Clinical spectrum of COVID-19 complications in young adults: combined analysis of the American Heart Association COVID-19 Cardiovascular Disease Registry and the Outcomes Registry for Cardiac Conditions in Athletes.

BACKGROUND: While young adults 18-24 years old bear a significant proportion of COVID-19 diagnoses, the risk factors for hospitalisation and severe COVID-19 complications in this population are poorly understood. OBJECTIVE: The objective of this study was to identify risk factors for hospitalisation and other COVID-19 complications across the health spectrum of young adults diagnosed with COVID-19 infection. STUDY DESIGN: Retrospective cohort study. PARTICIPANTS: Young adults (aged 18-24) with confirmed COVID-19 infection from the American Heart Association (AHA) COVID-19 Cardiovascular Disease Registry of hospitalised patients and the Outcomes Registry for Cardiac Conditions in Athletes (ORCCA) study of collegiate athletes. The AHA registry included 636 young adults from 152 hospitals. The ORCCA registry consisted of 3653 competitive college athletes from 42 colleges and universities. INTERVENTION: None (exposure to COVID-19). PRIMARY AND SECONDARY OUTCOME MEASURES: Main outcomes included hospitalisation, death, major adverse cardiovascular events (MACE) and other severe clinical events. RESULTS: In comparison to the ORCCA registry, patients in the AHA registry were more likely to be female (59% vs 33%); had higher average body mass index (BMI) (32.4 vs 25.6); and had increased prevalence of diabetes (10% vs 0.4%), hypertension (7% vs 0.6%), chronic kidney disease (2% vs 0%) and asthma (14% vs 8%), all with p<0.01. There were eight (2%) deaths in the AHA hospitalised registry compared with zero in the ORCCA cohort. BMI was a statistically significant predictor of death in the hospitalised cohort (OR 1.05, 95% CI 1.00, 1.10). No significant predictors of MACE or other severe clinical events were identified. CONCLUSIONS: The risk of cardiac events in young adults aged 18-24 diagnosed with COVID-19 infection is low. Patients who were hospitalised (AHA registry) were more likely to have pre-existing medical comorbidities and higher BMI than healthy collegiate athletes (ORCCA registry). Once hospitalised, elevated BMI is associated with increased mortality although other drivers of MACE and other severe clinical events remain unclear.

Organosulfur Compound Identified from Striga angustifolia (D. Don) C.J. Saldanha Inhibits Lung Cancer Growth and Induces Apoptosis via p53/mTOR Signaling Pathway.

The Striga angustifolia (D. Don) C.J. Saldanha was used as an Ayurvedic and homeopathic medicine for cancer by the tribal peoples of the Maruthamalai Hills, Coimbatore, India. Hence, the traditional use that has been proven to be effective lacks convincing scientific references. This present study was conducted to investigate the presence of potentially bioactive compounds from S. angustifolia and provides a scientific basis for the ethnobotanical utility. The organosulfur compound 5,5'-dithiobis(1-phenyl-1H-tetrazole) (COMP1) was isolated from S. angustifolia extracts, and the structures of COMP1 were elucidated and characterized by using 13C and 1H nuclear magnetic resonance (NMR) and single crystal X-ray powder diffraction (XRD). Our findings showed that COMP1 significantly reduced cell proliferation of breast and lung cancer cells, but not that of non-malignant epithelial cells. Further analysis revealed that COMP1 promoted cell cycle arrest and apoptosis of lung cancer cells. Mechanistically, COMP1 facilitates p53 activity and inhibits mammalian target of rapamycin (mTOR) signaling, thereby inducing cell cycle arrest and apoptosis of lung cancer cells by inhibiting cell growth. Our findings suggest that COMP1 may serve as a potential drug for lung cancer through the regulation of p53/mTOR pathways.

Exploration of phytochemicals and probing potential effects of Priva cordifolia active extract on PACAP 38 and its nociceptor in the human trigeminovascular system.

Several tribal medicinal systems assert anti-migraine and common headache-remedying properties in all parts of Priva cordifolia (L.f.) Druce. Therefore, there are no clear scientific references to the validated traditional use of this plant. The present study provides a scientific basis for the ethnobotanical utility of P. cordifolia whose whole-plant extracts were evaluated against target proteins (PACAP 38 and PAC1-R) that cause migraine. Understanding the polarity-based distribution and oxidative stress scavenging ability was reported higher in ethyl acetate extracts due to the moderate distribution of secondary metabolites. Based on the preliminary analysis anti-migraine activity in the wet and dry lab experiments was compared with a commercial drug Sumatriptan. The GC-MS analysis revealed that two lead volatile compounds Bicyclo(3.2.1)oct-3-en-2-one,3,8-Dihydroxy-1-methoxy-7-(7-methoxy-1,3- and -Hexyl-2-nitrocyclohexane, present in the ethyl acetate extract showed favourable in silico anti-migraine efficiency. Notably, the ex-vivo results also showed considerable downregulation of the extract-induced mRNA expression of PACAP38. The conclusion of our study justifies that P. cordifolia has valuable plant metabolites that portray it as an efficient anti-oxidant and anti-migraine source. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-023-03462-w.

The development and initial validation of the PROMIS®+HF-27 and PROMIS+HF-10 profiles.

AIMS: Heart failure (HF) is a common and morbid condition impacting multiple health domains. We previously reported the development of the PROMIS®-Plus-HF (PROMIS+HF) profile measure, including universal and HF-specific items. To facilitate use, we developed shorter, PROMIS+HF profiles intended for research and clinical use. METHODS AND RESULTS: Candidate items were selected based on psychometric properties and symptom range coverage. HF clinicians (n = 43) rated item importance and clinical actionability. Based on these results, we developed the PROMIS+HF-27 and PROMIS+HF-10 profiles with summary scores (0-100) for overall, physical, mental, and social health. In a cross-sectional sample (n = 600), we measured internal consistency reliability (Cronbach's alpha and Spearman-Brown), test-retest reliability (intraclass coefficient; n = 100), known-groups validity via New York Heart Association (NYHA) class, and convergent validity with Kansas City Cardiomyopathy Questionnaire (KCCQ) scores. In a longitudinal sample (n = 75), we evaluated responsiveness of baseline/follow-up scores by calculating mean differences and Cohen's d and comparing with paired t-tests. Internal consistency was good to excellent (α 0.82-0.94) for all PROMIS+HF-27 scores and acceptable to good (α/Spearman-Brown 0.60-0.85) for PROMIS+HF-10 scores. Test-retest intraclass coefficients were acceptable to excellent (0.75-0.97). Both profiles demonstrated known-groups validity for the overall and physical health summary scores based on NYHA class, and convergent validity for nearly all scores compared with KCCQ scores. In the longitudinal sample, we demonstrated responsiveness for PROMIS+HF-27 and PROMIS+HF-10 overall and physical summary scores. For the PROMIS+HF overall summary scores, a group-based increase of 7.6-8.3 points represented a small to medium change (Cohen's d = 0.40-0.42). For the PROMIS+HF physical summary scores, a group-based increase of 5.0-5.9 points represented a small to medium change (Cohen's d = 0.29-0.35). CONCLUSIONS: The PROMIS+HF-27 and PROMIS+HF-10 profiles demonstrated good psychometric characteristics with evidence of responsiveness for overall and physical health. These new measures can facilitate patient-centred research and clinical care, such as improving care quality through symptom monitoring, facilitating shared decision-making, evaluating quality of care, assessing new interventions, and monitoring during the initiation and titration of guideline-directed medical therapy.

Reducing Readmissions in Patients With Both Heart Failure and COPD.

Patients with both COPD and heart failure (HF) pose particularly high costs to the health-care system. These diseases arise from similar root causes, have overlapping symptoms, and share similar clinical courses. Because of these strong parallels, strategies to reduce readmissions in patients with both conditions share synergies. Here we present 10 practical tips to reduce readmissions in this challenging population: (1) diagnose the population accurately, (2) detect admissions for exacerbations early and consider risk stratification, (3) use specialist management in hospital, (4) modify the underlying disease substrate, (5) apply and intensify evidence-based therapies, (6) activate the patient and develop critical health behaviors, (7) setup feedback loops, (8) arrange an early follow-up appointment prior to discharge, (9) consider and address other comorbidities, and (10) consider ancillary support services at home. The multidisciplinary care teams needed to support these care models pose expense to the health-care system. Although these costs may more easily be recouped under financial models such as accountable care organizations and bundled payments, the opportunity cost of an admission for COPD or HF may represent an underrecognized financial lever.

In vitro antibacterial, cytotoxicity and haemolytic activities and phytochemical analysis of seagrasses from the Gulf of Mannar, South India.

It is essential to study the phytochemical constituents and toxicological properties of seagrasses when considering their food applications. Aqueous methanolic extracts of six seagrasses were evaluated for their antibacterial, cytotoxic (brine shrimp leathality assay) and haemolytic activity. Thin layer chromatography (TLC) and phytochemical analysis were used to compare the phytochemical profiles of six seagrasses. Among the six seagrasses examined, Halodule pinifolia and Cymodocea rotundata showed predominant growth inhibitory activity against all the tested human pathogens. Cytotoxicity of seagrass extracts against nauplii of Artemia salina revealed that Syringodium isoetifolium exhibited lesser toxicity with LC(50) value of 699.096 µg/ml. Of all the seagrasses tested, H. pinifolia recorded the minimum haemolytic activity of 2.07±0.63% at 1000 µg/ml concentration. Phytochemical analysis showed the presence of common plant chemical constituents which varied with respect to species. The present findings suggest the possible pharmacological applications of selected seagrasses that can be used as food ingredients.

Determination of element contents in herbal drugs: chemometric approach.

The elemental content of 23 commercial herbal drugs was evaluated and multivariate analysis such as principal component analysis (PCA) and hierarchical cluster analysis (HCA) were performed with aim to know the relationship among the elements in the herbal drugs. Among the 13 elements investigated K (8096.97), Na (581.53), Cu (2.06); Mg (678.4); Fe (476.93), Al (321.5), Co (0.22); Zn (4.46), Ni (0.56); Mn (25.77); Pb (13.33); and Cr (13.18)mg/kg dry weight, respectively, were found at high concentrations in Eclipta prostrata; Adhatoda vasica; Phyllanthus amarus; Hybanthus enneaspermus; Cardiospermum halicacabum; Acacia nilotica; and Denolix elata. Interestingly, the toxic element Cd was below detectable level in all the samples and Cr, Pb and Ni were lower than the permissible limit as prescribed by the World Health Organisation (WHO). This study clearly shows that PCA and HCA procedures appear useful tools for the differentiation and classification of herbal drugs using the profile of elements.

Chemical composition and antibacterial activity of Indian seagrasses against urinary tract pathogens.

Seagrasses have a long history of being used for a variety of remedial purposes, such as the fever, skin diseases, muscle pains, wounds and stomach problems. Hence it is essential to study their bioactive metabolites and medicinal properties when considering their food applications. The chemical composition of six seagrasses were determined and evaluated for their potential to urinary tract infection bacteria (UTI). The chemical composition determined by GC-MS yielded 24 compounds. For the first time 4H-Pyran-4-one-2,3-dihydro-3,5-dihydroxy-6-methyl- (6.68%), d-allose (3.67%) and 5-Caranol, trans,trans-(+)- (2.14%) were identified from Halodule pinifolia. d-Allose is a aldo-hexose (sugar) used as a potential inhibitor of glycosidases and low-calorie carbohydrate sweeteners. Among the six seagrasses tested, H. pinifolia and Cymodocea rotundata exhibited predominant growth inhibitory activity against all the UTI bacteria. This study shows the presence of various biological metabolites in tested seagrasses that can be used effectively in food and pharmacological industries.

Antioxidant activity of seagrasses of the Mandapam coast, India.

CONTEXT: In the search for new sources of safe and inexpensive antioxidants, the leaves of eight species of seagrasses were screened for antioxidant properties. OBJECTIVE: Most of the seagrasses were evaluated for the first time for their antioxidant activities. MATERIALS AND METHODS: Total phenolic content and in vitro antioxidant activity using, 2,2-diphenyl-1-picrylhydrozyl (DPPH) radical scavenging capacity and FRAP assay. RESULTS: The leaves of Halophila stipulacea (Forssk.) Aschers showed high levels of phenols (1.398 ± 0.055 mg GAE/g) and high reducing power (46.289 ± 1.002) in terms of mg GAE/g. Similarly, H. pinifolia exhibited high total antioxidant activity (132.38, 75.027 mg AscAE/g) and a high percentage of DPPH radical scavenging activity (68.14%). The TAA and FRAP assays showed positive and significantly high correlation (R2 = 0.646). The total phenolic content in the seagrass extracts showed a better correlation with reducing power (R2 = 0.597) than the DPPH radical-scavenging activity (R2 = 0.495). DISCUSSION AND CONCLUSIONS: The antioxidant capacities of the seagrasses showed potential rich sources of natural antioxidants. Further studies are necessary for isolation and characterization of the active antioxidant compounds, which can be used to treat various oxidative stress-related diseases.

Chemometric studies of multielemental composition of few seagrasses from Gulf of Mannar, India.

This paper discusses the determination of minerals content (cadmium, cobalt, chromium, copper, nickel, lead, manganese, magnesium, iron, zinc, sodium, potassium and calcium) of six seagrass samples, Enhalus acoroides, Thalassia hemprichii, Halodule pinifolia, Syringodium isoetifolium, Cymodocea serrulata and Cymodocea rotundata using inductively coupled plasma optical emission spectrophotometry and flame photometer. Principal component analysis (PCA) and hierarchical cluster analysis revealed different mineral compositions of the seagrass samples. Among the 13 elements investigated, Ni 1.513, Na 690.167 and Ca 220.333; Cr 3.957; Mn 23.427, Zn 17.593 and Fe 156.567; Cd 0.357, Co 0.431, Pb 2.040, Mg 912.733 and K 300.9; Cu 7.8 mg/kg dry weight, respectively, were found at high concentrations in E. acoroides; T. hemprichii; H. pinifolia; S. isoetifolium and C. rotundata. PCA analysis confirmed the presence of three components with 91.28% of the total variance. The toxic elements Pb, Cr and Cd were also found in all six seagrasses, although the concentrations were below the permissible limits proposed by the World Health Organization.

Computer three-dimensional reconstruction of the atrioventricular conduction system.

The human atrioventricular conduction system (AVCS), which includes the AV node and its approaches, AV bundle (penetrating, branching, and bifurcating parts), and the bundle branches, is a curved complex structure that has not been reconstructed in three dimensions using computer technology. Microscopic slides of every 40(th) serial section (cut at 7 micron level) of the AVCS were digitized into 600 dots/inch color images. External outlines of each section were manually segmented using commercially available three-dimensional rendering software (Rhinoceros). The AVCS was traced from light microscopy and superimposed onto the external outlines. To account for inherent errors in histological slide preparation, an optimization procedure was used to align external outlines of all sections. The optimal rotation and translation of each section was established by maximizing area of overlap between adjacent sections. A sequential one-dimensional minimization algorithm was used for optimization. Rotation and translation values were then used to align external outlines and the superimposed conduction system, reconstructing the AVCS in three-dimensions. To validate the method, the algorithm was applied to a digitized image transformed with known translations and rotations. The validation procedure demonstrated that each test image aligned in translations and to within 0.01 degree in rotations. Spatial error determined by resolution of the digitized images was +/-0.5/600 inch (+/-21 microns). Three-dimensional reconstruction of every 40th serial section clearly demonstrated the complex curved shape of the AVCS. Three-dimensional reconstruction of the human and canine AVCS permits accurate pathological and electrophysiological correlation of the conduction system.