Cardiovascular magnetic resonance imaging for sequential assessment of cardiac fibrosis in mice: technical advancements and reverse translation.

Cardiovascular magnetic resonance (CMR) imaging has become an essential technique for the assessment of cardiac function and morphology, and is now routinely used to monitor disease progression and intervention efficacy in the clinic. Cardiac fibrosis is a common characteristic of numerous cardiovascular diseases and often precedes cardiac dysfunction and heart failure. Hence, the detection of cardiac fibrosis is important for both early diagnosis and the provision of guidance for interventions/therapies. Experimental mouse models with genetically and/or surgically induced disease have been widely used to understand mechanisms underlying cardiac fibrosis and to assess new treatment strategies. Improving the appropriate applications of CMR to mouse studies of cardiac fibrosis has the potential to generate new knowledge, and more accurately examine the safety and efficacy of antifibrotic therapies. In this review, we provide 1) a brief overview of different types of cardiac fibrosis, 2) general background on magnetic resonance imaging (MRI), 3) a summary of different CMR techniques used in mice for the assessment of cardiac fibrosis including experimental and technical considerations (contrast agents and pulse sequences), and 4) provide an overview of mouse studies that have serially monitored cardiac fibrosis during disease progression and/or therapeutic interventions. Clinically established CMR protocols have advanced mouse CMR for the detection of cardiac fibrosis, and there is hope that discovery studies in mice will identify new antifibrotic therapies for patients, highlighting the value of both reverse translation and bench-to-bedside research.

Fecal microbiota transplantation for treatment of refractory or recurrent Clostridioides difficile infection in Taiwan: a cost-effectiveness analysis.

Background: Compared to antibiotic treatment, fecal microbiota transplantation (FMT) is a more effective treatment for refractory or recurrent CDI (rCDI). Patients with inflammatory bowel disease (IBD) have a higher incidence of CDI and worse outcomes. There has been no study from Asia to evaluate the cost-effectiveness of FMT for overall rCDI patients and rCDI patients with IBD. Methods: We applied a Markov model with deterministic and probabilistic sensitivity analyses to evaluate the cost and effectiveness of different treatments for rCDI patients with a time horizon of 1 year from the payer's perspective. We compared the cost and clinical outcomes of FMT through colonoscopy to two antibiotics (vancomycin and fidaxomicin) using data from Chang Gung Memorial Hospital, Taoyuan, Taiwan. Results: Compared to vancomycin, FMT was cost-effective in overall rCDI patients as well as IBD patients with rCDI [USD 39356 (NT$1,101,971.98)/quality-adjusted life year (QALY) gained in overall patients; USD65490 (NT$1,833,719.14)/QALY gained in IBD patients]. Compared to fidaxomicin, FMT was only cost-effective in overall rCDI patients [USD20255 (NT$567,133.45)/QALY gained] but slightly increased QALY (0.0018 QALY gained) in IBD patients with rCDI. Conclusion: FMT is cost-effective, compared to vancomycin or fidaxomicin, for the treatment of rCDI in most scenarios from the payers' perspective in Taiwan.

Life cycle assessment of paper mill wastewater: a case study in Viet Nam.

Although in a critical position in the economy, the paper industry releases a lot of wastewater that requires adequate treatment for sustainable development. This study presents an application of Life cycle assessment (LCA) with the ReCiPe tool on the wastewater treatment plant (WWTP) of a paper factory in Vietnam to evaluate the environmental effect of the individual techniques in WWTP, especially the internal circulation (IC) reactor, a pioneer and practical anaerobic technology. Both Midpoint and Endpoint categories results demonstrated that chemical use and electricity consumption mainly contributed to the environmental impact in the WWTP. The Dissolved air flotation (DAF) and Moving bed biofilm reactor (MBBR) are classified as effective techniques to reduce the impacts on the environment. Moreover, the comparison of LCA between IC and up-flow anaerobic sludge bed (UASB) shows that IC is the better practically green technique for the environment.

Reduced Patellar Tendon Elasticity with Aging: In Vivo Assessment by Shear Wave Elastography.

How aging affects the elasticity of tendons has long been debated, partly because of the limited methods for in vivo evaluation, which differ vastly from those for in vitro animal studies. In this study, we tested the reliability of shear wave elastography (SWE) in the evaluation of patellar tendons and their change in elasticity with age. We recruited 62 healthy participants in three age groups: 20-30 years (group 1), 40-50 years (group 2) and 60-70 years (group 3). Shear wave velocity and elastic modulus were measured at the proximal, middle and distal areas of the patellar tendon. Reliability was excellent at the middle area and fair to good at both ends. Compared with the other groups, group 3 had significantly decreased elastic modulus and shear wave velocity values (p ≤ 0.001 vs. group 1 or 2), with significant increased side-to-side differences. SWE may be valuable in detecting aging tendons before visible abnormalities are observed on B-mode ultrasonography.

Assessment of the quality of stormwater from an industrial park in central Taiwan.

The purposes of this study were to assess the quality of rainstorm runoffs from an industrial park developed to accommodate general industries in Taiwan and to investigate the possible contributors of pollutants in the runoffs. Rainstorm runoffs from this industrial park were found to contain COD and TSS with average event mean concentrations of two events of 2,202.6 ± 1,356 and 784.7 ± 409 mg/l, respectively. The pollution level of these runoffs was found to be tens of times higher than that which may be contributed by accumulation of pollutants in top soils. Other possible sources of the pollutants were those accumulated in rainwater discharge channels and those which overflow from individual pre-treatment plants within the industrial lots. The assessment results are useful in devising the best management practices for the stormwater discharges. The heavy loadings suggest that installations of additional runoff pollution control practices at different zones are necessary at this and similar industrial parks.

Assessment of H reflex sensitivity with M wave alternation consequent to fatiguing contractions.

The objective of this study was to examine the changes in H reflex sensitivity after neuromuscular fatigue associated with fluctuations of the M wave. In the maximal and submaximal voluntary contraction (MVC and SMVC) paradigms, subjects performed voluntary plantarflexion at 100% MVC and 40% MVC respectively until the limit of torque maintenance was reached. In the submaximal electrical stimulation (SMES) paradigm, the tricep surae was exhausted with sustained electrical stimulation of 40% of the maximal tolerable intensity at a 40-Hz stimulus rate. The H reflexes and maximal M waves (M(max)) of the soleus were recorded before and after the three fatigue paradigms, and the H reflex was standardized with M(max) to minimize possible bias due to fatigue-induced M wave fluctuation. The results showed a significant increase in the standardized H reflex due to the SMES paradigm in spite of M(max) potentiation. The SMVC paradigm led to a reduction in size of the standardized H reflex without modification of M(max), whereas the standardized H reflex was not mediated by the MVC paradigm, which contributed to a noticeable M(max) potentiation. The present study underscored the fact that the H reflex sensitivity and M wave amplitude were not necessarily suppressed consequent to neuromuscular fatigue, but varied with the activation history of a muscle for size-dependent efficacy of the Ia transmission pathways and postactivation potentiation.