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A CROSS-SECTIONAL STUDY ON COVID-19 VACCINATION HESITATION AMONG UNIVERSITY STUDENTS. GEORGIAN MEDICAL NEWS 2024:19-23. [PMID: 38609107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Students serve as ambassadors, conveying effective messages to encourage the adoption of promotes healthy behaviors. Recognizing their consciousness about corona illness 2019 (COVID-19), desires to utilize the COVID-19 vaccines, and other associated variables will aid in developing viable vaccination promotion tactics for the present COVID-19 pandemic. A transverse-segment internet poll of university students in the healthcare and non-healthcare industries was conducted to analyze their motivations to be vaccinated against the coronavirus. To recruit research participants, a random snowball sampling approach was utilized using digital media sites and mails. The contestants were chosen from throughout India, including several main geographic areas, between Nov-2020 and Jan-2021, prior to the release of the COVID-19 vaccination. There were descriptive metrics utilized to illustrate the research participants' socio-demographics and vaccine-related behaviors. Using logistic regression modeling, key characteristics that are expected to influence vaccination uptake among students were modeled. p 0.06 was judged substantial in each study. 656 students participated in the study, with 48.4% coming from the healthcare sector & 51.5% from other fields. Of these 655 students, 43.6 and 22.4% came from India's northern and eastern areas. Graduate students accounted for 41.1% of the total population, and graduates for around 43.2%. The age range of 56.0% of the students was 18 to 25. Women made up 62% of the population, and 69.5% of them were unmarried. Seventy-eight percent of the students were from the medium socioeconomic level. Concerns about side effects and safety, distrust of government officials, and questions about the vaccine's efficacy were among the reasons given by students in this study for their reluctance to get vaccinated. It is essential to remember that these investigations were carried out at various times and in various nations; thus, the conclusions may not apply to all college students throughout the globe. According to the findings of this research, Indian university students showed rather a great deal of motivating desire to acquire COVID-19 immunizations. The people were either doubtful or reluctant to get the vaccination, which suggests possible vaccine aversion. There is a need for information campaigns and other actions to lessen vaccine hesitancy in order to promote the usage of COVID-19 vaccines.
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Genomic heterogeneity as a barrier to precision oncology in urothelial cancer. Cell Rep 2022; 41:111859. [PMID: 36543146 PMCID: PMC9882421 DOI: 10.1016/j.celrep.2022.111859] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/13/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Precision oncology relies on the accurate molecular characterization of individual patients with cancer at the time of treatment initiation. However, tumor molecular profiles are not static, and cancers continually evolve because of ongoing mutagenesis and clonal selection. Here, we performed genomic analyses of primary tumors, metastases, and plasma collected from individual patients to define the concordance of actionable genomic alterations and to identify drivers of metastatic disease progression. We observed a high degree of discordance of actionable genomic alterations, with 23% discordant between primary and metastatic disease sites. Among chromatin-modifying genes, ARID1A mutations, when discordant, were exclusive to the metastatic tumor samples. Our findings indicate that the high degree of lesion-to-lesion genomic heterogeneity may be a barrier to precision oncology approaches for bladder cancer and that circulating tumor DNA profiling may be preferred to tumor sequencing for a subset of patients.
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446 Metabolites in early life bronchoalveolar fluid associate with future bronchiectasis risk in children with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01136-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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A study on Environment-friendly Lifestyle and other major factors influencing household recycling in India. CARDIOMETRY 2022. [DOI: 10.18137/cardiometry.2022.23.489498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Waste Management in India has always been a severe problem, and tackling this issue would require a social mindset towards adopting green practices. This study aims to understand the consumer mindset and awareness of recycling in India and explore factors that could influence India’s recycling behavior. The data for this study has been obtained through a primary research – survey questionnaire. Correlation analysis and regression have been applied to understand the result of the questionnaire data. Promoting recycling amongst people takes into consideration many factors. The results suggest that recycling behavior is mostly influenced by factors, such as willingness to adopt environment-friendly behavior, awareness towards recycling, and providing incentives. This study aimed to explore recycling in India and study the major factors that can influence people to adopt recycling. It also explored a possible relationship between providing incentives and influencing recycling behavior. These findings will help to analyze and develop strategies to boost the recycling rate in India.
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Pilot study of bempegaldesleukin in combination with nivolumab in patients with metastatic sarcoma. Nat Commun 2022; 13:3477. [PMID: 35710741 PMCID: PMC9203519 DOI: 10.1038/s41467-022-30874-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 05/23/2022] [Indexed: 12/15/2022] Open
Abstract
PD-1 blockade (nivolumab) efficacy remains modest for metastatic sarcoma. In this paper, we present an open-label, non-randomized, non-comparative pilot study of bempegaldesleukin, a CD122-preferential interleukin-2 pathway agonist, with nivolumab in refractory sarcoma at Memorial Sloan Kettering/MD Anderson Cancer Centers (NCT03282344). We report on the primary outcome of objective response rate (ORR) and secondary endpoints of toxicity, clinical benefit, progression-free survival, overall survival, and durations of response/treatment. In 84 patients in 9 histotype cohorts, all patients experienced ≥1 adverse event and treatment-related adverse event; 1 death was possibly treatment-related. ORR was highest in angiosarcoma (3/8) and undifferentiated pleomorphic sarcoma (2/10), meeting predefined endpoints. Results of our exploratory investigation of predictive biomarkers show: CD8 + T cell infiltrates and PD-1 expression correlate with improved ORR; upregulation of immune-related pathways correlate with improved efficacy; Hedgehog pathway expression correlate with resistance. Exploration of this combination in selected sarcomas, and of Hedgehog signaling as a predictive biomarker, warrants further study in larger cohorts.
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216 Open Versus Minimally Invasive Surgery (MIS) Transforaminal Lumbar Interbody Fusion (TLIF): A Single-Centre Experience. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Transforaminal Lumbar Interbody Fusion (TLIF) is a technique used for the management of various pathologies such as degenerative disc disease, recurrent disc herniations and spondylolisthesis, to mention the most common indications. There is an ongoing debate regarding the use of open versus minimally invasive techniques for TLIF. Each has its own advantages and disadvantages. In the present study, we aim to present our experience regarding the use of open vs MIS TLIF at Stepping Hill Hospital in Manchester.
Method
A retrospective observational cohort study involving 60 patients was conducted at Stepping Hill Hospital in the UK. Patients who had TLIF surgery between 2019 and 2020 were included. Patients were consecutively allocated to either the open TLIF or the MIS TLIF group. Data were collected from hospital records including pre- and post-operative follow up notes. We also assessed pain score using the visual analogue scale.
Results
26 patients underwent MIS TLIF whereas 34 patients underwent an open procedure. The MIS group showed better outcomes compared to the open group in terms of post-operative complications, improvement of symptoms and the average hospital stay: 7.6% vs 8.8%, 73.7% vs 58.8% and 1.82 vs 2.76 days, however, the open group had a lower rate of metalwork failure 8.8% vs 11.5% in the MIS.
Conclusions
Our study showed that MIS TLIF at our unit seems to result in better outcomes related to symptoms alleviation, post-operative complications and less hospital stay despite having a slightly higher rate of metalwork failure.
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824 UK CoPACK Study: Health Care Workers Knowledge and Confidence in Using Personal Protective Equipment (PPE) And Related Anxiety Levels During The COVID-19 Pandemic. Br J Surg 2021. [PMCID: PMC8524503 DOI: 10.1093/bjs/znab259.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Aim
The COVID-19 pandemic has resulted in significant pressures on the NHS. Healthcare workers (HCWs) are at increased risk of infection. Personal protective equipment (PPE) lowers the risk of infection transmission. However, during the early phases of the pandemic, the information available regarding COVD-19 and the use of PPE has been unclear, with constantly changing guidelines. The aim of this study was to determine the knowledge and confidence about PPE usage among HCWs, in addition to measuring their anxiety levels during the COVID pandemic.
Method
A validated questionnaire was distributed among HCWs in as many UK hospitals as possible, during April 2020. The questionnaire consisted of 13 questions regarding demographics, knowledge on PPE guidance, HCW training and confidence levels in PPE usage and finally anxiety levels measured using the GAD-7 psychometric tool.
Results
1055 responses were received. Nurses (49%), Healthcare Assistants (HCA - 20%), Doctors (17%), Physios (8%) and other (6%). 99% of respondents indicated they were familiar with PPE guidance, but only 1.6% answered all 3 questions on PPE guidance accurately. 86.4% of respondents received mask-fitting checks. 79.7% received donning-doffing training. Despite this, only 46.8% were confident on their familiarity with PPE. 32.5% felt that their hospital communication regarding PPE policy during COVID-19 pandemic was poor or very poor. 30% HCWs experienced severe anxiety.
Conclusions
National guidance and local training on PPE usage during the COVID-19 pandemic has been unsatisfactory, leading to higher anxiety among HCWs. Improved information delivery and training are essential in preparation for the second wave and future pandemics.
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In vitroand in vivoeffect of polycaprolactone nanofiber coating on polyethylene glycol diacrylate scaffolds for intervertebral disc repair. Biomed Mater 2021; 16. [PMID: 33915528 DOI: 10.1088/1748-605x/abfd12] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/29/2021] [Indexed: 12/11/2022]
Abstract
Polyethylene glycol diacrylate (PEGDA) is an important class of photosensitive polymer with many tissue engineering applications. This study compared PEGDA and polycaprolactone (PCL) nanofiber matrix (NFM) coated PEGDA, referred to as PCL-PEGDA, scaffolds for their application in multiple tissue repair such as articular cartilage, nucleus pulposus of the intervertebral disc (IVD). We examined each scaffold morphology, porosity, swelling ratio, degradation, mechanical strength, andin vitrocytocompatibility properties. A defect was created in Sprague Dawley rat tail IVD by scraping native cartilage tissue and disc space, then implanting the scaffolds in the disc space for 4 weeks to evaluatein vivoefficacy of multi-tissue repair. Maintenance of disc height and creation of a new cell matrix was assessed to evaluate each scaffold's ability to repair the tissue defect. Although both PEGDA and PCL-PEGDA scaffolds showed similar porosity ∼73%, we observed distinct topographical characteristics and a higher effect of degradation on the water-absorbing capacity for PEGDA compared to PCL-PEGDA. Mechanical tests showed higher compressive strength and modulus of PCL-PEGDA compared to PEGDA.In vitrocell studies show that the PCL NFM layer covering PEGDA improved osteoblast cell adhesion, proliferation, and migration into the PEGDA layer.In vivostudies concluded that the PEGDA scaffold alone was not ideal for implantation in rat caudal disc space without PCL nanofiber coating due to low compressive strength and modulus.In vivoresults confirm that the PCL-PEGDA scaffold-maintained disc space and created a proteoglycan and collagen-rich new tissue matrix in the defect site after 4 weeks of scaffold implantation. We concluded that our developed PCL-PEGDA has the potential to be used in multi-tissue defect site repair.
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Germ cell tumors and associated hematologic malignancies evolve from a common shared precursor. J Clin Invest 2021; 130:6668-6676. [PMID: 32897884 DOI: 10.1172/jci139682] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/03/2020] [Indexed: 12/12/2022] Open
Abstract
Germ cell tumors (GCTs) are the most common cancer in men between the ages of 15 and 40. Although most patients are cured, those with disease arising in the mediastinum have distinctly poor outcomes. One in every 17 patients with primary mediastinal nonseminomatous GCTs develop an incurable hematologic malignancy and prior data intriguingly suggest a clonal relationship exists between hematologic malignancies and GCTs in these cases. To date, however, the precise clonal relationship between GCTs and the diverse additional somatic malignancies arising in such individuals have not been determined. Here, we traced the clonal evolution and characterized the genetic features of each neoplasm from a cohort of 15 patients with GCTs and associated hematologic malignancies. We discovered that GCTs and hematologic malignancies developing in such individuals evolved from a common shared precursor, nearly all of which harbored allelically imbalanced p53 and/or RAS pathway mutations. Hematologic malignancies arising in this setting genetically resembled mediastinal GCTs rather than de novo myeloid neoplasms. Our findings argue that this scenario represents a unique clinical syndrome, distinct from de novo GCTs or hematologic malignancies, initiated by an ancestral precursor that gives rise to the parallel evolution of GCTs and blood cancers in these patients.
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Doppler radar rainfall prediction and gauge data. BMC Res Notes 2020; 13:482. [PMID: 33054846 PMCID: PMC7559437 DOI: 10.1186/s13104-020-05311-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 09/28/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The data herein represents multiple gauge sets and multiple radar sites of like-type Doppler data sets combined to produce populations of ordered pairs. Publications spanning decades yet specific to Doppler radar sites contain graphs of data pairs of Doppler radar precipitation estimates versus rain gauge precipitation readings. DATA DESCRIPTION Taken from multiple sources, the data set represents several radar sites and rain gauge sites combined for 8830 data points. The data is relevant in various applications of hydrometeorology and engineering as well as weather forecasting. Further, the importance of accuracy in radar and precipitation estimates continues to increase, necessitating the incorporation of as much data as possible.
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Phlebotomy resulting in controlled hypovolaemia to prevent blood loss in major hepatic resections (PRICE-1): a pilot randomized clinical trial for feasibility. Br J Surg 2020; 107:812-823. [PMID: 31965573 DOI: 10.1002/bjs.11463] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/28/2019] [Accepted: 11/15/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Major liver resection is associated with blood loss and transfusion. Observational data suggest that hypovolaemic phlebotomy can reduce these risks. This feasibility RCT compared hypovolaemic phlebotomy with the standard of care, to inform a future multicentre trial. METHODS Patients undergoing major liver resections were enrolled between June 2016 and January 2018. Randomization was done during surgery and the surgeons were blinded to the group allocation. For hypovolaemic phlebotomy, 7-10 ml per kg whole blood was removed, without intravenous fluid replacement. Co-primary outcomes were feasibility and estimated blood loss (EBL). RESULTS A total of 62 patients were randomized to hypovolaemic phlebotomy (31) or standard care (31), at a rate of 3·1 patients per month, thus meeting the co-primary feasibility endpoint. The median EBL difference was -111 ml (P = 0·456). Among patients at high risk of transfusion, the median EBL difference was -448 ml (P = 0·069). Secondary feasibility endpoints were met: enrolment, blinding and target phlebotomy (mean(s.d.) 7·6(1·9) ml per kg). Blinded surgeons perceived that parenchymal resection was easier with hypovolaemic phlebotomy than standard care (16 of 31 versus 10 of 31 respectively), and guessed that hypovolaemic phlebotomy was being used with an accuracy of 65 per cent (20 of 31). There was no significant difference in overall complications (10 of 31 versus 15 of 31 patients), major complications or transfusion. Among those at high risk, transfusion was required in two of 15 versus three of nine patients (P = 0·326). CONCLUSION Endpoints were met successfully, but no difference in EBL was found in this feasibility study. A multicentre trial (PRICE-2) powered to identify a difference in perioperative blood transfusion is justified. Registration number: NCT02548910 ( http://www.clinicaltrials.gov).
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Child and adolescent psychiatry training in Australia and New Zealand. Eur Child Adolesc Psychiatry 2020; 29:95-103. [PMID: 31641901 DOI: 10.1007/s00787-019-01422-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/10/2019] [Indexed: 10/25/2022]
Abstract
The specialty of Child and Adolescent Psychiatry was formally recognised in the 1930s. The Faculty of Child and Adolescent Psychiatry was established in 1964 in Australia, as a subspecialty in The Royal Australian and New Zealand College of Psychiatrists (RANZCP). The aim of the current article is first to provide a brief summary and overview of the current status of Child and Adolescent Psychiatry (CAP), followed by an outline of the requirements of the Training Program for CAP in Australia and New Zealand. The training required to become a fully qualified child and adolescent psychiatrist in Australia and New Zealand consists of different stages and takes the form of competency-based training. Information relating to assessment types, supervision and research requirements is also described. Accreditation procedures for the training program are stipulated by RANZCP to monitor standards and to ensure consistency within the programs delivered across Australia and New Zealand. Employment opportunities for trainees upon completion of the program are discussed. In summary, this article highlights the requirements of the training programs for CAP in Australia and New Zealand.
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Optimal lung cancer pathway implementation in a tertiary care centre and its impact on reducing emergency presentations. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30046-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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P6595The optogenetic defibrillation of ventricular arrhythmia in myocardial infarction rats in vivo. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Optogenetics is a low-invasive, flexible and highly selective intervention that enables electrical excitation with light on myocardium overexpressing light-sensitive proteins. Optical illumination can control the simultaneous exciting of the whole myocardium under the spot, which is more conducive to recovery from electrical disturbance to sinus rhythm.
Purpose
We explored optogenetic defibrillation for different illumination parameters how to affect defibrillation rates and the possible mechanism of continuous illumination defibrillation.
Methods
Systemic delivery via right jugular vein injection of (AAV9-CAG-hChR2(H134R)-mCherry) were performed in juvenile SD rats to achieve the light sensitive protein Channelrhodopsin-2 (ChR2) transfer throughout the whole heart. We intubated and ventilated rats, opened chest and recorded the ECG. After ligation of the left anterior descending coronary artery, ventricular arrhythmia was induced by electrical burst stimulation (10v, 50Hz, 2s). Cardiac epicardium illumination with 470nm blue laser was performed to investigate the effects of optogenetic defibrillation and its underlying mechanism. Every heart accepted 30 pulses of 20ms duration on 8Hz to test the light intensity threshold for 1:1 capture. Different illumination modes of multiple light intensity (2,4,8,10,20 times threshold intensity), pulse duration (20, 50, 200, 500 and 1000ms) and illumination position (RV apex, RV, RVOT, septum, LV) were applied in each attempt for 4 repetitions with 1 s interval.
Results
We demonstrated that ventricular arrhythmias could be terminated by illumination of the right ventricle at 20 times threshold intensity in 1s (figure A) with the successful defibrillation rate of 95±2.673% (mean ±SEM; N=7). Herein, the successful optogenetic defibrillation rate was strongly depending on light intensity (N=5, n=50 episodes, p=0.0118) and duration of illumination (N=5, n=50 episodes, p<0.0001) (figure B.C). Notably when there were higher intensity and longer pulse duration, the higher defibrillation rate appeared. There was no significant difference in the defibrillation rate among different illumination positions (N=5, n=25episodes per position, p=0.1177) (figure D). To explore the underlying mechanism of optogenetic defibrillation, we performed the same illumination mode during sinus rhythm in 2 rats (figure E. F. G). We observed that higher light intensity and longer pulse duration were more conducive to induce an episode of higher frequency focal excitement.
Views of optogenetic defibrillation
Conclusions
We demonstrated that optogenetic defibrillation is a highly effective intervention and the possible mechanism is partly attributed to overdrive suppression. We believe that optogenetic approach is potentially to be translated into more efficient and pain-free clinical termination of ventricular arrhythmia.
Acknowledgement/Funding
The national natural science foundation of China (81772044)
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Charot-marie-tooth disease type 2O: First case report from India. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Atypical multiple sclerosis with antibody to MOG. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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A pilot study of tremelimumab (treme) with or without cryoablation (cryo) in patients (pts) in metastatic renal cell carcinoma (mRCC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Severe 5,10‐Methylenetetrahydrofolate reductase deficiency: A rare, treatable cause of complicated hereditary spastic paraplegia. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Study of spectrum of inflammatory demyelinating disease of central nervous system. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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P3504Near-Infrared photoactivation via upconversion nanoparticles promotes new advances in cardiac optogenetics toolbox. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The optogenetics manipulation of the heart based on the visible light is limited in the therapeutic potential because of the low tissue penetration. Near-infrared (NIR) light has deeper tissue penetration capabilities but radiates at unsuitable wavelengths, while upconversion nanoparticles (UCNPs) absorb NIR light to convert visible light.
Purpose
We aimed to investigate the efficient NIR control of the rat heart in vivo via UCNPs mediated cardiac optogenetics.
Methods
Systemic delivery via jugular vein injection of (AAV9-CAG-hChR2 (H134R)-mCherry) were performed in SD rats to achieve sufficient Channelrhodopsin-2 (ChR2) transfer throughout the whole heart. UCNPs of NaYF4:Yb/Tm with optimal excitation wavelength at 975nm were chosen to emit upconverted blue light. Different concentrations of UCNPs cyclohexane solution were embed in composite polydimethylsiloxane films to make flexible substrates for cardiac optogenetics study in open-chest rats (n=3). The UCNPs film was attached to the right ventricle and the 980nm NIR illumination was applied.
Results
The upconversion luminescence spectra of four concentrations (2.5, 5, 10 and 20mg/ml) of NaYF4:Yb/Tm scanned under 980nm excitation at 0.5w showed similar peaks around 475, 645 and 695nm. Emission intensity increased with the UCNPs concentration (Figure 1). The NIR-upconverted blue light from the freestanding films embedded with 2.5 and 5mg/ml UCNPs failed to capture the heart till the peak output power of the NIR laser, and the hearts were successfully captured and paced by the upconverted blue light from 10 and 20mg/mL UCNPs films (20 pulses in 8Hz with 20ms duration were repeated 3 times with the interval of 1s). However the NIR power was lower on 10mg/mL UCNPs film than the 20mg/mL one (0.93±0.11w vs 1.71±0.75w). Therefore, UCNPs film with concentration of 10mg/mL NaYF4:Yb/Tm were used for efficient cardiac optogenetic pacing by NIR light from a 400um optical fiber. Optogenetics capture of the ventricle was achieved at different NIR power, pulse duration and flash frequency. The strength-duration curve summarized the minimal NIR irradiance power of 8Hz flash required for 100% capture at different pulse duration (2, 5, 10, 20 and 50ms). Notably the longer the pulse duration was, the lower the light intensity required. Furthermore, the increasing flash frequency (6, 7, 8 and 10Hz) of the NIR light setting at 1.66w (2-fold threshold power) and 20ms duration induced sufficient cardiac pacing (Figure 2).
The efficient NIR control of the heart
Conclusion
We demonstrated the successful NIR photo-activation of ChR2 expressed in the heart by the upconverted blue light via UCNPs, which resulted in a flexible UCNPs-assisted cardiac optogenetic approach for optical control of heart activity. We believe that these advances in cardiac optogenetic toolbox not only represent a novel practical application of UCNPs, but also open up new possibilities for remote or tissue penetrating heart control.
Acknowledgement/Funding
The national natural science foundation of China (81772044)
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A study of clinical,radiological and thrombophilia profile in cerebral venous sinus thrombosis. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Complications following Percutaneous Bone Cryoablation: Retrospective Analysis of 239 Consecutive Patients. Semin Musculoskelet Radiol 2019. [DOI: 10.1055/s-0039-1692561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Priming rTMS in resistant obsessive compulsive disorder: In search of a new paradigm. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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03:27 PM Abstract No. 241 Effects of time to visceral angiography for gastrointestinal bleeding on angiographic success. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Serotonin and aggressive behaviour in children and adolescents: a systematic review. Acta Psychiatr Scand 2019; 139:117-144. [PMID: 30446991 DOI: 10.1111/acps.12986] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The role of serotonin (5-HT) in human aggression has been the subject of a large number of studies, mostly with adults. Meta-analyses indicate a small but significant inverse relationship between central nervous 5-HT availability and aggression, but genetically informed studies suggest two pathways: one to reactive aggression and the other to proactive aggression. METHOD We conducted a systemic review on central nervous 5-HT function in children and adolescents, with attention to the function of aggression. RESULTS In total, 675 articles were screened for relevance, with 45 reviewed. These included blood assays (e.g. plasma, 5-HIAA; platelet 5-HTR2A ), epigenetic studies, retrospective PET studies and 5-HT challenge paradigms (e.g. tryptophan depletion). Overall, findings were mixed, with support both for negative and for positive associations of central nervous 5-HT function with aggression in children and adolescents. CONCLUSION We propose factors that may be blurring the picture, including problems in the conceptualization and measurement of aggression in young people, the lack of prospective designs and the bias towards clinical samples of boys. Research needs to account for variance in the both motivation for and implementation of aggression, and look to the behavioural economics literature to consider the roles of reward, vengeance and self-control more clearly.
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Emergent Dirac Gullies and Gully-Symmetry-Breaking Quantum Hall States in ABA Trilayer Graphene. PHYSICAL REVIEW LETTERS 2018; 121:167601. [PMID: 30387651 DOI: 10.1103/physrevlett.121.167601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Indexed: 06/08/2023]
Abstract
We report on quantum capacitance measurements of high quality, graphite and hexagonal boron nitride encapsulated Bernal stacked trilayer graphene devices. At zero applied magnetic field, we observe a number of electron density- and electrical displacement-tuned features in the electronic compressibility associated with changes in Fermi surface topology. At a high displacement field and low density, strong trigonal warping gives rise to three new emergent Dirac cones in each valley, which we term "gullies." The gullies are centered around the corners of a hexagonal Brillouin zone and related by threefold rotation symmetry. At low magnetic fields of B=1.25 T, the gullies manifest as a change in the degeneracy of the Landau levels from two to three. Weak incompressible states are also observed at integer filling within these triplet Landau levels, which a Hartree-Fock analysis indicates are associated with Coulomb-driven nematic phases that spontaneously break rotation symmetry.
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Preoperative prediction of Difficult Laryngeal Exposure (DLE) during Microlaryngoscopy (ML): Use of LARYNGOSCORE in a scottish teaching hospital. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Large cystic lympangioma of the pancreas: a case reportum. Ann R Coll Surg Engl 2017; 100:e12-e14. [PMID: 29046074 DOI: 10.1308/rcsann.2017.0178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Lymphangioma of the pancreas is rare and presents as a large cystic mass in the retroperitoneum. The pancreatic origin can be confirmed by careful evaluation of cross sectional imaging. Preoperative differentiation from other pancreatic cystic neoplasms is difficult but possible. Large symptomatic lesions warrant surgery. The diagnosis is confirmed by typical features on histopathology and immunohistochemistry. Presented here is a case report of a pancreatic lymphangioma, discussed in the context of available literature.
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Association of angiogenic cytokines (VEGF-A and VEGF-C) and clinical characteristic in women with unexplained recurrent miscarriage. ACTA ACUST UNITED AC 2017; 118:258-264. [PMID: 28516786 DOI: 10.4149/bll_2017_051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Recurrent miscarriage (RM) defined as 2 or more spontaneous miscarriage before 20 weeks of gestation, affects at least 1 % of couples trying to conceive. In over 50 % of cases, the cause of the loss of pregnancy remains unexplained. Reduced expression of Angiogenic factors such as: vascular endothelial growth factor (VEGF-A) and VEGF-C has been linked with spontaneous miscarriage, likely due to defective foetal and placental angiogenesis. AIMS AND OBJECTIVES To investigate the relationships between serum level of VEGF-A and VEGF-C with clinical characteristic in women with URM and compare to pregnant and healthy women. MATERIALS AND METHODS A case-control study, which was conducted between 90 non-pregnant women with history of RM, age-matched with 70 non-pregnant women without history of recurrent abortion with at least one child (controls) and 70 pregnant women without history of recurrent abortion with at least one child (controls). Those with unexplained RM were eligible. Demographic and Anthropometric data were retrieved by pre-test questionnaire and serum level of VEGF-A and VEGF-C measured by ELISA kit. RESULTS This study showeds that maternal levels of VEGF-A and VEGF-C were distinctly lower in RSA (189.87±88.1 vs 238.8±99.6) compared to healthy (239.1±99.7 vs 275.5±133.08) and pregnant (301.5±76.4 vs 402.5±128.6) women as control groups. Univariate analysis demonstrated that clinical characteristic factors were significantly associated with concentration of VEGF-A and VEGF-C in cases and controls. CONCLUSIONS Our findings suggest that these molecules could be used as potential predictive markers of miscarriage in these women presenting with URM (Tab. 4, Fig. 5, Ref. 40).
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Attention-deficit/hyperactivity disorder and the encoding of emotional information. Acta Psychiatr Scand 2017; 135:503-505. [PMID: 28474350 DOI: 10.1111/acps.12744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Identification and Validation of Non-HLA Antibodies in Cardiac Allograft Rejection. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Reactive aggression in young patients with ADHD-a critical role for small provocations. Acta Psychiatr Scand 2016; 134:566-568. [PMID: 27869991 DOI: 10.1111/acps.12661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Endovascular therapy including thrombectomy for acute ischemic stroke: a systematic review and meta-analysis with trial sequential analysis. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Disruptive mood dysregulation disorder in ICD-11: a new disorder or ODD with a specifier for chronic irritability? Eur Child Adolesc Psychiatry 2016; 25:331-2. [PMID: 26578258 DOI: 10.1007/s00787-015-0789-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 10/22/2015] [Indexed: 10/22/2022]
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Human breast milk and adipokines – A potential role for the soluble leptin receptor (sOb-R) in the regulation of infant energy intake and development. Med Hypotheses 2016; 86:53-5. [DOI: 10.1016/j.mehy.2015.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/19/2015] [Indexed: 11/29/2022]
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Abstract
A 38-year-old female on Vitamin D therapy presented with hypercalcemia induced acute kidney injury. Evaluation revealed primary hyperparathyroidism (PHPT) and iatrogenic hypervitaminosis D. After medical stabilization, she underwent surgical removal of the parathyroid adenoma, and made a full recovery. This case highlights unmasking of subclinical hyperparathyroidism by vitamin D therapy leading to severe hypercalcemia.
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MRI-Guided Percutaneous Biopsy of Mediastinal Masses Using a Large Bore Magnet: Technical Feasibility. Cardiovasc Intervent Radiol 2015; 39:761-767. [PMID: 26604114 DOI: 10.1007/s00270-015-1246-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 09/11/2015] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate the diagnostic accuracy and safety of magnetic resonance imaging (MRI)-guided percutaneous biopsy of mediastinal masses performed using a wide-bore high-field scanner. MATERIALS AND METHODS This is a retrospective study of 16 consecutive patients (8 male, 8 female; mean age 74 years) who underwent MRI-guided core needle biopsy of a mediastinal mass between February 2010 and January 2014. Size and location of lesion, approach taken, time for needle placement, overall duration of procedure, and post-procedural complications were evaluated. Technical success rates and correlation with surgical pathology (where available) were assessed. RESULTS Target lesions were located in the anterior (n = 13), middle (n = 2), and posterior mediastinum (n = 1), respectively. Mean size was 7.2 cm (range 3.6-11 cm). Average time for needle placement was 9.4 min (range 3-18 min); average duration of entire procedure was 42 min (range 27-62 min). 2-5 core samples were obtained from each lesion (mean 2.6). Technical success rate was 100%, with specimens successfully obtained in all 16 patients. There were no immediate complications. Histopathology revealed malignancy in 12 cases (4 of which were surgically confirmed), benign lesions in 3 cases (1 of which was false negative following surgical resection), and one inconclusive specimen (treated as inaccurate since repeat CT-guided biopsy demonstrated thymic hyperplasia). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in our study were 92.3, 100, 100, 66.7, and 87.5%, respectively. CONCLUSION MRI-guided mediastinal biopsy is a safe procedure with high diagnostic accuracy, which may offer a non-ionizing alternative to CT guidance.
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Diagnostic inexactitude - Reframing and relabelling Disruptive Mood Dysregulation Disorder for ICD-11 does not solve the problem. Med Hypotheses 2015; 85:1035-6. [PMID: 26545314 DOI: 10.1016/j.mehy.2015.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/18/2015] [Accepted: 10/11/2015] [Indexed: 11/26/2022]
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Prevalence of Hepatitis A virus (HAV) and Hepatitis E virus (HEV) in the patients presenting with acute viral hepatitis. Indian J Med Microbiol 2015; 33 Suppl:102-5. [PMID: 25657123 DOI: 10.4103/0255-0857.150908] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Hepatitis A virus (HAV) and Hepatitis E virus (HEV) are both enterically transmitted, resulting in acute viral hepatitis (AVH) in developing countries. They pose major health problems in our country. This study was done to determine prevalence of HAV and HEV in patients presenting with AVH and the co-infection of HAV and HEV in these patients. MATERIALS AND METHODS A cross-sectional study of 2-years duration was conducted in the Department of Microbiology, KMC, Mangalore. A non-random sampling of 958 patients presenting with AVH was considered in the study. On the basis of history, serum samples were analysed for IgM anti-HAV and IgM anti-HEV for the detection of HAV and HEV, respectively using commercially available ELISA kits. Data collected was analysed by using Statistical Package for the Social Sciences (SPSS) version 11.5. RESULTS The seroprevalence of HAV- and HEV-positive patients were 19.31% and 10.54%, respectively. The seroprevalence of both HAV and HEV in patients with acute viral hepatitis was 11.5%. The prevalence of HAV and HEV among males (68% and 31%) was higher than in females (31% and 20%) and was predominantly seen among young adults. These infections were predominantly seen during end of monsoons and beginning of winter. CONCLUSION Though the prevalence of HAV is much higher than that of HEV, co-infection rate of 11.5% mandates the screening for HEV which will be of immense importance in pregnant women and improving levels of personal hygiene among higher socio-economic population. These data will be essential for planning of future vaccination strategies and for better sanitation programme in this part of the country.
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Role of Chandipura virus in an “epidemic brain attack” in Andhra Pradesh, India. JOURNAL OF PEDIATRIC NEUROLOGY 2015. [DOI: 10.1055/s-0035-1557208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
Fungal infections of the urinary tract are usually encountered following prolonged antibiotic use, instrumentation and indwelling urinary catheters. These type of infections are mostly seen in immuno-compromised patients. Candida is the most common among the fungal infections of urinary tract followed by Aspergillus infection. Here is a case report of a 26 year old diabetic female who presented with abdominal pain, fever, nausea and vomiting. She had undergone double-J stenting 15-20 days back. The cause of the symptoms was not detected till the patient underwent C.T Scan-KUB with excretory urography which showed the displaced D-J stent. Then on performing replacement of D-J stent, cystoscopy was done and the tissue sample was sent for microbiological and histopathological examination. On Microbiological examination, Aspergillus flavus was isolated from the tissue, which was culprit behind the disease. Patient was then treated with anti-fungal drugs, following which she gradually improved.
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Effect of Everolimus Immunotherapy on HLA Antibody Production in Heart Transplantation. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Normothermic ex vivo perfusion provides superior organ preservation and enables viability assessment of hearts from DCD donors. Am J Transplant 2015; 15:371-80. [PMID: 25612491 DOI: 10.1111/ajt.12994] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 08/11/2014] [Accepted: 08/25/2014] [Indexed: 01/25/2023]
Abstract
The shortage of donors in cardiac transplantation may be alleviated by the use of allografts from donation after circulatory death (DCD) donors. We have previously shown that hearts exposed to 30 min warm ischemic time and then flushed with Celsior supplemented with agents that activate ischemic postconditioning pathways, show complete recovery on a blood-perfused ex vivo working heart apparatus. In this study, these findings were assessed in a porcine orthotopic heart transplant model. DCD hearts were preserved with either normothermic ex vivo perfusion (NEVP) using a clinically approved device, or with standard cold storage (CS) for 4 h. Orthotopic transplantation into recipient animals was subsequently undertaken. Five of six hearts preserved with NEVP demonstrated favorable lactate profiles during NEVP and all five could be weaned off cardiopulmonary bypass posttransplant, compared with 0 of 3 hearts preserved with CS (p < 0.05, Fisher's exact test). In conclusion, DCD hearts flushed with supplemented Celsior solution and preserved with NEVP display viability before and after transplantation. Viability studies of human DCD hearts using NEVP are warranted.
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260 Hsp90 Inhibitor Drug Conjugates (HDC): Payloads and possibilities. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70386-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Patient-Reported Medical Expenditures For Insulin-Treated Diabetes Patients In Eastern, Central And Western Regions Of China. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2014; 17:A747. [PMID: 27202701 DOI: 10.1016/j.jval.2014.08.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Anti-Angiogenic Therapy Induces T-Lymphocyte Infiltration Associated with Poor Survival in Metastatic Renal Cell Carcinoma Patients. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu342.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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MRI-Based Verification of Plaque Positioning and Treatment Planning for Episcleral Brachytherapy. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Increasing the tolerance of DCD hearts to warm ischemia by pharmacological postconditioning. Am J Transplant 2014; 14:1744-52. [PMID: 25040306 DOI: 10.1111/ajt.12782] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 03/10/2014] [Accepted: 03/30/2014] [Indexed: 01/25/2023]
Abstract
Donation after circulatory death (DCD) offers a potential additional source of cardiac allografts. We used a porcine asphyxia model to evaluate viability of DCD hearts subjected to warm ischemic times (WIT) of 20–40 min prior to flushing with Celsior (C) solution. We then assessed potential benefits of supplementing C with erythropoietin, glyceryl trinitrate and zoniporide (Cs), a combination that we have shown previously to activate ischemic postconditioning pathways. Hearts flushed with C/Cs were assessed for functional, biochemical and metabolic recovery on an ex vivo working heart apparatus. Hearts exposed to 20-min WIT showed full recovery of functional and metabolic profiles compared with control hearts (no WIT). Hearts subjected to 30- or 40-min WIT prior to C solution showed partial and no recovery, respectively. Hearts exposed to 30-min WIT and Cs solution displayed complete recovery, while hearts exposed to 40-min WIT and Cs solution demonstrated partial recovery. We conclude that DCD hearts flushed with C solution demonstrate complete recovery up to 20-min WIT after which there is rapid loss of viability. Cs extends the limit of WIT tolerability to 30 min. DCD hearts with ≤30-min WIT may be suitable for transplantation and warrant assessment in a transplant model.
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