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Sodium-glucose co-transporter-2 inhibitors (SGLT2i) added to optimal medical therapy have been shown to reduce the risk of cardiovascular death and recurrent heart failure (HF) hospitalization in HF patients. But whether SGLT2i reduce ventricular arrhythmias and sudden cardiac death (SCD) is controversial. Ventricular repolarization heterogeneity is associated with ventricular arrhythmias. We aimed to evaluate the effect of Dapagliflozin on the ventricular repolarization markers (VRM) in patients with HF with reduced ejection fraction (HFrEF). This retrospective study included patients referred to our cardiology department between February 2022 and June 2023 for assessment of HFrEF and who were on beta-blocker, angiotensin-converting enzyme inhibitor (ACE-I)/angiotensin receptor blocker (ARB) and mineralocorticoid receptor antagonist. They underwent before introduction of dapagliflozin and 6 months later electrocardiograms (ECG) with measurement of QT interval, QTc (corrected by Bazett formula), QT dispersion (QTd), QTc dispersion (QTc-d), Tpeak to Tend (Tp-e) interval, Tp-e/QT, and Tp-e/QTc ratios. A total of 50 patients in sinus rhythm were included. The mean age was 60.88 ± 11.36 years old, and 11 (22%) were female patients. The mean ejection fraction was 30.86 ± 7.2%. Diabetes, hypertension, and chronic kidney disease were reported in 48%, 30%, and 20% of the patients, respectively. We compared VRM before and after introduction of dapagliflozin and we noticed a significant decrease in QTc intervals (430.74 ± 33.81 ms vs. 408.74 ± 32.45 ms; P < 0.001), QT-d (54 ± 19.24 ms vs. 36.2 ± 11.8 ms; P < 0.001) and Tp-e interval (95.8 ± 24.83 ms vs. 74.8 ± 22.87 ms; P < 0.001). Following the introduction of dapagliflozin, we observed a significant increase in left ventricular ejection fraction (LVEF) (30.86 ± 7.2% vs. 38.93 ± 7.07%; P < 0.001). Additionally, left ventricular end-diastolic diameter and left ventricular end-systolic diameter decreased significantly (58.68 ± 7.05 mm vs. 56.28 ± 6.3 mm; P < 0.001, 46.7 ± 8.1 mm vs. 40.7 ± 7.82 mm; P < 0.001). In addition, study participants experienced an improvement in functional capacity. The addition of dapagliflozin to optimal medical therapy in HFrEF patients positively changes VRM (QT, QTc, QTd, Tp-e, and Tp-e/QTc). [ABSTRACT FROM AUTHOR]

Heart failure (HF) continues to be a prevalent condition with high morbidity and mortality despite numerous therapeutic advances. Thus, we created a Heart Failure Therapeutic Unit (HFTU) to optimize medical treatment promptly. Primary objective: to study the impact of the HFTU on reducing cardiovascular mortality and heart failure rehospitalizations at 1 year. Secondary objectives: to study the impact of the HFTU on treatment dose optimization and patient therapeutic adherence. We conducted a prospective, longitudinal, and single-center study at our cardiology department, with a follow-up period of 1 year. We included 159 patients with chronic HF (108 were included in the HFTU group and 51 in the control group). Patients included in the HFTU group received more frequent follow-up, early initiation of medical treatment with rapid progression to optimal doses, and transition to second-line treatments if there was no improvement and if indicated. The control group received standard care. The average age was 62.5 ± 11.7 years, with a male predominance (80.5%), and a high prevalence of diabetes (44%); ischemic cardiomyopathy was the dominant etiology (57.9%), with a mean left ventricular ejection fraction (LVEF) of 31.6 ± 8%. The most common inclusion criterion in the HFTU group was the absence of optimal medical treatment (97.2%). We observed a significant reduction in cardiovascular mortality and HF rehospitalizations at 1 year, as well as a significant decrease in HF rehospitalizations at 1 year in the UTIC group compared to the control group (15.7% vs 41.2%; P < 0.001; 11.1% vs 35.3%; P < 0.001 respectively), regardless of age, gender, and comorbidities (P < 0.001). Acquisition of optimal medical treatment (P < 0.001) and therapeutic adherence (P = 0.015) were more frequent in the HFTU group. We noted an improvement in dyspnea (P = 0.003), in LVEF (from ≤ 40% to > 40%) (P < 0.001) and in heart rate control (HR < 70 bpm) (P < 0.001) in the HFTU group compared to the control group. HFTU was associated with a significant reduction in the combined endpoint of cardiovascular mortality and heart failure rehospitalizations, as well as a decrease in heart failure rehospitalizations. Additionally, it was associated with more therapeutic optimization and adherence, and an improvement in symptoms, LVEF, and heart rate control. [ABSTRACT FROM AUTHOR]

The effect of 40-min nap (NAP) opportunity on psycho-physiological outcomes and technical performance during small-sided basketball game (SSG) was examined in ten professional basketball players. Nocturnal sleep and naps were monitored by actigraphic recording and sleep diaries. Nocturnal total sleep time (TST), time in bed (TIB), sleep efficiency (SE), sleep onset latency (SOL) and wake after sleep onset (WASO) were analyzed. Subjective sleep quality was assessed with visual analogue scale (VAS). Profile of mood state (POMS) and simple reaction time (SRT) were measured before and after Nap and no-nap (CON) conditions. During both test sessions, participants played 10-min SSG. Technical and tactical performances were assessed using Team Sport Assessment Procedure. Volume of play (VP), attack with ball (AB), efficiency index (EI) and performance score (PS) were determined. Heart rate (HR) was measured during SSG, and rating of perceive excretion (RPE) after. Lower HR (p ≤ 0.03, d ≥ 0.78) and RPE (p = 0.007, d = 1.11) were obtained in NAP compared to CON. There was no significant difference in TIB, TST, SE, WASO and VAS between CON and NAP conditions. AB, EI and PS were higher in NAP compared to CON (0.0002 ≤ p ≤ 0.001, 1.3 ≤ d ≤ 1.8). A significant reduction was observed in POMS' fatigue (p = 0.005, d = -1.16, Δ = -53.6%), anxiety (p = 0.02, d = -0.9, Δ = -32.1%), anger (p = 0.01, d = -0.94, Δ = -30.3%), and an improvement in vigor (p = 0.01, d = 0.99, Δ = + 23.8%); which may reflect better readiness after nap and more concentration to start a game-situation. In summary, NAP reduced fatigue, anger, anxiety and enhanced vigor, allowing better technical and tactical performances during basketball SSG., (Copyright © Biology of Sport 2023.)

Background: Theory of mind (ToM) refers to the ability to understand others' states of mind, desires, emotions, beliefs, and intentions to predict the content of their mental representations. Two major dimensions within ToM have been studied. The first is the type of inferred mental state, which can be cognitive or affective. The second comprises the types of processes involved according to their degree of complexity (first- and second-order false belief and advanced ToM). ToM acquisition is fundamental-a key component in the development of everyday human social interactions. ToM deficits have been reported in various neurodevelopmental disorders through various tools assessing disparate facets of social cognition. Nevertheless, Tunisian practitioners and researchers lack a linguistically and culturally appropriate psychometric tool for ToM assessment among school-aged children., Objective: To assess the construct validity of a translated and adapted French ToM Battery for Arabic-speaking Tunisian school-aged children., Methods: The focal ToM Battery was designed with neuropsychological and neurodevelopmental theory and composed of 10 subtests distributed evenly in three parts: Pre-conceptual, cognitive, and affective ToM. Translated and adapted to the Tunisian sociocultural context, this ToM battery was individually administered to 179 neurotypical Tunisian children (90 girls and 89 boys) aged 7-12 years., Results: After controlling for the age effect, construct validity was empirically confirmed on two dimensions (cognitive and affective) via structural equation modeling (SEM) analysis, demonstrating that this solution has a good fit. The results confirmed that the age affected differentially the performance obtained on ToM tasks based on the two components of the battery., Conclusion: Our findings confirm that the Tunisian version of the ToM Battery has robust construct validity for the assessment of cognitive and affective ToM in Tunisian school-aged children; hence, it could be adopted in clinical and research settings., 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., (Copyright © 2023 Salhi, Lancelot, Marzouki, Souissi, Besbes, Le Gall and Bellaj.)

Passage experiments that sequentially infect hosts with parasites have long been used to manipulate virulence. However, for many invertebrate pathogens, passage has been applied naively without a full theoretical understanding of how best to select for increased virulence and this has led to very mixed results. Understanding the evolution of virulence is complex because selection on parasites occurs across multiple spatial scales with potentially different conflicts operating on parasites with different life histories. For example, in social microbes, strong selection on replication rate within hosts can lead to cheating and loss of virulence, because investment in public goods virulence reduces replication rate. In this study, we tested how varying mutation supply and selection for infectivity or pathogen yield (population size in hosts) affected the evolution of virulence against resistant hosts in the specialist insect pathogen Bacillus thuringiensis , aiming to optimize methods for strain improvement against a difficult to kill insect target. We show that selection for infectivity using competition between subpopulations in a metapopulation prevents social cheating, acts to retain key virulence plasmids, and facilitates increased virulence. Increased virulence was associated with reduced efficiency of sporulation, and possible loss of function in putative regulatory genes but not with altered expression of the primary virulence factors. Selection in a metapopulation provides a broadly applicable tool for improving the efficacy of biocontrol agents. Moreover, a structured host population can facilitate artificial selection on infectivity, while selection on life-history traits such as faster replication or larger population sizes can reduce virulence in social microbes., Competing Interests: This work formed part of international patent application number WO 2019/030529 A1 by BR & NC., (© 2023 The Authors. Evolutionary Applications published by John Wiley & Sons Ltd.)

The present study aimed to assess the effects of repeated administration of low-dose caffeine during a night of total sleep deprivation on physical and cognitive performance. Twelve recreational runners (being non-habitual caffeine users) performed four test sessions in a double-blind randomized order after (i) a placebo or 6 mg/kg of caffeine ingestion during a baseline night (BN) or (ii) a placebo or three doses of 2 mg/kg of caffeine during a night of total sleep deprivation (TSD). At each session, they completed an exhaustive run at 75% of the final velocity in a Vameval test (Vvameval) around a 400 m outdoor athletics track and performed the correct detection and reaction time tasks. In comparison with BN, the TSD condition significantly impaired running performance, reaction time, and correct detections. On the contrary, caffeine intake improved exhaustive running performance after BN by 5.2% (p < .001) and after TSD by 8.9% (p < .001), increased correct detections after BN (p < .05) and TSD (p < .05), and decreased reaction time after BN (p < .01) and TSD (p < .05) compared to placebo. Therefore, the repeated ingestion of low-dose caffeine is an effective strategy to counteract the detrimental effects of total sleep deprivation on physical and cognitive performance.

Cry41Aa, also called parasporin-3, belongs to a group of toxins from the entomopathogenic bacterium Bacillus thuringiensis that show activity against human cancer cells. Cry41Aa exhibits preferential cytocidal activity towards HL-60 (human promyelocytic leukaemia cells) and HepG2 (human liver cancer cells) cell lines after being proteolytically activated. To better understand the mechanism of action of Cry41Aa, we evolved resistance in HepG2 cells through repeated exposure to increasing doses of the toxin. Concentrations of Cry41Aa that killed over 50% of the parental HepG2 cells had no significant effect on the viability of the resistant cells and did not induce either pore formation or p38 phosphorylation (both characteristic features of pore-forming toxins). Preliminary RNA sequencing data identified AQP9 as a potential mediator of resistance, but extensive investigations failed to show a causal link and did not support an enhanced cell repair process as the resistance mechanism.