Background
In Europe cardiovascular disease (CVD) is responsible for 3.9 million deaths (45% of deaths), being ischaemic heart disease, stroke, hypertension (leading to heart failure) the major cause ...of these CVD related deaths. Periodontitis is also a chronic non‐communicable disease (NCD) with a high prevalence, being severe periodontitis, affecting 11.2% of the world's population, the sixth most common human disease.
Material and Methods
There is now a significant body of evidence to support independent associations between severe periodontitis and several NCDs, in particular CVD. In 2012 a joint workshop was held between the European Federation of Periodontology (EFP) and the American Academy of Periodontology to review the literature relating periodontitis and systemic diseases, including CVD. In the last five years important new scientific information has emerged providing important emerging evidence to support these associations
Results and Conclusions
The present review reports the proceedings of the workshop jointly organised by the EFP and the World Heart Federation (WHF), which has updated the existing epidemiological evidence for significant associations between periodontitis and CVD, the mechanistic links and the impact of periodontal therapy on cardiovascular and surrogate outcomes. This review has also focused on the potential risk and complications of periodontal therapy in patients on anti thrombotic therapy and has made recommendations for dentists, physicians and for patients visiting both the dental and medical practices.
The evolution of the circulatory system from invertebrates to mammals has involved the passage from an open system to a closed in-parallel system via a closed in-series system, accompanying the ...increasing complexity and efficiency of life's biological functions. The archaic heart enables pulsatile motion waves of hemolymph in invertebrates, and the in-series circulation in fish occurs with only an endothelium, whereas mural smooth muscle cells appear later. The present review focuses on evolution of the circulatory system. In particular, we address how and why this evolution took place from a closed, flowing, longitudinal conductance at low pressure to a flowing, highly pressurized and bifurcating arterial compartment.The general teleonomy of the evolution of species is the differentiation of individual organ function, supported by specific fueling allowing and favoring partial metabolic autonomy. This was achieved via the establishment of an active contractile tone in resistance arteries, which permitted the regulation of blood supply to specific organ activities via its localized function-dependent inhibition. The resistance to viscous blood flow is the peripheral increase in frictional forces caused by the tonic change in arterial radius, which backscatter as systemic arterial blood pressure. Consequently, the arterial pressure gradient from blood to the adventitial interstitium generates the outward radial advective conductance of plasma solutes across the wall. This hemodynamic evolution was accompanied by important changes in arterial wall structure, supported by smooth muscle cell functional plasticity. These adaptive phenotypic shifts are due to epigenetic regulation, mainly related to mechanotransduction. These paradigms actively participate in cardio-arterial pathologies.
Abstract
Vascular smooth muscle cells (vSMCs) play a crucial role in both the pathogenesis of Aneurysms and Dissections of the ascending thoracic aorta (TAAD) in humans and in the associated adaptive ...compensatory responses, since thrombosis and inflammatory processes are absent in the majority of cases. Aneurysms and dissections share numerous characteristics, including aetiologies and histopathological alterations: vSMC disappearance, medial areas of mucoid degeneration, and extracellular matrix (ECM) breakdown. Three aetiologies predominate in TAAD in humans: (i) genetic causes in heritable familial forms, (ii) an association with bicuspid aortic valves, and (iii) a sporadic degenerative form linked to the aortic aging process. Genetic forms include mutations in vSMC genes encoding for molecules of the ECM or the TGF-β pathways, or participating in vSMC tone. On the other hand, aneurysms and dissections, whatever their aetiologies, are characterized by an increase in wall permeability leading to transmural advection of plasma proteins which could interact with vSMCs and ECM components. In this context, blood-borne plasminogen appears to play an important role, because its outward convection through the wall is increased in TAAD, and it could be converted to active plasmin at the vSMC membrane. Active plasmin can induce vSMC disappearance, proteolysis of adhesive proteins, activation of MMPs and release of TGF-β from its ECM storage sites. Conversely, vSMCs could respond to aneurysmal biomechanical and proteolytic injury by an epigenetic phenotypic switch, including constitutional overexpression and nuclear translocation of Smad2 and an increase in antiprotease and ECM protein synthesis. In contrast, such an epigenetic phenomenon is not observed in dissections. In this context, dysfunction of proteins involved in vSMC tone are interesting to study, particularly in interaction with plasma protein transport through the wall and TGF-β activation, to establish the relationship between these dysfunctions and ECM proteolysis.
We constructed a corpus of digitized texts containing about 4% of all books ever printed. Analysis of this corpus enables us to investigate cultural trends quantitatively. We survey the vast terrain ...of 'culturomics,' focusing on linguistic and cultural phenomena that were reflected in the English language between 1800 and 2000. We show how this approach can provide insights about fields as diverse as lexicography, the evolution of grammar, collective memory, the adoption of technology, the pursuit of fame, censorship, and historical epidemiology. Culturomics extends the boundaries of rigorous quantitative inquiry to a wide array of new phenomena spanning the social sciences and the humanities.
Sulfate ions in seawater or underground can attack the cement paste leading to expansion and strength loss. This expansion is usually related to ettringite and gypsum precipitation. This study aims ...to characterize the possible altered zone and to identify the mechanisms of degradation under such conditions. For this study, cement pastes manufactured using CEM I with two w/c ratios (0.45 and 0.60) were exposed to sodium sulfate solutions (semi-immersion at a controlled pH = 8.0 ± 0.1) after one year of curing in water. The analysis of the physical aspect of this phenomenon shows that two modes of transfer occur: transfer of sulfate ions to the cement matrix and leaching of calcium ions to the external solution. The analysis of the chemical composition of the affected material highlights the progressive consumption of portlandite at the surface, the decalcification of C-S-H and the formation of AFt from both Afm and aluminium incorporated in C-S-H.
•In seawater, cementitious material are exposed to both ESA and leaching.•ESA is characterized by the sulfate diffusion and its physicochemical fixation.•This fixation occurs causing self-deceleration of the sulfate ingress in the material.•Ettringite is formed from both AFm and aluminium incorporated in C-S-H.•At low pH, the simultaneous formation of gypsum and ettringite can be highlighted.
Among the most significant causes of concrete degradation is ESA (external sulfate attack). The majority of studies are currently conducted on samples that have been saturated and matured. Concrete ...structures, however, are exposed to the environment once the formwork has been removed. The purpose of this study is to determine what effects early exposure to external sulfates may have on degradation mechanisms. Microstructure, physical, and chemical behavior are monitored using a variety of experimental techniques, including NMR (27Al and 29Si), ICP, XRD, MIP, and SEM. Based on expansion measurements, mature Portland cement paste, unlike the early-age case, degraded rapidly due to the presence of compressed ettringite and gypsum, highlighted by SEM analysis. During ESA, sulfate ions diffuse through the cement matrix and are bound by chemical agents. Chemical analyses indicate that the chemical mechanism varies with the duration of curing. At an early age, external sulfates and aluminates are the most important reagents. For matured cases, these reagents include external sulfates, calcium derived from CH dissolution, and aluminates derived from the total dissolution of AFm.
Neutrophil Extracellular Traps (NETs) are DNA extracellular networks decorated with histones and granular proteins produced by activated neutrophils. NETs have been identified as major triggers and ...structural factors of thrombosis. A recent study designated extracellular DNA threads from NETs as a potential therapeutic target for improving tissue-type plasminogen activator (tPA)-induced thrombolysis in acute coronary syndrome. The aim of this study was to assess the presence of NETs in thrombi retrieved during endovascular therapy in patients with acute ischemic stroke (AIS) and their impact on tPA-induced thrombolysis.
We analyzed thrombi from 108 AIS patients treated with endovascular therapy. Thrombi were characterized by hematoxylin/eosin staining, immunostaining, and ex vivo enzymatic assay. Additionally, we assessed ex vivo the impact of deoxyribonuclease 1 (DNAse 1) on thrombolysis of AIS thrombi.
Histological analysis revealed that NETs contributed to the composition of all AIS thrombi especially in their outer layers. Quantitative measurement of thrombus NETs content was not associated with clinical outcome or AIS pathogenesis but correlated significantly with endovascular therapy procedure length and device number of passes. Ex vivo, recombinant DNAse 1 accelerated tPA-induced thrombolysis, whereas DNAse 1 alone was ineffective.
This study suggests that thrombus NETs content may be responsible for reperfusion resistance, including mechanical or pharmacological approaches with intravenous tPA, irrespectively of their etiology. The efficacy of a strategy involving an administration of DNAse 1 in addition to tPA should be explored in the setting of AIS.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT02907736.
Human abdominal aortic aneurysm (AAA) pathophysiology is not yet completely understood. In conductance arteries, the insoluble extracellular matrix, synthesized by vascular smooth muscle cells, ...assumes the function of withstanding the intraluminal arterial blood pressure. Progressive loss of this function through extracellular matrix proteolysis is a main feature of AAAs. As most patients are now treated via endovascular approaches, surgical AAA specimens have become rare. Animal models provide valuable complementary insights into AAA pathophysiology. Current experimental AAA models involve induction of intraluminal dilation (nondissecting AAAs) or a contained intramural rupture (dissecting models). Although the ideal model should reproduce the histological characteristics and natural history of the human disease, none of the currently available animal models perfectly do so. Experimental models try to represent the main pathophysiological determinants of AAAs: genetic or acquired defects in extracellular matrix, loss of vascular smooth muscle cells, and innate or adaptive immune response. Nevertheless, most models are characterized by aneurysmal stabilization and healing after a few weeks because of cessation of the initial stimulus. Recent studies have focused on ways to optimize existing models to allow continuous aneurysmal growth. This review aims to discuss the relevance and recent advances of current animal AAA models.
An online visual overview is available for this article.
Antibiotic resistance can evolve through the sequential accumulation of multiple mutations. To study such gradual evolution, we developed a selection device, the 'morbidostat', that continuously ...monitors bacterial growth and dynamically regulates drug concentrations, such that the evolving population is constantly challenged. We analyzed the evolution of resistance in Escherichia coli under selection with single drugs, including chloramphenicol, doxycycline and trimethoprim. Over a period of ∼20 days, resistance levels increased dramatically, with parallel populations showing similar phenotypic trajectories. Whole-genome sequencing of the evolved strains identified mutations both specific to resistance to a particular drug and shared in resistance to multiple drugs. Chloramphenicol and doxycycline resistance evolved smoothly through diverse combinations of mutations in genes involved in translation, transcription and transport. In contrast, trimethoprim resistance evolved in a stepwise manner, through mutations restricted to the gene encoding the enzyme dihydrofolate reductase (DHFR). Sequencing of DHFR over the time course of the experiment showed that parallel populations evolved similar mutations and acquired them in a similar order.
Flavescence dorée is a grapevine disease affecting European vineyards which has severe economic consequences and containing its spread is therefore considered as a major challenge for viticulture. ...Flavescence dorée is subject to mandatory pest control including removal of the infected vines and, in this context, automatic detection of Flavescence dorée symptomatic vines by unmanned aerial vehicle (UAV) remote sensing could constitute a key diagnosis instrument for growers. The objective of this paper is to evaluate the feasibility of discriminating the Flavescence dorée symptoms in red and white cultivars from healthy vine vegetation using UAV multispectral imagery. Exhaustive ground truth data and UAV multispectral imagery (visible and near-infrared domain) have been acquired in September 2015 over four selected vineyards in Southwest France. Spectral signatures of healthy and symptomatic plants were studied with a set of 20 variables computed from the UAV images (spectral bands, vegetation indices and biophysical parameters) using univariate and multivariate classification approaches. Best results were achieved with red cultivars (both using univariate and multivariate approaches). For white cultivars, results were not satisfactory either for the univariate or the multivariate. Nevertheless, external accuracy assessment show that despite problems of Flavescence dorée and healthy pixel misclassification, an operational Flavescence dorée mapping technique using UAV-based imagery can still be proposed.
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