Heart Research Articles

Diet and Coronary Heart Disease : Dietary Analysis on Fifty Females

Diet and Coronary Heart Disease : Dietary Analysis on Fifty Females

And Love Itself by Drago Jancar

Reviewed by: And Love Itself by Drago Jancar Elizabeth Fifer DRAGO JANCAR And Love Itself Trans. David Limon. Dallas. Dalkey Archive Press. 2022. 352 pages. ALTHOUGH HE IS RELATIVELY UNKNOWN in the United States, the philosophical and historical sweep of the fiction of Slovenian author Drago Jancar has been compared to Milan Kundera, Franz Kafka, and Günter Grass. Jancar was awarded the European Prize for Literature in 2011 and in 2014 received the Best Foreign Book Prize and the Kresnick Award for best novel of the year for I Saw Her That Night. In And Love Itself, a World War II novel, Jancar asks if love can exist in wartime. Its title comes from Byron's poem "So We'll Go No More a Roving": "For the sword outwears its sheath, / And the soul outwears the breast, / And the heart must pause to breathe, / And love itself have rest." These lines accurately summarize the action. Sofia and Valentin's prewar romance will return to the narrative again and again but only as memory. Jancar skillfully changes points of view, from the peasants in the villages to the Resistance fighters in the woods adjacent to the front lines. When people speak Slovene instead of German or Russian, it signals their nationalism. Intermingling present and past, he moves around the war years to provide a Slovenian perspective. From their hidden camps the Partisans sing, "We bring thunder to the devil, / With weapon in hand. / Write justice in the blood, / Demanded by our land." Fierce love for their land fuels their fighting spirit. That land's occupiers threaten harsh penalties for not speaking German. They decimate the population either by murdering people on the spot or sending them to camps on trumped-up charges. The army of occupation and the Resistance each use interrogation to test loyalty. Trust is a scarce commodity—both sides fear infiltration. Successive waves of armies pass through—Germans, Russians, Partisans, bandits—each taking their toll on the local populace. In scratched photographs, faces appear blurred, looking out of ruined windows. As they push the Germans out, the Russians kill collaborators. When factions disagree about guilt, Slovenes fight Slovenes, brother against brother. The hour of victory brings revenge. Love and poetry can conquer everything except war. Jancar has created a tender love story about the impossibility of love, about heroism without reward. Elizabeth Fifer Center Valley, Pennsylvania Copyright © 2023 World Literature Today and the Board of Regents of the University of Oklahoma

Comment on Trans fatty acids and coronary heart disease risk

Comment on Trans fatty acids and coronary heart disease risk

Proof of Concept of a Novel Multiepitope Recombinant Protein for the Serodiagnosis of Patients with Chagas Disease.

Chagas disease remains a neglected disease that is considered to be a public health problem. The early diagnosis of cases is important to improve the prognosis of infected patients and prevent transmission. Serological tests are the method of choice for diagnosis. However, two serological tests are currently recommended to confirm positive cases. In this sense, more sensitive and specific serological tests need to be developed to overcome these current diagnosis problems. This study aimed to develop a new recombinant multiepitope protein for the diagnosis of Chagas disease, hereafter named rTC. The rTC was constructed based on amino acid sequences from different combinations of Trypanosoma cruzi antigens in the same polypeptide and tested using an enzyme-linked immunosorbent assay (ELISA) to detect different types of Chagas disease. rTC was able to discriminate between indeterminate (IND) and cardiac (CARD) cases and cross-reactive diseases, as well as healthy samples, with 98.28% sensitivity and 96.67% specificity, respectively. These data suggest that rTC has the potential to be tested in future studies against a larger serological panel for the diagnosis of Chagas disease.

The heart field transcriptional landscape at single-cell resolution.

Organogenesis requires the orchestrated development of multiple cell lineages that converge, interact, and specialize to generate coherent functional structures, exemplified by transformation of the cardiac crescent into a four-chambered heart. Cardiomyocytes originate from the first and second heart fields, which make different regional contributions to the definitive heart. In this review, a series of recent single-cell transcriptomic analyses, together with genetic tracing experiments, are discussed, providing a detailed panorama of the cardiac progenitor cell landscape. These studies reveal that first heart field cells originate in a juxtacardiac field adjacent to extraembryonic mesoderm and contribute to the ventrolateral side of the cardiac primordium. In contrast, second heart field cells are deployed dorsomedially from a multilineage-primed progenitor population via arterial and venous pole pathways. Refining our knowledge of the origin and developmental trajectories of cells that build the heart is essential to address outstanding challenges in cardiac biology and disease.

Morphological Study in Heart of Wild Chinese Alligator (Alligator sinensis)

The Chinese alligator (Alligator sinensis) belongs to the genus Alligator, which is a unique crocodile in China. In order to study the macroscopic structure of the heart of Chinese alligator, we performed detailed cardiac anatomy on five specimens. The heart is in the cranial mediastinum. It is caudally involved by the liver cranial margins, and ventrally by the ribs, intercostal muscles, and sternum and dorsally by the lungs. The wild Chinese alligator heart is a typical four-chamber heart, with two (right and left) atria and ventricles, left and right aorta, pulmonary artery and subclavian artery branch from the aorta. Morphology measures the circumference (129.36 mm), weight (44.14 g), and length of the heart from apex to bottom (52.50 mm). Studies have shown that the shape of the wild Chinese alligator’s heart is consistent with the anatomy of other crocodiles.

Cinematic Rendering of Acute Myocardial Infarction.

HomeRadiologyRecently Published PreviousNext Reviews and CommentaryFree AccessImages in RadiologyCinematic Rendering of Acute Myocardial InfarctionXiaoqing Ding , Zhigang GongXiaoqing Ding , Zhigang GongAuthor AffiliationsFrom the Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No 528, Zhangheng R. Pudong New Area, Shanghai, 201203, China.Address correspondence to X.D. (email: [email protected]).Xiaoqing Ding Zhigang GongPublished Online:Jan 31 2023https://doi.org/10.1148/radiol.221828MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Supplemental material is available for this article.A 43-year-old male patient presented to the emergency department with acute chest pain. The patient condition was stable, and an electrocardiography scan was obtained and showed ST segment changes with troponin I levels of 106.251 ng/mL; however, the patient refused percutaneous catheter intervention. To exclude aortic and pulmonary artery disease, dual-source CT angiography (CTA) of the chest was performed. No aortic or pulmonary artery abnormalities were identified; however, CTA demonstrated suspicious occlusion of left anterior descending coronary artery, focal hypodensity of the anterior wall, and interventricular septum, which is further highlighted with use of cinematic rendering reconstruction technique (Figure, Movie).CT angiography of the chest in a 43-year-old man with acute chest pain. Cinematic rendering of (A) four-chamber heart view and (B) anteroposterior view shows a focal area of decreased attenuation in the myocardium (anterior wall and interventricular septum).Download as PowerPointOpen in Image Viewer Get the Flash Player to see this video.Movie: Cinematic rendering of the heart, show a focal area of decreased attenuation in the myocardium.Download Original Video (20.9 MB)With increasing temporal resolution, it becomes possible to observe changes in myocardial density in the setting of acute myocardial infarction with use of conventional CTA of the chest (1). Cinematic rendering reconstruction technique (2) allows CTA to achieve highly realistic, photograph-level, postprocessed images that show the areas of acute myocardial ischemia more intuitively in three dimensions.Disclosures of conflicts of interest: X.D. No relevant relationships. Z.G. No relevant relationships.

The Impact of Standard Ablation Strategies for Atrial Fibrillation on Cardiovascular Performance in a Four-Chamber Heart Model

PurposeAtrial fibrillation is one of the most frequent cardiac arrhythmias in the industrialized world and ablation therapy is the method of choice for many patients. However, ablation scars alter the electrophysiological activation and the mechanical behavior of the affected atria. Different ablation strategies with the aim to terminate atrial fibrillation and prevent its recurrence exist but their impact on the performance of the heart is often neglected.MethodsIn this work, we present a simulation study analyzing five commonly used ablation scar patterns and their combinations in the left atrium regarding their impact on the pumping function of the heart using an electromechanical whole-heart model. We analyzed how the altered atrial activation and increased stiffness due to the ablation scars affect atrial as well as ventricular contraction and relaxation.ResultsWe found that systolic and diastolic function of the left atrium is impaired by ablation scars and that the reduction of atrial stroke volume of up to 11.43% depends linearly on the amount of inactivated tissue. Consequently, the end-diastolic volume of the left ventricle, and thus stroke volume, was reduced by up to 1.4 and 1.8%, respectively. During ventricular systole, left atrial pressure was increased by up to 20% due to changes in the atrial activation sequence and the stiffening of scar tissue.ConclusionThis study provides biomechanical evidence that atrial ablation has acute effects not only on atrial contraction but also on ventricular performance. Therefore, the position and extent of ablation scars is not only important for the termination of arrhythmias but is also determining long-term pumping efficiency. If confirmed in larger cohorts, these results have the potential to help tailoring ablation strategies towards minimal global cardiovascular impairment.

Three-Dimensional-Enabled Surgical Planning for the Correction of Right Partial Anomalous Pulmonary Venous Return.

Objectives: The surgical technique for right partial anomalous pulmonary venous return (PAPVR) depends on the location of the anomalous pulmonary veins (PVs). With this in mind, we sought to evaluate the impact of 3D heart segmentation and reconstruction on preoperative surgical planning. Methods: A retrospective study was conducted on all patients who underwent PAPVR repair at our institution between January 2018 and October 2021; three-dimensional segmentations and reconstructions of all the heart anatomies were performed. A score (the PAPVR score) was established and calculated using two anatomical parameters (the distance between the most cranial anomalous PV and the superior rim of the sinus venosus defect/the sum of the latter and the distance between the PV and the azygos vein) to predict the type of correction. Results: A total of 30 patients were included in the study. The PAPVR score was found to be a good predictor of the type of surgery performed. A value > 0.68 was significantly associated with a Warden procedure (p < 0.001) versus single/double patch repair. Conclusions: Three-dimensional heart segmentations and reconstructions improve the quality of surgical planning in the case of PAPVR and allow for the introduction of a score that may facilitate surgical decisions on the type of repair required.

Application of Artificial Intelligence in Anatomical Structure Recognition of Standard Section of Fetal Heart.

Congenital heart defect (CHD) refers to the overall structural abnormality of the heart or large blood vessels in the chest cavity. It is the most common type of fetal congenital defects. Prenatal diagnosis of congenital heart disease can improve the prognosis of the fetus to a certain extent. At present, prenatal diagnosis of CHD mainly uses 2D ultrasound to directly evaluate the development and function of fetal heart and main structures in the second trimester of pregnancy. Artificial recognition of fetal heart 2D ultrasound is a highly complex and tedious task, which requires a long period of prenatal training and practical experience. Compared with manual scanning, computer automatic identification and classification can significantly save time, ensure efficiency, and improve the accuracy of diagnosis. In this paper, an effective artificial intelligence recognition model is established by combining ultrasound images with artificial intelligence technology to assist ultrasound doctors in prenatal ultrasound fetal heart standard section recognition. The method data in this paper were obtained from the Second Affiliated Hospital of Fujian Medical University. The fetal apical four-chamber heart section, three vessel catheter section, three vessel trachea section, right ventricular outflow tract section, and left ventricular outflow tract section were collected at 20-24 weeks of gestation. 2687 image data were used for model establishment, and 673 image data were used for model validation. The experiment shows that the map value of this method in identifying different anatomical structures reaches 94.30%, the average accuracy rate reaches 94.60%, the average recall rate reaches 91.0%, and the average F1 coefficient reaches 93.40%. The experimental results show that this method can effectively identify the anatomical structures of different fetal heart sections and judge the standard sections according to these anatomical structures, which can provide an auxiliary diagnostic basis for ultrasound doctors to scan and lay a solid foundation for the diagnosis of congenital heart disease.

Leadless biventricular left bundle and endocardial lateral wall pacing versus left bundle only pacing in left bundle branch block patients.

Biventricular endocardial (BIV-endo) pacing and left bundle pacing (LBP) are novel delivery methods for cardiac resynchronization therapy (CRT). Both pacing methods can be delivered through leadless pacing, to avoid risks associated with endocardial or transvenous leads. We used computational modelling to quantify synchrony induced by BIV-endo pacing and LBP through a leadless pacing system, and to investigate how the right-left ventricle (RV-LV) delay, RV lead location and type of left bundle capture affect response. We simulated ventricular activation on twenty-four four-chamber heart meshes inclusive of His-Purkinje networks with left bundle branch block (LBBB). Leadless biventricular (BIV) pacing was simulated by adding an RV apical stimulus and an LV lateral wall stimulus (BIV-endo lateral) or targeting the left bundle (BIV-LBP), with an RV-LV delay set to 5ms. To test effect of prolonged RV-LV delays and RV pacing location, the RV-LV delay was increased to 35ms and/or the RV stimulus was moved to the RV septum. BIV-endo lateral pacing was less sensitive to increased RV-LV delays, while RV septal pacing worsened response compared to RV apical pacing, especially for long RV-LV delays. To investigate how left bundle capture affects response, we computed 90% BIV activation times (BIVAT-90) during BIV-LBP with selective and non-selective capture, and left bundle branch area pacing (LBBAP), simulated by pacing 1cm below the left bundle. Non-selective LBP was comparable to selective LBP. LBBAP was worse than selective LBP (BIVAT-90: 54.2 ± 5.7ms vs. 62.7 ± 6.5, p < 0.01), but it still significantly reduced activation times from baseline. Finally, we compared leadless LBP with RV pacing against optimal LBP delivery through a standard lead system by simulating BIV-LBP and selective LBP alone with and without optimized atrioventricular delay (AVD). Although LBP alone with optimized AVD was better than BIV-LBP, when AVD optimization was not possible BIV-LBP outperformed LBP alone, because the RV pacing stimulus shortened RV activation (BIVAT-90: 54.2 ± 5.7ms vs. 66.9 ± 5.1ms, p < 0.01). BIV-endo lateral pacing or LBP delivered through a leadless system could potentially become an alternative to standard CRT. RV-LV delay, RV lead location and type of left bundle capture affect leadless pacing efficacy and should be considered in future trial designs.

Intranasal butorphanol and midazolam administered prior to intramuscular alfaxalone provides safe and effective sedation in Quaker parrots (Myiopsitta monachus).

To evaluate 2 doses of alfaxalone on cardiopulmonary parameters, temperature, sedation, endotracheal intubation, the incidence of muscle tremors, and radiographic positioning in Quaker parrots previously administered intranasal midazolam and butorphanol. 10 healthy adult Quaker parrots (male = 5; female = 5). A randomized, masked, crossover study was conducted where birds received midazolam (2 mg/kg) and butorphanol (2 mg/kg) intranasally 15 minutes prior to a low- or high-dose of intramuscular alfaxalone: 2 mg/kg (LDA) or 5 mg/kg (HDA), respectively. Heart (HR) and respiratory rate (RR), cloacal temperature, sedation quality, and ability to position for radiographs were recorded over time. The incidence of muscle tremors and the ability to intubate were recorded. Data were compared to baseline values and between treatments where appropriate. Significance was set at P < .05. There were no significant differences in HR, RR, cloacal temperature, and sedation scores between treatments at any time point. Duration of time from midazolam-butorphanol administration to complete recovery from treatment administration was significantly shorter for LDA when compared to HDA (90 [60 to 195] vs 127.5 [90 to 10] minutes, respectively). Compared to baseline, sedation scores were significantly higher from T = 15 to 60 for LDA and from T = 15 to 75 for HDA. The incidence of muscle tremors was greater in HDA (9/10) than in LDA (7/10). All birds were successfully intubated and positioned for radiographs. The combination of intranasal midazolam-butorphanol and intramuscular alfaxalone at the doses examined was a safe and effective method for sedating Quaker parrots. LDA produced adequate sedation with a shorter time to recovery and with fewer muscle fasciculations when compared to HDA.

Comparison between conduction system pacing and cardiac resynchronization therapy in right bundle branch block patients.

A significant number of right bundle branch block (RBBB) patients receive cardiac resynchronization therapy (CRT), despite lack of evidence for benefit in this patient group. His bundle (HBP) and left bundle pacing (LBP) are novel CRT delivery methods, but their effect on RBBB remains understudied. We aim to compare pacing-induced electrical synchrony during conventional CRT, HBP, and LBP in RBBB patients with different conduction disturbances, and to investigate whether alternative ways of delivering LBP improve response to pacing. We simulated ventricular activation on twenty-four four-chamber heart geometries each including a His-Purkinje system with proximal right bundle branch block (RBBB). We simulated RBBB combined with left anterior and posterior fascicular blocks (LAFB and LPFB). Additionally, RBBB was simulated in the presence of slow conduction velocity (CV) in the myocardium, left ventricular (LV) or right ventricular (RV) His-Purkinje system, and whole His-Purkinje system. Electrical synchrony was measured by the shortest interval to activate 90% of the ventricles (BIVAT-90). Compared to baseline, HBP significantly improved activation times for RBBB alone (BIVAT-90: 66.9 ± 5.5 ms vs. 42.6 ± 3.8 ms, p < 0.01), with LAFB (69.5 ± 5.0 ms vs. 58.1 ± 6.2 ms, p < 0.01), with LPFB (81.8 ± 6.6 ms vs. 62.9 ± 6.2 ms, p < 0.01), with slow myocardial CV (119.4 ± 11.4 ms vs. 97.2 ± 10.0 ms, p < 0.01) or slow CV in the whole His-Purkinje system (102.3 ± 7.0 ms vs. 75.5 ± 5.2 ms, p < 0.01). LBP was only effective in RBBB cases if combined with anodal capture of the RV septum myocardium (BIVAT-90: 66.9 ± 5.5 ms vs. 48.2 ± 5.2 ms, p < 0.01). CRT significantly reduced activation times in RBBB in the presence of severely slow RV His-Purkinje CV (95.1 ± 7.9 ms vs. 84.3 ± 9.3 ms, p < 0.01) and LPFB (81.8 ± 6.6 ms vs. CRT: 72.9 ± 8.6 ms, p < 0.01). Both CRT and HBP were ineffective with severely slow CV in the LV His-Purkinje system. HBP is effective in RBBB patients with otherwise healthy myocardium and Purkinje system, while CRT and LBP are ineffective. Response to LBP improves when LBP is combined with RV septum anodal capture. CRT is better than HBP only in patients with severely slow CV in the RV His-Purkinje system, while CV slowing of the whole His-Purkinje system and the myocardium favor HBP over CRT.

From Molecular to Functional Effects of Different Environmental Lead Exposure Paradigms.

Simple SummaryOur comparative study brings new insights regarding the effects of environmental lead exposure on the cardiorespiratory and nervous systems. We show how various kinds of exposure can lead to different toxicities, with various degrees of nefarious effects. The developmental period is of utmost importance to the toxicity of environmental lead; however, we found that the duration of exposure is the prime reason for stronger effects, even though the dual effect of intermittent exposure causes greater molecular neuronal alterations. Lead is a heavy metal whose widespread use has resulted in environmental contamination and significant health problems, particularly if the exposure occurs during developmental stages. It is a cumulative toxicant that affects multiple systems of the body, including the cardiovascular and nervous systems. Chronic lead exposure has been defined as a cause of behavioral changes, inflammation, hypertension, and autonomic dysfunction. However, different environmental lead exposure paradigms can occur, and the different effects of these have not been described in a broad comparative study. In the present study, rats of both sexes were exposed to water containing lead acetate (0.2% w/v), from the fetal period until adulthood. Developmental Pb-exposed (DevPb) pups were exposed to lead until 12 weeks of age (n = 13); intermittent Pb exposure (IntPb) pups drank leaded water until 12 weeks of age, tap water until 20 weeks, and leaded water for a second time from 20 to 28 weeks of age (n = 14); and the permanent (PerPb) exposure group were exposed to lead until 28 weeks of age (n = 14). A control group (without exposure, Ctrl), matched in age and sex was used. After exposure protocols, at 28 weeks of age, behavioral tests were performed for assessment of anxiety (elevated plus maze test), locomotor activity (open-field test), and memory (novel object recognition test). Metabolic parameters were evaluated for 24 h, and the acute experiment was carried out. Blood pressure (BP), electrocardiogram, and heart (HR) and respiratory (RF) rates were recorded. Baroreflex gain, chemoreflex sensitivity, and sympathovagal balance were calculated. Immunohistochemistry protocol for NeuN, Syn, Iba-1, and GFAP staining was performed. All Pb-exposed groups showed hypertension, concomitant with a decrease in baroreflex gain and chemoreceptor hypersensitivity, without significant changes in HR and RF. Long-term memory impairment associated with reactive astrogliosis and microgliosis in the dentate gyrus of the hippocampus, indicating the presence of neuroinflammation, was also observed. However, these alterations seemed to reverse after lead abstinence for a certain period (DevPb) and were enhanced when a second exposure occurred (IntPb), along with a synaptic loss. These results suggest that the duration of Pb exposure is more relevant than the timing of exposure, since the PerPb group presented more pronounced effects and a significant increase in the LF and HF bands and anxiety levels. In summary, this is the first study with the characterization and comparison of physiological, autonomic, behavioral, and molecular changes caused by different low-level environmental lead exposures, from the fetal period to adulthood, where the duration of exposure was the main factor for stronger adverse effects. These kinds of studies are of immense importance, showing the importance of the surrounding environment in health from childhood until adulthood, leading to the creation of new policies for toxicant usage control.

A Soft and Skin-Interfaced Smart Patch Based on Fiber Optics for Cardiorespiratory Monitoring.

Wearables are valuable solutions for monitoring a variety of physiological parameters. Their application in cardiorespiratory monitoring may significantly impact global health problems and the economic burden related to cardiovascular and respiratory diseases. Here, we describe a soft biosensor capable of monitoring heart (HR) and respiratory (RR) rates simultaneously. We show that a skin-interfaced biosensor based on fiber optics (i.e., the smart patch) is capable of estimating HR and RR by detecting local ribcage strain caused by breathing and heart beating. The system addresses some of the main technical challenges that limit the wide-scale use of wearables, such as the simultaneous monitoring of HR and RR via single sensing modalities, their limited skin compliance, and low sensitivity. We demonstrate that the smart patch estimates HR and RR with high fidelity under different respiratory conditions and common daily body positions. We highlight the system potentiality of real-time cardiorespiratory monitoring in a broad range of home settings.

Computationally Assessed 3D Anatomical Proximities and Spatial Relationships Among the Tricuspid Valve Annulus, Right Coronary Artery, and Triangle of Koch: Implications for Transcatheter Tricuspid Annuloplasty Repair

BackgroundTranscatheter-based annuloplasty therapies for tricuspid regurgitation have demonstrated significant development over recent years. However, the tricuspid valve and neighboring vasculature and conductive tissue regions can present anatomical and device deployment challenges. This present study investigated the anatomical dimensions and spatial relationships of the cardiac structures essential to percutaneous annuloplasty procedures: the tricuspid annulus (TA), right coronary artery (RCA), and triangle of Koch border region. MethodsMeasurements were derived from computational three-dimensional reconstructions of static magnetic resonance imaging scans of perfusion-fixed human hearts (n = 82) with preserved right-sided heart anatomies. This specimen set included heart samples presenting with prediagnosed atrioventricular valvular regurgitation. ResultsOur anatomical assessments demonstrated that the TA to RCA proximities were intensified with the presence of atrioventricular valvular regurgitation, compared with healthy heart specimens. The minimal distances were frequently located between the lateral and posterior annular points. This annular region corresponds to the RCA distal segments and posterior descending branch origins. Greater portions and incidences of the RCA coursing parallel or inferior to the TA plane were recorded for these diseased hearts. Patient demographic variables (gender, age, and body mass index) were insignificant determinants of change for a majority of our results. ConclusionsThese three-dimensional reconstructions provide insights to guide the development and future iterations of transcatheter tricuspid valve annuloplasty systems with regards to device anchoring, annular geometry, tissue proximities, and implantation considerations.

Synthetic PPG Signal Generation to Improve Coronary Artery Disease Classification: Study With Physical Model of Cardiovascular System.

This paper presents a novel approach of generating synthetic Photoplethysmogram (PPG) data using a physical model of the cardiovascular system to improve classifier performance with a combination of synthetic and real data. The physical model is an in-silico cardiac computational model, consisting of a four-chambered heart with electrophysiology, hemodynamic, and blood pressure auto-regulation functionality. Starting with a small number of measured PPG data, the cardiac model is used to synthesize healthy as well as PPG time-series pertaining to coronary artery disease (CAD) by varying pathophysiological parameters. A Variational Autoencoder (VAE) structure is proposed to derive a statistical feature space for CAD classification. Results are presented in two perspectives namely, (i) using artificially reduced real disease data and (ii) using all the real disease data. In both cases, by augmenting with the synthetic data for training, the performance (sensitivity, specificity) of the classifier changes from (i) (0.65, 1) to (1, 0.9) and (ii) (1, 0.95) to (1, 1). The proposed hybrid approach of combining physical modelling and statistical feature space selection generates realistic PPG data with pathophysiological interpretation and can outperform a baseline Generative Adversarial Network (GAN) architecture with a relatively small amount of real data for training. This proposed method could aid as a substitution technique for handling the problem of bulk data required for training machine learning algorithms for cardiac health-care applications.

Evaluation of vasomotor dysfunction with a reduction of disease activity in patients with rheumatoid arthritis: a prospective study

Introduction. Endothelial dysfunction (ED) makes a significant contribution to the pathogenesis of rheumatoid arthritis (RA). However, changes of vasomotor function (VF) in patients with a reduction in disease activity have not been studied enough. Objective – to study VF changes in patients with RA and a reduce in disease activity, to clarify the role of RA serological profile and the presence of arterial hypertension (AH) in the formation of vasomotor dysfunction.Materials and methods. A total of 94 patients took part in the study (74 – the study group, 20 – the comparison group). The longitudinal study included 48 patients with 10 days interval between visits. RA activity reduced after prescribed anti-inflammatory therapy. All patients underwent laser Doppler flowmetry with functional tests (FT) to study VF. Also, the intensity of oxidative phosphorylation (IOP), levels of rheumatoid factor, antibodies to cyclic citrullinated peptide (ACCP) and antinuclear factor titer were assessed.Results. Correlations of ACCP with endothelial (EС), neurogenic (NС) and cardiac (CC) components of the amplitude-frequency spectrum were revealed. With a decrease in RA activity, an increase in CC and a decrease in the total tone of resistive vessels (TTRV) were observed. There was a tendency to improve the parameters of post-occlusive hyperemia (not statistically significant). The duration and area of the reaction after acetylcholine iontophoresis increased and IOP decreased. The presence of AH reduced EС and NС, worsened post-occlusive hyperemia, and was associated with the presence of factors for RA unfavourable course.Conclusion. The RA activity, the level of ACCP and the presence of AH make a significant contribution to the vasomotor dysfunction. At the same time, AH can be considered as a surrogate marker of an unfavourable course of RA. Endothelium-dependent regulation of blood flow, measured in FT, and IOP are closely related to disease activity. The reduce of RA activity was accompanied by a decrease in TTRV, confirming the leading role of the vasoconstriction in formation the ED pattern, the severity of ED will predominantly depend on the activity of the disease.

Drawing matters

As the faculties of literacy and numeracy are universally recognized as worthy of pedagogical nurturing, so this article champions an older, graphic articulacy: visualcy. An articulacy with the language of drawing that distinguishes the visual arts from other disciplines. Its nurturing has been compromised by the shift away from teaching drawing in UK secondary schools and HE art schools, even before COVID. We argue that this shift is in part a consequence – perhaps unintended – of the neo-liberal values permeating the UK education sector. The article presents a critique of the those values seen as a significant obstacle to drawing’s educational benefits, and offers an optimistic basis for its place in the curriculum.

Associations between objectively measured physical activity, sedentary time, and cardiorespiratory fitness with inflammatory and oxidative stress markers and heart rate variability.

To assess the associations between physical activity (PA) and sedentary time (SEDT) with inflammatory and oxidative stress markers, heart rate variability (HRV) and post-exercise recovery (HRR) controlling for cardiorespiratory fitness (CRF) and potential confounders. The following data was collected from 44 participants during 2019 (age = 49.5 ± 6.4 years, 66% women): Plasma levels of C-reactive protein (CRP) and cytokines (IL-1β, INF-γ, TNF-α, MCP-1, IL-6, IL-8, IL-10, IL-18, IL-23); catalase (CAT) and glutathione peroxidase (GPX) activities; resting heart (HR) rate for HRV analysis, anthropometric measures, a submaximal cycling test to evaluate CRF with active recovery to assess and HRR (absolute and ΔHR), and 7-day accelerometry. Women spent significantly more SEDT (p = 0.035), had higher inflammatory markers (IL-6 and TNF) and lower HRV indices [SDNN, LF/HF, SD2 (p > 0.05)]. Significant associations were found between SEDT and markers of inflammation [CRP, B = 0.006, p = 0.001; MCP-1, B = 0.003, p = 0.038]. HRV indices were significantly associated with inflammatory/oxidative stress markers [IL-10 (p = 0.04), GPX (p = 0.014), ln-IL 23 (p = 0.036), CAT (p = 0.026)] while HRR was positively associated with light PA [Δ3 (B = 0.051, p = 0.043), Δ4 (B = 0.062, p = 0.021)] and inversely related to catalase [Δ3 (B = -54.7, p = 0.042), Δ4 (B = -54.1, p = 0.021] and CRP [Δ5 (B = -19.8, p = 0.033)]. Higher CRF showed lower values for TNF-α (p = 0.02) and IL-10 (p = 0.003) and better HRV/HRR indices [RMSSD, PNS, SampEn, SD1 (p < 0.05)]. SEDT had a higher impact on inflammation and autonomic balance, independently of PA levels with differences by sex and CRF. PA appears to be more important for a better HRR. Lower HRV and HRR could be indicative of inflammatory status.