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Introduction: Physical exercise affects the morphology and function of the left atrium. Elite athletes have increased volume without increasing stiffness. The effect of exercise on the atria of the general population is less well known. Objective: To evaluate the effect of aerobic exercise on the anatomy and function of the left atrium. Main objective: compare left atrial volume indexed to body surface area; secondaries: to compare ejection fraction and left atrial peak longitudinal strain, E/e ́ ratio and new atrial fibrillation in a population that practices aerobic exercise for at least 4 weeks vs non-active.Method: Meta-analysis of observational or experimental studies. Excluded: subjects with baseline atrial fibrillation, non-aerobic exercise; elite/professional athletes. Keywords: “physical exercise AND left atrial function”, until 2/21/2022 in Pubmed, Scielo, clinicaltrials.gov and hand-search.Results: Eleven studies included in main outcome; 789 subjects, median age 52 years; female sex 24%. Main outcome (only statistically significant): left atrial index volume 2.65 ml/m2 ˃ in the exercise group (p=0.006). No results were found for incidence of atrial fibrillation.Conclusions: In the general population, aerobic exercise favors dilation of the left atrium. The relevance is doubtful due to contradictory and non-significant results on atrial stiffness. Introducción: El ejercicio físicoafecta la morfología y función de la aurícula izquierda. Atletas de élite tienen aumento del volumen sin aumentar la rigidez. El efecto del ejercicio en la aurícula de la población general es menos conocido. Objetivo: Evaluar el efecto del ejercicio aeróbico en anatomía y función de aurícula izquierda. Objetivo primario: comparar volumen de aurícula izquierda indexado a superficie corporal; secundarios: comparar fracción de eyección y strain longitudinal pico de aurícula izquierda, relación E/e ́y nueva fibrilación auricular en población que practique ejercicio aeróbico por al menos 4 semanas vs no activos.Método: Meta-análisis de estudios observacionales o experimentales. Se excluyeron sujetos con fibrilación auricular basal, ejercicio no aeróbico; atletas de élite/profesionales. Palabras claves: “physical exercise AND left atrialfunction”, hasta 21/2/2022 en Pubmed, Scielo, clinicaltrials.gov y búsqueda manual.Resultados:Once estudios incluidos en objetivo primario; 789 sujetos, mediana edad 52 años; sexo femenino 24%. Resultado primario (único estadísticamente significativo): volumen indexado de aurícula izquierda 2,65 ml/m2 ˃ en grupo ejercicio (p=0,006). No se encontraron resultados para incidencia de fibrilación auricular. Conclusiones: En población general, el ejercicio aeróbico favorece la dilatación de la aurícula izquierda. La relevancia es dudosa por resultados contradictorios y no significativos sobre rigidez auricular.

Background: Endothelial dysfunction, coupled with inflammation, induces thrombo-inflammation. In COVID-19, this process is believed to be associated with clinical severity. Von Willebrand factor (VWF), and a disintegrin and metalloproteinase with thrombospondin motifs 13 (ADAMTS-13), are strong markers of endothelial dysfunction. We evaluated the impact of the VWF/ADAMTS-13 fraction on COVID-19 severity and prognosis. Materials and methods: A cohort study including 74 COVID-19 patients, with 22 admitted to the intensive care unit (ICU) and 52 to the medical ward (MW), was carried out. We also evaluated, in a group of 54 patients who were prospectively observed, whether variations in VWF/ADAMTS-13 correlated with the degree of severity and routine blood parameters. Results: A VWF:RCo/ADAMTS-13 fraction above 6.5 predicted in-hospital mortality in the entire cohort. At admission, a VWF:RCo/ADAMTS-13 fraction above 5.7 predicted admission to the ICU. Furthermore, the VWF:RCo/ADAMTS-13 fraction directly correlated with C-reactive protein (CRP) (Spearman r: 0.51, p &lt, 0.0001) and D-dimer (Spearman r: 0.26, p = 0.03). In the prospective cohort, dynamic changes in VWF:RCo/ADAMTS-13 and the CRP concentration were directly correlated (Spearman r, p = 0.0014). This relationship was significant in both groups (ICU: p = 0.006, MW: p = 0.02).Conclusions: The present findings show that in COVID-19, the VWF/ADAMTS-13 fraction predicts in-hospital mortality. The VWF/ADAMTS-13 fraction may be a helpful tool to monitor COVID-19 patients throughout hospitalization.

Hepatitis B virus (HBV) is a DNA virus belonging to Hepadnaviridae family. Chronic infection with HBV is one major risk factor of hepatic disease. In Madagascar, former studies classified the country as part of high endemic area, as HBV prevalence can reach 23% in general population. However, this prevalence differs largely between urban and rural areas and is estimated to be, respectively, 5% and 26%. The aims of the present study were to describe the genetic diversity of HBV strains from different regions of Madagascar, and to describe the viral gene flow throughout the country by using phylogenetic analysis. This is the first large-scale molecular and phylogenetic study analyzing HBV sequences from 28 different Malagasy areas, never sampled in the past. In this study, the most prevalent genotype/sub-genotypes was E. Migration analysis showed a gene flow from zone 3 (rural) to zone 2 (suburban), and a greater gene flow from the middle part of Madagascar to the north than to the south. It is important to study the HBV infections in Madagascar and to monitor the potential spread of this viral strain inside this country. J. Med. Virol. 88:2138-2144, 2016. © 2016 Wiley Periodicals, Inc.

Fioravante Capone,1,2 Matteo Paolucci,1,2 Federica Assenza,1,2 Nicoletta Brunelli,1,2 Lorenzo Ricci,1,2 Lucia Florio,1,2 Vincenzo Di Lazzaro1,2 1Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy; 2Fondazione Alberto Sordi – Research Institute for Aging, Rome, ItalyAbstract:Neurophysiological and neuroanatomical studies have found that the same basic structural and functional organization of neuronal circuits exists throughout the cortex. This kind of cortical organization, termed canonical circuit, has been functionally demonstrated primarily by studies involving visual striate cortex, and then, the concept has been extended to different cortical areas. In brief, the canonical circuit is composed of superficial pyramidal neurons of layers II/III receiving different inputs and deep pyramidal neurons of layer V that are responsible for cortex output. Superficial and deep pyramidal neurons are reciprocally connected, and inhibitory interneurons participate in modulating the activity of the circuit. The main intuition of this model is that the entire cortical network could be modeled as the repetition of relatively simple modules composed of relatively few types of excitatory and inhibitory, highly interconnected neurons. We will review the origin and the application of the canonical cortical circuit model in the six sections of this paper. The first section (The origins of the concept of canonical circuit: the cat visual cortex) reviews the experiments performed in the cat visual cortex, from the origin of the concept of canonical circuit to the most recent developments in the modelization of cortex. The second (The canonical circuit in neocortex) and third (Toward a canonical circuit in agranular cortex) sections try to extend the concept of canonical circuit to other cortical areas, providing some significant examples of circuit functioning in different cytoarchitectonic contexts. The fourth section (Extending the concept of canonical circuit to economic decisions circuits) reviews the experiments conducted in humans by using transcranial magnetic stimulation to demonstrate the validity of the canonical cortical circuit model. The fifth section (Extending the concept of canonical circuit to economic decisions circuits) explores the hypothesis that also complex human behaviors such as economic decision-making could also be explained in terms of canonical cortical circuit. The final section (Conclusion) provides a critical point of view, evidencing the limits of the available data and tracking directions for future research.Keywords: canonical cortical circuit, cortex, cortical layers, cortical physiology