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Pheochromocytomas are catecholamine-producing tumors and a rare cause of sudden cardiac death. We describe the case of a previously healthy 28-year-old man who presented after a ventricular fibrillation out-of-hospital cardiac arrest (OHCA). His clinical investigation, including a coronary evaluation, was unremarkable. A protocolized head-to-pelvis computed tomography (CT) scan was ordered and revealed a large right adrenal mass with subsequent laboratory studies showing markedly elevated urine and plasma catecholamines. This raised suspicion for a pheochromocytoma as the underlying etiology behind his OHCA. He received appropriate medical management, underwent adrenalectomy with subsequent normalization of his metanephrines, and fortunately did not have recurrent arrythmias. This case highlights the first documented case of a ventricular fibrillation arrest as the initial presentation of pheochromocytoma crisis in a previously healthy individual, and how the use of early protocolized sudden death CT scan allowed for the prompt diagnosis and management of a rare cause of OHCA. LEARNING OBJECTIVE: We review the typical cardiac manifestations of pheochromocytoma and describe the first case of a pheochromocytoma crisis presenting as sudden cardiac death (SCD) in a previously asymptomatic individual. In young patients with unexplained SCD, it is important to consider pheochromocytoma in the differential diagnosis. We also review why an early head-to-pelvis sudden death computed tomography scan protocol may be helpful in the evaluation of patients resuscitated from SCD without an obvious etiology.

Artificial intelligence (AI) and machine learning (ML) have significantly impacted the field of cardiovascular medicine, especially cardiac electrophysiology (EP), on multiple fronts. The goal of this review is to familiarize readers with the field of AI and ML and their emerging role in EP. The current review is divided into 3 sections. In the first section, we discuss the definitions and basics of AI, ML, and big data. In the second section, we discuss their application to EP in the context of detection, prediction, and management of arrhythmias. Finally, we discuss the regulatory issues, challenges, and future directions of AI in EP.

Cyprinid herpesvirus 3 (CyHV-3) is the archetype of fish alloherpesviruses and is advantageous to research because, unlike many herpesviruses, it can be studied in the laboratory by infection of the natural host (common and koi carp). Previous studies have reported a negative correlation among CyHV-3 strains between viral growth in vitro (in cell culture) and virulence in vivo (in fish). This suggests the existence of genovariants conferring enhanced fitness in vitro but reduced fitness in vivo and vice versa. Here, we identified the syncytial plaque formation in vitro as a common trait of CyHV-3 strains adapted to cell culture. A comparison of the sequences of virion transmembrane protein genes in CyHV-3 strains, and the use of various recombinant viruses, demonstrated that this trait is linked to a single-nucleotide polymorphism (SNP) in the open reading frame (ORF) 131 coding sequence (C225791T mutation) that results in codon 183 encoding either an alanine (183A) or a threonine (183T) residue. In experiments involving infections with recombinant viruses differing only by this SNP, the 183A genovariant associated with syncytial plaque formation was the more fit in vitro but the less fit in vivo. In experiments involving coinfection with both viruses, the more fit genovariant contributed to the purifying selection of the less fit genovariant by outcompeting it. In addition, this process appeared to be accelerated by viral stimulation of interference at a cellular level and stimulation of resistance to superinfection at a host level. Collectively, this study illustrates how the fundamental biological properties of some viruses and their hosts may have a profound impact on the degree of diversity that arises within viral populations.

There are several concerns with the use of bioelectronic sensors for healthcare applications, including: 1. Implantation: Bioelectronic sensors that are implanted into the body can cause discomfort, infection, and scarring, and they can also trigger an immune response that can affect their performance over time. This degradation of the sensor can be toxic to the body. 2. Power supply: Bioelectronic sensors often require a power source to operate, which can be a challenge for devices especially those that are implanted inside the body. If at all, bioelectronic sensors must draw power, then it must be at a minimum possible. 3. Data security: Bioelectronic sensors can generate sensitive medical information, which must be protected from unauthorized access, hacking, or data breaches. 4. Performance: Bioelectronic sensors must be highly accurate and reliable, as even small errors in readings can have significant consequences for patient health. 5. Interoperability: Bioelectronic sensors must be able to work seamlessly with other medical devices and software, to enable the exchange and analysis of data. 6. Cost: Bioelectronic sensors can be expensive, both to manufacture and to maintain, which can limit their accessibility and affordability for patients. 7. Regulatory approval: Bioelectronic sensors must be approved by regulatory agencies such as the FDA, which can be a lengthy and complex process that requires extensive testing and data analysis. 8. Designing good bioelectronic sensors remains a challenge due to unavailability of necessary circuit simulation tools. Software currently available may be good for normal electronic circuits, but design of any bioelectronic circuit is different and challenging. Proposed solutions must show that value addition.

Background The corrected QT interval (QTc) is a measure of ventricular repolarization time, and a prolonged QTc increases risk for malignant ventricular arrhythmias. Pulmonary vein isolation (PVI) may increase QTc but its effects have not been well studied. Objective Determine the incidence, risk factors, and outcomes of patients presenting for PVI in sinus and atrial fibrillation with postoperative QTc prolongation in a large cohort. Methods We performed a single-center retrospective study of consecutive atrial fibrillation ablations. QTc durations using Bazett correction were obtained from electrocardiograms at different postoperative intervals and compared to preoperative QTc. We studied clinical outcomes including clinically significant ventricular arrhythmia and death. A multivariable model was used to identify factors associated with clinically significant QTc prolongation, defined as ΔQTc ≥60 ms or new QTc duration ≥500 ms. Results A total of 352 PVIs were included in this study. We observed a statistically significant increase in mean QTc compared to baseline (446.3 ± 37.8 ms) on postoperative day (POD)0 (471.7 ± 38.2 ms, P < .001) and at POD1 (456.5 ± 35.0 ms, P < .001). There was no significant difference at 1 month (452.4 ± 33.5 ms, P = .39) and 3 months (447.3 ± 40.0 ms, P = .78). Sixty-six patients (19.2%) developed ΔQTc ≥60 ms or QTc ≥500 ms on POD0, with 4.1% persisting past 90 days. Female sex (odds ratio [OR] = 1.82, 95% confidence interval [CI] =1.01–3.29, P = .047) and history of coronary artery disease (OR = 2.16, 95% CI = 1.03–4.55, P = .042) were independently predictive of QTc prolongation ≥500 ms or ΔQTc ≥60 ms. There were no episodes of clinically significant ventricular arrhythmia or death attributable to arrhythmia. Conclusion QTc duration increased significantly immediately post-PVI and returned to baseline by 1 month. PVI did not provoke significant ventricular arrhythmias in our cohort., Graphical abstract

Purpose After antral pulmonary vein isolation (PVI), electrical potentials may persist deep in the right superior pulmonary vein (RSPV). Whether these potentials signify true pulmonary vein potential (PVP) (implying inadequate RSPV isolation) or are far-field potentials (FFP) from the superior vena cava (SVC) is unclear. Here, we attempt to assess the incidence of persistent potentials in RSPV post-isolation and methods to differentiate PVP from FFP. Methods Following PVI, we mapped the RSPV and the SVC with simultaneously placed catheters. We recorded the incidence of SVC potentials, RSPV potentials, and distance between the 2 structures. When RSPV potentials were present, we assessed (1) relationship to SVC potentials, (2) RSPV-SVC distance, and (3) responses on pacing from either site. Results Among 43 consecutive post-PVI patients, 39 (91%) patients had SVC electrical activity but only 10 had persistent RSPV potentials. Of these, 2/10 had true PVP, and 8 were FFP from SVC. Bipolar electrogram morphology did not differentiate PVP from FFP, but low-amplitude (5 mA) SVC pacing was an effective maneuver. However, high-amplitude (≥ 10 mA) pacing from SVC and/or RSPV could result in far-field capture of the other site even when RSPV was devoid of electrical activity. Average RSPV-SVC distance was 15.9 mm. Conclusions Persistent RSPV potentials occur rarely post-PVI despite the close proximity to electrically active SVC. When present, true PVP can be differentiated from FFP by low-amplitude pacing from SVC. Bipolar EGM morphology and high-amplitude pacing are unreliable at differentiating these potentials.

Subtilosin A, a cyclic peptide from Bacillus subtilis is known for its antimicrobial activity against a diverse range of bacteria. Herein, we report the specific interaction between subtilosin A against virulent proteins of Aeromonas hydrophila through in silico analysis. Aeromonas toxic proteins such as aerolysin and hemolysin were selected from the non-redundant database. The hemolysin protein was designed by homology modelling tool, and it was validated using Ramachandran plot. Then subtilosin A and target toxin proteins were energy minimized for further docking study. The whole docking experiments were done using antibody mode in Cluspro. Subtilosin A building an active interaction with Aeromonas toxins through H-bonds and protein–protein docking analysis revealed that the hemolysin has 6 H-bond interaction towards the antimicrobial target protein subtilosin A than aerolysin, which has 9 H-bonds. The most favourable interacting residues of subtilosin A are Thr6, Cys13, Ile19, Pro20, Asp21, Phe22, Glu23 and Gly35 involving in the strong H-bond formation and proceeds to inhibition of toxin. Hence, the study confirmed that the subtilosin A has more antimicrobial activity to inhibit the Aeromonas toxins by interacting with their binding site residues for preventing extracellular cleavage.

Heart rhythm assessment is indispensable in diagnosis and management of many cardiac conditions and to study heart rate variability in healthy individuals. We present a proof-of-concept system for acquiring individual heart beats using smart speakers in a fully contact-free manner. Our algorithms transform the smart speaker into a short-range active sonar system and measure heart rate and inter-beat intervals (R-R intervals) for both regular and irregular rhythms. The smart speaker emits inaudible 18–22 kHz sound and receives echoes reflected from the human body that encode sub-mm displacements due to heart beats. We conducted a clinical study with both healthy participants and hospitalized cardiac patients with diverse structural and arrhythmic cardiac abnormalities including atrial fibrillation, flutter and congestive heart failure. Compared to electrocardiogram (ECG) data, our system computed R-R intervals for healthy participants with a median error of 28 ms over 12,280 heart beats and a correlation coefficient of 0.929. For hospitalized cardiac patients, the median error was 30 ms over 5639 heart beats with a correlation coefficient of 0.901. The increasing adoption of smart speakers in hospitals and homes may provide a means to realize the potential of our non-contact cardiac rhythm monitoring system for monitoring of contagious or quarantined patients, skin sensitive patients and in telemedicine settings., Anran Wang et al. present a contact-free method of monitoring individual heart beats by converting smart-speakers into active sonar systems. Their approach is capable of measuring heart rhythms with high accuracy in both healthy participants and hospitalized patients, and may be a useful healthcare tool for remote diagnosis or patient monitoring.

The teleost fish skin mucus acts as an important physical and biological barrier that prevents fish from the surrounding environment. Many studies reported the presence of various immunological molecules in fish skin mucus that involve in protection against invading microbes. In the present study, the skin mucus proteins of freshwater fish Cirrhinus mrigala (mrigal) were extracted using organic solvent (methanol) and further analyzed by liquid chromatography-tandem mass spectrometry (LC–MS/MS) to identify proteins by database retrieval. LC–MS/MS analysis revealed the presence of diverse proteins in the methanol skin mucus extract. The identified proteins were classified into biological process, cellular process and molecular functions by Gene Ontology (GO) enrichment analysis. A peptide was selected, modelled and compared with other antimicrobial peptides sequences through phylogenetic analysis and showed that the modelled peptide shared high similarity with Arminin-1 of Cnidaria animals. We also investigated the potentiality of the modelled peptide against Infectious Pancreatic Necrosis Virus sub viral particle and Infectious Salmon Anemia Virus hemagglutinin-esterase protein through protein-peptide docking using ClusPro. The docking results confirmed that the modelled peptide has good interactions with viral particles. Therefore, these results suggest that the modelled peptide molecule from C. mrigala methanol skin mucus extract can be further studied that aid in the development of novel peptide candidate for the control of aquaculture viral diseases.

Fish skin mucus acts as an immunological barrier that prevents entry of pathogens. However, there are gaps in the knowledge of microbes inhabiting skin mucus constituents to invade the host and induce pathogenecity. Hence, in the present study, skin and skin mucus of three freshwater fishes Cyprinus carpio, Labeo rohita, Cirrhinus mrigala was analyzed to compare histology and mucus activity against cancer cells. The skin mucus elemental composition and its influence on bacterial growth were also investigated. Histological examination of fish skin showed the presence of mucus secreting cells and differences in the distribution of cells were clearly seen depending on fish species. The cytotoxic potential of lyophilized skin mucus against human lung adenocarcinoma cells revealed a higher percentage of cell death at 1000 µg mL-1 in C. mrigala skin mucus when comparing other two fish species. Elemental analysis of lyophilized skin mucus through Field Emission Scanning Electron Microscope coupled with Energy Dispersive X-ray (FESEM-EDX) confirmed the presence of carbon, nitrogen, oxygen and sulfur in C. carpio and C. mrigala. In the case of L. rohita, the element sulfur was absent. The results of bacterial growth in autoclaved skin mucus demonstrated an initial reduction in bacterial population and gradually increased over time. Initial reduction in bacteria might be due to the presence of inhibitory molecules in fish skin mucus. Subsequently, the bacteria utilize the elemental composition of skin mucus as a nutrient source to increase their growth. Study findings suggest that the presence of bioactive compounds in lyophilized skin mucus hinder the proliferation of cancer cells. Nevertheless, after autoclaving the skin mucus components, it supports the growth of bacteria due to the absence of immune molecules. The present study represents the knowledge of skin mucus composition, which could be explored further to understand how pathogens overcome the skin mucus barrier.

Prostaglandin E2 (PGE2) instilled into the bladder generates symptoms of urinary urgency in healthy women and reduces bladder capacity and urethral pressure in both humans and female rats. Systemic capsaicin desensitization, which causes degeneration of C-fibers, prevented PGE2-mediated reductions in bladder capacity, suggesting that PGE2 acts as an irritant (Maggi CA, Giuliani S, Conte B, Furio M, Santicioli P, Meli P, Gragnani L, Meli A. Eur J Pharmacol 145: 105–112, 1988). In the present study, we instilled PGE2 in female rats after capsaicin desensitization but without the hypogastric nerve transection that was conducted in the Maggi et al. study. One week after capsaicin injection (125 mg/kg sc), rats underwent cystometric and urethral perfusion testing under urethane anesthesia with saline and 100 µM PGE2. Similar to naïve rats, capsaicin-desensitized rats exhibited a reduction in bladder capacity from 1.23 ± 0.08 mL to 0.70 ± 0.10 mL ( P = 0.002, n = 9), a reduction in urethral perfusion pressure from 19.3 ± 2.1 cmH2O to 10.9 ± 1.2 cmH2O ( P = 0.004, n = 9), and a reduction in bladder compliance from 0.13 ± 0.020 mL/cmH2O to 0.090 ± 0.014 mL/cmH2O ( P = 0.011, n = 9). Thus, changes in bladder function following the instillation of PGE2 were not dependent on capsaicin-sensitive pathways. Further, these results suggest that urethral relaxation/weakness and/or increased detrusor pressure as a result of decreased compliance may contribute to urinary urgency and highlight potential targets for new therapies for overactive bladder.

Electrical stimulation therapies to promote bladder filling and prevent incontinence deliver continuous inhibitory stimulation, even during bladder emptying. However, continuous inhibitory stimulation that increases bladder capacity (BC) can reduce the efficiency of subsequent voiding (VE). Here we demonstrate that state-dependent stimulation, with different electrical stimulation parameters delivered during filling and emptying can increase both BC and VE relative to continuous stimulation in rats and cats of both sexes. We show that continuous 10 Hz pudendal nerve stimulation increased BC (120–180% of control) but decreased VE (12–71%, relative to control). In addition to increasing BC, state-dependent stimulation in both rats and cats increased VE (280–759% relative to continuous stimulation); motor bursting in cats increased VE beyond the control (no stimulation) condition (males: 323%; females: 161%). These results suggest that a bioelectronic bladder pacemaker can treat complex voiding disorders, including both incontinence and retention, which paradoxically are often present in the same individual.

Catheter-based ablation is increasingly being used as first-line therapy for atrial fibrillation (AF). Cerebrovascular accidents (CVA) are a known complication. In this study, we investigate the 30-day incidence and predictors of acute CVA postcatheter ablation for AF. The Nationwide Readmissions Database from 2010 to September 2015 was queried for hospitalizations with an ablation procedure and a concurrent AF diagnosis. The primary end point was a composite end point of CVA during index admission or readmission for CVA within 30 days of admission for index hospitalization. The associations between the incidence of end points and the covariates of interest; which included age, gender, hospital characteristics (size, procedural volume, urban/rural status, and teaching status), CHA2DS2-VASc co-morbidity score and its components was assessed using logistic regression. Appropriate survey weighting methodology was applied to generate nationally representative estimates. Of 67,090 weighted hospitalizations for AF ablation, 566 (0.8%) had CVA within 30 days post-ablation. In multivariate regression analysis, factors associated with CVA included hypertension (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.04, 1.85), heart failure (OR 4.97, 95% CI 3.32, 7.44), previous stroke/ transient ischemic attack (OR 3.25, 95% CI 2.39, 4.42) and a lower procedural volume (OR for higher procedural volume: 0.6, 95% CI 0.42, 0.85). CHA2DS2-VASc score (OR 1.27, 95% CI 1.17, 1.39) was associated with CVA in univariate analysis. In conclusion, the CVA incidence within 30-day of catheter-based AF ablation therapy was 0.8%. Higher CHA2DS2-VASc score was associated with higher risk of CVA post-ablation. Hypertension, heart failure, previous stroke/transient ischemic attack, and procedural volume were independently associated with CVA post-ablation.

Ionic liquids (ILs) are thermally stable at both high and low temperatures, making them excellent solvents and electrolytes in extreme ambient conditions. In this work, we systematically studied th...

Selective electrical stimulation of the pudendal nerve exhibits promise as a potential therapy for treating overactive bladder (OAB) across species (rats, cats, and humans). More recently, pelvic nerve (PelN) stimulation was demonstrated to improve cystometric bladder capacity in a PGE2 rat model of OAB. However, PelN stimulation in humans or in an animal model that is more closely related to humans has not been explored. Therefore, our objective was to quantify the effects of PGE2 and PelN stimulation in the cat. Acute cystometry experiments were conducted in 14 α-chloralose-anesthetized adult, neurologically intact female cats. Intravesical PGE2 decreased bladder capacity, residual volume, threshold contraction pressure, and mean contraction pressure. PelN stimulation reversed the PGE2-induced decrease in bladder capacity and increased evoked external urethral sphincter electromyographic activity without influencing voiding efficiency. The increases in bladder capacity generated by PelN stimulation were similar in the rat and cat, but the stimulation parameters to achieve this effect differed (threshold amplitude at 10 Hz in the rat vs. twice threshold amplitude at 1 Hz in the cat). These results highlight the potential of PGE2 as a model of OAB and provide further evidence that PelN stimulation is a promising approach for the treatment of OAB symptoms.

Cobalt is an essential trace metal and plays a pivotal role in the growth of all living organisms. The exposure of cobalt in the aquatic environment is ubiquitous via both natural and anthropogenic activities. The present study was carried out to investigate the accumulation response of macrophyte Hydrilla verticillata (L.f.) Royle towards the cobalt exposure at different concentrations (1, 25, 50, 75 and 100 µM) for seven days. The results showed that the cobalt accumulation increased in treated H. verticillata (L.f.) Royle with increase in concentration. The Bioconcentration factor (BCF) values were high in plants exposed to higher concentration of cobalt. Increase in growth (shoot length) and pigments (chlorophyll a, b and total chlorophyll) were detected at 25 µM cobalt concentration, whereas the growth and pigments were declined in 50, 75 and 100 µM. There was no significant difference in the carotenoid content between control and treated plant. Antioxidant enzymes (superoxide dismutase, catalase, and peroxidase) were increased at higher concentrations of cobalt. The results indicated that the decline in growth and pigments, and an increase in antioxidant enzyme activities, were triggered by the accumulation of cobalt in the plant. These observations suggest that H. verticillata (L.f.) Royle is well equipped to accumulate low concentration of cobalt in tissues to increase its growth and detoxify ROS generation. The BCF results indicate the efficiency of using H. verticillata (L.f.) Royle as a phytostabilizer.

Objectives This study evaluated the rate and predictors of endoscopically detected esophageal thermal lesions (EDEL) in patients who underwent cryoballoon atrial fibrillation (AF) ablation (CBA). Background EDEL is a known complication of catheter ablation for AF and is the inciting factor for atrial esophageal fistula formation. Methods An observational study was conducted of patients with AF presenting for CBA. Pre-procedural magnetic resonance imaging was used to retrospectively evaluate the distance between the atrial endocardium and the esophageal lumen (AED). Intraprocedural esophageal luminal temperature and balloon temperatures were recorded. All patients underwent upper endoscopy (EGD) 24 h post-ablation. Clinical, anatomical, and ablation parameters were analyzed using logistic regression for association with thermal injury. Results A total of 95 patients (37% women; 71% paroxysmal AF) were included in the study. Esophageal thermal injury was detected on EGD in 21 patients (22%). EDEL was mostly mild (20 of 21 patients) and severe in only 1 of 21 patients. Univariate logistic regression identified gastroesophageal reflux disease to be associated with increased risk of thermal injury (odds ratio [OR]: 3.2; 95% confidence interval [CI]: 1.00 to 10.46; p = 0.04), whereas a wider AED was protective (OR: 0.16; 95% CI: 0.05 to 0.515; p = 0.002). Esophageal wall thickness was also protective (OR: 0.04; 95% CI: 0.002 to 0.864; p = 0.04). In multivariate analysis, only AED (OR: 0.22; 95% CI: 0.06 to 0.77; p = 0.018) and obesity (OR: 4.63; 95% CI: 1.13 to 18.97; p = 0.033) were associated with EDEL. Esophageal luminal temperature, number, and duration of cryoballoon applications and balloon temperature were not predictors of EDEL. Conclusions EDEL following CBA occurred in 22% of patients and was mostly mild. Obesity and atrioesophageal distance were independently associated with increased risk.

The present study investigated the dietary fishmeal replacement by marine red seaweed (Halymenia dilatata) meal (RSM) on growth performance, feed utilization, chemical body composition, hematological constituents, digestive, antioxidant, and metabolic enzymes in freshwater fish Labeo rohita (Rohu) fingerlings. The fish were fed with RSM-free control diet (RSM0) and four experimental diets, which replaced fish meal (FM) with varying levels of RSM (25%, 50%, 75%, and 100%, represented as RSM25, RSM50, RSM75, and RSM100 respectively). After a 60-day feeding trial, the survival rate (SR), growth performance (length gain, weight gain, and specific growth rate), protein efficiency ratio, chemical body composition (protein, lipid, and ash), and digestive enzymes (amylase and protease) were significantly increased (P 0.05) in the fish fed with RSM50 diet containing 39% protein level. The sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) revealed a higher staining intensity of muscle proteins in fish fed with the RSM50 diet. However, the hematological constituents (hemoglobin, hematocrit, red blood cell, white blood cell, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration), antioxidant enzyme - superoxide dismutase, and metabolic enzymes (glutamic oxaloacetic transaminase and glutamic pyruvic transaminase) were not significantly altered in RSM50 diet when compared to control. In contrast, hematological constituents were decreased (P 0.05), and antioxidant and metabolic enzymes were increased in rohu fed with RSM75 and RSM100 (P 0.05). Furthermore, these findings suggest that RSM might be adopted at a pace of 37% (estimated polynomial second-order regression) and is found to be beneficial for freshwater fish L. rohita diets that enhance growth and immune responses. The current study recommended substituting (50%) of marine red seaweed (Halymenia dilatata) for fish meal significantly improves the growth performance, chemical body composition, and digestive enzymes of L. rohita and this could be a valuable natural replacement for fishmeal to reduce the production cost of aquatic feed.

Green evolutionary products such as biologically fabricated nanoparticles (NPs) pose a hazard to aquatic creatures. Herein, biogenic silver nanoparticles (AgNPs) were synthesized by the reaction between ionic silver (AgNO

Introduction: Hypertension is a global burden. Renal denervation has been touted as a possible therapeutic strategy for the treatment of hypertension. However, neuromodulation of the renal nerves’ traffic in hypertension has yet to receive a similar attention. Aim: This study investigated cardio-respiratory responses to renal nerve stimulation in a genetic model of hypertension, the spontaneously hypertensive rat (SHR). Methods: In pentobarbital-anesthetized male SHRs (n = 9), the left renal nerve was stimulated 5 times (5-6 minutes apart) at 5 Hz, 0.5 ms, 0.5 mA for 30s. Mean arterial pressure (MAP), heart rate (HR), left renal cortical blood flow (CBF) and cortical vascular resistance (CVR), hindquarter aortic blood flow (ABF) and vascular resistance (AVR), upper (UAP) and lower (LAP) airway pressure, airway flow (AF), airway resistance (AR), respiration rate (RR) and diaphragmatic EMG (dEMG) were measured and averaged. Results: Cardiovascular responses to renal nerve stimulation were characterized by reductions in MAP, HR, CBF and AVR, which were associated with increases in ABF and CVR. Respiratory responses to renal nerve stimulation, on the other hand, demonstrated increases in AF, RR and dEMG, decreases in AR and no change in UAP and LAP. Conclusions: Under hypertensive conditions, the renal nerves not only modulate cardiovascular function but also improve respiratory function. These studies suggest that neuromodulation of the renal nerves may offer a therapeutic alternative for hypertensive patients.

Purpose: To investigate how modulating ocular sympathetic activity affects progression of choroidal neovascularization (CNV), a hallmark feature of wet age-related macular degeneration (AMD).Methods: In the first of two studies, Brown Norway rats underwent laser-induced CNV and were assigned to one of the following groups: daily eye drops of artificial tears (n = 10; control group); daily eye drops of the β-adrenoreceptor agonist isoproterenol (n = 10); daily eye drops of the β-adrenoreceptor antagonist propranolol (n = 10); sympathetic internal carotid nerve (ICN) transection 6 weeks prior to laser-induced CNV (n = 10). In the second study, rats underwent laser-induced CNV followed by ICN transection at different time points: immediately after the laser injury (n = 6), 7 days after the laser injury (n = 6), and sham surgery 7 days after the laser injury (n = 6; control group). All animals were euthanized 14 days after laser application. CNV development was quantified with fluorescein angiography and optical coherence tomography (in vivo), as well as lesion volume analysis using 3D confocal reconstruction (postmortem). Angiogenic growth factor protein levels in the choroid were measured with ELISA.Results: In the first study, blocking ocular sympathetic activity through pharmacological or surgical manipulation led to a 75% or 70% reduction in CNV lesion volume versus the control group, respectively (P < 0.001). Stimulating ocular sympathetic activity with isoproterenol also led to a reduction in lesion volume, but only by 27% versus controls (P < 0.05). VEGF protein levels in the choroid were elevated in the three treatment groups (P < 0.01). In the second study, fluorescein angiography and CNV lesion volume analysis indicated that surgically removing the ocular sympathetic supply inhibited progression of laser-induced CNV, regardless of whether ICN transection was performed on the same day or 7 days after the laser injury.Conclusion: Surgical and pharmacological block of ocular sympathetic activity can inhibit progression of CNV in a rat model. Therefore, electrical block of ICN activity could be a potential bioelectronic medicine strategy for treating wet AMD.

OBJECTIVE: To rapidly exclude severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection using artificial intelligence applied to the electrocardiogram (ECG).METHODS: A global, volunteer consortium from 4 continents identified patients with ECGs obtained around the time of polymerase chain reaction-confirmed COVID-19 diagnosis and age- and sex-matched controls from the same sites. Clinical characteristics, polymerase chain reaction results, and raw electrocardiographic data were collected. A convolutional neural network was trained using 26,153 ECGs (33.2% COVID positive), validated with 3826 ECGs (33.3% positive), and tested on 7870 ECGs not included in other sets (32.7% positive). Performance under different prevalence values was tested by adding control ECGs from a single high-volume site.RESULTS: The area under the curve for detection of acute COVID-19 infection in the test group was 0.767 (95% CI, 0.756 to 0.778; sensitivity, 98%; specificity, 10%; positive predictive value, 37%; negative predictive value, 91%). To more accurately reflect a real-world population, 50,905 normal controls were added to adjust the COVID prevalence to approximately 5% (2657/58,555), resulting in an area under the curve of 0.780 (95% CI, 0.771 to 0.790) with a specificity of 12.1% and a negative predictive value of 99.2%.CONCLUSION: Infection with SARS-CoV-2 results in electrocardiographic changes that permit the artificial intelligence-enhanced ECG to be used as a rapid screening test with a high negative predictive value (99.2%). This may permit the development of electrocardiography-based tools to rapidly screen individuals for pandemic control.

In this study, we emphasize a rapid and cost-effective biogenic approach for the synthesis of silver nanoparticles (AgNPs) using an aqueous extract of onion (Allium cepa L.) peel (brown skin) acting as a reducing and capping agent. The synthesized AgNPs were characterized by UV-visible spectroscopy, X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), transmission electron microscopy (TEM), and energy-dispersive X-ray spectroscopy (EDS) analysis. The morphology of synthesized AgNPs was a spherical shape, cubic structure with an average particle size range of 33–50 nm. The AgNPs have higher antioxidant activities (2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTs) when compared with ascorbic acid (vitamin C). The synthesized AgNPs have strong antipathogenic activity towards foodborne illness–causing bacterial pathogens of Gram-positive (Bacillus sp., Staphylococcus aureus, and Corynebacterium sp.) and Gram-negative (Escherichia coli, Salmonella sp., and Vibrio cholerae) organisms. Furthermore, the AgNPs have the potential anti-proliferative action on A549 lung cancer cell lines, suggesting a novel chemotherapeutic agent against human lung cancer.

Over 30 million Americans are diagnosed with diabetes and this number is only expected to increase. There are various causes that induce complications with diabetes, including oxidative stress. In oxidative stress, lipid peroxidation-derived reactive carbonyl species such as 4-hydroxy-2-nonenal (4-HNE) is shown to cause damage in organs that leads to diabetic complications. We provided evidence to show that 4-HNE or/and 4-HNE-protein adducts are elevated in various organ systems of diabetic patients and animal models. We then discussed the advantages and disadvantages of different methodologies used for the detection of 4-HNE in diabetic tissues. We also discussed how novel approaches such as electrochemistry and nanotechnology can be used for monitoring 4-HNE levels in biological systems in real-time. Thus, this review enlightens the involvement of 4-HNE in the pathogenesis of diabetes and its complications and efficient methods to identify it. Furthermore, the article presents that 4-HNE can be developed as a biomarker for end-organ damage in diabetes such as diabetic cardiac complications.