Hemodynamic effects of sodium bicarbonate in critically ill neonates.

OBJECTIVE: To analyze the cardiovascular effects of sodium bicarbonate in neonates with metabolic acidosis. DESIGN: Prospective, open, non-randomized, before-after intervention study with hemodynamic measurements performed before and 1, 5, 10, 20, and 30 min after bicarbonate administration. SETTING: Neonatal intensive care unit, tertiary care center. PATIENTS: Sequential sample of 16 paralysed and mechanically ventilated newborn infants with a metabolic acidosis (pH < 7.25 in premature and < 7.30 in term infants, base deficit > -8). INTERVENTION: An 8.4% sodium bicarbonate solution diluted 1:1 with water (final osmolality of 1000 mOsm/l) was administered in two equal portions at a rate of 0.5 mmol/min. The dose in mmol was calculated using the formula "base deficit x body weight (kg) x 1/3 x 1/2". MEASUREMENTS AND RESULTS: Sodium bicarbonate induced a significant but transient rise in pulsed Doppler cardiac output (CO) (+27.7%), aortic blood flow velocity (+15.3%), systolic blood pressure (BP) (+9.3%), (+14.6%), transcutaneous carbon dioxide pressure (PtcCO2) (+11.8%), and transcutaneous oxygen pressure (PtcO2) (+8%). In spite of the PaCO2 elevation, pH significantly improved (from a mean of 7.24 to 7.30), and the base deficit decreased (-39.3%). Calculated systemic vascular resistance (SVR) (-10.7%) and diastolic BP (-11.7%) decreased significantly, while PaO2 and heart rate (HR) did not change. Central venous pressure (CVP) (+6.5%) increased only slightly. By 30 min after bicarbonate administration all hemodynamic parameters, with the exception of the diastolic BP, had returned to baseline. CONCLUSION: Sodium bicarbonate in neonates with metabolic acidosis induces an increase in contractility and a reduction in afterload.

Artificial muscle for end-stage heart failure.

We describe a device made of artificial muscle for the treatment of end-stage heart failure as an alternative to current heart assist devices. The key component is a matrix of nitinol wires and aramidic fibers called Biometal muscle (BM). When heated electrically, it produces a motorless, smooth, and lifelike motion. The BM is connected to a carbon fiber scaffold, tightening the heart and providing simultaneous assistance to the left and right ventricles. A pacemaker-like microprocessor drives the contraction of the BM. We tested the device in a dedicated bench model of diseased heart. It generated a systolic pressure of 75 mm Hg and ejected a maximum of 330 ml/min, with an ejection fraction of 12%. The device required a power supply of 6 V, 250 mA. This could be the beginning of an era in which BMs integrate or replace the mechanical function of natural muscles.

Early Entry Sawed Portland Cement Concrete Transverse Joint Ends, MLR-97-5, 2003

Experiments with early entry light sawing of Portland cement concrete (PCC) contraction joints began in Iowa in 1989. Since that time, changes in early sawing equipment have occurred as well as changes in specifications for sawing. The option to use early sawing for transverse contraction joints was specified in 1992. A problem happening occasionally with early sawing was the break out of some of the concrete around the end of the joint as the saw blade approached the edge of the slab. To prevent this, it was proposed that the sawing would terminate approximately 1/2" to 3/4" before the edge of the slab, creating a "short joint". This procedure would also leave a concrete "dam" to prevent the run-out and waste of the hot liquid joint sealant onto the shoulder. It would also eliminate the need for the labor and material for applying a duct tape dam at the open ends of each sawed joint to stop hot liquid sealant run-out Agreements were made with the contractor to apply the "short joint" technique for 1 day of paving. The evaluation and results are compared with an adjoining control section. The research found no negative aspects from sawing the "short joint". Three specific findings were noted. They are the following: 1) No joint end "blow-out" spalls of concrete occurred. 2) The need for the duct tape dam to stop liquid sealant overflow was eliminated. 3) Joint end corner spalls appear to be caused mainly by construction shouldering operations equipment. The "short joint" sawing technique can be routinely applied to early entry sawed transverse contraction joints with expectations of only positive results.

Evaluation of Preformed Neoprene Joint Seals, HR-318, 1994

Most pavement contraction joint seals in Iowa, in general, have been performing in less than a satisfactory manner. The effective life of the seals, in maintaining a watertight joint, has been only from two to five years. In search of improvements, research was proposed to evaluate preformed neoprene joint seals. The performance of those seals was to be compared mainly with the hot poured rubberized asphalt sealants and cold applied silicone sealants or other sealants commonly used at the time this research began. Joint designs and methods of sawing were also investigated. All evaluations were done in new portland cement concrete (PCC) pavements. Three projects were initially selected and each included a research section of joint sealing. Some additional sites were later added for evaluation. Several joint sealants were evaluated at each research site. The various sites included high, medium and low levels of traffic. Evaluations were done over a five-year period. Neoprene joint seals provided better performance than hot or cold field formed joints.

Serum resistin concentrations and risk of new onset heart failure in older persons: the health, aging, and body composition (Health ABC) study.

OBJECTIVE: Resistin is associated with inflammation and insulin resistance and exerts direct effects on myocardial cells including hypertrophy and altered contraction. We investigated the association of serum resistin concentrations with risk for incident heart failure (HF) in humans. METHODS AND RESULTS: We studied 2902 older persons without prevalent HF (age, 73.6+/-2.9 years; 48.1% men; 58.8% white) enrolled in the Health, Aging, and Body Composition (Health ABC) Study. Correlation between baseline serum resistin concentrations (20.3+/-10.0 ng/mL) and clinical variables, biochemistry panel, markers of inflammation and insulin resistance, adipocytokines, and measures of adiposity was weak (all rho <0.25). During a median follow-up of 9.4 years, 341 participants (11.8%) developed HF. Resistin was strongly associated with risk for incident HF in Cox proportional hazards models controlling for clinical variables, biomarkers, and measures of adiposity (HR, 1.15 per 10.0 ng/mL in adjusted model; 95% CI, 1.05 to 1.27; P=0.003). Results were comparable across sex, race, diabetes mellitus, and prevalent and incident coronary heart disease subgroups. In participants with available left ventricular ejection fraction at HF diagnosis (265 of 341; 77.7%), association of resistin with HF risk was comparable for cases with reduced versus preserved ejection fraction. CONCLUSIONS: Serum resistin concentrations are independently associated with risk for incident HF in older persons.

The L-Type Ca2+ and KATP channels may contribute to pacing-induced protection against anoxia-reoxygenation in the embryonic heart model

Rapport de synthèse : Implication des canaux Ca2+ de type L et des canaux KATP dans la protection induite par pacing dans un modèle de coeur embryonnaire soumis à l'anoxieréoxygénation. Contexte et but : le canal Ca2+ de type L, les canaux K+ du sarcolemme (sarcKatp) et de la mitochondrie (mitoKatp) interviennent dans le préconditionnement ischémique ou pharmacologique du myocarde. La présente étude cherche à déterminer dans quelle mesure ces canaux peuvent aussi jouer un rôle dans la cardioprotection induite par pacing. Méthodes :des coeurs d'embryons de poulet âgés de 4 jours ont été soumis in ovo à un pacing durant 12 heures, en pratiquant une stimulation électrique ventriculaire asynchrone intermittente à 110% de la fréquence cardiaque intrinsèque. Les coeurs contrôles (sham) et les coeurs stimulés ont ensuite été soumis in vitro à une période d'anoxie de 30 minutes, suivie d'une réoxygénation de 60 minutes. Les coeurs ont été exposés à l'agoniste du canal Ca2+ de type L (Bay-K-8644, BAY-K) ou à son bloqueur (vérapamil, VERAP), à l'antagoniste non sélectif des canaux KATP (glibenclamide, GLIB), ainsi qu'à l'agoniste du canal mitoKATP (diazoxide, DIAZO), ou à son antagoniste (5-hydroxydécanoate, 5-HD). L'électrocardiogramme, le délai électro-mécanique (DEM) reflétant le couplage excitation-contraction, ainsi que la contractilité myocardique ont été systématiquement déterminés pendant l'anoxieréoxygénation. Résultats : en normoxie, la fréquence cardiaque, l'intervalle QT, la conduction atrioventriculaire, le DEM et le raccourcissement ventriculaires étaient identiques dans les coeurs sham et les coeurs stimulés. Par contre, au cours de la réoxygénation post-anoxique, les arythmies cessaient plus précocément et le DEM ventriculaire retrouvait plus rapidement son niveau initial dans les coeurs stimulés, comparés aux sham. Dans les coeurs sham, BAY-K (mais pas le VERAP), DIAZO (mais pas le 5HD) ou GLIB accéléraient la récupération du DEM ventriculaire, reproduisant ainsi la protection induite par le pacing. En revanche, aucun de ces agents n'affectait la récupération des cceurs stimulés. Conclusion : un pacing ventriculaire chronique et intermittent délivré à une fréquence quasi physiologique améliore la tolérance myocardique à une anoxie-réoxygénation ultérieure. L'approche pharmacologique amontré qu'une activation discrète du canal Ca2+ de type L, une inhibition du canal sarcKATP et/ou une ouverture du canal mitoKATP peuvent contribuer à la cardioprotection induite par le pacing.

Innovative Leak Test for Pavement Joint Seals, Progress Report, HR-318, 1993

Premature failure of concrete pavement contraction joint seals is an ongoing and costly problem for the Iowa Department of Transportation. Several joint seal test sections consisting of variations in sawing methods, joint cleaning techniques, sealant installation, and sealant types have been established over the past few years. Laboratory analysis and field inspections were done as a part of the tests, and core samples were taken for laboratory adhesion pull tests. Such methods often cover specifically small areas and may not expose hidden failures. Some tests are also labor-intensive and destructive, especially that of coring. An innovative, nondestructive, broad coverage joint seal tester that yields quick results has been designed and developed for evaluation of pavement joint seal performance. The Iowa vacuum joint seal tester (IA-VAC) applies a low vacuum above a joint seal that has been spray-covered with a foaming water solution. Any unsealed area or leak that exists along the joint will become quickly and clearly visible by the development of bubbles at the leak point. By analyzing the results from the IA-VAC tests, information on the number and types of leaks can be obtained; such information will help identify the source of the problem and direct efforts toward a solution.

Performance of Various Thicknesses of P.C. Concrete Secondary Pavement, HR-9, 1979

In 1951 Greene County and the Iowa Highway Research Board paved County Road E-33 from Iowa Highway No. 17 (now Iowa 4) to Farlin with various thicknesses [ranging from 4.5 in. (11.4 cm) to 6 in. (15.2 cm)] of portland cement concrete pavement. The project, designated HR-9, was divided into ten research sections. This formed pavement was placed on the existing grade. Eight of the sections were non-reinforced except for centerline tie bars and no contraction joints were used. Mesh reinforcing and contraction joints spaced at 29 ft 7 in. (9.02 m) intervals were used in two 4.5-in. (11.4-cm) thick sections. The concrete in one of the sections was air entrained. Signs denoting the design and limits of the research sections were placed along the roadway. The pavement has performed well over its 28-year life, carrying a light volume of traffic safely while requiring no major maintenance. The 4.5-in. (11.4-cm) thick mesh-reinforced pavement with contraction joints has exhibited the best overall performance.

Importance of polyethylene thickness in total shoulder arthroplasty: a finite element analysis.

BACKGROUND: Articular surfaces reconstruction is essential in total shoulder arthroplasty. Because of the limited glenoid bone support, thin glenoid component could improve anatomical reconstruction, but adverse mechanical effects might appear. METHODS: With a numerical musculoskeletal shoulder model, we analysed and compared three values of thickness of a typical all-polyethylene glenoid component: 2, 4 (reference) and 6mm. A loaded movement of abduction in the scapular plane was simulated. We evaluated the humeral head translation, the muscle moment arms, the joint force, the articular contact pattern, and the polyethylene and cement stress. Findings Decreasing polyethylene thickness from 6 to 2mm slightly increased humeral head translation and muscle moment arms. This induced a small decreased of the joint reaction force, but important increase of stress within the polyethylene and the cement mantel. Interpretation The reference thickness of 4mm seems a good compromise to avoid stress concentration and joint stuffing.

Functional homogenization of bumblebee communities in alpine landscapes under projected climate change

Background: Bumblebees represent an active pollinator group in mountain regions and assure the pollination of many different plant species from low to high elevations. Plant-pollinator interactions are mediated by functional traits. Shift in bumblebee functional structure under climate change may impact plant-pollinator interactions in mountains. Here, we estimated bumblebee upward shift in elevation, community turnover, and change in functional structure under climate change. Method: We sampled bumblebee species at 149 sites along the elevation gradient. We used stacked species distribution models (S-SDMs) forecasted under three climate change scenarios (A2, A1B, RCP3PD) to model the potential distribution of the Bombus species. Furthermore, we used species proboscis length measurements to assess the functional change in bumblebee assemblages along the elevation gradient. Results: We found species-specific response of bumblebee species to climate change. Species differed in their predicted rate of range contraction and expansion. Losers were mainly species currently restricted to high elevation. Under the most severe climate change scenarios (A2), we found a homogenization of proboscis length structure in bumblebee communities along the elevation gradient through the upward colonization of high elevation by species with longer proboscides. Conclusions: Here, we show that in addition to causing the shift in the distribution of bumblebee species, climate change may impact the functional structure of communities. The colonization of high elevation areas by bumblebee species with long proboscides may modify the structure of plant-pollination interaction networks by increasing the diversity of pollination services at high elevation.

Transverse Joint Sealing with Various Sealants, Progress Report, HR-203, 1979

The objective of this research was to evaluate the performance of portland cement concrete pavement contraction joints utilizing a variety of sealants and joint preparations and to identify an effective sealant system. The variables evaluated were: (1) sealant material; (2) joint preparation; (3) size of saw cut (sealant reservoir); and (4) the use of backing material. This progress report contains project results to date.

Deletion of the viral anti-apoptotic gene F1L in the HIV/AIDS vaccine candidate MVA-C enhances immune responses against HIV-1 antigens.

Vaccinia virus (VACV) encodes an anti-apoptotic Bcl-2-like protein F1 that acts as an inhibitor of caspase-9 and of the Bak/Bax checkpoint but the role of this gene in immune responses is not known. Because dendritic cells that have phagocytosed apoptotic infected cells cross-present viral antigens to cytotoxic T cells inducing an antigen-specific immunity, we hypothesized that deletion of the viral anti-apoptotic F1L gene might have a profound effect on the capacity of poxvirus vectors to activate specific immune responses to virus-expressed recombinant antigens. This has been tested in a mouse model with an F1L deletion mutant of the HIV/AIDS vaccine candidate MVA-C that expresses Env and Gag-Pol-Nef antigens (MVA-C-ΔF1L). The viral gene F1L is not required for virus replication in cultured cells and its deletion in MVA-C induces extensive apoptosis and expression of immunomodulatory genes in infected cells. Analysis of the immune responses induced in BALB/c mice after DNA prime/MVA boost revealed that, in comparison with parental MVA-C, the mutant MVA-C-ΔF1L improves the magnitude of the HIV-1-specific CD8 T cell adaptive immune responses and impacts on the CD8 T cell memory phase by enhancing the magnitude of the response, reducing the contraction phase and changing the memory differentiation pattern. These findings reveal the immunomodulatory role of F1L and that the loss of this gene is a valid strategy for the optimization of MVA as vaccine vector.

Cardiac rotation and relaxation in patients with aortic valve stenosis.

BACKGROUND: Diastolic dysfunction with delayed relaxation and abnormal passive elastic properties has been described in patients with severe pressure overload hypertrophy. The purpose of this study was to evaluate the time course of rotational motion of the left ventricle in patients with aortic valve stenosis using myocardial tagging. METHODS: Myocardial tagging is a non-invasive method based on magnetic resonance which makes it possible to label ('tag') specific myocardial regions. From the motion of the tag's cardiac rotation, radial displacement and translational motion can be determined. In 12 controls and 13 patients with severe aortic valve stenosis systolic and diastolic wall motion was assessed in an apical and basal short axis plane. RESULTS: The normal left ventricle performs a systolic wringing motion around the ventricular long axis with clockwise rotation at the base (-4.4+/-1.6 degrees) and counter-clockwise rotation at the apex (+6.8+/-2.5 degrees) when viewed from the apex. During early diastole an untwisting motion can be observed which precedes diastolic filling. In patients with aortic valve stenosis systolic rotation is reduced at the base (-2.4+/-2.0 degrees; P<0.01) but increased at the apex (+12.0+/-6.0 degrees; P<0.05). Diastolic untwisting is delayed and prolonged with a decrease in normalized rotation velocity (-6.9+/-1.1 s(-1)) when compared to controls (-10.7+/-2.2 s(-1); P<0.001). Maximal systolic torsion is 8.0+/-2.1 degrees in controls and 14.1+/-6.4 degrees (P<0.01) in patients with aortic valve stenosis. CONCLUSIONS: Left ventricular pressure overload hypertrophy is associated with a reduction in basal and an increase in apical rotation resulting in increased torsion of the ventricle. Diastolic untwisting is delayed and prolonged. This may explain the occurrence of diastolic dysfunction in patients with severe pressure overload hypertrophy.

Bacterial lipopolysaccharide induces apoptosis in the trout ovary

BACKGROUND: In mammals it is well known that infections can lead to alterations in reproductive function. As part of the innate immune response, a number of cytokines and other immune factors is produced during bacterial infection or after treatment with lipopolysaccharide (LPS) and acts on the reproductive system. In fish, LPS can also induce an innate immune response but little is known about the activation of the immune system by LPS on reproduction in fish. Therefore, we conducted studies to examine the in vivo and in vitro effects of lipopolysaccharide (LPS) on the reproductive function of sexually mature female trout. METHODS: In saline- and LPS -injected brook trout, we measured the concentration of plasma steroids as well as the in vitro steroidogenic response (testosterone and 17alpha-hydroxyprogesterone) of ovarian follicles to luteinizing hormone (LH), the ability of 17alpha,20beta-dihydroxy-4-pregnen-3-one to induce germinal vesicle breakdown (GVBD) in vitro, and that of epinephrine to stimulate follicular contraction in vitro. We also examined the direct effects of LPS in vitro on steroid production, GVBD and contraction in brook trout ovarian follicles. The incidence of apoptosis was evaluated by TUNEL analysis. Furthermore, we examined the gene expression pattern in the ovary of saline- and LPS-injected rainbow trout by microarray analysis. RESULTS: LPS treatment in vivo did not affect plasma testosterone concentration or the basal in vitro production of steroids, although a small but significant potentiation of the effects of LH on testosterone production in vitro was observed in ovarian follicles from LPS-treated fish. In addition, LPS increased the plasma concentration of cortisol. LPS treatment in vitro did not affect the basal or LH-stimulated steroid production in brook trout ovarian follicles. In addition, we did not observe any effects of LPS in vivo or in vitro on GVBD or follicular contraction. Therefore, LPS did not appear to impair ovarian steroid production, oocyte final maturation or follicular contraction under the present experimental conditions. Interestingly, LPS administration in vivo induced apoptosis in follicular cells, an observation that correlated with changes in the expression of genes involved in apoptosis, as evidenced by microarray analysis. CONCLUSION: These results indicate that female trout are particularly resistant to an acute administration of LPS in terms of ovarian hormone responsiveness. However, LPS caused a marked increase in apoptosis in follicular cells, suggesting that the trout ovary could be sensitive to the pro-apoptotic effects of LPS-induced inflammatory cytokines.

Cellular and molecular evidence for a role of tumor necrosis factor alpha in the ovulatory mechanism of trout

Background: The relevance of immune-endocrine interactions to the regulation of ovarian function in teleosts is virtually unexplored. As part of the innate immune response during infection, a number of cytokines such as tumor necrosis factor alpha (TNF alpha) and other immune factors, are produced and act on the reproductive system. However, TNF alpha is also an important physiological player in the ovulatory process in mammals. In the present study, we have examined for the first time the effects of TNF alpha in vitro in preovulatory ovarian follicles of a teleost fish, the brown trout (Salmo trutta). Methods: To determine the in vivo regulation of TNF alpha expression in the ovary, preovulatory brook trout (Salvelinus fontinalis) were injected intraperitoneally with either saline or bacterial lipopolysaccharide (LPS). In control and recombinant trout TNF alpha (rtTNF alpha)-treated brown trout granulosa cells, we examined the percentage of apoptosis by flow cytometry analysis and cell viability by propidium iodide (PI) staining. Furthermore, we determined the in vitro effects of rtTNF alpha on follicle contraction and testosterone production in preovulatory brown trout ovarian follicles. In addition, we analyzed the gene expression profiles of control and rtTNF alpha-treated ovarian tissue by microarray and real-time PCR (qPCR) analyses. Results: LPS administration in vivo causes a significant induction of the ovarian expression of TNF alpha. Treatment with rtTNF alpha induces granulosa cell apoptosis, decreases granulosa cell viability and stimulates the expression of genes known to be involved in the normal ovulatory process in trout. In addition, rtTNF alpha causes a significant increase in follicle contraction and testosterone production. Also, using a salmonid-specific microarray platform (SFA2.0 immunochip) we observed that rtTNF alpha induces the expression of genes known to be involved in inflammation, proteolysis and tissue remodeling. Furthermore, the expression of kallikrein, TOP-2, serine protease 23 and ADAM 22, genes that have been postulated to be involved in proteolytic and tissue remodeling processes during ovulation in trout, increases in follicles incubated in the presence of rtTNF alpha. Conclusions In view of these results, we propose that TNF alpha could have an important role in the biomechanics of follicle weakening, ovarian rupture and oocyte expulsion during ovulation in trout, primarily through its stimulation of follicular cell apoptosis and the expression of genes involved in follicle wall proteolysis and contraction.