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The aims of this study were to assess the efficacy of the rate of perceived exertion (RPE) scale based on the number of repetitions in reserve (RIR) before exhaustion for the prescription of resistance training in cardiac rehabilitation and to compare it to the percentage of estimated one-repetition maximum (1RM) prescription method. Sixteen male patients (age 60 ± 8) with history of coronary artery disease were randomly assigned to two resistance training rehabilitation protocols lasting nine weeks and consisting of three sessions per week, with the same exercise selection, number of sets and repetitions, and rest periods, but different load prescription method (RPE vs. %1RM). Patients' strength was evaluated pre- and post-intervention. Patients in the RPE group showed significant increases in strength across all the exercises of the protocol (leg press 24.25 ± 17.07 kg; chest press 7.25 ± 3.41 kg; seated row 13.88 ± 7.57 kg; leg extension 14.24 ± 4.53 kg; shoulder press 5.75 ± 4.06 kg; lat pulldown 7.50 ± 4.66 kg). Post-intervention between-group analysis showed no differences in strength gains (leg press p = 0.955; chest press p = 0.965; seated row p = 0.763; leg extension p = 0.565; shoulder press p = 0.868; lat pulldown p = 0.780) and trivial effect sizes (ES) for one prescription method over the other (leg press ES = -0.03; chest press ES = 0.00; seated row ES = 0.10; leg extension ES = -0.29; shoulder press ES = 0.18; lat pulldown ES = 0.05). RPE based on RIR seems to be an effective prescription method for resistance training in cardiac rehabilitation, showing similar efficacy to the standardized practice of percentage of 1RM.

Background: The acute hemodynamic response to isometric exercise in hypertensive patients' ischemic heart disease (IHD) has been poorly investigated. The aim of this study was to assess acute changes in left ventricular myocardial work (MW) during isometric bilateral knee extension in patients with IHD. Methods: Twenty stable hypertensive patients with IHD and ten healthy, age-matched controls (HC) were enrolled. All subjects performed an isometric knee extension exercise at 30% of their maximal voluntary contraction. The effort was maintained for three minutes or until exhaustion. At baseline, at peak exercise, and after 10 min of recovery, echocardiography evaluation was performed and blood pressure (BP) and heart rate (HR) were measured. Results: The exercise was well tolerated by all subjects. At peak exercise, systolic BP in the IHD was significantly higher than HC (37.6 ± 7.2 vs. 8.4 ± 2.3 mmHg; p 0.002). The HC group had a greater increase in HR than IHD (19.7 ± 6.2 vs. 8.4 ± 2.2 bpm; p 0.009). The E/E' ratio increased in IHD and was unchanged in the control group. The global work index increased significantly in IHD compared to HC (+15% vs. +3%; p 0.026). Global constructive work increased significantly in IHD compared to HC (+29.8% vs. +7.4 respectively, p 0.031). Global wasted work increased by 92.3% in IHD and was unchanged in HC. The global work efficiency decreased in IHD (-18%), but was unchanged in HC (between-groups p 0.019). Stroke volume decreased in IHD and was unchanged in HC. Cardiac output was unchanged in IHD, while it increased in HC. Conclusion: In patients with hypertension and underlying IHD, an acute isometric load causes a great increase in systolic BP and LV filling pressure. It follows a mostly ineffective increase in MW that fails to maintain stroke volume.

Purpose: Left atrial dysfunction has shown to play a prognostic role in patients with ischemic cardiomyopathy (ICM) and is becoming a therapeutic target for pharmacological and non-pharmacological interventions. The effects of exercise training on the atrial function in patients with ICM have been poorly investigated. In the present study, we assessed the effects of a 12-week combined training (CT) program on the left atrial function in patients with ICM., Methods: We enlisted a total of 45 clinically stable patients and randomly assigned them to one of the following three groups: 15 to a supervised CT with low-frequency sessions (twice per week) (CTLF); 15 to a supervised CT with high-frequency sessions (thrice per week) (CTHF); and 15 to a control group following contemporary preventive exercise guidelines at home. At baseline and 12 weeks, all patients underwent a symptom-limited exercise test and echocardiography. The training included aerobic continuous exercise and resistance exercise. The analysis of variance (ANOVA) was used to compare within- and inter-group changes., Results: At 12 weeks, the CTLF and CTHF groups showed a similar increase in the duration of the ergometric test compared with the control (ANOVA p  < 0.001). The peak atrial longitudinal strain significantly increased in the CTHF group, while it was unchanged in the CTLF and control groups (ANOVA p  = 0.003). The peak atrial contraction strain presented a significant improvement in the CTHF group compared with the CTLF and control groups. The left ventricular global longitudinal strain significantly increased in both the CTHF and the CTLF groups compared with the control group (ANOVA p  = 0.017). The systolic blood pressure decreased in the CTHF and CTLF groups, while it was unchanged in the control group. There were no side effects causing the discontinuation of the training., Conclusions: We demonstrated that a CT program effectively improved atrial function in patients with ICM in a dose-effect manner. This result can help with programming exercise training in this population., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declared that they were an editorial board member of Frontiers at the time of submission. This had no impact on the peer-review process and the final decision., (© 2024 Caminiti, Volterrani, Iellamo, Marazzi, Manzi, D'Antoni, Vadalà, Di Biasio, Catena, Morsella and Perrone.)

Background: We investigated the relationship between the backside deformation of polyethylene (PE) tibial inserts and aseptic loosening of the Option stemmed tibial tray used with Zimmer NexGen posterior-stabilised (PS) devices. We hypothesized that explanted inserts used in PS designs would exhibit greater extents of PE backside deformation than those used in equivalent cruciate retaining (CR) designs and that PE inserts retrieved from total knee arthroplasties (TKAs) revised for aseptic tibial tray loosening would exhibit greater extents of backside deformation than TKAs revised for other reasons., Methods: A total of 73 explanted fixed-bearing TKAs (42 CR and 31 PS) were examined. PE components underwent geometric examination with a coordinate measuring machine using validated techniques. Multiple regression modelling was used to identify variables associated with revision secondary to aseptic loosing and to determine factors associated with increased PE backside deformation., Results: PE inserts retrieved from TKAs with aseptic loosening had significantly greater backside deformation than those retrieved from TKAs revised for other reasons (p < 0.001). Greater PE backside deformation was significantly associated with larger tray/insert clearance heights (p < 0.001), thinner inserts (p < 0.001) and PS TKAs (p = 0.001)., Conclusion: PE backside deformation was significantly greater in the PS TKAs. This may provide one explanation for the increased rate of aseptic loosening reported with the Option tibial tray used with the Legacy Posterior Stabilised (LPS) system., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ‘None. R.M.B., S.R.W., M.E.N., S.S., and D.J.L. are ExplantLab employees. ExplantLab is a company which analyses removed orthopaedic products as a supplier to the National Health Service of the United Kingdom’., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: the aim of this study was to assess acute changes in left atrial (LA) function during incremental aerobic exercise in patients with heart failure with mildly reduced ejection fraction (HFmrEF) in comparison to healthy subjects (HS)., Methods: twenty patients with established HFmrEF were compared with 10 HS, age-matched controls. All subjects performed a stepwise exercise test on a cycle ergometer. Echocardiography was performed at baseline, during submaximal effort, at peak of exercise, and after 5 min of recovery., Results: HS obtained a higher value of METs at peak exercise than HFmrEF (7.4 vs. 5.6; between group p = 0.002). Heart rate and systolic blood pressure presented a greater increase in the HS group than in HFmrEF (between groups p = 0.006 and 0.003, respectively). In the HFmrEF group, peak atrial longitudinal strain (PALS) and conduit strain were both increased at submaximal exercise ( p < 0.05 for both versus baseline) and remained constant at peak exercise. Peak atrial contraction strain (PACS) did not show significant changes during the exercise. In the HS group, PALS and PACS increased significantly at submaximal level ( p < 0.05 for both versus baseline), but PALS returned near baseline values at peak exercise; conduit strain decreased progressively during the exercise in HS. Stroke volume (SV) increased in both groups at submaximal exercise; at peak exercise, SV remained constant in the HFmrEF, while it decreased in controls (between groups p = 0.002)., Conclusions: patients with HFmrEF show a proper increase in LA reservoir function during incremental aerobic exercise that contributes to maintain SV throughout the physical effort.

Left atrial dysfunction is associated with exercise intolerance and poor prognosis in heart failure (HF). The effects of exercise training on atrial function in patients with HF with mid-range ejection fraction (HFmrEF) are unknown. The purpose of the present study was to assess the effects of a supervised concurrent training (SCT) program, lasting 12 weeks, on left atrial function of patients with HFmrEF. The study included 70 stable patients, who were randomly assigned into two groups: SCT with (three sessions/week) or a control (CON) group directed to follow contemporary exercise preventive guidelines at home. Before starting the training program and at 12 weeks, all patients performed an ergometric test, a 6 min walk test, and echocardiography. Between-group comparisons were made by analysis of variance (ANOVA). At 12 weeks, the duration of the ergometric test and distance walked at 6 min walk test presented a significant greater increase in SCT compared to the control (between-group p 0.0001 and p 0.004 respectively). Peak atrial longitudinal strain and conduit strain presented an increase of 29% and 34%, respectively, in the SCT, and were unchanged in CON (between-group p 0.008 and p 0.001, respectively). Peak atrial contraction strain increased by 21% in SCT, with no changes in CON (between-group p 0.002). Left ventricular global longitudinal strain increased significantly in SCT compared to control (between-groups p 0.03). In conclusions, SCT improved left atrial and left ventricular function in HFmrEF. Further studies are needed in order to verify whether these favourable effects of SCT on LA function are sustained and whether they will translate into clinical benefits for patients with HFmrEF.

Visible light communications (VLC) is a technology that enables the transmission of digital information with a light source. VLC is nowadays seen as a promising technology for indoor applications, helping WiFi to handle the spectrum crunch. Possible indoor applications range from Internet connection at home/office to multimedia content delivery in a museum. Despite the vast interest of researchers in both theoretical analysis and experimentation on VLC technology, no studies have been carried out on the human perceptions of objects illuminated by VLC-based lamps. It is important to define if a VLC lamp decreases the reading capability or modifies the color perception in order to make VLC a technology appropriate for everyday life use. This paper describes the results of psychophysical tests on humans to define if VLC lamps modify the perception of colors or the reading speed. The results of the reading speed test showed a 0.97 correlation coefficient between tests with and without VLC modulated light, leading us to conclude that there is no difference in the reading speed capability with and without VLC-modulated light. The results of the color perception test showed a Fisher exact test p -value of 0.2351, showing that the perception of color is not influenced by the presence of the VLC modulated light.

Non-thermal plasma technology is increasingly being applied in the plant biology field. Despite the variety of beneficial effects of plasma-activated water (PAW) on plants, information about the mechanisms of PAW sensing by plants is still limited. In this study, in order to link PAW perception to the positive downstream responses of plants, transgenic Arabidopsis thaliana seedlings expressing the Ca 2+ -sensitive photoprotein aequorin in the cytosol were challenged with water activated by low-power non-thermal plasma generated by a dielectric barrier discharge (DBD) source. PAW sensing by plants resulted in the occurrence of cytosolic Ca 2+ signals, whose kinetic parameters were found to strictly depend on the operational conditions of the plasma device and thus on the corresponding mixture of chemical species contained in the PAW. In particular, we highlighted the effect on the intracellular Ca 2+ signals of low doses of DBD-PAW chemicals and also presented the effects of consecutive plant treatments. The results were discussed in terms of the possibility of using PAW-triggered Ca 2+ signatures as benchmarks to accurately modulate the chemical composition of PAW in order to induce environmental stress resilience in plants, thus paving the way for further applications in agriculture.

Background: Over five million joint replacements are performed across the world each year. Cobalt chrome (CoCr) components are used in most of these procedures. Some patients develop delayed-type hypersensitivity (DTH) responses to CoCr implants, resulting in tissue damage and revision surgery. DTH is unpredictable and genetic links have yet to be definitively established., Methods: At a single site, we carried out an initial investigation to identify HLA alleles associated with development of DTH following metal-on-metal hip arthroplasty. We then recruited patients from other centres to train and validate an algorithm incorporating patient age, gender, HLA genotype, and blood metal concentrations to predict the development of DTH. Accuracy of the modelling was assessed using performance metrics including time-dependent receiver operator curves., Results: Using next-generation sequencing, here we determine the HLA genotypes of 606 patients. 176 of these patients had experienced failure of their prostheses; the remaining 430 remain asymptomatic at a mean follow up of twelve years. We demonstrate that the development of DTH is associated with patient age, gender, the magnitude of metal exposure, and the presence of certain HLA class II alleles. We show that the predictive algorithm developed from this investigation performs to an accuracy suitable for clinical use, with weighted mean survival probability errors of 1.8% and 3.1% for pre-operative and post-operative models respectively., Conclusions: The development of DTH following joint replacement appears to be determined by the interaction between implant wear and a patient's genotype. The algorithm described in this paper may improve implant selection and help direct patient surveillance following surgery. Further consideration should be given towards understanding patient-specific responses to different biomaterials., Competing Interests: Competing interestsThe authors declare the following competing interests: the algorithm described in this study has been developed into software to be used as a commercial medical device (Orthotype). Orthotype has been patented, and is owned by the company PXD Ltd, trading as ExplantLab. David Langton, the lead author, is director of this company. Matthew Nargol is an employee of ExplantLab. All other authors have no competing interests to declare., (© The Author(s) 2022.)

In this study, we aimed to assess acute changes occurring on atrial function following single bouts of eccentric resistance exercise (ECC-RE) performed at two different loads. Twenty-five patients with chronic heart failure with middle range ejection fraction (HFmrEF) participated in three experimental sessions in a randomized order and on separate days: two sessions of ECC RE at 20% (ECC-20) of one-repetition maximum (1-RM) and 50% (ECC-50) 1-RM, and one session of control, without exercise. Each session lasted three minutes. Before and immediately after the sessions, patients underwent echocardiography and blood pressure and heart rate measurement. Peak atrial longitudinal strain (PALS) and peak atrial contractile strain (PACS) significantly increased after both ECC-20 (+16.3%) and ECC-50 (+18.1%) compared to control (between sessions p = 0.022). Peak atrial contractile strain (PACS) significantly increased after ECC-50 (+28.4%) compared to ECC-20 (+17.0%) and control (between sessions p = 0.034). The ratio of transmitral and annular velocities (E/E') increased significantly after ECC-20 (+10.4%) and ECC-50 (+19.0%) compared to control (between groups p = 0.003). EF, left ventricular longitudinal strain, and stroke volume did not change after ECC-RE sessions compared to control. Cardiac output increased significantly after ECC-20 and ECC-50 compared to control, (between groups p = 0.025). In conclusion, both ECC-RE sessions were well tolerated, and LA functional reserve was properly mobilized in response to ECC-RE in patients with HFmrEF. Cardiac output increased at the cost of an increased LV filling pressure, but no detrimental changes of LV function occurred.

Concurrent aerobic plus resistance exercise (RAE) and high-intensity interval exercise (HIIE) are both effective at inducing post-exercise hypotension (PEH) in patients with hypertension. However, central hemodynamic changes associated with PEH in hypertensive subjects with underlying ischemic heart disease (IHD) have been poorly investigated. The study aim was to compare the acute effects produced by these two exercise modalities on left ventricular diastolic function and left atrial function. Twenty untrained male patients with a history of hypertension and IHD under stable pharmacological therapy were enrolled. Each patient underwent three exercise sessions: RAE, HIIE and a control session without exercise, each lasting 45 min. An echocardiography examination was performed before and between 30 min and 40 min from the end of the exercise sessions. Following the exercise sessions, BP values decreased in a similar way in RAE and HIIE and were unchanged after the control session. Compared to pre-session, the ratio between early filling velocity (E) and mitral annulus early diastolic velocity (E'). E/E' increased after HIIE and remained unchanged after both RAE and control sessions (between-sessions p 0.002). Peak atrial longitudinal strain (PALS) increased slightly after RAE (+1.4 ± 1.1%), decreased after HIIE (-4.6 ± 2.4%) and was unchanged after the control session (between-sessions p 0.03). Peak atrial contraction strain (PACS) was mildly increased after RAE, was reduced after HIIE and was unchanged after the control session. Atrial volume was unchanged after both exercise sessions. Left ventricular and left atrial stiffness increased significantly after HIIE, but remained unchanged after the RAE and control sessions. Stroke volume and cardiac output increased after RAE, decreased after HIIE, and were unchanged after the control session. In conclusion, single session of RAE and HIIE brought about similar PEH in hypertensive subjects with IHD, while they evoked different central hemodynamic adjustments. Given its neutral effects on diastolic and atrial functions, RAE seems more suitable for reducing blood pressure in hypertensive patients with IHD.

Aims: The aim of this study was to investigate whether wear and backside deformation of polyethylene (PE) tibial inserts may influence the cement cover of tibial trays of explanted total knee arthroplasties (TKAs)., Methods: At our retrieval centre, we measured changes in the wear and deformation of PE inserts using coordinate measuring machines and light microscopy. The amount of cement cover on the backside of tibial trays was quantified as a percentage of the total surface. The study involved data from the explanted fixed-bearing components of four widely used contemporary designs of TKA (Attune, NexGen, Press Fit Condylar (PFC), and Triathlon), revised for any indication, and we compared them with components that used previous generations of PE. Regression modelling was used to identify variables related to the amount of cement cover on the retrieved trays., Results: A total of 114 explanted fixed-bearing TKAs were examined. This included 76 used with contemporary PE inserts which were compared with 15 used with older generation PEs. The Attune and NexGen (central locking) trays were found to have significantly less cement cover than Triathlon and PFC trays (peripheral locking group) (p = 0.001). The median planicity values of the PE inserts used with central locking trays were significantly greater than of those with peripheral locking inserts (205 vs 85 microns; p < 0.001). Attune and NexGen inserts had a characteristic pattern of backside deformation, with the outer edges of the PE deviating inferiorly, leaving the PE margins as the primary areas of articulation., Conclusion: Explanted TKAs with central locking mechanisms were significantly more likely to debond from the cement mantle. The PE inserts of these designs showed characteristic patterns of deformation, which appeared to relate to the manufacturing process and may be exacerbated in vivo. This pattern of deformation was associated with PE wear occurring at the outer edges of the articulation, potentially increasing the frictional torque generated at this interface. Cite this article: Bone Joint J  2021;103-B(12):1791-1801.

Increasing evidence indicates that water activated by plasma discharge, termed as plasma-activated water (PAW), can promote plant growth and enhance plant defence responses. Nevertheless, the signalling pathways activated in plants in response to PAW are still largely unknown. In this work, we analysed the potential involvement of calcium as an intracellular messenger in the transduction of PAW by plants. To this aim, Arabidopsis thaliana (Arabidopsis) seedlings stably expressing the bioluminescent Ca 2+ reporter aequorin in the cytosol were challenged with PAW generated by a plasma torch. Ca 2+ measurement assays demonstrated the induction by PAW of rapid and sustained cytosolic Ca 2+ elevations in Arabidopsis seedlings. The dynamics of the recorded Ca 2+ signals were found to depend upon different parameters, such as the operational conditions of the torch, PAW storage, and dilution. The separate administration of nitrate, nitrite, and hydrogen peroxide at the same doses as those measured in the PAW did not trigger any detectable Ca 2+ changes, suggesting that the unique mixture of different reactive chemical species contained in the PAW is responsible for the specific Ca 2+ signatures. Unveiling the signalling mechanisms underlying plant perception of PAW may allow to finely tune its generation for applications in agriculture, with potential advantages in the perspective of a more sustainable agriculture.

Background and Aim of the Study: COVID-19 is characterized by super spread events occurring in communities, e.g., hospitals. To limit virus diffusion among healthcare workers the use of personal protective equipment and screening tests are highly advised; also, isolation of virus positive professionals while monitoring their health condition is recommended. This study aims to assess, in a cohort of COVID-19 positive quarantined healthcare workers, the perceived source of infection and exposure risk as well as the clinical evolution of the disease through a surveillance interview., Methods: A retrospective observational study accounting 896 observations on 93 healthcare professionals tested positive for COVID-19. Data were collected from the Nursing and Technical Directorate of Romagna, Ravenna, Local Health Company, Italy., Results: 99.5% of the positive workers accepted phone interviews with management staff. 2.6% of workers were positive with increasing records in the specialist medical area. Nurses and social health professionals were mostly affected.  Patient exposure at a distance <1 m and a contact time > 2 hours was the first cause of positivity. In COVID-19 and territorial emergency departments, the first cause was the contact with colleagues. At the time of the infection, most of the staff wore a surgical mask. Cough, asthenia, fever, anosmia, dysgeusia, and rhinitis were common symptoms. Asymptomatic percentage was about 10%. The self-perceived physical condition was high (>7) and improved during the observation period., Conclusions: The diffusion rate of COVID-19 among healthcare workers is relatively low, probably due to the use of personal protective equipment. The distancing, also among colleagues, is a fundamental measure to reduce the possibility of infection. Symptoms are mild and can be controlled by surveillance measures. Constant contact with the organization is an essential strategy for promoting recovering of workers and reducing the spread of the virus within the healthcare organization.

The causes of the worldwide problem of encroachment of woody plants into grassy vegetation are elusive. The effects of soil nutrients on competition between herbaceous and woody plants in various landscapes are particularly poorly understood. A long-term experiment of 60 plots in a South African savanna, comprising annual applications of ammonium sulphate (146-1166 kg ha-1 yr-1) and superphosphate (233-466 kg ha-1 yr-1) over three decades, and subsequent passive protection over another three decades, during which indigenous trees encroached on different plots to extremely variable degrees, provided an opportunity to investigate relationships between soil properties and woody encroachment. All topsoils were analysed for pH, acidity, EC, water-dispersible clay, Na, Mg, K, Ca, P, S, C, N, NH4, NO3, B, Mn, Cu and Zn. Applications of ammonium sulphate (AS), but not superphosphate (SP), greatly constrained tree abundance relative to control plots. Differences between control plots and plots that had received maximal AS application were particularly marked (16.3 ± 5.7 versus 1.2 ± 0.8 trees per plot). Soil properties most affected by AS applications included pH (H2O) (control to maximal AS application: 6.4 ± 0.1 to 5.1 ± 0.2), pH (KCl) (5.5 ± 0.2 to 4.0 ± 0.1), acidity (0.7 ± 0.1 to 2.6 ± 0.3 cmol kg-1), acid saturation (8 ± 2 to 40 ± 5%), Mg (386 ± 25 to 143 ± 15 mg kg-1), Ca (1022 ± 180 to 322 ± 14 mg kg-1), Mn (314 ± 11 to 118 ± 9 mg kg-1), Cu (3.6 ± 0.3 to 2.3 ± 0.2 mg kg-1) and Zn (6.6 ± 0.4 to 3.7 ± 0.4 mg kg-1). Magnesium, B, Mn and Cu were identified using principal component analysis, boundary line analysis and Kruskal-Wallis rank sum tests as the nutrients most likely to be affecting tree abundance. The ratio Mn/Cu was most related to tree abundance across the experiment, supporting the hypothesis that competition between herbaceous and woody plants depends on the availability of anabolic relative to catabolic nutrients. These findings, based on more than six decades of experimentation, may have global significance for the theoretical understanding of changes in vegetation structure and thus the practical control of invasive woody plants.

A scheme of a neutral beam injector (NBI), based on electrostatic acceleration and magneto-static deflection of negative ions, is proposed and analyzed in terms of feasibility and performance. The scheme is based on the deflection of a high energy (2 MeV) and high current (some tens of amperes) negative ion beam by a large magnetic deflector placed between the Beam Source (BS) and the neutralizer. This scheme has the potential of solving two key issues, which at present limit the applicability of a NBI to a fusion reactor: the maximum achievable acceleration voltage and the direct exposure of the BS to the flux of neutrons and radiation coming from the fusion reactor. In order to solve these two issues, a magnetic deflector is proposed to screen the BS from direct exposure to radiation and neutrons so that the voltage insulation between the electrostatic accelerator and the grounded vessel can be enhanced by using compressed SF6 instead of vacuum so that the negative ions can be accelerated at energies higher than 1 MeV. By solving the beam transport with different magnetic deflector properties, an optimum scheme has been found which is shown to be effective to guarantee both the steering effect and the beam aiming.

Tryptophan is an essential amino acid for hosts and pathogens. The liver enzyme tryptophan 2,3-dioxygenase (TDO) provokes, by its ability to degrade tryptophan to N-formylkynurenine, the precursor of the immune-relevant kynurenines, direct and indirect antimicrobial and immunoregulatory states. Up to now these TDO-mediated broad-spectrum effector functions have never been observed under hypoxia in vitro, although physiologic oxygen concentrations in liver tissue are low, especially in case of infection. Here we analysed recombinant expressed human TDO and ex vivo murine TDO functions under different oxygen conditions and show that TDO-induced restrictions of clinically relevant pathogens (bacteria, parasites) and of T cell proliferation are abrogated under hypoxic conditions. We pinpointed the loss of TDO efficiency to the reduction of TDO activity, since cell survival and TDO protein levels were unaffected. In conclusion, the potent antimicrobial as well as immunoregulatory effects of TDO were substantially impaired under hypoxic conditions that pathophysiologically occur in vivo. This might be detrimental for the appropriate host immune response towards relevant pathogens.

Purpose: To evaluate the impact of right ventricular dysfunction on exercise tolerance and potential changes resulting from exercise training in patients with chronic obstructive pulmonary disease (COPD) undergoing pulmonary rehabilitation., Methods: Subjects were 44 patients with a history of symptomatic (Global Initiative for Chronic Obstructive Lung Disease classes 2-4) COPD attending a 4-week aerobic exercise training program. Right ventricle dysfunction was evaluated by echocardiography at admission using tricuspid annular plane systolic excursion (TAPSE). Exercise tolerance was evaluated at admission and discharge using the 6-minute walk test (6MWT). Change in distance walked (Δ6MWT) was defined as the difference between 6MWT distance at discharge minus distance at admission. Patients were divided into 2 groups according to the presence of right ventricle dysfunction (TAPSE ≤16 mm)., Results: Median age and left ventricular ejection fraction was 70.2 ± 5.2 years and 54.4 ± 9.1%, respectively. Of the 44 patients, 14 (31.8%) had TAPSE ≤16 mm. Baseline 6MWT distance was less in the group with TAPSE ≤16 mm compared with TAPSE >16 mm (110.2 ± 34 vs 185.7 ± 41, respectively; P = .02). After the training program, 6MWT distance increased in both groups, but there was less increase in the group with TAPSE ≤16 mm compared with TAPSE >16 mm (+24.3% vs +32.8%, respectively; P < .001). Tricuspid annular plane systolic excursion was significantly correlated to distance walked at the baseline 6MWT (r = 0.44; P = .002) and to Δ6MWT (r = .36; P = .006)., Conclusions: Tricuspid annular plane systolic excursion ≤16 mm was an indicator of decreased 6MWT distance at baseline and 6MWT distance change in COPD patients undergoing pulmonary rehabilitation. This relationship seems to be independent of pulmonary function.

Two Neutral Beam Injectors (NBI) are foreseen to provide a substantial fraction of the heating power necessary to ignite thermonuclear fusion reactions in ITER. The development of the NBI system at unprecedented parameters (40 A of negative ion current accelerated up to 1 MV) requires the realization of a full scale prototype, to be tested and optimized at the Test Facility under construction in Padova (Italy). The beam source is the key component of the system and the design of the multi-grid accelerator is the goal of a multi-national collaborative effort. In particular, beam steering is a challenging aspect, being a tradeoff between requirements of the optics and real grids with finite thickness and thermo-mechanical constraints due to the cooling needs and the presence of permanent magnets. In the paper, a review of the accelerator physics and an overview of the whole R&D physics program aimed to the development of the injector source are presented.

Objective: To determine whether elevated blood cobalt (Co) concentrations are associated with early failure of metal-on-metal (MoM) hip resurfacings secondary to adverse reaction to metal debris (ARMD)., Design: Cohort study., Setting: Single centre orthopaedic unit., Participants: Following the identification of complications potentially related to metal wear debris, a blood metal ion screening programme was instigated at our unit in 2007 for all patients with Articular Surface Replacement (ASR) and Birmingham MoM hip resurfacings. Patients were followed annually unless symptoms presented earlier. Symptomatic patients were investigated with ultrasound scan and joint aspiration. The clinical course of all 278 patients with 'no pain' or 'slight/occasional' pain and a Harris Hip Score greater than or equal to 95 at the time of venesection were documented. A retrospective analysis was subsequently conducted using mixed effect modelling to investigate the temporal pattern of blood Co levels in the patients and survival analysis to investigate the potential role of case demographics and blood Co levels as risk factors for subsequent failure secondary to ARMD., Results: Blood Co concentration was a positive and significant risk factor (z=8.44, p=2×10(-16)) for joint failure, as was the device, where the Birmingham Hip Resurfacing posed a significantly reduced risk for revision by 89% (z=-3.445, p=0.00005 (95% CI on risk 62 to 97)). Analysis using Cox-proportional hazards models indicated that men had a 66% lower risk of joint failure than women (z=-2.29419, p=0.0218, (95% CI on risk reduction 23 to 89))., Conclusions: The results suggest that elevated blood metal ion concentrations are associated with early failure of MoM devices secondary to adverse reactions to metal debris. Co concentrations greater than 20 µg/l are frequently associated with metal staining of tissues and the development of osteolysis. Development of soft tissue damage appears to be more complex with females and patients with ASR devices seemingly more at risk when exposed to equivalent doses of metal debris.

Tapirs (Perissodactyla: Tapiridae) are the only living vertebrates, beyond the order Proboscidea, found to possess a true proboscis, defined as a flexible tubular extension of the joint narial and upper labial musculature that serves, at least in part, to grasp food. Tapirs show only partial homology and analogy with elephants in the narial and upper labial structures, as well as in the skull bones and teeth. However, superficially similar extensions in other extant vertebrates differ greatly in anatomy and function. Therefore, they deserve new names: prorhiscis (e.g. Mammalia: Saiga tatarica), prorhinosis (e.g. Chondrichthyes: Callorhinchus spp.), prorhynchis (e.g. Osteichthyes: Campylomormyrus spp.) and progeneiontis (e.g. Osteichthyes: Gnathonemus spp.). Among non-mammalian vertebrates, no bird or reptile is known to possess a proboscis. Among fishes, there are various extensions of the rostrum, jaws, 'nose' and 'chin' that lack the required narial involvement. The skulls of extinct mammals within (e.g. deinotheres) and beyond (e.g. astrapotheres) the Proboscidea confirm that a proboscis evolved independently in several mammalian lineages before the Pliocene. This convergence with tapirs presumably reflects, in part, the advantages of concentrating the olfactory sensor on what is, effectively, the tip of a long mobile upper lip. However, the proboscis does not appear to have arisen de novo in any vertebrate post-Pliocene, and its continued evolution has apparently depended on the further development of its length, flexibility and innervations, as epitomized by elephants., (© 2012 Wiley Publishing Asia Pty Ltd, ISZS and IOZ/CAS.)

Recent guidelines have suggested that routine postoperative care of patients with metal-on-metal hip prostheses should involve metal ion analysis. This study sought to investigate the relationship between bearing surface wear rates of metal components and serum metal ion analysis and also to quantify the incidence of excessive increases in serum metal ion concentrations post-hip resurfacing arthroplasty., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

The use of large metal on metal bearings has led to a reduction in the risk of dislocation post hip arthroplasty. Because of this, and also because of the technical difficulties associated with resurfacing surgery in particular, it could be argued that a less meticulous approach to acetabular cup placement has developed in comparison with conventional metal on polyethylene arthroplasty. Resurfacing cups may produce significant clinical problems when placed at the extremes of version, including increased production of metal debris and psoas tendonitis. Presented in this article is evidence that EBRA software (Einzel-Bild-Roentgen-Analysis, University of Innsbruck, Austria) can be used to reliably assess the version of resurfacing cups, when radiographs are of sufficient quality. The cups have characteristic appearances when placed at the extremes of version. These characteristics can allow the surgeon to identify poorly positioned cups without the use of software., (Copyright 2010 Elsevier Inc. All rights reserved.)

The momentum balance has been applied to the ExB flow in the edge region of a reversed field pinch (RFP) configuration. All terms, including those involving fluctuations, have been measured in stationary condition in the edge region of the Extrap-T2R RFP experiment. It is found that the component of the Reynolds stress driven by electrostatic fluctuations is the term playing the major role in driving the shear of the ExB flow to a value marginal for turbulent suppression, so that the results are in favor of a turbulence self-regulating mechanism underlying the momentum balance at the edge. Balancing the sheared flow driving and damping terms, the plasma viscosity is found anomalous and consistent with the diffusivity due to electrostatic turbulence.

The authors studied the surface electromyographic (EMG) spectrum of the paraspinal muscles of 350 subjects. They were classified by their history as normal (n=175), chronic low back pain (n=145), or past history (n=30). They pulled upwards on a floor-mounted load cell at two-thirds of their maximum voluntary contraction for 30 s, while the EMG was measured from the paraspinal muscles at the L4/L5 level. From the EMG signal the root-mean-square (RMS) was calculated. Power spectrum analysis allowed calculation of the median frequency slope, the initial median frequency (IMF), modal frequency, peak amplitude and spectral width at half peak amplitude (half-width). All of the variables of the chronic group were significantly different from the normal group, except the median frequency slope, RMS slope and mode. Half-width, age and maximum voluntary contraction were shown to be independent predictors of back pain classification. Half-width classified the subjects with a sensitivity of 0.65 and a specificity of 0.75.

m-Iodobenzylguanidine (MIBG) is a functional analogue of the neurotransmitter norepinephrine. Radio-iodinated 131I-MIBG is used clinically as a tumor-targeted radiopharmaceutical agent in the diagnosis and treatment of adrenergic tumors. Native MIBG has previously been demonstrated to be cytotoxic in cultured cells and to produce anti-tumor responses in animals when non-toxic schedules are used. In this study the effect of MIBG was investigated on isolated rat liver mitochondria and on various tumor cell lines (human neuroblastoma SK-N-SH, mouse neuroblastoma N1E115 and mouse lymphosarcoma S49). Results revealed that MIBG inhibits respiration of isolated liver mitochondria at complex I of the respiratory chain, without affecting F1 ATP-ase. In cell lines, impairment of the mitochondrial respiration was evident from reduced oxygen consumption and decreased intracellular ATP levels. In response to this effect, the glycolytic flux was stimulated as shown by increased glucose consumption and lactic acid production. Cytotoxicity of MIBG was proportional to drug-induced alterations in glucose metabolism.