A toxic combination of poor social policies and programmes,unfair economic arrangements and bad politics: the experiences of poor Canadians with Type 2 diabetes

Type 2 diabetes (T2DM) is a serious life-threatening chronic disease whose prevalence is especially high among Canadians living in poverty. And these Canadians with T2DM in poverty are especially likely to experience serious consequences of the disease. Of special concern is Statistics Canada reporting an explosive increase in mortality rates from diabetes (of which 90% represent T2DM) in low-income urban neighbourhoods across Canada. We place findings from interviews with 60 Canadians with T2DM who live in poverty within the context of recent shifts in public policy that have affected the distribution of the social determinants of health. Findings of material deprivation among our participants indicate that it is almost impossible for these individuals to acquire the diet necessary to prevent the adverse outcomes associated with T2DM. These findings draw attention to consideration of the important role public policy plays in affecting the situation of people living in poverty who are afflicted with T2DM and other chronic diseases.     

Structural studies of the scrapie prion protein by electron crystallography

Because the insolubility of the scrapie prion protein (PrP(Sc)) has frustrated structural studies by x-ray crystallography or NMR spectroscopy, we used electron crystallography to characterize the structure of two infectious variants of the prion protein. Isomorphous two-dimensional crystals of the N-terminally truncated PrP(Sc) (PrP 27-30) and a miniprion (PrP(Sc)106) were identified by negative stain electron microscopy. Image processing allowed the extraction of limited structural information to 7 A resolution. By comparing projection maps of PrP 27-30 and PrP(Sc)106, we visualized the 36-residue internal deletion of the miniprion and localized the N-linked sugars. The dimensions of the monomer and the locations of the deleted segment and sugars were used as constraints in the construction of models for PrP(Sc). Only models featuring parallel beta-helices as the key element could satisfy the constraints. These low-resolution projection maps and models have implications for understanding prion propagation and the pathogenesis of neurodegeneration.     

Heartport endoclamp for complex cardiac repairs with total circulatory arrest

A method of performing redo cardiac operations using port-access technology and total circulatory arrest is described. The technique was useful in 2 cases requiring re-intervention within 4 months of the primary procedure. The indications were repair of an infected ventricular aneurysm and recurrence of a postinfarction ventricular septal defect. Dense mediastinal adhesions were avoided by approaching the site of pathology directly via a left anterior thoracotomy.     

Percutaneous Left Atrial Appendage Closure With the Ultraseal Device: Insights From the Initial Multicenter Experience

Objectives

This study sought to evaluate the feasibility, safety, and efficacy of the Ultraseal device for left atrial appendage closure (LAAC) (Cardia, Eagan, Minnesota) in patients with nonvalvular atrial fibrillation at high bleeding risk.

Changes in arterial stiffness following dialysis in relation to overhydration and to endothelial function

Introduction

Cardiovascular (CV) morbidity and mortality are greatly enhanced in patients with chronic kidney disease, partly due to increased arterial stiffness.

Material and method

The study included 63 stable HD patients. Stiffness parameters were evaluated by applanation tonometry before the mid-week HD sessions. Pre-HD bioimpedance parameters were measured. A phase angle <six degrees was previously reported as abnormal, reflecting extracellular overhydration. Fluid status was evaluated echocardiographic by measuring the inferior vena cava (IVC) diameter. Endothelium-dependent and endothelium-independent vascular reactivity were assessed by changes in Alx following sublingual nitroglycerin and inhaled salbutamol.

Results

PWV directly correlated with patients?? age and dialysis vintage. Patients with a phase angle <6°, were significantly overhydrated (larger IVC, increased ECW, and lower ICW), had stiffer arteries and greater left ventricle mass (LVM), compared with those with a phase angle >6°. Overhydration increases arterial stiffness, but has no influence on either EID or ED vascular reactivity.

Conclusion

In hemodialysis, volume overload is an important contributor to increased arterial stiffness and modifies cardiovascular status especially by LV hypertrophy. Achieving normohydration may significantly ameliorate cardiac abnormalities and arterial stiffness and may impact major clinical events and CV mortality.     

Non-Aqueous Electrodeposition and Characterization of AlCrCuFeNi High Entropy Alloy Thin Films

Materials used in the marine industry are exposed to extreme conditions, so it is necessary to meet remarkable characteristics, such as mechanical resistance, low density, and good corrosion resistance. The challenging environment requires continuous performance improvements, so this work is focused on developing new materials with superior properties, using the electrochemical deposition technique, which are convenient for marine engineering. High-entropy alloys have been attracting tremendous interest in many applications, due to their simple crystal structures and advantageous physical-chemical properties, such as high strength, anti-corrosion, erosion, and electro-magnetic capabilities. To identify the most appropriate compositions, MatCalc software was used to predict the structure and characteristics of the required materials, and thermodynamic and kinetic criteria calculations were performed. The modelling processes generated a series of optimal compositions in the AlCrCuFeNi alloy system, that are suitable to be used in anticorrosive and tribological applications. The composition and morphology of the obtained high entropy alloy thin films revealed a uniform structure, with a small grain profile. The corrosion resistance was investigated in artificial seawater to observe the behavior of the newly developed materials in demanding conditions, and the results showed improved results compared to the copper foil substrate.