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Culinary medicine and culinary nutrition programs have emerged as innovative approaches to influencing dietary and lifestyle behavior change. These models vary in reported use of behavioral frameworks for planning purposes and attributing efficacy to current inconsistencies in format and delivery. This report aims to review current practice of behavior change theories in culinary medicine/culinary nutrition, delineate constructs that support positive outcomes, and describe future directions for translational applications in integrating the skills of chefs, nutrition educators, and medical professionals., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The bioenergetic status of fishes has been used to study their physiological responses to temporal changes at interannual scales. We evaluated the physiological responses of swordfish at an interannual scale from the El Niño Southern Oscillation (ENSO): warm phase "El Niño" in 2015 to the cold phase "La Niña" in 2017 and under neutral conditions as well in 2019. Herein, muscle samples from females and males were analyzed to evaluate the bioenergetic status from their biochemical constituents (L: lipids, P: proteins and G: glucose, E: total energy, and FAs: fatty acid profile), elemental composition (C: carbon, N: nitrogen, H: hydrogen), and nutritional indices (L:P, C:N, DHA/C18:1n-3, DHA/C16:0 and ω3/ω6 FAs). The physiological response of swordfish showed an interaction between the year and sex. Herein, the L and E showed similar trends, with the lowest female values found in 2015 and the highest in 2019. Contrary, males showed their highest values in 2015 and lowest in 2019. FA profile differed among years and highlighted significant differences between females and males in 2019. Although the female L:P and C:N ratios were lower in 2015 than in 2017, a decreasing trend in these ratios was found from 2017 to 2019. Moreover, DHA/C18:1n-3, DHA/C16:0 and ω3/ω6 showed higher ratios in females than males in 2019. Our results coincide with the beginning of the ENSO phases; it is therefore likely that the swordfish diet changed in response to the disturbances in environmental conditions. Furthermore, the degree of individual dietary specialization found under the neutral conditions could indicate differences in the feeding behaviors of males vs. females, which may be an adaptive strategy in this species. These findings will aid in understanding the bioenergetic status of swordfish under different climatic scenarios and the current global warming, providing relevant information for the management of this resource., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The number of studies dealing with airborne microplastics (MPs) is increasing but sampling and sample treatment are not standardized, yet. Here, a fast and reliable method to characterize MPs is presented. It involves the study of two passive sampling devices to collect atmospheric bulk deposition (wet and dry deposition) and three digestion methods (two alkaline-oxidative and an oxidative) to treat the samples. The alkaline-oxidative method based on KOH and NaClO was selected for a mild organic matrix digestion. In addition, some operational parameters of a high-throughput quantum cascade laser-based infrared device (LDIR) were optimized: an effective automatic tiered approach to differentiate fibres from particles (>90 % success in validation) and a criterion to establish positive matches when comparing an unknown spectrum against the spectral database (proposed match index > 0.85). The procedural analytical recoveries were very good for particles (82-90 %) and slightly lower for fibres (62-73 %). Finally, the amount and type of MPs deposited at a sub-urban area NW Spain were evaluated. Most common polymers were Polyethylene (PE), Polypropylene (PP) and Polyethylene terephthalate (PET). The deposition rates ranged 98-1220 MP/m 2 /day, ca. 1.7 % of the total collected particles. More than 50 % of the total MPs deposited were in the 20-50 μm size range, whereas fibres were mostly in the 50-500 μm size range., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Plastic pellets represent a significant component of microplastic (< 5 mm) pollution. Impacts caused by plastic pellets involve physical harm and toxicity related to ingestion and non-ingestion (such as the release of chemicals in leachates). The latter is the main route of exposure for invertebrate macrobenthic populations. This study aimed to compare the toxicity of plastic pellets in distinct marine macrobenthic populations, considering the influence of sediment characteristics (organic matter and grain size) and quality (contamination by hydrophobic chemicals) on ecotoxicological effects, as well as the influence of color on the toxicity of beach-stranded plastic pellets. We performed three experiments on plastic pellet exposure using Excirolana armata from beaches with high and low pellet density. When exposed to pellets, populations that inhabit beaches without pellets demonstrate higher mortality than those inhabiting beaches with high pellet densities. The mortality of E. armata to pellets was higher when the exposure occurred in sediment with high organic matter (OM), suggesting that chemicals were transferred from pellets to OM. Yellowish beach-stranded pellets induced higher mortality of E. armata than the white tones did. We also observed lethargic (near-dead) and dead individuals being preyed upon by healthy individuals, a cannibalistic behavior that raises an ecological concern regarding the negative effects of this exposure on intraspecific interactions in marine macrobenthic populations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Freedom from atrial arrhythmia (AA) recurrence ≥30 seconds after pulsed field ablation (PFA) in patients with atrial fibrillation (AF) was reported in PULSED AF (Pulsed Field Ablation to Irreversibly Electroporate Tissue and Treat AF; ClinialTrials.gov Identifier: NCT04198701). AA burden may be a more clinically meaningful endpoint., Objective: The purpose of this study was to determine the influence of monitoring strategies on AA detection and AA burden association with quality of life (QoL) and health care utilization (HCU) after PFA., Methods: Patients underwent 24-hour Holter monitoring at 6 and 12 months and weekly, and symptomatic transtelephonic monitoring (TTM). AA burden post-blanking was calculated as the greater of (1) percentage of AA on total Holter time; or (2) percentage of weeks with ≥1 TTM with AA out of all weeks with ≥1 TTM., Results: Freedom from all AAs varied by >20% when differing monitoring strategies were used. PFA resulted in zero burden in 69.4% of paroxysmal atrial fibrillation (PAF) and 62.2% of persistent atrial fibrillation (PsAF) patients. Median burden was low (<9%). Most PAF and PsAF patients had ≤1 week of AA detection on TTM (82.6% and 75.4%) and <30 minutes of AA per day of Holter monitoring (96.5% and 89.6%), respectively. Only PAF patients with <10% AA burden averaged a clinically meaningful (>19 point) QoL improvement. PsAF patients experienced clinically meaningful QoL improvements irrespective of burden. Repeat ablations and cardioversions significantly increased with higher AA burden (P <.01)., Conclusion: The ≥30-second AA endpoint is dependent on the monitoring protocol used. PFA resulted in low AA burden for most patients, which was associated with clinically relevant improvement in QoL and reduced AA-related HCU., (Copyright © 2023 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

The temporal dynamics of energy reserves are associated with the physiological processes (i.e., reproduction) in marine fishes, in which storage organs play a key role for efficient energy investment. We evaluated the temporal (i.e., seasons) and intra-individual (i.e., organs) dynamics of adult female swordfish (Xiphias gladius) during its feeding period off the Chilean coast in the southeastern Pacific Ocean (SEPO). The biochemical composition (i.e., lipids, proteins, and glucose), energy content and fatty acid profile of the muscle, liver and gonad were evaluated during the austral autumn, winter, and spring. Our results showed principally an intra-individual effect in both the muscle and liver in the autumn and spring. Herein, a trend of higher amounts of lipids and total energy were found in the muscle, while the liver showed greater protein and glucose contents. Consequently, the muscle showed a higher saturated, monounsaturated, and polyunsaturated fatty acid contents than the liver. Although the gonad showed no significant temporal effect in the lipids and proteins contents, an increasing trend of each biochemical constituent, fatty acid group and gonadosomatic index were found from autumn to winter. Consistently, the glucose and total energy content as well Fulton's condition factor were significantly higher in winter. These findings reflect the spatial-temporal physiological dynamic of swordfish based on the storage of energy reserves in different organs during its feeding period. In this way, the products obtained from swordfish could have an added value depending on the season and capture zone, which could benefit the exploitation and regulation measures of this resource under an ecological approach of conservation and sustainability in the SEPO., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

A number of societies produce heart failure (HF) management guidelines, comprising official recommendations on the basis of recent research discoveries, but their applicability to specific situations encountered in daily practice might be difficult. In this clinical practice update we aim to provide responses to fundamental questions that face health care providers, like appropriate timing for the introduction and optimization of different classes of medication according to specific patient phenotypes, when second-line therapies and valvular interventions should be considered, and management of difficult clinical scenarios such as cardiorenal syndrome and frailty. A consensus-based methodology was used. Approaches to 5 different phenotypes are presented: (1) The wet HF phenotype is the easiest to manage, decongestion being performed alongside introduction of guideline-directed medical therapy (GDMT); (2) The de novo HF phenotype requires the introduction of the 4 pillars of GDMT, personalizing the order on the basis of the individuals' biological and physiological characteristics; (3) The worsening HF phenotype is a marker of poor prognosis, and therefore should motivate optimization of GDMT, start second-line therapies, and/or reevaluate goals of care/advanced HF therapies; (4) The cardiorenal phenotypes require correct volume assessment, because renal function usually improves with decongestion; and (5) The frail HF phenotype require special attention, careful drug titration, and consideration of cardiac rehabilitation programs. In conclusion, specific common HF phenotypes call for a personalized approach to improve adoption of the HF guidelines into clinical practice., (Copyright © 2023 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Background: Rates of early mortality and complications after catheter ablation (CA) of atrial fibrillation (AF) vary across health care settings., Objective: The purpose of this study was to identify the rate and predictors of early mortality (within 30 days) after CA in the inpatient and outpatient settings., Methods: Using the Medicare Fee for Service database, we analyzed 122,289 patients who underwent CA for treatment of AF between 2016 and 2019 to define 30-day mortality in both inpatients and outpatients. Odds of adjusted mortality were assessed with several methods, including inverse probability of treatment weighting., Results: Mean age was 71.9 ± 6.7 years, 44% were women, and mean CHA 2 DS 2 -VASc score was 3.2 ± 1.7. Overall, 82% underwent AF ablation as an outpatient. Mortality rate 30 days after CA was 0.6%, with inpatients accounting for 71.5% of deaths (P <.001). Early mortality rates were 0.2% for outpatient procedures and 2.4% for inpatient procedures. The prevalence of comorbidities was significantly higher in patients with early mortality. Patients with early mortality had significantly higher rates of postprocedural complications. After adjustment, inpatient ablation was significantly associated with early mortality (adjusted odds ratio [aOR] 3.81; 95% confidence interval [CI] 2.87-5.08; P <.001). Hospitals with high overall ablation volume had 31% lower odds of early mortality (highest vs lowest tertile: aOR 0.69; 95% CI 0.56-0.86; P <.001)., Conclusion: AF ablation conducted in the inpatient setting is associated with a higher rate of early mortality compared with outpatient AF ablation. Comorbidities are associated with enhanced risk of early mortality. High overall ablation volume is associated with a lower risk of early mortality., (Copyright © 2023. Published by Elsevier Inc.)

Background: Transvenous lead extraction can have serious adverse events, such as cardiac or vascular perforation. Risk factors have not been well characterized., Objective: The purpose of this study was to identify factors associated with perforation and death, and to characterize lead extraction in a large contemporary population., Methods: We performed a retrospective multicenter study examining patients undergoing lead extraction at 8 Canadian institutions from 1996 through 2016. Demographic and clinical data were used to identify variables associated with perforation and mortality using logistic regression modeling., Results: A total of 2325 consecutive patients (age 61.9 ±16.5 years) underwent extraction of 4527 leads. Perforation rate was 2.7% (63/2325) and 30-day mortality was 1.6% (38/2325), with mortality of 0.4% due to perforation (10/2325). Variables associated with perforation included no previous cardiac surgery (odds ratio [OR] 3.33; 95% confidence interval [CI] 1.54-7.19; P = .002), female sex (OR 3.27; 95% CI 1.91-5.60; P <.001); left ventricular ejection fraction ≥40% (OR 2.81; 95% CI 1.28-6.14; P = .010); lead age >8 years (OR 2.64; 95% CI 1.52-4.60; P <.001); ≥2 leads extracted (OR 2.49; 95% CI 1.23-5.04; P = .011); and diabetes (OR 2.12; 95% CI 1.16-3.86; P = .014). Variables associated with death included infection as indication for extraction (OR 3.85; 95% CI 1.38-10.73; P = .010); anemia (OR 3.14; 95% CI 1.38-6.61; P = .003), and patient age (OR 1.04; 95% CI 1.01-1.07; P = .012)., Conclusion: Risk factors associated with perforation in lead extraction include no history of cardiac surgery, female sex, preserved left ventricular ejection fraction, lead age >8 years, ≥2 leads extracted, and diabetes., (Copyright © 2021. Published by Elsevier Inc.)

Background: Atrial fibrillation (AF) is the most common arrhythmia in men and women worldwide, and its prevalence is increasing. Management of AF is guided by evidence-based clinical practice guidelines which provide recommendations based on available evidence. The extent of sex-specific data in the AF literature used to provide guideline recommendations has not been investigated. Therefore, using the 2020 Canadian Cardiovascular Society (CCS) AF management guidelines as an example, the purpose of this study was to review female representation and the reporting of sex-disaggregated data in the studies referenced in AF guidelines., Methods: Randomised controlled trials (RCTs) and prospective and retrospective cohorts were screened to calculate the proportion of study participants who were female and to establish whether studies provided sex-disaggregated analyses. The participant-prevalence ratio (PPR), a quotient of the female participant rate and the prevalence of women in the AF population, was calculated for each study., Results: A total of 885 studies included in the CCS guidelines were considered. Of those, 467 met the inclusion criteria. Overall, women represented 39.1% of the population over all of the studies and RCTs had the lowest proportions of women (33.8%, PPR 0.70). Of studies with sex-disaggregated analyses (n = 140; 29.9%), single-centre RCTs and retrospective cohorts had the lowest and highest rates of sex-specific analyses, respectively (11.5% and 32.5%)., Conclusions: The evidence used to derive guideline recommendations may be inadequate for sex-specific recommendations. Until enough data can support women-specific guidelines, increased inclusion of females in AF studies, may aid in the precision of recommendations., (Copyright © 2022 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Societal and environmental concern due to frequent reports of microplastics in fish stomachs raised as they may accumulate along the trophic chain. The request for analysing microplastics in fish stresses two major analytical issues: sample treatment and final characterization. The, so far, workhorse for chemical characterization is infrared spectroscopy which is time-consuming. Here, a quantum cascade laser-based device is used to accelerate the characterization stage. Its novelty poses new challenges for sample processing and particle handling because the unknown particles must be transferred to a reflective slide. In this study, three sample digestion protocols (alkaline-oxidative with H 2 O 2 , and alkaline-oxidative with NaClO and enzymatic-oxidative) and three different procedures to transfer the filter cake to reflective slides are compared. A simplified enzymatic-oxidative digestion (validated through an interlaboratory exercise) combined with a Syncore® automatic evaporation system and a Laser Direct Infrared Imaging (LDIR) device is proposed first time as a reliable and relatively fast method to treat gastrointestinal tracts of fish. Analytical recoveries were studied using samples of Scomber scombrus and they were ca. 100% for big -i.e., >500 μm- and ca. 90% for medium -i.e., 200-300 μm- particles and ca. 75% for 10 μm thick fibres., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Hypertransaminasemia is a frequent finding in pediatrics, which could reflect potentially treatable serious disease. The aim of this document is to establish, by reviewing the available evidence, a consensus for an adequate management of hypertransaminasemia, from its detection until the study is complete. To this end, a working group was formed with the participation of members of the Society of Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP), the Spanish Association of Primary Care Pediatrics (AEPap) and the Spanish Society of Primary Care Pediatrics (SEPEAP). Twenty-one recommendations are established with a marked practical component that will be useful in hospital clinical practice and primary care., (Copyright © 2022 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Concurrent chemotherapy and thoracic radiotherapy followed by prophylactic cranial irradiation (PCI) is the standard treatment in limited-disease small-cell lung cancer (LD-SCLC), with 5-year overall survival (OS) of only 25% to 33%., Patients and Methods: STIMULI is a 1:1 randomised phase II trial aiming to demonstrate superiority of consolidation combination immunotherapy versus observation after chemo-radiotherapy plus PCI (protocol amendment-1). Consolidation immunotherapy consisted of four cycles of nivolumab [1 mg/kg, every three weeks (Q3W)] plus ipilimumab (3 mg/kg, Q3W), followed by nivolumab monotherapy (240 mg, Q2W) for up to 12 months. Patient recruitment closed prematurely due to slow accrual and the statistical analyses plan was updated to address progression-free survival (PFS) as the only primary endpoint., Results: Of the 222 patients enrolled, 153 were randomised (78: experimental; 75: observation). Among the randomised patients, median age was 62 years, 60% males, 34%/65% current/former smokers, 31%/66% performance status (PS) 0/1. Up to 25 May 2020 (median follow-up 22.4 months), 40 PFS events were observed in the experimental arm, with median PFS 10.7 months [95% confidence interval (CI) 7.0-not estimable (NE)] versus 42 events and median 14.5 months (8.2-NE) in the observation, hazard ratio (HR) = 1.02 (0.66-1.58), two-sided P = 0.93. With updated follow-up (03 June 2021; median: 35 months), median OS was not reached in the experimental arm, while it was 32.1 months (26.1-NE) in observation, with HR = 0.95 (0.59-1.52), P = 0.82. In the experimental arm, median time-to-treatment-discontinuation was only 1.7 months. CTCAE v4 grade ≥3 adverse events were experienced by 62% of patients in the experimental and 25% in the observation arm, with 4 and 1 fatal, respectively., Conclusions: The STIMULI trial did not meet its primary endpoint of improving PFS with nivolumab-ipilimumab consolidation after chemo-radiotherapy in LD-SCLC. A short period on active treatment related to toxicity and treatment discontinuation likely affected the efficacy results., Competing Interests: Disclosure SP reports personal fees from Abbvie, Bayer, Daiichi Sankyo, Debiopharm, Eli Lilly, F. Hoffman–La Roche, Foundations Medicine, Janssen, Pharma Mar, Regeneron, Sanofi, Seattle Genetics, Takeda, Merck Serono, Merrimack, Medscape, Phosphoplatin Therapeutics, Beigene, Imedex and grants and personal fees from Amgen, AstraZeneca, Boehringer-Ingelheim, Bristol-Myers Squibb, Clovis, Illumina, Novartis, Pfizer, Merck Sharp and Dohme, outside the submitted work; all fees to the institution. UD reports personal fees from F. Hoffman–La Roche, outside the submitted work. MD reports personal fees from AstraZeneca, Bristol-Myers Squibb, Boehringer-Ingelheim, F. Hoffman–La Roche, Merck Sharp and Dohme, Pfizer, and Takeda, outside the submitted work. SP reports personal fees from Amgen, AstraZeneca, Bayer, BeiGene, Blueprint Medicines, Boehringer-Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, F. Hoffman–La Roche, GlaxoSmithKline, Guardant Health, Incyte, Janssen, Lilly, Merck KGaA, and Takeda, outside the submitted work. MR reports personal fees from Amgen, AstraZeneca, Bristol-Myers Squibb, Boehringer-Ingelheim, Lilly, Merck KGaA, Merck Sharp and Dohme, Mirati, Novartis, Pfizer, F. Hoffman–La Roche, and Regeneron, outside the submitted work. DMS reports grants, personal fees and non-financial support from AstraZeneca, Bristol-Myers Squibb, Merck Sharp and Dohme, F. Hoffman–La Roche, during the conduct of the study; grants, personal fees and non-financial support from Boehringer-Ingelheim, Pfizer, and Takeda, grants and non-financial support from Lilly, outside the submitted work. OM reports personal fees from AstraZeneca, Merck Sharp and Dohme, Bristol-Myers Squibb, and Takeda, outside the submitted work. KN reports personal fees from Amgen, AbbVie, AstraZeneca, Bristol-Myers Squibb Belgium, and F. Hoffman–La Roche Belgium, outside the submitted work. AIM reports personal fees from Amgen, AstraZeneca, Boehringer-Ingelheim, Bristol, F. Hoffman–La Roche, Merck Sharp and Dohme, Pfizer, and Takeda, outside the submitted work. JM reports other from Boehringer-Ingelheim, Bristol-Myers Squibb, F. Hoffman–La Roche, and Pfizer, outside the submitted work. JM reports grants and personal fees from AstraZeneca, F. Hoffman–La Roche, Pierre Fabre and personal fees from Boehringer-Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Hengrui, Merck, Merck Sharp and Dohme, and Pfizer, outside the submitted work. MF reports personal fees from AstraZeneca, Bristol-Myers Squibb, F. Hoffman–La Roche, and Merck Sharp and Dohme, outside the submitted work. FG reports grants and personal fees from AstraZeneca, Boehringer-Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline, F. Hoffman–La Roche, Lilly, Merck Sharp and Dohme, Novartis, Pfizer, Siemens, and Takeda, and personal fees from Abbvie, outside the submitted work. MM reports grants and personal fees from Bristol-Myers Squibb, Pierre Fabre, personal fees and non-financial support from AstraZeneca, Boehringer-Ingelheim, F. Hoffman–La Roche, Merck Sharp and Dohme, and personal fees from Kyowa Kirin, outside the submitted work. MPP reports grants, personal fees and non-financial support from AstraZeneca, Bristol-Myers Squibb, and F. Hoffman–La Roche, personal fees from Merck Sharp and Dohme, and Takeda, outside the submitted work. PM reports personal fees from Amgen, AstraZeneca, Bristol-Myers Squibb, F. Hoffman–La Roche, Merck Sharp and Dohme, Puma Biotechnology, Specialised Therapeutics and grants from AstraZeneca, and Bristol-Myers Squibb, outside the submitted work. RAS reports grants and personal fees from AstraZeneca, Bristol-Myers Squibb, F. Hoffman–La Roche, Merck Sharp and Dohme, Pfizer, and Novartis, grants from F. Hoffman–La Roche, Ipsen, Pierre Fabre, personal fees from Amgen, Blueprint, Boehringer-Ingelheim, Eli Lilly, GlaxoSmithKline, Janssen, Regeneron, Seattle Genetics, and Sandoz, personal fees and other from Genentech/F. Hoffman–La Roche, Lung Cancer, Takeda, and other from CTR, outside the submitted work. CLP reports other from Amgen, AstraZeneca, F. Hoffman–La Roche, Lilly, Medscape, and Nanobiotix, and personal fees from PrimeOncology, outside the submitted work. DDR reports grants from AstraZeneca, Bristol-Myers Squibb, Olink, Philips Health, and Seattle Genetics, and outside the submitted work. All other authors have declared no conflicts of interest., (Copyright © 2021 European Society for Medical Oncology. Published by Elsevier Ltd. All rights reserved.)

In the Southeast Pacific Ocean, Xiphias gladius migrates through the Chilean coastal zone for feeding. Here, it forages for different prey items from autumn to spring, acquiring a great variety of energy and nutritional reserves. We evaluated seasonal variations in the biochemical reserves (i.e., contents of lipids, proteins, and glucose), total energy content and fatty acid profile of specimens captured during the austral autumn, winter, and spring. Our results show that higher amounts of lipids were found in the winter and spring, while protein and glucose were higher in the autumn. Thus, the energy content showed significant differences, with higher levels in winter and spring. Furthermore, the fatty acid profile was more diverse in the spring than the autumn and winter and was characterized by higher amounts of polyunsaturated fatty acids. These findings suggest that temporal changes in the biochemical reserves, total energy content and fatty acid profile support the idea of a "trophic migration" (i.e., the feeding period) established by the dynamics of fishery fleets. The high amounts of lipids and diverse fatty acid profile found in the spring could indicate the end of the trophic migration during this season. Thus, X. gladius may reach an optimum nutritional condition in the spring and make energetic adjustments to carry out its reproductive migration during the austral summer. Therefore, this species seems to meet the high energy demands of the reproductive season by foraging for a wide range of prey items from autumn to spring and storing an increased amount of lipids at the end of the feeding period. Overall, our data provides crucial baseline knowledge for future research on the ecophysiology of X. gladius, as well as for the management and conservation of this fishery resource under an ecosystem approach., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Hamiltonian Monte Carlo (HMC) is a Markov chain Monte Carlo method to estimate unknown quantities through sample generation from a target distribution for which an analytical solution is difficult. The strength of this method lies in its geometrical foundations, which render it efficient for traversing high-dimensional spaces. First, this paper analyses the performance of HMC in calibrating five variants of inputs to an age-structured SEIR model. Four of these variants are related to restriction assumptions that modellers devise to handle high-dimensional parameter spaces. The other one corresponds to the unrestricted symmetric variant. To provide a robust analysis, we compare HMC's performance to that of the Nelder-Mead algorithm (NMS), a common method for non-linear optimisation. Furthermore, the calibration is performed on synthetic data in order to avoid confounding effects from errors in model selection. Then, we explore the variation in the method's performance due to changes in the scale of the problem. Finally, we fit an SEIR model to real data. In all the experiments, the results show that HMC approximates both the synthetic and real data accurately, and provides reliable estimates for the basic reproduction number and the age-dependent transmission rates. HMC's performance is robust in the presence of underreported incidences and high-dimensional complexity. This study suggests that stringent assumptions on age-dependent transmission rates can be lifted in favour of more realistic representations. The supplementary section presents the full set of results., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)

This study investigated the potential of aqueous epazote (AE) and ethanolic extract of epazote (ETHE) as inhibitors of lipid oxidation in raw and cooked ground beef stored at 4 °C for 9 days as well as frozen beef patties stored at -18 °C for 90 days. Organic acids were identified in AE and ETHE using ultra-high-performance liquid chromatography-quadrupole time-of-flight (UHPLC-qTOF). Chemical composition, TBARS, pH, colour, sensory acceptability and intensity of oxidised flavour were analysed in the three different meat products. ETHE showed higher values in organic acid content than AE. In raw ground beef, ETHE inhibited lipid oxidation and received the highest score in the three sensorial attributes evaluated at the end of the storage period, whereas in cooked ground beef it showed the highest intensity of oxidised flavour. Regarding CTL, AE reduced lipid oxidation in the cooked ground beef as well as the frozen patties, with improved colour. Therefore, epazote may be a promising natural antioxidant source for use in meat., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Aims: The aim of the present study was to evaluate the oral resveratrol effects associated with diet and physical training changes on anthropometric and biochemical parameters., Main Methods: 25 individuals aged from 30 to 60 years old; with Body Mass Index (BMI) ≥ 30 kg/m 2 were included in the study. Following the primary evaluation (anthropometric and clinical), the patients were randomly divided into 2 groups: (1) Placebo: Physical activity program + Diet + Placebo; (2) Resveratrol: Physical activity program + Diet + Resveratrol (RVS) (250 mg/day) for three months. Anthropometric and biochemical parameters were evaluated at baseline and after the treatment period., Key Findings: The main findings showed that the resveratrol supplementation improved total cholesterol (TC), High-density Lipoprotein cholesterol (HDL-c), Very-low density Lipoprotein cholesterol (VLDL-c), urea, creatinine and albumin serum levels., Significance: These findings indicate that this polyphenol may be an option to potentiate the beneficial effects induced by dietary and physical activity programs in the Metabolic Syndrome (MetS) treatment., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Accidental awareness during general anaesthesia (AAGA) is a complex and rare outcome to investigate in surgical patient populations, particularly obstetric patients. We report the protocol of the Direct Reporting of Awareness in Maternity patients (DREAMY) study, illustrating how the research was designed to address practical and methodological challenges for investigating AAGA in an obstetric cohort., Methods: This is the trial protocol of a prospective, multicentre cohort study of patients undergoing obstetric surgery under general anaesthesia. Accidental awareness during general anaesthesia will be detected using three repetitions of standardised direct questioning over 30 days, with responses indicating memories during general anaesthesia verified using structured interviews. Reports will be adjudicated, then classified, in accordance with pre-defined and pre-validated structures, including the Michigan Awareness Classification tool. Quantitative data will be collected on general anaesthesia conduct for all participants. This descriptive study is being conducted in England and aims to recruit a minimum of 2015 patients., Results: The DREAMY study was prospectively registered (ClinicalTrials.gov Identifier: NCT03100396) and ethical approval granted. Participant recruitment began in May 2017 and one year follow up concluded in August 2019. Publication of the results is anticipated in 2020., Conclusions: The DREAMY study will provide data on incidence, experience and implications of AAGA for obstetric patients, using a robust methodology that will reliably detect and translate subjective AAGA reports into objective outcomes. In addition, the study is expected to improve vigilance for AAGA in participating hospitals and encourage adoption of recommendations for support of patients experiencing AAGA., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Introduction: Cellular senescence has been linked to the pathogenesis of idiopathic pulmonary fibrosis (IPF). CCN1 is a matricellular protein that has been shown to induce cellular senescence and contribute to lung fibrosis in pre-clinical models. In this report, we determined plasma CCN1 levels in patients with IPF and its potential role in clinical outcomes., Methods and Results: We evaluated 88 patients diagnosed with IPF at the University of Alabama at Birmingham. CCN1 levels were measured in plasma specimens by ELISA. The primary outcome measure was transplant-free survival (TFS) duration. High-CCN1 levels were associated with a lower transplant-free survival independent of %FVC and %D L CO compared to patients with low plasma CCN1 (HR = 2.15; 95%CI 1.04-4.45, p = 0.04)., Conclusion: This study demonstrates that plasma levels of CCN1 may be predictive of survival in IPF. Given the plausible role of CCN1 in cellular senescence and pathobiology of IPF, the predictive value of CCN1 in disease progression among patients with IPF warrants further investigation., Competing Interests: Declaration of competing interest TK and TL have received speaker fees from Boehringer Ingelheim Pharmaceuticals, Inc, outside the submitted work. VJT has received research grants from the NIH and personal fees from Boehringer Ingelheim Pharmaceuticals, Inc, personal fees from Kadmon Corporation, grants from Genkyotex, outside the submitted work. JAD has received research grants from the NIH, Genentech, Boehringer Ingelheim, and Fibrogen; and consulting fees from Genentech, Boehringer Ingelheim, and Immuneworks, outside the submitted work. AK and YK have no conflicts of interest to disclose., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Introduction: The increment of breast cancer screening coverage should lead to an increase in the proportion of early tumors diagnosed and the decrease of the cancer-related mortality. However, the effectiveness of opportunistic mammography screening is not well documented for public health systems in middle-income countries., Patients and Methods: We conducted an ecologic study to evaluate the association of mammography coverage with trends in breast cancer stage distribution. We used data from a total of 42,850 breast cancer patients, diagnosed between 2000 and 2016, combined with estimated mammography coverage from 3 surveys (2003, 2008, and 2013)., Results: Biannual mammography coverage increased from 62.4% in 2003 to 73.9% in 2013. From 2000 to 2016, the proportion of in situ tumors increased 6.9%, the proportion of localized tumors increased 3.9%, the proportion of regional tumors decreased 6.9% and the frequency of distant tumors decreased 4% (P < .00001)., Conclusion: Mammography coverage in the context of opportunistic breast cancer screening was associated with the increase of in situ and localized tumors and decrease of regional and distant tumors., (Copyright © 2019 Elsevier Inc. All rights reserved.)

In this work, we developed a simple, comprehensive, and effective device and procedure for sample preparation based on dispersive micro-solid phase extraction (d-μ-SPE) for the simultaneous determination of 30 polycyclic aromatic compounds or PACs (including 16 polycyclic aromatic hydrocarbons (PAHs), 3 quinones, and 11 nitro-PAHs) in water samples. The extraction/preconcentration step was carried out in a customized glass device (20-250 mL) using C 18 as the sorbent. A mini-UniPrep syringeless filter was used as a desorption device, which allowed one-step desorption, filtration, and injection. The main factors affecting the d-μ-SPE were optimized using the Doehlert design. The optimal d-μ-SPE conditions were 100 mg of C 18 , 32 min of extraction at 1000 rpm, and 20 min of sonication (at the desorption step). The limit of detection (LOD) for PAHs and nitro-PAHs ranged from 0.8 ng L -1 (phenanthrene) to 1.5 ng L -1 (indene [1,2,3-cd]pyrene) and from 300 ng L -1 (2-nitrofluorene) to 500 ng L -1 (2-nitrobiphenyl), respectively. For quinones, it varied from 1.12 μg L -1 (1,4-naphthoquinone) to 1.70 μg L -1 (9,10-phenanthrenequinone). Relative recoveries ranged from 59.1% (benzo[a]pyrene) to 110% (chrysene) for most PAHs and 68.9% (2-nitrofluorene) to 124% (1-methyl-6-nitronaphthalene) for the nitro-PAHs. The recoveries for quinones ranged from 65.3% (9,10-phenanthrenequinone) to 95.3% (9,10-anthraquinone). The enrichment factor varied from 213 (Nap) to 497 (Flu), from 39 (1,4-naphthoquinone) to 254 (9,10-anthraquinone), and from 122 (2-nitrobiphenyl) to 295 (1-methyl-4-nitronaphthalene) for the PAHs, nitro-PAHs, and quinones, respectively. After validation, the procedure was successfully applied toward the determination of PACs in river and marine water samples. Low-molecular-weight PAHs were detected with high frequencies (62.5-100%) and the total PAH concentration ranged from 2.30 ng L -1 (benzo[a]pyrene) to 1070 ng L -1 (pyrene). Quinones were found at concentrations ranging from below the LOD to up to 19.8 μg L -1 . The proposed procedure was thus found to be comprehensive, precise, accurate, and suitable for determination of PACs in water samples., (Copyright © 2019 Elsevier B.V. All rights reserved.)

This study investigated different combinations of Pd/Mg, as chemical modifier, for sulfur determination, via CS molecule, in shale oil samples by high-resolution continuum source graphite furnace molecular absorption spectrometry (HR-CS GF MAS). It was evaluated the mixture Pd/Mg in aqueous solution, Pd/Mg in propan-1-ol and the Pd/Mg in propan-1-ol plus Ru as a permanent modifier. The best sensitivity was achieved with Pd/Mg mixture in propan-1-ol. The high solubility of the samples in propan-1-ol promotes a better interaction with the modifier and, consequently, a more efficient thermal stability of the CS molecules. Due to the high sulfur content in the samples, the analytical line at 258.288 nm was used. Only a minimum sample preparation was required, i.e., a dilution in propan-1-ol by a factor of 1:10 (w/w). Temperatures of 800 °C and 2200 °C were the optimized conditions for pyrolysis and vaporization, respectively. The calibration curve was constructed with l-cysteine aqueous standard solutions. The characteristic mass was 27 ng; detection and quantification limits were 0.012% (w/w) and 0.039% (w/w), respectively. The accuracy of the proposed method was confirmed by the statistical agreement (Student's and Welch's t-test at 95% confidence level) using the certified reference material CRM NIST 1084a and an OTE oil sample whose sulfur content was previously determined by the standard method ASTM D4294. The method was successfully applied in three shale oil samples. The sulfur content in the investigated samples ranged from 1.0% (w/w) to 1.3% (w/w)., (Copyright © 2019. Published by Elsevier B.V.)

Background: Compelling evidence showing a link between atrial fibrillation (AF) and cognitive decline and dementia is accumulating., Methods: Blinded Randomized Trial of Anticoagulation to Prevent Ischemic Stroke and Neurocognitive Impairment in Atrial Fibrillation (BRAIN-AF) is a prospective, multicentric, double-blind, randomized-controlled trial, recruiting patients with nonvalvular AF and a low risk of stroke. Patients with a high risk of bleeding will be excluded from the study. Participants will be randomized to receive either rivaroxaban (15 mg daily) or standard of care (placebo in patients without vascular disease or acetylsalicylic acid 100 mg daily in patients with vascular disease)., Results: The primary outcome is the composite of stroke, transient ischemic attack, and cognitive decline (defined by a decrease in the Montreal Cognitive Assessment score ≥ 3 at any follow-up visit after baseline). Approximately 3250 patients will be enrolled in approximately 130 clinical sites until 609 adjudicated primary outcome events have occurred., Conclusions: BRAIN-AF determines whether oral anticoagulation therapy with rivaroxaban compared with standard of care reduces the risk of stroke, transient ischemic attack, or cognitive decline in patients with nonvalvular AF and a low risk of stroke., (Copyright © 2019 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

We determined depth profiles of total mercury (T-Hg) in six 210 Pb-dated sediment cores from Todos os Santos Bay to reconstruct the history of anthropogenic Hg accumulation. We also assessed superficial sediments samples from five estuaries. T-Hg concentrations (5-3500 μg kg -1 ) presented a large spatial and temporal variability. T-Hg concentrations in Ribeira Bay increased up to 200-fold along time, whereas the fluxes of T-Hg are substantially higher (up to 10,000 fold) than present-day wet deposition for industrialized areas. Sedimentary records indicate that a chlor-alkali plant has been the main source of Hg pollution until the present, although the T-Hg records suggest that harbor, shrimp farming, and oil refinery activities, besides Hg atmospheric depositions, are important across the bay. Sediments in the Ribeira Bay act as an important Hg sink. If sediments are eroded or disturbed, they may release Hg, thus posing a serious risk to wildlife and ecosystem health. CAPSULE: Sedimentary cores provide data on preindustrial levels and also anthropogenic fluxes of Hg for the appraisal of the magnitude, processes and potential risks of the contamination., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The paradoxical absence of a split-brain syndrome in most cases of callosal dysgenesis has originated three main hypotheses, namely, (i) bilateral cortical representation of language, (ii) bilateral thalamocortical projections of somatosensory pathways conveyed by the spinothalamic-medial lemniscus system, and (iii) a variable combination of (i) and (ii). We used functional neuroimaging to investigate the cortical representation and lateralization of somatosensory information from the palm of each hand in six cases of callosal dysgenesis (hypothesis [ii]). Cortical regions of interest were contralateral and ipsilateral S1 (areas 3a and 3b, 1 and 2 in the central sulcus and postcentral gyrus) and S2 (parts of areas 40 and 43 in the parietal operculum). The degree of cortical asymmetry was expressed by a laterality index (LI), which may assume values from -1 (fully left-lateralized) to +1 (fully right-lateralized). In callosal dysgenesis, LI values for the right and the left hands were, respectively, -1 and + 1 for both S1 and S2, indicating absence of engagement of ipsilateral S1 and S2. In controls, LI values were - 0.70 (S1) and - 0.51 (S2) for right hand stimulation, and 0.82 (S1) and 0.36 (S2) for left hand stimulation, reflecting bilateral asymmetric activations, which were significantly higher in the hemisphere contralateral to the stimulated hand. Therefore, none of the main hypotheses so far entertained to account for the callosal dysgenesis-split-brain paradox have succeeded. We conclude that the preserved interhemispheric transfer of somatosensory tactile information in callosal dysgenesis must be mediated by a fourth alternative, such as aberrant interhemispheric bundles, reorganization of subcortical commissures, or both., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)

Since the evaluation of the cryoballoon in the Sustained Treatment Of Paroxysmal Atrial Fibrillation trial, more than 350,000 patients with atrial fibrillation have been treated. Several studies have reported improved outcomes using the second-generation cryoballoon, and recent publications have evaluated modifications, refinements, and improvements in procedural techniques. Here, peer-reviewed articles published since the first cryoballoon best practices review were summarized against the technical practices of physicians with a high level of experience with the cryoballoon (average ≥6 years of experience in ≥900 cases). This summary includes a comprehensive literature review along with practical usage guidance from physicians using the cryoballoon to facilitate safe, efficient, and effective outcomes for patients with atrial fibrillation., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)

Dental anxiety is a prevalent problem with marked psychological, physical and public health implications. Based on cognitive theory and evidence, we hypothesized that vivid, sensory image-based cognitions play a role in dental anxiety. A quantitative online survey (N = 306) and qualitative semi-structured interviews (N = 18) found that vivid sensory images were common irrespective of dental anxiety levels, but that their content, associated distress and responses varied. Participants reporting higher anxiety experienced intense and intrusive fear-provoking dental imagery focusing on unpleasant sensations, which were associated with the intrusive recollection of negative past experiences and avoidance of dentistry. Participants with lower anxiety ratings, reported images that were less distressing and centered around reassuring aspects and positive appointment outcomes, potentially acting as protective factors against dental anxiety and facilitating appointment attendance. The inclusion of components aimed at reducing intrusive memories and dental imagery rescripting may help improve interventions for dental anxiety., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Omega-3 fatty acids, specifically docosahexaenoic acid (DHA, 22 carbons and 6 double bonds) are fundamental compounds for a healthy diet. However, due to their unsaturated nature, omega fatty acid-rich oils are chemically unstable and susceptible to oxidative deterioration. The oxidation results in production of free radicals and unpleasant tastes, negatively impacting the shelf-life, sensory properties, and acceptability of food products. This study was conducted to examine the effect of wall materials on protection of DHA in canola oil against oxidation. A total of 4 wall materials including pea protein isolate (PPI), pea protein isolate - modified starch complex (PPI-MS), Tween 20, and SDS were used for microemulsion preparation with canola oil containing DHA. The freeze-dried powders were analyzed with respect to physicochemical characteristics, oxidative stability, and release properties. The results showed that the PPI-MS as a natural polymeric wall material exhibited similar or better encapsulation efficiency and acceptable level of peroxide value compared to the synthetic surfactants (Tween 20 and SDS). The utilization of protein-polysaccharide complexes enabled the incorporation of specific properties of each biopolymer to further improve emulsion stability for the production of capsules with improved oxidative stability., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Next-generation sequencing (NGS) diagnostic assays increasingly are becoming the standard of care in oncology practice. As the scale of an NGS laboratory grows, management of these assays requires organizing large amounts of information, including patient data, laboratory processes, genomic data, as well as variant interpretation and reporting. Although several Laboratory Information Systems and/or Laboratory Information Management Systems are commercially available, they may not meet all of the needs of a given laboratory, in addition to being frequently cost-prohibitive. Herein, we present the System for Informatics in the Molecular Pathology Laboratory (SIMPL), a free and open-source Laboratory Information System/Laboratory Information Management System for academic and nonprofit molecular pathology NGS laboratories, developed at the Genomic and Molecular Pathology Division at the University of Chicago Medicine. SIMPL was designed as a modular end-to-end information system to handle all stages of the NGS laboratory workload from test order to reporting. We describe the features of SIMPL, its clinical validation at University of Chicago Medicine, and its installation and testing within a different academic center laboratory (University of Colorado), and we propose a platform for future community co-development and interlaboratory data sharing., (Copyright © 2018 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.)

A fast (16min) procedure to assess the bioaccessible metallic fraction of Cd, Cr, Cu, Ni, Pb and Zn simultaneously extracted (SEM) from marine sediments plus an indirect approach to determine acid volatile sulfides (AVS) are presented. For the extraction process magnetic agitation was compared with ultrasonic stirring (using a bath and a probe), and several stirring times were assayed. The proposed SEM procedure uses an ultrasonic probe and 1mL of HCl. It dramatically minimizes the turnaround time and the residues. AVS were evaluated as the difference between the amounts of sulphur in the solid residue after the extraction and total sulphur in the original sample. These procedures are fast, easy to implement and cost-effective to assess the potential risk posed by metals in marine sediments. They were tested using several CRMs and applied to sediments from two Galician Rias (NW Spain); their SEM-AVS differences indicated no biological risk., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background and Aim: Epicardial fat (EF) is increased in obesity and has important interactions with atrial and ventricular myocardium. Most of the evidence in this scenario can be confused by the presence of comorbidities such as hypertension, diabetes and dyslipidemia, which are very common in this population. The influence of EF on atrial remodeling and cardiac function demands further investigation on morbidly obese without these comorbidities., Methods and Results: We prospectively recruited 20 metabolically healthy morbidly obese and 20 normo-weights controls. The maximum P-wave duration (PWD) was analyzed by 12-lead electrocardiogram. Left atrial diameter (LAD), left ventricular ejection fraction (LVEF) and EF thickness (EFT) were evaluated by two-dimensional echocardiography. The mean of maximum PWD and LAD were significantly larger in the obese group as compared to the control group: 109.55 ± 11.52 ms × 89.38 ± 11.19 ms and 36.12 ± 3.46 mm × 31.45 ± 2.64 mm, (p < 0.0001). The mean LVEF was lower in the obese group: 63.15 ± 4.25% × 66.17 ± 3.37% (p < 0.017). The mean EFT was higher in the obese group: 7.72 ± 1.60 mm × 3.10 ± 0.85 mm (p < 0.0001). A positive correlation was found between EFT and PWD (r = 0.70; p = 0.001) and LAD (r = 0.667; p = 0.001). An inverse correlation was found between EFT and LVEF (r = -0.523; p = 0.001). In a multiple multivariate regression analysis the EFT remains correlated with LAD and LVEF., Conclusions: In a select group of morbidly obese, the excess of EF had a significant impact on atrial remodeling and cardiac function., (Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Brazilian spotted fever (BSF) is an endemic anthropozoonosis caused by Gram-negative bacteria (Rickettsia rickettsii) that is associated with the risk of human infection by ticks. In the city of Americana, São Paulo (SP), Brazil, there were 12 cases (67% lethal) between 2004 and 2015. This study evaluated the effectiveness of control over tick infestations in an area at risk of BSF, in a field trial on an association of alpha-cypermethrin (3%) and flufenoxuron (3%) (Tenopa ® ) conducted in Americana. The infestation levels of the target species (Amblyomma sculptum and Amblyomma dubitatum) in the field trial were evaluated through acarological surveys (CO 2 traps) on days 0, 22, 43 and 62 after treatment, both in the treatment area and in a control area. In the treatment area, the insecticide formulation was applied using a motorized sprayer, at the dosage of 80mL/10L of water per 200m 2 . These surveys in the treatment area showed that there were reductions in the infestation levels of the adult stage on days 22 (33%), 43 (87%) and 62 (70%) and immature stages (nymphs and larvae) on days 22 (54%), 43 (87%) and 62 (97%), in relation to day zero and to infestation levels in the control area. This study demonstrated that the product applied was effective for reducing the environmental infestation of ticks and that this effect persisted two months after a single application in areas of proven risk of BSF., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Arrhythmic or electrical storm (AES) is a clinical condition characterized by 3 or more sustained ventricular arrhythmia episodes leading to appropriate device therapy in a 24-hour period and is associated with very high mortality. The clinical presentation is dramatic, and the management remains challenging. Although pharmacologic treatment and sedation are still part of the initial treatment, newer approaches that include ablation (endocardial, epicardial, or alternative procedures), sympathetic blockade (pharmacologic or by interventional sympathetic denervation), and mechanical hemodynamic support are used increasingly in this setting. In this article we review the current technologies at our disposal clinically to treat AES., (Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Background: Patients with Brugada syndrome (BrS) are at risk for ventricular arrhythmias (VAs) and sudden death. Identification of high-risk individuals beyond those with syncope or resuscitated sudden death remains a major challenge., Methods: We assessed the value of clinical, electrophysiological, and electrocardiographic (ECG) features, including depolarization and repolarization metrics, in predicting arrhythmic events and sudden death in consecutive patients with BrS diagnosed between 2002 and 2013 in Quebec, Canada. Qualifying electrocardiograms with the highest type 1 ST-segment elevations were reviewed and analyzed by 2 electrophysiologists who were blinded to clinical history. Survival analyses were adjusted for Firth bias correction and left truncation., Results: A total of 105 patients, 79.8% of whom were men, were diagnosed with BrS at a mean age of 46.2 ± 13.3 years and were followed for 59.6 ± 16.4 months. Ten (9.5%) had a history of cardiac arrest, 37 (35.2%) had syncope, and 7 (6.7%) experienced 20 arrhythmic events during follow-up, all consisting of appropriate ICD therapy (7 antitachycardia pacing; 13 shocks). In multivariate Cox regression analyses, a spontaneous type 1 electrocardiographic (ECG) pattern (hazard ratio [HR], 10.80; 95% confidence interval [CI], 1.03-113.87; P = 0.0476), maximal T peak-end (T p-e ) duration ≥ 100 ms (HR, 29.73; 95% CI, 1.33-666.37; P = 0.0325), and QRS duration in lead V 6 > 110 ms (HR, 15.27; 95% CI, 1.07-217.42; P = 0.0443) were independently associated with VAs or aborted sudden cardiac death., Conclusions: In a multicentre cohort with BrS from Quebec, Canada, VAs and sudden death were independently associated with standard 12-lead ECG features, including a spontaneous type 1 pattern, depolarization (QRS in lead V 6 ), and repolarization (maximal T p-e duration) criteria., (Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Background: OSA is associated with increased cancer incidence and mortality. Exosomes are vesicles secreted by most cells. They are released into the bloodstream and play a role in tumor progression and metastasis. We evaluated whether the chronic intermittent hypoxia (IH) that characterizes OSA leads to release of tumor-promoting exosomes in the circulation., Methods: C57/B6 male mice were randomized to 6 weeks of IH or room air (RA). A subgroup was injected with TC1 lung carcinoma cells in the left flank after 2 weeks of IH. Exosomes from mouse plasma and from 10 adult human patients with OSA before and after treatment for 6 weeks were cocultured with mouse TC1 and human adenocarcinoma cells lines. Malignant tumor properties such as proliferation, migration, invasion, and endothelial monolayer disruption were assessed, as was micro-RNA (miRNA), exosomal content, and transcriptomic effects of exosomes on TC1 cells in vitro to identify target genes., Results: Application of IH-induced exosomes from either IH-exposed tumor-bearing (IH+) or non-tumor-bearing (IH-) mice significantly promoted TC1 malignant properties. Similarly, before adherent treatment, exosomes from patients with OSA significantly enhanced proliferation and migration of human adenocarcinoma cells compared with after adherent treatment. Eleven distinct miRNAs emerged in IH-exposed mice, and their gene targets in TC1 cells were identified., Conclusions: Circulating exosomes released under IH conditions in vivo selectively enhance specific properties of lung tumor cell cultures. Thus, plasma exosomes participate in the increased tumor aggressiveness observed in patients with OSA., (Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)

Background: OSA is a highly prevalent condition that is associated with a wide range of long-term morbidities including metabolic, cardiovascular, and cognitive alterations, possibly via activation of systemic inflammatory and oxidative stress pathways. Implementation of positive airway pressure (PAP) is the first-line treatment for OSA, as well as for obesity hypoventilation syndrome (OHS), its most severe phenotype. However, the molecular and cellular mechanisms underlying OHS-induced morbidities and their response to PAP treatment remain unclear, and could be mediated, in part, by OSA-induced epigenetic changes., Methods: Blood was collected before starting PAP treatment (PRE group), as well as 6 weeks after PAP treatment (POST group) in 15 adult patients with OHS. DNA methylation profiles were studied by methylated DNA immunoprecipitation coupled to microarrays (MeDIP-chip) in six representative patients and further verified in a cohort of 15 patients by MeDIP-quantitative PCR., Results: We identified 1,847 regions showing significant differential DNA methylation (P < .001; model-based analysis of tiling arrays score, > 4) between the groups. Analysis of biochemical pathways and gene networks demonstrated that differentially methylated regions were associated with immune responses, and particularly with mechanisms governing gene regulation by peroxisome proliferation-activated receptors (PPARs). Single-locus quantitative PCR analysis revealed that DNA methylation was increased at the PPAR-responsive elements (PPAREs) of eight genes in the post-treatment samples (PRE/POST fold changes: ABCA1, 3.11; ABCG1, 1.72; CD36, 5.04; FABP4, 2.49; HMOX, 2.74; NOS2, 7.78; PEPCK, 9.27; and ADIPOQ, 1.73), suggesting that PAP treatment leads to an increase in DNA methylation at PPAREs, possibly affecting the binding of the PPAR-γ complex and downstream gene expression., Conclusions: Our work provides initial evidence of epigenetic regulation particularly involving metabolic pathways in patients with OHS who are responsive to PAP treatment., (Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)

Background and Objectives: This study sought to reconcile two lines of research. Previous studies have identified a prevalent and causal role of negative imagery in social phobia and public speaking anxiety; others have demonstrated that lateral eye movements during visualisation of imagery reduce its vividness, most likely by loading the visuospatial sketchpad of working memory. It was hypothesised that using eye movements to reduce the intensity of negative imagery associated with public speaking may reduce anxiety resulting from imagining a public speaking scenario compared to an auditory control task., Methods: Forty undergraduate students scoring high in anxiety on the Personal Report of Confidence as a Speaker scale took part. A semi-structured interview established an image that represented the participant's public speaking anxiety, which was then visualised during an eye movement task or a matched auditory task. Reactions to imagining a hypothetical but realistic public speaking scenario were measured., Results: As hypothesised, representative imagery was established and reduced in vividness more effectively by the eye movement task than the auditory task. The public speaking scenario was then visualised less vividly and generated less anxiety when imagined after performing the eye movement task than after the auditory task., Limitations: Self-report measures and a hypothetical scenario rather than actual public speaking were used. Replication is required in larger as well as clinical samples., Conclusions: Visuospatial working memory tasks may preferentially reduce anxiety associated with personal images of feared events, and thus provide cognitive resistance which reduces emotional reactions to imagined, and potentially real-life future stressful experiences., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: The National Heart, Lung, and Blood Institute-sponsored IPF Clinical Research Network (IPFnet) studies enrolled subjects with idiopathic pulmonary fibrosis (IPF) to evaluate drug therapies in treatment trials. An adjudication committee (AC) provided a structured review of cases in which there was uncertainty or disagreement regarding diagnosis or clinical event classification. This article describes the diagnosis and adjudication processes., Methods: The diagnostic process was based on review of clinical data and high-resolution CT scans with central review of lung biopsies when available. The AC worked closely with the data coordinating center to obtain clinical, radiologic, and histologic data and to communicate with the clinical centers. The AC used a multidisciplinary discussion model with four clinicians, one radiologist, and one pathologist to adjudicate diagnosis and outcome measures., Results: The IPFnet trials screened 1,015 subjects; of these, 23 cases required review by the AC to establish eligibility. The most common diagnosis for exclusion was suspected chronic hypersensitivity pneumonitis. The AC reviewed 88 suspected acute exacerbations (AExs), 93 nonelective hospitalizations, and 16 cases of bleeding. Determination of AEx presented practical challenges to adjudicators, as necessary clinical data were often not collected, particularly when subjects were evaluated outside of the primary study site., Conclusions: The IPFnet diagnostic process was generally efficient, but a multidisciplinary adjudication committee was critical to assure correct phenotype for study enrollment. The AC was key in adjudicating all adverse outcomes in two IPFnet studies terminated early because of safety issues. Future clinical trials in IPF should consider logistical and cost issues as they incorporate AExs and hospitalizations as outcome measures., Trial Registry: ClinicalTrials.gov; No.: NCT00517933, NCT00650091, NCT00957242; URL: www.clinicaltrials.gov.

Introduction: Stillbirth remains a devastating health issue with 26,000 stillbirths occurring annually in the United States. Formalin-fixed, paraffin-embedded (FFPE) umbilical cord samples are available for many stillbirths. Our aim was to validate the use of these samples in identifying genetic variations in stillbirth through microarray analysis., Methods: This is a retrospective case-control study from a single institution of stillbirths ≥ 23 weeks gestational age and control liveborn infants. Fetal genomic DNA was extracted from FFPE umbilical cord samples of stillborn and control placentas, and genotyping was performed using the Illumina HumanOmniExpresss-12v1 Beadchip. Array results were verified with qPCR., Results: 31 case-specific CNVs (17 deletions and 14 amplifications) with an average size of 294 kb for amplifications and 74 kb for deletions were identified among 94 FFPE samples (86 cases; 8 controls). In total 38 (44%) of the stillbirth samples had a CNV detected. Validation of a subset of microarray findings with qPCR confirmed deletions on 1p (2 cases), 11q (4 cases) and amplifications on 18 (1 case). Placental underperfusion changes were seen in stillborns with deletions on 1p, a region containing complement regulatory genes which have been shown to play a role in preeclampsia., Discussion: This study validated the use of archived FFPE umbilical cord samples for genome-wide copy number profiling in stillbirths, and demonstrates specific CNV deletions and amplifications. Microarray analysis in an expanded cohort of stillbirth FFPE samples has the potential to identify biomarkers involved in stillbirth pathogenesis., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Oil spill identification relies usually on a wealth of chromatographic data which requires advanced data treatment (chemometrics). A simple approach based on Kohonen neural networks to handle three-dimensional arrays is presented. A suite of 28 diagnostic ratios was considered to monitor six oils along four months. It was found that some traditional diagnostic ratios were not stable enough. In particular, alkylated PAHs (e.g. 1-methyldibenzothiophene, 4-methylpyrene, 27bbSTER and the TA21 and TA26 triaromatic steroids) seemed less resistant to medium-weathering than biomarkers. One (or two) ratios were found to differentiate each product: 30O, 28ab (and 25nor30ab), C3-dbt/C3-phe, 27Ts, TA26 and 29Ts characterized Ashtart, Brent, Maya, Sahara, IFO and Prestige oils, respectively., (Copyright © 2015 Elsevier Ltd. All rights reserved.)