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This study aimed to analyze two decades of consecutive mortality data to investigate cardiovascular deaths in Systemic Lupus Erythematosus (SLE) across the United States (US), identifying patterns and disparities in mortality rates. A retrospective analysis was conducted using mortality data from the CDC WONDER database spanning 1999-2020. ICD-10 codes for diseases of circulatory system (I00-I99) and for SLE (M32) were used to identify cardiovascular-related deaths in SLE among adults aged 25 years and older at the time of death. Age-adjusted mortality rates (AAMRs) per 1,000,000 persons were calculated, and trends were assessed using Average Annual Percentage Change (AAPC) and Annual Percent Change (APC) using Joinpoint. Data were stratified by year, sex, race/ethnicity, and geographical regions. Between 1999 and 2020, cardiovascular-related deaths in SLE accounted for 6,548 deaths among adults aged 25 and older in the US. The overall AAMR for cardiovascular-related deaths in SLE decreased from 1.81 in 1999 to 1.53 in 2020, with an AAPC of -1.00 (95% CI: -1.91 to -0.24, p=0.025). A significant decline occurred from 1999 to 2014 with an APC of -3.20 (95% CI: -5.56 to -2.18; p=0.02), followed by a notable increase of 4.73 (95% CI: 0.41 to 18.29, p=0.23) from 2014 to 2020. Women exhibited higher AAMRs compared to men (women: 2.12, men: 0.53). The AAMR decreased for both men and women, with a steeper decline for men from 1999 to 2014 (APC: -4.85 95% CI: -15.58 to -2.62; p<0.02) compared to women in the same period (APC: -2.81 95% CI: -5.78 to -1.73; p<0.03). The Black cohort had a higher AAMR (3.54 95% CI: 3.37 to 3.70), compared to the White cohort (1.12 95% CI: 1.09 to 1.16). The highest mortality was in the Western region (AAMR: 1.60 95% CI: 1.52 to 1.68). Geographically, AAMRs ranged from 0.62 in Massachusetts to 3.11 in Oklahoma. Metropolitan areas had higher AAMRs than Non-metropolitan areas [(1.41 95% CI: 1.37 to 1.45) vs (1.29 95% CI: 1.21 to 1.37)], with a significant mortality reduction in Metropolitan area from 1999-2020 (AAPC: -1.04 95% CI: -1.95 to -0.28, p=0.0064) compared to Non-metropolitan areas in the same time frame (AAPC: -0.86, 95% CI: -2.43 to 0.33 p=0.152). This analysis highlights notable differences in mortality rates related to cardiovascular deaths in SLE. The target population was adult patients aged 25 and older in the United States. These results are based on demographic and geographic factors. Initially, there was a considerable decrease, but recently the mortality rates have started to rise. This highlights the importance of patient focused interventions to address disparities and improve health outcomes. [ABSTRACT FROM AUTHOR]

β-Galactosidase was immobilized on modified nanosilver reduced graphene oxide (Ag@rGO) nanocomposite prepared by in vitro synthesis using same enzyme. The effectiveness factor, η value of the immobilized enzyme was calculated to be 0.968, suggesting enhancement in enzyme activity after immobilization. The morphological structure of the crosslinked biopolymer was analyzed using electron microscopy and other characterization techniques. The kinetics displayed a decrease in K m value from 0.50 to 0.44 mmol L−1 while there was an increase in V max values from 0.031 to 0.039 μmol min−1 mL−1. The immobilized enzyme retained 85% activity after its 10th repeated use. Inhibition constant (K i) value suggests galactose to be a more potent inhibitor of the enzyme. Despite the inhibitory potential of these hydrolysis products, the immobilized enzyme preparation retained 44.2% activity in the presence of both inhibitory sugars. The as-synthesized nanobiocatalyst was found quite effective in hydrolyzing 89% of lactose from whey. Hence, this nanobiocatalyst can be used in removing lactose from dairy waste, whey before releasing it into the water bodies. Also, the cytotoxicity and genotoxicity of Ag@rGO NC was assessed on human blood lymphocytes using flow cytometry and comet assay, respectively. [Display omitted] • Formulation of nanosilver reduced graphene oxide nanocomposite using chemical synthesis approach. • Successful immobilization of β galactosidase on in vitro synthesized support using physical adsorption • Improved resistance to inhibition by the hydrolysis products by the immobilized enzyme • Synthesized support was found to be non toxic and biocompatible. • Enhanced lactose hydrolyzing potential of the immobilized enzyme [ABSTRACT FROM AUTHOR]

This research comprehensively analyzed a unique solar desalination unit that operates on concentrated solar energy. The analysis primarily focused on evaluating three crucial components: the condenser, flash chamber, and brine heater. Testing was initially performed using seawater sourced from the eastern region of Saudi Arabia. Subsequently, to investigate the influence of salinity on the system performance, the device was tested under variable salinity levels ranging from 15,000 ppm to 35,000 ppm. Key parameters, including condenser temperature, brine heater temperature, and distillate production, were measured throughout the experimentation. The findings unveiled an inverse correlation between salinity and distillate production, as increasing the salinity from 15,000 ppm to 35,000 ppm resulted in a decline in distillate production. The maximum distillate achieved was 2400 ml/h at a salinity level of 15,000 ppm, corresponding to a constant feed rate of 0.2 l/min. The average energy efficiency of the brine heater was determined to be 61.9%. Moreover, the average exergy efficiencies were calculated as 81.3% for the condenser, 4.4% for the brine heater, and 44.3% for the flash chamber. Mathematical models were subsequently developed to establish the relationships between salinity and various system responses. Furthermore, performance metrics such as gain output ratio, energy utilization factor, and specific energy consumption were evaluated. The proposed system has a maximum gain output ratio of 16, a maximum energy utilization factor of 2.2, and a minimum specific energy consumption of 299.3 kWh/m3. • Novel spray flash desalination system powered by concentrated solar energy. • Energy and exergy analysis of condenser, brine heater, and flash chamber. • Mathematical model development to relate salinity to system responses. • Feed water salinity negatively impacts distillate production. • Enhancement in gain output ratio and energy utilization factor. [ABSTRACT FROM AUTHOR]

Advanced glycation end-products (AGEs) from non-enzymatic glycation are implicated in several degenerative diseases, including being a crucial contributor in secondary complications of diabetes. This has garnered significant scientific interest in inhibiting agents of AGEs to prevent and remediate disorders arising due to glycation. In the current study, inhibitory effects on AGEs formation were investigated using bio-enzymatically synthesized nanoformulations of gold (AuNPs) and silver (AgNPs) by physiologically important enzyme, β galactosidase. Human serum albumin, most abundant protein in human blood plasma, was glycated by incubating with glucose leading to AGEs formation. The AGEs formation was significantly minimized with both AuNPs and AgNPs, as confirmed by various biophysical and biochemical techniques. Circular dichroism and Fourier transform infrared spectroscopy further affirmed antiglycation potential of AuNPs and AgNPs. The results were corroborated with thiol group, free lysine and carbonyl content estimation for native, glycated and nanoparticles (NPs) treated samples. Confocal microscopic imaging was performed to exhibit glycation inhibiting potential of the NPs. The inhibition of AGEs was observed to be slightly stronger in case of AgNPs than AuNPs with both exhibiting promising results as potential anti-glycating agents. The study sheds light on potential of non-toxic NPs being utilized as controlling agents against hyperglycemic conditions and diabetes management. Image 1 • β galactosidase mediated enzymatic synthesis of gold and silver nanoformulations. • HSA glycation by glucose leading to AGEs formation. • Significant inhibition in advanced glycation end-products by AuNPs and AgNPs. • Comparison of anti-glycation potential of these AuNPs and AgNPs. [ABSTRACT FROM AUTHOR]

Bedaquiline was approved by USFDA in 2012 for pulmonary MDR-TB. The IC 50 value of bedaquiline was reported to be remarkably low (25 nM), effectively inhibiting mycobacterial ATP synthase. In addition to these obvious assets of bedaquiline, the potential disadvantages of bedaquiline include inhibition of the hERG (human Ether-à-go-related gene; KCNH 2) potassium channel (concurrent risk of cardiac toxicity), hepatic toxicity and possibly phospholipidosis. The current review focuses primarily on the structural part of bedaquiline for the activity-toxicity optimization. This critical analysis of the structure of bedaquiline will help medicinal chemists to synthesize the better modified analouge of bedaquiline with reduced cardiotoxicity, hepatotoxicity potential and improved pharmacokinetics. Image 1 • Bedaquilline effective drug for the MDR-TB treatment. • Cardiotoxicity and hepatotoxicity are the major hurdles. • Structural changes could resolve the problem. [ABSTRACT FROM AUTHOR]

Heart failure with preserved ejection fraction is a growing public health concern, a disease with poor health outcomes, and is showing increased prevalence globally. This review paper explores the literature with a focus on the pathophysiology and microbiology of preserved ejection fraction heart failure while drawing connections between preserved and reduced ejection fraction states. The discussion teases out the cellular level changes that affect the overall dysfunction of the cardiac tissue, including the clinical manifestations, microbiological changes (endothelial cells, fibroblasts, cardiomyocytes, and excitation-contraction coupling), and the burden of structural diastolic dysfunction. The goal of this review is to summarize the pathophysiological disease state of heart failure with preserved ejection fraction to enhance understanding, knowledge, current treatment models of this pathology. [ABSTRACT FROM AUTHOR]

Background Nephrotoxicity is a severe complication in patients undergoing cisplatin (CP) chemotherapy. Previous studies in our lab have shown that administration of a single dose of CP results in decrease in the activities of brush border membrane (BBM) and free radical scavenging enzymes and induces oxidative stress in rat kidney. Nigella sativa , is one of the most revered medicinal plant known for its numerous health benefits. Nigella sativa seed/oil has been shown to improve kidney functions in animal models of acute kidney injury. Objective The present study was undertaken to investigate whether Nigella sativa oil (NSO) can prevent the CP-induced nephrotoxic effects. Results The effect of NSO was determined on CP induced alterations in various serum parameters and on enzymes of carbohydrate metabolism, BBM and antioxidant defense system in renal cortex and medulla. Administration of NSO (2 ml/kg bwt. orally), prior to and following a single dose CP treatment (6 mg/kg bwt. i.p), significantly attenuated the CP induced increase in serum creatinine (Scr) and blood urea nitrogen (BUN) and decrease in the activities of BBM enzymes in renal cortical and medullary homogenates as well as in isolated BBM vesicles (BBMV). NSO administration also precluded CP induced alterations in the activities of carbohydrate metabolism enzymes and in the enzymatic and non-enzymatic antioxidant parameters. Histopathological observations showed extensive kidney damage in CP treated animals and remarkably reduced renal injury in CP and NSO co-treated group. Conclusion The biochemical and histological data suggest a protective effect of NSO against CP-induced acute kidney injury. [ABSTRACT FROM AUTHOR]

Objective: To compare the effects of manual hyperinflation (MHI) and ventilator hyperinflation (VHI) delivered to completely sedated and paralyzed patients undergoing mitral valve replacement (MVR) while maintaining minute ventilation. Methods: This was a randomized study with a 2-group, pre-test, post-test experimental design. Effects of hyperinflation were studied on static compliance (Cstat), dynamic compliance (Cdyn), oxygenation (Pao 2:Fio 2), partial pressure of carbon dioxide in arterial blood (Paco 2), and cologarithm of activity of dissolved hydrogen ions in arterial blood (pH). A sample of 30 patients in the immediate postoperative phase of MVR surgery were included in the study. Results: No significant differences were found between the groups. Significant improvements were found in oxygenation at both 1minute and 20minutes after MHI, but only at 1minute after VHI (P < .05). VHI led to improved Cdyn (P < .05). Conclusion: In the immediate postoperative phase of MVR, both techniques produced similar effects on respiratory compliance and oxygenation. MHI produced longer lasting improvements in oxygenation than VHI, whereas VHI produced better improvements in dynamic compliance. Paco 2 and pH were maintained by both. [Copyright &y& Elsevier]

Treatment of unprotected severely calcified left main coronary artery (LMCA) disease is a complex interventional procedure. Intravascular lithotripsy (IVL) and rotational atherectomy (RA) are safe and effective methods of treating coronary calcification in the non-LMCA setting. This retrospective analysis assessed the feasibility of IVL versus RA in unprotected LMCA disease. We analyzed IVL and RA procedures performed at a large tertiary hospital in the Northeast of England from January 1, 2019 to April 31, 2022. Major safety and efficacy endpoints were procedural and angiographic success, defined by stent delivery with <50 % residual stenosis and without clinical or angiographic complications, respectively. Another important clinical endpoint was the composite of major adverse cardiac events (MACE) at 1 year. From 242 patients, 44 had LMCA IVL, 81 had LMCA RA and 117 had non-LMCA IVL. Patients with LMCA disease were older and more likely to have aortic stenosis. IVL was a second-line or bailout technique in 86.4 % LMCA and 92.2 % non-LMCA cases. Procedural and angiographic success rates were ≥ 84 % across all groups (p > 0.05). In 3 LMCA IVL and 3 LMCA RA cases arrhythmias and cardiac tamponade complicated the procedures respectively. At 1 year, MACE occurred in 10/44 (22.7 %) LMCA IVL, 16/81 (19.8 %) LMCA RA and 25/117 (21.4 %) cases (p > 0.05). In our single center retrospective analysis, IVL is feasible in unprotected calcified LMCA as a second-line and third-line adjuvant calcium modification technique. Its use in unprotected calcified LMCA disease should be formalized with the undertaking of large randomized controlled trials. [Display omitted] • Left main coronary artery (LMCA) patency is life-sustaining and life-prolonging. • Calcific LMCA disease is a significant interventional challenge. • Intravascular lithotripsy (IVL) acoustic shockwaves modify coronary calcium. • IVL is feasible with specific risks and benefits in the setting of calcific LMCA disease. • Treatment of calcific LMCA disease should be guided by the heart team. [ABSTRACT FROM AUTHOR]

Angiotensin converting enzyme (ACE) is well known for its role producing the vasoconstrictor angiotensin II and ACE inhibitors are commonly used for treating hypertension and cardiovascular disease. However, ACE has many different substrates besides angiotensin I and plays a role in many different physiologic processes. Here, we discuss the role of ACE in the immune response. Several studies in mice indicate that increased expression of ACE by macrophages or neutrophils enhances the ability of these cells to respond to immune challenges such as infection, neoplasm, Alzheimer's disease, and atherosclerosis. Increased expression of ACE induces increased oxidative metabolism with an increase in cell content of ATP. In contrast, ACE inhibitors have the opposite effect, and in both humans and mice, administration of ACE inhibitors reduces the ability of neutrophils to kill bacteria. Understanding how ACE affects the immune response may provide a means to increase immunity in a variety of chronic conditions now not treated through immune manipulation. [ABSTRACT FROM AUTHOR]

Background: Patients with end-stage renal disease (ESRD) were excluded from all major trials on the safety of transcatheter aortic valve replacement (TAVR). This study aims to identify the predictors of mortality due to the rising rate of TAVR utilization and subsequent mortality in patients with ESRD.Methods: The National Inpatient Sample (NIS) (2002-2017) was queried to identify all patients with ESRD undergoing TAVR. The trend of all-cause mortality and its predictors were determined using a binary logistic regression model to obtain adjusted odds ratios (aOR).Results: A total of 6836 patients (6341 survived, 495 died) were included in the analysis. The proportion of demographic and baseline comorbidities for survived vs. non-survived was nearly identical between the two groups. A rising trend in the utilization and mortality of TAVR in ESRD was noted. The adjusted odds of mortality was significantly higher for hypertension (6.92, 95% CI 3.78-12.66, p ≤ 0.0001), liver disease (4.51, 955 CI 3.30-6.17, p ≤ 0.0001), drug abuse (aOR 34.88, 95% CI 12.79-95.13, p ≤ 0.0001), periprocedural pneumonia (aOR 2.80, 95% CI 1.98-3.96, p ≤ 0.0001), cardiogenic shock (aOR, 5.97, 95% CI 4.63-7.70, p ≤ 0.0001), ST-elevation myocardial infarction (aOR 5.13, 95% CI 2.29-11.49, p ≤ 0.0001) and third-degree heart block (aOR 1.47, 955 CI 1.10-1.97, p0.01) in patients with ESRD undergoing TAVR. The mean length of stay and mean number of diagnoses recorded were also significantly higher for non-surviving TAVR patients.Conclusion: Baseline hypertension, liver disease, third-degree heart block, periprocedural pneumonia, cardiogenic shock and STEMI can significantly increase the in-hospital mortality rate in ESRD patients undergoing TAVR. [ABSTRACT FROM AUTHOR]