Ventricular force‐frequency relationships during biventricular or multisite pacing in congenital heart disease

Background: Traditional indices to evaluate biventricular (BiV) pacing are load dependent, fail to assess dynamic changes, and may not be appropriate in patients with congenital heart disease (CHD). We therefore measured the force‐frequency relationship (FFR) using tissue Doppler‐de‐ rived isovolumic acceleration (IVA) to assess the dynamic adaption of the myocardium and its vari‐ ability with different ventricular pacing strategies.
Methods: This was a prospective pilot study of pediatric and young adult CHD patients with biventricular or multisite pacing systems. Color‐coded myocardial velocities were recorded at the base of the systemic ventricular free wall. IVA was calculated at resting heart rate and with incremental pacing. FFR curves were obtained by plotting IVA against heart rate for different ventricular pacing strategies.
Results: Ten patients were included (mean: 22 ± 7 years). The FFR identified a best and worst ventricular pacing strategy for each patient, based on the AUC at baseline, submaximal, and peak heart rates (P < .001). However, there was no single best ventricular pacing strategy that was optimal for all patients. Additionally, the best ventricular pacing strategy often differed within the same patient at different heart rates.
Conclusion: This novel assessment demonstrates a wide variability in optimal ventricular pac‐ ing strategy. These inherent differences may play a role in the unpredictable clinical response to BiV pacing in CHD, and emphasizes an individualized approach. Furthermore, the optimal ventricular pacing varies with heart rate within individuals, suggesting that rate‐responsive ventricular pacing modulation may be required to optimize ventricular performance.     

RNase L is a negative regulator of cell migration

RNase L is a regulated endoribonuclease that functions in the interferon antiviral response. Activation of RNase L by 2′, 5′-oligoadenylates has been linked to apoptosis, autophagy and inflammation. Genetic studies have also suggested the possible involvement of the RNase L gene (RNASEL) on chromosome 1q25.3 in several types of cancer. Here we report that ablation of RNase L in human prostate cancer PC3 cells by CRISPR/Cas9 gene editing technology enhanced cell migration as determined both by transwell assays and scratch wound healing assays. In addition, RNase L knockdown by means of RNAi increased migration of PC3 and DU145 cells in response to either fibronectin or serum stimulation, as did homozygous disruption of the RNase L gene in mouse embryonic fibroblasts. Serum or fibronectin stimulation of focal adhesion kinase (FAK) autophosphorylation on tyrosine-397 was increased by either knockdown or ablation of RNase L. In contrast, a missense mutant RNase L (R667A) lacking catalytic activity failed to suppress cell migration in PC3 cells. However, a nuclease-inactive mutant mouse RNase L (W630A) was able to partially inhibit migration of mouse fibroblasts. Consistent with a role for the catalytic activity of RNase L, transfection of PC3 cells with the RNase L activator, 2′, 5′-oligoadenylate, suppressed cell migration. RNase L knockdown in PC3 cells enhanced tumor growth and metastasis following implantation in the mouse prostate. Our results suggest that naturally occurring mutations in the RNase L gene might promote enhanced cell migration and metastasis.     

Structural Morphology and Optical Properties of Strontium-Doped Cobalt Aluminate Nanoparticles Synthesized by the Combustion Method

The study of structural morphology and the optical properties of nanoparticles produced by combustion methods are gaining significance due to their multifold applications. In this regard, in the present work, the strontium-doped cobalt aluminate nanoparticles were synthesized by utilizing Co_1−xSr_xAl₂O₄ (0 ≤ x ≤ 0.5) L-Alanine as a fuel in an ignition cycle. Subsequently, several characterization studies viz., X-ray diffraction (XRD), energy-dispersive X-ray (EDX) analysis, high-resolution scanning electron microscopy (HRSEM), Fourier transform infrared spectroscopy (FTIR), ultraviolet (UV) spectroscopy and vibrating sample magnetometry (VSM) were accomplished to study the properties of the materials. The XRD analysis confirmed the cubic spinel structure, and the average crystallite size was found to be in the range of 14 to 20 nm using the Debye–Scherrer equation. High-resolution scanning electron microscopy was utilized to inspect the morphology of the Co_1−xSr_xAl₂O₄ (0 ≤ x ≤ 0.5) nanoparticles. Further, EDS studies were accomplished to determine the chemical composition. Kubelka–Munk’s approach was used to determine the band gap, and the values were found to be in the range of 3.18–3.32 eV. The energy spectra for the nanoparticles were in the range of 560–1100 cm⁻¹, which is due to the spinel structure of Sr-doped CoAl₂O₄ nanoparticles. The behavior plots of magnetic induction (M) against the magnetic (H) loops depict the ferromagnetic behavior of the nanomaterials synthesized.     

Validation of an algorithm combining haemoglobin A1c and fasting plasma glucose for diagnosis of diabetes mellitus in UK and Australian populations

Aim To determine whether glycated haemoglobin (HbA_1c) can be used in combination with fasting plasma glucose (FPG) for the diagnosis of diabetes in patients with impaired fasting glucose (IFG) and in a broader spectrum of patients. Methods An algorithm was derived from oral glucose tolerance test (OGTT) capillary samples in 500 consecutive UK patients with IFG by World Health Organization criteria. It was validated in a further 500 UK patients and, with venous specimens, in 1175 unselected Australian patients. Results The derivation cohort was aged 61 years (50–69 years) (median IQ range) with 52% male and 12% South Asian. Diabetes Control and Complications Trial‐aligned HbA_1c was 6.2% (5.8–6.6%) (reference interval < 6.0%) and FPG 6.7 mmol/l (6.3–7.2 mmol/l). FPG was in the diabetes range in 36% of patients, with an OGTT identifying a further 12% with diabetes. The derived algorithm, (HbA_1c ≥ 6.0% with FPG < 7.0 mmol/l) identified those patients requiring an OGTT to diagnose diabetes. When applied to the UK validation cohort, sensitivity was 97% and specificity 100%. The algorithm was equally effective in the unselected group, aged 59 years (49–68 years) and 54% male, with sensitivity 93% and specificity 100%. HbA_1c was 6.0% (5.6–6.6%) and FPG 6.0 mmol/l (5.3–6.8 mmol/l), with 26% having IFG. Use of the algorithm would reduce the number of OGTTs performed in the UK validation cohort by 33% and by 66% in the Australian patients studied. Conclusions Use of this algorithm would simplify procedures for diagnosis of diabetes and could also be used for monitoring pre‐diabetes. Validation is now required in other populations and patient groups.