Intravenous iron therapy results in rapid and sustained rise in myocardial iron content through a novel pathway.

BACKGROUND AND AIMS: Intravenous iron therapies contain iron-carbohydrate complexes, designed to ensure iron becomes bioavailable via the intermediary of spleen and liver reticuloendothelial macrophages. How other tissues obtain and handle this iron remains unknown. This study addresses this question in the context of the heart. METHODS: A prospective observational study was conducted in 12 patients receiving ferric carboxymaltose (FCM) for iron deficiency. Myocardial, spleen, and liver magnetic resonance relaxation times and plasma iron markers were collected longitudinally. To examine the handling of iron taken up by the myocardium, intracellular labile iron pool (LIP) was imaged in FCM-treated mice and cells. RESULTS: In patients, myocardial relaxation time T1 dropped maximally 3 h post-FCM, remaining low 42 days later, while splenic T1 dropped maximally at 14 days, recovering by 42 days. In plasma, non-transferrin-bound iron (NTBI) peaked at 3 h, while ferritin peaked at 14 days. Changes in liver T1 diverged among patients. In mice, myocardial LIP rose 1 h and remained elevated 42 days after FCM. In cardiomyocytes, FCM exposure raised LIP rapidly. This was prevented by inhibitors of NTBI transporters T-type and L-type calcium channels and divalent metal transporter 1. CONCLUSIONS: Intravenous iron therapy with FCM delivers iron to the myocardium rapidly through NTBI transporters, independently of reticuloendothelial macrophages. This iron remains labile for weeks, reflecting the myocardium's limited iron storage capacity. These findings challenge current notions of how the heart obtains iron from these therapies and highlight the potential for long-term dosing to cause cumulative iron build-up in the heart.

Adaptive Sports in Spinal Cord Injury: a Systematic Review.

Purpose of Review: Adaptive sports (AdS), sports modified or created to accommodate persons with disabilities, have been gaining popularity over the last decade. The benefits of exercise in the able-bodied population are well-established. Literature in adaptive sport and the para-athlete continues to improve but is not yet as comprehensive as their able-bodied peers, in part due to the heterogeneity of participants. In this review, we appraise the recent literature pertaining to AdS and identify developing areas within the field. Recent Findings: AdS have been shown to have positive health benefits as well as positive psychosocial benefits. Para-athletes often must overcome a variety of barriers to participation, such as transportation, accessibility, and socioeconomic factors. Facilitators to participation have also been identified, including pre-injury interest in sports, male sex, younger age, and more. In addition to well-known sports like handcycling and wheelchair basketball, adaptive sport continues to evolve, in part due to the COVID-19 pandemic, now including virtual options and E-sports. Para-athletes are also being more closely monitored and evaluated pre, peri, and post competition for injury and injury prevention, including in the realm of concussion management, requiring healthcare professionals, coaches, players, and all to gain further knowledge in adaptive sport and the participating para-athletes. Summary: The physical, psychological, and social benefits of adaptive sports for individuals with disabilities are numerous. Addressing barriers to participation, including novel forms of AdS that utilize innovative technology, may allow more individuals to benefit from AdS.

Perceptions of horizontal violence in staff nurses and intent to leave.

BACKGROUND: The impact of horizontal violence is multifaceted. From the impact upon the individual, the unit, and the institution, horizontal violence affects professional nursing activities in a variety of aspects of health care. OBJECTIVE: To examine registered nurses' experiences with horizontal violence and explore the relationship between horizontal violence and intent to leave. PARTICIPANTS: A random sample of 300 registered nurses from a Midwestern hospital received the Briles' Sabotage Savvy Questionnaire (BSSQ), the Michigan Organizational Assessment Questionnaire (MOAQ) Intent to Turnover measure, and a Demographic questionnaire. METHODS: Descriptive correlational study was implemented. Questionnaires were distributed to the selected registered nurses. Descriptive and correlational statistics were calculated. RESULTS: Horizontal violence had been experienced by nurses of all ages and experience. Based upon measurement tools, examples of horizontal violence were: Being held responsible for coworkers' duties; Reprimanded or confronted in front of others; Failure to be acknowledged or confronted in front of others; and Untrue information about you being passed or exchanged. Correlations indicated a significant, positive relationship between perceptions of horizontal violence and intent to leave. Results also indicated the longer nurses were employed the more likely to perceive themselves as victims of horizontal violence. Additionally, results associated with the MOAQ, age and years employed indicated that older nurses and those with increasing years of employment were less likely to leave. Younger nurses indicated more willingness to leave a position due to perceived horizontal violence than older nurses. CONCLUSIONS: Activities to address the impact of perceived horizontal violence are needed. Workplace strategies may include mentoring, ongoing assessment of organizational climate, and zero tolerance for horizontal violence.

Development of rabbit monoclonal antibodies for detection of alpha-dystroglycan in normal and dystrophic tissue.

Alpha-dystroglycan requires a rare O-mannose glycan modification to form its binding epitope for extracellular matrix proteins such as laminin. This functional glycan is disrupted in a cohort of muscular dystrophies, the secondary dystroglycanopathies, and is abnormal in some metastatic cancers. The most commonly used reagent for detection of alpha-dystroglycan is mouse monoclonal antibody IIH6, but it requires the functional O-mannose structure for recognition. Therefore, the ability to detect alpha-dystroglycan protein in disease states where it lacks the full O-mannose glycan has been limited. To overcome this hurdle, rabbit monoclonal antibodies against the alpha-dystroglycan C-terminus were generated. The new antibodies, named 5-2, 29-5, and 45-3, detect alpha-dystroglycan from mouse, rat and pig skeletal muscle by Western blot and immunofluorescence. In a mouse model of fukutin-deficient dystroglycanopathy, all antibodies detected low molecular weight alpha-dystroglycan in disease samples demonstrating a loss of functional glycosylation. Alternately, in a porcine model of Becker muscular dystrophy, relative abundance of alpha-dystroglycan was decreased, consistent with a reduction in expression of the dystrophin-glycoprotein complex in affected muscle. Therefore, these new rabbit monoclonal antibodies are suitable reagents for alpha-dystroglycan core protein detection and will enhance dystroglycan-related studies.