Search

Background: The current study aimed to evaluate changes in treatment delay and outcome for ST-segment elevation myocardial infarction (STEMI) in the Netherlands during the first coronavirus disease 2019 (COVID-19) outbreak, thereby comparing regions with a high and low COVID-19 hospitalisation rate. Methods: Clinical characteristics, STEMI timing variables, 30-day all-cause mortality and cardiovascular complications of all consecutive patients admitted for STEMI from 1 January to 30 June in 2020 and 2019 to six hospitals performing a high volume of percutaneous coronary interventions were collected retrospectively using data from the Netherlands Heart Registry, hospital records and ambulance report forms. Patient delay, pre-hospital delay and door-to-balloon time before and after the outbreak of COVID-19 were compared to the equivalent periods in 2019. Results: A total of 2169 patients were included. During the outbreak median total treatment delay significantly increased (2 h 51 min vs 2 h 32 min; p = 0.043) due to an increased patient delay (1 h 20 min vs 1 h; p = 0.030) with more late presentations > 24 h (1.1% vs 0.3%) in 2020. This increase was particularly evident during the peak phase of COVID-19 in regions with a high COVID-19 hospitalisation rate. During the peak phase door-to-balloon time was shorter (38 min vs 43 min; p = 0.042) than in 2019. All-cause 30-day mortality was comparable in both time frames (7.8% vs 7.3%; p = 0.797). Conclusions: During the outbreak of COVID-19 patient delay caused an increase in total ischaemic time for STEMI, with a more pronounced delay in high-endemic regions, stressing the importance of good patient education during comparable crisis situations. [ABSTRACT FROM AUTHOR]

In 2017, Irma and Maria highlighted the vulnerability of small islands to cyclonic events and the necessity of advancing the forecast techniques for cyclone-induced marine flooding. In this context, this paper presents a generic approach to deriving time-varying inundation forecasts from ensemble track and intensity forecasts applied to the case of Reunion Island in the Indian Ocean. The challenge for volcanic islands is to account for the full complexity of wave overtopping processes while also ensuring a robustness and timeliness that are compatible with emergency requirements. The challenge is addressed by following a hybrid approach relying on the combination of process-based models with a statistical model (herein, a random-forest classifier) trained with a precalculated database. The latter enables one to translate any time series of coastal marine conditions into the time-varying probability of inundation for different sectors. The application detailed for the case of Cyclone Dumile at Sainte-Suzanne city shows that the proposed approach enables quick discrimination, in both space and time, thereby identifying safe and exposed areas and demonstrating that probabilistic forecasting of marine flooding by overtopping is feasible. The whole method can be easily adapted to other territories and scales provided that validated process-based models are available. Beyond early warning applications, the developed database and statistical models may also be used for informing risk prevention and adaptation strategies. [ABSTRACT FROM AUTHOR]

Summary: Low bone mass is a consequence of anorexia nervosa (AN). This study assessed the effects of energy deficiency on various bone and hormonal parameters. The interrelationships between energy deficiency and bone remodelling, glucose homeostasis and adipokines underscore the importance of preventing energy deficiency to limit demineralisation and hormonal alterations in AN patients. Introduction: Low areal bone mineral density (aBMD) is a well-known consequence of AN. However, the impact of reduced energy expenditure on bone metabolism is unknown. This study assessed the effects of energy deficiency on bone remodelling and its potential interactions with glucose homeostasis and adipose tissue-derived hormones in AN, a clinical model for reduced energy expenditure. Methods: Fifty women with AN and 50 age-matched controls (mean age 18.1 ± 2.7 and 18.0 ± 2.1 years, respectively) were enrolled. aBMD was determined with DXA. Resting energy expenditure (REE), a marker of energy status, was indirectly assessed by calorimetry. Bone turnover markers, undercarboxylated osteocalcin (ucOC), parameters of glucose homeostasis, adipokines and growth factors were concomitantly evaluated. Results: AN patients presented low aBMD at all bone sites. REE, bone formation markers, ucOC, glucose, insulin, HOMA-IR, leptin and IGF-1 were significantly reduced, whereas the bone resorption marker, leptin receptor (sOB-R) and adiponectin were elevated in AN compared with CON. In AN patients, REE was positively correlated with weight, BMI, whole body (WB) fat mass, WB fat-free soft tissue, markers of bone formation, glucose, insulin, HOMA-IR, leptin and IGF-1 and negatively correlated with the bone resorption marker and sOB-R. Biological parameters, aBMD excepted, appeared more affected by the weight variation in the last 6 months than by the disease duration. Conclusions: The strong interrelationships between REE and bone remodelling, glucose homeostasis and adipokines underscore the importance of preventing energy deficiency to limit short- and long-term bone demineralisation and hormonal alterations in AN patients. [ABSTRACT FROM AUTHOR]

The Bay of Biscay, located in the Northeast Atlantic Ocean, is exposed to energetic waves coming from the open ocean that have crucial effects on the coast. Knowledge of the wave climate and trends in this region are critical to better understand the last decade's evolution of coastal hazards and morphology and to anticipate their potential future changes. This study aims to characterize the long-term trends of the present wave climate over the second half of the twentieth century in the Bay of Biscay through a robust and homogeneous intercomparison of five-wave datasets (Corrected ERA-40 (C-ERA-40), ECMWF Reanalysis Interim (ERA-Interim), Bay Of Biscay Wave Atlas (BOBWA-10kH), ANEMOC, and Bertin and Dodet )). The comparison of the quality of the datasets against offshore and nearshore measurements reveals that at offshore locations, global reanalyses slightly underestimate wave heights, while regional hindcasts overestimate wave heights, especially for the highest quantiles. At coastal locations, BOBWA-10kH is the dataset that compares the best with observations. Concerning long time-scale features, the comparison highlights that the main significant trends are similarly present in the five datasets, especially during summer for which there is an increase of significant wave heights and mean wave periods (up to +15 cm and +0.6 s over the period 1970-2001) as well as a southerly shift of wave directions (around −0.4° year). Over the same period, an increase of high quantiles of wave heights during the autumn season (around 3 cm year for 90th quantile of significant wave heights (SWH)) is also apparent. During winter, significant trends are much lower than during summer and autumn despite a slight increase of wave heights and periods during 1958-2001. These trends can be related to modifications in the wave-type occurrence. Finally, the trends common to the five datasets are discussed by analyzing the similarities with centennial trends issued from longer time-scale studies and exploring the various factors that could explain them. [ABSTRACT FROM AUTHOR]

Summary: Peripubertal artistic gymnasts display elevated areal bone mineral density at various bone sites, despite delayed menarche and a high frequency of menstrual disorders, factors that may compromise bone health. The concomitant improvement in femoral bone geometry and strength suggested that this type of physical activity might have favourable clinical impact. Introduction: The purpose of this study is to evaluate the effect of artistic gymnastics (GYM) on areal bone mineral density (aBMD), femoral bone geometry and bone markers and its relationship with the osteoprotegerin (OPG)/rank-ligand (RANKL) system in peripubertal girls. Methods: Forty-six girls (age 10-17.2 years) were recruited for this study: 23 elite athletes in the GYM group (training 12-30 h/week, age at start of training 5.3 years) and 23 age-matched (±6 months; leisure physical activity ≤ 3 h/week) controls (CON). The aBMD at whole body, total proximal femur, lumbar spine, mid-radius and skull was determined using dual-X-ray absorptiometry. Hip structural analysis (HSA software) was applied at the femur to evaluate cross-sectional area (CSA, cm), cross-sectional moment of inertia (CSMI, cm), and the section modulus (Z, cm) and buckling ratio at neck, intertrochanteric region and shaft. Markers of bone turnover and OPG/RANKL levels were also analysed. Results: GYM had higher (5.5-16.4%) non-adjusted aBMD and adjusted aBMD for age, fat-free soft tissue and fat mass at all bone sites, skull excepted and the difference increased with age. In the three femoral regions adjusted for body weight and height, CSA (12.5-18%), CSMI (14-18%), Z (15.5-18.6%) and mean cortical thickness (13.6-21%) were higher in GYM than CON, while the buckling ratio (21-27.1%) was lower. Bone markers decreased with age in both groups and GYM presented higher values than CON only in the postmenarchal period. A similar increase in RANKL with age without OPG variation was observed for both groups. Conclusion: GYM is associated not only with an increase in aBMD but also an improvement in bone geometry associated with an increase in bone remodelling. These adaptations seem to be independent of the OPG/RANKL system. [ABSTRACT FROM AUTHOR]

Study design:This cross-sectional study compared the androgen and growth factor profiles and the bone turnover of patients with spinal cord injury (SCI) versus able-bodied controls (AB).Objective:Determine whether androgens, GH, or either IGF-I or IGFBP-3, are implicated in bone turnover alteration in patients with recent SCI.Setting:Propara Center, Montpellier, France.Methods:In all, 16 men (31.3 years) with complete SCI, seven paraplegics and nine tetraplegics, who had sustained injury an average of 3 months earlier, and 12 AB who served as controls (27.5 years) participated. Androgens, growth hormone and its mediators were investigated. The bone resorption process was evaluated by urinary and plasma type I collagen C-telopeptide (CTXu, CTXp), while bone formation was evaluated by osteocalcin (OC) and bone alkaline phosphatase.Results:Total testosterone (TT) and the free androgen index (FAI) were significantly lower in the SCI patients, whereas FSH was significantly higher (P<0.05). These hormonal variations were not related to the level of neurological lesion. There was no significant difference in GH, IGF-I, or IGFBP-3 levels. CTXu and CTXp indicated high bone resorption activity in the SCI patients (P<0.05). Regarding bone formation markers, only OC was affected by neurological lesion (P<0.05). Basal hormone levels did not correlate with markers of bone turnover.Conclusion:The high bone resorption process observed in SCI patients did not seem directly related to testicular endocrine abnormalities or an altered growth factor profile. Nevertheless, the reduced TT and FAI levels could be aggravating factors in the development of acute bone loss.Spinal Cord (2006) 44, 791–797. doi:10.1038/sj.sc.3101922; published online 28 March 2006 [ABSTRACT FROM AUTHOR]

The present work deals with the recovery of the in-boundary stress on smooth boundary parts in Boundary Element Method (BEM) in two dimensions. First, two Boundary Integral Representations (BIRs) of tangential derivative of boundary displacements, whose integral kernels multiplying either tangential derivative of displacements or displacements are smooth and bounded, are presented. Two procedures for an in-boundary stress recovery based on these BIRs are developed and analyzed. The first procedure, which directly uses the results obtained from a BEM analysis, displacements and tractions, requires the performing of integrations involved in these BIRs either over the real boundary of the solid or over a smooth approximation of the boundary part where the evaluation point is placed. The second procedure, which can be applied on a non-smooth (e.g. polygonal) approximation of the boundary, requires the use, in the first BIR introduced here, of an integral density which is previously smoothed by a local smoothing procedure. The third recovery procedure considered in this work is directly given by a local smoothing procedure of this kind. Results obtained by these three recovery procedures are compared in a series of numerical tests, the best results being obtained by the first procedure developed in this work. [ABSTRACT FROM AUTHOR]

Cromakalim (BRL 34915) is a potassium channel opener with therapeutic potential as a bronchodilator in asthma. Cromakalim (0.1-30 μmol/l) inhibited the spontaneous tone of human isolated bronchi n a concentration-related manner being nearly as effective as isoprenaline or theophylline. The order of relaxant potencies (expressed as -log IC mol/l; mean ±SEM) was isoprenaline (7.29 ± 0.27; n = 8) > cromakalim (5.89 ± 0.12; n = 7) > theophylline (4.07 ±0.13; n = 10). In human bronchi where tone had been raised by addition of histamine (0.1 mmol/l), acetylcholine (0.1 mmol/l) or leukotriene D (LTD, 0.1 μmol/l), the relaxant effect of cromakalim was substantially reduced. Cromakalim suppressed the contraction produced by KCI (25 mmol/l) but not that produced by KCl (120 mmol/l). Tetraethylammonium (8 mmol/l) was without effect against the relaxant action of cromakalimbut procaine (0.5 - 5 mmol/l) and glibenclamide (0.3 μmol/l) antagonised it. Cromakalim (10 μmol/l) produced an upward displacement of concentration-effect curves forKCI (1-100 mmol/l), acetylcholine (1 nmol/l-1 mmol/) and histamine (1 nmol/l-1 mmol/l) but it did not alter the concentration-effect curve for LTD (0.1 nmol/l-0.1 μmol/l). When tissues were challenged in the presence of cromakalim (10 μmol/l) with KCI (100 mmol/l), acetylcholine (1 mmol/l) or histamine (1 mmol/l), an enhanced contraction was observed compared to control tissues. This enhancement by cromakalim was absent when tissues were challenged with acetylcholine or histamine in either a Ca-free medium (plus EGTA 0.1 mmol/l) or in the presence of verapamil (10 μmol/l). It is concluded that cromakalim is an effective relaxant of human airway smooth muscle in vitro and this activity may depend on the opening of K channels in the plasma membrane of smooth muscle cells but other actions cannot be ruled out. [ABSTRACT FROM AUTHOR]

An abstract of the article "Investigation of 5-HT2B receptor induced dural plasma protein extravasation in a mouse migraine model" by A. Hunfeld, D. Segelcke, M. Andriske, F. Paris, X. Zhu and H. Lübbert is presented.

A correction to the article "ATM Regulates Target Switching to Escalating Doses of Radiation in the Intestines" that was published in February 2006 issue is presented.

Presents a correction to an error made in the article 'Sphingosine 1-phosphate preserves fertility in irradiated female mice without propagating genomic damage in offspring,' by F. Paris et al published in 'Nature Medicine' in 2002.