Association of uncertain significance genetic variants with myocardial mechanics and morphometrics in patients with nonischemic dilated cardiomyopathy.

BACKGROUND: Careful interpretation of the relation between phenotype changes of the heart and gene variants detected in dilated cardiomyopathy (DCM) is important for patient care and monitoring. OBJECTIVE: We sought to assess the association between cardiac-related genes and whole-heart myocardial mechanics or morphometrics in nonischemic dilated cardiomyopathy (NIDCM). METHODS: It was a prospective study consisting of patients with NIDCM. All patients were referred for genetic testing and a genetic analysis was performed using Illumina NextSeq 550 and a commercial gene capture panel of 233 genes (Systems Genomics, Cardiac-GeneSGKit®). It was analyzed whether there are significant differences in clinical, two-dimensional (2D) echocardiographic, and magnetic resonance imaging (MRI) parameters between patients with the genes variants and those without. 2D echocardiography and MRI were used to analyze myocardial mechanics and morphometrics. RESULTS: The study group consisted of 95 patients with NIDCM and the average age was 49.7 ± 10.5. All echocardiographic and MRI parameters of myocardial mechanics (left ventricular ejection fraction 28.4 ± 8.7 and 30.7 ± 11.2, respectively) were reduced and all values of cardiac chambers were increased (left ventricular end-diastolic diameter 64.5 ± 5.9 mm and 69.5 ± 10.7 mm, respectively) in this group. It was noticed that most cases of whole-heart myocardial mechanics and morphometrics differences between patients with and without gene variants were in the genes GATAD1, LOX, RASA1, KRAS, and KRIT1. These genes have not been previously linked to DCM. It has emerged that KRAS and KRIT1 genes were associated with worse whole-heart mechanics and enlargement of all heart chambers. GATAD1, LOX, and RASA1 genes variants showed an association with better cardiac function and morphometrics parameters. It might be that these variants alone do not influence disease development enough to be selective in human evolution. CONCLUSIONS: Combined variants in previously unreported genes related to DCM might play a significant role in affecting clinical, morphometrics, or myocardial mechanics parameters.

Phenolic Compounds in Berries of Winter-Resistant Actinidia arguta Miq. and Actinidia kolomikta Maxim.: Evidence of Antioxidative Activity.

Variations between fruit cultivars can significantly impact their biochemical composition. The present research examined the variability in the qualitative and quantitative content of phenolic compounds in berry extracts of Actinidia kolomikta and Actinidia arguta cultivars. Additionally, antioxidant activities of berry extracts were evaluated. The total phenolic, flavonoid, proanthocyanidin contents and hydroxycinnamic acid derivatives were determined using the appropriate methodologies. The average amount of phenolic compounds in A. kolomikta berries (177.80 mg/g) was three times higher than that of A. arguta (54.45 mg/g). Our findings revealed that berries of A. kolomikta and A. arguta accumulated, on average, 1.58 RE/g DW (rutin equivalent/g dry weight) and 0.615 mg RE/g DW of total flavonoids, 1439.31 mg EE/g DW (epicatechin equivalent/g dry weight) and 439.97 mg EE/g DW of proanthocyanidins, and 23.51 mg CAE/g DW (chlorogenic acid equivalent/g dry weight) and 5.65 mg CAE/g DW of hydroxycinnamic acid derivatives, respectively. The cultivars of both species were characterized by higher antioxidant activity of total phenolic compounds determined using CUPRAC and FRAP methods compared to the ABTS•+ method. The variability in phenolic compounds' qualitative and quantitative content in tested berry extracts was evaluated by applying ultra-high performance liquid chromatography (UHPLC) coupled to mass spectrometry in tandem with electrospray ionization. Significant intraspecific differences in the amounts of total phenolic compounds, total flavonoid compounds, proanthocyanidins, and hydroxycinnamic acid derivatives were determined among cultivars. Four phenolic acids, eight flavonols, two flavones, and five flavon-3-ols were identified in the berry extracts.

Digital Phenotyping for Monitoring and Disease Trajectory Prediction of Patients With Cancer: Protocol for a Prospective Observational Cohort Study.

BACKGROUND: Timely recognition of cancer progression and treatment complications is important for treatment guidance. Digital phenotyping is a promising method for precise and remote monitoring of patients in their natural environments by using passively generated data from sensors of personal wearable devices. Further studies are needed to better understand the potential clinical benefits of digital phenotyping approaches to optimize care of patients with cancer. OBJECTIVE: We aim to evaluate whether passively generated data from smartphone sensors are feasible for remote monitoring of patients with cancer to predict their disease trajectories and patient-centered health outcomes. METHODS: We will recruit 200 patients undergoing treatment for cancer. Patients will be followed up for 6 months. Passively generated data by sensors of personal smartphone devices (eg, accelerometer, gyroscope, GPS) will be continuously collected using the developed LAIMA smartphone app during follow-up. We will evaluate (1) mobility data by using an accelerometer (mean time of active period, mean time of exertional physical activity, distance covered per day, duration of inactive period), GPS (places of interest visited daily, hospital visits), and gyroscope sensors and (2) sociability indices (frequency of duration of phone calls, frequency and length of text messages, and internet browsing time). Every 2 weeks, patients will be asked to complete questionnaires pertaining to quality of life (European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire [EORTC QLQ-C30]), depression symptoms (Patient Health Questionnaire-9 [PHQ-9]), and anxiety symptoms (General Anxiety Disorder-7 [GAD-7]) that will be deployed via the LAIMA app. Clinic visits will take place at 1-3 months and 3-6 months of the study. Patients will be evaluated for disease progression, cancer and treatment complications, and functional status (Eastern Cooperative Oncology Group) by the study oncologist and will complete the questionnaire for evaluating quality of life (EORTC QLQ-C30), depression symptoms (PHQ-9), and anxiety symptoms (GAD-7). We will examine the associations among digital, clinical, and patient-reported health outcomes to develop prediction models with clinically meaningful outcomes. RESULTS: As of July 2023, we have reached the planned recruitment target, and patients are undergoing follow-up. Data collection is expected to be completed by September 2023. The final results should be available within 6 months after study completion. CONCLUSIONS: This study will provide in-depth insight into temporally and spatially precise trajectories of patients with cancer that will provide a novel digital health approach and will inform the design of future interventional clinical trials in oncology. Our findings will allow a better understanding of the potential clinical value of passively generated smartphone sensor data (digital phenotyping) for continuous and real-time monitoring of patients with cancer for treatment side effects, cancer complications, functional status, and patient-reported outcomes as well as prediction of disease progression or trajectories. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/49096.

The concern about main crises such as the Covid-19 pandemic, the war in Ukraine, and climate change's impact on energy-saving behavior.

The number of crises experienced around the world forces people to reconsider and reassess various aspects of their lives. The energy crisis caused by the war in Ukraine and uncontrolled climate change revealed the importance of energy-saving behavior. Thus, the aim of this paper is to analyze the concerns about current crises such as the Covid-19 pandemic, the war in Ukraine, and climate change's impact on energy-saving behavior and changes in environmental concern. Referring to the survey conducted in Lithuania in 2022, where 1000 respondents participated, the results revealed that the war in Ukraine was the most concerning problem. The level of climate change concern was slightly lower. Meanwhile, the Covid-19 pandemic was the least important problem in Lithuania in 2022. Furthermore, respondents stated that the Covid-19 pandemic contributed to the changes in environmental concern and energy-saving actions more than the war in Ukraine did. Meanwhile, the Generalized Linear Model results revealed that only the war in Ukraine positively and significantly influenced energy-saving behavior. The Covid-19 pandemic concern negatively affected energy-saving behavior, while the climate change concern factor affected it indirectly, as the interaction of attitudes toward energy consumption. Thus, this study revealed the main aspect of and how to encourage energy-saving behavior in the context of the main current crises.

The Covid-19 pandemic in context of climate change perception and resource-saving behavior in the European Union countries.

The resource-saving behavior in the recent period is escalating particularly due to the energy and prices crises in all of the European Union (EU). The COVID-19 pandemic not only caused changes in health concerns but also in environmental awareness and behavior. Thus, this paper aims to reveal whether the COVID-19 pandemic contributed to the resource-saving behavior, and how this pandemic changed the climate change perception and personal responsibility in the EU countries. Referring to two surveys conducted in all EU countries in 2019 and 2021, the results revealed that the level of climate change perception during this period significantly decreased in all EU. Meanwhile, the level of responsibility placed on the government to solve the climate change problem increased the most. A level of the personal responsibility increased negligibly. Considering resource-saving behaviors, only the lesser usage of disposable items from 2019 to 2021 increased statistically significantly. The results of an analysis of the main determinants of resource-saving behavior during the COVID-19 pandemic period revealed that personal responsibility and the climate change solution's benefit for health positively and significantly determined all the analyzed actions. The climate change perception and climate change solution's benefit for the economy statistically significantly influenced waste reduction, the purchase of efficient appliances, and the usage of pro-environmental transportation mode instead of personal cars. Health benefits instead of the economic benefits statistically significantly contributed to the resource-saving behaviors, except for actions that require more monetary investments. The satisfaction with the COVID-19 pandemic management had an insignificant negative impact on all resource-saving actions. Thus, the tools assigned to manage this pandemic did not motivate people to save natural resources.

Smartphone sensors for evaluating COVID-19 fear in patients with cancer: a prospective study.

Objective: This study aimed to analyze the association between the behavior of cancer patients, measured using passively and continuously generated data streams from smartphone sensors (as in digital phenotyping), and perceived fear of COVID-19 and COVID-19 vaccination status. Methods: A total of 202 patients with different cancer types and undergoing various treatments completed the COVID-19 Fears Questionnaire for Chronic Medical Conditions, and their vaccination status was evaluated. Patients' behaviors were monitored using a smartphone application that passively and continuously captures high-resolution data from personal smartphone sensors. In all, 107 patients were monitored for at least 2 weeks. The study was conducted between August 2022 and August 2023. Distributions of clinical and demographical parameters between fully vaccinated, partially vaccinated, and unvaccinated patients were compared using the Chi-squared test. The fear of COVID-19 among the groups was compared using the Mann-Whitney and the Kruskal-Wallis criteria. Trajectories of passively generated data were compared as a function of fear of COVID-19 and COVID-19 vaccination status using local polynomial regression. Results: In total, 202 patients were included in the study. Most patients were fully (71%) or partially (13%) vaccinated and 16% of the patients were unvaccinated for COVID-19. Fully vaccinated or unvaccinated patients reported greater fear of COVID-19 than partially vaccinated patients. Fear of COVID-19 was higher in patients being treated with biological therapy. Patients who reported a higher fear of COVID-19 spent more time at home, visited places at shorter distances from home, and visited fewer places of interest (POI). Fully or partially vaccinated patients visited more POI than unvaccinated patients. Local polynomial regression using passively generated smartphone sensor data showed that, although at the beginning of the study, all patients had a similar number of POI, after 1 week, partially vaccinated patients had an increased number of POI, which later remained, on average, around four POI per day. Meanwhile, fully vaccinated or unvaccinated patients had a similar trend of POI and it did not exceed three visits per day during the entire treatment period. Conclusion: The COVID-19 pandemic continues to have an impact on the behavior of cancer patients even after the termination of the global pandemic. A higher perceived fear of COVID-19 was associated with less movement, more time spent at home, less time spent outside of home, and a lower number of visited places. Unvaccinated patients visited fewer places and were moving less overall during a 14-week follow-up as compared to vaccinated patients.

The differences of climate change perception, responsibility and climate-friendly behavior among generations and the main determinants of youth's climate-friendly actions in the EU.

The role of society to mitigate climate change is particularly important. However, generations, different age cohorts are differently related to and concerned about climate change. The main criticism of the young generation is that they talk about climate change a lot but do not behave in a climate-friendly manner. Therefore, the aim of this paper is to analyze the difference of climate change perception, responsibility and climate-friendly behavior among Baby Boomer generation, Generations X, Y and Z in all European Union (EU) countries. After applying the Chi-square test, the results showed that younger people in the EU tend to have the perception of climate change more often than their older counterparts. Moreover, people from younger generations tend to place responsibility of solving climate change on the business/industrial sectors and environmental groups more often than the preceding generations do. Furthermore, more of young people assumed personal responsibility, used environmentally friendly alternatives to personal cars, and considered carbon footprint before purchasing a product, as opposed to older generations. However, the youth separated waste and decreased the use of disposable items less comparing with older generations. Applying binary logistic regression, the results showed that climate change perception and placement of responsibility on environmental groups positively and statistically significantly influenced all climate-friendly actions of the youth. Personal responsibility statistically significantly decreased probability of all climate-friendly actions. Responsibility placement on the government and business/industrial sectors reduced the probability to carry out waste reduction behavior. Thus, this study revealed that young people are not always climate-friendly, and this study provides the insights into how to promote climate-friendly behavior among youths.

The main determinants of changes in biomass extraction: the decomposition analysis approach.

Sustainability is highlighted in renewed European Union (EU) bioeconomy strategy. Sustainable bioeconomy requires improvement in the productivity level of bioresources, which is included in almost all national bioeconomy strategies. However, the aspects of sustainable bioeconomy were analyzed rather scarcely. Therefore, the aim of this paper is to reveal how productivity (or conversely, intensity) level contributes to the changes in biomass extraction in all EU countries. Applying the decomposition of impact (I), population, (P), affluence, (A); and technology (IPAT) approach, the results showed that in separate EU countries and analyzed periods, the changes in biomass extraction were different. During the period of economic growth (2000-2007) and transition (2008-2012), biomass extraction decreased in more than half of all EU countries. The decline of value added in the agriculture sector and/or reduction in biomass intensity level were the main determinants of these changes. Meanwhile, during the bioeconomy strategy period (2013-2018), the reduction in biomass extractions was observed in only six EU countries. During this period, the productivity level of biomass increased and offset the economic and population growth only in Greece, Italy and Malta. Thus, due to advanced technologies in these countries, the economy grew but biomass extraction decreased. Meanwhile, in Estonia, Germany and Poland, despite the reduction in value added in the agriculture sector, the growth of the intensity level of biomass determined the increase in extraction of biomass. Therefore, this study showed that achievement of sustainable bioeconomy principles in the majority of EU countries remains a great challenge, and countries should make all efforts to enhance the productivity level of biomass.

Impact of tick-borne Anaplasma phagocytophilum infections in calves of moose (Alces alces) in southern Norway.

The Gram-negative, obligate intracellular tick-transmitted pathogen Anaplasma phagocytophilum can cause acute febrile diseases in humans and domestic animals. The expansion of the tick Ixodes ricinus (Linnaeus, 1758) in northern Europe due to climate change is of serious concern for animal and human health. The aim of the present study was to investigate the impact of A. phagocytophilum infection in moose Alces alces (Linnaeus) calves by evaluating the carcass weights of infected and non-infected animals and examining animal tissues samples for co-infections with either species of Babesia Starcovici, 1893 or bacteria of the genus Bartonella. The carcasses of 68 free-ranging moose calves were weighed by hunters during the hunting seasons from 2014 to 2017 in two regions in southern Norway and spleen samples were collected. Anaplasma phagocytophilum was detected in moose sampled from locations infected with ticks with a prevalence of 82% (n = 46). The carcass weights of A. phagocytophilum-infected calves (n = 46) and non-infected (n = 22) calves were compared. Although the average weight of infected calves (45.6 kg) was lower than that of non-infected calves (46.5 kg), the difference was not statistically significant. Three different variants of the bacterium 16S rRNA gene were identified. The average weight of animals infected with variant I was 49.9 kg, whereas that of animals infected with variant III was 42.0 kg, but the difference was not statistically significant (p = 0.077). Co-infections of A. phagocytophilum with Bartonella spp. or with Babesia spp. were found in 20 and two calves, respectively. A triple infection was found in two calves. Sequence analysis of the 18S rRNA gene of Babesia-positive samples revealed the presence of Babesia cf. odocoilei (Emerson et Wright, 1970). Strains of Bartonella closely related to Bartonella bovis (Bermond, Boulouis, Heller, Laere, Monteil, Chomel, Sander, Dehio et Piemont, 2002) were identified based on phylogenetic analysis of the gltA and rpoB genes. The loss of body mass in moose calves in the tick-infected site was probably influenced by multiple factors.

New localities of Dermacentor reticulatus ticks in the Baltic countries.

According to previous observations in three Baltic States, Dermacentor reticulatus was found only in Lithuania where it occurred mainly in the central and western parts of the country. During the past decade, evidence about a changing distribution of D. reticulatus in the Baltic countries was provided by the occurrence of canine babesiosis in the new locations in Lithuania and Latvia. In the present study the current distribution of D. reticulatus in Lithuania and Latvia was investigated. Ticks were collected in different habitats in 2013-2014. A total of 3693 questing ticks belonging to D. reticulatus (n = 2789), Ixodes ricinus (n = 896) and I. persulcatus (n=8) were collected in Lithuania and Latvia. Questing D. reticulatus ticks were found in 73.4% (58/79) and in 44.4% (12/28) of the sampling localities in Lithuania and Latvia, respectively. Relative abundances of the ticks in different habitats were compared. All sites with high abundance of D. reticulatus ticks were localized in open areas close to a water basin and mixed forest. The present study demonstrates that during the past two decades D. reticulatus has expanded its range in the Baltic countries. D. reticulatus has been detected in 38 new localities in which this species had not been previously reported. The northern border of D. reticulatus in central Europe moved further to the north. New localities (n = 12) with D. reticulatus occurrence have been found in southern Latvia.