Pressure Treatment Research Articles

How does high hydrostatic pressure treatment improve the esterification of quinoa (Chenopodium quinoa Willd.) starch?

High hydrostatic pressure (HHP) treatment was combined with octenyl succinic anhydride (OSA) modification of quinoa starch (QS) to improve esterification efficiency. The modified QS was used as a stabilizer to prepare a Pickering emulsion. The results showed that the HHP treatment disrupted the morphology and crystalline structure of QS, exposed numerous hydrophilic hydroxyl groups, and added esterification reaction sites. The degree of substitution (DS) and esterification efficiency (RE) of OSA-HHP-QS were significantly (p < 0.05) increased compared with OSA-QS. In addition, the short-range ordering, relative crystallinity, and thermal stability of OSA-HHP-QS decreased with increasing treatment pressure. Except for OSA-HHP200-QS, the starch granules treated at 200 MPa were annealed, resulting in molecular recrystallization. The Contact angle, emulsion stability index (ESI), and emulsion activity index (EAI) indicated that the emulsions stabilized with OSA-HHP-QS were highly stable. Therefore, HHP can be used as a novel technology to assist OSA modified starches in stabilizing Pickering emulsions.

Multi-targeted action of rooibos may protect against ischaemic stroke-induced neurological deficit and endothelial dysfunction

Ethnopharmacological relevanceIndigenous use communities in the Western Cape (South Africa) where Aspalathus linearis (Brum.f) R.Dahlgren - or rooibos - grows naturally, has a long history of using rooibos for medicinal purposes. Apart from its well-known antioxidant effect, the Cederberg community in particular has been using rooibos as a treatment for high blood pressure. Given the detrimental effects of high blood pressure on endothelial cells, rooibos may either directly or indirectly affect vascular health. This, together with more recent reports of neuroprotective effects, may position rooibos as complementary medicine in related vascular conditions such as ischaemic stroke. Aims of the studyThe study aimed to evaluate the potential benefit of acute administration of unfermented rooibos, on vascular health in a larval zebrafish model of stroke. Materials and methodsStroke was induced via 24-h ponatinib exposure, in the presence or absence of an aqueous solution of an ethanolic extract of unfermented Rooibos (GreenOxithin™). The magnitude of stroke was assessed by monitoring larval locomotion and thrombus formation. In terms of specific mechanisms probed, changes in redox status (MDA and TEAC), neurological markers (TH and NeuroD1) and endothelial health (tight/adhesion junction protein expression) were assessed. ResultsRooibos treatment limited thrombus formation and prevented stroke-induced deficits on larval motility. In terms of redox status, rooibos treatment prevented lipid peroxidation 3 days after initial stroke induction, reducing the need for significant upregulation of endogenous antioxidant mechanisms. Stroke-induced changes in neuronal (NeuroD1 and TH) protein expression were normalized in the presence of rooibos, suggesting a neuroprotective role. In terms of tight junction proteins, stroke-related decreases in ZO-1 expression were again prevented by rooibos treatment. In addition, rooibos treatment may beneficially modulate levels of claudin-5 and VE-cadherin, to indirectly limit stroke-associated vascular dysfunction. ConclusionsTaken together, activity data and physiological assessments suggest that unfermented rooibos may indeed have benefit in the context of stroke, via action at multiple targets. Thus, current data further our understanding of the mechanisms of actions of rooibos and warrant future research to confirm sufficient bioavailability of rooibos in target tissues, in mammalian systems.

Elevated systemic venous pressures as a possible pathology in prepubertal pediatric idiopathic intracranial hypertension.

Pediatric idiopathic intracranial hypertension (IIH) is a rare and challenging condition. As implied by the nomenclature, the etiologies remain unknown, and multiple etiologies are being investigated. In this study, we explored the potential role of increased systemic or cerebral venous pressure in the pathogenesis. An observational cohort study following the STROBE guidelines, including prepubertal children with clinical symptoms and imaging findings consistent with IIH referred to the neurosurgical department, was conducted. The patients underwent a comprehensive diagnostic protocol, including MRI, continuous intracranial pressure (ICP) monitoring, and endovascular venography with venous pressure measurements. The study included 11 consecutive patients (six boys and five girls) with an average age of 2.3years, and an average BMI of 18.4. Among these, one patient was found to have venous stenosis with a gradient; the other 10 patients presented with normal intracranial anatomy. All patients exhibited elevated venous pressures, with an average superior sagittal sinus pressure of 18.9mmHg, average internal jugular vein pressure of 17.0mmHg, and average central venous pressure of 15.9mmHg. Daytime ICP averaged 12.9mmHg, whereas nighttime ICP averaged 17.2mmHg with either A- or B-waves in 10 of the 11 patients. Despite pathological ICP, only three patients had papilledema. All patients had an increased systemic venous pressure, indicating a possible pathological factor for prepubertal IIH. Additionally, our findings show that young children often only partly meet the Friedman criteria due to a lack of papilledema, emphasizing the need for pediatric-specific diagnostic criteria. Further large-scale studies are needed to confirm these findings and to explore the underlying reasons for this increase in venous pressure and potential new treatment avenues.

Brightening triplet excitons enable high-performance white-light emission in organic small molecules via integrating n–π*/π–π* transitions

Luminescent materials that simultaneously embody bright singlet and triplet excitons hold great potential in optoelectronics, signage, and information encryption. However, achieving high-performance white-light emission is severely hampered by their inherent unbalanced contribution of fluorescence and phosphorescence. Herein, we address this challenge by pressure treatment engineering via the hydrogen bonding cooperativity effect to realize the mixture of n–π*/π–π* transitions, where the triplet state emission was boosted from 7% to 40% in isophthalic acid (IPA). A superior white-light emission based on hybrid fluorescence and phosphorescence was harvested in pressure-treated IPA, and the photoluminescence quantum yield was increased to 75% from the initial 19% (blue-light emission). In-situ high-pressure IR spectra, X-ray diffraction, and neutron diffraction reveal continuous strengthening of the hydrogen bonds with the increase of pressure. Furthermore, this enhanced hydrogen bond is retained down to the ambient conditions after pressure treatment, awarding the targeted IPA efficient intersystem crossing for balanced singlet/triplet excitons population and resulting in efficient white-light emission. This work not only proposes a route for brightening triplet states in organic small molecules, but also regulates the ratio of singlet and triplet excitons to construct high-performance white-light emission.

Cost-effectiveness analysis of continuous positive airway pressure treatment for obstructive sleep apnea in Singapore from a health system perspective.

This study assessed the cost-effectiveness of continuous positive airway pressure treatment for obstructive sleep apnea in Singapore from a health system perspective. The analysis evaluated a 5-year care pathway using a Markov model, considering per-patient costs of treatment, health system cost savings of obstructive sleep apnea and attributed conditions, the effectiveness measured in disability-adjusted life years with a discount rate of 3% and a weighted 5-year continuous positive airway pressure adherence of 74.1% from Singapore studies. Per-patient costs of treatment were from a large public hospital in Singapore. Efficacy of continuous positive airway pressure treatment, health system costs and disability-adjusted life years were obtained from literature; costs are in US dollars. We conducted probabilistic sensitivity analysis, one-way sensitivity analysis and what-if analysis. Based on a willingness-to-pay threshold of US $50,000 per disability-adjusted life year in USA, continuous positive airway pressure therapy was highly cost-effective, with an incremental cost-effectiveness ratio of $13,822 per disability-adjusted life year averted. Compared with the annual total costs of $856 for patients with continuous positive airway pressure treatment diagnosed by an inpatient sleep study, the total costs for those diagnosed by a home sleep test were $625, resulting in a remarkable 27% reduction per patient per year. One-way sensitivity analysis indicated that costs of treatment, effectiveness of continuous positive airway pressure treatment and adherence had a higher impact on the cost-effectiveness of continuous positive airway pressure therapy. The what-if analysis suggested that for continuous positive airway pressure treatment to be cost-effective, adherence rate should be at least 16.1%. These findings provide valuable insights for policymakers in making informed decisions on funding diagnosis and continuous positive airway pressure therapy within Singapore's healthcare system.

O90 EFFICACY AND SAFETY OF DUAL COMBINATIONS OF ANTIHYPERTENSIVE DRUGS AS FIRST-LINE THERAPY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

Background: Hypertension remains the primary cause of mortality worldwide, resulting in about 11 million deaths annually. Despite recent hypertension guidelines advocating for dual combination of antihypertensive drugs as the first-line therapy for most patients, many patients do not receive this therapy. Objective: To assess, among adults with hypertension, dual combinations of AHTDs compared to monotherapy as first-line treatment for blood pressure (BP)-lowering efficacy and safety. Methods: We systematically searched multiple electronic databases until December 2022 to identify relevant randomized, double-blind trials. We included trials involving adults with hypertension who were either treatment naive or untreated for at least 2 weeks, compared dual combinations of drugs with monotherapy from 5 major classes of AHTDs (angiotensin converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers, beta blockers, and diuretics), for a duration of at least 4 weeks and reported data on BP reduction. AHTDs and their combinations were categorized based on standard daily doses. Outcomes were reduction in BP, treatment related adverse events (TRAE) and withdrawals from the treatment due to adverse events (WDAE). Meta-analyses were conducted using random-effects model. Results: We included 98 trials (636 comparisons and 25892 participants). Overall, baseline mean BP was 159/102 mmHg. Overall BP reduction with dual combination compared to monotherapy was 4.4 (CI: 3.8-5.1)/3.5 (CI:3.2-3.9) mmHg. Compared with standard-dose monotherapy, dual combinations of &lt;1 + &lt;1, 1 + &lt;1 and 1 + 1 (i.e. low-to-standard dose), showed a dose-response relationship in reducing BP by 1.4 (CI: 0.01-2.7)/2.3 (CI: 1.4-3.1), 4.4 (CI: 3.6-5.2)/ 3.3 (CI: 2.9-3.8) and 7.8 (CI: 6.2-8.9)/5.2 (CI: 4.4-5.9) mmHg, respectively. TRAEs [4.8% vs 4.9%; RR 0.92 (0.80 to 1.06)] and WDAEs [0.8% vs 0.9%; RR 1.8 (1.5 to 2.1)] were uncommon with low-to-standard dose dual combinations, with no significant difference compared with standard-dose monotherapy. Conclusion: First-line treatment with low-to-standard dose dual combination therapy is more efficacious and equally safe compared to monotherapy to reduce BP.

Abstract 17: First-Line Beta Blocker Use Among &gt;3.1 Million Veterans Initiating Hypertension Treatment, 2000-2022

Introduction: It is unknown how often beta blockers (BB) are used first line for high blood pressure (BP) treatment among patients without compelling indications, despite US BP guidelines not recommending this practice since 2014. Research Question: How many start, and what factors influence, first line BB use among patients without compelling indications? Methods: Serial cross-sectional study of outpatients newly diagnosed and initiating treatment in the Veterans Health Administration, 1/1/2000–12/31/2022. We removed prevalent users, categorized drugs by class, and presented compelling indication status by initial BB use (mono- or combination therapy). Among those without compelling indications (ie, aortic aneurysm/disease, angina, atrial fibrillation/tachyarrhythmia, chronic liver disease/cirrhosis, heart failure with reduced ejection fraction, myocardial infarction, or coronary revascularization), multivariable Poisson regression estimated factors associated with BB use. Results: Of 3138304 Veterans (mean age 61 years, 94% male, 65% Non-Hispanic White), 774821 (25%) initiated a BB, of which the proportion without compelling indications decreased over time from 91% to 81%; the proportion with compelling indications increased from 9% to 19% (Panel A). Specific BBs used changed over time (Panel B). Among those without compelling indications, BB initiation was more likely with increasing age, females, current smokers, alcohol abuse, aspirin or statin use, each additional antihypertensive prescribed, each pre-index hospitalization, and urban setting (Panel C). Conclusions: Most Veterans using BB first line for high BP do not have compelling indications. Interventions are needed to align real world treatments with guidelines.

Risk Factors Related to the Development of Full-thickness Pressure Injuries in Hospitalized Pediatric Patients.

Current pediatric pressure injury (PI) prevention measures are based on risk factors related to PI development in adults. Children offer a unique concern for PI development because their bodies are still developing, and their skin responds differently to external pressure. To explore risk factors for the development of full-thickness PIs in children aged 21 weeks' gestation to 21 years. This retrospective, observational, correlational study included 799 hospitalized children who developed a PI. The pediatric and adult PI risk factors used in the study were identified from the International Pressure Ulcer Prevention and Treatment Guideline. A stepwise multivariate logistic regression model was used. Multivariate analyses revealed that risk factors for predicting a full-thickness PI varied by age. For children aged 38 weeks to 12 months, risk factors included tissue perfusion and oxygenation: generalized edema, conditions of the OR, and nutrition deficits. For children aged 1 to 7 years, fragile skin status was a risk factor. For youth aged 8 to 21 years, the two risk factors were tissue perfusion and oxygenation: decreased oxygenation and extracorporeal membrane oxygenation. Across the total sample, extracorporeal membrane oxygenation, tissue perfusion and oxygenation: decreased oxygenation and malnutrition were risk factors for predicting a full-thickness PI. Full-thickness PI risk factors differ among the ages of pediatric patients.

Heterogeneous Outcome Selection and Incomplete Prespecification of Outcomes in Systematic Reviews: A Case Study on Pressure Injury.

To understand how reviewers select and prespecify outcomes for systematic reviews (SRs), the authors report on the outcomes used in SRs of pressure injury (PI) intervention and treatment and evaluate their completeness of prespecification. The authors searched four electronic databases for SRs involving PI prevention and/or treatments. Inclusion criteria were SRs and meta-analyses evaluating interventions for preventing or treating PI. Studies without systematic search or risk-of-bias assessment, conference proceedings, and articles not in Chinese or English were excluded. Two reviewers extracted and categorized the outcomes in domains, assessing outcome prespecification using a five-element framework. Data items included study characteristics, target population, type of interventions, and outcome variables. This review included 95 SRs that reported a total of 432 instances of 24 different outcome domains. An average of four outcome domains were reported per SR. The most frequently reported domains were PI healing, PI occurrence, and PI status. Of the 62 SRs that prespecified primary outcomes, 40 (64.52%) reported more than one primary outcome. Only 24 of the 432 instances (5.56%) were completely specified. Among the 24 outcome domains, 12 (50.00%) were listed as primary outcomes at least once. Primary outcomes were more completely specified than nonprimary outcomes. Systematic reviews of PI prevention and/or treatment report diverse, incompletely prespecified outcomes, highlighting the need for a core outcome set to standardize key clinical outcomes.

Enhanced mechanical properties of LPSOp/Mg composites using super high pressure treatment

The super high pressure (SHP) technique was employed to fabricate the magnesium matrix composites (MMCs) reinforced with long-period stacking order structure powder (LPSOp) by cubic-anvil large-volume press with six rams. The LPSOp was optimized through high energy ball milling (HEBM) with a chemical composition of Mg85Zn6Y9 (at%). The microstructure and mechanical properties of LPSOp/Mg composite was characterized by X-ray diffraction (XRD), scanning electron microscopy/transmission electron microscopy (SEM/EDS), transmission electron microscopy (TEM), microhardness and compressive tests. The microhardness of LPSOp exhibits a notable increase after HEBM, and the thermal stability of LPSOp is affirmed through elevated annealing. The SHPed LPSOp/Mg consists of Mg and LPSO phase. Upon annealing at 400 °C for 1 h, the LPSO phase precipitates from solid solution of Mg and W phase is also identified. The strength of composites by SHP treatment and subsequently annealing is significantly improved compared with the pure Mg without LPSOp, which demonstrates the maximum compression yield strength (CYS) of 250 MPa and ultimate compression strength (UCS) of 375 MPa with satisfactory ductility. The enhanced mechanical properties are attributed to the synergistic reinforcement effects of the dispersed and 3D skeletal structure of LPSOp with excellent interfacial bonding, the coexistence of nano-scale LPSO and W phase and partial solid solution strengthening.

Abstract P341: Orthostatic Hypertension Does Not Alter the Effect of Intensive Blood Pressure Treatment on Cardiovascular Disease and All-Cause Mortality: An Individual-Level Meta-analysis

Background: Orthostatic hypertension (OHTN) is common among adults with hypertension (HTN) and associated with cardiovascular disease (CVD). It is unclear whether HTN treatment reduces CVD outcomes similarly in adults with OHTN as adults without OHTN. Methods: We performed an individual-level meta-analysis, updating a previous systematic review of MEDLINE, EMBASE, and CENTRAL databases through November 13, 2023, which included randomized trials of blood pressure (BP) pharmacologic treatment (more intensive BP goal or active agent) on CVD or death. CVD events were adjudicated and included fatal and nonfatal coronary heart disease, stroke, and congestive heart failure. OHTN was defined as a rise in systolic BP ≥20 mmHg and/or diastolic BP ≥10 mmHg after changing positions from sitting to standing. Effects were examined overall and by trial type (BP goal or active agent), using Cox proportional hazard models adjusted for age and sex. Results: Of the 9 trials included, there were 29,235 participants followed for median of 4 years (mean age 69.5±10.9 years; 48.3% female; 21.0% with OHTN at baseline). Baseline OHTN was not associated with a higher risk of CVD or death (HR 1.03; 95% CI: 0.95, 1.13). More intensive BP treatment or active therapy lowered risk of CVD or death among those with OHTN at baseline (HR 0.80; 95% CI: 0.69, 0.93) and without OHTN at baseline (HR 0.81; 95% CI: 0.75, 0.87) with no difference between strata ( P -interaction 0.95) ( Figure ). Conclusion: While baseline OHTN was common among adults with HTN, it was not associated with CVD or death and did not alter the protective effect of more intensive treatment. More intensive treatment is an effective approach to prevent CVD events among adults with OHTN.

Synergistically improved strength and damping capacity of Mg-Li-Y-Er-Zn-Zr alloy by ultra-high pressure treatment

The application of Mg-Li alloys has been consistently constrained by the trade-off between strength and damping capacity (Q−1). In this paper, the strength and Q−1 of Mg-8Li-4Y-2Er-2Zn-0.6Zr alloy were significantly enhanced using ultra-high pressure (UHP) treatment. After UHP treatment, the tensile strength, the elongation, and the Q−1 of the alloy reached 277 MPa, 24 %, and 0.05, respectively. The synergistic improvement of mechanical and damping characteristics of the alloy is analyzed comprehensively. The proposed UHP technology has the potential to be widely utilized for the development of high-performance Mg-Li components.

Prevalence of continuous positive airway pressure-related aerophagia in obstructive sleep apnea: an observational study of 753 cases undergoing CPAP/BiPAP treatment in a sleep clinic - part one of a two-part series.

Aerophagia occurring during continuous positive airway pressure (C-aerophagia in CPAP) in patients with obstructive sleep apnea (OSA) disturbs CPAP therapy. However, the diagnostic criteria and exact prevalence of C-aerophagia are not well documented; therefore, this study aimed to evaluate them. Newly developed criteria (flatulence, eructation, and abdominal bloating, with quantitative evaluation of these symptoms and a clear timing of onset) were used to diagnose C-aerophagia. The study included 753 adults with OSA who underwent follow-up visits for positive airway pressure treatment (including CPAP and bilevel positive airway pressure). The observation period ranged from 6 months to 3 years past the survey date (between May 1 and July 31, 2023). Medical records of patients were retrospectively analyzed. Discomfort associated with C-aerophagia was examined using a visual analog scale (VAS); a score ≥ 7 was associated with definite discomfort. Association of patient demographics and CPAP parameters with occurrence of C-aerophagia was analyzed using multivariate analysis. The prevalence of C-aerophagia was 7.2%. Although more than half of these patients reported discomfort associated with aerophagia, only 44.4% reported to their physician. The multivariate analysis showed that increased CPAP pressure level (odds ratio [OR] = 1.24) and comorbid gastroesophageal reflux disease (GERD; OR = 2.52) promote C-aerophagia, while increased age (OR = 0.76) and body mass index (BMI; OR = 0.88) inhibit it. The prevalence of C-aerophagia was 7.2%. Most patients with C-aerophagia experience discomfort, but may not report these symptoms. High CPAP pressure and GERD promoted C-aerophagia, while aging and increased BMI prevented it.

Investigation of starch hierarchical structure in relation to physicochemical properties and digestive behavior under different high hydrostatic pressure treatment time

Changes and causal relationships in the hierarchical structure, thermal, pasting and rheological properties, as well as the digestive behavior of starch under different high hydrostatic pressure (HHP) treatment time were investigated. At 5 min, the thickness of amorphous lamellae increased (2.76 nm) and the content of B2 and B3 chains in the amorphous lamellae decreased significantly (10.78 % and 9.08 %). As the treatment time increased, the crystalline lamellae swelled and tightly arranged double helices located in the crystalline lamellae were disturbed, resulting in a decrease in the content of double helices (12.16 %) and relative crystallinity (16.96 %). Helix dissociation, crystal disruption, lamellar collapse and granule deformation were observed at 20 min. These structural changes were closely linked to variations in the physicochemical behaviors. The thermal parameters decreased gradually, accompanied by a decrease in double helix stability. The swollen crystalline lamellae provided more space for molecular stretching, thus enhancing the pasting characteristics. Regarding the digestive behavior, the swollen amorphous lamellae facilitated the invention of enzyme molecules to hydrolyze the starch at 5 min. The digestion rate coefficient and rapidly digestible starch content increased significantly until 15 min, which demonstrated that starch was more easily digested while retaining its intact granular form.

Obstructive Sleep Apnea and Serotoninergic Signalling Pathway: Pathomechanism and Therapeutic Potential.

Obstructive Sleep Apnea (OSA) is a disorder characterized by repeated upper airway collapse during sleep, leading to apneas and/or hypopneas, with associated symptoms like intermittent hypoxia and sleep fragmentation. One of the agents contributing to OSA occurrence and development seems to be serotonin (5-HT). Currently, the research focuses on establishing and interlinking OSA pathogenesis and the severity of the disease on the molecular neurotransmitter omnipresent in the human body-serotonin, its pathway, products, receptors, drugs affecting the levels of serotonin, or genetic predisposition. The 5-HT system is associated with numerous physiological processes such as digestion, circulation, sleep, respiration, and muscle tone-all of which are considered factors promoting and influencing the course of OSA because of correlations with comorbid conditions. Comorbidities include obesity, physiological and behavioral disorders as well as cardiovascular diseases. Additionally, both serotonin imbalance and OSA are connected with psychiatric comorbidities, such as depression, anxiety, or cognitive dysfunction. Pharmacological agents that target 5-HT receptors have shown varying degrees of efficacy in reducing the Apnea-Hypopnea Index and improving OSA symptoms. The potential role of the 5-HT signaling pathway in modulating OSA provides a promising avenue for new therapeutic interventions that could accompany the primary treatment of OSA-continuous positive airway pressure. Thus, this review aims to elucidate the complex role of 5-HT and its regulatory mechanisms in OSA pathophysiology, evaluating its potential as a therapeutic target. We also summarize the relationship between 5-HT signaling and various physiological functions, as well as its correlations with comorbid conditions.

Effect of high hydrostatic pressure treatment on food composition and applications in food industry: A review

Nowadays, with the diversification of nutritious and healthy foods, consumers are increasingly seeking clean-labeled products. High hydrostatic pressure (HHP) as a cold sterilization technology can effectively sterilize and inactivate enzymes, which is conducive to the production of high-quality and safe food products with extended shelf life. This technology reduces the addition of food additives and contributes to environmental protection. Moreover, HHP enhances the content and bioavailability of nutrients, reduces the anti-nutritional factors and the risk of food allergen concerns. Therefore, HHP is widely used in the processing of fruit and vegetable juice drinks, alcoholic, meat products and aquatic products, etc. A better understanding of the influence of HHP on food composition and applications can guide the development of food industry and contribute to the development of non-thermally processed and environmentally friendly foods.

Chemical composition, anti-hypertensive properties, and sensory attributes of salt extracted from ash of Hygrophilia schulli.

The traditional usage of salt taken from vegetables for the treatment of blood pressure and diabetes is seen in several regions of Ethiopia, particularly in Gambella. The aim of the study was to investigate the mineral content, anti-hypertensive properties, and sensory attributes of salt obtained from the Hygrophilia schulli. The salt was extracted from the ashing of stems of Hygrophilia schulli. Optical Emission Spectroscopy with Inductively Coupled Plasma was used to identify macro-minerals, micro-minerals, and some toxic metals. Flame Atomic Absorption Spectroscopy was used to assess the levels of arsenic and mercury. The anti-hypertensive property of the salt was determined invivo using the Wistar rats. The extracted salt was rich in potassium and was deficient in sodium from the analyzed macro-minerals. It was free from mercury, cadmium, chromium, and arsenic. Lead and nickel were below the Tolerable Weekly Intake Provisional specified by the European Union. Among carbonate and sulfate, chloride was the main anion in this salt. The salt was discovered to have a low taste characteristic compared to common salt. However, the taste attribute of the combination of vegetable and common salt in different proportions was better than common salt. Rats fed with salt from Hygrophilia schulli showed a statistically significant lower systolic, diastolic, and mean blood pressure compared to normal-fed and common salt-fed rat groups. Generally, this study suggests that Hygrophilia schulli salt has the potential to be a viable alternative to common salt, particularly for those suffering from hypertension and other related chronic conditions.

Non-invasive hemodynamic monitoring during initiation of positive airway pressure treatment in patients with obstructive sleep apnea: a feasibility study

BackgroundThe association of obstructive sleep apnea (OSA) with cardiovascular morbidity has been repeatedly reported in numerous studies and argues for treatment initiation even in the absence of significant day time sleepiness. While the long-term consequences of positive airway pressure (PAP) treatment on OSA related comorbidities like secondary hypertension are based on substantial clinical evidence, less is known about the immediate hemodynamic effects.MethodsThis study tried to investigate the impact of PAP treatment on different hemodynamic parameters in 48 patients with OSA by extending the standard polysomnographic assessment with non-invasive hemodynamic monitoring using impedance cardiography (ICG). On two consecutive nights under diagnostic and therapeutic conditions, polysomnographic and hemodynamic data were acquired. In addition, we subdivided the participants according to their treatment related change in stroke volume (SV) and assigned the hemodynamic measurements to the corresponding sleep stage.ResultsComparing both conditions, a non-statistically significant decrease in SV and cardiac output (CO) was observed for all participants. Treatment initiation was associated with a statistically significant prolongation of the pre-ejection period (PEP) for the entire study population (p = 0.001) and the subgroup with decreasing SV (p = 0.008). In addition, systolic blood pressure (SBP) (p = 0.026) and pulse pressure (PP) (p = 0.041) were lowered significantly for patients with a therapeutically reduced SV under treatment conditions. A higher BMI (p = 0.020) and a more pronounced reduction of the respiratory distress index (RDI) (p = 0.030) and the arousal-index (p = 0.021) were observed for patients with decreasing SV. Correlational analysis revealed a negative relationship between the diagnostic values for both SBP (r=-0.324, p = 0.025) and PP (r=-0.407, p = 0.004) with the change in SV and a positive correlation with the change of the SBP (r = 0.317, p = 0.028) for all participants.ConclusionsTo conclude, our results indicate that treatment with a PAP device in patients with OSA can lead to a decrease in SV which is associated with a lowering of the SBP. This may be caused by a reduced sympathetic tone due to less respiratory events and an improved sleep profile.

Design and rationale for a randomized, open-label, parallel clinical trial evaluating major adverse cardiovascular events (pharmacological treatment versus diet control) in patients with high-normal blood pressure: the PRINT-TAHA9 trial

BackgroundThe distinction between normal and high blood pressure remains a debated topic, with varying guidelines on when to start medication. Contemporary guidelines advocate for the initiation of antihypertensive therapy in individuals who present with high-normal blood pressure, particularly those exhibiting elevated 10-year atherosclerotic cardiovascular disease (ASCVD) risk scores. Despite these recommendations, there is a notable lack of direct evidence supporting the efficacy of treating high-normal blood pressure to prevent major adverse cardiovascular events (MACE).MethodsThe PRINT-TAHA9 trial, a unicentric, randomized, open-label, controlled, parallel clinical study, seeks to explore the effects of intensive blood pressure control on MACE in participants with high-normal blood pressure. We will enroll 1620 adults aged 18 years and above with a systolic blood pressure range of 130–140 mmHg, diastolic blood pressure under 90 mmHg, and atherosclerotic cardiovascular disease (ASCVD) risk score exceeding 7.5%. The study will be executed in five distinct phases, with each phase enrolling between 300 and 400 participants. Participants will be randomly assigned to either the treatment group receiving antihypertensive medication (amlodipine/valsartan) and a low-salt/low-fat diet or to the control group receiving a similar diet. Follow-up visits are scheduled every 6 months over a 3-year period to monitor blood pressure, evaluate medication adherence, document any adverse events, and adjust the intervention as necessary. Cox proportional hazards regression analysis will be employed to examine the disparities between the two arms.DiscussionDespite guidelines promoting early treatment of elevated blood pressure, the debate continues due to insufficient evidence that such interventions significantly reduce the occurrence of MACE. This trial seeks to address this critical evidence gap.Trial registrationThe PRINT-TAHA9 trial was registered in October 2019 with the Iranian Registry of Clinical Trials (IRCT.ir) under the registration number IRCT20191002044961N1. https://irct.behdasht.gov.ir/trial/43092.

Research on the Functional Improvement of Ultra-high Pressure Rice Soaked in Ferulic Acid

In today s society, with the rising number of diabetes patients, the project group studied the effect of different concentrations of ferulic acid solution and ultra-high pressure processing on rice quality. The results showed that ultra-high pressure technology could improve taste, appearance and reduce GI value. With the increase of ferulic acid concentration under the joint action of UHP and ferulic acid solution, the hypoglycemic effect improved. SPSS analysis found that 1.5% ferulic acid and 400MPa, 10min ultra-high pressure treatment had the best comprehensive effects. It is hoped to develop ultra-high pressure rice suitable for diabetics, obese and weight loss people, upgrading ordinary rice to nutritional rice and hypoglycemic rice .