The value of cardiopulmonary exercise testing and stress echocardiography in the prediction of all-cause mortality in adults with end-stage renal disease.

We aimed to assess the prognostic utility of different parameters routinely assessed from cardiopulmonary exercise testing (CPET) and exercise echocardiography in adults with end-stage renal disease (ESRD). Forty-two ESRD (37 male) individuals (age: 58 ± 13 years, height: 169.30 ± 8.30 cm, weight: 81 ± 15 kg, body surface area: 1.92 ± 0.20 m2) underwent a maximal/symptom limited CPET, with a full cross-sectional echocardiogram performed at baseline and peak exercise. All participants were prospectively followed over a 10-year period, with all-cause mortality as the primary endpoint. After the follow-up period, a total of 19 participants (45%) died. Left atrial size (4.70 ± 0.70 vs. 3.65 ± 0.50 cm, P < 0.001) and anteroseptal wall thickness (1.28 ± 0.40 vs. 1.06 ± 0.02 cm, P = 0.002) were significantly greater in those that died, while peak heart rate was significantly lower (108 ± 12 vs. 128 ± 14 bpm, P < 0.001). The prevalence of myocardial ischaemia (13 vs. 8 participants, P = 0.03) was significantly greater, while peak VO2 (9.80 ± 2.10 vs. 15.90 ± 4.30 ml·kg-1·min-1, P < 0.001) was significantly lower in those that died. Following multivariate cox regression, myocardial ischaemia (Hazard Ratio 3.08; 95% Confidence Interval 1.09-8.70; P = 0.03) and peak VO2 (HR 0.73; 95% CI 0.64-0.84; P < 0.001) were significant independent predictors of 10-year all-cause mortality. This is the first study to establish peak VO2 as powerful marker of all-cause mortality when assessed with clinical, resting and stress echocardiography parameters in people with ESRD over a 10-year follow up period. This observation indicates that, in clinical practice, CPET and exercise echocardiography may serve as valuable tools for the risk stratification of individuals with ESRD.HighlightsWe aimed to assess the prognostic utility of cardiopulmonary exercise testing (CPET) and exercise echocardiography in end-stage renal disease (ESRD) with 10-year mortality.Peak aerobic capacity and the presence of ischaemic heart disease were independently associated with all-cause mortality.This observation indicates that, in clinical practice, CPET and exercise echocardiography may serve as valuable tools for the risk stratification of individuals with end-stage renal disease.

The Effect of Season and Meteorological Conditions on Parasite Infection in Farm-Maintained Mouflons (Ovis aries Musimon).

Due to their limited environment, farm animals are at greater risk of parasitic infection than free-living animals, which also have greater natural resistance to parasitic diseases. The aim of the present study was to determine the influence of season and meteorological conditions (temperature and humidity) on the species composition and dynamics of parasitic infections in farmed mouflons. The study was conducted in a herd of mouflon (n = 40) in an extensive system: the animals remained on pasture all year round. The herd was dewormed twice per year with albendazole. Fecal samples were collected at monthly intervals over three years and tested. The prevalence of infection was defined based on coproscopic methods. For most of the studied protozoans (except for E. parva), a greater prevalence was recorded in spring and summer (i.w. from May to September). Regarding nematodes, Capillaria spp., Nematodirus sp., and the Trichostrongylidae demonstrated a much greater prevalence in winter (i.e., in January and December). Temperature and precipitation were found to be positively correlated with intensity of infection by protozoans. However, maximum air temperature was negatively correlated with infection intensity by some nematodes. The deworming practice used in the herd (selection of substance, date, and method of dosing) did not effectively protect the mouflons against parasitoses. Changes in the microclimate resulted in high extent and intensity of mouflon infection with gastrointestinal parasites. Understanding the dynamics of parasitic infections in mouflons during the year allows the development of an appropriate preventive programme.

Effect of alkalinization and ultra-high-pressure homogenization on casein micelles in raw and pasteurized skim milk.

Mechanical and physicochemical treatments of milk induce structural modifications of the casein (CN) micelles, affecting their techno-functional properties in dairy processing. Here, we studied the effect of alkalinization and ultra-high-pressure homogenization (UHPH) on CN micelles in raw skim milk (rSM) and pasteurized skim milk (pSM). The pH of both skim milks (approximately 6.7) was adjusted to 8.5 and 10.5 before UHPH at 100, 200, and 300 MPa. The structural changes of the CN micelles during the treatments were assessed using laser diffraction, transmission electron microscopy, and turbidity measurements. Finally, ultracentrifugation (70,000 × g for 1 h at 20°C) was carried out to evaluate the protein's distribution between the supernatant (serum phase) and the pellet (colloidal phase) by gel electrophoresis and protein concentration measurement. Alkalinization of both skim milks induced a significant reduction in turbidity, whereas an increase of the average particle size was observed, the effect being more severe in pSM than rSM. At alkaline pH, more proteins were recovered in the serum phase, which suggested that the CN underwent major rearrangements into nonsedimentable CN forms of various sizes, as confirmed by transmission electron microscopy. The amount of CN found in the serum phase at pH 8.5 also increased with the UHPH pressure. Although UHPH did not influence the average CN micelle size at pH 6.7 and 8.5, a pressure-dependent decrease was observed at pH 10.5 for both skim milks. The structural changes of the CN micelles observed in this study throughout the combination of alkalinization and UHPH could be of interest for developing new dairy ingredients with improved functionality.

Effects of probiotics supplementation on the hormone and body mass index in perimenopausal and postmenopausal women using the standardized diet. A 5-week double-blind, placebo-controlled, and randomized clinical study.

OBJECTIVE: The results of pioneering studies indicate that probiotics can alleviate menopausal symptoms (including cardiometabolic dysfunctions) and improve the quality of life of perimenopausal/postmenopausal women. However, the results of randomized control trials are scarce to evaluate whether the administration of probiotics could affect the balance of sex hormones during the menopause period. PATIENTS AND METHODS: In this randomized, double-blind, and placebo-controlled study, 48 perimenopausal and postmenopausal women received multispecies probiotic Sanprobi Barrier in a dose of 2.5 × 109 (CFU) for five weeks. Dietary guidelines were introduced in both groups simultaneously (~1800 kcal/per day, whole grain, no-wheat meals). The study aimed to assess the variations in follicle-stimulating hormone (FSH), estradiol (E2), cortisol (as the hypothalamic-pituitary-ovarian axis hormone), and the body mass during the intervention. RESULTS: At the endpoint, FSH level has increased significantly concerning the baseline after the probiotic intake (31.91 vs. 42.00 mIU/ml; p < 0.009). Also, in the placebo group, a strong trend to elevate FSH was observed (22.31 vs. 41.99 mIU/ml; p = 0.055). Body mass has crucially decreased in reference to the baseline in both groups (PRO: 27.90 vs. 26.30 kg/m2, p<0.001; PBO: 25.90 to 24.60 kg/m2, p<0.001). CONCLUSIONS: Probiotics affect FSH levels in perimenopausal women while simultaneously representing a non-invasive strategy to impact hormonal homeostasis. They could potentially have an impact on cardiometabolic health.

The effect of the sex, age, and breed of farmed rabbits and the choice of management system on the extensity and intensity of Eimeria infection.

BACKGROUND AND AIM: The most common causes of loss and diarrhea in rabbit farming are nutritional errors and coccidiosis. The infection can spread rapidly throughout a breeding area, reducing the rabbit population, and causing heavy losses. The aim of the study was to determine the influence of the system of animal management on the extensity and intensity of infection by Eimeria of farmed rabbits, together with the effect of the sex, age, and breed of the rabbits themselves. MATERIALS AND METHODS: The study included 91 rabbits (Flemish Giant, New Zealand White, French Lope, Vienna Blue, California White, and mixed breed) from eight domestic (small-scale) farms from Poland. The prevalence and intensity of coccidial infection were determined by the Willis-Schlaf and McMaster coprological methods. The species were determined based on oocyst morphology: Their shape, color, form index, the presence or absence of micropyle and cap, and the presence or absence of residual, polar, and Stiedé bodies. RESULTS: Seven species of Eimeria were isolated from the tested rabbits: Eimeria magna, Eimeria media, Eimeria perforans, Eimeria stiedae, Eimeria coecicola, Eimeria exigua, and Eimeria irresidua. Most infections were found to be of relatively low intensity. No significant differences in the extensity of Eimeria protozoan infection were observed with regard to sex. However, rabbit age had a significant influence on the extensity of infection by E. magna and of Eimerian protozoans combined. The greatest extensity was observed in rabbits aged below 6 months. For all species of Eimeria, greater extensity was observed among rabbits kept in groups than individually. The system of rabbit management also had a significant influence on the intensity of infection. Those kept in groups demonstrated a significantly higher mean intensity of infection of E. magna and all Eimeria species combined than those kept individually. CONCLUSION: Our findings indicate that Eimeria protozoa are a common occurrence on small-scale rabbit farms. As coccidiosis treatment does not always give good results, prevention is very important in the fight against this disease. It is necessary to develop a new preventive paradigm that pays special attention to the factors that promote the spread and development of infection in domestic (small-scale) farms from Poland. For example, it would be recommended to use large, dry, bright rooms with access to the sun, as these are conducive to preventing the occurrence of coccidia infections.

Signatures of Enhanced Superconducting Phase Coherence in Optimally Doped Bi_{2}Sr_{2}Y_{0.08}Ca_{0.92}Cu_{2}O_{8+δ} Driven by Midinfrared Pulse Excitations.

Optimally doped cuprate are characterized by the presence of superconducting fluctuations in a relatively large temperature region above the critical transition temperature. We reveal here that the effect of thermal disorder, which decreases the condensate phase coherence at equilibrium, can be dynamically contrasted by photoexcitation with ultrashort midinfrared pulses. In particular, our findings reveal that light pulses with photon energy comparable to the amplitude of the superconducting gap and polarized in plane along the copper-copper direction can dynamically enhance the optical response associated with the onset of superconductivity. We propose that this effect can be rationalized by an effective d-wave BCS model, which reveals that midinfrared pulses result in a transient increase of the phase coherence.

Electron correlation driven non-adiabatic relaxation in molecules excited by an ultrashort extreme ultraviolet pulse.

The many-body quantum nature of molecules determines their static and dynamic properties, but remains the main obstacle in their accurate description. Ultrashort extreme ultraviolet pulses offer a means to reveal molecular dynamics at ultrashort timescales. Here, we report the use of time-resolved electron-momentum imaging combined with extreme ultraviolet attosecond pulses to study highly excited organic molecules. We measure relaxation timescales that increase with the state energy. High-level quantum calculations show these dynamics are intrinsic to the time-dependent many-body molecular wavefunction, in which multi-electronic and non-Born-Oppenheimer effects are fully entangled. Hints of coherent vibronic dynamics, which persist despite the molecular complexity and high-energy excitation, are also observed. These results offer opportunities to understand the molecular dynamics of highly excited species involved in radiation damage and astrochemistry, and the role of quantum mechanical effects in these contexts.

Influence of long-range Coulomb interaction in velocity map imaging.

The standard velocity-map imaging (VMI) analysis relies on the simple approximation that the residual Coulomb field experienced by the photoelectron ejected from a neutral or ion system may be neglected. Under this almost universal approximation, the photoelectrons follow ballistic (parabolic) trajectories in the externally applied electric field, and the recorded image may be considered as a 2D projection of the initial photoelectron velocity distribution. There are, however, several circumstances where this approximation is not justified and the influence of long-range forces must absolutely be taken into account for the interpretation and analysis of the recorded images. The aim of this paper is to illustrate this influence by discussing two different situations involving isolated atoms or molecules where the analysis of experimental images cannot be performed without considering long-range Coulomb interactions. The first situation occurs when slow (meV) photoelectrons are photoionized from a neutral system and strongly interact with the attractive Coulomb potential of the residual ion. The result of this interaction is the formation of a more complex structure in the image, as well as the appearance of an intense glory at the center of the image. The second situation, observed also at low energy, occurs in the photodetachment from a multiply charged anion and it is characterized by the presence of a long-range repulsive potential. Then, while the standard VMI approximation is still valid, the very specific features exhibited by the recorded images can be explained only by taking into consideration tunnel detachment through the repulsive Coulomb barrier.

XUV-induced reactions in benzene on sub-10 fs timescale: nonadiabatic relaxation and proton migration.

Unraveling ultrafast dynamical processes in highly excited molecular species has an impact on our understanding of chemical processes such as combustion or the chemical composition of molecular clouds in the universe. In this article we use short (<7 fs) XUV pulses to produce excited cationic states of benzene molecules and probe their dynamics using few-cycle VIS/NIR laser pulses. The excited states produced by the XUV pulses lie in an especially complex spectral region where multi-electronic effects play a dominant role. We show that very fast τ ≈ 20 fs nonadiabatic processes dominate the relaxation of these states, in agreement with the timescale expected for most excited cationic states in benzene. In the CH3+ fragmentation channel of the doubly ionized benzene cation we identify pathways that involve structural rearrangement and proton migration to a specific carbon atom. Further, we observe non-trivial transient behavior in this fragment channel, which can be interpreted either in terms of propagation of the nuclear wavepacket in the initially excited electronic state of the cation or as a two-step electronic relaxation via an intermediate state.

Wild boars (Sus scrofa) as bioindicators of environmental levels of selenium in Poland.

The objective of the study was to determine selenium content in selected organs (liver, kidney) of wild boars from different regions of Poland. Materials for the study were obtained from 28 sites located in 16 provinces of Poland. Selenium concentrations in organs were determined using spectrofluorometric methods after wet mineralization in HNO3 and HClO4 mixture. Mean selenium concentrations in the investigated wild boars from Poland were 0.230 µg/g wet weight in the liver and 1.327 µg/g w.w. in the kidneys. Hepatic and nephric Se concentrations ranged from 0.036-0.626 µg/g w.w. and 0.322-4.286 µg/g w.w., respectively. Selenium concentrations in the wild boars differed considerably according to geographical location. Concentrations of selenium were highest in wild boars from south-eastern provinces and lowest in animals from northern provinces. Most of Poland's area is environmentally deficient in this trace element, as evidenced by marginal selenium levels in the organs of the wild boars.

Interstitial ectopic pregnancy after salpingectomy due to previous tubal pregnancy - a case report.

Ectopic pregnancy is the development of the embryo outside the uterine cavity. In recent years an increase in the incidence of ectopic pregnancies has been observed. It is mainly related to the increased number of IVF procedures. The most frequent localization is the ampulla of the fallopian tube. In cases of intramural or cornual ectopic pregnancies, many patients have a history of ectopic pregnancy on the same side or underwent partial salpingectomy in the past. Treatment of such pregnancies involves laparotomy and removal of the uterus or comu of the uterus. This case concerns a patient operated because of intramural pregnancy. She had a salpingectomy in the past because of tubal ectopic pregnancy on the same side. This case shows that even after removal of the fallopian tube there is still a risk of ectopic pregnancy in the intramural part of this tube.

XUV excitation followed by ultrafast non-adiabatic relaxation in PAH molecules as a femto-astrochemistry experiment.

Highly excited molecular species are at play in the chemistry of interstellar media and are involved in the creation of radiation damage in a biological tissue. Recently developed ultrashort extreme ultraviolet light sources offer the high excitation energies and ultrafast time-resolution required for probing the dynamics of highly excited molecular states on femtosecond (fs) (1 fs=10(-15) s) and even attosecond (as) (1 as=10(-18) s) timescales. Here we show that polycyclic aromatic hydrocarbons (PAHs) undergo ultrafast relaxation on a few tens of femtoseconds timescales, involving an interplay between the electronic and vibrational degrees of freedom. Our work reveals a general property of excited radical PAHs that can help to elucidate the assignment of diffuse interstellar absorption bands in astrochemistry, and provides a benchmark for the manner in which coupled electronic and nuclear dynamics determines reaction pathways in large molecules following extreme ultraviolet excitation.

Attosecond Hole Migration in Benzene Molecules Surviving Nuclear Motion.

Hole migration is a fascinating process driven by electron correlation, in which purely electronic dynamics occur on a very short time scale in complex ionized molecules, prior to the onset of nuclear motion. However, it is expected that due to coupling to the nuclear dynamics, these oscillations will be rapidly damped and smeared out, which makes experimental observation of the hole migration process rather difficult. In this Letter, we demonstrate that the instantaneous ionization of benzene molecules initiates an ultrafast hole migration characterized by a periodic breathing of the hole density between the carbon ring and surrounding hydrogen atoms on a subfemtosecond time scale. We show that these oscillations survive the dephasing introduced by the nuclear motion for a long enough time to allow their observation. We argue that this offers an ideal benchmark for studying the influence of hole migration on molecular reactivity.

Rare case of coexistence of primary ovarian carcinoid in mature teratoma with primary serous carcinoma in second ovary--a case report.

Ovarian malignant tumours are mostly ovarian cancers. The most frequent ovarian benign lesions are mature teratomas. A very rare ovarian neoplasm is carcinoid. It mostly occurs as a component of mature teratoma, what causes rare diagnosis before surgery. Study presents the case of patient with primary ovarian carcinoid in mature teratoma of one ovary, co-existing with primary epithelial carcinoma of another ovary. Surgical treatment of carcinoid involves adnexectomy or hysterectomy with adnexa and removal of great omenturn, followed by chemotherapy and radiotherapy. In young women with early-stage tumours, treatment can be limited to adnexectomy followed by close monitoring. In the presented case, management associated with the diagnosis of ovarian carcinoid, resulted in the detection of early-stage ovarian epithelial cancer. This case seems to confirm the recommendations to take tissue samples from the other ovary for histopathological evaluation in cases of ovarian unilateral benign tumours.

Ondansetron attenuates the decrease in blood pressure due to spinal anesthesia in the elderly: a double blind, placebo-controlled study.

BACKGROUND: Ondansetron was effectively used to prevent spinal anesthesia-induced hypotension in the general population and women anesthetised for cesarean section. The aim of this study was to test the hypothesis that blocking type 3 serotonin receptors with intravenous ondansetron administration reduces hypotension and bradycardia induced by spinal anesthesia in elderly patients. METHODS: Fifty-three patients participated in the study with 26 in the ondansetron group (received 8 mg intravenous ondansetron) and 27 in the placebo group (received 0.9% NaCl solution). The heart rate and arterial blood pressure were measured every 5 minutes after spinal anaesthesia, which was performed with 2.5 to 3 mL of 0.5% hyperbaric bupivacaine solution. RESULTS: Decreases in both the heart rate and mean systolic, as well as diastolic, arterial pressure compared to the baseline values were noted in both groups. The minimum diastolic and mean blood pressure values obtained over a 20-minute observation period were significantly higher in the ondansetron group. There were no significant differences in the systolic blood pressure and heart rate values between the groups. CONCLUSION: Administration of intravenous ondansetron prior to spinal anesthesia in geriatric patients attenuates the drop in the diastolic and mean arterial pressure without substantially affecting the systolic blood pressure.

The effect of dose and water treatment on EPR signals in irradiated fingernails.

Fast and precise retrospective dosimetry is crucial in making decisions about medical procedures and safety measures in radiation accidents. Electron paramagnetic resonance (EPR) spectroscopy has a potential as one of available biodosimetry methods for use in victims of such incidents. In this study, authors present the findings on EPR dosimetry in fingernails. Authors describe changes of EPR signals in unirradiated and irradiated nails in time after cutting and the effect of water on the mechanically induced and radiation-induced EPR signals measured ex vivo in the fingernails. The effect of dose on amplitude of the EPR signal was measured in nails that were soaked for 10 min in water after their irradiation. The obtained dose-response curves, which reflect changes in concentration of the radiation-induced RIS5 radicals, reach their maximum for doses of 40-60 Gy.

Serum selenium concentration and glutathione peroxidase activity and selenium content in testes of Polish Konik horses from selenium--deficient area in North-Western Poland.

The aim of this study was to determine serum selenium concentrations in Polish Konik horses residing in the Odra Delta Nature Park (Poland) and to evaluate the activity of glutathione peroxidase and Se content in testes of this horse breed. In over 95% of cases, serum Se concentration was below the optimal range, and none of the horses examined was deficient in this trace element. The lack of Se deficiency in the animals examined suggests however, that the Polish Konik horses have a natural ability to the optimal use of nutrients available in their life area. Testicular content of Se and GSHPx activity in the colts was higher than those found in stallions, and a positive relationship between these antioxidants was demonstrated. The differences in Se contents and GSHPx activities in testes between colts and stallions suggest that selenoenzymes play important roles during the puberty of male horses.

Fear of falling, fracture history, and comorbidities are associated with health-related quality of life among European and US women with osteoporosis in a large international study.

UNLABELLED: We studied 7,897 women with postmenopausal osteoporosis to assess factors that influence health-related quality of life (HRQoL). An increased number of comorbidities, fear of falling, and previous vertebral fracture were associated with significant reductions in HRQoL. Understanding the factors that affect HRQoL may improve management of these patients. INTRODUCTION: HRQoL is impaired in women treated for postmenopausal osteoporosis (PMO). The objective of this study was to examine the relationship between clinical characteristics, comorbidities, medical history, patient demographics, and HRQoL in women with PMO. METHODS: Baseline data were obtained and combined from two large and similar multinational observational studies: Prospective Observational Scientific Study Investigating Bone Loss Experience in Europe (POSSIBLE EU®) and in the US (POSSIBLE US™) including postmenopausal women in primary care settings initiating or switching bone loss treatment, or who had been on bone loss treatment for some time. HRQoL measured by health utility scores (EQ-5D™) were available for 7,897 women (94 % of study participants). The relationship between HRQoL and baseline clinical characteristics, medical history and patient demographics was assessed using parsimonious, multivariable, mixed-model analyses. RESULTS: Median health utility score was 0.80 (interquartile range 0.69-1.00). In multivariable analyses, young age, low body mass index, previous vertebral fracture, increased number of comorbidities, high fear of falling, and depression were associated with reduced HRQoL. Regression-based model estimates showed that previous vertebral fracture was associated with lower health utility scores by 0.08 (10.3 %) and demonstrated the impact of multiple comorbidities and of fear of falling on HRQoL. CONCLUSIONS: In this large observational study of women with PMO, there was substantial interindividual variability in HRQoL. An increased number of comorbidities, fear of falling, and previous vertebral fracture were associated with significant reductions in HRQoL.