Circulatory Research Articles

Changes in heart rate variability and subclinical heart failure with preserved left ventricular ejection fraction in workers of the main professions at the coal industry

Introduction. The high prevalence of diseases of the circulatory system necessitates their detection and prevention at an early stage, especially in regions with high industrial potential. The occurrence of subclinical heart failure depends on a cascade of processes that are already occurring in the body and may eventually manifest themselves in clinically pronounced diseases. One of the possible mechanisms of its development is a violation of the balance of the autonomic nervous system with a violation of adaptive capabilities to the labour process, characterized by severe physical overloads among miners. The study aims to evaluate changes in heart rate variability in workers of the main professions at the coal industry with signs of heart failure with a preserved left ventricular ejection fraction. Materials and methods. The study included 78 employees of the main professions at the coal industry. Specialists performed ultrasound examination of the heart according to generally accepted methods with the study of longitudinal deformation of the myocardium. The concentration of NT-proBNP in the blood serum was determined by solid-phase enzyme immunoassay. The authors also conducted an analysis of heart rate variability, determined temporal, spectral and linear parameters. Results. Specialists revealed a decrease in longitudinal myocardial deformation in 38.5% of the examined patients, signs of diastolic dysfunction in 41%; in these groups, a tendency to increase the concentration of NT-proBNP was revealed. In the examined miners with heart failure with preserved ejection fraction, they revealed a significant decrease in the SDNN index and an increase in IC values. The increase in DFA and LF/HF indicators reflects a vegetative imbalance towards sympathetic activation observed in all surveyed miners. Limitations. This study is limited to a sample of employees of the main professions of the coal industry undergoing periodic medical examination at the Research Institute of Complex Problems of Hygiene and Occupational Diseases. Conclusion. The revealed relationship between indicators of heart failure and heart rate variability (SDNN, LF/HF, DFA and IC) in miners allows us to identify a group of people at greatest risk of adverse outcomes. Ethics. The study was conducted in compliance with the standards of the Bioethical Committee of the Research Institute of Complex Problems of Hygiene and Occupational Diseases, established in accordance with the Helsinki Declaration of the World Medical Association "Ethical Principles of Conducting medical Research with human participation as a subject" as amended in 2013 and the "Rules of Good Clinical Practice" approved by Order No. 200n of the Ministry of Health of the Russian Federation dated 04/01/2016. The subjects signed an informed consent to participate in the study.

Endothelial dysfunction in combination of occupational pathology of the respiratory system and atherosclerosis in coal industry workers

Introduction. The increasing prevalence of cardiovascular pathology among industrial workers determines the importance of studying not only occupational diseases, but also their combination with diseases of the circulatory system. Endothelial dysfunction is a key link in the pathogenesis of atherosclerosis. Evaluation of endothelial function indicators in occupational respiratory diseases in combination with atherosclerosis in workers of the coal mining industry is an urgent task. The study aims to consider the indicators of endothelial function in miners with occupational respiratory diseases in combination with atherosclerosis. Materials and methods. The authors have examined 88 miners with previously diagnosed occupational respiratory diseases (chronic dust bronchitis, anthracosilicosis, chronic obstructive pulmonary disease), 45 of them showed signs of atherosclerosis. There were two comparison groups without signs of atherosclerosis: 44 miners who work long-term in harmful working conditions, without lung pathology (control group) and 42 residents of Novokuznetsk who have never worked in harmful working conditions, and without lung pathology (unexposed group). Results. We found that miners with occupational respiratory diseases in combination with atherosclerosis had several forms of endothelial dysfunction: vasomotor (decreased synthesis of nitric oxide, increased endothelin-1 levels), hemostatic (increased levels of Willebrand factor), adhesive (increased levels of endothelial adhesion molecules sVCAM-1). The development of respiratory insufficiency in miners with occupational respiratory diseases increases endothelial dysfunction: miners with respiratory insufficiency have lower levels of nitric oxide (NO), higher levels of endothelin-1 and endothelial adhesion molecules sVCAM-1 than miners without respiratory insufficiency. There are correlations between indicators of endothelial function and production factors: with work experience in harmful working conditions, the level of the average concentration of coal-rock dust in the workplace and the frequency of exceeding the maximum permissible concentration of coal-rock dust. Limitations. The study is limited to a sample of workers in the main professions of coal mines who were examined at the Research Institute of Complex Hygiene Problems and Occupational Diseases, aged 40 to 54 years, with more than 15 years of experience working in underground dust conditions. Conclusion. Miners with occupational respiratory diseases in combination with atherosclerosis develop several forms of endothelial dysfunction: vasomotor, hemostatic, adhesive. The development of respiratory failure increases endothelial dysfunction. Ethics. This medical study involving a human as a subject was carried out in compliance with the Ethical principles presented in the latest version of the Helsinki Declaration, developed by the World Medical Association.

Anthrax lethal toxin exerts potent metabolic inhibition of the cardiovascular system

ABSTRACT Bacillus anthracis causes anthrax through a combination of bacterial infection and toxemia. As a major virulence factor of B. anthracis , anthrax lethal toxin (LT) is a zinc-dependent metalloproteinase, exerting its cytotoxicity through proteolytic cleavage of the mitogen-activated protein kinase kinases, thereby shutting down the MAPK pathways. Anthrax lethal toxin induces host lethality mostly by targeting the cardiovascular system. Although the enzymatic activity and the molecular targets of LT have long been known, the detailed mechanisms underlying cellular/tissue/organ toxicity are still poorly understood. In this work, we sought to investigate the mechanism of LT-induced cellular damage in the cardiovascular system. We demonstrate for the first time that anthrax lethal toxin has potent inhibitory effects on the central metabolism of cardiomyocytes and endothelial cells. This is likely due to the observed downregulating of c-Myc expression through the toxin-induced inhibition of the ERK pathway. Since c-Myc is a master transcription factor controlling the expression of many rate-limiting metabolic enzymes in glycolysis and the tricarboxylic acid cycle, LT’s downregulation of c-Myc may lead to the observed bioenergetic collapse, particularly, in cardiomyocytes. Since cardiac cell contraction requires continuous production of large amounts of ATP, potent inhibition of the bioenergetics of cardiomyocytes would be incompatible with life. Thus, LT-induced lethality through targeting cardiomyocytes and endothelial cells appears to be a consequence of a bioenergetic collapse, likely due to the toxin’s potent inhibitory activity on the MEK-ERK-c-Myc-metabolic/bioenergetic axis within these target cells of cardiovascular system. IMPORTANCE Anthrax lethal toxin (LT) is a major virulence factor of Bacillus anthracis , the causative pathogen of anthrax disease. Anthrax lethal toxin is a metalloproteinase that cleaves and inactivates MEKs, thereby shutting down MAPK pathways, leading to host mortality primarily through targeting of the cardiovascular system. However, the detailed mechanisms underlying the toxin’s cellular and tissue toxicity are still poorly understood. Here, we found that anthrax lethal toxin has potent inhibitory activity on glycolysis and oxidative phosphorylation of cardiomyocytes and endothelial cells. These effects appear to be the consequence of downregulation of c-Myc, a master transcription factor that controls many rate-limiting enzymes of glycolysis and the tricarboxylic acid cycle. With the high demand on energy for cardiac contraction, the potent inhibition of cardiomyocyte metabolism by LT would be incompatible with life. This work provides critical insights into why the cardiovascular system is the major in vivo target of LT-induced lethality.

Role of Plant Phytochemicals: Resveratrol, Curcumin, Luteolin and Quercetin Indemyelination, Neurodegeneration, and Epilepsy

Polyphenols are an important group of biologically active compounds present in almost all food sources of plant origin and are primarily known for their anti-inflammatory and antioxidative capabilities. Numerous studies have indicated their broad spectrum of pharmacological properties and correlations between their increased supply in the human diet and lower prevalence of various disorders. The positive effects of polyphenols application are mostly discussed in terms of cardiovascular system well-being. However, in recent years, they have also increasingly mentioned as prophylactic and therapeutic factors in the context of neurological diseases, being able to suppress the progression of such disorders and soothe accompanying symptoms. Among over 8000 various compounds, that have been identified, the most widely examined comprise resveratrol, curcumin, luteolin and quercetin. This review focuses on in vitro assessments, animal models and clinical trials, reflecting the most actual state of knowledge, of mentioned polyphenols’ medicinal capabilities in epilepsy, demyelinating and neurodegenerative diseases of the central nervous system.

Dapagliflozin or saxagliptin in pediatric type 2 diabetes: a plain language summary

Plain Language Summary What is this plain language summary about? The T2NOW study was a clinical trial which tested the use of two different blood sugar-reducing drugs (dapagliflozin or saxagliptin) in young people aged between 10 and 17 years with type 2 diabetes. Each drug was compared with a placebo to see to what extent the treatment can control blood sugar levels, and to observe any side effects. Type 2 diabetes is a chronic condition affecting how the body processes sugar, resulting in high levels of sugar in the blood. Over time, high blood sugar levels can cause damage to certain parts of the body such as the cardiovascular system, the kidneys, nerves, and eyes, often resulting in serious health problems. Once considered a disease of middle-age or older-age, it is becoming more common in younger people, in part because of an increase in childhood obesity. This is concerning, as when diabetes starts at a young age it can progress quickly and lead to these serious health problems earlier in life. Improvements in diet and exercise are important elements for everyone with type 2 diabetes. However, there are currently very few other treatments available for children and adolescents. What are the key takeaways? When compared to a group of participants receiving placebo in the study, participants receiving dapagliflozin had significantly improved blood sugar control but participants receiving saxagliptin did not. Both the dapagliflozin and saxagliptin treatments were generally well tolerated by participants, with similar proportions in each group experiencing side effects. Only one participant in each group stopped treatment because of side effects. Similar proportions of participants in all groups–including the placebo group–had hypoglycemia, suggesting that neither dapagliflozin nor saxagliptin affected the likelihood of experiencing this important side effect. What are the main conclusions reported by the researchers? The T2NOW study showed that dapagliflozin could be an addition to treatment options for young people with type 2 diabetes as it helped to control blood sugar levels and did not raise any safety concerns. In contrast, although there were no safety concerns related to use of saxagliptin, it did not significantly help to control blood sugar levels in this study. This is an abstract of the Plain Language Summary of Publication article. View the full Plain Language Summary PDF of this article to read the full-text Link to original article here

Prenatal diagnosis, ultrasound findings and pregnancy outcome of 7q11.23 deletion and duplication syndromes: what are the fetal features?

Analyze the ultrasound findings, single nucleotide polymorphism array (SNP-array) results, and pregnancy outcomes of fetuses with 7q11.23 deletions and duplications in the second and third trimesters. Investigate the prenatal ultrasound characteristics and follow up information of these fetuses. Seven fetuses were diagnosed with 7q11.23 deletion and six with 7q11.23 duplication via SNP-array at the prenatal diagnosis center of a single Chinese tertiary medical center from January 2017 to May 2024. Maternal demographics, ultrasound findings, SNP-array results, pregnancy outcomes, and follow-up information were comprehensively reviewed and analyzed. The copy number variations (CNVs) ranged from 1.43Mb to 1.78Mb in cases of 7q11.23 deletions and from 1.42Mb to 1.68Mb in cases of 7q11.23 duplications. These CNVs encompassed 29 OMIM-listed genes, including ELN, DNAJC30, GTF2IRD1, and GTF2I. Among the seven cases of 7q11.23 deletion syndrome, six exhibited ultrasound abnormalities. The main clinical phenotypes included three cases of intrauterine growth restriction and four cases of cardiovascular system abnormalities, specifically two cases with ventricular septal defects, one case with aortic narrowing, and one case with supravalvular pulmonary stenosis. One case was particularly notable, exhibiting complex multi-organ structural malformations. Out of six cases of 7q11.23 duplication syndrome, five exhibited ultrasound abnormalities. These included two cases of cardiovascular abnormalities: one case with a widened left ventricle and another case with a shortened fetal humerus length. One case revealed complex multi-organ structural malformations, including hydronephrosis, a microgallbladder, and a cleft lip and palate. All seven cases of 7q11.23 deletions and three cases of 7q11.23 duplications opted for termination of the pregnancy. The remaining three cases of 7q11.23 duplications chose to continue the pregnancy. One case underwent surgical treatment for a ventricular septal defect after birth, and the prognosis was favorable. Another case involved a full-term delivery, this child was followed up at the age of 4 and exhibited a phenotype of poor language expression ability. Our study broadened the clinical phenotype spectrum of fetuses with 7q11.23 deletions and duplications. Additionally, it conducted a preliminary evaluation of prenatal ultrasound findings and postnatal clinical phenotypes in follow-up cases. The clinical phenotype of fetuses with 7q11.23 deletion and duplication syndromes involves multiple systems and is relatively complex. Cardiovascular abnormalities and intrauterine growth restriction are the most common clinical manifestations observed in prenatal 7q11.23 deletion syndrome. Fetuses with 7q11.23 duplications exhibit a wide range of clinical phenotypes that lack specificity.

Fabrication of apigenin and adenosine-loaded nanoparticles against doxorubicin-induced myocardial infarction by reducing inflammation and oxidative stress.

The study's goals are to fabricate PLGA nanoparticles (PNPs) loaded with apigenin (AP) and adenosine (AD) using a microfluidic preparation method to a standard emulsification method and investigate the possible heart-protective effects of AP-AD PNPs made using the emulsification method. Compared to microfluidics, the emulsification method fabricated small-size nanoparticles, which are better at encapsulating drugs, retaining more drugs, and having a low viscosity for the myocardial infarction (MI) injection. TheMI model was developed using SD rats injected under the skin with 85mg/kg doxorubicin (DOX) for 2 days. The metabolic results showed that our AP-AD PNPs accelerated the blood flow in rats with MI, which increased the amounts of AP and AD in the circulatory system. This led to significant improvements in the cardiac index and lower amounts of AST, LDH, and CK in the blood. A histopathological study using Hematoxylin&eosin, and TUNEL staining showed that cardiac function had improved and apoptosis had decreased. Moreover, tests that checked the amounts of IL-6, TNF-α, NO, GSH, MDA, and SOD showed that AP-AD PNPs may help treat MI by reducing oxidative stress and inflammation, making it a potentially useful therapeutic approach.

SUMO regulation of ion channels in health and disease.

The Small Ubiquitin-like Modifier (SUMO) protein pathway governs a panoply of vital biological processes ranging from cell death, proliferation, differentiation, metabolism, and signal transduction by diversifying the functions, half-lives, and partnerships of target proteins in situ. More recently, SUMOylation has emerged as a key regulator of ion homeostasis and excitability across multiple tissues due to regulation of a plethora of ion channels expressed in a range of tissues subtypes. Altogether, the balance of SUMOylation states amongst relevant ion channels can result in graded biophysical effects that tune excitability and contribute to a range of disease states including cardiac arrythmia, epilepsy, pain transmission, and inflammation. Here, we consolidate these concepts by focusing on the role of ion channel SUMOylation in the central nervous system, peripheral nervous system and the cardiovascular system. In addition, we review what is known about the enigmatic factors that regulate the SUMO pathway and consider the emerging role of small molecule SUMO-modulators as potential therapeutics in a range of diseases.

Comparative Analysis of In Vitro Pumps Used in Cardiovascular Investigations: Focus on Flow Generation Principles and Characteristics of Generated Flows

A comprehensive analysis of in vitro pumps used in cardiovascular research is provided in this review, with a focus on the characteristics of generated flows and principles of flow generations. The cardiovascular system, vital for nutrient circulation and waste removal, generates complex hemodynamics critical for endothelial cell function. Cardiovascular diseases (CVDs) could be caused by the disturbances in these flows, including aneurysms, atherosclerosis, and heart defects. In vitro systems simulate hemodynamic conditions on cultured cells in the laboratory to study and evaluate these diseases to advance therapies. Pumps used in these systems can be classified into contact and non-contact types. Contact pumps, such as piston and gear pumps, can generate higher flow rates, but they have a higher risk of contamination due to the direct interaction of pump with the fluid. Non-contact pumps, such as peristaltic and lab-on-disk centrifugal pumps, minimize contamination risks, but they are limited to lower flow rates. Advanced pumps including piezoelectric and I-Cor diagonal pumps are focused on improving the accuracy of flow replication and long-term stability. The operational principles, advantages, and some disadvantages of these pump categories are evaluated in this review, while providing insights for optimizing in vitro cardiovascular models and advancing therapeutic strategies against CVDs. The outcomes of the review elaborate the importance of selecting an appropriate pump system, to accurately replicate cardiovascular flow patterns.

ECG signal reconstruction from PPG using a hybrid attention-based deep learning network

Electrocardiography (ECG) and photoplethysmography (PPG) are non-invasive methods used to quantify signals originating from the cardiovascular system. Although there is a strong correlation between the cycles of the two measures, the correlation between the waveforms has received little attention in research. Measuring the PPG is significantly simpler and more convenient compared to the ECG measure. Recent research has demonstrated that PPG signals can be utilized to rebuild the ECG signals, suggesting that healthcare professionals might acquire a comprehensive comprehension of patients' cardiovascular well-being by only measuring PPG. With the advancement of artificial intelligence, the deep learning model has made significant progress in reconstructing ECG signals from PPG signals. However, the quality of the reconstructed ECG signal is still in need of more enhancement. In order to enhance the quality of the reconstructed ECG signal, we propose an innovative hybrid attention-based bidirectional recurrent neural network (Bi-RNN) that incorporates a dilated convolutional neural network technique for the purpose of reconstructing ECG signals from PPG signals. This addresses issues that occur when standard dilated CNN (DCNN) models neglect the link between circumstances and dispersion of gradients. The suggested approach maximizes the utilization of the DCNN and Bi-RNN unit design to provide fusion features. In order to ensure the model's resilience to deformation, it is imperative to initially extract spatial properties utilizing convolutional neural networks (CNNs). Once we have obtained geographic data, we employ BiLSTM to extract temporal features. The proposed model is so-called hybrid attention-based CNN and BiLSTM (HA-CNN-BiLSTM). BiLSTM mitigates the issues of gradient vanishing and exploding while maintaining accuracy. To showcase the advantages of the suggested model, we conduct a comparison between HA-CNN-BiLSTM and each separate state-of-the-art method. The simulation results indicated that the proposed method yielded superior root mean square error (RMSE) when reconstructing the ECG signal across different optimizers. The results also demonstrated that the proposed method results in the lowest RMSE with SGDM optimizer which is 0.031.

The Complementary Role of Cardiopulmonary Exercise Testing in Coronary Artery Disease: From Early Diagnosis to Tailored Management

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, accounting for over 9 million deaths annually. The prevalence of CAD continues to rise, driven by ageing and the increasing prevalence of risk factors such as hypertension, diabetes, and obesity. Current clinical guidelines emphasize the importance of functional tests in the diagnostic pathway, particularly for assessing the presence and severity of ischemia. While recommended tests are valuable, they may not fully capture the complex physiological responses to exercise or provide the necessary detail to tailor personalized treatment plans. Cardiopulmonary exercise testing (CPET) offers a comprehensive assessment of the cardiovascular, pulmonary, and muscular systems under stress, potentially addressing these gaps and providing a more precise understanding of CAD, particularly in settings where traditional diagnostics may be insufficient. By enabling more personalized and precise treatment strategies, CPET could play a central role in the future of CAD management. This narrative review examines the current evidence supporting the use of CPET in CAD diagnosis and management and explores the potential for integrating CPET into existing clinical guidelines, considering its diagnostic and prognostic capabilities, cost-effectiveness, and the challenges associated with its adoption.

Indoor Airborne Microplastics: Human Health Importance and Effects of Air Filtration and Turbulence

Microplastics (MPs) are omnipresent particles that receive special attention because of their persistent nature and their potential impact on human disease and on the environment. Most MPs are generated by the degradation of larger plastic items such as clothing, car tires, and discarded plastic materials. In indoor environments, where human beings spend most of their time, aerial MP levels are higher, and the majority are fibers produced from textiles. Airborne MPs indoors are a greater potential danger to humans than MPs ingested in food and drink. Fragments small enough to remain substantially suspended in the air column, the small airborne microparticles that are measured as PM10 and PM2.5, become available for assimilation by human beings through respiration, potentially producing various health problems. Larger MPs act by ingestion and skin contact. MPs can carry microorganisms and micropollutants adsorbed to their surfaces, facilitating their uptake and survival within the human body. Indoor airborne MPs thus represent emerging pollutants of fast-growing concern that are especially important as potential invaders of the human respiratory system, reaching the alveoli of the lungs and finally entering the circulatory system and other tissues. Since this direct human exposure to MP contamination via indoor air is so important, we discuss in this article the ways in which MP concentration and dispersal in indoor air can be affected by air turbulence that is induced by anthropogenic objects such as air conditioners, filters, and purifiers. Much evidence is equivocal and further research is necessary.

Elevated Perspectives: Unraveling Cardiovascular Dynamics in High-Altitude Realms.

High-altitude regions pose distinctive challenges for cardiovascular health because of decreased oxygen levels, reduced barometric pressure, and colder temperatures. Approximately 82 million people live above 2400 meters, while over 100 million people visit these heights annually. Individuals ascending rapidly or those with pre-existing cardiovascular conditions are particularly vulnerable to altitude-related illnesses, including Acute Mountain Sickness (AMS) and Chronic Mountain Sickness (CMS). The cardiovascular system struggles to adapt to hypoxic stress, which can lead to arrhythmias, systemic hypertension, and right ventricular failure. Pathophysiologically, high-altitude exposure triggers immediate increases in cardiac output and heart rate, often due to enhanced sympathetic activity. Over time, acclimatisation involves complex changes, such as reduced stroke volume and increased blood volume. The pulmonary vasculature also undergoes significant alterations, including hypoxic pulmonary vasoconstriction and vascular remodelling, contributing to conditions, like pulmonary hypertension and high-altitude pulmonary edema. Genetic adaptations in populations living at high altitudes, such as gene variations linked to hypoxia response, further influence these physiological processes. Regarding cardiovascular disease risk, stable coronary artery disease patients generally do not face significant adverse outcomes at altitudes up to 3500 meters. However, those with unstable angina or recent cardiac interventions should avoid high-altitude exposure to prevent exacerbation. Remarkably, high-altitude living correlates with reduced cardiovascular mortality rates, possibly due to improved air quality and hypoxia-induced adaptations. Additionally, there is a higher incidence of congenital heart disease among children born at high altitudes, highlighting the profound impact of hypoxia on heart development. Understanding these dynamics is crucial for managing risks and improving health outcomes in high-altitude environments.

Effects of cannabis use on the heart.

Cannabis and the marijuana derived from it, which mainly contains the psychoactive ingredient tetrahydrocannabinol (THC), is increasingly being used both for medicinal purposes and as anarcotic. While many emphasize the positive aspects and uses of cannabis, it is equally important to examine the potential negative effects on health. Here, we pay special attention to undesired cardiovascular effects, as the cardiovascular system is known to react strongly to psychoactive substances. This article highlights the current scientific findings on the effects of cannabis and marijuana on the heart and cardiovascular system. Since many patients conceal their marijuana consumption, we expect ahigh number of unreported cases. Therefore, the need to disclose any drug consumption is crucial for further therapeutic decisions when taking the medical history.

Streptococcus salivarius pneumonia-associated pneumomediastinum: a case report and literature review

BackgroundStreptococcus salivarius is an opportunistic pathogen, and there have been no reported cases of Streptococcus salivarius pneumonia to date. Pneumomediastinum is usually secondary to tracheal or esophageal injury and is very rare as a complication of pneumonia. We report a case of Streptococcus salivarius pneumonia complicated by pneumomediastinum, aiming to enhance clinicians’ awareness of rare pathogens and uncommon complications in pneumonia.Case presentationThe patient, a 36-year-old male, presented with a persistent cough and sputum production for one week, accompanied by a sore throat that had developed just one day prior. Chest computed tomography (CT) disclosed pneumomediastinum alongside obstructive atelectasis in the left lower lobe. Streptococcus salivarius infection was conclusively identified through bronchoalveolar lavage metagenomic next-generation sequencing (mNGS), as well as smear and culture analyses. The patient was administered intravenous amoxicillin-clavulanate potassium for a duration of seven days as part of the anti-infection regimen. Given the stability of the patient’s respiratory and circulatory systems, a tube drainage procedure was deemed unnecessary. Post-treatment, the patient’s clinical symptoms notably improved. A subsequent chest CT scan revealed the re-expansion of the left lower lung and near-complete resolution of pneumomediastinum.ConclusionThere are numerous pathogens that can cause pneumonia. While focusing on common pathogens, it is important not to overlook rare ones. When considering infections from rare pathogens, it is recommended to promptly perform a bronchoscopy and submit bronchoalveolar lavage fluid for mNGS to improve pathogen detection rates. During the diagnosis and treatment of pneumonia, it is crucial to be vigilant for rare complications. When a patient presents with symptoms such as dyspnea or subcutaneous emphysema, it is advisable to immediately perform a chest CT scan to rule out pneumomediastinum.

Myroides species, pathogenic spectrum and clinical microbiology sight in Mexican isolates.

Myroides is a bacterial genus of opportunistic bacteria responsible for diverse infections including in the skin and soft tissues, urinary tract, cardiovascular system, and bacteremia, although the incidence of its reported infections is low, it is increasing, likely due the use of better bacterial identification methods, but also perhaps due an increase in its prevalence. In addition, their pathogenic role is limited in terms of reporting their microbial physiology, so the present work provides information in this regard in addition to the information that is available in the international literature. To describe the microbiological and genetic characteristics of seven different Myroides spp. clinical strains and comment on their phylum, pathogenic and resistance characteristics. Seven Myroides spp., strains associated with infections were included from 1/January/2012 to 1/January/20 and identified by miniaturized biochemistry and MALDI-ToF. Susceptibility tests were performed according to CLSI recommendations by broth microdilution. Whole genome sequencing was performed for each strain and bioinformatics analysis were performed. Strains were identified at genus level by two methodologies. Our results revealed that likely four strains belong to the species Myroides odoratimimus, while the other two may be undescribed ones. Remarkably, all isolates harbored several genes encoding antibiotic resistance determinants for ß-lactams, aminoglycosides and glycopeptides and in concordance, presented high levels of resistance, against these antibiotics (AK and GN both 100%, ATM, CAZ and FEP 100%, e.g.); moreover, the presences of carbapenemases were evidenced by meropenem (mCIM) and imipenem (CARBA NP) degrading activity in six isolates and two strains possessed plasmids harboring mainly ribosomal RNA genes, tRNAs and genes encoding proteins with unknown functions. Our study increases the knowledge about the biology of this understudied genus and highlights the potential of Myroides to emerge as a broader cause of recalcitrant opportunistic infections.

Circadian rhythm and daytime variation do not affect intraoperative bacterial sternal contamination and postoperative wound infections following cardiac surgery

Studies have documented various effects of circadian rhythm and daytime variations on the cardiovascular and immune system as well as wound healing. From June to December 2016, n = 367 cardiac surgery patients were enrolled. Microbiological swabs from the mediastinum and subcutaneous wound were taken before sternal closure. Patients were assigned to groups based on operation start: morning (n = 219) or afternoon (n = 135). Bacterial contamination and wound infections were studied in relation to circadian rhythm and daytime variation. We did not observe any difference in mortality (morning: 3.7%, afternoon: 3.0%, p > 0.99) and major adverse events (morning: 8.2%, afternoon: 5.9%, p = 0.53). In 27.7% of the morning group, at least one positive intraoperative swab was observed, similar to the afternoon group (25.6%, p = 0.71). The incidence of positive presternal swabs was 15.6% in the morning compared to 9.1% in the afternoon (p = 0.18). About 90% of the germs detected were part of the natural skin flora (e.g., Cutibacterium acnes and Staphylococcus epidermidis). The incidence of sternal wound infections was 7.3% (morning) and 3.0% (afternoon) (p = 0.18). We did not find differences in the incidence of intraoperative bacterial sternal contamination, nor postoperative infections, between patients who underwent cardiac surgery in the morning or afternoon.

Towards Reliable ECG Analysis: Addressing Validation Gaps in the Electrocardiographic R-Peak Detection

Electrocardiographic (ECG) R-peak detection is essential for every sensor-based cardiovascular health monitoring system. To validate R-peak detectors, comparing the predicted results with reference annotations is crucial. This comparison is typically performed using tools provided by the waveform database (WFDB) or custom methods. However, many studies fail to provide detailed information on the validation process. The literature also highlights inconsistencies in reporting window size, a crucial parameter used to compare predictions with expert annotations to distinguish false peaks from the true R-peak. Additionally, there is also a need for uniformity in reporting the total number of beats for individual or collective records of the widely used MIT-BIH arrhythmia database. Thus, we aim to review validation methods of various R-peak detection methodologies before their implementation in real time. This review discusses the impact of non-beat annotations when using a custom validation method, allowable window tolerance, the effects of window size deviations, and implications of varying numbers of beats and skipping segments on ECG testing, providing a comprehensive guide for researchers. Addressing these validation gaps is critical as they can significantly affect validatory outcomes. Finally, the conclusion section proposes a structured concept as a future approach, a guide to integrate WFDB R-peak validation tools for testing any QRS annotated ECG database. Overall, this review underscores the importance of complete transparency in reporting testing procedures, which prevents misleading assessments of R-peak detection algorithms and enables fair methodological comparison.

Changes in the functional state of athletes under the influence of physical load

The main goal of the presented research is to study the effect of sports physical activity on the quality of regulation and adaptive capacity of the cardiovascular system of athletes and non-athletes. The obtained results showed that the number of heart beats decreases during the rest period. Changes in the number of heart rates when performing a physical load correspond to the age norms of athletes. In addition, no significant changes were founding in the number of heart rates and systolic blood pressure, but diastolic blood pressure significantly decreased, and pulse pressure increased.

Space Travel: The Radiation and Microgravity Effects on the Cardiovascular System

Space flight modulates the functions of the cardiovascular system. The exposure to space conditions can alter the cerebral blood flow, as well as the venous return. Anemia, cardiac output changes, and increased activity of the sympathetic nervous system can also be seen. Understanding cardiac changes prepares astronauts for both better in-flight adaptations and long-term protection against cardiovascular diseases. The heart could undergo radio-degenerative effects when exposed to space radiation, increasing the risk of cardiovascular diseases in the long run. A high frequency of arrhythmias, such as ventricular/atrial premature complexes, have been reported during the Gemini and Apollo missions. Additionally, microgravity can lead to progressive degeneration of the myocytes and muscle atrophy with altered gene expression and calcium handling, along with impaired contractility. This review summarizes the potential cardiovascular effects of spaceflight and prevention measures.