The effects of medications on the outcome of aortic dissection remain poorly understood. We sought to address this by analyzing the International Registry of Acute Aortic Dissection (IRAD) global ...registry database. A total of 1,301 patients with acute aortic dissection (722 with type A and 579 with type B) with information on their medications at discharge and followed for ≤5 years were analyzed for the effects of the medications on mortality. The initial univariate analysis showed that use of β blockers was associated with improved survival in all patients (p = 0.03), in patients with type A overall (p = 0.02), and in patients with type A who received surgery (p = 0.006). The analysis also showed that use of calcium channel blockers was associated with improved survival in patients with type B overall (p = 0.02) and in patients with type B receiving medical management (p = 0.03). Multivariate models also showed that the use of β blockers was associated with improved survival in those with type A undergoing surgery (odds ratio 0.47, 95% confidence interval 0.25 to 0.90, p = 0.02) and the use of calcium channel blockers was associated with improved survival in patients with type B medically treated patients (odds ratio 0.55, 95% confidence interval 0.35 to 0.88, p = 0.01). In conclusion, the present study showed that use of β blockers was associated with improved outcome in all patients and in type A patients (overall as well as in those managed surgically). In contrast, use of calcium channel blockers was associated with improved survival selectively in those with type B (overall and in those treated medically). The use of angiotensin-converting enzyme inhibitors did not show association with mortality.
We present a systematic study on the possible mechanisms of hydrogen spillover onto several carbon-based materials using density functional theory (DFT). Adsorption and diffusion of atomic hydrogen ...on a graphene sheet, single-walled carbon nanotubes, and a polyaromatic compound, hexabenzocoronene, were calculated, and the potential energies along the selected adsorption and diffusion minimum energy pathways were mapped out. We show that the migration of H atoms from a Pt cluster catalyst to the substrates is facile at ambient conditions with a small energy barrier, although the process is slightly endothermic, and that the H atoms can be either physisorbed or chemisorbed on carbon surfaces. Our results indicate that diffusion of H atoms in a chemisorbed state is energetically difficult since it requires C−H bond breaking and hydrogen spillover would occur likely via physisorption of H atoms. The curvature of the carbon materials is found to have a pronounced influence on the mobility of H atoms. The role of the “bridge” materials used in experiments is also discussed.
The absorption, diffusion, and desorption of atomic hydrogen in layered orthorhombic molybdenum trioxide (α-MoO3) was investigated using density functional theory. Hydrogen atoms are absorbed in bulk ...α-MoO3 to form the hydrogen molybdenum bronze H x MoO3 (x = 0.25, 0.5, 0.75, 1, 1.25, and 1.5). The semiconductor band gap of bulk α-MoO3 shifts to metallic upon hydrogen bronze formation at the H atom loadings selected in the present study. The hydrogen atoms become protonic when coordinated to oxygen, which gives rise to a charge reduction on the Mo atoms adjacent to the absorption sites. Hydrogen migration along a prescribed diffusion pathway in the lattice was found to be facile due to small energy barriers for H atom transfer between O atoms, facilitated by a hydrogen bonding network. The sequential hydrogen desorption from the bronze and the mechanisms of hydrogen spillover in α-MoO3 are also discussed.
Hydrogen spillover on the MoO3 (010) surface in the presence of a platinum catalyst was modeled using periodic density functional theory (DFT). The migration of H from a saturated Pt6 cluster to the ...MoO3 (010) surface was found to undergo a transition from repulsive electrostatic to attractive proton−oxygen interactions. The hydrogen is able to move nearly freely on the surface and diffuse into the bulk lattice at ambient temperatures, leading to the formation of hydrogen molybdenum bronze. We show that the high proton mobility is largely attributed to the massive H-bonding network in the MoO3 lattice.
Hepatocellular carcinoma (HCC) is increasing in the U.S. despite a decline in cancer overall. Latinos have higher rates of HCC than the general population according to the Surveillance, Epidemiology, ...and End Results (SEER) Program. Not included in SEER, Texas Latinos make up one-fifth of the U.S. Latino population. To determine whether HCC incidence differs among U.S. and Texas Latinos, this descriptive study compares HCC incidence from 1995 through 2006 among three Latino populations: U.S. SEER, Texas overall and a South Texas subset. To identify lines of prevention research, we compare prevalence of known HCC risk factors among these Latino groups.
Data were collected from the U.S. SEER Program, Texas Cancer Registry and Texas Department of State Health Services (TDSHS). Annual age-specific and age-adjusted HCC incidence rates, annual percent changes (APCs) and 95% confidence intervals were calculated as well as prevalence of obesity, diabetes, heavy alcohol use and cigarette smoking.
Of the three Latino groups compared, South Texas Latinos had the highest age-adjusted HCC incidence rates and SEER Latinos had the lowest (10.6/100,000 (10.1-11.1) and 7.5/100,000 (7.2-7.7), respectively). HCC incidence significantly increased over time (APCs>0) among Latinos in all three geographic groups. Between 1995 and 2006, there was an increase in obesity among all three populations, and obesity was highest among South Texas Latinos. Diabetes increased among U.S. Latinos, and Latino women in South Texas had significantly higher diabetes prevalence than U.S. Latino women. Cigarette smoking and heavy alcohol use were similar among groups.
The incidence of HCC among Latinos in South Texas is higher than elsewhere in the United States. Higher rates of HCC among Texas and South Texas Latinos may be associated with greater prevalence of obesity and diabetes, risk factors for HCC that are amenable to intervention.
Hydrogen spillover has emerged as a possible technique for achieving high-density hydrogen storage at near-ambient conditions in lightweight, solid-state materials. We present a brief review of our ...combined theoretical and experimental studies on hydrogen spillover mechanisms in solid-state materials where, for the first time, the complete mechanisms that dictate hydrogen spillover processes in transition metal oxides and nanostructured graphitic carbon-based materials have been revealed. The spillover process is broken into three primary steps: (1) dissociative chemisorption of gaseous H2 on a transition metal catalyst; (2) migration of H atoms from the catalyst to the substrate and (3) diffusion of H atoms on substrate surfaces and/or in the bulk materials. In our theoretical studies, the platinum catalyst is modeled with a small Pt cluster and the catalytic activity of the cluster is examined at full H atom saturation to account for the essentially constant, high H2 pressures used in experimental studies of hydrogen spillover. Subsequently, the energetic profiles associated with H atom migrations from the catalyst to the substrates and H atom diffusion in the substrates are mapped out by calculating the minimum energy pathways. It is observed that the spillover mechanisms for the transition metal oxides and graphitic carbon-based materials are very different. Hydrogen spillover in the transition metal oxides is moderated by massive, nascent hydrogen bonding networks in the crystalline lattice, while H atom diffusion on the nanostructured graphitic carbon materials is governed mostly by physisorption of H atoms. The effects of carbon material surface curvature on the hydrogen spillover as well as on hydrogen desorption dynamics are also discussed. The proposed hydrogen spillover mechanism in carbon-based materials is consistent with our experimental observations of the solid-state catalytic hydrogenation/dehydrogenation of coronene.
This study evaluated the impact of anatomic aortic root parameters during valve-sparing root replacement on the probability of postoperative aortic insufficiency and freedom from aortic valve ...reoperation.
From 1995 to 2020, 177 patients underwent valve-sparing root replacement (163 reimplantations, 14 remodeling). Preoperative and postoperative echocardiograms were analyzed to measure annulus and sinus diameters, effective height of leaflet coaptation, and degree of aortic insufficiency. Logistic regression was used to evaluate predictors of 2+ or greater late postoperative aortic insufficiency. Fine-Gray regression determined predictors for aortic valve reintervention.
The study population included 122 (69%) men with a mean age of 43 ± 15 years. A total of 119 patients (67%) had an identified connective tissue disorder. The cumulative incidence of aortic valve reoperation was estimated as 7% at 5 years and 12% at 10 years. The probability of 2+ or greater late postoperative aortic insufficiency was inversely related to effective height during valve-sparing root replacement (P = .018). As postoperative effective height fell below 11 mm, the probability of 2+ or greater aortic insufficiency exceeded 10%. On multivariable logistic regression, effective height (odds ratio, 0.53; 0.33-0.86; P = .010), preoperative annulus diameter (odds ratio, 1.44; 1.13-1.82; P = .003), and degree of preoperative aortic insufficiency (odds ratio, 2.57; 1.45-4.52; P = .001) were associated with increased incidence of 2+ or greater late postoperative aortic insufficiency. On multivariable Fine-Gray regression, risk factors for aortic valve reintervention included preoperative annulus diameter (subdistribution hazard ratio, 1.28 1.03-1.59, P = .027), history of 3+ or greater aortic insufficiency (subdistribution hazard ratio, 4.28; 1.60-11.44; P = .004), and 2+ or greater early postoperative aortic insufficiency (subdistribution hazard ratio, 5.22; 2.29-11.90; P < .001).
Measures to increase effective height during valve-sparing root replacement may decrease the risk of more than mild postoperative aortic insufficiency after repair and the need for aortic valve reoperation.
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Hypothalamic tanycytes are considered to function as sensors of peripheral metabolism 1. To facilitate this role, they express a wide range of receptors, including fibroblast growth factor receptor 1 ...(FGFR1). Using a monoclonal antibody (IMC-H7) that selectively antagonizes the FGFR1c isoform 2, we investigated possible actions of FGFR1c in a natural animal model of adiposity, the Siberian hamster. Infusion of IMC-H7 into the third ventricle suppressed appetite and increased energy expenditure. Likewise, peripheral treatment with IMC-H7 decreased appetite and body weight and increased energy expenditure and fat oxidation. A greater reduction in body weight and caloric intake was observed in response to IMC-H7 during the long-day fat state as compared to the short-day lean state. This enhanced response to IMC-H7 was also observed in calorically restricted hamsters maintained in long days, suggesting that it is the central photoperiodic state rather than the peripheral adiposity that determines the response to FGFR1c antagonism. Hypothalamic thyroid hormone availability is controlled by deiodinase enzymes (DIO2 and DIO3) expressed in tanycytes and is the key regulator of seasonal cycles of energy balance 3, 4. Therefore, we determined the effect of IMC-H7 on hypothalamic expression of these deiodinase enzymes. The reductions in food intake and body weight were always associated with decreased expression of DIO2 in the hypothalamic ependymal cell layer containing tanycytes. These data provide further support for the notion the tanycytes are an important component of the mechanism by which the hypothalamus integrates central and peripheral signals to regulate energy intake and expenditure.
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•FGFR1c is expressed in the hamster ependymal cell layer containing tanycytes•Central or peripheral treatment with a mAb raised against FGFR1c reduces body weight•Weight loss reflects both a suppression of appetite and increased energy expenditure•FGFR1c blockade causes a decrease in deiodinase 2 gene expression in tanycytes
Seasonal cycles of food intake and energy expenditure arise from changes in deiodinase gene expression and thyroid hormone production in hypothalamic tanycytes. Using a monoclonal antibody antagonist of FGFR1c, Samms et al. demonstrate that signaling via FGF receptors occurs through a similar pathway in tanycytes to regulate energy balance.
We present systematic molecular dynamics simulation studies of hydrogen storage in single walled carbon nanotubes of various diameters and chiralities using a recently developed curvature-dependent ...force field. Our main objective is to address the following fundamental issues: 1. For a given H2 loading and nanotube type, what is the H2 distribution in the nanotube bundle? 2. For a given nanotube type, what is the maximal loading (H2 coverage)? 3. What is the diameter range and chirality for which H2 adsorption is most energetically favorable? Our simulation results suggest strong dependence of H2 adsorption energies on the nanotube diameter but less dependence on the chirality. Substantial lattice expansion upon H2 adsorption was found. The average adsorption energy increases with the lowering of nanotube diameter (higher curvature) and decreases with higher H2 loading. The calculated H2 vibrational power spectra and radial distribution functions indicate a strong attractive interaction between H2 and nanotube walls. The calculated diffusion coefficients are much higher than what has been reported for H2 in microporous materials such as zeolites, indicating that diffusivity does not present a problem for hydrogen storage in carbon nanotubes.
FGF21 exerts profound metabolic effects in Siberian hamsters exposed to long day (LD) photoperiods that increase appetite and adiposity, however these effects are attenuated in short day (SD) animals ...that display hypophagia and reduced adiposity. The aim of this study was to investigate whether the beneficial effects of a novel mimetic of FGF21 in the LD state are a consequence of increased adiposity or of the central photoperiodic state. This was achieved by investigating effects of FGF21 in aged hamsters, which is associated with reduced adiposity. In LD hamsters with increased adiposity, FGF21 lowered body weight as a result of both reduced daily food intake and increased caloric expenditure, driven by an increase in whole-body fat oxidation. However, in LD animals with reduced adiposity, the effect of FGF21 on body weight, caloric intake and fat oxidation were significantly attenuated or absent when compared to those with increased adiposity. These attenuated/absent effects were underpinned by the inability of FGF21 to increase the expression of key thermogenic genes in interscapular and visceral WAT. Our study demonstrates the efficacy of a novel FGF21 mimetic in hamsters, but reveals attenuated effects in the animal model where adiposity is reduced naturally independent of photoperiod.
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