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Background: Data regarding ventricular tachycardia (VT) or premature ventricular complex (PVC) ablation following MVS is limited.) CA can be challenging given perivalvular substrate in the setting of mitral annuloplasty or prosthetic valves. Objective: To investigate the characteristics, safety, and outcomes of radiofrequency catheter ablation (CA) in patients with prior mitral valve surgery (MVS) and ventricular arrhythmias (VA). Methods: We identified consecutive patients with prior MVS who underwent CA for VT or PVC between January 2013- December 2018. We investigated the mechanism of arrhythmia, ablation approach, peri-operative complications, and outcomes. Results: In our cohort of 31 patients (77% men, mean age 62.3±10.8 years, left ventricular ejection fraction 39.2±13.9%) with prior MVS underwent CA (16 VT; 15 PVC). Access to the left ventricle was via transseptal approach in 17 patients, and a retrograde aortic approach was used in 13 patients. A combined transseptal and retrograde aortic approach was used in one patient, and a percutaneous epicardial approach was combined with trans-septal approach in 1patient. Heterogenous scar regions were present in 94% of VT patients and scar-related reentry was the dominant mechanism of VT. Clinical VA substrates involved the peri-mitral area in 6 patients with VT and 5 patients with PVC ablation. No procedure-related complications were reported. The overall recurrence-free rate at 1-year was 72.2%; 67% in the VT group and 78% in the PVC group. No arrhythmia-related death was documented on long-term follow-up. Conclusion: CA of VAs can be performed safely and effectively in patients with MVS

For a proangiogenic therapy to be successful, it must promote the development of mature vasculature for rapid reperfusion of ischemic tissue. Whole growth factor, stem cell, and gene therapies have yet to achieve the clinical success needed to become FDA-approved revascularization therapies. Herein, we characterize a biodegradable peptide-based scaffold engineered to mimic VEGF and self-assemble into a nanofibrous, thixotropic hydrogel, SLanc. We found that this injectable hydrogel was rapidly infiltrated by host cells and could be degraded while promoting the generation of neovessels. In mice with induced hind limb ischemia, this synthetic peptide scaffold promoted angiogenesis and ischemic tissue recovery, as shown by Doppler-quantified limb perfusion and a treadmill endurance test. Thirteen-month-old mice showed significant recovery within 7 days of treatment. Biodistribution studies in healthy mice showed that the hydrogel is safe when administered intramuscularly, subcutaneously, or intravenously. These preclinical studies help establish the efficacy of this treatment for peripheral artery disease due to diminished microvascular perfusion, a necessary step before clinical translation. This peptide-based approach eliminates the need for cell transplantation or viral gene transfection (therapies currently being assessed in clinical trials) and could be a more effective regenerative medicine approach to microvascular tissue engineering.

We examined macrophyte-environment relationships in shallow lakes located within the Prairie Parkland and Laurentian Mixed Forest provinces of Minnesota. Environmental variables included land cover within lake watersheds, and within-lake, water and sediment characteristics. CCA indicated that sediment fraction smaller than 63 μm (f

In a recent study, researchers found that multiple elements accumulated near the roots of Rumex crispus more under wetland conditions and element uptake was significantly greater in the plants grown under wetland compared to dryland conditions. The study reported here also found that elements accumulated in the root zone (up to 3 mm beyond the rhizoplane) of Typha angustifolia grown under wetland conditions. In comparison to the bulk zone, Be, Cu, Fe, Li, Sr and Zn accumulated more in the root zone of the flooded treatment whereas Ni and Sr accumulated more in the root zone of the non-flooded treatment. On average, T. angustifolia produced 4 times more biomass and element uptake was 2–27 times greater under wetland compared to dryland conditions.

Rumex crispus was grown under wet and dry conditions in two-chamber columns such that the roots were confined to one chamber by a 21 μm nylon mesh, thus creating a soil–root interface (‘rhizoplane’). Element concentrations at 3 mm intervals below the ‘rhizoplane’ were measured. The hypothesis was that metals accumulate near plant roots more under wetland than dryland conditions. Patterns in element distribution were different between the treatments. Under dryland conditions Al, Ba, Cu, Cr, Fe, K, La, Mg, Na, Sr, V, Y and Zn accumulated in soil closest to the roots, above the ‘rhizoplane’ only. Under wetland conditions Al, Fe, Cr, K, V and Zn accumulated above as well as 3 mm below the ‘rhizoplane’ whereas La, Sr and Y accumulated 3 mm below the ‘rhizoplane’ only. Plants on average produced 1.5 times more biomass and element uptake was 2.5 times greater under wetland compared to dryland conditions.

Background Chronic pain is common and challenging to treat. Although cognitive behavioral therapy (CBT) is efficacious, its benefit in disadvantaged populations is largely unknown. Objective To evaluate the efficacy of literacy-adapted and simplified group CBT versus group pain education (EDU) versus usual care. Design Randomized controlled trial. (ClinicalTrials.gov: NCT01967342). Setting Community health centers serving low-income patients in Alabama. Patients Adults (aged 19 to 71 years) with mixed chronic pain. Interventions CBT and EDU delivered in 10 weekly 90-minute group sessions. Measurements Self-reported, postintervention pain intensity (primary outcome) and physical function and depression (secondary outcomes). Results 290 participants were enrolled (70.7% of whom were women, 66.9% minority group members, 72.4% at or below the poverty level, and 35.8% reading below the fifth grade level); 241 (83.1%) participated in posttreatment assessments. Linear mixed models included all randomly assigned participants. Members of the CBT and EDU groups had larger decreases in pain intensity scores between baseline and posttreatment than participants receiving usual care (estimated differences in change scores-CBT: -0.80 [95% CI -1.48 to -0.11]; P = 0.022; EDU: -0.57 [CI, -1.04 to -0.10]; P = 0.018). At 6-month follow-up, treatment gains were not maintained in the CBT group but were still present in the EDU group. With regard to physical function, participants in the CBT and EDU interventions had greater posttreatment improvement than those receiving usual care, and this progress was maintained at 6-month follow-up. Changes in depression (secondary outcome) did not differ between either the CBT or EDU group and the usual care group. Limitations Participants represented a single health care system. Self-selection bias may have been present. Conclusion Simplified group CBT and EDU interventions delivered at low-income clinics significantly improved pain and physical function compared with usual care. Primary funding source Patient-Centered Outcomes Research Institute.

We measured concentrations of multiple elements, including rare earth elements, in waters and sediments of 38 shallow lakes of varying turbidity and macrophyte cover in the Prairie Parkland (PP) and Laurentian Mixed Forest (LMF) provinces of Minnesota. PP shallow lakes had higher element concentrations in waters and sediments compared to LMF sites. Redundancy analysis indicated that a combination of site- and watershed-scale features explained a large proportion of among-lake variability in element concentrations in lake water and sediments. Percent woodland cover in watersheds, turbidity, open water area, and macrophyte cover collectively explained 65.2 % of variation in element concentrations in lake waters. Sediment fraction smaller than 63 μm, percent woodland in watersheds, open water area, and sediment organic matter collectively explained 64.2 % of variation in element concentrations in lake sediments. In contrast to earlier work on shallow lakes, our results showed the extent to which multiple elements in shallow lake waters and sediments were influenced by a combination of variables including sediment characteristics, lake morphology, and percent land cover in watersheds. These results are informative because they help illustrate the extent of functional connectivity between shallow lakes and adjacent lands within these lake watersheds.

Cadmium, present locally in naturally high concentrations in the Northern Plains of the United States, is of concern because of its toxicity, carcinogenic properties, and potential for trophic transfer. Reports of natural concentrations in soils are dominated by dryland soils with agricultural land uses, but much less is known about cadmium in wetlands. Four wetland categories – prairie potholes, shallow lakes, riparian wetlands, and river sediments – were sampled comprising more than 300 wetlands across four states, the majority in North Dakota. Cd, Zn, P, and other elements were analyzed by ICP-MS, in addition to pH and organic matter (as loss-on-ignition). The overall cadmium content was similar to the general concentrations in the area's soils, but distinct patterns occurred within categories. Cd in wetland soils is associated with underlying geology and hydrology, but also strongly with concentrations of P and Zn, suggesting a link with agricultural land use surrounding the wetlands.