Pregnancy During the COVID-19 Pandemic: Communicated Narrative Sense-Making and Resilience.

Grounded in communicated narrative sense-making (CNSM) theory and communication theory of resilience (CTR), the current study investigated how women narratively constructed resilience surrounding pregnancy during the COVID-19 pandemic. Given the adverse effects of stress on pregnant individuals and their babies, it is important to understand the triggers and process of resilience in this context. We interviewed 21 cisgender women who were pregnant during the COVID-19 pandemic to solicit their stories of stress and resilience. Findings revealed that pregnant women managed structural, informational, and interpersonal stressors unique to the COVID-19 pandemic. They engaged in re-storying to reconcile the gap between their expected pregnancy, fueled by the U.S. master narrative of pregnancy and birth, and their lived pregnancy during a pandemic. Participants demonstrated narrative resilience through reconnecting, reframing, and recentering. These findings advance theorizing in communicated resilience by centering CNSM as the sense-making process of enacting resilience and recognizing the importance and burden of resilience during pregnancy. Practical applications are explored such as contributing to narrative-informed programming, interventions, and education efforts regarding future health crises.

Bio-sorptive remediation of crude oil polluted sea water using plantain (Musa parasidiaca) leaves as bio-based sorbent: Parametric optimization by Taguchi technique, equilibrium isotherm and kinetic modelling studies.

This study investigated the potential of employing plantain leaves as a natural bio-based sorbent for crude oil spill polluted seawater remediation. Type L9(34) Taguchi orthogonal array technique was used to evaluate the effect of four independent bio-sorption factors at three different levels (crude oil initial concentration (X1 7.8, 11.5 and 15.6 g/L), seawater-crude oil temperature (X2 25, 35 and 45 °C), bio-sorbent dosage (X3 1, 2 and 3 g) and bio-sorbent particle size (X4 1.18, 2.36 and 4.72 mm) on two response indices (bio-sorption efficiency (%) and bio-sorption capacity (g/g)). Taguchi optimization technique, numerical-desirability index function optimization technique and a proposed optimization method were utilized to determine the optimum bio-sorption factors needed for the optimum bio-sorption efficiency and bio-sorption capacity. The results demonstrated that the crude oil bio-sorption efficiency of the plantain leaves was significantly influenced by X1, X3 and X4 and the bio-sorption capacity was mainly influenced by X1 and X3. The optimum bio-sorption efficiency and the optimum bio-sorption capacity were 99.05 % and 12.82 g/g, respectively, obtained at optimum combination of factors and levels of X11 (7.8 g/L), X33 (3 g) and X41 (1.18 mm) for bio-sorption efficiency and X13 (15.6 g/L) X31 (1 g) for bio-sorption capacity. The Freundlich and Dubinin-Rudeshkevich isotherm models best explain the equilibrium bio-sorption data, while the pseudo-second order kinetic model best describes the bio-sorption kinetics. The bio-sorptive remediation mechanism followed dual mechanism of physical and chemical bio-sorption and the mass transfer controlled by film diffusion. The maximum bio-sorption capacity (Kf) was 14.0 gg-1.

Maize cob (Zea mays) as natural biomass sorbent for crude oil biosorptive removal from contaminated seawater: Taguchi process optimization and biosorptive removal mechanism.

Crude oil pollution poses a serious threat to the aquatic environment. Hence, there is an increasing interest in developing an efficient cleaner process technique for oil spill cleanup via agricultural biomass waste-organic sorbent utilization. This work evaluated the effects of independent biosorptive removal at three varying levels (initial concentration of crude oil (Z1, 7.8-15.6 g/L), seawater-oil temperature (Z2, 25-45 °C), sorbent dose (Z3, 1-3 g), and sorbent particle size diameter (Z4, 1.18-4.72 mm)) on the biosorptive removal efficiency and biosorptive capacity performance of maize cob sorbent for crude oil biosorptive removal from seawater. Experiments were designed based on Taguchi orthogonal array experimental design (L9(34)) to study the effects and process optimization. The results revealed that the maize cob sorbent's crude oil biosorptive removal efficiency is related to Z1, Z3, and Z4, while the biosorptive capacity is related to Z1 and Z3. The optimum biosorptive removal efficiency and the biosorptive capacity values were 96.53% and 12.64 g/g, respectively, achieved at optimum factors of Z1 (7.8 g/L), Z3 (3 g), and Z4 (1.18 mm), as well as at Z1 (15.6 g) and Z3 (1 g). The isotherm and kinetic data, respectively, followed the Langmuir isotherms and the pseudo-second-order kinetics with a maximum monolayer biosorptive capacity of 23.31 g g-1. The mechanism of biosorptive crude oil removal was by physical sorption and film diffusion control. Therefore, the maize cob represents an inexpensive and effective natural sorbent for oil spill removal from water bodies.

Preparation and characterization of rice husk activated carbon-supported zinc oxide nanocomposite (RHAC-ZnO-NC).

Indiscriminate waste discharge into water bodies has increased the level of water pollution via anthropogenic activities. Hence the need for the development of sustainable and environmentally benign nanomaterials has the potential for wastewater treatment. Rice husk activated carbon (RHAC) prepared by orthophosphoric acid activation was successfully loaded with freshly prepared ZnO nanoparticles by a bottom-up approach via precipitation method resulting in the RHAC-ZnO-NC. RHAC-ZnO-NC's mineralogy with 72% zincite was determined by XRD, morphology by SEM, and the functional group by FTIR. The physicochemical parameters showed surface area 615.2 m2 g-1 , pH (pzc) (6.62), pH (6.53), bulk density (0.88 g/cm3), ash content (18.45%), and volatile matter (58.08%). The porosity was determined by iodine number. Boehm titration was carried out for oxygen-bearing functional group determination. The study substantiated RHAC-ZnO-NC as a promising material for adsorption and photocatalytic degradation.

Fipronil use and associated effects on hematological and biochemical parameters of blue land crab (Cardisoma guanhumi Latreille): Ecological implication.

Fipronil is used to control pests to improve farm yield, however, indiscriminate use of fipronil has been reported to endanger crabs leading to their extinction. Therefore, this study investigated the impact of fipronil on several hematological and biochemical parameters of blue land crabs. We exposed blue land crabs to either fipronil or to a control treatment; fipronil reduced the protein content of the crab and also led to hematological and oxidative damages to the crabs' oxy-hemocyanin. Based on our results, there is need for guided use of agrochemicals such as fipronil to avoid/reduce their adverse effects on economically important species such as crabs.

Novel plantain peel activated carbon-supported zinc oxide nanocomposites (PPAC-ZnO-NC) for adsorption of chloroquine synthetic pharmaceutical used for COVID-19 treatment.

Chloroquine has been reported as an effective drug for the treatment of COVID-19 and with the rise in its administration and continued use, metabolites of chloroquine invariably find their way into the environment. There are many concerns recently on the presence of pharmaceuticals in the aquatic environment, hence the need for environmental remediation via effective adsorbent. Plantain peel activated carbon-supported zinc oxide (PPAC-ZnO) nanocomposite was prepared and characterized using physicochemical and spectroscopic techniques. The rate of uptake of chloroquine by PPAC-ZnO nanocomposite was investigated by batch technique under different operational parameters. PPAC-ZnO nanocomposite was characterized by various physicochemical techniques by SBET = 606.07 m2g-1, pH(pzc) = 4.98 surface area by Saer's method = 273.4 m2g-1. The carboxylic, phenols, lactone, and basic sites were determined by the Boehm method. Chloroquine uptake was confirmed by FTIR and SEM before and after adsorption. Change in morphology after adsorption was revealed by scanning electron microscopy (SEM). X-ray diffraction (XRD) showed the crystallinity of PPAC-ZnO nanocomposite. The batch adsorption experiment results showed that adsorption capacity increased with an increase in temperature. The maximum chloroquine sorption was 78.89% at a concentration of 10 ppm and a temperature of 313 K. Equilibrium sorption fitted well to Langmuir and Temkin isotherms with a high correlation coefficient (R 2) of 0.99. Pseudo-second-order best described the kinetic data and adsorption mechanism was pore diffusion dependent. Thermodynamics parameters (ΔG = - 25.65 to - 28.79 kJmol-1; ΔH = 22.06 kJmol-1 and ΔS = 157.69 Jmol-1) demonstrated feasibility, spontaneity, and endothermic behavior of the process with degrees of randomness. The activation energy for adsorption was less than 40 kJmol-1 suggesting a physisorption mechanism. This study results revealed that PPAC-ZnO nanocomposites are a sustainable and effective adsorbent for the removal of pharmaceutical waste.

Gestational and Hormonal Effects on Magnesium Sulfate's Ability to Inhibit Mouse Uterine Contractility.

Magnesium sulfate is used as a tocolytic, but clinical efficacy has been seriously questioned. Our objective was to use controlled ex vivo conditions and known pregnancy stages, to investigate how 2 key factors, hormones and gestation, affect magnesium's tocolytic ability. We hypothesized that these factors could underlie the varying clinical findings around magnesium's efficacy. Myometrial strips were obtained from nonpregnant (n = 10), mid-pregnant (n = 12), and term-pregnant (n = 11) mouse uterus. The strips were mounted in organ baths superfused with oxygenated physiological saline at pH 7.4 and 37 °C. The effect of different concentrations of MgSO4 (2-20 mM) was examined on spontaneous and oxytocin-induced (0.5-1 nM) contractions. Contractile properties (amplitude, frequency, and area under the curve) were measured before and after application of magnesium. Magnesium sulfate had a dose-dependent inhibitory effect on both spontaneous and oxytocin-induced contractions but was less effective in the presence of oxytocin. In spontaneous contractions, magnesium was more potent as gestation progressed (P < .0001). In the presence of oxytocin, however, there were no significant gestational differences in its effects on contraction. The rapid onset and reversal of magnesium's effects suggest an extracellular action on calcium entry. Taken together, we conclude that magnesium's actions are influenced by both gestational state and hormones, such that, at least in mice, it is least effective in early gestation with oxytocin present and most effective at term in the absence of oxytocin. That magnesium is least effective preterm and oxytocin decreases its effectiveness throughout gestation, may explain its disappointing clinical effects as a tocolytic.

Inherited alterations of TGF beta signaling components in Appalachian cervical cancers.

PURPOSE: This study examined targeted genomic variants of transforming growth factor beta (TGFB) signaling in Appalachian women. Appalachian women with cervical cancer were compared to healthy Appalachian counterparts to determine whether these polymorphic alleles were over-represented within this high-risk cancer population, and whether lifestyle or environmental factors modified the aggregate genetic risk in these Appalachian women. METHODS: Appalachian women's survey data and blood samples from the Community Awareness, Resources, and Education (CARE) CARE I and CARE II studies (n = 163 invasive cervical cancer cases, 842 controls) were used to assess gene-environment interactions and cancer risk. Polymorphic allele frequencies and socio-behavioral demographic measurements were compared using t tests and χ2 tests. Multivariable logistic regression was used to evaluate interaction effects between genomic variance and demographic, behavioral, and environmental characteristics. RESULTS: Several alleles demonstrated significant interaction with smoking (TP53 rs1042522, TGFB1 rs1800469), alcohol consumption (NQO1 rs1800566), and sexual intercourse before the age of 18 (TGFBR1 rs11466445, TGFBR1 rs7034462, TGFBR1 rs11568785). Interestingly, we noted a significant interaction between "Appalachian self-identity" variables and NQO1 rs1800566. Multivariable logistic regression of cancer status in an over-dominant TGFB1 rs1800469/TGFBR1 rs11568785 model demonstrated a 3.03-fold reduction in cervical cancer odds. Similar decreased odds (2.78-fold) were observed in an over-dominant TGFB1 rs1800469/TGFBR1 rs7034462 model in subjects who had no sexual intercourse before age 18. CONCLUSIONS: This study reports novel associations between common low-penetrance alleles in the TGFB signaling cascade and modified risk of cervical cancer in Appalachian women. Furthermore, our unexpected findings associating Appalachian identity and NQO1 rs1800566 suggests that the complex environmental exposures that contribute to Appalachian self-identity in Appalachian cervical cancer patients represent an emerging avenue of scientific exploration.

Gestational and Hormonal Effects on Magnesium Sulfate's Ability to Inhibit Mouse Uterine Contractility.

Magnesium sulfate is used as a tocolytic, but clinical efficacy has been seriously questioned. Our objective was to use controlled ex vivo conditions and known pregnancy stages, to investigate how 2 key factors, hormones and gestation, affect magnesium's tocolytic ability. We hypothesized that these factors could underlie the varying clinical findings around magnesium's efficacy. Myometrial strips were obtained from nonpregnant (n = 10), mid-pregnant (n = 12), and term-pregnant (n = 11) mouse uterus. The strips were mounted in organ baths superfused with oxygenated physiological saline at pH 7.4 and 37°C. The effect of different concentrations of MgSO4 (2-20 mM) was examined on spontaneous and oxytocin-induced (0.5-1 nM) contractions. Contractile properties (amplitude, frequency, and area under the curve) were measured before and after application of magnesium. Magnesium sulfate had a dose-dependent inhibitory effect on both spontaneous and oxytocin-induced contractions but was less effective in the presence of oxytocin. In spontaneous contractions, magnesium was more potent as gestation progressed ( P < .0001). In the presence of oxytocin, however, there were no significant gestational differences in its effects on contraction. The rapid onset and reversal of magnesium's effects suggest an extracellular action on calcium entry. Taken together, we conclude that magnesium's actions are influenced by both gestational state and hormones, such that, at least in mice, it is least effective in early gestation with oxytocin present and most effective at term in the absence of oxytocin. That magnesium is least effective preterm and oxytocin decreases its effectiveness throughout gestation, may explain its disappointing clinical effects as a tocolytic.

Sexual Dimorphism and Hemispheric Asymmetry of Hippocampal Volumetric Integrity in Normal Aging and Alzheimer Disease.

BACKGROUND AND PURPOSE: Asymmetric atrophy of the hippocampus is an important clinical finding in normal aging and Alzheimer disease. In this study, we investigate the associations between the magnitude and asymmetry of hippocampal volumetric integrity and age, sex, and dementia severity. MATERIALS AND METHODS: We have recently developed a rapid fully automatic algorithm to measure the hippocampal parenchymal fraction, an index of hippocampal volumetric integrity on structural MR imaging of the brain. We applied this algorithm to measure the hippocampal parenchymal fraction bilaterally on 775 MR imaging volumes scanned from 198 volunteers in a publicly available data base. All subjects were right-handed and older than 60 years of age. Subjects were categorized as cognitively healthy (n = 98), with mild cognitive impairment (n = 70), or with mild/moderate Alzheimer disease (n = 30). We used linear mixed-effects models to analyze the hippocampal parenchymal fraction and its asymmetry with respect to age, sex, dementia severity, and intracranial volume. RESULTS: After controlling for age, sex, and intracranial volume, we found that the magnitude of the hippocampal parenchymal fraction decreased and its asymmetry increased significantly with dementia severity. Also, hippocampal parenchymal fraction asymmetry was significantly higher in men after controlling for all other variables, but there was no sex effect on hippocampal parenchymal fraction magnitude. The magnitude of the hippocampal parenchymal fraction decreased and its asymmetry increased significantly with age in subjects who were cognitively healthy, but associations with age were different in nature in the mild cognitive impairment and Alzheimer disease groups. CONCLUSIONS: Hippocampal atrophy progresses asymmetrically with age in cognitively healthy subjects. Hippocampal parenchymal fraction asymmetry is significantly higher in men than women and in mild cognitive impairment/Alzheimer disease relative to cognitively healthy individuals.

The effectiveness of the paclitaxel-coated Luminor® balloon catheter versus an uncoated balloon catheter in superficial femoral and popliteal arteries in preventing vessel restenosis or reocclusion: study protocol for a randomized controlled trial.

BACKGROUND: The aim of this investigator-initiated trial is to evaluate the safety and efficacy of the novel Luminor® paclitaxel-coated drug-eluting balloon (DEB) catheter (iVascular, S.L.U., Barcelona, Spain) in inhibiting restenosis and in ensuring long-term vascular patency. METHODS/DESIGN: This is a multicenter randomized controlled trial to evaluate the Luminor® paclitaxel-coated DEB catheter for stenotic or occlusive lesions (length ≤15 cm) in the superficial femoral artery (SFA) and the popliteal artery (PA) up to the P1 segment compared to the noncoated, plain old balloon angioplasty (POBA) catheter. In total 172 subjects will be treated with either the DEB catheter or the POBA catheter in 11 German study centers in a 1:1 randomization study design. The primary endpoint is late lumen loss (LLL) at 6 months. Secondary endpoints are patency rate, target lesion/vessel revascularization, quality of life (assessed with the Walking Impairment Questionnaire (WIQ) and the EQ-5D), change of Rutherford stage and ankle-brachial index, major and minor amputation rate at the index limb, number of dropouts and all-cause mortality. DISCUSSION: EffPac represents a randomized controlled trial that will provide evidence on the effectiveness of the Luminor® paclitaxel-coated DEB catheter for the reduction of restenosis compared to the POBA catheter for the SFA and the PA. The results of EffPac will allow direct comparison to other already-completed RCTs applying paclitaxel-coated DEBs from different manufacturers with different coating technologies in the same target vessel. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02540018 , registered on 17 August 2015. Protocol version: CIP Version Final04, 11 February 2016. EUDAMED No: CIV-15-03-013204.

ATR-FTIR spectroscopy reveals polycyclic aromatic hydrocarbon contamination despite relatively pristine site characteristics: Results of a field study in the Niger Delta.

Fourier-transform infrared (FTIR) spectroscopy is an emerging technique to detect biochemical alterations in biological tissues, particularly changes due to sub-lethal exposures to environmental contaminants. We have previously shown the potential of attenuated total reflection FTIR (ATR-FTIR) spectroscopy to detect real-time exposure to contaminants in sentinel organisms as well as the potential to relate spectral alterations to the presence of specific environmental agents. In this study based in the Niger Delta (Nigeria), changes occurring in fish tissues as a result of polycyclic aromatic hydrocarbon (PAH) exposure at contaminated sites are compared to the infrared (IR) spectra of the tissues obtained from a relatively pristine site. Multivariate analysis revealed that PAH contamination could be occurring at the pristine site, based on the IR spectra and significant (P<0.0001) differences between sites. The study provides evidence of the IR spectroscopy techniques' sensitivity and supports their potential application in environmental biomonitoring.

Redox status of the testes and sperm of rats following exposure to 2,5-hexanedione.

OBJECTIVES: Exposure to 2,5-hexanedione (2,5-HD) is well known to be associated with reproductive dysfunctions in both humans and animals. However, the role of oxidative stress in 2,5-HD-induced toxicity in testes and sperm has not yet been studied. METHODOLOGY: The present study investigated the influence of 2,5-HD on antioxidant systems in the testes and epididymal sperm of rats following exposure to 0, 0.25, 0.5, and 1% 2,5-HD in drinking water for 21 consecutive days. RESULTS: Administration of 0.5% 2,5-HD significantly (P < 0.05) decreased epididymis weight, whereas 1% 2,5-HD-treated rats showed significantly decreased body weight, testis, and epididymis weights compared with the control group. Exposure to 2,5-HD caused a significant dose-dependent increase in the activities of superoxide dismutase, catalase, and glutathione peroxidase in both testes and sperm compared with the control group. Moreover, 2,5-HD-exposed rats showed significant decrease in glutathione-S-transferase activity and glutathione level with concomitant significant elevation in the levels of hydrogen peroxide and malondialdehyde in both testes and sperm. Testicular and epididymal atrophy with significant, dose-dependent, decrease in epididymal sperm number, sperm motility, and viability were observed in 2,5-HD-treated rats. CONCLUSION: 2,5-HD exposure impaired testicular function and sperm characteristics by disruption of the antioxidant systems and consequently, increased oxidative stress in the treated rats.

[Update peripheral arterial occlusive disease]. / Update periphere arterielle Verschlusskrankheit.

Due to demographic changes, peripheral arterial occlusive disease (PAD) has become one of the most prevalent diseases in western industrial nations. In recent years the trend towards initial endovascular treatment approaches has further continued. Because of the high primary success and low complication rates, intervention-based revascularization strategies are the method of choice in the majority of cases. The treatment strategy should always be assessed in a multidisciplinary setting and if possible, within a designated vascular center. One of the main limitations of interventions is the occurrence of restenosis, in particular in infrapopliteal arterial lesions. A major progress arose from drug-eluting balloons, which dramatically reduced restenosis rates particular for femoropopliteal lesions. A potential alternative strategy could be the use of a combination therapy, such as plaque removal followed by insertion of drug-eluting balloons; however, economic issues have to be kept in mind for such approaches.

Distinguishing nuclei-specific benzo[a]pyrene-induced effects from whole-cell alterations in MCF-7 cells using Fourier-transform infrared spectroscopy.

Exposure to chemicals such as benzo[a]pyrene (B[a]P) can generate intracellular toxic mechanisms. Fourier-transform infrared (FTIR) spectroscopy is a novel approach that allows the non-destructive analysis of underlying chemical bond alterations in patho-physiological processes. This study set out to examine whether B[a]P-induced whole cell alterations could be distinguished from effects on nuclei of exposed cells. Using attenuated total reflection FTIR (ATR-FTIR) spectroscopy, alterations in nuclei isolated from B[a]P-treated MCF-7 cells concentrated either in G0/G1- or S-phase were observed. B[a]P-induced effects in whole-cells included alterations to lipids, DNA and protein spectral regions. Absorbance areas for protein and DNA/RNA regions in B[a]P-treated whole cells differed significantly (P<0.0001) from vehicle controls and these observations correlated with alterations noted in isolated nuclei. Our findings provide evidence that FTIR spectroscopy has the ability to identify specific chemical-induced alterations.

Anti-inflammatory activity of Buchholzia coriacea Engl. (Capparaceae) leaf extract: evaluation of components of the inflammatory response involved.

BACKGROUND: Earlier studies in our laboratory demonstrated the anti-inflammatory activity of Buchholzia coriacea Engl. (Capparaceae) leaf extract, a herbal remedy used to treat disorders of inflammation. This study was undertaken to evaluate its anti-inflammatory mechanism(s). METHODS: The effects of methanol leaf extract of B. coriacea (200 and 400 mg/kg) on vascular permeability and leukocyte migration were studied in rodents, while activity on complement system and membrane stabilization were evaluated in vitro. RESULTS: The extract (200 and 400 mg/kg) inhibited acetic acid-induced increase in vascular permeability in a non-dose-related manner and significantly (p < 0.05) reduced the total and differential leukocyte counts, respectively, in a dose-related manner. It also significantly (p < 0.05) inhibited complement-induced hemolysis of sheep red blood cells (40-72%) and moderately inhibited heat- (6%) and hypotonic solution-(24%) induced hemolysis in vitro in a non-dose-related manner. CONCLUSIONS: Results demonstrated that the anti-inflammatory activity of B. coriacea leaf extract is mediated through inhibition of increase in vascular permeability, leukocyte migration and complement system, and enhanced membrane stabilization.

Linking biochemical perturbations in tissues of the African catfish to the presence of polycyclic aromatic hydrocarbons in Ovia River, Niger Delta region.

Petroleum hydrocarbons including polycyclic aromatic hydrocarbons (PAHs) are a pollution issue in the Niger Delta region due to oil industry activities. PAHs were measured in the water column of the Ovia River with concentrations ranging from 0.1 to 1055.6 ng L(-1). Attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy detected alterations in tissues of the African catfish (Heterobranchus bidorsalis) from the region showed varying degrees of statistically significant (P<0.0001, P<0.001, P<0.05) changes to absorption band areas and shifts in centroid positions of peaks. Alteration patterns were similar to those induced by benzo[a]pyrene in MCF-7 cells. These findings have potential health implications for resident local communities as H. bidorsalis constitutes a key nutritional source. The study provides supporting evidence for the sensitivity of infrared spectroscopy in environmental studies and supports their potential application in biomonitoring.

Impairment of hepatic and renal functions by 2,5-hexanedione is accompanied by oxidative stress in rats.

2,5-Hexanedione (2,5-HD) is the toxic metabolite of n-hexane which is widely used as solvent in numerous industries. The present study elucidated the precise mechanism of 2,5-HD in hepatorenal toxicity by determining the involvement of oxidative stress in rats. Adult male Wistar rats were exposed to 0, 0.25, 0.5, and 1% 2,5-HD in drinking water for 21 days. Exposure to 2,5-HD caused liver and kidney atrophy evidenced by significant elevation in serum aminotransferases, alkaline phosphatase, albumin, bilirubin, urea, creatinine, and electrolytes levels compared with control. The marked dose-dependent increase in total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) was accompanied with significant decrease in high-density lipoprotein (HDL) levels in 2,5-HD-exposed animals when compared with the control. Administration of 2,5-HD significantly diminished glutathione (GSH) level but increased the activities of superoxide dismutase (SOD), catalase, glutathione peroxidase (GPx), and glutathione-S-transferase (GST) concomitantly with marked elevation in hydrogen peroxide (H2O2) and malondialdehyde (MDA) levels in liver and kidney of the treated groups compared with control. These findings suggest that undue exposure to 2,5-HD at environmentally relevant levels may impair liver and kidney functions through induction of oxidative stress.

Offroad re-entry catheter system for subintimal recanalization of chronic total occlusions in femoropopliteal arteries: primary safety and effectiveness results of the re-route trial.

AIM: Aim of the study was to provide additional clinical data regarding the safety and technical success of the OffRoad Re-Entry Catheter System (Boston Scientific, Natick, MA, USA) for subintimal recanalization of chronic total occlusions (CTO) in the femoropopliteal arteries. METHODS: A total of 92 patients (mean age 70.3±10.6 years; 70% male) were enrolled in this prospective, single-arm, post-market study conducted at 12 European centers. Patients were required to have claudication or critical limb ischemia and a CTO lesion in a native femoropopliteal artery. The primary safety endpoint was the composite rate of device-related major adverse events (MAEs; i.e., death, perforation requiring intervention, clinically significant peripheral embolism, and major amputation of the treated lower limb) at 30 days. Effectiveness was based on device technical success, defined as placement of a guidewire in the true lumen distal to a CTO. RESULTS: Ninety patients were evaluable for the primary safety endpoint. The 30-day device-related MAE rate was 3.3% (3/90), with an upper confidence bound of 6.5%, which was lower than the prespecified performance goal of 15%. All 3 events were clinically significant peripheral emboli. Technical success was 84.8% (78/92) with a lower confidence bound of 78.6%, which exceeded the prespecified performance goal of 76%. A decrease of ≥1 Rutherford category was observed in 75% (65/87) of patients at the 30 day visit. CONCLUSION: The Re-ROUTE trial results demonstrate acceptable performance of the OffRoad system in terms of safety and technical success for the recanalization of femoropopliteal CTOs.