CAF Group Research Articles

Aerobic exercise training prevents renal damage in insulin resistance mice

Insulin resistance is associated with lipid accumulation in the kidney which leads to renal damage. We investigated the potential of aerobic exercise training (AET) to prevent renal damage in mice with diet‐induced insulin resistance. Adult male C57BL6/J mice were assigned into chow‐fed controls (C, n=7), cafeteria diet (CAF, n=7), chow‐fed trained (T, n=7), and cafeteria diet plus trained (CAFT=7). The standard chow diet contained 4% of kilocalories from fat, 55% from carbohydrate and 22% from proteins (Nuvilab®, Paraná, Brazil). The cafeteria diet contained 18.7% of kilocalories from fat, 56% from carbohydrate and 14.8% from proteins. PT was performed simultaneously with diet and consisted of 8‐wk running session of 60 min at 60% of maximal speed, 5 days/wk. Experimental procedures were approved by Ethics Committee from Faculty of Medicine of University of São Paulo (#18/2014). Cafeteria diet induced insulin resistance in CAF group compared to C group during insulin tolerance test, which was counteracted by AET in CAFT group. The glomerular filtration rate (GFR) increased by 88% in the CAF group compared to other groups. The water intake was lower in the CAF group (3.5 ± 0.3 mL) compared to the C (5.4 ± 0.5 mL), but there was no difference in urinary flow, urinary excretion of Na +, K +, Cl‐, total protein and urinary osmolarity. Histological analysis showed that CAF group increased intra‐renal lipid deposition (4.12 ± 0.48 %/area) compared to C group (1.70 ± 0.55 %/area), and that AET was able to prevent this increase in CAFT group (2.11 ± 0.51 %/area). There was a reduction in the Bowman's space in CAF group (104.4 ± 5.2 μm) compared to C group (154.3 ± 15.0 μm) and the AET prevented this decrease in CAFT (117.3 ± 5.3 μm). No changes were observed in the glomerular tuft area, however the CAF group showed a tendency to reduce Bowman's capsule area compared to C group (405.04 ± 21.23 vs. 470.7± 16.5 μm; p= 0.07). Protein expression of p‐AMPK increased in the CAFT group compared to the T group but there were no changes in t‐AMPK, t‐ACC, p‐ACC, PGC1‐α, SIRT‐1 expressions. In conclusion, our results showed that AET was efficient to prevent lipid deposition, the exacerbation of GFR and morphological impairments associated with insulin resistance. These responses may be associated, at least in part, with the increase in p‐AMPK in the kidney.Support or Funding InformationFAPESP # 2015/04948‐4.

Differentiated contribution of fat pads to the prevention of insulin resistance through aerobic exercise training

Increased white adipose tissue (WAT) is associated with the development of insulin resistance (IR), and this response may be due to impaired insulin signaling caused by excess of lipids. Aerobic exercise training (AET) prevents IR by improving lipid oxidation and glucose metabolism. Here we evaluated the relative contribution of fat pads to the prevention of IR through AET. Adult male C57BL6/J mice were assigned into chow‐fed controls (C, n=5), cafeteria diet (CAF, n=5), chow‐fed trained (T, n=5), and cafeteria diet plus trained (CAFT, n=5). AET was performed simultaneously with diet and consisted of 8‐wk running session of 60 min at 60% of maximal speed, 5 days/wk. Experimental procedures were approved by Ethics Committee from Faculty of Medicine of University of São Paulo (# 002/15). The body weight of T and CAFT groups were lower from the third week of experimental protocol compared to C. The CAF group had higher retroperitoneal (RP) and subcutaneous (SC) WAT weights compared to C, but the AET was able to prevent these increases in CAFT group. The T group presented lower periepididimal (PE) WAT compared to other groups, but interscapular BAT weight did not differ among groups. Cafeteria diet induced glucose intolerance and IR in CAF group (AUC: 35200± 1076 mg/dL/120min; kITT: 2,5 ± 0,17 %/min, respectively) compared to C group (AUC: 28333±1305 mg/dL/120min; kITT:, 3,7 ± 0,21 %/min respectively) during glucose and insulin tolerance tests, respectively, which were counteracted by AET in CAFT group (AUC: 28896 ± 1133 mg/dL/120min; kITT: 3,9 ± 0,33 %/min, respectively). Protein expressions of GLUT‐4 and t‐AKT were not different among groups, but p‐AKT reduced in T, CAF and CAFT groups compared to C in the PE‐WAT, and the p‐AKT/t‐AKT ratio was lower in CAFT compared to C in SC‐WAT. There were no differences in t‐AMPK and p‐AMPK expressions in SC‐WAT, but increase in t‐AMPK and p‐AMPK in T and CAFT groups compared to C and CAF groups in PE‐WAT. Histological analysis of the SC‐WAT showed the presence of multilocular adipocytes agglometares in T and CAFT groups, which is typical of WAT browning. In conclusion, the prevention of IR by AET is associated with lower visceral and subcutaneous WAT deposition, changes in the expression of metabolic proteins in PE‐WAT, such as reduction in p‐AKT and increase in t‐AMPK and p‐AMPK, and browning in the SC‐WAT.Support or Funding InformationFAPESP # 2015/04948‐4.

Chronic supplementation with dietary proanthocyanidins protects from diet-induced intestinal alterations in obese rats.

Increased attention has been paid to the link between altered intestinal function and elevated incidence of metabolic disorders, such as in obesity. This study investigated in obese rats the role of grape seed proanthocyanidin extract (GSPE) chronic treatment, taken in a low, moderate, or high dose, on obesity-associated intestinal alterations in response to a cafeteria diet (CAF). To evaluate the degree of intestinal inflammation, reactive oxygen species (ROS) production and myeloperoxidase (MPO) activity were measured as well as the expression of inflammatory-related genes. The barrier integrity was assessed by quantifying the gene expression of tight-junction components and measuring the plasma LPS. GSPE decreased the ROS levels and MPO activity, without substantial differences among the doses. The supplementation with moderate and high GSPE doses significantly decreased iNOS expression compared to the CAF group, and the same pattern was observed in the low-dose animals with respect to IL-1β expression. Moreover, the results show that GSPE significantly increases zonulin-1 expression with respect to the CAF animals. This study provides evidence for the ameliorative effect of a proanthocyanidin extract on high-fat/high-carbohydrate diet-induced intestinal alterations, specifically reducing intestinal inflammation and oxidative stress and suggesting a protection against a barrier defect.

Impact of a cafeteria diet and daily physical training on the rat serum metabolome.

Regular physical activity and healthy dietary patterns are commonly recommended for the prevention and treatment of metabolic syndrome (MetS), which is diagnosed at an alarmingly increasing rate, especially among adolescents. Nevertheless, little is known regarding the relevance of physical exercise on the modulation of the metabolome in healthy people and those with MetS. We have previously shown that treadmill exercise ameliorated different symptoms of MetS. The aim of this study was to investigate the impact of a MetS-inducing diet and different intensities of aerobic training on the overall serum metabolome of adolescent rats. For 8 weeks, young rats were fed either standard chow (ST) or cafeteria diet (CAF) and were subjected to a daily program of training on a treadmill at different speeds. Non-targeted metabolomics was used to identify changes in circulating metabolites, and a combination of multivariate analysis techniques was implemented to achieve a holistic understanding of the metabolome. Among all the identified circulating metabolites influenced by CAF, lysophosphatidylcholines were the most represented family. Serum sphingolipids, bile acids, acylcarnitines, unsaturated fatty acids and vitamin E and A derivatives also changed significantly in CAF-fed rats. These findings suggest that an enduring systemic inflammatory state is induced by CAF. The impact of physical training on the metabolome was less striking than the impact of diet and mainly altered circulating bile acids and glycerophospholipids. Furthermore, the serum levels of monocyte chemoattractant protein-1 were increased in CAF-fed rats, and C-reactive protein was decreased in trained groups. The leptin/adiponectin ratio, a useful marker of MetS, was increased in CAF groups, but decreased in proportion to training intensity. Multivariate analysis revealed that ST-fed animals were more susceptible to exercise-induced changes in metabolites than animals with MetS, in which moderate-intensity seems more effective than high-intensity training. Our results indicate that CAF has a strong negative impact on the metabolome of animals that is difficult to reverse by daily exercise.

A cafeteria diet triggers intestinal inflammation and oxidative stress in obese rats

The gastrointestinal alterations associated with the consumption of an obesogenic diet, such as inflammation, permeability impairment and oxidative stress, have been poorly explored in both diet-induced obesity (DIO) and genetic obesity. The aim of the present study was to examine the impact of an obesogenic diet on the gut health status of DIO rats in comparison with the Zucker (fa/fa) rat leptin receptor-deficient model of genetic obesity over time. For this purpose, female Wistar rats (n 48) were administered a standard or a cafeteria diet (CAF diet) for 12, 14·5 or 17 weeks and were compared with fa/fa Zucker rats fed a standard diet for 10 weeks. Morphometric variables, plasma biochemical parameters, myeloperoxidase (MPO) activity and reactive oxygen species (ROS) levels in the ileum were assessed, as well as the expressions of proinflammatory genes (TNF-α and inducible nitric oxide synthase (iNOS)) and intestinal permeability genes (zonula occludens-1, claudin-1 and occludin). Both the nutritional model and the genetic obesity model showed increased body weight and metabolic alterations at the final time point. An increase in intestinal ROS production and MPO activity was observed in the gastrointestinal tracts of rats fed a CAF diet but not in the genetic obesity model. TNF-α was overexpressed in the ileum of both CAF diet and fa/fa groups, and ileal inflammation was associated with the degree of obesity and metabolic alterations. Interestingly, the 17-week CAF group and the fa/fa rats exhibited alterations in the expressions of permeability genes. Relevantly, in the hyperlipidic refined sugar diet model of obesity, the responses to chronic energy overload led to time-dependent increases in gut inflammation and oxidative stress.

Impact of Atrial Natriuretic Peptide Value for Predicting Paroxysmal Atrial Fibrillation in Ischemic Stroke Patients

The impact of atrial natriuretic peptide (ANP) value for predicting paroxysmal atrial fibrillation (pAF) in ischemic stroke patients remains uncertain. The consecutive 222 ischemic stroke patients (median 77 [IQR 68-83] years old, 93 females) within 48 hours after onset were retrospectively studied. Plasma ANP and brain natriuretic peptide (BNP) levels were simultaneously measured at admission. Of all, 158 patients had no evidence of atrial fibrillation (AF) (sinus rhythm [SR] group), 25 patients had pAF (pAF group), and the other 39 patients had chronic AF (cAF group). We investigated predicting factors for pAF, with focus on ANP, BNP, and ANP/BNP ratio. ANP value was significantly higher in the pAF than in the SR group (97 [50-157] mg/dL versus 42 [26-72] mg/dL, P < .05) and further increased in the cAF group (228 [120-392], P < .05 versus pAF and SR groups). Similarly, the BNP value was higher in the pAF than in the SR group (116 [70-238] mg/dL versus 34 [14-72] mg/dL, P < .05) and further increased in the cAF group (269 [199-423], P < .05 versus pAF and SR groups). ANP/BNP ratio was lower in the pAF and cAF groups than in the SR group (.6 [.5-1.2] and .7 [.5-1.0] versus 1.3 [.8-2.4], both P < .05]. Multivariate analysis in the SR and pAF groups (n = 183) demonstrated that age, congestive heart failure, ANP, and BNP, but not ANP/BNP ratio, were independent predictors for detecting pAF. Receiver operating characteristic curve analysis further showed that area under the curve was similar between ANP and BNP (.76 and .80). ANPmay be clinically useful for detecting pAF in ischemic stroke patients as well as BNP.

Increased α-Actinin-2 Expression in the Atrial Myocardium of Patients with Atrial Fibrillation Related to Rheumatic Heart Disease

Objectives: Atrial fibrosis, a marker of atrial structural remodeling, plays a critical role in atrial fibrillation (AF). α- Actinin-2 is associated with structural remodeling related to stretching. The transforming growth factor-β₁ (TGF-β1)/Smad pathway plays an important role in atrial fibrosis. We investigated the effects of the TGF-β1/Smad signaling pathway on α-actinin-2 in atrial fibrosis in patients with AF. Methods: Forty-one right atrial specimens obtained from patients with rheumatic heart disease (RHD) were divided into a chronic (c)AF group, i.e. RHD + cAF (n = 29), and a sinus rhythm group, i.e. RHD + sinus rhythm (n = 12). Patients with congenital heart disease (CHD) and sinus rhythm who underwent heart surgery served as controls (n = 10). Fibrosis was assessed by histological examination, and expression of α-actinin-2, TGF-β1 and Smad2/phosphorylated Smad2 (p-Smad2) was evaluated by immunohistochemistry, quantitative real-time PCR and Western blotting. In rat atrial fibroblasts treated with TGF-β1, the collagen content was measured using hydroxyproline detection, and α-actinin-2 and p-Smad2 were evaluated by semiquantitative reverse-transcription PCR and Western blotting. Results: The histology results revealed a significant increase in atrial fibrosis in AF patients. The collagen content, mRNA and protein expression levels of α-actinin-2 and the components of the TGF-β1/Smad signaling pathway were significantly gradually increased in the CHD + sinus rhythm, RHD + sinus rhythm and RHD + cAF groups (p < 0.05). The mRNA and protein levels of α-actinin-2 and TGF-β1 in RHD patients were positively correlated with the collagen volume fraction. A positive correlation between the expression of α-actinin-2 and TGF-β1 was also observed. In rat atrial fibroblasts treated with TGF-β1, the collagen content was greater than that in the control group (p < 0.05), and the expression levels of α- actinin-2 and p-Smad2 were also upregulated (p < 0.05). Conclusions: α-Actinin-2 expression was increased in the atrial tissues of patients with AF secondary to RHD. α-Actinin-2 was upregulated via the TGF-β1/Smad pathway in atrial fibroblasts, which suggests that it may be involved in TGF-β1/Smad pathway-induced atrial fibrosis in patients with AF.

Caffeine supplementation delays the fatigue through central nervous system modulation

This study verifies if caffeine supplementation delays the onset of fatigue, enhancing performance, and whether this effect is due to modulation of the caffeine in the rating of perceived exertion, motor drive activation, autonomic nervous system, and energy metabolism. Nine recreational athletes were submitted to two constant load tests after supplementation of caffeine and placebo. In both conditions, the fatigue was not identified by the motor drive activity, autonomic nervous system, and energy metabolism. CAF group improved performance (total time until exhaustion) in 27 % compared with PLA (1220 ± 245 vs 963 ± 243 s, P < 0.05). When compared with the absolute time, the RPE presents a reduction on the final term of the caffeine condition on the same time when compared with the placebo condition (17 ± 2 vs 19 ± 1, P < 0.05). This ergogenic effect has not changed cardiac autonomic activity and energy metabolism. We showed that caffeine supplementation increases the time associated with a reduction in the ratings of perceived exertion concluding that fatigue is controlled by central mechanisms.

Coronally advanced flap with or without porcine collagen matrix for root coverage: a randomized clinical trial.

The objective of this study is to clinically evaluate the outcomes following treatment of single gingival recessions with either coronally advanced flap technique (CAF) alone or combined with a porcine collagen matrix graft (CM). This is a randomized parallel design clinical trial, including forty patients with single Miller Class I or II gingival recession, with a depth≥2mm and located at upper canines or premolars. The patients were randomly assigned to receive either CAF or CAF+CM. The primary outcome variable was gingival recession reduction (Rec Red). Baseline recession depth was 3.14±0.51mm for CAF group and 3.16±0.65mm for CAF+CM group (p>0.05). Both groups showed significant Rec Red (p<0.05), up to 6months. Rec Red for CAF+CM was 2.41±0.73mm and was 2.25±0.50mm for CAF alone (p>0.05). Root coverage was 77.2% in the CAF+CM group and 72.1% in the CAF group (p>0.05). Complete root coverage (CRC) was found in 40% of the cases in the CAF+CM group and in 35% of the sites treated with CAF. Keratinized tissue thickness (KTT) was 0.26mm higher in CAF+CM group (p<0.05). It can be concluded that CAF+CM does not provide a superior recession reduction when compared to CAF; however, it may offer a small gain in KTT after 6months. CAF+CM can be suggested as a valid therapeutic option to achieve root coverage and some increase in soft tissue thickness after 6months.

Obesity and Hyperlipidemia Modulate Alveolar Bone Loss in Wistar Rats.

A positive association between obesity-associated metabolic disorders (e.g., hyperlipidemia and diabetes) and periodontitis has been demonstrated in the literature. This study evaluates the role of cafeteria diet-induced obesity/hyperlipidemia (CAF) on alveolar bone loss (ABL) in rats. Sixty male Wistar rats were randomly divided in four groups: control, periodontitis (PERIO), obesity/hyperlipidemia (CAF), and obesity/hyperlipidemia plus periodontitis (CAF+PERIO). Groups CAF and CAF+PERIO were exposed to a high-fat, hypercaloric diet. At week 12, periodontal disease was induced in groups PERIO and CAF+PERIO by ligatures in the upper second molar. The contralateral tooth was considered the intragroup control. Body weight and Lee index were evaluated weekly during the experiment. Serum glucose and cholesterol/triglycerides in the liver were evaluated, and percentage of ABL was measured by microcomputed tomography. Serum tumor necrosis factor (TNF)-α and interleukin (IL)-1β were evaluated by enzyme-linked immunosorbent assay at week 17. Body weight, Lee index, and cholesterol/triglycerides in the liver increased in groups exposed to the cafeteria diet. Groups PERIO and CAF+PERIO exhibited a significantly higher ABL compared to control and CAF groups. The presence of obesity and hyperlipidemia significantly increased ABL in the CAF+PERIO group compared to the PERIO group (53.60 ± 3.44 versus 42.78 ± 7.27, respectively) in the sides with ligature. Groups exposed to CAF exhibited higher ABL in the sides without ligature. No differences were observed among groups for IL-1β and TNF-α. Obesity and hyperlipidemia modulate the host response to challenges in the periodontium, increasing the expression of periodontal breakdown.

Obesity induced by cafeteria diet disrupts fertility in the rat by affecting multiple ovarian targets

Obesity constitutes a health problem of increasing worldwide prevalence. Among the health detriments caused by obesity, reproduction is disrupted. However, the mechanisms involved in this disruption are not fully understood. Animals fed a cafeteria diet constitute the model for the study of obesity that most closely reflects Western diet habits. The aims of this study were to evaluate whether a cafeteria diet affects ovarian function and to contribute to the understanding of the mechanisms involved. For that purpose, 22-day-old female Wistar rats were fed ad libitum with a standard diet (control group; n = 20) or cafeteria diet (CAF group; n = 20). The cafeteria diet induced obesity and hyperglycaemia, without altering serum triglycerides, cholesterol or C-reactive protein concentrations. This diet also altered ovarian function: the rats showed prolonged dioestrous phases, decreased serum oestradiol concentrations and increased number of antral atretic follicles. Moreover, follicular cysts were detected in the CAF group, concomitantly with a decrease in the number of anti-Müllerian hormone immunoreactive pre-antral follicles and COX-2-positive antral and pre-ovulatory follicles. The authors conclude that a cafeteria diet reduces ovarian reserve, induces the presence of follicular cysts and disturbs the ovulatory process, leading to the delayed pregnancy observed in these animals.

Effects of palatable cafeteria diet on cognitive and noncognitive behaviors and brain neurotrophins' levels in mice.

The consumption of palatable high-fat and high-sugar foods have increased dramatically over the past years. Overconsumption of calorically dense food contributes to increasing rates of overweight and obesity that are associated with psychiatry disorders, in particular mood and anxiety disorders. This study evaluated the impact of palatable cafeteria diet (CAF) intake on cognitive and noncognitive behaviors, as well as identified factors related to these behaviors through an evaluation of brain neurotrophic factor (BDNF, NGF, and GDNF) levels in hippocampus of mice. Male Swiss mice received two different diets during 13weeks: standard chow (STA) and highly CAF. Posteriorly, forced swimming test (FST), tail suspension test (TST), plus-maze test (PMT), open-field tests (OFT), and object recognition task (ORT) were utilized as behavioral tests. In addition, brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), and nerve growth factor (NGF) neurotrophins' levels were evaluated in hippocampus of mice. The results demonstrated that mice from the CAF group showed a decrease in the immobility time in the FST and TST. Besides, mice in the CAF group spent more time in the open arms of the PMT. No significant differences were observed in the cognitive behaviors, which were evaluated in the OFT and ORT. In addition, the CAF group showed that BDNF and NGF protein levels increased in the hippocampus of mice. In conclusion, our data suggest that the consumption of palatable high-fat and high-sugar foods induces antidepressant- and anxiolytic-like behaviors, which can be related with BDNF and NGF expression increases in hippocampus of mice in the CAF group.

Effects of dietary supplementation with fermented ginkgo leaves on antioxidant capacity, intestinal morphology and microbial ecology in broiler chicks

The purpose of this study was to evaluate the effects of supplementing diets with three types of fermented Ginkgo-leaves (FGL) on growth, antioxidant capacity, intestinal morphology and microbial ecology in broiler chicks.A total of 300 d-old broilers were randomly allocated to 4 dietary treatments with 6 replications of 10 birds each. Birds were fed on basal diets (Control) or basal diets supplemented with 0.5% FGL with Candida utilis (CF group), Aspergillus niger (AF group) or their combined fermentation (CAF group), respectively, for a 42 d feeding trial.AF and CAF supplementation improved body weight gain (BWG) (22–42 d) and feed conversion ratio (22–42 d and 1–42 d). Concentrations of serum α-tocopherol in CAF group, as well as hepatic α-tocopherol in the three FGL groups were increased, while hepatic reactive oxygen species (ROS) levels were greatly decreased in group AF and CAF. Chickens in AF and CAF groups had decreased hepatic protein carbonyls and malondialdehyde (MDA), as well as jejunal and ileal protein carbonyls. The total superoxide dismutase (T-SOD) activities and glutathione (GSH) of both jejunum and ileum of the CAF group were higher than the other groups.Duodenal and jejunal villous height of birds fed on the AF and CAF diets were increased, while jejunal crypt depth (CD) was decreased. Furthermore, birds fed on AF and CAF supplemented diets had increased ileal lactobacilli populations. Decreased ileal and caecal Escherichia coli and Salmonellas populations was found for the birds fed on CAF supplemented diets.The present study may indicate that the improved feed efficiency and intestinal functions in the group supplemented with AF and CAF are directly connected with the improved antioxidant capacity and intestinal microbial ecology.

Evaluation of root coverage with and without connective tissue graft for the treatment of single maxillary gingival recession using an image analysis system: a randomized controlled clinical trial.

The aim of this prospective randomized clinical study was to evaluate, by means of an image analysis system, the efficacy of two different surgical procedures for the treatment of Miller Class I and II maxillary gingival recession. Patients treated for maxillary gingival recession were recruited and randomly divided into two groups: patients who received a coronally advanced flap with connective tissue graft (CAF + CTG) or CAF alone. Outcome parameters included complete root coverage, recession reduction, and keratinized tissue amount. Twenty-five patients completed the 12-month follow-up period. Patients in the CAF + CTG group showed a better primary outcome- gingival recession at 12 months-than CAF patients (P = .0001). Gingival recession at 12 months had a median of 0.5 (interquartile range [IQR] 0.5 to 0.6) in the CAF + CTG group and a median of 1.0 (IQR 0.9 to 1.1) in the CAF group. CAF + CTG and CAF groups had similar complete root coverage at 6 and 12 months. Recession and keratinized tissue width significantly decreased over time (P < .0001), with no effect of treatment or of treatment over time. Buccal probing depth had similar values over time (P = .28) and in the two groups (P = .52). Buccal clinical attachment level had similar values in the two groups (P = .87); moreover, mesial and distal clinical attachment levels did not show any variation over time (P = .88 and P = .68, respectively). By means of a computerized image analysis system better outcomes in terms of recession reduction after 12 months of follow-up were measured for maxillary gingival recessions treated with CAF and CTG. Adjunctive application of a CTG under a CAF increased the probability of achieving complete root coverage in maxillary Miller Class I and II defects (61.5% versus 83.3%; P = .38). Both treatments were equally effective in providing a consistent reduction of the baseline recession.

Image quality and radiation dose of single heartbeat 640-slice coronary CT angiography: A comparison between patients with chronic Atrial Fibrillation and subjects in normal sinus rhythm by propensity analysis

ObjectivesTo evaluate image quality and radiation dose of single heartbeat 640-slice coronary CT angiography (CCTA) in patients with chronic Atrial Fibrillation (cAF) in comparison with subjects in normal sinus rhythm. MethodsA cohort of 71 patients with cAF was matched with 71 subjects in normal sinus rhythm (NSR) and HR≤65bpm using a matched by propensity analysis. All subjects underwent a single heartbeat CCTA with prospective gating. In subjects with cAF, we manually established the acquisition of data only from a single heartbeat. Mean effective dose and image quality, with both objective and subjective measures, were assessed. Results96.4% of all segments in the cAF group had diagnostic image quality. The rate of subjects with at least one non-diagnostic segment was 14% and 2.8% (p=0.031) in the cAF and NRS groups, respectively. In the cAF group, the percentage of patients with at least one non-diagnostic segment for acquisition HR≤72 was 1.8% (1/55), and it did not significantly differ from the NSR group (2.8%; 2/71) (p=1.0). Objective quality parameters did not show a statistically significant difference between the two groups. The mean effective dose was 4.24±1.24mSv in the cAF group and 2.67±0.5mSv in the sinus rhythm group (p<0.0001) with an increase by 59% in the cAF group with respect to the SNR group. ConclusionsA single heartbeat acquisition protocol with a 640-slice prospectively ECG-triggered CT angiography may be feasible in patients with cAF and HR below 72bpm at the CT acquisition, although mean effective dose of this protocol in cAF group was 59% higher than in sinus rhythm one. In patients with cAF and a heart rate higher than 72bpm, CCTA tends to have more movement-associated artefacts.

Caffeine Mitigates Lung Inflammation Induced by Ischemia-Reperfusion of Lower Limbs in Rats.

Reperfusion of ischemic limbs can induce inflammation and subsequently cause acute lung injury. Caffeine, a widely used psychostimulant, possesses potent anti-inflammatory capacity. We elucidated whether caffeine can mitigate lung inflammation caused by ischemia-reperfusion (IR) of the lower limbs. Adult male Sprague-Dawley rats were randomly allocated to receive IR, IR plus caffeine (IR + Caf group), sham-operation (Sham), or sham plus caffeine (n = 12 in each group). To induce IR, lower limbs were bilaterally tied by rubber bands high around each thigh for 3 hours followed by reperfusion for 3 hours. Caffeine (50 mg/kg, intraperitoneal injection) was administered immediately after reperfusion. Our histological assay data revealed characteristics of severe lung inflammation in the IR group and mild to moderate characteristic of lung inflammation in the IR + Caf group. Total cells number and protein concentration in bronchoalveolar lavage fluid of the IR group were significantly higher than those of the IR + Caf group (P < 0.001 and P = 0.008, resp.). Similarly, pulmonary concentrations of inflammatory mediators (tumor necrosis factor-α, interleukin-1β, and macrophage inflammatory protein-2) and pulmonary myeloperoxidase activity of the IR group were significantly higher than those of the IR + Caf group (all P < 0.05). These data clearly demonstrate that caffeine could mitigate lung inflammation induced by ischemia-reperfusion of the lower limbs.

Association between transforming growth factor β1 and atrial fibrillation in essential hypertensive patients

Background: Transforming growth factor β1 (TGFβ1) was one of the main factors for accelerating atrial fibrosis and has been reported with significantly higher level in plasma of the patients with essential hypertension (EH), especially in those with target organ damage. The contribution of TGFβ1 in the pathogenesis of atrial fibrillation (AF) in EH patients remains unknown. Methods: 75 EH patients with documented AF were divided into the paroxysmal AF group (EH+pAF, n = 44) or the chronic AF group (EH+cAF, n = 31), and 37 EH patients with sinus rhythm (SR) were assigned into the EH+SR group. All data including EH duration, blood pressure, lipids, glucose and left atrial diameter (LAD) measured by ultrasonic cardiogram were recorded. The serum levels of TGFβ1 and connective tissue growth factor (CTGF) were detected, and compared with normal controls (NC group, n = 36). Results: The serum levels of TGFβ1 and CTGF in all EH groups were significantly higher than those in the NC group (p < 0.001, respectively). Among the EH groups, TGFβ1 and CTGF levels were highest in the cAF group, followed by the pAF and the SR groups (p < 0.005). However, no significant difference was observed in TGFβ1 and CTGF levels between the cAF group and the pAF group. The serum TGFβ1 in AF patients was independently correlated with LAD, the presence of AF, aldosterone, CTGF and age. Conclusion: The serum TGFβ1 promotes CTGF synthesis and causes left atrial enlargement and remodeling, which is possibly involved in the pathogenesis of AF in EH patients.

Do-It-Together Finance! A participatory action research on community-based finance systems in the Netherlands

This paper provides insights into the operational features of community-based financing mechanisms like CAF groups. CAF groups are self-financed communities where people save and lend money to each other. The implementation of such self- financed communities in the Netherlands is supported by participatory action research. This paper discusses the first results of this research by exploring whether and how participation of group members can improve their well-being in regard to social networks, financial household management and entrepreneurial positioning based on the capability approach of Sen. For this participatory action research, three groups have been set up, guided, observed, analysed and compared. This paper demonstrates how solidarity economy processes at the grassroots can contribute to the general well-being of vulnerable people in The Netherlands. Sen’s notion of freedom has to be reconsidered when discussed in a context. For this context of overconsumption, inequality and overindebtedness, Sen’s notion of freedom will be reconsidered and adjusted.

Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivative for root coverage: a RCT using 3D digital measuring methods. Part II. Volumetric studies on healing dynamics and gingival dimensions

The aim of this randomized clinical trial (RCT) was to compare the clinical performance of the tunnel technique with subepithelial connective tissue graft (TUN) versus a coronally advanced flap with enamel matrix derivative (CAF) in the treatment of gingival recession defects. The use of innovative 3D digital measuring methods allowed to study healing dynamics at connective tissue (CT)-grafted sites and to evaluate the influence of the thickness of the root covering soft tissues on the outcome of surgical root coverage. Twenty-four patients contributed a total of 47 Miller class I or II recessions for scientific evaluation. Precise study models collected at baseline and follow-up examinations were optically scanned and virtually superimposed for digital evaluation of clinical outcome measures including mean marginal soft tissue thickness (THK). Healing dynamics were measured in a defined region of interest at CT-grafted sites where volume differences between time points were calculated. At 12months, recession reduction as well as mean root coverage were significantly better at CT-grafted sites treated in the TUN group (1.94mm and 98.4% respectively) compared to the non-augmented sites of the CAF group (1.17mm and 71.8% respectively) and statistical analysis revealed a positive correlation of THK (1.63mm TUN versus 0.91mm CAF, p<0.0001) to both these variables. Soft tissue healing following surgical root coverage with CT-grafting was mainly accomplished after 6months, with around two-thirds of the augmented volume being maintained after 12months. The TUN resulted in thicker gingiva and better clinical outcomes compared to CAF. Increased gingival thickness was associated with better surgical outcomes in terms of recession reduction and root coverage.

Development of an alternative non-obese non-genetic rat model of type 2 diabetes using caffeine and streptozotocin

BackgroundThe aim of the present study was to develop an alternative non-obese non-genetic rat model of type 2 diabetes (T2D). MethodsSix-week-old male SD rats were randomly divided into six groups, namely: Normal Control (NC), Diabetic Control (DBC), Caffeine 5mg/kg BW+STZ (CAF5), Caffeine 10mg/kg BW+STZ (CAF10), Caffeine 20mg/kg BW+STZ (CAF20) and Caffeine 40mg/kg BW+STZ (CAF40) and were fed a normal rat pellet diet and drinking water ad libitum throughout the experimental period. After a one week acclimatization period, diabetes was induced in the animals in DBC and all CAF groups with an injection (i.p.) of the respective dosages of caffeine (mg/kg BW) 15min before the injection of STZ (65mg/kg BW) when normal saline was injected to the DBC group instead of caffeine. The NC group received normal saline and buffer instead of caffeine and STZ, respectively. One week after the STZ injection, animals with non-fasting blood glucose>300mg/dl were considered as diabetic. Three weeks after the STZ injection, the animals in the CAF5 and CAF10 groups were eliminated from the study due to the severity of diabetes and the experiment was continued with the remainder groups for a 13 weeks period. Results and conclusionThe data of food and fluid intake, body weight, blood glucose, glucose tolerance test, HOMA-IR, HOMA-beta, serum insulin, fructosamine, lipid profile and organ specific enzymes, anti-diabetic drug response tests, and pancreatic histopathology suggest that CAF20 group can be a better alternative non-genetic model of non-obese T2D.