Reactivity Rate Research Articles

Hemodynamic response to exercise is impaired in individuals with Parkinson's disease

The aim of this study was to assess hemodynamic and cardiac autonomic response to high-intensity interval exercise (HIIE) versus moderate-intensity continuous exercise (MICE) in individuals with Parkinson's disease (PD). Twelve individuals (six men) with PD were randomly assigned to perform HIIE (4 min of warm-up followed by 21 min alternating 1 min at levels 15-17 with 2 min at levels 9-11 of rating of perceived exertion [RPE] in a cycle ergometer), MICE (4 min of warm-up followed by 26 min at levels 11-14 of RPE in a cycle ergometer) and control (CON; 30 min of sitting rest) interventions in separate days. Heart rate (HR), blood pressure (BP), endothelial reactivity and heart rate variability (HRV) were assessed before, immediately after and 45 min after each intervention. HR and exercise workload were measured during each intervention. Despite the within (high- vs. low-intensity intervals of HIIE) and between (HIIE vs. MICE) differences in workload during exercise sessions, HR was not different between high- (average HR=98±18 bpm) and low-intensity (average HR 97±19 bpm) intervals of HIIE, as well as between HIIE (average HR=97±18 bpm) and MICE (average HR=93±19 bpm) throughout the exercise. There were significant, but small, increases (P<0.01) in HR and systolic BP at post HIIE and MICE, which returned to levels similar to preintervention during recovery. There were no within- and between-intervention differences in diastolic BP, endothelial reactivity and HRV. The present results suggest that hemodynamic response to exercise is impaired in individuals with PD.

Fabrication of iron oxide nanoparticles from ammonia vapor and their importance in plant growth and dye degradation

Iron oxide (Fe2O3) nanoparticles are of great interest compared to their bulk counterpart due to their higher surface area, enhanced possibilities of bio-distribution and high rate of reactivity. In the present work, we report a simple, rapid, and cost-effective method for the synthesis of Fe2O3 nanoparticles based on the aqueous-gaseous phase reaction of iron (III) chloride solution by ammonia vapor. Post-physicochemical characterization of these nanoparticles, we have further reported that these positive surface charged containing particles can increase the plant growth under in vitro conditions. Investigations on maize plant show that Fe2O3 nanoparticles could have potential as a fertilizer substituent. Moreover, these particles were found to exhibit good photocatalytic activity against Rhodamine B, indicating their potential use toward soil remediation affected with industrial wastewater from dye industries.

Psychophysiological assessment of stress reactivity and recovery in anxiety disorders

The present study aimed to examine changes in psychophysiological arousal from baseline to a stressor phase (reactivity) and from the stressor phase to a second resting phase (recovery) in patients with anxiety disorders. Fifty adult patients with DSM-5 anxiety disorders (panic disorder, generalized anxiety disorder, or social anxiety disorder) and 28 healthy control (HC) participants underwent psychophysiological monitoring including electrocardiogram, respiration rate, electrodermal activity, gastrocnemius electromyograph, and end-tidal CO2 for a 3-min resting phase, a 6-min mild stressor phase, and a 3-min recovery phase. Anxious patients then went on to receive naturalistic cognitive-behavioral therapy (CBT) in a specialty outpatient clinic. Results for the reactivity phase indicated that compared to HCs, patients with social anxiety disorder exhibited heightened psychophysiological reactivity while patients with panic disorder and generalized anxiety disorder exhibited attenuated reactivity. Results for physiological recovery (return to baseline after the stressor was withdrawn) were mixed, but provided some support for slower autonomic recovery in patients with generalized anxiety disorder and panic disorder compared to HCs. Participants with all anxiety disorders exhibited diminished change in high frequency heart rate variability compared to HCs. Generally, psychophysiological reactivity and recovery were not associated with CBT outcome, though exploratory analyses indicated that greater respiration rate reactivity and stronger respiration rate recovery were associated with better CBT outcomes in patients with panic disorder.

Characteristics of newly diagnosed HIV-positive service users using a pan-London e-sexually transmitted infection screening service.

Maximising opportunities and removing barriers to HIV testing can help reduce the undiagnosed HIV population. Digital STI/HIV screening services have increased in availability and can improve access and testing coverage. We identified the characteristics of individuals who tested HIV positive using a regional, integrated, self-sampling STI service. The e-notes of service users with reactive HIV screening results were reviewed. Between 8 January 2018 and 31 December 2019, 0.097% (144/148,257) users received a reactive HIV result, 30/144 (20.8%) of whom had previously diagnosed HIV infection. All of the remaining 114 users were notified of their screening result, an estimated 109/114 (95.6%) received confirmatory testing (CT) at a sexual health clinic (SHC) and the confirmatory outcome was documented in 102/114 (89.5%) of cases: 34/114 (29.8%)were HIV positive, 68/114 (59.6%) HIV were negative and the result was unknown in 12/114 (10.5%). All new diagnoses transitioned to HIV outpatient care. These individuals were median age 28years; 94.1% (32/34) male; 88.2% (30/34) men who have sex with men and 11.8% (4/34) heterosexual; 58.8% (20/34) of white/'white other' ethnicity and 42.2% of Black, Asian and minority ethnic group; 50%(17/34) had a concurrent STI; 9% and 21% had never tested for HIV or attended a SHC before. n HIV test reactivity rate of 0.1%(95% CI) was observed. Confirmed new HIV diagnoses comprised 0.023% of all HIV tests performed. All individuals where CT confirmed a new HIV diagnosis transitioned to HIV specialist care.

High-intensity interval vs moderate-intensity continuous exercise in heated water-based on acute hemodynamic, vascular, and cardiac autonomic responses in older individuals with hypertension

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP #2017/25648-4 #2018/09695-5) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES – Finance Code 001). OnBehalf Exercise and Chronic Disease Research Laboratory (ECDR) Introduction Post-exercise hypotension is an important tool in the treatment and control of hypertension. In recent years, high-intensity interval exercise (HIIE) has gained significant popularity in exercise-based prevention and rehabilitation of clinical populations. However, to date, it is not clarifying the acute responses of exercise performed in heated water-based in older individuals with hypertension. Purpose To assess hemodynamic, vascular, and cardiac autonomic responses to heated water-based HIIE versus moderate-intensity continuous exercise (MICE) in older individuals with hypertension. Methods Twenty older individuals (67 ± 7 y) under treatment for hypertension were randomly assigned to perform HIIE (25 min), MICE (30 min) and control (CON; 30 min) sessions in a heated swimming pool (30-32ºC). Blood pressure (BP), arterial stiffness, endothelial reactivity, and heart rate variability (HRV) were measured before (PRE), immediately after (POST), and after 45 min (REC). 24-h ambulatory BP monitoring and ambulatory HRV were also performed after each intervention. HRV were analyzed in ms² (ms²) or normalized units (nu) and then converted into natural logarithms (ln). Time domain markers as mean of intervals R-R (µi-RR), and frequency domain such as high frequency band (HF) and low frequency band (LF). Results Systolic BP increased at POST (p &amp;lt; 0.05) in all interventions, with higher increases in CON (29 ± 3 mmHg) and MICE (19 ± 3 mmHg) than HIIE (9 ± 4 mmHg). Although systolic BP reduced at REC in all interventions, it returned to levels similar to PRE in HIIE, and continue at higher levels than PRE in MICE and CON. HIIE promoted a higher response on markers of parasympathetic modulation at REC compared to MICE (HFln,nu 0.14 ± 0.06, p = 0.02) and CON (µi-RR: 0.02 ± 0.01, p = 0.05). By contrast, during night-time, HIIE demonstrated a lower parasympathetic modulation than CON (HFln,nu: -0.06 ± 0.03, p = 0.05). In addition, CON showed a higher HRV during 24-h compared to HIIE and MICE. Conclusion Despite differences between interventions in BP and cardiac autonomic responses, heated water-based HIIE or MICE were not effective to improve hemodynamic and vascular responses. These results may have important implications in the management of older individuals with hypertension in heated water-based.

Cerebral hemodynamic alterations in patients with Covid-19

Background/aim Coronavirus 2019 disease (Covid-19) was first seen in December 2019 and afterwards it became pandemic. Several systemic involvements have been reported in Covid-19 patients. In this study, it was aimed to investigate the cerebrovascular hemodynamics in patients with Covid-19.Materials and methods The sample of this study included 20 patients hospitalized in our clinic diagnosed with Covid-19 via PCR modality and 20 healthy volunteers of similar age and sex. Bilateral middle cerebral arteries were investigated with transcranial Doppler ultrasonography. Basal cerebral blood flow velocities and vasomotor reactivity rates were determined and statistically compared. ResultsWhen patient and control groups were compared, the mean blood flow velocity was found to be higher in Covid-19 patients than in the healthy volunteers and it was statistically significant (P = 0.00). The mean vasomotor reactivity rates values were found to be lower in the Covid-19 group than the healthy group and was also statistically significant (P = 0.00). Conclusion An increase in basal cerebral blood velocity and a decrease in vasomotor reactivity rates in patients with Covid-19 can be considered as an indicator of dysfunction of cerebral hemodynamics in the central nervous system and this can be evaluated as a result of endothelial dysfunction.

The Role of Dynamic Subtraction MRI in assessment of reactivity of HFLs post TACE by 3 tesla MRI machine

Background: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, and has a poor prognosis unless treated. The aim of this work was to assess HCC cases after trans-arterial chemoembolization by subtraction dynamic contrast enhanced MRI to detect its accuracy, sensitivity and specifity in detecting residual tumor and assess the need for further treatment. Methods: 35 patients with 42 HCC lesions underwent transarterial chemoembolization were included in this study. Those patients underwent MRI after 3 months where dynamic MRI and subtraction dynamic MRI were obtained. The interpretation of dynamic MRI and the subtraction dynamic MRI was done by two different readers experienced in hepatic imaging blinded to each other. Patients were classified according to reactivity rate into 2 independent groups: Reactive group (30 patients), Not reactive group (5 patients). Results: Comparative study between D-MRI and DS-MRI assessments revealed; highly significant increase in reactivity rate in DS-MRI in HCC patients during 1st and 2nd readings; with highly significant difference (p = 0.0078 respectively). By using ROC-curve analysis, DS-MRI assessment discriminated patients with reactivity from patients without, with perfect accuracy, sensitivity= 100% and specificity= 100% (p < 0.0001). Conclusion: Dynamic MRI is valuable in detecting recurrent lesions however, this value is augmented by the addition of subtraction technique especially in lesions having high signal before administration of contrast medium.

Development of CuO-based oxygen carriers supported on diatomite and kaolin for chemical looping combustion

Chemical Looping Combustion (CLC) technology has emerged as a promising alternative capable of restricting the effects of global warming due to anthropogenic gas emissions, especially CO2, through its inherent capture. This study aims to synthesize and evaluate Cu-based oxygen carriers supported on natural materials such as diatomite and kaolin, through the incipient wet impregnation method for CLC process applications. Oxygen carriers were characterized by X-ray diffraction (XRD), temperature-programmed reduction (TPR), and scanning electron microscopy with surface energy dispersive x-ray spectroscopy (SEM-EDS). The mechanical strength of the two oxygen carrier particles was determined after the sintering procedure resulting in high crushing force. Reactivity of oxygen carriers was evaluated in a thermobalance with CH4 and H2 gases. Different reaction pathways were attempted when undergoing the redox cycles: total direct reduction of CuO to Cu0 for Cu-K and partial reduction of CuO to Cu2O and CuO to Cu-D. However, the highest reactivity and reaction rate was achieved in Cu-D due to the pore structure of diatomite, the chemical composition and the resulting interaction between CuO and the support. H2 gas reactivity tests showed a higher conversion rate and greater stability between cycles for both oxygen carriers. Thus, the reducible CuO content present in Cu-Diatomite during the reactivity test with H2 as the fuel gas was ideal for achieving high solids conversion, tendency for greater stability and a higher reaction rate.

Cardiac vagal control in response to acute stress during pregnancy: Associations with life stress and emotional support.

Life stressors during pregnancy can disrupt maternal stress regulation and negatively impact offspring health. Despite the important role of cardiac vagal control (e.g., heart rate variability; HRV) in stress regulation, few studies have investigated how life stressors and emotional support influence vagal control during pregnancy. This study aimed to (a) characterize patterns of cardiac vagal control in response to a stressor administered in pregnancy, and (b) examine the effects of life stress and emotional support on vagal control during rest, reactivity, and recovery. Participants included 191 pregnant women (79% Black; 21% White) living in an urban U.S. city (73% receiving public assistance). Heart rate (HR) and HRV (indexed by RMSSD) were recorded continually during the preparation, task, and recovery periods of the Trier Social Stress Test (TSST). Participants reported recent life stressors (e.g., relationship problems, financial hardship) and emotional support. Piecewise growth curve modeling was used to model rates of reactivity and recovery, adjusting for gestational age at time of assessment and recent health problems. Life stress predicted greater HR and HRV reactivity to the TSST as well as greater HRV recovery (vagal rebound). However, associations were only evident for women reporting high emotional support. Results suggest that pregnant women living with frequent life stressors may exhibit more rapid autonomic responses to acute stress, including more rapid vagal rebound after stressors, potentially reflecting physiological adaptation to anticipated high-stress environments; emotional support may enhance these responses. Studies are needed to investigate long-term health outcomes related to this stress response pattern.

Copolymerization behavior of diallyldimethylammonium chloride‐nonionic macromonomer in water‐ether mixture solution and flotation performance of the copolymer for treating oily wastewater

AbstractCopolymerization of cationic monomer and nonionic macromonomer in water‐ether mixture solution is useful for preparing the functional polymer. Copolymer of diallyldimethylammonium chloride (DMDAAC) and a nonionic block polyether macromonomer (PEP‐65) has been found that has very well reverse demulsification performance, but the polymerization phenomenon cannot be described by any reported polymerization method. In this paper, the copolymerization behavior including polymer mechanism, polymerization kinetics, and reactivity rate of DMDAAC and PEP‐65 in the mixture solution of water and propylene glycol methyl ether (PGME) was studied for explaining the special copolymerization phenomenon and its flotation performance for treating oily wastewater was also investigated. The results showed that DMDAAC‐PEP‐65 copolymerization in water‐PGME mixture solution has four stages and has both characteristics of emulsion polymerization and dispersion polymerization. In addition, the copolymer also has excellent flotation performance.

Tuning the reactivity and energy release rate of I2O5 based ternary thermite systems

Iodine pentoxide (I2O5) based nanothermites are one of the most promising candidates for biocidal energetic materials due to superior reactivity and high iodine content. However, the tunability of nanothermites, which is important for biocidal performance, has not been fully exploited for I2O5 based nanothermites. In this work, I2O5 with various fuels (Al, Ti, Si) and their mixtures (i.e., a ternary system) have been investigated. The reactivity and flame temperature were evaluated by a pressure cell coupled with a spectrometer. Temperature-Jump time-of-flight mass spectrometry (T-Jump TOFMS) was used to probe the reaction mechanism and iodine release behavior, along with a high-speed camera to capture the ignition event. I2O5 showed distinct reactivity with different fuels. As a result, by varying the fuel composition of ternary systems, the combustion properties can be tuned. Rapid heating experiments revealed that the reaction initiation was shifted from gas phase dominated to condensed phase dominated mechanism after introducing Ti or Si into Al/I2O5 system. Further analysis of the ternary systems found that the energy release rate correlates with burn time instead of flame temperature. This study shows an approach to tune the reactivity and energy release rate of I2O5 based nanothermites without compromising the energy density.

Investigation of aging induced processes on thermo-kinetic and combustion characteristics of tungsten pyrotechnic delay composition

A degradation in performance parameters related to thermal decomposition and combustion behaviour of tungsten based pyrotechnic delay composition can occur when subjected to accelerated aging conditions in a controlled environment. The present study utilizes various methods to quantify the extent of degradation in thermo-kinetic and burning characteristics as well as to postulate a fundamental aging mechanism for traditional tungsten (W) pyrotechnic delay material, which has not been attempted in the past. The delay composition based on metallic fuel (W) and perchlorate oxidizer is subjected to aging at constant temperature of 71 °C and 95% relative humidity, for 2 and 12 weeks, respectively. Experiments including thermal analysis, combustion temperature profile and burning rate measurements are conducted together with numerical simulation of an actual pyrotechnic delay device. Moreover, the reaction mechanism, chemical kinetics, and combustion behaviour between pristine and aged cases are examined. Results illustrate that there exist two aging induced processes, which increases the presence of large agglomerated particles, high metal oxide content by thickening the outer oxide layer of metallic fuel, and more unreacted oxygen to instigate incomplete combustion in aged samples. This alters the reaction pathway of combustion process, lowers average thermal conductivity, and reduces diffusion of reactants in aged samples, thus causing significant decrement in the heat of reaction (31%), combustion zone temperature (10%), reactivity (12%), and burning rates (10%), such that the overall pyrotechnic delay device experiences misfiring during operation or a failure in accomplishing its actual intended task.

Coconut allergy: Characteristics of reactions and diagnostic predictors in a pediatric tertiary care center

BackgroundLittle is known on the clinical manifestations of coconut allergy. Our knowledge to date is mainly based on case reports. ObjectiveTo characterize the allergic reactions to coconut and suggest diagnostic cutoffs for specific immunoglobulin E (sIgE) and skin prick testing (SPT) to predict clinically reactive coconut allergy. MethodsMethods include retrospective chart review at an urban tertiary care center of patients with positive testing result for coconut. Probability curves were computed by logistic regression for SPT and coconut sIgE. ResultsOf 275 records reviewed, 69 patients reported coconut reactions and 206 were sensitized only or nonallergic. The reactions occurred with breastfeeding (n = 2), contact (n = 10), or oral ingestion (n = 57). Approximately 50% of oral ingestion reactions were associated with mild/moderate anaphylaxis. Clinical reactivity vs sensitization was more common in topical coconut users (2-fold) (P = .02). Although not statistically significant, there was a trend toward more coconut allergy vs sensitization in Asian and African American patients. The probability of allergy with positive SPT result was approximately 50% and with sIgE was approximately 60%. At an SPT of 9 mm wheal or sIgE of 58 kU of allergen/L, there is a 95% probability of reaction. Cosensitization with tree nuts, legumes, and seeds was common. Macadamia nut had the strongest correlation with coconut (r = 0.81, P < .001, n = 101). ConclusionAlthough the rate of reactivity to coconut in sensitized individuals is low, half of the reactions from consumption met the criteria for anaphylaxis. Clinicians should be aware of the spectrum of reactions and diagnostic use of sIgE and SPT.

Tobacco Use and Skin Reactivity in Patients With Percutaneous Auditory Osseointegrated Implants.

To determine if there is an association between tobacco use and the development of postoperative skin reactions in patients undergoing percutaneous osseointegrated auditory implant (pOAI) surgery. Single surgeon retrospective cohort study. Academic medical center. Retrospective chart review was performed on all patients who underwent pOAI. Smoking status (current and former users versus never-users) was recorded as were numerous demographic and surgical variables. The primary outcome measure was skin reactivity as measured by Holgers score. Secondary outcomes studied included total number of problem visits, minor interventions, and major interventions. 126 patients, 73 with no tobacco history (NT) and 53 with a positive smoking tobacco history (T) underwent pOAI surgery in this study. The T group was found to have higher rates of first postoperative visit soft tissue reactions compared with the NT group (24.5% versus 6.8%, p 1/4 0.011, odds ratio [OR] 4.42, 95% confidence interval [CI]: 1.5, 13.3), but not at long-term follow-up. When former smokers were eliminated from analysis, differences were also found at long- term follow-up (40.9% versus 19.2%, p 1/4 0.037, OR 2.92, 95% CI [1.0 - 8.1]). There were no differences in total number of problem visits or total number of minor or major interventions. Patients with a history of tobacco use have a significantly higher rates of skin reactivity compared with patients without, though smoking cessation may partially mitigate long-term risks. Surgeons should be aware of the risks of early skin reactivity and should counsel patients accordingly.

Oral Prescription Opioids as a High-Risk Indicator for Hepatitis C Infection: Another Step Toward HCV Elimination.

BackgroundThe opioid epidemic across the U.S. poses an array of public health concerns, especially HCV transmission. HCV is now widely curable, yet incident rates are increasing due to the opioid epidemic. Despite the established trajectory from oral prescription opioids (OPOs) to opioid use disorder (OUD), OUD to injection drug use (IDU), and IDU to hepatitis C virus (HCV), OPOs are not a defined risk factor (RF) for HCV infection. The objective of this study was to observe rates of HCV testing and Ab reactivity (HCVAb+) in patients receiving OPOs to substantiate them as a RF, ultimately contributing to HCV elimination.MethodsData from MedStar Health patients receiving OPOs from 1/2017 to 12/2018 were collected and analyzed using chi-squared or student t-tests and logistic regression for uni- or multi-variable analyses, respectively. Statistical significance was defined as P < .05; Epi Info and SAS v 9·4 were used for statistical analyses; IRB approval was received.ResultsThere were 115 415 individuals prescribed OPOs over the study period. In this population, 8.6% (932) were HCVAb+ when tested and not previously diagnosed (10 900); 3.4% (3893) had an OUD diagnosis, 20.6% (803) of whom were HCV tested; 25.4% (361) of all HCVAb+ (1421) had an OUD diagnosis. OUD (ORadj 8.53 [7.22-10.07]) was an independent predictor of HCVAb+ in this population.Conclusions(1) In a large population prescribed oral opioids, HCVAb+ was 8.6%, higher than our previously published data (2.5%) and the US rate (1.7%); (2) only 20% of patients diagnosed with OUD were tested; and (3) only 25% of HCVAb+ patients were classified with OUD; this suggests underreporting of OUD in this population. Primary Care and Community Health Recommendations: (1) Re-testing for HCV in patients taking OPOs; (2) increased HCV testing among OUD patients; and (3) improved surveillance and reporting of OUD.

Prevalence of syphilis reactivity in patients with stroke, cognitive impairment and extrapyramidal syndromes: a retrospective study.

In the last two decades, there has been a resurgence of syphilis worldwide. However, epidemiological data on neurosyphilis are inconsistent for the lack of reporting data and diagnostic gold standard tests. The aim of the present study was to estimate the prevalence of syphilis reactivity in a cohort of patients with neurological diseases of our hospital. We retrospectively analyzed the medical records of the patients hospitalized at the Stroke Unit of the Neurology Clinic and those suffering from cognitive impairment hospitalized at the acute ward of the Geriatrics Clinic between January 2017 and December 2019. Also the patients who attended the Movement disorder outpatient clinic during the same study period were examined. To detect syphilis reactivity a qualitative specific treponemal test on patient’s serum was performed: the Treponema pallidum haemagglutination assay (TPHA). A total of 652 patients were admitted and 315 of them (52%) were submitted to a routine screening for syphilis: 307 (97%) were negative while 8 (3%) had a positive syphilis serology. The TPHA-positive patients (4 males, 4 females) were 2 patients with stroke, 5 with cognitive impairment and 1 with Parkinsonism with a mean age of 83 years, suffering from multiple comorbidities. Although the patients we have retrospectively studied have not undergone lumbar puncture to confirm the diagnosis of neurosyphilis, the not negligible syphilis reactivity rate found in our series suggests that serological screening for syphilis should be reviewed as a routine screening test in neurology and geriatrics departments, especially if the clinical presentation of the neurological diseases is atypical.

Prediction of photofading of N‐β‐hydroxyethylamino‐o‐nitrophenyl derivatives: a theoretical study

AbstractUntil now, the lightfastness of hair dyes had not been investigated using all‐valence molecular orbital methods. The results of calculations are used to obtain the highest occupied molecular orbital (HOMO) and lowest unoccupied molecular orbital (LUMO) frontier electron density, which can reflect the propensity for electrophilic or nucleophilic attack at an atom in a molecule. Using semi‐empirical quantum chemical methods AM1 and PM3, we have calculated the reactivity rates , superdelocalisability and electron density distribution in the tested dyes. We have found that the photooxidation of hair dyes (photochemical decomposition of hair dyes) and derivatives of N‐β‐hydroxyethylamino‐o‐nitrobenzene occurs through the degradation of the N‐β‐hydroxyethylamine substituent and on C2 or C4 atom (C4–NO2) in the process of electrophilic reaction with singlet oxygen 1O2 or nucleophilic reaction on the C1 carbon atom of the aromatic ring, with the use of superoxide anion radical O2●. The structures of the dyes were optimised using MM+, DM and AM1 or PM3 until constant energy value was realised with a 0.01 kcal/mol convergence criterion.

Psychophysiological responses underlying unresolved loss and trauma in the Adult Attachment Interview.

Unresolved loss/trauma in the context of the Adult Attachment Interview (AAI) has been theorised to result from dissociative processing of fear-related memories and ideas. To examine the plausibility of this model, this study tested hypothesised associations between unresolved loss/trauma and indicators of autonomic nervous system (ANS) reactivity. First-time pregnant women (N = 235) participated in the AAI while heart rate (interbeat interval; IBI) and indicators of parasympathetic reactivity (respiratory sinus arrhythmia; RSA) and sympathetic reactivity (pre-ejection period; PEP, skin conductance level; SCL) were recorded. Using multilevel modelling, ANS reactivity was examined in relation to topic (loss/trauma versus other questions); discussion of actual loss/trauma; classification of unresolved/disorganised; and unresolved responses during the interview. Responses to loss/trauma questions and discussion of loss were associated with respectively larger and smaller IBIs. There was no moderation by unresolved/disorganised status. Unresolved responses about loss were associated with smaller IBIs. Participants classified as unresolved/disorganised showed decreasing PEP and blunted SCL throughout the whole interview. The findings suggest that unresolved speech about loss co-occurs with physiological arousal, although the inconclusive findings regarding parasympathetic and sympathetic nervous system responses fail to clearly support the role of fear.

Source apportionment of volatile organic compounds: Implications to reactivity, ozone formation, and secondary organic aerosol potential

Volatile organic compounds (VOCs) are important contributors to atmospheric chemical reactivity rate (LOH), ozone formation potential (OFP), and secondary organic aerosol formation potential (SOAP). The purpose of this study was to determine the contributions of different VOC sources to LOH, OFP, and SOAP using positive matrix factorization (PMF) model. Hourly observation of ambient VOCs at a megacity of Central China was conducted for one month in winter. The LOH, OFP, and SOAP of VOC species were firstly estimated. The PMF model was then used to apportion their sources. Five VOC sources including solvent usage, gasoline evaporation, combustion sources, vehicle emissions, and industrial sources were apportioned with their average contributions of 11.6%, 14.2%, 39.0%, 22.5%, and 12.6%, respectively. Industrial sources were the highest contributors to the LOH and SOAP with average contributions of 32.2% and 32.8%, respectively, while vehicle emissions contributed most to the OFP (27.8%). This study highlighted that the VOCs and ozone pollution control should give priority to the reactivity (OFP and SOAP) based strategies rather than concentration contribution-based strategies.

Platelet reactivity among patients with acute coronary syndromes and multivessel coronary artery disease

Abstract Background Patients with multivessel or complex coronary artery disease (CAD) are at increased risk of atherothrombotic events. It has been suggested that these patients may derive an incremental benefit with more intense antiplatelet strategies, according to prior subgroup analyses from randomized clinical trials. However, whether there is any association between the presence and extension of multivessel CAD and platelet aggregability (PA) in patients with acute coronary syndromes (ACS) is unknown. Purpose To analyze the independent association between PA and presence of multivessel CAD in patients with ACS. Methods Patients with ACS on dual antiplatelet therapy (aspirin plus clopidogrel) were included in this study. Multivessel CAD was defined as the presence of significant ≥50% stenosis at two or more major epicardic vessels. Platelet aggregability was assessed by VerifyNow P2Y12 assay expressed in P2Y12 Reactivity Units (PRU) on the day of discharge from the coronary care unit. High On-treatment platelet reactivity (HPR) was defined as PRU ≥208. Stepwise linear and logistic regression models were applied to adjust for confounders. Models were adjusted for: age, sex, race, diabetes, hypertension, smoking, dyslipidemia, prior MI, prior PCI, prior CABG, prior HF, prior stroke and ACS phenotype (STEMI vs. Non-ST-segment elevation ACS). Results A total of 237 patients were included, among whom 143 (60.3%) had multivessel CAD at the coronary angiogram and 175 (73.8%) were submitted to PCI during index hospitalization. Patients with multivessel disease were older (mean age 64.8±12.1 vs. 58.9±11.2 years; p&amp;lt;0.001) and more likely to have a history of diabetes (47.6% vs. 29.8%; p=0.006) and non-ST-segment elevation ACS as the index event (55.2% vs. 28.7%; p&amp;lt;0.001), compared to patients without multivessel CAD. After adjustments, presence of multivessel CAD was associated with higher PA (mean 161.4±74 PRU in patients with versus 140.3±70.9 PRU in patients without multivessel CAD; adjusted mean difference 23.7 PRU; 95% CI 4.8 to 42.5; p=0.014). Additionally, there was an incremental of 12.5 PRU (95% CI 2.8 to 22.3; adj p=0.012) for each diseased vessel and of 4.67 PRU (95% CI 0.11 to 9.22; adj p=0.045) for each diseased coronary segment. Compared to patients with single-vessel disease, patients with three-vessel disease had higher rates of HPR. (Figure). Conclusion In patients with ACS, the presence and extension of multivessel CAD were associated with higher levels of platelet aggregability and higher rates of high on-treatment platelet reactivity with clopidogrel. This finding may explain the incremental benefit with more intense antiplatelet therapies seen in this particular subgroup in prior clinical trials. Prevalence of HPR and extension of CAD Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Sao Paulo Research Foundation (FAPESP)