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Hyperinsulinemia concurrent with hypoglycemia is one of a myriad of physiological changes typically experienced by lactating dairy cows exposed to heat stress, the consequences of which are not yet well defined or understood. Therefore, the objective of this experiment was to separate the production-related effects of hyperinsulinemia with hypoglycemia from those of a hyperthermic environment. Multiparous lactating Holstein cows (n = 23; 58 ± 4 d in milk, 3.1 ± 0.3 lactations) were housed in temperature-controlled rooms and all were subjected to 4 experimental periods as follows: (1) thermoneutral (TN; temperature-humidity index of 65.1 ± 0.2; d 1–5), (2) TN + hyperinsulinemic-hypoglycemic clamp (HHC; insulin infused at 0.3 µg/kg of BW per h, glucose infused to maintain 90 ± 10% of baseline blood glucose for 96 h; d 6–10), (3) heat stress (HS; temperature-humidity index of 72.5 ± 0.2; d 16–20), and (4) HS + euglycemic clamp (EC; glucose infused to reach 100 ± 10% of TN baseline blood glucose for 96 h; d 21–25). Cows were fed and milked twice daily. Feed refusals were collected once daily for calculation of daily dry matter intake, and milk samples were collected at the beginning and end of each period for component analyses. Circulating insulin concentrations were measured in daily blood samples, whereas glucose concentrations were measured more frequently and variably in association with clamp procedures. Rectal temperatures and respiration rates were greater during HS than TN, as expected, and states of hyperinsulinemia and hypoglycemia were successfully induced by the HHC and high ambient temperatures (HS and EC). Feed intake differed based upon thermal environment as it was similar during TN and HHC periods, and declined for HS and EC. Milk production was not entirely reflective of feed intake as it was greatest during TN, intermediate during HHC, and lowest during HS and EC. All milk components differed with the experimental period, primarily in response to the thermal environment. Interestingly, TN baseline glucose concentrations were highly correlated with the change in glucose from TN to HS, and were related to glycemic status during HS. Furthermore, although few in number, those cows that failed to become hypoglycemic during HS tended to have a greater reduction in milk yield. The work presented here addresses a critical knowledge gap by broadening our understanding of the physiological response to heat stress and the related changes in glycemic state. This broadened understanding is fundamental for the development of novel, innovative management strategies as the dairy industry is compelled to become increasingly efficient in spite of global warming. [ABSTRACT FROM AUTHOR]

Failure to rescue (FTR), defined as death after a complication, is an established hospital quality metric for coronary and valve surgery. While prior work has documented interhospital variability in FTR after durable left ventricular assist device (LVAD), less is known about patient and complication-specific predictors of FTR in this setting. Patients undergoing primary LVAD implantation from 2012-2017 were selected from the INTERMACS database. The cohort was divided into two groups and compared based on patient survival following complications and FTR. FTR was defined as patient in-hospital mortality after experiencing at least one of the following major complications: severe right heart failure, respiratory failure, renal failure requiring dialysis, major infection, device malfunction, and bleeding requiring reoperation. Multivariable logistic regression was used to evaluate both pre-operative patient and complication specific predictors of FTR. Stepwise selection was used to arrive at the final model. Of the 13,617 patients in the sample, 4,839 (35.5%) experienced a major complication of which 854 (17.6%) died (i.e., FTR). Patients in the FTR group were more likely to be older (61.3 +/- 11.5 vs 56.9 +/-12.9, p<0.001), INTERMACS Profile 1 (30.9% vs 20.9%, p<0.0001), and Destination Therapy (55.6% vs 48.3%, p=0.0003). Significant predictors of FTR included: a history of prior CABG (OR = 1.54, CI95%: 1.31-1.82), valve surgery (OR = 1.50, CI95%: 1.07-2.11), preoperative dialysis (OR = 2.29, CI95%: 1.70-3.08) and preoperative ECMO (OR=4.27, CI95%: 3.01-6.04). Patients developing right heart failure had the highest complication-specific FTR rate (75.3%) followed by reintubation (45.1%), Table 1. This study identified four significant preoperative predictors of FTR after durable LVAD placement. Future work should focus on identifying patients at highest risk of FTR, as well as early recognition and management of complications. [ABSTRACT FROM AUTHOR]

Abstract: Bone formation and resorption are influenced by inflammatory processes. We examined the relationships among inflammatory markers and bone mineral content (BMC) and density (BMD) and determined the contribution of inflammatory markers to 1-yr changes in BMC and BMD in healthy postmenopausal women. This analysis included 242 women at baseline from our parent Soy Isoflavones for Reducing Bone Loss project who were randomly assigned to 1 of 3 treatment groups: placebo, 80mg/d soy isoflavones, or 120mg/d soy isoflavones. BMD and BMC from the lumbar spine (LS), total proximal femur (hip), and whole body were measured by dual energy X-ray absorptiometry and the 4% distal tibia by peripheral quantitative computed tomography. Serum inflammatory markers (C-reactive protein, interleukin [IL]-1β, IL-6, tumor necrosis factor-alpha [TNF-α], and white blood cell count [WBC]) were measured at baseline, 6, and 12mo. Because of attrition or missing values, data analysis at 12mo includes only 235 women. Significant associations among IL-6, TNF-α, and WBC were observed with percent change in LS, hip, and whole body BMC and BMD. Multiple regression analysis indicated that in combination inflammatory markers accounted for 1.1–6.1% of the variance to the observed 12-mo changes in BMC and BMD. Our results suggest that modifying inflammatory markers, even in healthy postmenopausal women, may possibly reduce bone loss. [Copyright &y& Elsevier]

Abstract: Y3Fe5O12 (YIG) crystal has many attractive characteristics, such as low dielectric loss, narrow resonance linewidth in microwave region and also possesses a good saturated magnetization value. Composite technology in general sets out to combine materials in such a way that the properties of the composite are the optimum for a particular application. The different materials work together to give a composite of unique properties. In this work, we present the preparation procedure (obtaining) of the GdIG X :YIG1− X ferrimagnetic ceramic matrix composite by mechanical alloying and calcinations. Besides that, we study its properties by X-ray powder diffraction, infrared, Micro-Raman, 57Fe Mössbauer spectroscopy and hysteresis loop measurements. [Copyright &y& Elsevier]