fiber Specific Effects

New Zealand blackcurrant (NZBC) extract has shown performance-enhancing effects during cycling, running and sport climbing. We examined effects of NZBC extract on (1) voluntary and twitch force of the quadriceps femoris muscles during repeated isometric contraction-induced fatigue, (2) twitch force during recovery and (3) muscle fiber-specific effects. Familiarized recreationally active males (n = 12, age: 24 ± 5 yrs; height: 180 ± 5 cm; body mass: 89 ± 11 kg) performed sixteen, 5-s voluntary maximal isometric contractions (iMVC) separated by 3-s rest. Twitch force was recorded before, during the 3-s rests and 5-min recovery. Supplementation consisted of 7-days intake of NZBC extract (600 mg∙day⁻¹ containing 210 mg anthocyanin) in a double-blind, randomized, placebo-controlled crossover design with a 14-days washout. NZBC extract allowed for greater force in the first quartile of the iMVCs. Twitch force at baseline was 12% higher with NZBC extract (p = 0.05). However, there was no effect of NZBC for twitch force during the 16-iMVCs and recovery. Based on the maximum post-activation potentiation during the placebo 16-iMVCs, four subjects were classified of having a predominant type I or II muscle fiber typology. In type II, NZBC extract provided a trend for increased MVC force (~14%) in the first quartile and for type I in the fourth quartile (~10%). In type I, NZBC extract seemed to have higher twitch forces during the fatiguing exercise protocol and recovery, indicating increased fatigue resistance. New Zealand blackcurrant extract affects force during repeated maximal isometric contractions. Future work on mechanisms by NZBC extract for muscle fiber-specific fatigue-induced force responses is warranted.

Establishment of adult right ventricle failure in ovine using a graded, animal-specific pulmonary artery constriction model

BACKGROUND

Right ventricle failure (RVF) is associated with serious cardiac and pulmonary diseases that contribute significantly to the morbidity and mortality of patients. Currently, the mechanisms of RVF are not fully understood and it is partly due to the lack of large animal models in adult RVF. In this study, we aim to establish a model of RVF in adult ovine and examine the structure and function relations in the RV.

METHODS

RV pressure overload was induced in adult male sheep by revised pulmonary artery constriction (PAC). Briefly, an adjustable hydraulic occluder was placed around the main pulmonary artery trunk. Then, repeated saline injection was performed at weeks 0, 1, and 4, where the amount of saline was determined in an animal-specific manner. Healthy, age-matched male sheep were used as additional controls. Echocardiography was performed bi-weekly and on week 11 post-PAC, hemodynamic and biological measurements were obtained.

RESULTS

This PAC methodology resulted in a marked increase in RV systolic pressure and decreases in stroke volume and tricuspid annular plane systolic excursion, indicating signs of RVF. Significant increases in RV chamber size, wall thickness, and Fulton's index were observed. Cardiomyocyte hypertrophy and collagen accumulation (particularly type III collagen) were evident, and these structural changes were correlated with RV dysfunction.

CONCLUSION

In summary, the animal-specific, repeated PAC provided a robust approach to induce adult RVF, and this ovine model will offer a useful tool to study the progression and treatment of adult RVF that is translatable to human diseases.

Effects of blackcurrant extract on arterial functions in older adults: A randomized, double-blind, placebo-controlled, crossover trial

PURPOSE

Blackcurrant extract mainly contains anthocyanins. Several reports suggest that anthocyanins have beneficial effect for cardiovascular functions. The aim of this study was to examine the effect of 7-day intake of New Zealand blackcurrant (NZBC) extract on arterial functions, e.g. arterial stiffness, and serum lipids.

METHODS

A randomized, double-blind, placebo-controlled, crossover design study with a washout period of 28 days was conducted. Fourteen older adults participated in this study (age 73.3 ± 1.7 years). Participants took either a 7-day course of placebo or two capsules of NZBC extract (each 300 mg capsule contains 35% blackcurrant extract). Participants took one of the two trials first and then took the other after a washout period. Carotid-femoral pulse-wave velocity, an index of central arterial stiffness, and central blood pressure were measured at baseline and again at the end of the 7-day study period.

RESULTS

Compared to baseline, carotid-femoral pulse-wave velocity (P = .03) and central blood pressure (P = .02) decreased significantly after the 7-day study period with NZBC intake. In addition, carotid-femoral pulse-wave velocity (P = .04) and central blood pressure (P = .001) in the NZBC intake trial decreased significantly more than in the placebo intake trial. No effects were observed on serum lipids.

CONCLUSION

These results suggest that short-term NZBC intake reduces central arterial stiffness and central blood pressure in older adults. Therefore, anthocyanin-rich blackcurrants might be beneficial for maintaining or improving cardiovascular health as an alternative to pharmaceutical medications.

ABBREVIATIONS

Aix: augmentation index; BP: blood pressure; cfPWV: carotid-femoral pulse-wave velocity;  CVD: cardiovascular diseases; DBP: diastolic blood pressure;  faPWV: femoral-ankle pulse-wave velocity; FG: fasting glucose; HDL: high-density lipoprotein cholesterol; LDL: low-density lipoprotein cholesterol; MBP: mean blood pressure; NZBC: New Zealand blackcurrant; PP: pulse pressure; SBP: systolic blood pressure; TG: triglycerides.

Criterion validity of the Ekblom-Bak and the Åstrand submaximal test in an elderly population

Purpose

The aim of this study was to validate the submaximal Ekblom-Bak test (EB-test) and the Åstrand test (Å-test) for an elderly population.

Methods

Participants (n = 104), aged 65–75 years, completed a submaximal aerobic test on a cycle ergometer followed by an individually adjusted indirect calorimetry VO₂max test on a treadmill. The HR from the submaximal test was used to estimate VO₂max using both the EB-test and Å-test equations.

Results

The correlation between measured and estimated VO₂max using the EB method and Å method in women was r = 0.64 and r = 0.58, respectively and in men r = 0.44 and r = 0.44, respectively. In women, the mean difference between estimated and measured VO₂max was − 0.02 L min⁻¹ (95% CI − 0.08 to 0.04) for the EB method and − 0.12 L min⁻¹ (95% CI − 0.22 to − 0.02) for the Å method. Corresponding values for men were 0.05 L min⁻¹ (95% CI − 0.04 to 0.14) and − 0.28 L min⁻¹ (95% CI − 0.42 to − 0.14), respectively. However, the EB method was found to overestimate VO₂max in men with low fitness and the Å method was found to underestimate VO₂max in both women and men. For women, the coefficient of variance was 11.1%, when using the EB method and 19.8% when using the Å method. Corresponding values for men were 11.6% and 18.9%, respectively.

Conclusion

The submaximal EB-test is valid for estimating VO₂max in elderly women, but not in all elderly men. The Å-test is not valid for estimating VO₂max in the elderly.

Electronic supplementary material

The online version of this article (10.1007/s00421-019-04275-7) contains supplementary material, which is available to authorized users.

Transitional human alveolar type II epithelial cells suppress extracellular matrix and growth factor gene expression in lung fibroblasts

Epithelial-fibroblast interactions are thought to be very important in the adult lung in response to injury, but the specifics of these interactions are not well defined. We developed coculture systems to define the interactions of adult human alveolar epithelial cells with lung fibroblasts. Alveolar type II cells cultured on floating collagen gels reduced the expression of type 1 collagen (COL1A1) and α-smooth muscle actin (ACTA2) in fibroblasts. They also reduced fibroblast expression of hepatocyte growth factor (HGF), fibroblast growth factor 7 (FGF7, KGF), and FGF10. When type II cells were cultured at an air-liquid interface to maintain high levels of surfactant protein expression, this inhibitory activity was lost. When type II cells were cultured on collagen-coated tissue culture wells to reduce surfactant protein expression further and increase the expression of some type I cell markers, the epithelial cells suppressed transforming growth factor-β (TGF-β)-stimulated ACTA2 and connective tissue growth factor (CTGF) expression in lung fibroblasts. Our results suggest that transitional alveolar type II cells and likely type I cells but not fully differentiated type II cells inhibit matrix and growth factor expression in fibroblasts. These cells express markers of both type II cells and type I cells. This is probably a normal homeostatic mechanism to inhibit the fibrotic response in the resolution phase of wound healing. Defining how transitional type II cells convert activated fibroblasts into a quiescent state and inhibit the effects of TGF-β may provide another approach to limiting the development of fibrosis after alveolar injury.

Western Diet-Fed, Aortic-Banded Ossabaw Swine: A Preclinical Model of Cardio-Metabolic Heart Failure

The development of new treatments for heart failure lack animal models that encompass the increasingly heterogeneous disease profile of this patient population. This report provides evidence supporting the hypothesis that Western Diet-fed, aortic-banded Ossabaw swine display an integrated physiological, morphological, and genetic phenotype evocative of cardio-metabolic heart failure. This new preclinical animal model displays a distinctive constellation of findings that are conceivably useful to extending the understanding of how pre-existing cardio-metabolic syndrome can contribute to developing HF.

Elamipretide Improves Mitochondrial Function in the Failing Human Heart

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Mitochondrial function is impaired in explanted failing pediatric and adult human hearts.

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Elamipretide is a novel mitochondria-targeted drug that is targeted to cardiolipin on the inner mitochondrial membrane and improves coupling of the electron transport chain.

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Treatment of explanted human hearts with elamipretide improves human cardiac mitochondrial function.

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The study provides novel methods to evaluate the influence of compounds on mitochondria in the human heart and provides proof of principle for the use of elamipretide to improve mitochondrial energetics in failing myocardium due to multiple etiologies and irrespective of age.

Negative alterations of mitochondria are known to occur in heart failure (HF). This study investigated the novel mitochondrial-targeted therapeutic agent elamipretide on mitochondrial and supercomplex function in failing human hearts ex vivo. Freshly explanted failing and nonfailing ventricular tissue from children and adults was treated with elamipretide. Mitochondrial oxygen flux, complex (C) I and CIV activities, and in-gel activity of supercomplex assembly were measured. Mitochondrial function was impaired in the failing human heart, and mitochondrial oxygen flux, CI and CIV activities, and supercomplex-associated CIV activity significantly improved in response to elamipretide treatment. Elamipretide significantly improved failing human mitochondrial function.

Effect of New Zealand Blackcurrant Extract on Physiological Responses at Rest and during Brisk Walking in Southeast Asian Men: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study

New Zealand blackcurrant (NZBC) extract affects cardiovascular and metabolic responses during rest and exercise in Caucasian men. Ethnicity and nutritional habits may affect responses to nutritional ergogenic aids. We examined the effects of NZBC extract on cardiovascular, metabolic, and physiological responses during seated rest and moderate-intensity exercise in Southeast Asian men. Seventeen healthy Thai men (age: 22 ± 3 years; body mass index (BMI): 21.8 ± 1.1 kg·m^-2) participated. Resting metabolic equivalent (1-MET) was measured (Oxycon™ mobile, Germany), and an incremental walking protocol was completed to establish the relationship between walking speed and MET. In a double-blind, randomized, placebo-controlled, crossover design, cardiovascular (Physioflow, n = 12) and physiological responses (Oxycon, n = 17) were measured during both seated rest and a 30-min treadmill walk at five metabolic equivalent (5-MET), with either a seven-day intake of placebo (PL) or two capsules of NZBC extract (each 300 mg capsule contains 35% blackcurrant extract) with a 14-day washout. Paired t-tests were used with significance accepted at p < 0.05 and a trend for 0.05 > p ≤ 0.10. During 30 min of treadmill walking at 5-MET, no differences were observed for heart rate and substrate oxidation. With intake of NZBC during treadmill walking, there was a trend for increased stroke volume by 12% (PL: 83.2 ± 25.1; NZBC: 93.0 ± 24.3 mL; p = 0.072) and cardiac output increased by 12% (PL: 9.2 ± 2.6; NZBC: 10.3 ± 2.8 L·min^-1; p = 0.057). Systemic vascular resistance decreased by 10% (PL: 779 ± 267; NZBC: 697 ± 245 dyn·s·cm^-5; p = 0.048). NZBC extract had no effect on metabolic, physiological, and cardiovascular parameters during seated rest and exercise-induced fat oxidation in Thai men, in contrast to observations in Caucasian men. During treadmill walking, Thai men showed cardiovascular response, indicating vasodilatory effects during moderate-intensity exercise with the intake of NZBC extract. Our findings suggest that the ergogenic responses to anthocyanin intake from New Zealand blackcurrant may be ethnicity-dependent.

TGF beta inhibits HGF, FGF7, and FGF10 expression in normal and IPF lung fibroblasts

TGF beta is a multifunctional cytokine that is important in the pathogenesis of pulmonary fibrosis. The ability of TGF beta to stimulate smooth muscle actin and extracellular matrix gene expression in fibroblasts is well established. In this report, we evaluated the effect of TGF beta on the expression of HGF, FGF7 (KGF), and FGF10, important growth and survival factors for the alveolar epithelium. These growth factors are important for maintaining type II cells and for restoration of the epithelium after lung injury. Under conditions of normal serum supplementation or serum withdrawal TGF beta inhibited fibroblast expression of HGF, FGF7, and FGF10. We confirmed these observations with genome wide RNA sequencing of the response of control and IPF fibroblasts to TGF beta. In general, gene expression in IPF fibroblasts was similar to control fibroblasts. Reduced expression of HGF, FGF7, and FGF10 is another means whereby TGF beta impairs epithelial healing and promotes fibrosis after lung injury.

Impairment of retinal function in yellow perch (Perca flavescens) by Diplostomum baeri metacercariae

Histologic studies of fish from Douglas Lake, Cheboygan County, Michigan, USA show that Diplostomum spp. infect the lens of spottail shiners (Notropis hudsonius) and common shiners (Luxilus cornutus). In contrast, infection was confined to the choroidal vasculature of yellow perch (Perca flavescens), and the morphology of the pigment epithelium and retina in regions adjacent to the metacercariae was abnormal. The difference in location of metacercariae within the host suggested that different Diplostomum species may infect shiners and perch in Douglas Lake. Species diversity was investigated by sequencing the barcode region of the cytochrome oxidase I gene of metacercariae. Four species of Diplostomum were identified, all four of which were present in shiner lenses; however, only Diplostomum baeri was present in the perch choroid. To determine whether infection of perch eyes affects the response of the retina to a light stimulus, electroretinograms (ERG) were recorded. The amplitude of the b-wave of the ERG was reduced and the b-wave latency was increased in infected perch, as compared to uninfected eyes, and the flicker-fusion frequency was also reduced. Infection of the yellow perch choroid by Diplostomum baeri, which shows strong host and tissue specificity, has an adverse effect on retinal function, lending support to the hypothesis that parasite-induced impairment of host vision may afford Diplostomum baeri the evolutionary benefit of increasing the likelihood of transmission, via host fish predation, to its definitive avian host.

Acute isoproterenol leads to age-dependent arrhythmogenesis in guinea pigs

Sudden cardiac death from ventricular arrhythmias is more common in adult patients with with heart failure compared with pediatric patients with heart failure. We identified age-specific differences in arrhythmogenesis using a guinea pig model of acute β-adrenergic stimulation. Young and adult guinea pigs were exposed to the β-adrenergic agonist isoproterenol (ISO; 0.7 mg/kg) for 30 min in the absence or presence of flecainide (20 mg/kg), an antiarrhythmic that blocks Na⁺ and ryanodine channels. Implanted cardiac monitors (Reveal LINQ, Medtronic) were used to monitor heart rhythm. Alterations in phosphorylation and oxidation of ryanodine receptor 2 (RyR2) were measured in left ventricular tissue. There were age-specific differences in arrhythmogenesis and sudden death associated with acute β-adrenergic stimulation in guinea pigs. Young and adult guinea pigs developed arrhythmias in response to ISO; however, adult animals developed significantly more premature ventricular contractions and experienced higher arrhythmia-related mortality than young guinea pigs treated with ISO. Although there were no significant differences in the phosphorylation of left ventricular RyR2 between young and adult guinea pigs, adult guinea pigs exposed to acute ISO had significantly more oxidation of RyR2. Flecainide treatment significantly improved survival and decreased the number of premature ventricular contractions in young and adult animals in association with lower RyR2 oxidation. Adult guinea pigs had a greater propensity to develop arrhythmias and suffer sudden death than young guinea pigs when acutely exposed to ISO. This was associated with higher oxidation of RyR2. The incidence of sudden death can be rescued with flecainide treatment, which decreases RyR2 oxidation. NEW & NOTEWORTHY Clinically, adult patients with heart failure are more likely to develop arrhythmias and sudden death than pediatric patients with heart failure. In the present study, older guinea pigs also showed a greater propensity to arrhythmias and sudden death than young guinea pigs when acutely exposed to isoproterenol. Although there are well-described age-related cardiac structural changes that predispose patients to arrhythmogenesis, the present data suggest contributions from dynamic changes in cellular signaling also play an important role in arrhythmogenesis.

Guidelines on statistics for researchers using laboratory animals: the essentials

There is growing concern that the omnipresence of flawed statistics and the deficient reproducibility that arises therefrom results in an unethical waste of animals in research. The present review aims at providing guidelines in biostatistics for researchers, based on observed frequent mistakes, misuses and misconceptions as well as on the specificities of animal experimentation. Twelve recommendations are formulated that cover sampling, sample size optimisation, choice of statistical tests, understanding p-values and reporting results. The objective is to expose important statistical issues that one should consider for the correct design, execution and reporting of experiments.

Chronic interval exercise training prevents BKCa channel-mediated coronary vascular dysfunction in aortic-banded miniswine

Conventional treatments have failed to improve the prognosis of heart failure with preserved ejection fraction (HFpEF) patients. Thus, the purpose of this study was to determine the therapeutic efficacy of chronic interval exercise training (IT) on large-conductance Ca²⁺-activated K⁺ (BK_Ca) channel-mediated coronary vascular function in heart failure. We hypothesized that chronic interval exercise training would attenuate pressure overload-induced impairments to coronary BK_Ca channel-mediated function. A translational large-animal model with cardiac features of HFpEF was used to test this hypothesis. Specifically, male Yucatan miniswine were divided into three groups ( n = 7/group): control (CON), aortic banded (AB)-heart failure (HF), and AB-interval trained (HF-IT). Coronary blood flow, vascular conductance, and vasodilatory capacity were measured after administration of the BK_Ca channel agonist NS-1619 both in vivo and in vitro in the left anterior descending coronary artery and isolated coronary arterioles, respectively. Skeletal muscle citrate synthase activity was decreased and left ventricular brain natriuretic peptide levels increased in HF vs. CON and HF-IT animals. A parallel decrease in NS-1619-dependent coronary vasodilatory reserve in vivo and isolated coronary arteriole vasodilatory responsiveness in vitro were observed in HF animals compared with CON, which was prevented in the HF-IT group. Although exercise training prevented BK_Ca channel-mediated coronary vascular dysfunction, it did not change BK_Ca channel α-subunit mRNA, protein, or cellular location (i.e., membrane vs. cytoplasm). In conclusion, these results demonstrate the viability of chronic interval exercise training as a therapy for central and peripheral adaptations of experimental heart failure, including BK_Ca channel-mediated coronary vascular dysfunction. NEW & NOTEWORTHY Conventional treatments have failed to improve the prognosis of heart failure with preserved ejection fraction (HFpEF) patients. Our findings show that chronic interval exercise training can prevent BK_Ca channel-mediated coronary vascular dysfunction in a translational swine model of chronic pressure overload-induced heart failure with relevance to human HFpEF.

Chronic low-intensity exercise attenuates cardiomyocyte contractile dysfunction and impaired adrenergic responsiveness in aortic-banded mini-swine

Exercise improves clinical outcomes in patients diagnosed with heart failure with reduced ejection fraction (HFrEF), in part via beneficial effects on cardiomyocyte Ca²⁺ cycling during excitation-contraction coupling (ECC). However, limited data exist regarding the effects of exercise training on cardiomyocyte function in patients diagnosed with heart failure with preserved ejection fraction (HFpEF). The purpose of this study was to investigate cardiomyocyte Ca²⁺ handling and contractile function following chronic low-intensity exercise training in aortic-banded miniature swine and test the hypothesis that low-intensity exercise improves cardiomyocyte function in a large animal model of pressure overload. Animals were divided into control (CON), aortic-banded sedentary (AB), and aortic-banded low-intensity trained (AB-LIT) groups. Left ventricular cardiomyocytes were electrically stimulated (0.5 Hz) to assess Ca²⁺ homeostasis (fura-2-AM) and unloaded shortening during ECC under conditions of baseline pacing and pacing with adrenergic stimulation using dobutamine (1 μM). Cardiomyocytes in AB animals exhibited depressed Ca²⁺ transient amplitude and cardiomyocyte shortening vs. CON under both conditions. Exercise training attenuated AB-induced decreases in cardiomyocyte Ca²⁺ transient amplitude but did not prevent impaired shortening vs. CON. With dobutamine, AB-LIT exhibited both Ca²⁺ transient and shortening amplitude similar to CON. Adrenergic sensitivity, assessed as the time to maximum inotropic response following dobutamine treatment, was depressed in the AB group but normal in AB-LIT animals. Taken together, our data suggest exercise training is beneficial for cardiomyocyte function via the effects on Ca²⁺ homeostasis and adrenergic sensitivity in a large animal model of pressure overload-induced heart failure. NEW & NOTEWORTHY Conventional treatments have failed to improve the prognosis of heart failure with preserved ejection fraction (HFpEF) patients. Our findings show chronic low-intensity exercise training can prevent cardiomyocyte dysfunction and impaired adrenergic responsiveness in a translational large animal model of chronic pressure overload-induced heart failure with relevance to human HFpEF.

Effect of New Zealand Blackcurrant Extract on Performance during the Running Based Anaerobic Sprint Test in Trained Youth and Recreationally Active Male Football Players

It was observed previously that New Zealand blackcurrant (NZBC) extract reduced slowing of the maximal 15 m sprint speed during the Loughborough Intermittent Shuttle Test. We examined the effect of NZBC extract on the performance of the Running Based Anaerobic Sprint Test (RAST, 6 × 35-m sprints with 10 seconds passive recovery) in trained youth and recreationally active football players. Fifteen recreationally active (University team) (age: 20 ± 1 years, height: 174 ± 19 cm, body mass: 80 ± 13 kg) and nine trained youth players (English professional club) (age: 17 ± 0 years, height: 178 ± 8 cm, body mass: 69 ± 9 kg, mean ± SD) participated in three testing sessions. Prior to the RASTs, participants consumed two capsules of NZBC extract (600 mg∙day⁻¹ CurraNZ^®) or placebo (P) for 7 days (double blind, randomised, cross-over design, wash-out at least 14 days). Ability difference between groups was shown by sprint 1 time. In the placebo condition, trained youth players had faster times for sprint 1 (5.00 ± 0.05 s) than recreationally active players (5.42 ± 0.08 s) (p < 0.01). In trained youth players, there was a trend for an effect of NZBC extract (p = 0.10) on the slowing of the sprint 1 time. NZBC extract reduced slowing of the sprint 5 time (P: 0.56 ± 0.22 s; NZBC: 0.35 ± 0.25, p = 0.02) and this was not observed in recreationally active players (P: 0.57 ± 0.48 s; NZBC: 0.56 ± 0.33, p = 0.90). For fatigue index, expressed as a % change in fastest sprint time, there was a strong trend to be lower in both trained youth and recreationally active players combined by NZBC extract (P: −13 ± 7%; NZBC: −11 ± 6%, p = 0.06) with 12 participants (five trained youth) experiencing less fatigue. New Zealand blackcurrant extract seems to benefit repeated sprint performance only in trained football players.

Effect of New Zealand Blackcurrant Extract on Repeated Cycling Time Trial Performance

New Zealand blackcurrant (NZBC) extract increased 16.1 km cycling time trial performance. The aim of the present study was to examine the effect of NZBC extract on 2 × 4 km time trial performance. Ten male cyclists (age: 30 ± 12 years, body mass: 74 ± 9 kg, height: 179 ± 7 cm, body fat: 11 ± 3%, V˙O_2max: 55 ± 7 mL·kg⁻¹·min⁻¹, mean ± SD) volunteered. Participants were familiarized with the time trials. Participants consumed capsulated NZBC extract (300 mg·day⁻¹ CurraNZ™; containing 105 mg anthocyanin) or placebo for seven days (double blind, randomised, cross-over design, wash-out at least seven days) before 2 × 4 km time trials (10 min active self-paced recovery between trials) (SRM ergometer, SRM International, Germany). Heart rate was recorded and blood lactate sampled immediately after each trial and 8 min into recovery between the trials. Times over comparable one km distances in each 4 km time trial were similar. No effect was observed for the time to complete the first (placebo: 380 ± 28 s, NZBC: 377 ± 27 s) and second 4 km of cycling (placebo: 391 ± 32 s, NZBC: 387 ± 30 s), within both groups the second 4 km times slower by 11 ± 8 s and 11 ± 9 s for placebo and NZBC, respectively. However, the total time of the two 4 km cycling trials was 0.82% faster with NZBC extract (placebo: 771 ± 60 s, NZBC 764 ± 56 s, p = 0.034) with seven participants having faster total times. There was no effect of NZBC on heart rate and lactate values at identical time points. New Zealand blackcurrant extract seems to be beneficial in repeated short-distance cycling time trials for overall performance.

Questionable science and reproducibility in electrical brain stimulation research

Electrical brain stimulation (EBS) is a trendy new technique used to change brain function and treat neurological, psychiatric and psychological disorders. We were curious whether the published literature, which is dominated by positive results, reflects the experience of researchers using EBS. Specifically, we wanted to know whether researchers are able to reproduce published EBS effects and whether they engage in, but fail to report, questionable research practices. We invited 976 researchers to complete an online survey. We also audited 100 randomly-selected published EBS papers. A total of 154 researchers completed the survey. Survey respondents had a median of 3 [1 to 6, IQR] published EBS papers (1180 total) and 2 [1 to 3] unpublished ones (380 total). With anodal and cathodal EBS, the two most widely used techniques, 45–50% of researchers reported being able to routinely reproduce published results. When asked about how study sample size was determined, 69% of respondents reported using the sample size of published studies, while 61% had used power calculations, and 32% had based their decision on pilot data. In contrast, our audit found only 6 papers where power calculations were used and a single paper in which pilot data was used. When asked about questionable research practices, survey respondents were aware of other researchers who selectively reported study outcomes (41%) and experimental conditions (36%), adjusted statistical analysis to optimise results (43%), and engaged in other shady practices (20%). Fewer respondents admitted to engaging in these practices themselves, although 25% admitted to adjusting statistical analysis to optimize results. There was strong agreement that such practices should be reported in research papers; however, our audit found only two such admissions. The present survey confirms that questionable research practices and poor reproducibility are present in EBS studies. The belief that EBS is effective needs to be replaced by a more rigorous approach so that reproducible brain stimulation methods can be devised and applied.

Concurrent validity of different functional and neuroproteomic pain assessment methods in the rat osteoarthritis monosodium iodoacetate (MIA) model

Background

Lack of validity in osteoarthritis pain models and assessment methods is suspected. Our goal was to 1) assess the repeatability and reproducibility of measurement and the influence of environment, and acclimatization, to different pain assessment outcomes in normal rats, and 2) test the concurrent validity of the most reliable methods in relation to the expression of different spinal neuropeptides in a chemical model of osteoarthritic pain.

Methods

Repeatability and inter-rater reliability of reflexive nociceptive mechanical thresholds, spontaneous static weight-bearing, treadmill, rotarod, and operant place escape/avoidance paradigm (PEAP) were assessed by the intraclass correlation coefficient (ICC). The most reliable acclimatization protocol was determined by comparing coefficients of variation. In a pilot comparative study, the sensitivity and responsiveness to treatment of the most reliable methods were tested in the monosodium iodoacetate (MIA) model over 21 days. Two MIA (2 mg) groups (including one lidocaine treatment group) and one sham group (0.9 % saline) received an intra-articular (50 μL) injection.

Results

No effect of environment (observer, inverted circadian cycle, or exercise) was observed; all tested methods except mechanical sensitivity (ICC <0.3), offered good repeatability (ICC ≥0.7). The most reliable acclimatization protocol included five assessments over two weeks. MIA-related osteoarthritic change in pain was demonstrated with static weight-bearing, punctate tactile allodynia evaluation, treadmill exercise and operant PEAP, the latter being the most responsive to analgesic intra-articular lidocaine. Substance P and calcitonin gene-related peptide were higher in MIA groups compared to naive (adjusted P (adj-P) = 0.016) or sham-treated (adj-P = 0.029) rats. Repeated post-MIA lidocaine injection resulted in 34 times lower downregulation for spinal substance P compared to MIA alone (adj-P = 0.029), with a concomitant increase of 17 % in time spent on the PEAP dark side (indicative of increased comfort).

Conclusion

This study of normal rats and rats with pain established the most reliable and sensitive pain assessment methods and an optimized acclimatization protocol. Operant PEAP testing was more responsive to lidocaine analgesia than other tests used, while neuropeptide spinal concentration is an objective quantification method attractive to support and validate different centralized pain functional assessment methods.

Utilization of central nervous system resources for preparation and performance of complex walking tasks in older adults

Introduction: Walking in the home and community often involves performance of complex walking tasks. Understanding the control of such tasks is crucial to preserving independence and quality of life in older adults. However, very little research has been conducted in this area. Here, we assess the extent to which two measures of central nervous system (CNS) activity are responsive to the challenges posed by preparation and performance of complex walking tasks. Prefrontal cortical activity was measured by functional near-infrared spectroscopy (fNIRS) and sympathetic nervous system arousal was measured by skin conductance level (SCL).

Materials and methods: Sixteen older men and women (age: 77.2 ± 5.6 years) with mild mobility deficits participated in this study. Participants walked at their preferred speed without distractions along an unobstructed, well-lit course (control task) and also walked on the same course under five separate challenging conditions: performing a cognitive verbal fluency task (verbal task), dim lighting (dim task), carrying a tray (carry task), negotiating obstacles (obstacles task) and wearing a weighted vest (vest task). Mean prefrontal activation and SCL were calculated during the preparation and performance phases of each task. Gait spatiotemporal measurements were acquired by an instrumented gait mat.

Results: Prefrontal cortical activity and SCL were elevated during the preparation phase of complex walking tasks relative to the control task. During the performance phase, prefrontal activity remained elevated to a similar level as during task preparation. In contrast, SCL continued to increase beyond the level observed during task preparation. A larger increase in prefrontal activity was found to be linked to preserved quality of gait during complex walking tasks.

Discussion: These findings indicate that availability and utilization of CNS resources are important for optimizing performance of complex walking tasks in older adults.

A new twist on an old idea part 2: cyclosporine preserves normal mitochondrial but not cardiomyocyte function in mini-swine with compensated heart failure

We recently developed a clinically relevant mini‐swine model of heart failure with preserved ejection fraction (HFpEF), in which diastolic dysfunction was associated with increased mitochondrial permeability transition (MPT). Early diastolic function is ATP and Ca²⁺‐dependent, thus, we hypothesized chronic low doses of cyclosporine (CsA) would preserve mitochondrial function via inhibition of MPT and subsequently maintain normal cardiomyocyte Ca²⁺ handling and contractile characteristics. Left ventricular cardiomyocytes were isolated from aortic‐banded Yucatan mini‐swine divided into three groups; control nonbanded (CON), HFpEF nontreated (HF), and HFpEF treated with CsA (HF‐CsA). CsA mitigated the deterioration of mitochondrial function observed in HF animals, including functional uncoupling of Complex I‐dependent mitochondrial respiration and increased susceptibility to MPT. Attenuation of mitochondrial dysfunction in the HF‐CsA group was not associated with commensurate improvement in cardiomyocyte Ca²⁺ handling or contractility. Ca²⁺ transient amplitude was reduced and transient time to peak and recovery (tau) prolonged in HF and HF‐CsA groups compared to CON. Alterations in Ca²⁺ transient parameters observed in the HF and HF‐CsA groups were associated with decreased cardiomyocyte shortening and shortening rate. Cellular function was consistent with impaired in vivo systolic and diastolic whole heart function. A significant systemic hypertensive response to CsA was observed in HF‐CsA animals, and may have played a role in the accelerated the development of heart failure at both the whole heart and cellular levels. Given the significant detriment to cardiac function observed in response to CsA, our findings suggest chronic CsA treatment is not a viable therapeutic option for HFpEF.

In a recently developed a translational mini‐swine model of heart failure with preserved ejection fraction (HFpEF), we hypothesized inhibiting mitochondrial permeability transition using cyclosporine (CsA) would improve cardiomyocyte function and calcium handling by supporting mitochondrial function. The purpose of this study was to examine the impact of inhibiting cyclophilin D on mitochondrial function and subsequent cardiomyocyte calcium handling using a reduced, nonimmunosuppressive dose of CsA chronically. We found improved mitochondrial function following chronic CsA treatment was not associated with a parallel improvement in cardiomyocyte calcium handling and contractile function, and demonstrate for the first time impaired cardiomyocyte calcium handling and contractile function are present early in the disease process in our HFpEF model.

Should we use one-sided or two-sided P values in tests of significance?

'P' stands for the probability, ranging in value from 0 to 1, that results from a test of significance. It can also be regarded as the strength of evidence against the statistical null hypothesis (H₀). When H₀ is evaluated by statistical tests based on distributions such as t, normal or Chi-squared, P can be derived from one tail of the distribution (one-sided or one-tailed P), or it can be derived from both tails (two-sided or two-tailed P). Distinguished statisticians, the authors of statistical texts, the authors of guidelines for human and animal experimentation and the editors of biomedical journals give confusing advice, or none at all, about the choice between one- and two-sided P values. Such a choice is available only when there are no more than two groups to be compared. I argue that the choice between one- and two-sided P values depends on the alternative hypothesis (H₁), which corresponds to the scientific hypothesis. If H₁ is non-specific and merely states that the means or proportions in the two groups are unequal, then a two-sided P is appropriate. However, if H₁ is specific and, for example, states than the mean or proportion of Group A is greater than that of Group B, then a one-sided P maybe used. The form that H₁ will take if H₀ is rejected must be stipulated a priori, before the experiment is conducted. It is essential that authors state whether the P values resulting from their tests of significance are one- or two-sided.

A new twist on an old idea: a two-dimensional speckle tracking assessment of cyclosporine as a therapeutic alternative for heart failure with preserved ejection fraction

We recently reported that mitochondrial dysfunction, characterized by increased mitochondrial permeability transition (MPT), was present in a translational swine model of heart failure with preserved ejection fraction (HFpEF). Cyclophilin D is a key component of the MPT pore, therefore, the purpose of this study was to test the efficacy of a novel cyclosporine (CsA) dosing scheme as a therapeutic alternative for HFpEF. Computed tomography (CT), two‐dimensional speckle tracking two‐dimensional speckle tracking (2DST), and invasive hemodynamics were used to evaluate cardiac function. CT imaging showed 14 weeks of CsA treatment caused eccentric myocardial remodeling (contrasting concentric remodeling in untreated HF animals) and elevated systemic pressures. 2DST detected left ventricular (LV) mechanics associated with systolic and diastolic dysfunction prior to the onset of significantly increased LV end diastolic pressure including: (1) decreased systolic apical rotation rate, longitudinal displacement, and longitudinal/radial/circumferential strain; (2) decreased early diastolic untwisting and longitudinal strain rate; and (3) increased late diastolic radial/circumferential mitral strain rate. LV mechanics associated with systolic and diastolic impairment was enhanced to a greater extent than seen in untreated HF animals following CsA treatment. In conclusion, CsA treatment accelerated the development of heart failure, including dilatory LV remodeling and impaired systolic and diastolic mechanics. Although our findings do not support CsA as a viable therapy for HFpEF, 2DST was effective in differentiating between progressive gradations of developing HF and detecting diastolic impairment prior to the development of overt diastolic dysfunction.

We recently reported that mitochondrial dysfunction, characterized by increased mitochondrial permeability transition (MPT), was present in a translational swine model of heart failure with preserved ejection fraction (HFpEF). Cyclophilin D is a key component of the MPT pore, therefore, the purpose of this study was to test the efficacy of a novel cyclosporine (CsA) dosing scheme as a therapeutic alternative for HFpEF. CsA treatment accelerated the development of heart failure, including dilatory LV remodeling and impaired systolic and diastolic mechanics. Although our findings do not support CsA as a viable therapy for HFpEF, 2DST was effective in differentiating between progressive gradations of developing HF and detecting diastolic impairment prior to the development of overt diastolic dysfunction.

Single bright light exposure decreases sweet taste threshold in healthy volunteers

INTRODUCTION

Bright light exposure can alter circulating serotonin levels, and alteration of available serotonin by acute selective serotonin reuptake inhibition significantly lowers sweet but not salt taste recognition thresholds. We tested the hypothesis that bright light exposure would increase sweet but not salt taste sensitivity in healthy adults.

METHODS

Fourteen healthy volunteers were exposed to bright (10,000 lux) and dim (<20 lux) light for 30 min each, in counterbalanced order. Measures of taste perception (salt and sweet) and mood were determined at baseline, and before and after each light exposure period.

RESULTS

Recognition thresholds for sucrose were significantly lower after bright but not dim light exposure. Thresholds for salt were unaffected by either condition. There were no significant changes in taste acuity, intensity or pleasantness for both the taste modalities and on visual analogue scales (VASs) for mood, anxiety, sleepiness and alertness, under either light condition.

CONCLUSION

Brief bright light exposure reduces sweet but not salt taste recognition thresholds in healthy humans.

The AIN-76A defined rodent diet accelerates the development of heart failure in SHHF rats: a cautionary note on its use in cardiac studies

Previous studies from our laboratory have shown positive benefits of linoleic acid (LA) feeding for attenuation of rat heart failure (HF). However, another research group concluded LA feeding was detrimental to cardiac function, using the American Institute of Nutrition 76A (AIN) diet as a background diet for the experimental animals only. To reconcile these conflicting results and determine whether (i) AIN has effects on cardiovascular function, and (ii) AIN reverses the positive effects of LA feeding, studies were performed using spontaneously hypertensive heart failure (SHHF) rats in both a survival study with lifetime feeding of AIN (control: Purina 5001) and a 2 × 2 factorial design for 6 weeks in young male SHHF rats with background diet and LA as variables. During a lifetime of AIN feeding, mortality from heart failure is significantly accelerated, cardiolipin altered and triglycerides increased. In young rats, 6 weeks on the AIN diet promoted increased systolic and diastolic blood pressure, increased fed and fasting blood glucose, increased serum inflammatory eicosanoids, decreased docosahexanoic acid, increased posterior wall thickness in diastole and an altered cardiolipin subspecies profile. The addition of LA to the AIN diet was able to rescue blood pressure. However, the combination increased retroperitoneal fat mass, body weight and fed blood glucose beyond the levels with the AIN diet alone. Because the AIN diet has wide ranging effects on cardiovascular parameters, our results suggest that it should not be used in animal studies involving the cardiovascular system unless induction of cardiac dysfunction is the desired outcome.

Heart failure with preserved ejection fraction: chronic low-intensity interval exercise training preserves myocardial O2 balance and diastolic function

We have previously reported chronic low-intensity interval exercise training attenuates fibrosis, impaired cardiac mitochondrial function, and coronary vascular dysfunction in miniature swine with left ventricular (LV) hypertrophy (Emter CA, Baines CP. Am J Physiol Heart Circ Physiol 299: H1348-H1356, 2010; Emter CA, et al. Am J Physiol Heart Circ Physiol 301: H1687-H1694, 2011). The purpose of this study was to test two hypotheses: 1) chronic low-intensity interval training preserves normal myocardial oxygen supply/demand balance; and 2) training-dependent attenuation of LV fibrotic remodeling improves diastolic function in aortic-banded sedentary, exercise-trained (HF-TR), and control sedentary male Yucatan miniature swine displaying symptoms of heart failure with preserved ejection fraction. Pressure-volume loops, coronary blood flow, and two-dimensional speckle tracking ultrasound were utilized in vivo under conditions of increasing peripheral mean arterial pressure and β-adrenergic stimulation 6 mo postsurgery to evaluate cardiac function. Normal diastolic function in HF-TR animals was characterized by prevention of increased time constant of isovolumic relaxation, normal LV untwisting rate, and enhanced apical circumferential and radial strain rate. Reduced fibrosis, normal matrix metalloproteinase-2 and tissue inhibitors of metalloproteinase-4 mRNA expression, and increased collagen III isoform mRNA levels (P < 0.05) accompanied improved diastolic function following chronic training. Exercise-dependent improvements in coronary blood flow for a given myocardial oxygen consumption (P < 0.05) and cardiac efficiency (stroke work to myocardial oxygen consumption, P < 0.05) were associated with preserved contractile reserve. LV hypertrophy in HF-TR animals was associated with increased activation of Akt and preservation of activated JNK/SAPK. In conclusion, chronic low-intensity interval exercise training attenuates diastolic impairment by promoting compliant extracellular matrix fibrotic components and preserving extracellular matrix regulatory mechanisms, preserves myocardial oxygen balance, and promotes a physiological molecular hypertrophic signaling phenotype in a large animal model resembling heart failure with preserved ejection fraction.

Basic biostatistics for post-graduate students

Statistical methods are important to draw valid conclusions from the obtained data. This article provides background information related to fundamental methods and techniques in biostatistics for the use of postgraduate students. Main focus is given to types of data, measurement of central variations and basic tests, which are useful for analysis of different types of observations. Few parameters like normal distribution, calculation of sample size, level of significance, null hypothesis, indices of variability, and different test are explained in detail by giving suitable examples. Using these guidelines, we are confident enough that postgraduate students will be able to classify distribution of data along with application of proper test. Information is also given regarding various free software programs and websites useful for calculations of statistics. Thus, postgraduate students will be benefitted in both ways whether they opt for academics or for industry.

Low-intensity interval exercise training attenuates coronary vascular dysfunction and preserves Ca²⁺-sensitive K⁺ current in miniature swine with LV hypertrophy

Coronary vascular dysfunction has been observed in several models of heart failure (HF). Recent evidence indicates that exercise training is beneficial for patients with HF, but the precise intensity and underlying mechanisms are unknown. Left ventricular (LV) hypertrophy can play a significant role in the development of HF; therefore, the purpose of this study was to assess the effects of low-intensity interval exercise training on coronary vascular function in sedentary (HF) and exercise trained (HF-TR) aortic-banded miniature swine displaying LV hypertrophy. Six months postsurgery, in vivo coronary vascular responses to endothelin-1 (ET-1) and adenosine were measured in the left anterior descending coronary artery. Baseline and maximal coronary vascular conductance were similar between all groups. ET-1-induced reductions in coronary vascular conductance (P < 0.05) were greater in HF vs. sedentary control and HF-TR groups. Pretreatment with the ET type A (ET(A)) receptor blocker BQ-123 prevented ET-1 hypersensitivity in HF animals. Whole cell voltage clamp was used to characterize composite K(+) currents (I(K(+))) in coronary smooth muscle cells. Raising internal Ca(2+) from 200 to 500 nM increased Ca(2+)-sensitive K(+) current in HF-TR and control, but not HF animals. In conclusion, an ET(A)-receptor-mediated hypersensitivity to ET-1, elevated resting LV wall tension, and decreased coronary smooth muscle cell Ca(2+)-sensitive I(K(+)) was found in sedentary animals with LV hypertrophy. Low-intensity interval exercise training preserved normal coronary vascular function and smooth muscle cell Ca(2+)-sensitive I(K(+)), illustrating a potential mechanism underlying coronary vascular dysfunction in a large-animal model of LV hypertrophy. Our results demonstrate the potential clinical impact of exercise on coronary vascular function in HF patients displaying pathological LV hypertrophy.

Reporting characteristics of cancer pain: a systematic review and quantitative analysis of research publications in palliative care journals

Objective:

A common disorder requiring symptom palliation in palliative and end-of-life care is cancer. Cancer pain is recognized as a global health burden. This paper sought to systematically examine the extent to which there is an adequate scientific research base on cancer pain and its reporting characteristics in the palliative care journal literature.

Materials and Methods:

Search conducted in MEDLINE and CINAHL sought to locate all studies published in 19 palliative/ hospice/ supportive/ end-of-life care journals from 2009 to 2010. The journals included were: American Journal of Hospice and Palliative Care, BMC Palliative Care, Current Opinion in Supportive and Palliative Care, End of Life Care Journal, European Journal of Palliative Care, Hospice Management Advisor, Indian Journal of Palliative Care, International Journal of Palliative Nursing, Internet Journal of Pain Symptom Control and Palliative Care, Journal of Pain and Palliative Care Pharmacotherapy, Journal of Palliative Care, Journal of Palliative Medicine, Journal of Social Work in End-of-life and Palliative Care, Journal of Supportive Oncology, Palliative Medicine, Palliative and Supportive Care, and Supportive Care in Cancer. Journal contents were searched to identify studies that included cancer pain in abstract.

Results:

During the years 2009 and 2010, of the selected 1,569 articles published in the journals reviewed, only 5.86% (92 articles) were on cancer pain.

Conclusion:

While researchers in the field of palliative care have studied cancer pain, the total percentage for studies is still a low 5.86%. To move the field of palliative care forward so that appropriate guidelines for cancer pain management can be developed, it is critical that more research be reported upon which to base cancer pain therapy in an evidence-based palliative care model.

Stimulation of neoplastic mouse lung cell proliferation by alveolar macrophage-derived, insulin-like growth factor-1 can be blocked by inhibiting MEK and PI3K activation

Background

Worldwide, lung cancer kills more people than breast, colon and prostate cancer combined. Alterations in macrophage number and function during lung tumorigenesis suggest that these immune effector cells stimulate lung cancer growth. Evidence from cancer models in other tissues suggests that cancer cells actively recruit growth factor-producing macrophages through a reciprocal signaling pathway. While the levels of lung macrophages increase during tumor progression in mouse models of lung cancer, and high pulmonary macrophage content correlates with a poor prognosis in human non-small cell lung cancer, the specific role of alveolar macrophages in lung tumorigenesis is not clear.

Methods

After culturing either an immortalized lung macrophage cell line or primary murine alveolar macrophages from naïve and lung-tumor bearing mice with primary tumor isolates and immortalized cell lines, the effects on epithelial proliferation and cellular kinase activation were determined. Insulin-like growth factor-1 (IGF-1) was quantified by ELISA, and macrophage conditioned media IGF-1 levels manipulated by IL-4 treatment, immuno-depletion and siRNA transfection.

Results

Primary macrophages from both naïve and lung-tumor bearing mice stimulated epithelial cell proliferation. The lungs of tumor-bearing mice contained 3.5-times more IGF-1 than naïve littermates, and media conditioned by freshly isolated tumor-educated macrophages contained more IGF-1 than media conditioned by naïve macrophages; IL-4 stimulated IGF-1 production by both macrophage subsets. The ability of macrophage conditioned media to stimulate neoplastic proliferation correlated with media IGF-1 levels, and recombinant IGF-1 alone was sufficient to induce epithelial proliferation in all cell lines evaluated. Macrophage-conditioned media and IGF-1 stimulated lung tumor cell growth in an additive manner, while EGF had no effect. Macrophage-derived factors increased p-Erk1/2, p-Akt and cyclin D1 levels in neoplastic cells, and the combined inhibition of both MEK and PI3K ablated macrophage-mediated increases in epithelial growth.

Conclusions

Macrophages produce IGF-1 which directly stimulates neoplastic proliferation through Erk and Akt activation. This observation suggests that combining macrophage ablation therapy with IGF-1R, MEK and/or PI3K inhibition could improve therapeutic response in human lung cancer. Exploring macrophage-based intervention could be a fruitful avenue for future research.

Metabolic consequences of sepsis-induced acute lung injury revealed by plasma ¹H-nuclear magnetic resonance quantitative metabolomics and computational analysis

Metabolomics is an emerging component of systems biology that may be a viable strategy for the identification and validation of physiologically relevant biomarkers. Nuclear magnetic resonance (NMR) spectroscopy allows for establishing quantitative data sets for multiple endogenous metabolites without preconception. Sepsis-induced acute lung injury (ALI) is a complex and serious illness associated with high morbidity and mortality for which there is presently no effective pharmacotherapy. The goal of this study was to apply ¹H-NMR based quantitative metabolomics with subsequent computational analysis to begin working towards elucidating the plasma metabolic changes associated with sepsis-induced ALI. To this end, this pilot study generated quantitative data sets that revealed differences between patients with ALI and healthy subjects in the level of the following metabolites: total glutathione, adenosine, phosphatidylserine, and sphingomyelin. Moreover, myoinositol levels were associated with acute physiology scores (APS) (ρ = -0.53, P = 0.05, q = 0.25) and ventilator-free days (ρ = -0.73, P = 0.005, q = 0.01). There was also an association between total glutathione and APS (ρ = 0.56, P = 0.04, q = 0.25). Computational network analysis revealed a distinct metabolic pathway for each metabolite. In summary, this pilot study demonstrated the feasibility of plasma ¹H-NMR quantitative metabolomics because it yielded a physiologically relevant metabolite data set that distinguished sepsis-induced ALI from health. In addition, it justifies the continued study of this approach to determine whether sepsis-induced ALI has a distinct metabolic phenotype and whether there are predictive biomarkers of severity and outcome in these patients.