Mineralocorticoid receptor antagonists and atrial fibrillation: a meta-analysis of clinical trials.

BACKGROUND AND AIMS: Mineralocorticoid receptor antagonists (MRAs) improve cardiovascular outcomes in a variety of settings. This study aimed to assess whether cardioprotective effects of MRAs are modified by heart failure (HF) and atrial fibrillation (AF) status and to study their impact on AF events. METHODS: MEDLINE, Embase, and Cochrane Central databases were searched to 24 March 2023 for randomized controlled trials evaluating the efficacy of MRAs as compared with placebo or usual care in reducing cardiovascular outcomes and AF events in patients with or at risk for cardiovascular diseases. Random-effects models and interaction analyses were used to test for effect modification. RESULTS: Meta-analysis of seven trials (20 741 participants, mean age: 65.6 years, 32% women) showed that the efficacy of MRAs, as compared with placebo, in reducing a composite of cardiovascular death or HF hospitalization remains consistent across patients with HF [risk ratio = 0.81; 95% confidence interval (CI): 0.67-0.98] and without HF (risk ratio = 0.84; 95% CI: 0.75-0.93; interaction P = .77). Among patients with HF, MRAs reduced cardiovascular death or HF hospitalization in patients with AF (hazard ratio = 0.95; 95% CI: 0.54-1.66) to a similar extent as in those without AF (hazard ratio = 0.82; 95% CI: 0.63-1.07; interaction P = .65). Pooled data from 20 trials (21 791 participants, mean age: 65.2 years, 31.3% women) showed that MRAs reduce AF events (risk ratio = 0.76; 95% CI: 0.67-0.87) in both patients with and without prior AF. CONCLUSIONS: Mineralocorticoid receptor antagonists are similarly effective in preventing cardiovascular events in patients with and without HF and most likely retain their efficacy regardless of AF status. Mineralocorticoid receptor antagonists may also be moderately effective in preventing incident or recurrent AF events.

Aldosterone and aldosterone synthase inhibitors in cardiorenal disease.

Modulation of the renin-angiotensin-aldosterone system is a foundation of therapy for cardiovascular and kidney diseases. Excess aldosterone plays an important role in cardiovascular disease, contributing to inflammation, fibrosis, and dysfunction in the heart, kidneys, and vasculature through both genomic and mineralocorticoid receptor (MR)-mediated as well as nongenomic mechanisms. MR antagonists have been a key therapy for attenuating the pathologic effects of aldosterone but are associated with some side effects and may not always adequately attenuate the nongenomic effects of aldosterone. Aldosterone is primarily synthesized by the CYP11B2 aldosterone synthase enzyme, which is very similar in structure to other enzymes involved in steroid biosynthesis including CYP11B1, a key enzyme involved in glucocorticoid production. Lack of specificity for CYP11B2, off-target effects on the hypothalamic-pituitary-adrenal axis, and counterproductive increased levels of bioactive steroid intermediates such as 11-deoxycorticosterone have posed challenges in the development of early aldosterone synthase inhibitors such as osilodrostat. In early-phase clinical trials, newer aldosterone synthase inhibitors demonstrated promise in lowering blood pressure in patients with treatment-resistant and uncontrolled hypertension. It is therefore plausible that these agents offer protection in other disease states including heart failure or chronic kidney disease. Further clinical evaluation will be needed to clarify the role of aldosterone synthase inhibitors, a promising class of agents that represent a potentially major therapeutic advance.

Mechanisms of benefits of sodium-glucose cotransporter 2 inhibitors in heart failure with preserved ejection fraction.

For decades, heart failure with preserved ejection fraction (HFpEF) proved an elusive entity to treat. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have recently been shown to reduce the composite of heart failure hospitalization or cardiovascular death in patients with HFpEF in the landmark DELIVER and EMPEROR-Preserved trials. While improvements in blood sugar, blood pressure, and attenuation of kidney disease progression all may play some role, preclinical and translational research have identified additional mechanisms of these agents. The SGLT2 inhibitors have intriguingly been shown to induce a nutrient-deprivation and hypoxic-like transcriptional paradigm, with increased ketosis, erythropoietin, and autophagic flux in addition to altering iron homeostasis, which may contribute to improved cardiac energetics and function. These agents also reduce epicardial adipose tissue and alter adipokine signalling, which may play a role in the reductions in inflammation and oxidative stress observed with SGLT2 inhibition. Emerging evidence also indicates that these drugs impact cardiomyocyte ionic homeostasis although whether this is through indirect mechanisms or via direct, off-target effects on other ion channels has yet to be clearly characterized. Finally, SGLT2 inhibitors have been shown to reduce myofilament stiffness as well as extracellular matrix remodelling/fibrosis in the heart, improving diastolic function. The SGLT2 inhibitors have established themselves as robust, disease-modifying therapies and as recent trial results are incorporated into clinical guidelines, will likely become foundational in the therapy of HFpEF.

Fractal characterizations of MeV ion treated CaF2 thin films.

We present the morphological evolution and fractal characterizations of CaF2 thin-film surfaces modified by bombardment with 100 MeV Au+8 ions at various fluences. Atomic force microscopy (AFM) combined with line profile and two-dimensional power spectral density (2D-PSD) analysis was utilized to investigate the evolution of surface morphology as a function of fluence. The AFM images were utilized to investigate the relationship between fractal dimension, roughness exponent, lateral correlation length, and ion fluence. The surface erosion owing to sputtering was depicted using Rutherford backscattering spectrometry. The structural characteristics' dependency on fluence was explored with the help of glancing angle x-ray diffraction measurements on virgin and irradiated samples. Tensile stress calculated using a peak shift in the glancing angle x-ray diffractogram showed an increase in tensile stress with fluence that caused the surface to crack after the fracture strength of the surface was crossed. 2D-PSD analysis signified the role of sputtering over surface diffusion for the observed surface modifications. Fractal dimensions first increased and then decreased with ion fluence. The lateral correlation length decreased, while the roughness exponent increased with fluence after the threshold value.

Sequencing and de novo transcriptome assembly for discovering regulators of gene expression in Jack (Artocarpus heterophyllus).

Jack (Artocarpus heterophyllus) is a multipurpose fruit-tree species with minimal genomic resources. The study reports developing comprehensive transcriptome data containing 80,411 unigenes with an N50 value of 1265 bp. We predicted 64,215 CDSs from the unigenes and annotated and functionally categorized them into the biological process (23,230), molecular function (27,149), and cellular components (17,284). From 80,411 unigenes, we discovered 16,853 perfect SSRs with 192 distinct repeat motif types reiterating 4 to 22 times. Besides, we identified 2741 TFs from 69 TF families, 53 miRNAs from 19 conserved miRNA families, 25,953 potential lncRNAs, and placed three functional eTMs in different lncRNA-miRNA pairs. The regulatory networks involving genes, TFs, and miRNAs identified several regulatory and regulated nodes providing insight into miRNAs' gene associations and transcription factor-mediated regulation. The comparison of expression patterns of some selected miRNAs vis-à-vis their corresponding target genes showed an inverse relationship indicating the possible miRNA-mediated regulation of the genes.

Formulation and performance evaluation of polymeric mixed micelles encapsulated with baicalein for breast cancer treatment.

The present study is aimed to formulate baicalein-loaded mixed micelles to enhance the solubility and oral bioavailability. Baicalein encapsulated D-α-tocopherol polyethylene glycol 1000 succinate (TPGS) and pluronic F127 (F127) combined micelles were prepared and investigated for anticancer effect. The optimized formulation contains 25.04 ± 0.24 nm mean particle size of micelles with a zeta potential value of -4.01 ± 0.5 mV. The calculated entrapment efficiency percentage of baicalein within the micellar structure was 83.43 ± 0.13% and the in vitro release of baicalein from micelles displayed a sustained release profile at pH 7.4. The incorporation of baicalein within micelles core was also confirmed by FTIR analysis of formulation, which hardly represents the characteristic peak of baicalein, indicating successful entrapment of the drug. In vitro cell culture experiments revealed baicalein-loaded micelles significantly enhanced cellular uptake and cytotoxicity against MDAMB-231 cell lines in comparison to free baicalein. Additionally, as compared to free baicalein, baicalein micelles demonstrated greater apoptosis-inducing potential while the results of the cell cycle study exhibited arrest of cells at the G0/G1 phase of the cell cycle. Results of ROS (reactive oxygen species) and MMP (mitochondrial membrane potential) assay revealed the ROS-dependent mitochondrial-mediated apoptosis pathway utilized by developed formulation to inhibit cell proliferation. Thus, the developed nano micelles can serve as a potent carrier system for baicalein against breast cancer.

A new clustering method for the diagnosis of CoVID19 using medical images.

With the spread of COVID-19, there is an urgent need for a fast and reliable diagnostic aid. For the same, literature has witnessed that medical imaging plays a vital role, and tools using supervised methods have promising results. However, the limited size of medical images for diagnosis of CoVID19 may impact the generalization of such supervised methods. To alleviate this, a new clustering method is presented. In this method, a novel variant of a gravitational search algorithm is employed for obtaining optimal clusters. To validate the performance of the proposed variant, a comparative analysis among recent metaheuristic algorithms is conducted. The experimental study includes two sets of benchmark functions, namely standard functions and CEC2013 functions, belonging to different categories such as unimodal, multimodal, and unconstrained optimization functions. The performance comparison is evaluated and statistically validated in terms of mean fitness value, Friedman test, and box-plot. Further, the presented clustering method tested against three different types of publicly available CoVID19 medical images, namely X-ray, CT scan, and Ultrasound images. Experiments demonstrate that the proposed method is comparatively outperforming in terms of accuracy, precision, sensitivity, specificity, and F1-score.

Evaluation of forewarning models for mustard aphids in different agro-climatic zones of India.

Mustard aphid, Lipaphis erysimi (Kaltenbach), is the most serious pest of Rapeseed-Mustard which is known to be responsible for a tremendous loss in yield and oil content, under various agro-climatic conditions of India. Information support on aphid occurrence and intensity is necessary for effective management by the farmers in the mustard-growing belt. In this study, an effort is made to develop forewarning model using the field data on aphid for 12 consecutive rabi seasons from 2003-2004 to 2014-2015 under different agro-climatic locations in India. Three main components of aphid-related stages were identified for which necessary forewarnings were needed to be issued: (1) severity, (2) the time of reaching the economic threshold level (ETL) for decision-making on pesticide application, and (3) time of occurrence of peak population. To address these, three different models were developed/used and validated using incident field dataset. Those field observations when the infestation level were below severe category (< 60) during rising phase of the aphid population were found to indicate highest R sqr. (0.82) for the model-I during validation. When model-II was used, 11 out of 14 locations (78.57%) stood validated. The assumptions made in model-III also got validated when humidity thermal ratio (HTR) of the week of peak population ranged between 1.5 and 4 (lowest among the weeks considered), and population reached severe category. The models showed better results during real-time validation in seasons 2016-2017 and 2017-2018, thus suggesting that these three models can be used to ascertain the severity, week of ETL, and week of peak aphid population for Brassica juncea varieties all over the mustard belt in India and can be operationalized spatially to forewarn against the aphid pest population in future under Gramin Krishi Mausam Sewa (GKMS) scheme.

Marker-trait association for low-light intensity tolerance in rice genotypes from Eastern India.

Light intensity is a crucial environmental factor that affects photosynthesis and ultimately, grain yield in rice. However, no gene or marker directly associated with improved performance under low-light intensity under field conditions has been identified till date. With an aim of identifying genes and markers associated with improved performance (measured in terms of better yields) under low-light intensity, an integrated field screening, in silico and wet lab validation analysis was performed. Field-based screening of a diverse set of 110 genotypes led to the identification of two physiological and three morphological parameters critical for low-light tolerance in rice. In silico analysis using information available in public databases led to the identification of a set of 90 potential candidate genes which were narrowed to thirteen genic targets for possible marker-trait association. Marker-trait association on the panel of 48 diverse rice genotypes varying in their response to low-light intensity led to the identification of six markers [HvSSR02-44 (biological yield), HvSSR02-52 (spikelet fertility), HvSSR02-54 (grain yield), HvSSR06-56 (spikelet fertility), HvSSR06-69 (spikelet fertility; biological yield), HvSSR09-45 (spikelet fertility)] lying on chromosomes 2, 6 and 9 showing significant association (R2 > 0.1) for traits like grain yield/plant, biological yield and spikelet fertility under low light. Eight rice genes [including member of BBX (B-box) family] lying within 10 kb distance of these identified markers already reported for their role in response to stress or change in plant architecture in rice were also identified. The eight rice genotypes, five traits, eight genes and six markers identified in the current study will help in devising strategies to increase yield under low light intensity and pave way for future application in marker-assisted breeding.

The emerging role of proprotein convertase subtilisin/kexin type-9 inhibition in secondary prevention: from clinical trials to real-world experience.

PURPOSE OF REVIEW: The recent advent of a highly efficacious class of low-density lipoprotein cholesterol (LDL-C) lowering agents, the proprotein convertase subtilisin/kexin type-9 (PCSK9) inhibitors, has transformed dyslipidaemia management in patients with cardiovascular disease as well as those with familial hypercholesterolemia. RECENT FINDINGS: Recent positive results of the landmark Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk cardiovascular outcome trial with evolocumab as an add-on to statin therapy demonstrate further reduction of cardiovascular events. Additional safety outcomes from this large randomized trial, as well as the EBBINGHAUS substudy, allay fears of neurocognitive disorder as an adverse effect of achieving very low LDL-C levels with these agents. SUMMARY AND IMPLICATIONS: Widespread clinical adoption of PCSK9 inhibitors will depend on the results from ongoing and planned cardiovascular efficacy and safety trials with PCSK9 inhibitors. In addition, understanding the practical challenges and barriers to usage of these injectable agents by high cardiovascular risk patients will also affect clinical adoption of this class of agents. Analysis of cost-benefit models, along with anticipated updates to practice guidelines for dyslipidaemia management are likely to strengthen the clinical utility of PCSK9 inhibitors. Importantly, the potency of this new class of agents provides a huge opportunity to extend further the 'lower LDL-C is better' hypothesis in an effort to reduce rates of cardiovascular morbidity and mortality on a population level.

SHI induced surface re-organization of non-amorphisable nanodimensional fluoride thin films.

Surface re-organization in nanodimensional fluoride (LiF and BaF2) thin films is observed under dense electronic excitation produced by swift heavy ion (SHI) irradiation. The irradiation was performed at an angle of less than 15° with respect to the film surface while keeping the sample at liquid nitrogen temperature. The surface of the irradiated samples was characterized by atomic force microscopy (AFM) and scanning electron microscopy (SEM) complemented by energy dispersive X-ray spectroscopy (EDX). Detailed analyses indicate that the surface starts cracking at lower fluence. With an increase in the ion fluence, the materials shrinking and surface re-structuring lead to lamellae periodic structures. The average width of the wall decreases, while the separation and the height of the structures increase with the fluence. The composition of the lamellae walls and the gap in between were analyzed by EDX. At the highest fluence of irradiation, a strong signal of the substrate and negligible signals of F and Ba are observed between the walls of the lamellae structures, which shows that the entire deposited material is removed and the Si substrate is completely exposed to the ion beam. It is also observed that the substrate remains unaffected by SHI irradiation and does not undergo any structural transformation as evident by cross-sectional SEM micrographs. Such surface re-organization is not expected in fluoride thin films due to their non-amorphizable nature even at very high fluence SHI irradiation. The concept of grain rotation under SHI irradiation is used to explain the re-organization phenomena in such non-amorphizable materials.

Genetic characterization of chayote [Sechium edule (Jacq.) Swartz.] landraces of North Eastern Hills of India and conservation measure.

Chayote or chow-chow is an underutilized cucurbit vegetable crop, widely cultivated by farmers in the backyards and Jhum lands for its tender leaves, fruits and tuberous root. In order to initiate crop improvement program in this crop, the present study was undertaken to assess the genetic variations in the 74 chow-chow landraces collected from the North Eastern Hill region of India. Wide variations for fruit colors, fruit length (6.5-21.5 cm), fruit width (4.2-10.7 cm), fruit weight (60-560 g), vitamin-C (2.6-13.8 mg/100 g), reducing sugar (0.18-2.77%), total sugar (1.09-2.94%) and phenol content (0.17-3.85 mg/100 g FW) were recorded among the landraces. All the landraces were also characterized using random amplified polymorphic DNA (RAPD) and inter simple sequence repeat (ISSR) markers. In RAPD analyses, out of 28 primers a total of 198 reproducible amplicons were formed at an average of 7.01 per primer and an overall polymorphism of 88.38%. Eight fragments were specific to landraces with light green fruits. Four fragments were observed to be specific to RCSC-22 (dark green fruits) and another four specific to a RCSC-30 (pale yellow fruits). Out of 30 ISSR, only 5 primers generated a total of 32 reproducible amplicons with an average of 6.4 per primer and overall polymorphism of 62.5%. The pair wise similarity coefficient values ranged from 0.55 to 0.96. The grouping of landraces in cluster analysis was found to be independent of their respective geographic locations. The cuttings of suckers and shoot top (2 months old) treated with indole-3-butyric acid (200 mg l-1) provide an alternative for the conservation of the diverse genetic materials to the researchers.

Exploration of anti-Malassezia potential of Nyctanthes arbor-tristis L. and their application to combat the infection caused by Mala s1 a novel allergen.

BACKGROUND: Malassezia commensal yeasts along with multitude of antigens have been found to be associated with various skin disorders including Pityriasis versicolor (PV). Amongst them Mala s1, a 37 kDa protein has been proved to be a major allergen reacting with a large panel of sera. However, there exists no therapeutic alternative to combat such problems in form of plant based natural compounds. The purpose of this study is in the first place, to determine the anti-Malassezia activity of Nyctanthes arbor-tristis L. (NAT) ethanolic leaf extract through turbidimetric growth curves, disruption of plasma membrane and secondly, it aims to present in silico validation of its active constituents over Mala s1a novel allergen. METHODS: The antifungal susceptibility 50 % ethanolic extract of NAT was determined by broth microdilution method according to CLSI guidelines. Further MICs and IC50 were determined spectrophotometrically using the software SoftMax® Pro-5 (Molecular Devices, USA). Active constituents mediated disruption of plasma membrane was studied through flowcytometry by permeabilization of fluorescent dye Propidium Iodide (PI). Antioxidant activity of the extract was determined using the DPPH stable radical. Molecular validation of fungal DNA from the extract was observed using PCR amplification. In silico analysis of its active constituents over Mala s1 was performed using HEX software and visualized through Pymol. RESULTS: The anti-Malassezia potential of NAT leaf extracts reflected moderate MIC 1.05 µg/µl against M. globosa, while least effective against M. restricta with MIC 1.47 µg/µl. A linear correlation coefficient R (2) = 0.866 was obtained in case of M. globosa while minimum was observed in M. restricta with R (2) = 0.732. The flow cytometric data reveal ~ 75 % cell death when treated with active constituents ß-Sitosterol and Calceolarioside A. The docking confirmations and the interaction energies between Mala s1 and the active constituents (ß-Sitosterol and Calceolarioside A) from extracts showed an effective binding which suggests Mala s1 as efficient allergen for site specific targeting. CONCLUSIONS: This study revealed that Nyctanthes arbor-tristis L. (NAT) extracts possess high anti-Malassezia potential which is driven mainly by disruption of plasma membrane. Also in silico validation and molecular modeling studies establishes Mala s1 as a novel allergen that could be a potential target in disease treatment. Our results would also provide a foundation for the development of new therapeutic approach using NAT extract as lead compound with high antioxidant property as an added trait for skin care.

Ecology, genetic diversity, and population structure among commercial varieties and local landraces of Capsicum spp. grown in northeastern states of India.

Northeastern states of India are known for unique landraces of Capsicum spp. with geographical indications. However, little information is available about these valuable landraces of chillies. Surveys and collections were carried out in niche areas to find out their ecology and diversity through morphological traits and molecular analysis using microsatellite markers. Our result characterized the ecology of niche areas as cool (11.0°C-20.7°C) and humid (>60% relative humidity) climates for dalle-chilli (Capsicum annuum L.); mild-warm (12.2°C-28.6°C) and humid for king-chilli (C. chinense Jacq.); and cool to warm (11.3°C-33.1°C) and humid for bird's eye chilli (C. frutescens L.) during the crop period. The canonical correspondence analysis has shown the significant impact of temperature on the agro-morphological traits and distribution of the landraces in their niche areas. A wide variability was observed for different quantitative traits and yield attributing characters (fruit length, diameter, weight, and yield), showing high heritability (97.0%-99.0%), and genetic advance as a percentage of the mean (119.8%-434.0%). A total of 47 SSR markers used for the molecular analysis generated 230 alleles, ranging from 2 (HPMSE-7) to 10 (HPMSE-5), with an average of 4.89 alleles per locus. The average polymorphism information content was also high (0.61) and ranged from 0.20 (HPMSE-7) to 0.85 (CAMS-91). The observed average heterozygosity was lower than the expected value. Analysis of molecular variance has shown significant variation within (69%) and between (31%) of the populations of Capsicum spp. Based on Nei's genetic distance, bird's eye chilli and king-chilli were found to be closer to each other, whereas dalle-chilli, a tretraploid species, was closer to hot pepper (C. annuum). However, the flower size of dalle-chilli was large and found closer to king-chilli in color and differs from C. chinense due to the presence of calyx teeth. For quality traits, landraces king-chilli, dalle-chilli, and bird's eye chilli have shown 2.8, 2.0, and 1.4 times higher average capsaicin and 0.46, 0.25, and 0.22 times higher average oleoresin content over the hot pepper, respectively. The knowledge of ecology and diversity can be used in identifying new areas for production, selection of elite lines, conservation, and crop improvement.

ZnSe/ZnSe:Ag nanoparticles: synthesis, characterizations, optical and raman studies.

Nanoparticles (NPs), grown in liquid media, stand out over other classes of inorganic nanomaterials due to the high degree of control with which their crystal structure, size, shape, and surface functionalities can be engineered in the synthesis stage and to the versatility with which they can be processed and implemented into a large spectrum of devices and processes. In present work pure and Ag-doped ZnSe NPs were successfully synthesized from the solution phase chemistry and investigated with respect to their structural and optical properties. The resulting powder consists of nanocrystalline particles were characterized by X-ray diffraction (XRD), UV-Visible spectroscopy, photoluminescence spectroscopy, transmission electron microscopy (TEM), high resolution transmission electron microscopy (HRTEM), energy dispersive X-ray analysis (EDX) techniques and Raman spectroscopy. A UV emission peak was observed from the excitons transition at 380 nm in the room temperature photo luminescent (PL) spectra. The blue emission band was assigned to the Zn interstitial and vacancy level transition. Even though Ag ions known to act as an efficient non-radiative loss center for near band gap emission (NBE), a decreased NBE is obtained at room temperature even for a nominal Ag concentration. XRD data analysis shows that the Ag dopant atoms are incorporated into the cubic ZnSe host lattice.

A Novel Blockchain and Internet of Things-Based Food Traceability System for Smart Cities.

Rapid urbanization has recently caused serious problems for cities all around the world. Smart cities have drawn much interest from researchers in the present research paradigm to manage the expanding urban population. Frameworks for smart cities are planned and implemented using platforms based on blockchain and the Internet of Things (BIOT). Smart cities may use the BIoT platform to provide improved transportation, food traceability, and healthcare services. Food safety is one of the sectors where less research has been done than the others. The importance of food safety is now more widely recognized, making it essential to improve the traceability and transparency of the food supply chain. In this paper, a novel BIOT-based layered framework using EOSIO has been proposed for effective food traceability. The proposed system first identifies the suitable traceability units to provide better transparency and traceability and then defines and implements a layered architecture using Ethereum and EOSIO blockchain platforms. The performance of the proposed EOSIO-based model is evaluated using the practicality of the consensus algorithm, block production rate, throughput, and block confirmation time. The proposed traceability system attains a block production rate of 0.5 s and a block confirmation time of 1 s, which is much lower than the Ethereum-based traceability system. Hence, from the experimental evidence, the superiority of the proposed EOSIO-based food traceability can be observed.

A Web-Based Application for Risk Stratification and Optimization in Patients With Cardiovascular Disease: Pilot Study.

BACKGROUND: In addition to aspirin, angiotensin-converting enzyme inhibitors, statins, and lifestyle modification interventions, novel pharmacological agents have been shown to reduce morbidity and mortality in atherosclerotic cardiovascular disease patients, including new antithrombotics, antihyperglycemics, and lipid-modulating therapies. Despite their benefits, the uptake of these guideline-directed therapies remains a challenge. There is a need to develop strategies to support knowledge translation for the uptake of secondary prevention therapies. OBJECTIVE: The goal of this study was to test the feasibility and usability of Stratification and Optimization in Patients With Cardiovascular Disease (STOP-CVD), a point-of-care application that was designed to facilitate knowledge translation by providing individualized risk stratification and optimization guidance. METHODS: Using the REACH (Reduction of Atherothrombosis for Continued Health) Registry trial and predictive modeling (which included 67,888 patients), we designed a free web-based secondary risk calculator. Based on demographic and comorbidity profiles, the application was used to predict an individual's 20-month risk of cardiovascular events and cardiovascular mortality and provides a comparison to an age-matched control with an optimized cardiovascular risk profile to illustrate the modifiable residual risk. Additionally, the application used the patient's risk profile to provide specific guidance for possible therapeutic interventions based on a novel algorithm. During an initial 3-month adoption phase, 1-time invitations were sent through email and telephone to 240 physicians that refer to a regional cardiovascular clinic. After 3 months, a survey of user experience was sent to all users. Following this, no further marketing of the application was performed. Google Analytics was collected postimplementation from January 2021 to December 2021. These were used to tabulate the total number of distinct users and the total number of monthly uses of the application. RESULTS: During the 1-year pilot, 47 of the 240 invited clinicians used the application 1573 times, an average of 131 times per month, with sustained usage over time. All 24 postimplementation survey respondents confirmed that the application was functional, easy to use, and useful. CONCLUSIONS: This pilot suggests that the STOP-CVD application is feasible and usable, with high clinician satisfaction. This tool can be easily scaled to support the uptake of guideline-directed medical therapy, which could improve clinical outcomes. Future research will be focused on evaluating the impact of this tool on clinician management and patient outcomes.

Luminescence nanothermometry using a trivalent lanthanide co-doped perovskite.

This study investigates in detail the laser-mediated upconversion emission and temperature-sensing capability of (Ca0.99-a Yb0.01Er a )TiO3. Samples were prepared at different concentrations to observe the effect of erbium on upconversion while increasing its concentration and keeping all the other parameters constant. Doping is a widespread technological process which involves incorporating an element called a dopant in a lower ratio to the host lattice to derive hybrid materials with desired properties. The (Ca0.99-a Yb0.01Er a )TiO3 perovskite nanoparticles were synthesized via a sol-gel technique. The frequency upconversion was performed using a 980 nm laser diode excitation source. X-ray diffractometry (XRD) confirmed that the synthesized samples are crystalline in nature and have an orthorhombic structure. The temperature-sensing ability was examined using the fluorescence intensity ratio (FIR) algorithm of two emission bands (2H11/2 → 4I15/2 and 4S3/2 → 4I15/2) of the Er3+ ion. Temperature-dependent upconversion luminescence is observed over a broad temperature range of 298-623 K. The maximum sensor sensitivity obtained is 6.71 × 10-3 K-1 at 110°.

Impact of Yoga on Global Cardiovascular Risk as an Add-On to a Regular Exercise Regimen in Patients With Hypertension.

BACKGROUND: We aimed to determine whether the addition of yoga to a regular exercise training regimen improves cardiometabolic risk profile. METHODS: Sixty individuals with diagnosed hypertension (≥ 140/90 mm Hg for 3 measurements on different days) were recruited in an exercise training program. In addition to aerobic exercise training, participants were randomised into either a yoga or a stretching control group. Participants, over the 3-month intervention regimen, performed 15 minutes of either yoga or stretching in addition to 30 minutes of aerobic exercise training 5 times weekly. Blood pressure, anthropometry, high-sensitivity C-reactive protein (hs-CRP), glucose, and lipid levels as well as the Framingham and Reynolds Risk Scores were measured. RESULTS: At baseline, there was no difference in age, sex, smoking status, body mass index, blood pressure, heart rate, lipid and glucose levels, and Framingham Risk Score between groups. After the 3-month intervention period, the decrement in systolic and diastolic blood pressures (before vs after stretching: 126 ± 11/76 ± 7 vs 122 ± 11/73 ± 8 mm Hg; before vs after yoga: 130 ± 13/77 ± 10 vs 119 ± 11/69 ± 8 mm Hg) and heart rate was greater (P < 0.001) in the yoga group, with similar decreases in lipid, glucose, and hs-CRP levels and Framingham Risk Score in both groups. Reynolds Risk Score decrement was higher in the yoga vs the control group (absolute reduction -1.2 ± 1.2 vs -0.6 ± 0.8; relative reduction 13.2 ± 11.8% vs 9.3 ± 6.5%; P < 0.05). CONCLUSION: In patients with hypertension, the practice of yoga incorporated in a 3-month exercise training program was associated with greater improvement in resting blood pressure and heart rate and Reynolds Risk Score compared with stretching.

A comprehensive survey of image segmentation: clustering methods, performance parameters, and benchmark datasets.

Image segmentation is an essential phase of computer vision in which useful information is extracted from an image that can range from finding objects while moving across a room to detect abnormalities in a medical image. As image pixels are generally unlabelled, the commonly used approach for the same is clustering. This paper reviews various existing clustering based image segmentation methods. Two main clustering methods have been surveyed, namely hierarchical and partitional based clustering methods. As partitional clustering is computationally better, further study is done in the perspective of methods belonging to this class. Further, literature bifurcates the partitional based clustering methods into three categories, namely K-means based methods, histogram-based methods, and meta-heuristic based methods. The survey of various performance parameters for the quantitative evaluation of segmentation results is also included. Further, the publicly available benchmark datasets for image-segmentation are briefed.