Myocardial healing using cardiac fat

Introduction: Chronic diseases, including myocardial scar healing and heart failure remission, impose huge social and economic burdens, and novel approaches are needed. Several therapeutic modalities are currently being evaluated, including cell therapy, stem cell conditioning, and cardiac tissue engineering.

Areas covered: This review discusses the restoration of cardiac function after myocardial infarction using a vascularized flap of autologous cardiac adipose tissue over an akinetic scar. It addresses the risks and benefits of using cardiac adipose progenitors and the adipose graft transposition procedure (AGTP) to ameliorate cardiac dysfunction in preclinical and clinical trials.

Expert commentary: The focus is shifting from first-generation studies that used ex vivo expanded and manipulated progenitors to newer second-generation approaches, including AGTP, which are inexpensive and do not raise ethical issues. AGTP safety has been validated, and the ongoing AGTP-2 trial to determine AGTP efficacy and outcome is currently recruiting patients (NCT02798276). This reparative strategy is safe, avoids the risks associated with ex vivo manipulation, and the preclinical and clinical trials performed to date show cardiac function recovery and reduced necrosis. Confirmation of these data in the AGTP-2 trial could pave the way for the clinical use of this novel modality.     

Profiles of Food Security for US Farmworker Households and Factors Related to Dynamic of Change

Objectives. We recruited 248 farmworker families with preschool-aged children in North Carolina and examined food security indicators over 24 months to identify food security patterns and examine the dynamic of change over time.Methods. Participants in the Niños Sanos study, conducted 2011 to 2014, completed quarterly food security assessments. Based on responses to items in the US Household Food Security Survey Module, we identified different states of food security by using hidden Markov model analysis, and examined factors associated with different states. We delineated factors associated with changes in state by using mixed-effect ordinal logistic regression.Results. About half of the households (51%) consistently stayed in the most food-secure state. The least food-secure state was transient, with only 29% probability of this state for 2 consecutive quarters. Seasonal (vs migrant) work status, having immigration documents (vs not documented), and season predicted higher levels of food security.Conclusions. Heterogeneity in food security among farmworker households calls for tailoring intervention strategies. The transiency and unpredictability of low food security suggest that access to safety-net programs could reduce low food security risk in this population.Farmworkers in the United States experience challenging living conditions and economic insecurity because of low-paying and contingent employment. Although an exact number of farmworkers is not available, estimates place the population at 900 000, plus dependents.1 This includes migrant farmworkers, who establish temporary residences to do farm work, as well as seasonal workers who reside in one place and do farm work during the agricultural season.2 Currently, most farmworkers are Latino and foreign-born,3 which can limit their eligibility and access to food safety-net programs such as the Supplemental Nutrition Assistance Program. In addition, many reside in rural areas where access to healthy food retail stores may be limited by both availability and transportation, although home food production is sometimes possible.4 Together, these create a situation in which farmworker households are likely to experience low food security (resulting from insufficient household resources), but this may be episodic. Children in farmworker households may be particularly vulnerable to the effects of low food security.5Low food security is associated with negative developmental outcomes in infants and toddlers.6 Persistently low food security in early childhood is associated with long-term lower health status.7 For children at school age, this can adversely affect academic performance, weight gain, and social skills.8 With the large population of farmworkers in the United States, food security among their families is an important public health issue.Previous reports of food security for farmworker households have found 20% to 80% to be food insecure.9–14 However, all of these reports have been cross-sectional, and most have used an extended recall period, asking respondents to recall whether their household was food insecure at any time during the past year. Such data provide no information on the duration of food security states or on factors associated with transitions in and out of low food security. Examining food security over time as a dynamic construct is necessary to understand its duration and to develop protective measures for low food security.This repeated-measures study gathered data quarterly for 24 months, and examined different states of food security by using the 18-item US Household Food Security Survey Module.15 Instead of constructing a single score, we used the full item set to form a food security profile. The approach allowed us to delineate several different states of food security within the food security profile, and examine the dynamic of change in food security over the 24-month period. The aims of the study were to (1) describe multiple states of food security of farmworker households, (2) identify factors associated with the different food security states, and (3) delineate the dynamic of change in food security states across a period of 24 months.     

Association between overweight and characteristics of young adult students: support for nursing care

OBJECTIVE:

to verify associations between overweight and the characteristics of young adult students to support nursing care.

METHOD:

case-control study conducted with young adults from public schools. The sample was composed of 441 participants (147 cases and 294 controls, with and without excess weight, respectively). Sociodemographic and clinical characteristics were collected together with exposure factors and anthropometrics. Multiple logistic regression was used. The study received Institutional Review Board approval.

RESULTS:

statistically significant association with overweight: non-Caucasian, having a partner; weight gain during adolescence, mother''s excess weight, the use of obesogenic medication, augmented diastolic blood pressure, of abdominal circumference and waist/hip ratio. In addition to these, schooling and weight gain during childhood were also included in the multivariate analysis. After adjustment, the final model included: having a partner, weight gain during adolescence, augmented diastolic blood pressure and abdominal circumference.

CONCLUSION:

the analysis of predictor variables for excess weight among young adult students supports nurses in planning and developing educational practices aimed to prevent this clinical condition, which is a risk factor for other chronic comorbidities, such as cardiovascular diseases.     

Correction: Tunnel injection from WS2 quantum dots to InGaN/GaN quantum wells

Correction for ‘Tunnel injection from WS₂ quantum dots to InGaN/GaN quantum wells’ by Svette Reina Merden Santiago et al., RSC Adv., 2018, 8, 15399–15404.

Eqn (4) in the published paper was incorrect; the correct version is shown below:4The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.     

Screening for sleep apnea using pulse oximetry and a clinical score

Confirmation of the diagnosis of OSA currently requires overnight polysomnography. This study evaluates the usefulness of pulse oximetry together with a clinical score in identifying OSA. Forty patients were assigned a clinical score based on the presence or absence of loud snoring, observations of interrupted breathing during sleep, hypersomnolence, obesity and essential hypertension. Each underwent a night of domiciliary pulse oximetry followed by nocturnal polysomnography. Significant OSA was confirmed in 26. All 15 patients with positive pulse oximetry tracings had significant OSA (apnea index greater than or equal to 10). Five of eight with negative tracings were also shown to have significant OSA along with six of the seven patients with inadequate or indeterminate tracings. Clinical scores were significantly different for those with and without OSA. This study confirms the usefulness of nocturnal pulse oximetry in establishing the diagnosis of OSA and highlights the value of a clinical score in improving its sensitivity as a screening tool.     

Precision Medicine in Catecholaminergic Polymorphic Ventricular Tachycardia: JACC Focus Seminar 5/5

In this final of a 5-part Focus Seminar series on precision medicine, we focus on catecholaminergic polymorphic ventricular tachycardia (CPVT). This focus on CPVT allows us to take a “deep dive” and explore the full extent of the precision medicine opportunities for a single cardiovascular condition at a level that was not possible in the preceding articles. As a new paradigm presented in this article, it has become clear that CPVT can occur as either a typical or atypical form. Although there is a degree of overlap between the typical and atypical forms, it is notable that they arise due to different underlying genetic changes, likely exhibiting differing mechanisms of action, and presenting with different phenotypic features. The recognition of these differing forms of CPVT and their different etiologies and mechanisms is an important step toward implementing rapidly emerging precision medicine approaches that will tailor novel therapies to specific gene defects.     

Late life metabolic syndrome, early growth, and common polymorphism in the growth hormone and placental lactogen gene cluster

Low rates of fetal and infant growth are associated with the metabolic syndrome and cardiovascular disease in later life. We investigated common genetic variation in the GH-CSH gene cluster on chromosome 17q23 encoding GH, placental lactogens [chorionic somatomammotropins (CSH)], and placental GH variant in relation to fetal and infant growth and phenotypic features of the metabolic syndrome in subjects aged 59-72 yr from Hertfordshire, UK. Allele groups T, D1, and D2 of a locus herein designated CSH1.01 were examined in relation to GH-CSH single nucleotide polymorphisms and to specific phenotypes. Average birth weights were similar for all genotype groups. Men with T alleles were significantly lighter at 1 yr of age, shorter as adults, and had higher blood pressures, fasting insulin (T/T 66% higher than D2/D2) and triglyceride concentrations, and insulin and glucose concentrations during a glucose tolerance test. Birth weight and 1-yr weight associations with metabolic syndrome traits were independent of the CSH1.01 effects. Common diversity in GH-CSH correlates with low 1-yr weight and with features of the metabolic syndrome in later life. GH-CSH genotype adds substantially to, but does not account for, the associations between low body weight, at birth and in infancy, and the metabolic syndrome.