Comparing cardiorespiratory fitness and physical activity levels between third- and fifth-year medical students in a South African university

Background

Cardiovascular disease (CVD) risk factors such as sedentary behaviour, decreased physical activity (PA), and low cardiorespiratory fitness lead to an increased and accelerated risk of cardiovascular disease and mortality. Medical students tend to adopt sedentary lifestyles due to a demanding curriculum. This may have a negative effect on CVD risk factors and cardiorespiratory fitness levels of medical students.

Objectives

To compare physical activity and cardiorespiratory fitness levels in a cohort of third- and fifth-year undergraduate medical students in a South African university.

Methods

Data from 123 third-year and 139 fifth-year medical students in the Graduate Entry Medical Programme (GEMP) at the Faculty of Health Sciences, University of the Witwatersrand, were collected. Measurements included CVD risk factors, height, weight, blood pressure, waist circumference, cardiorespiratory fitness, physical activity vital signs and pre-participation health screening questionnaires. Descriptive statistics were presented as mean ± standard deviation or median [interquartile range] depending whether the data were normally distributed or not.

Results

Both groups had low cardiorespiratory fitness when compared to norm values (GEMPI VO2 peak was 29.1 ± 5.9 ml.kg-1.min-1 and GEMPIII VO2 peak was 30.0[11.0] ml.kg-1.min-1). Most participants did not meet WHO physical activity requirements (GEMP I: 72%; GEMP III: 78%). There were significant differences in BMI (p=0.046), diastolic blood pressure (p=0.034) and VO2 peak (p=0.00001) between students meeting and not meeting WHO physical activity requirements (p<0.05).

Conclusion

Third- and fifth-year medical students at a South African university fail to meet recommended WHO physical activity levels and are below cardiorespiratory fitness norms. Therefore, medical institutions should promote and implement targeted physical activity interventions to reduce the prevalence of low fitness levels and the associated health hazards among their students.

The quality and pattern of rehabilitation interventions prescribed for post-COVID-19 infection patients: A systematic review and meta-analysis

Patients with prior COVID-19 infection may present with lasting multisystem symptoms that require intervention and includes exercise rehabilitation. The aim of this systematic review was to investigate the quality of articles, with emphasis on exercise rehabilitation, and conduct a meta-analysis on experimental and observational rehabilitation intervention studies on cardiorespiratory fitness and pulmonary function in post-COVID-19 infection patients. This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines for evaluating rehabilitation interventions in clinical practice. A methodical search of cohort and experimental studies occurred from January 2019 up to March 2023. Thirty-two studies were included for complete analysis. The quality of the eligible studies for complete review was fair overall. The studies did not provide a detailed account of key descriptors of exercise such as volume, progression, motivational strategies, adherence and replication. There was a significant difference in the 6-minute walk test (Mean difference (MD) = 51.69 m; confidence intervals (CIs) = 36.99 to 66.38; p < 0.001, level of heterogeneity (I2) = 0), percent of predicted forced expiratory volume in one second (MD = 7.95%; CIs = 3.46 to 12.44; p = 0.0005, I2 = 65%) and percent of predicted forced vital capacity (MD = 3.49%; 95% CI = 1.25 to 5.73; p = 0.002; I2 = 37%) between the experiment and control groups. The current evidence suggests that rehabilitation interventions significantly improve cardiorespiratory fitness and pulmonary function in post-COVID-19 infection patients; however, there is a need for conceptualising high-quality and long-term rehabilitation interventions, especially exercise interventions.

Effect of a novel 90-second "Gear" exercise programme on markers of inflammation and cardiorespiratory fitness measurements in person at risk of cardiovascular disease

The study compared the effect of the novel "Gear" exercise programmes on inflammatory markers and cardiorespiratory fitness measurements. The participants mean age was 38 ± 5.74 years, with a mean body mass of 83 ± 16.93kg. Participants were randomly assigned to either the "Gear" exercise programme repeated at different times during the day (GEP-DT): cycled for 90 seconds, repeated three times per day, three days per week; the "Gear" exercise programme repeated at one point in time (GEP-OT): cycled for 90 seconds followed by four minutes and 30 seconds rest, repeated three times at one point in time, three days per week; moderate-intensity continuous exercise group (MICE): cycled for 30 minutes at 55-69% of HRmax or the control group (CTRL): did not exercise. The GEP-DT demonstrated a moderate increase in load at ventilation threshold (VT-L) (MD = 8.18 ± 12.30, % Δ = 14.53, d = 0.77, d (95% CI): (-0.17, 1.64)). The GEP-OT group demonstrated a large effect size for VT-L (MD = 11.79 ± 18.77, % Δ = 18.86, d = 0.81, d (95% CI): (-0.02, 1.63)). The GEP-DT and GEP-OT raised the VT-L, which prevented premature fatigue and improved the efficiency of the cardiorespiratory system.

Exercise intervention for post-acute COVID-19 syndrome - do FITT-VP principles apply? A case study

The lack of standardisation of reporting exercise interventions hampers the development of best practice guidelines for long COVID patients. This case study on the effect of an exercise intervention in a long COVID patient applied the Consensus on Exercise Reporting Template (CERT) for reporting interventions. FITT-VP exercise prescription principles for long COVID rehabilitation are also suggested. A 58-year-old male, previously hospitalised for 14 days in the ward for the intensive care for the management of severe COVID-19 infection, joined an exercise rehabilitation programme. A medical history, anthropometric, biochemical, lung function, blood pressure, cardiorespiratory fitness and strength measures were all assessed before and after the eight week exercise intervention programme. Positive changes were found in all lung function test measures. Cardiorespiratory fitness, endurance capacity and muscle strength improved. However, the greatest improvements occurred in functional status, fatigue, dyspnoea and the state of depression levels. This case study suggested that in the absence of other instruments, the FITT-VP principles may be used for long COVID patients, and CERT for reporting interventions, but these should be further researched.

High genetic diversity and zoonotic potential of Staphylococcus aureus strains recovered from bovine intramammary infections in Colombians dairy herds

Genotyping of Staphylococcus aureus isolated from mastitis has become a fundamental tool to understand its complex epidemiology and to evaluate spillover events. The aim of this study was to describe the frequency of genotypes of the S. aureus strains isolated from intramammary infections by spa typing technique, and to evaluate the association between genotypes and the ability to form biofilm under in vitro conditions. Sixty-six strains of S. aureus recovered from bovines intramammary infections on 56 dairy herds located in 14 municipalities of the department of Antioquia were characterized. The majority of strains (65/66) were isolated from milk samples collected from dairy cows with subclinical intramammary infections. Nineteen different spa types were found in this study, t521 (19.70%), t267 (15.15%), and t605 (12.12%) being the most frequent. The strains from the t605 spa type showed the highest biofilm production. The high frequency of spa types with zoonotic potential found in this study, identified cattle as an important reservoir of theses clones for people in close proximity, such as milkers and consumers of unpasteurized dairy products.

Ultra Deep Sequencing of Circulating Cell-Free DNA as a Potential Tool for Hepatocellular Carcinoma Management

Simple Summary

In this unicentric prospective study, we analyzed the most prevalent mutations in HCC (TERT promoter, TP53, CTNNB1, AXIN1 and ARID1A) in plasma cfDNA by next-generation sequencing, aiming to elucidate their value as prognostic noninvasive biomarkers. Total cfDNA (cut-off value 2 ng/µL), number of mutated genes and number of detectable mutations on cfDNA were significantly related to mortality. Number of mutated genes and number of detected mutations in cfDNA and the ratio between number of mutations and total amount of cfDNA were also significantly associated with recurrence. Detection of more than four mutations in cfDNA correlated with a higher risk of death. Dynamic changes in cfDNA mutations were detected prior to radiological detection of HCC recurrence. We believe that these results support the proof of principle and launching of validation studies to confirm that total cfDNA and detection of prevalent HCC mutations could have prognostic implications in early-stage HCC patients.

Abstract

Background: Cell-free DNA (cfDNA) concentrations have been described to be inversely correlated with prognosis in cancer. Mutations in HCC-associated driver genes in cfDNA have been reported, but their relation with patient’s outcome has not been described. Our aim was to elucidate whether mutations found in cfDNA could be representative from those present in HCC tissue, providing the rationale to use the cfDNA to monitor HCC. Methods: Tumoral tissue, paired nontumor adjacent tissue and blood samples were collected from 30 HCC patients undergoing curative therapies. Deep sequencing targeting HCC driver genes was performed. Results: Patients with more than 2 ng/µL of cfDNA at diagnosis had higher mortality (mean OS 24.6 vs. 31.87 months, p = 0.01) (AUC = 0.782). Subjects who died during follow-up, had a significantly higher number of mutated genes (p = 0.015) and number of mutations (p = 0.015) on cfDNA. Number of mutated genes (p = 0.001), detected mutations (p = 0.001) in cfDNA and ratio (number of mutations/cfDNA) (p = 0.003) were significantly associated with recurrence. However, patients with a ratio (number of mutations/cfDNA) above 6 (long-rank p = 0.0003) presented a higher risk of recurrence than those with a ratio under 6. Detection of more than four mutations in cfDNA correlated with higher risk of death (long-rank p = 0.042). Conclusions: In summary, cfDNA and detection of prevalent HCC mutations could have prognostic implications in early-stage HCC patients

Long-term effect of obstructive sleep apnea and CPAP treatment on blood pressure control in patients after acute coronary syndrome

Funding Acknowledgements

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Instituto de Salud Carlos III (ISCIII) (PI10/02763, PI10/02745, PI18/00449, PI19/00907), co-funded by FEDER “Una manera de hacer Europa”, SEPAR, Catalonian Cardiology Society, ResMed Ltd. (Australia), EsteveTeijin (Spain), Oxigen Salud (Spain), Associació Lleidatana de Respiratori (ALLER), CIBERES. MS received financial support from a "Ramón y Cajal" grant (RYC2019-027831-I) from the“Ministerio de Ciencia e Innovación - Agencia Estatal de Investigación” co-funded by the European Social Fund (ESF)/“Investing in your future”. AZ held the predoctoral fellowship “Ajuts 2021 de Promoció de la Recerca en Salut-9ª edició” from IRBLleida/Diputació de Lleida. JdB acknowledges receiving financial support from ISCIII (Miguel Servet 2019: CP19/00108), co-funded by the European Social Fund (ESF), “Investing in your future”.

Rationale

Obstructive sleep apnea (OSA) is prevalent in acute coronary syndrome (ACS) patients and is a cause of secondary hypertension.

Objectives

To evaluate the long-term effects of OSA and CPAP treatment on blood pressure (BP) control in patients discharged after an ACS.

Methods

Post hoc analysis of the ISAACC study included 1803 patients admitted for ACS (NCT01335087). Patients with OSA (apnea-hypopnea index ≥15 events/h) were randomly assigned to receive either CPAP or/and usual care and followed up for one to 5 years. Office BP was determined at each visit.

Measurements and Main Results

We included 596 patients without OSA, 605 patients in the CPAP group, and 602 patients in the usual care group. 52% of the patients had a diagnosis of hypertension at baseline. Median age and body mass index were 59 [52.0;67.0] years and 28.2 [25.6;31.2] kg/m2, respectively. After a median [25th;75th percentile] follow-up of 41.2 [18.3;59.6] months, BP changes were similar between OSA and non-OSA groups. However, we observed an increase in BP in the third tertile of the AHI (AHI&gt;40 events/h) with a maximum difference in mean BP of +3.3 mmHg at 30 months. OSA patients with good CPAP adherence (≥4 hours/night) reduced mean BP after 18 months compared to non-OSA and poor CPAP adherence patients, maximum mean difference (95% CI) of -4.7 (-6.7,-2.7) mmHg. In patients with severe OSA we observed a maximum mean difference of -7.1 (-10.3,-3.8) mmHg.

Conclusions

In patients discharged after an ACS, severe OSA is associated with a long-term increase in BP, which is reduced by good CPAP adherence.

The World Organisation for Animal Health - current and potential roles in safe international trade of bees and other insects

The World Organisation for Animal Health (WOAH, founded as OIE) is the recognised intergovernmental standard-setting organisation for animal health and welfare. The WOAH mandate is to support its members in the prevention of the spread of animal diseases of concern, as listed in the Terrestrial Animal Health Code (Terrestrial Code). Once a disease, infection or infestation is listed, national Veterinary Authorities have the obligation regularly to notify WOAH of the presence or absence of the listed disease. In regard to insects, the scope of the Terrestrial Code limits its recommendations to preserving the health of bees (species of the genus Apis, extended to the genus Bombus and to the stingless bees for one disease). However, it does not include standards to mitigate the potential animal health risks associated with the international trade of other insects. A description of the standard-setting process and a review of the history of the standards for bee health highlight the resources and requirements to expand the scope of the Terrestrial Code to include recommendations for animal health risk mitigation measures for the safety of international trade in insects. Any initiative to develop guidance on insect trade should include WOAH in its role as the sole global standard-setting organisation on animal health and welfare matters. This aligns with the WOAH commitment to a One Health approach.

Issues and gaps in international guidance and national regulatory systems affecting international live insect trade

International trade in live insects involves the shipping of many different species, for various purposes, with a variety of handling requirements regulated by numerous authorities with varying objectives. The diversity of factors at play has both created and been subject to a complex regulatory landscape. A review of global production, shipping and use experiences from a range of perspectives has shown gaps and inconsistencies in international guidance and national implementation. Private carriers add another layer of uncertainty that is disproportionate to risks, resulting in variable practices and charges. Many benefits can come from international trade in insects, including pollinator services, control of pests and of disease vectors, and enhanced international scientific research and innovation. These benefits will be better achieved through a more evidence-based and efficient approach to regulating trade. This change in approach will in turn require an improved and widely accepted risk-management landscape for insect trade.

International live insect trade: a survey of stakeholders

There are significant numbers of transboundary shipments of live insects for pollination, pest management, industrial processes, research and other uses, but data collection and analysis have proved difficult. The World Organisation for Animal Health and Collectif TIS (Technique de l'Insecte Stérile), a French think tank, carried out a stakeholder survey to understand the nature of the live insect trade and potential challenges to safety and efficiency. Target respondents had experience in the areas of biocontrol, sterile insect technique, entomological research and regulatory affairs. Although the survey was sent globally, the responses were unintentionally biased towards Europe, where interest is high, since this region is developing a comprehensive framework to promote the use of beneficial insects to replace pesticides. The survey also explored respondents' knowledge of several international agreements on the movement and risk management of beneficial or invasive insects. Knowledge of the various regulations was generally poor, and respondents highlighted a perceived lack of clarity regarding live insect shipments in the existing international regulations and guidelines. Almost two-thirds of participants reported reluctance by carriers to accept live insects for shipment, and three-quarters described occasional to systematic delays that resulted in a reduction of quality or viability. Some respondents reported that they instead hand-carry live insects, mostly in small quantities. Participants described being directly involved in trade covering 70 species of live insects and ticks transported among 37 countries, with volumes ranging from fewer than ten insects to over a million per shipment. Of these, 30% were potential vectors of pathogens to humans or animals, 42% were potential plant pest species (including some used for biocontrol), and 17% were classical biocontrol agents. The results of this survey begin to define the current scope, scale and issues for those involved in shipping live insects and ticks across political boundaries. The survey's aim is to persuade regulatory bodies and shipping operators to facilitate safety, efficiency and consistency in this underdeveloped sector.

Can there be a common, risk-based framework for decisions around live insect trade?

A network of scientists involved in shipment of live insects has met and generated a series of articles on issues related to live insect transport. The network is diverse, covering large-scale commercial interests, government operated areawide control programmes, biomedical research and many smaller applications, in research, education and private uses. Many insect species have a record of safe transport, pose minimal risks and are shipped frequently between countries. The routine shipments of the most frequently used insect model organism for biomedical research, Drosophila melanogaster, is an example. Successful large scale shipments from commercial biocontrol and pollinator suppliers also demonstrate precedents for low-risk shipment categories, delivered in large volumes to high quality standards. Decision makers need access to more information (publications or official papers) that details actual risks from the insects themselves or their possible contaminants, and should propose proportionate levels of management. There may be harm to source environments when insects are collected directly from the wild, and there may be harm to receiving environments. Several risk frameworks include insects and various international coordinating bodies, with experience of guidance on relevant risks, exist. All stakeholders would benefit from an integrated overview of guidance for insect shipping, with reference to types of risk and categories of magnitude, without trying for a single approach requiring universal agreement. Proposals for managing uncertainty and lack of data for smaller or infrequent shipments, for example, must not disrupt trade in large volumes of live insects, which are already supporting strategic objectives in several sectors.

Association of the acute:chronic workload ratio and wellness scores in premier league male hockey players

Background

The relationship between acute:chronic workload ratios (ACWR) and the incidence of injury, as well as the relationship between subjective wellness scores and training load, is unclear in hockey players.

Objectives

This study investigated these relationships to determine if the ACWR is a useful workload management tool for field hockey players. In addition, the study investigated the association between specific subjective wellness scores (fatigue, sleep quality, general muscle soreness, mood and stress level) and the acute:chronic workload ratio and training load. The study also assessed the association between individual players' training loads with the self-reported wellness scores.

Methods

Fourteen male field hockey players from the men's first team at the University of the Witwatersrand participated in the study over ten weeks during a premier league competition phase. A Google form was completed within thirty minutes of every training session/match. This form consisted of questions that allowed for the calculation of the ACWR.

Results

No incidence of injury was reported during the ten-week period. ACWR scores ranged between 0.67 and 1.87. The ACWR was associated with general muscle soreness (p = 0.010) and training load was associated with fatigue (p = 0.002), sleep quality (p = 0.05), general muscle soreness (p = 0.004), and mood (p=0.025).

Conclusion

There may be some merit in the use of subjective wellness measures as workload management tools in field hockey. Further research is required to determine if there is an optimal ACWR for this sport.

Characterization of Agfa Structurix series D4 and D3sc x-ray films in the 0.7-4.6 keV energy range

X-ray films remain a key asset for high-resolution x-ray spectral imaging in high-energy-density experiments conducted at the National Ignition Facility (NIF). The soft x-ray Opacity Spectrometer (OpSpec) fielded at the NIF has an elliptically shaped crystal design that measures x rays in the 900-2100 eV range and currently uses an image plate as the detecting medium. However, Agfa D4 and D3sc x-ray films' higher spatial resolution provides increased spectral resolution to the data over the IP-TR image plates, driving the desire for regular use of x-ray film as a detecting medium. The calibration of Agfa D4 x-ray film for use in the OpSpec is communicated here. These calibration efforts are vital to the accuracy of the NIF opacity measurements and are conducted in a previously un-studied x-ray energy range under a new film development protocol required by NIF. The absolute response of Agfa D4 x-ray film from 705 to 4620 eV has been measured using the Nevada National Security Site Manson x-ray source. A broader range of energies was selected to compare results with previously published data. The measurements were taken using selected anodes, filters, and applied voltages to produce well-defined energy lines.

Deletion of Ulk1 inhibits neointima formation by enhancing KAT2A/GCN5-mediated acetylation of TUBA/α-tubulin in vivo

ULK1 (unc-51 like autophagy activating kinase) has a central role in initiating macroautophagy/autophagy, a process that contributes to atherosclerosis and neointima hyperplasia, or excessive tissue growth that leads to vessel dysfunction. However, the role of ULK1 in neointima formation remains unclear. We aimed to determine how Ulk1 deletion affected neointima formation and to investigate the underlying mechanisms. We measured autophagy activity, vascular smooth muscle cell (VSMC) migration and neointima hyperplasia in cultured VSMCs and ligation-injured mouse carotid arteries from male wild-type (WT, C57BL/6 J) and VSMC-specific ulk1 knockout (ulk1 KO) mice. Carotid artery ligation in WT mice increased ULK1 protein expression, and concurrently increased autophagic flux and neointima formation. Treating human aortic smooth muscle cells (HASMCs) with PDGF (platelet derived growth factor) increased ULK1 expression, activated autophagy, and promoted cell migration. Further, smooth muscle cell-specific deletion of Ulk1 suppressed autophagy, inhibited VSMC migration, and impeded neointima hyperplasia. Mechanistically, Ulk1 deletion inhibited autophagic degradation of histone acetyltransferase protein KAT2A/GCN5 (K[lysine] acetyltransferase 2A), resulting in accumulation of KAT2A that directly acetylated TUBA/α-tubulin and subsequently increased protein levels of acetylated TUBA. The acetylation of TUBA increased microtubule stability and inhibited VSMC directional migration and neointima formation. Finally, local transfection of Kat2a siRNA decreased TUBA acetylation and prevented the attenuation of vascular injury-induced neointima formation in ulk1 KO mice. These findings suggest that Ulk1 deletion inhibits neointima formation by reducing autophagic degradation of KAT2A and increasing TUBA acetylation in VSMCs.Abbreviations: ACTA2/α-SMA: actin, alpha 2, smooth muscle, aorta; ACTB: actin beta; ATAT1: alpha tubulin acetyltransferase 1; ATG: autophagy related; BECN1: beclin 1; BP: blood pressure; CAL: carotid artery ligation; CQ: chloroquine diphosphate; EC: endothelial cells; EEL: external elastic layer; FBS: fetal bovine serum; GAPDH: glyceraldehyde 3-phosphate dehydrogenase; HASMCs: human aortic smooth muscle cells; HAT1: histone acetyltransferase 1; HDAC: histone deacetylase; IEL: inner elastic layer; IP: immunoprecipitation; KAT2A/GCN5: K(lysine) acetyltransferase 2A; KAT8/hMOF: lysine acetyltransferase 8; MAP1LC3: microtubule associated protein 1 light chain 3; MYH11: myosin heavy chain 11; PBS: phosphate-buffered saline; PDGF: platelet derived growth factor; PECAM1/CD31: platelet and endothelial cell adhesion molecule 1; RAC3: Rac family small GTPase 3; SIRT2: sirtuin 2; SPP1/OPN: secreted phosphoprotein 1; SQSTM1/p62: sequestosome 1; TAGLN/SM22: transgelin; TUBA: tubulin alpha; ULK1: unc-51 like autophagy activating kinase; VSMC: vascular smooth muscle cell; VVG: Verhoeff Van Gieson; WT: wild type.

'I'm doing it for myself': Using a smartphone-based exercise service during the COVID-19 lockdown in the Faculty of Health Sciences, University of the Witwatersrand, South Africa

Background

Sufficient physical activity (PA) lowers poor health outcomes, with data showing these protective effects in populations under varying levels of lockdown during the COVID-19 pandemic. The advent of online PA programmes has created novel opportunities to offset the deleterious effects of inactivity. However, data are limited and the readiness and acceptance of such technology is unknown. These authors nevertheless noted an opportunity to investigate this approach based on promising emerging data at the time of the hard lockdown in South Africa.

Objective

This exploratory study investigated the engagement and perceptions of a smartphone application to promote health and fitness in a sample of employees at a South African university.

Methods

Employed members of staff (n=15) of the University of the Witwatersrand were recruited through email invitation during the hard Level 5 COVID-19 lockdown in 2020. Individualised home-based PA programmes were prescribed through a mobile application for a period of eight weeks. Researchers qualified in Biokinetics provided online supervision of the exercise sessions during the intervention. Participants were asked to complete a self-reported questionnaire about their use of the application. Thematic analysis was used to understand these responses.

Results

Lack of motivation was perceived to have a negative effect on participation in the online PA programme. Only one participant reported using the mobile application consistently during the study period, while half of the participants reported having trouble with the usage of the application. The participants frequently mentioned the need for technical support and further engagement from the clinicians supervising the PA programme to ensure use and progression. Staff identified issues with connectivity and already having too many phone applications (apps) amongst the reasons for the technical difficulties.

Conclusion

This study demonstrates the challenges and potential for the uptake of online PA interventions during COVID-19 and, despite its small sample size, the data provide important lessons learned that will be used as information in further investigations.

Effect of the 90-second 'Gear' exercise programme on cardiometabolic risk factors in persons with an elevated risk of cardiovascular disease

Background

High-intensity interval training has recently gained popularity at improving cardiometabolic health. However, a close investigation of high-intensity interval training reveals that the exercise duration is similar to moderate-intensity continuous exercise.

Objective

To compare the effect of the time-efficient 'Gear' exercise programmes to traditional exercise on cardiometabolic risk factors in persons with an elevated risk of cardiovascular disease.

Methods

The study implemented a six-week, randomised controlled trial. The variables were low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, total cholesterol, glycated haemoglobin (HbA1c), blood pressure and body composition. Forty-eight participants completed the study. Participants were randomly assigned to either the 'Gear' exercise programme repeated at different times during the day (GEP-DT): cycled for 90 seconds, repeated three times/day, for three days/week (n = 12); 'Gear' exercise programme at one point in time (GEP-OT): cycled for 90 seconds followed by 4 minutes and 30 seconds rest, repeated three times at one point in time, for three days/week (n = 14); 30 minutes of moderate-intensity continuous cycling repeated three days/week at 55-69% HR_max (n = 11); and the controls, who were encouraged not to exercise (n = 11).

Results

The 90-second GEP-DT intervention reduced HbA1c post six-weeks of training (MD = 0.1±0.4, % Δ = -1.3%, d = -0.70). The GEP-OT group decreased blood triglycerides with a large effect size (MD = 0.6±1.3, % Δ = -31.9%, d = -0.83).

Conclusion

The novel 90-second 'Gear' exercise programme moderately reduced HbA1c and the 18-minute GEP-OT lowered blood triglycerides. 'Gear' exercise programmes will encourage future research in persons with non-communicable diseases, and it should be considered as a public health initiative to promote exercise in clinical, home and work environments.

Identification and validation of endogenous control miRNAs in plasma samples for normalization of qPCR data for Alzheimer's disease

Background

MicroRNAs (miRNAs) are noncoding RNAs that are highly relevant as disease biomarkers. Several studies that explored the role of miRNAs in Alzheimer’s disease (AD) demonstrated their usefulness in clinical identification. Nevertheless, miRNAs that may act as endogenous controls (ECs) have not yet been established. The identification of ECs would contribute to the standardization of these biomarkers in AD. The objective of the study was to identify miRNAs that can be used as ECs in AD.

Methods

We evaluated 145 patients divided into two different cohorts. One was a discovery cohort of 19 women diagnosed with mild to moderate AD (Mini-Mental State Examination (MMSE) score ≥ 20) and with confirmed pathologic levels of Aβ42 in CSF. The stability assessment cohort consisted of 126 individuals: 24 subjects without AD or any kind of dementia and negative for all core CSF biomarkers of AD, 25 subjects with MCI and negative for CSF biomarkers (MCI −), 22 subjects with MCI and positive for CSF biomarkers (MCI +), and 55 subjects with AD and positive for CSF biomarkers. In the discovery cohort, a profile of 384 miRNAs was determined in the plasma by TaqMan low-density array. The best EC candidates were identified by mean-centering and concordance correlation restricted normalization methods. The stability of the EC candidates was assessed using the GeNorm, BestKeeper, and NormFinder algorithms.

Results

Nine miRNAs (hsa-miR-324-5p, hsa-miR-22-5p, hsa-miR-103a-2-5p, hsa-miR-362-5p, hsa-miR-425-3p, hsa-miR-423-5p, hsa-let-7i-3p, hsa-miR-532-5p, and hsa-miR-1301-3p) were identified as EC candidates in the discovery cohort. The validation results indicated that hsa-miR-103a-2-5p was the best EC, followed by hsa-miR-22-5p, hsa-miR-1301-3p, and hsa-miR-425-3p, which had similar stability values in all three algorithms.

Conclusions

We identified a profile of four miRNAs as potential plasma ECs to be used for normalization of miRNA expression data in studies of subjects with cognitive impairment.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13195-020-00735-x.

Changes in cardiorespiratory fitness and cardiovascular health in the workplace: a case study

Background

Cardiorespiratory fitness (CRF) is an independent predictor of cardiovascular (CV) and all-cause mortality, contributing a higher proportion of CV risk compared to other traditionally recognised risk factors. However, CRF is not included in usual workplace wellness protocols and, as such, employers are not aware of the importance of this factor.

Aim

The aim of this case study was to explore the effect of a 12-week exercise intervention programme on CRF, CV health and medical health claims in a male participant who was employed by a corporate company with existing chronic diseases.

Findings

Health outcome measures improved after the 12-week exercise intervention programme. CRF showed the greatest improvement and medical health claims were lowered during the three-month post-intervention period.

Implications

CRF should be included as a health outcome measure in worksite wellness programmes and monitored.

Genotypic and phenotypic characterization of biofilm production by Staphylococcus aureus strains isolated from bovine intramammary infections in Colombian dairy farms

The ability of Staphylococcus aureus to form biofilms is an important virulence factor because this has been associated with persistent bovine intramammary infections. Different mechanisms of biofilm formation have been described in S. aureus; however, the process has been found to be mainly driven by the ica and bap genes. The presence of the ica and bap genes, as well as the biofilm formation in vitro were evaluated in 229 S. aureus strains isolated from bovine milk collected from different regions of Department of Antioquia, Colombia. Three different genotypes grouped into three separate clusters were identified from in vitro assays. Genotype 1 (ica positive and bap negative) was the most prevalent (78.17%), followed by genotype 2 (ica and bap positive) (12.66%) and genotype 0 (ica and bap negative) (9.17%). Biofilm formation was observed in 81.26% of the strains from which 100% of genotype 2 isolates showed biofilm formation. The biofilms formed by genotype 2 isolates were also found to have the highest optical density (>2.4). These results showed that most of the S. aureus strains were capable of biofilm formation, suggesting the virulence potential particularly in bap-positive strains.

PPARγ Regulates Mitochondrial Structure and Function and Human Pulmonary Artery Smooth Muscle Cell Proliferation

Pulmonary hypertension (PH) is a progressive disorder that causes significant morbidity and mortality despite existing therapies. PH pathogenesis is characterized by metabolic derangements that increase pulmonary artery smooth muscle cell (PASMC) proliferation and vascular remodeling. PH-associated decreases in peroxisome proliferator-activated receptor γ (PPARγ) stimulate PASMC proliferation, and PPARγ in coordination with PPARγ coactivator 1α (PGC1α) regulates mitochondrial gene expression and biogenesis. To further examine the impact of decreases in PPARγ expression on human PASMC (HPASMC) mitochondrial function, we hypothesized that depletion of either PPARγ or PGC1α perturbs mitochondrial structure and function to stimulate PASMC proliferation. To test this hypothesis, HPASMCs were exposed to hypoxia and treated pharmacologically with the PPARγ antagonist GW9662 or with siRNA against PPARγ or PGC1α for 72 hours. HPASMC proliferation (cell counting), target mRNA levels (qRT-PCR), target protein levels (Western blotting), mitochondria-derived H₂O₂ (confocal immunofluorescence), mitochondrial mass and fragmentation, and mitochondrial bioenergetic profiling were determined. Hypoxia or knockdown of either PPARγ or PGC1α increased HPASMC proliferation, enhanced mitochondria-derived H₂O₂, decreased mitochondrial mass, stimulated mitochondrial fragmentation, and impaired mitochondrial bioenergetics. Taken together, these findings provide novel evidence that loss of PPARγ diminishes PGC1α and stimulates derangements in mitochondrial structure and function that cause PASMC proliferation. Overexpression of PGC1α reversed hypoxia-induced HPASMC derangements. This study identifies additional mechanistic underpinnings of PH, and provides support for the notion of activating PPARγ as a novel therapeutic strategy in PH.

Observations and Projections of Heat Waves in South America

Although Heat Waves (HWs) are expected to increase due to global warming, they are a regional phenomenon that demands for local analyses. In this paper, we assess four HW metrics (HW duration, HW frequency, HW amplitude, and number of HWs per season) as well as the share of extremely warm days (TX95, according to the 95th percentile) in South America (SA). Our analysis included observations as well as simulations from global and regional models. In particular, Regional Climate Models (RCMs) from the Coordinated Regional Climate Downscaling Experiment (CORDEX), and Global Climate Models (GCMs) from the Coupled Model Intercomparison Project Phase 5 (CMIP5) were used to project both TX95 estimates and HW metrics according to two representative concentration pathways (RCP4.5 and RCP8.5). We found that in recent decades the share of extremely warm days has at least doubled over the period December-January-February (DJF) in northern SA; less significant increases have been observed in southern SA. We also found that by midcentury, under the RCP4.5 scenario, extremely warm DJF days (as well as the number of HWs per season) are expected to increase by 5-10 times at locations close to the Equator and in the Atacama Desert. Increases are expected to be less pronounced in southern SA. Projections under the RCP8.5 scenario are more striking, particularly in tropical areas where half or more of the days could be extremely warm by midcentury.

Global rabies control: the role of international organisations and the Global Strategic Plan to eliminate dog-mediated human rabies

International partners are united to reach the shared goal of zero dog-mediated human rabies deaths by 2030, worldwide. Under the Tripartite collaboration, the World Health Organization, the World Organisation for Animal Health and the Food and Agriculture Organization of the United Nations are prioritising rabies as a model for 'One Health' in action. In 2015, the Global Rabies Conference led to the development of the Global Framework for the Elimination of Dog-Mediated Human Rabies. This long-term strategy centres around five pillars of rabies elimination (STOP-R): i) Sociocultural; ii) Technical; iii) Organisational; iv) Political; and v) Resources. Together with their partners, the Tripartite are working to operationalise the Framework through: i) engaging communities to build rabies awareness; ii) strengthening human and animal health systems, surveillance, and providing proof of concept that rabies elimination is feasible; iii) promoting intersectoral and regional collaboration; iv) advocating for political engagement and support; and v) building the case for investment through public-private partnerships and a Global Strategic Plan to end human deaths from dog-mediated rabies. By creating an enabling environment for countries to prioritise rabies and implement existing tools, the Tripartite are committed to catalysing change, empowering nations and providing the necessary support to consign rabies to the history books.

A review of surrogate motherhood regulation in south American countries: pointing to a need for an international legal framework

Background

Advances in science and technology coupled with globalization are changing access to and utilization of reproductive health services. This includes the transnational phenomenon of families who use surrogate mothers to reproduce, with forms of altruistic and commercial surrogacy becoming more commonplace. Simultaneously, changes in law, regulation, and policy are necessary to protect surrogates, intended parents, and resulting children. These developments have been slow to adapt to challenges inherent to surrogacy arrangements, most specifically in low-and middle-income countries, including in South American countries.

Methods

We conducted an interdisciplinary non-systematic literature review and legal analysis of existing and pending policy, laws, and regulations related to commercial surrogacy arrangements in Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Uruguay, and Venezuela. The review focused on articles that discussed topics of domestic and international law, policy, regulation, and governance related to commercial surrogacy. We queried PubMed, JSTOR, and Google Scholar for Spanish and English-language articles limited to those published between 2000 and 2016.

Results

Our literature and legal review found a wide variance in how different countries address the issue, including two (Brazil and Uruguay) that have issued guidance attempting to clarify the legality of commercial surrogacy, others who have introduced surrogacy-specific legislation, and a final group with no specific legal mechanisms in place. Our extracted legal case studies also indicate that courts have a hard time interpreting existing law and its applicability to surrogacy. The influence of Catholicism also played a role in the adoption of surrogacy and other advanced reproductive technology (ART)-related legislation.

Conclusions

Changes in global infertility rates, the emergence of new family structures, and advancement of ART are factors that will influence future development of legal frameworks addressing surrogacy in South America. Despite a growing transnational market for commercial surrogacy in many of the countries examined, the current patchwork of policy does little to clarify what forms of surrogacy are legally permissible, nor do they adequately protect surrogates, intended parents, or the children themselves. This points to an urgent need for regional legal and policy harmonization specifically designed to align with public health and human rights principles.

Electronic supplementary material

The online version of this article (10.1186/s12884-019-2182-1) contains supplementary material, which is available to authorized users.

Image-plate sensitivity to x rays at 2 to 60 keV

The sensitivity of Fuji SR and MS image plates (IPs) used in x-ray spectrometers on OMEGA and the National Ignition Facility has been measured using two techniques. A set of radioisotopes has been used to constrain image-plate sensitivity between 6 and 60 keV, while a Manson source has been used to expose image plates to x rays at energies between 1.5 and 8 keV. These data have shown variation in sensitivity on the order of 5% for a given IP type and scanner settings. The radioisotope technique has also been used to assess IP fading properties for MS-type plates over long times. IP sensitivity as a function of scanner settings and pixel size has been systematically examined, showing variations of up to a factor of 2 depending on the IP type. Cross-calibration of IP scanners at different facilities is necessary to produce a consistent absolute sensitivity curve spanning the energy range of 2-60 keV.

Additional malignancies in patients with gastrointestinal stromal tumors (GIST): incidence, pathology and prognosis according to a time of occurrence-based classification

BACKGROUND

The aim of the study is to clarify if a classification based on the time of occurrence of associated malignancies in GIST patients can help in the understanding of the clinical controversies observed in these patients.

METHODS

We retrospectively reviewed all the patients diagnosed with GIST tumors between January 1999 and October 2016. They were divided into GIST patients associated with other tumors (A-GIST) and those not associated (NA-GIST). A-GIST patients were also divided into four types according to the proposed classification.

RESULTS

Of 104 GIST patients, 32 (30.7%) (A-GIST group) had at least one additional primary malignancy. The most frequent location of the associated malignancy was the GI tract (26%). Compared to NA-GIST, A-GIST were more often asymptomatic with a lower risk of recurrence. The main cause of death in NAGIST was GIST itself, being associated tumors the main cause of death in A-GIST group. No differences were found in DFS and OS between A-GIST and NA-GIST.

CONCLUSIONS

The use of the proposed classification classifies GIST patients with associated malignancies in different subtypes that differ substantially in terms of incidence, type of neoplasms associated, cause of the association and prognosis.

Effects of soiling on photovoltaic (PV) modules in the Atacama Desert

Soiling by dry deposition affects the power output of photovoltaic (PV) modules, especially under dry and arid conditions that favor natural atmospheric aerosols (wind-blown dust). In this paper, we report on measurements of the soiling effect on the energy yield of grid-connected crystalline silicon PV modules deployed in five cities across a north-south transect of approximately 1300 km in the Atacama Desert ranging from latitude 18°S to latitude 30°S. Energy losses were assessed by comparing side-by-side outputs of four co-planar PV modules. Two of the PV modules of the array were kept clean as a control, while we allowed the other two to naturally accumulate soiling for 12 months (from January 2017 to January 2018). We found that the combination of high deposition rates and infrequent rainfalls led to annual energy losses that peaked at 39% in the northern coastal part of the desert. In contrast, annual energy losses of 3% or less were measured at relatively high-altitude sites and also at locations in the southern part of the desert. For comparison, soiling-induced annual energy losses of about 7% were measured in Santiago, Chile (33°S), a major city with higher rainfall frequency but where urban pollution plays a significant role.

Abstract P4-20-01: Implications of financial modeling in breast cancer clinical research from 1990 to 2010

SUMMARY: Over the past two decades significant progress has been made in breast cancer treatment resulting in a substantial improvement in patients' outcome. But we have to think about who promotes all this research and the consequences of the type of fundingThis project aims to evaluate the implication of finance in clinical research and the variance according to the type of funding.

OBJETIVES: To evaluate the financial evolvement of breast cancer clinical trials in the past two decades, regarding the phase of development design of the studies, the collaboration between Academy (Acad) and Industry (Ind), the sample size, the study results and the statistical analyses conducted.

METHODS: A systematic review was performed using MEDLINE to identify breast cancer randomized clinical trials published between January1990 and December2010. Studies that involved chemotherapy, endocrine and/or targeted therapies, wherethe primary endpoint was considered adequate to support a drug approval in oncology according to the FDA and EMA (U.S. Food and Drug Administration and European Medicines Agency, respectively), were included.

RESULTS:Data were evaluated 2,211 and 472 met selection criteria comprised in the methodology During the first decade the Acad was the main breast cancer research promoter being replaced by the Inv. throughout the second decade (p &lt;0.0001). Thirty nine percent of the studies evaluated were phase III (39% Acad, 61% Ind), 15% were phase II (30% Acad, 70% Ind) and the remaining 47% were not classified by authors (65% Acad 35% Ind). As for the primary endpoint, 25% of the phase III trials evaluated progression free survival, 15% overall response rate, 1% time to progression and only 5% examined overall survival. Sixty five percent of the trials were national (60% Acad 40% Ind) and 35% international (25% Acad 75% Ind). Single-center studies accounted for 11% of the trial (65% Acad 35% Ind). Most of the national trials were developed by the US. Fifty four percent of the studies were conducted by research groups (67% supported by Ind. and 33% Acad.). The Ind sponsored 26% of the studies in the first decade and 50% during the second. The median number of patients enrolled by research groups was 892 in contrast with 409 included by other organizations. The primary endpoint was achieved in 19% of the Acad trials and 21% of the Ind trials. Only 53% of the studies declared intention to treat based analysis in their statistical workout.

RESULTS  ACADEMY(%)INDUSTRY (%)PPROMOTION OF THE STUDY1990-2000121(26)68(14)0,0001 2001-2010105(22)178(38)0,0001STUDY DESIGNUNICENTRIC TRIALS34(7)18(4)0,007 MULTICENTRIC TRIALS191(40)228(48)  NATIONAL TRIALS183(39)122(26)0,0001 INTERNATIONAL TRIALS42(9)124(26)  COOPERATIVE GROUP95(20)160(34)  NOT COOPERATIVE GROUP130(28)86(18) STATISTICAL ANALYSISINTENT OF TREAT86(18)163(35)  NOT DECLARATED140(30)83(18) 

CONCLUSIONS:There is a significant tendency towards the promotion of research by the pharmaceutical industries during the last two decades, leading a change in the clinical trials design and the endpoints.

Citation Format: Jerez Y, Lopez-Tarruella S, Marquez-Rodas I, Perez S, Ocaña A, Echavarria I, Lobo M, Gallego I, Torres G, Ortega L, Garcia G, Palomero I, Gonzalez Del Val R, Massarrah T, Esteban M, Del Monte-Millan M, Martin M. Implications of financial modeling in breast cancer clinical research from 1990 to 2010 [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-20-01.

[Epidemiology and risk factors of patients with intra-abdominal postsurgical infection treated with tigecycline: a cohort study]

OBJECTIVE

To study a cohort of patients with intra-abdominal postsurgical infection treated with tigecycline to analyze its effectiveness and mortality related factors.

METHODS

Prospective study of patients with intra-abdominal postsurgical infection with microbiological isolation and treated with tigecycline.

RESULTS

Out of 103 patients only 61 full fit inclusion criteria. Mean age was 67 year-old and 72% were male. Charlson score was ≥ 3 in 65.5%, being diabetes and colon cancer the most prevalent diseases. Cancer surgery was the most frequent procedure (n=44, 72%) and previous antibiotic administration was present in 43 cases (69%). Pitt score was ≥ 3 in 69% and most prevalent bacteria were Escherichia coli (38 %), Enterococcus spp. (34%; mainly Enterococcus faecium) and Klebsiella pneumoniae together with Enterobacter cloacae (28%). Tigecycline was prescribed alone (17; 28%) or in combination with other antibiotics (44; 72%), mainly meropenem (25; 57%) or amikacin (19, 43%). 11 patients died (18%), all of which suffered extended cancer surgery and isolation of extended-spectrum betalactamase producing Enterobacteriaceae. Factors statistically associated to death in univariate analysis were Charlson score >3, pH <7.3 and leucocyte count >20.000 cells/mm3.

CONCLUSIONS

As being a cohort of patients treated with tigecycline, E. faecium isolation was very frequent. Non-fatal evolution was achieved in 82% cases, being tigecycline a potentially good option in the empiric treatment of very severe infections.

Metformin Suppresses Diabetes-Accelerated Atherosclerosis via the Inhibition of Drp1-Mediated Mitochondrial Fission

Metformin is a widely used antidiabetic drug that exerts cardiovascular protective effects in patients with diabetes. How metformin protects against diabetes-related cardiovascular diseases remains poorly understood. Here, we show that metformin abated the progression of diabetes-accelerated atherosclerosis by inhibiting mitochondrial fission in endothelial cells. Metformin treatments markedly reduced mitochondrial fragmentation, mitigated mitochondrial-derived superoxide release, improved endothelial-dependent vasodilation, inhibited vascular inflammation, and suppressed atherosclerotic lesions in streptozotocin (STZ)-induced diabetic ApoE^-/- mice. In high glucose-exposed endothelial cells, metformin treatment and adenoviral overexpression of constitutively active AMPK downregulated mitochondrial superoxide, lowered levels of dynamin-related protein (Drp1) and its translocation into mitochondria, and prevented mitochondrial fragmentation. In contrast, AMPK-α2 deficiency abolished the effects of metformin on Drp1 expression, oxidative stress, and atherosclerosis in diabetic ApoE^-/-/AMPK-α2^-/- mice, indicating that metformin exerts an antiatherosclerotic action in vivo via the AMPK-mediated blockage of Drp1-mediated mitochondrial fission. Consistently, mitochondrial division inhibitor 1, a potent and selective Drp1 inhibitor, reduced mitochondrial fragmentation, attenuated oxidative stress, ameliorated endothelial dysfunction, inhibited inflammation, and suppressed atherosclerosis in diabetic mice. These findings show that metformin attenuated the development of atherosclerosis by reducing Drp1-mediated mitochondrial fission in an AMPK-dependent manner. Suppression of mitochondrial fission may be a therapeutic approach for treating macrovascular complications in patients with diabetes.

Advances in the Interpretation of Tomographic Images as an Early Detection Method of Oil Palm Affected by Basal Stem Rot in Colombia

Basal stem rot, one of the most important diseases of oil palm in Southeast Asia, has also been identified in Colombia. The increase in disease incidence in the last decade has attracted the attention of producers and researchers. In the search for a procedure that allows for the early identification of diseased palm, Cenipalma evaluated the use of electrical impedance tomography to identify the different stages of development of basal stem rot. The tomograms were compared with transversal sections of healthy and diseased oil palm trees. Following Cenipalma's preliminary studies on early diagnosis of basal stem rot with tomography, the present study improved upon the technique by analyzing the tomograms of 209 diseased palm trees (confirmed by symptomatology), 346 asymptomatic palm trees, and 132 healthy palm trees. The minimum and maximum electric impedance values as well as the ratio between these values was recorded. The range of 1 to 95 Ω was used to represent the internal damage. The ratios averaged 5.1 for diseased, 1.9 for asymptomatic, and 1.5 for healthy palm trees. With the range and the ratio criteria established, it was possible to identify the disease in 100% of asymptomatic sampled palm trees. This study demonstrated that electrical impedance tomography is a powerful tool for early detection of basal stem rot, which can be used to establish an early disease management program.

No Sun-like dynamo on the active star ζ Andromedae from starspot asymmetry

Sunspots are cool areas caused by strong surface magnetic fields that inhibit convection. Moreover, strong magnetic fields can alter the average atmospheric structure, degrading our ability to measure stellar masses and ages. Stars that are more active than the Sun have more and stronger dark spots than does the Sun, including on the rotational pole. Doppler imaging, which has so far produced the most detailed images of surface structures on other stars, cannot always distinguish the hemisphere in which the starspots are located, especially in the equatorial region and if the data quality is not optimal. This leads to problems in investigating the north-south distribution of starspot active latitudes (those latitudes with more starspot activity); this distribution is a crucial constraint of dynamo theory. Polar spots, whose existence is inferred from Doppler tomography, could plausibly be observational artefacts. Here we report imaging of the old, magnetically active star ζ Andromedae using long-baseline infrared interferometry. In our data, a dark polar spot is seen in each of two observation epochs, whereas lower-latitude spot structures in both hemispheres do not persist between observations, revealing global starspot asymmetries. The north-south symmetry of active latitudes observed on the Sun is absent on ζ And, which hosts global spot patterns that cannot be produced by solar-type dynamos.

Glucagon-like peptide-1 inhibits vascular smooth muscle cell dedifferentiation through mitochondrial dynamics regulation

Glucagon-like peptide-1 (GLP-1) is a neuroendocrine hormone produced by gastrointestinal tract in response to food ingestion. GLP-1 plays a very important role in the glucose homeostasis by stimulating glucose-dependent insulin secretion, inhibiting glucagon secretion, inhibiting gastric emptying, reducing appetite and food intake. Because of these actions, the GLP-1 peptide-mimetic exenatide is one of the most promising new medicines for the treatment of type 2 diabetes. In vivo treatments with GLP-1 or exenatide prevent neo-intima layer formation in response to endothelial damage and atherosclerotic lesion formation in aortic tissue. Whether GLP-1 modulates vascular smooth muscle cell (VSMC) migration and proliferation by controlling mitochondrial dynamics is unknown. In this report, we showed that GLP-1 increased mitochondrial fusion and activity in a PKA-dependent manner in the VSMC cell line A7r5. GLP-1 induced a Ser-637 phosphorylation in the mitochondrial fission protein Drp1, and decreased Drp1 mitochondrial localization. GLP-1 inhibited PDGF-BB-induced VSMC migration and proliferation, actions inhibited by overexpressing wild type Drp1 and mimicked by the Drp1 inhibitor Mdivi-1 and by overexpressing dominant negative Drp1. These results show that GLP-1 stimulates mitochondrial fusion, increases mitochondrial activity and decreases PDGF-BB-induced VSMC dedifferentiation by a PKA/Drp1 signaling pathway. Our data suggest that GLP-1 inhibits vascular remodeling through a mitochondrial dynamics-dependent mechanism.

Modulation of the Nuclear Factor (Erythroid 2-Derived)-Like 2 Pathway by Antidepressants In Rats

Introduction

Patients with major depression who are otherwise medically healthy have activated inflammatory pathways. It has been described that depression is not only escorted by inflammation but also by induction of multiple oxidative/nitrosative stress pathways. Nevertheless, there are finely regulated mechanisms involved in preserving cells from damage, such as the nuclear factor Nrf2.

Aims

To explore in a depression-like model the Nrf2 pathway in the prefrontal cortex (PFC) and the hippocampus of rats and to analyze which classic antidepressants affect the antioxidant activity of the Nrf2 pathway.

Methods

Male Wistar rats were exposed to chronic mild stress (CMS) and some of them were treated with desipramine, escitalopram or duloxetine. We studied the expression in the PFC and hippocampus of upstream and downstream elements of the Nrf2 pathway and the oxidative damage induced by the CMS.

Results

After exposure to a CMS protocol, in the PFC, there is an inhibition of upstream and downstream elements of the Nrf2 pathway. Moreover, antidepressant treatments, particularly desipramine and duloxetine, are able to recover some of these elements and to reduce the oxidative damage induced by the depression model. In the hippocampus however, Nrf2 pathways are not that affected and antidepressants do not have many actions.

Conclusions

Nrf2 pathway is differentially regulated by antidepressants in the PFC and hippocampus. The Nrf2 pathway is involved in the oxidative/nitrosative damage detected in the PFC after CMS exposure. However, it seems that Nrf2 is not very involved in the effects caused by the CMS in the hippocampus.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Evaluation of the efficacy of intramuscular versus intramammary treatment of subclinical Streptococcus agalactiae mastitis in dairy cows in Colombia

A randomized controlled trial was performed in 17 Colombian dairy herds to determine the cure risk among cows subclinically infected with Streptococcus agalactiae exposed to 2 antibiotic therapies. Composite milk samples were collected before milking at the onset of the trial (pretreatment) and 2 subsequent times over a period of approximately 63 d. The intramammary application (IMM) of ampicillin-cloxacillin was compared with the intramuscular application (IM) of penethamate hydriodide, and cure risks after an initial and retreatment application were assessed. Cure risk after the initial treatment was higher (82.4%) for the IMM treatment than for IM therapy (65.8%). However, no difference was observed in the cure risk of refractory cases after retreatment (IMM=52.6% vs. IM=51.2%). The cumulative cure risk (both initial and retreatment) was 90.4 and 82.9% for the IMM and IM products, respectively. A 2-level random effects logistic model that controlled for pretreatment cow-level somatic cell count, indicated that IM treatment (odds ratio=0.37) had a lower cure risk than IMM and a tendency for a lower cure risk with increasing baseline somatic cell count. Our findings suggest that both products and administration routes can reduce the prevalence of S. agalactiae in affected herds, but the IMM product had a better efficacy in curing the infection. In addition to the treatment protocol, the cow somatic cell count should be considered when making management decisions for cows infected with S. agalactiae.

Merkel cell carcinoma of the eyelid. A series of 5 cases and review of the literature

OBJECTIVE

Presentation of 5 clinical cases of Merkel cell carcinoma of the eyelid, highlighting the clinical, histopathological, management, and monitoring features. Review of related literature.

METHODS

Retrospective review of clinical records and telephone interview of the 5 patients treated for Merkel cell carcinoma between 2006 and 2013, in the Orbit and Oculoplastic Department, Clinical Hospital of the University of Chile.

RESULTS

Five patients (2 men, 3 women); 79.2 years (range 64-94 years), with a mean onset of 10 weeks (range 5-16 weeks), tumour size reaching a mean of 2.5×2×2.1cm at the time of surgery. Described as a nodular mass, exophytic, solid, reddish coloured. With no infiltrated lymph nodes or metastases in the first match. Staging as T2N0M0, after the first surgery with oncological criteria. Two lymph node recurrences detected during monitoring. Distant metastasis was found in one patient. The histopathological diagnosis was confirmed by immunohistochemical study of the biopsy. The surgical strategy was full excision, control of surgical margins in the intraoperative period, and eyelid reconstruction with Hughes flap, Cutler/Beard flap or primary closure, depending on the case.

CONCLUSIONS

Early diagnosis, wide excision of the tumour with intraoperative control of clear margins with conventional or Mohs surgery, and proper eyelid reconstruction are adequate for a good survival in elderly patients with this eyelid tumour. The study of sentinel lymph node biopsy in primary intervention is recommended; with subsequent radiotherapy to decrease the recurrence and increase survival.