Nevin Manimala

J Hypertens. 2022 Jun 1;40(Suppl 1):e314. doi: 10.1097/01.hjh.0000838808.45705.35.

ABSTRACT

OBJECTIVE: To evaluate the effects of Sacubitril-Valsartan on early renal function and vascular function in patients during perimenopause with hypertension.

DESIGN AND METHOD: This study was a prospective, randomized, positive control and open label test. The subjects were 427 perimenopausal women (30-65 years old) with mild or moderate hypertension who were treated in the Department of Cardiovascular Medicine of the Second Hospital of Lanzhou University. They were randomly assigned to Sacubitril-Valsartan group (n = 165) or valsartan group (n = 262) for 24 weeks. Renal function, urinary renal function and vascular function were evaluated at baseline and 24 weeks after treatment.

RESULTS: There was no significant difference in the clinical baseline data between patients with sacubitril-valsartan and patients with valsartan (P> 0.05). Comparison of the systolic blood pressure (oSBP) and diastolic blood pressure(oDBP)before and after treatment: the baseline vs. 24-week difference between the sacubitril-valsartan group and the valsartan group was statistically significant (p < 0.001). The carotid-femoral pulse wave velocity (cfPWV) in the vascular function indexes of the sacubitril-valsartan group was significantly improved (p < 0.001). The improvement of valsartan group was not obvious. Other vascular function parameters such as cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) were not significantly improved in the two groups. Urinary microalbumin (MAU)was significantly improved in both blood renal function and urine renal function. The improvement was observed in the sacubitril-valsartan group (p < 0.001) and valsartan group (p = 0.027), but the improvement was stronger in the sacubitril-valsartan group (p < 0.001).

CONCLUSIONS: Sacubictril-valsartan has a stronger antihypertensive effect than valsartan in patients during perimenopause with hypertension, and can improve MAU and cfPWV in patients.

PMID:36027471 | DOI:10.1097/01.hjh.0000838808.45705.35

J Hypertens. 2022 Jun 1;40(Suppl 1):e314. doi: 10.1097/01.hjh.0000838800.92823.fc.

ABSTRACT

OBJECTIVE: It has been shown a significant difference in clinical characteristics of HTN and treatment response to antihypertensive therapy between males and females. The purpose of our article was to examine gender differences in the regulation of blood pressure (BP) by using ambulatory blood pressure monitoring (ABPM).

DESIGN AND METHOD: Two hundred seventy-five consecutive hypertensive patients were included in the study (146 females, mean age 64.11 ± 10.47 and 129 males, mean age 61.69 ± 13.59). All patients were on antihypertensive treatment for more than one year (average duration of HTN was 11.07 ± 8.24 years for women, and 10.31 ± 7.5 years for men). In all pts, AMBP was performed. The values obtained by AMBP were compared between the two groups.

RESULTS: There were no significant differences in the presence of coronary artery disease, obesity, diabetes mellitus, or heredity between the groups. There were more smokers among male patients (p = 0.007), while dyslipidemia was more present in female pts (p = 0.005). Male pts had higher values of systolic (124.05 ± 13.89 vs. 119.5 ± 16.58, p = 0.015) and diastolic BP (72.77 ± 8.42 vs. 69.24 ± 8.23, p = 0.001) and larger burden of high BP during the night (56.54 ± 35.52 vs. 33.11 ± 35.27, p = 0.000) compared to female pts. There were no significant differences in pulse pressure (PP) values between the male and female groups (51.17 ± 11.33 vs. 50.72 ± 10.38, p = 0.730). However, pathological values of PP (<40 mmHg or > 60 mmHg) were found in almost 1/3 of pts (34.92% in men and 28.57% in women). Also, there was no significant difference in dipping pattern but only 40 (31.01%) male and 50 (34.25%) female patients had dipper status. There was no statistically significant difference in antihypertensive therapy between the groups. The most commonly used drugs were the angiotensin-converting enzyme inhibitors (82.21% of all pts) and beta blockers (78.78%), while the angiotensin receptor blockers were the least used (15.98%).

CONCLUSIONS: Results indicate that women have better BP control than men. However, a high frequency of pathological PP values and disturbed dipping status detected by ABPM, in women as well as men, should highlight the importance of better BP management in both genders.

PMID:36027469 | DOI:10.1097/01.hjh.0000838800.92823.fc

J Hypertens. 2022 Jun 1;40(Suppl 1):e313. doi: 10.1097/01.hjh.0000838792.47980.37.

ABSTRACT

OBJECTIVE: To evaluate the 24-hour blood pressure (BP) control and the effect of the triple fixed combination (TFC) amlodipine / indapamide / perindopril on the arterial stiffness parameters according to 24-hour blood pressure monitoring (ABPM) data in patients with uncontrolled hypertension (HTN).

DESIGN AND METHOD: The study involved 78 patients with insufficient BP control, against the background of previous combination therapy. All patients received TFC amlodipine / indapamide / perindopril. The patient’s condition was assessed during 4 observation visits: visit 1- inclusion, visit 2 – 4 weeks, visit 3 -12 weeks, visit 4 – 24 weeks observation. At each visit, the achievement of the target BP level < 130/80 mm Hg was assessed, as well as the effect of therapy on the parameters of arterial stiffness (pulse wave velocity (PWVao), pulse pressure (PP), agumentation index (Aix), arterial stiffness index (ASI)) and central aortic pressure parameters (systolic aortic pressure (SBPao), diastolic pressure in the aorta (DBPao), central pulse pressure (PPao)) according to ABPM.

RESULTS: In subjects with HTN with ineffective antihypertensive therapythe initial office BP was 160.8 ± 10.3 / 91.5 ± 8.1 mm Hg. After 24 weeks of therapy with a TFC there was a significant decrease in blood pressure to 121.3 ± 3.5 / 73.6 ± 4.2 mm Hg (p < 0.001). According to ABPM data, mean values of daily BP significantly (p < 0.001) decreased from 153.9 ± 9.04 / 8.38 ± 9.18 to 120.3 ± 4.7 / 73.4 ± 4.7 mm Hg. Data analysis showed a decrease PWVao (11.39 ± 1.32 m/s vs 9.98 ± 0.91 m/s, p < 0,05) as well as ASI (174 (138, 253) vs 139 (107.196) mmHg; p < 0.001) and Aix -29,9 (-41,12) vs – 33,7 (-53, 9) p < 0,05. There was a statistically significant decrease in the parameters the central pressure in the aorta (Fig.1).

CONCLUSIONS: In patients with HTN and previous uneffective antihypertensive therapy the FTC amlodipine / indapamide / perindopril provided high antihypertensive effectiveness. Parameters of vascular stiffness can serve as criteria for quality control of blood pressure and can be used to assess the effectiveness of antihypertensive therapy.

PMID:36027467 | DOI:10.1097/01.hjh.0000838792.47980.37

J Hypertens. 2022 Jun 1;40(Suppl 1):e311-e312. doi: 10.1097/01.hjh.0000838780.75182.bb.

ABSTRACT

OBJECTIVE: To check adherence to the antihypertensive medication in patients with arterial hypertension and a possible impact of fixed-dose drug combinations, cardiovascular event in history, and diabetes on it.

DESIGN AND METHOD: In this cross-sectional study, every fifth patient with arterial hypertension in two family medicine practices in Zagreb, Croatia (found by Medicus search engine) was analyzed during February 2022. We included medical records of 210 patients (116 males, 94 females) from which we checked the number and type of used antihypertensive medication (single pill or fixed-dose drug combinations), statin use, diabetes type 2 or cardiovascular event in history, and the date of the last lab test results. The patient was considered adherent if she/he regularly ordered hers/his prescribed medication from January to December 2021. Chi-square and Student t-test were used for statistical analysis in Statistica 12.

RESULTS: There were no differences between genders. Women were slightly more adherent to the prescribed therapy than men (72.34 vs. 68.11%, P = 0.5076). Statins were prescribed in 65 (30.95%), fixed-dose combination in 139 (66.19%), 39 had diabetes (18.57%), and 28 patients had cardiovascular events in their medical history (13.33%). The adherence was not dependent on the patient’s age (66.75 vs. 66.64 years in adherent patients, P = 0.9509), the existence of diabetes (Chi2 = 1.093, 2, P = 0.2958) or previous cardiovascular event in medical history (Chi2 = 0.384, 2, P = 0.5351). Adherence correlated with the number of prescribed antihypertensive medications (r = 0.263; P < 0.05; and average 2.56 in adherent vs. 1.97 medication per day in non-adherent group, P < 0.001), especially if the therapy was in fixed-dose combination (Chi2 = 11.60, 2, P < 0.001). The age of the lab test results was less in adherent patients (1.25 vs. 1.86 years, P = 0.108). 116 patients (55.24%) had them in 2021, while 16 did not have any result in five and more years (7.14%).

CONCLUSIONS: The adherence to antihypertensive therapy was similar between genders and correlated with the number of prescribed medications with significantly better results in patients with fixed-dose combinations. The existence of the previous cardiovascular event and type 2 diabetes did not show any benefit on this type of adherence.

PMID:36027464 | DOI:10.1097/01.hjh.0000838780.75182.bb

JMIR Mhealth Uhealth. 2022 Aug 26;10(8):e39682. doi: 10.2196/39682.

ABSTRACT

BACKGROUND: The role of self-management in health promotion, as well as prevention and rehabilitation, is increasing through the use of mobile health (mHealth) apps. Such mHealth apps are also increasingly being used for self-management of low back pain (LBP), but their effectiveness has not been sufficiently explored.

OBJECTIVE: The aim of this scoping review was to provide an overview of the literature on self-management mHealth apps and their effects on the levels of pain and disability in people with LBP.

METHODS: We applied the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) methodology, including a priori research questions. A literature search was conducted in 2 databases (PubMed and PEDro) for studies published between January 1, 2015, and June 17, 2021. Interventional, cohort, or case series studies with an interventional period were included if the mHealth app included built-in self-management content, the app was used for self-management for people with LBP, and the study reported outcomes regarding pain and disability in people with LBP.

RESULTS: In total, 7 studies were selected for the review with overall 2307 persons with LBP, of whom 1328 (57.56%) were women. Among the studies (5/7, 71%) that reported the type of pain, 85% (390/459) of the participants were experiencing chronic LBP. A total of 5 different mHealth apps were identified, of which 4 contributed to a statistically significant reduction in LBP and clinically meaningful changes. Of the 7 studies, 4 (57%) used 4 different assessments for disability, of which 3 (75%) showed statistically significant improvements in the level of functional ability of participants in the experimental groups using an mHealth app with built-in self-management content for LBP.

CONCLUSIONS: This scoping review supports the conclusion that people with LBP may benefit from mHealth apps that provide self-management content. However, the generalizability of the findings is limited because of heterogeneity in the pain characterization of the included participants and the intervention durations. More high-quality studies with longer follow-up periods to investigate personalized mHealth approaches are recommended for LBP self-management.

PMID:36018713 | DOI:10.2196/39682

Phys Rev Lett. 2022 Aug 12;129(7):075001. doi: 10.1103/PhysRevLett.129.075001.

ABSTRACT

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin “burn propagation” into surrounding cold fuel, enabling the possibility of high energy gain. While “scientific breakeven” (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion.

PMID:36018710 | DOI:10.1103/PhysRevLett.129.075001

Phys Rev Lett. 2022 Aug 12;129(7):070401. doi: 10.1103/PhysRevLett.129.070401.

ABSTRACT

The non-Hermitian skin effect (NHSE), the accumulation of eigen-wave functions at boundaries of open systems, underlies a variety of exotic properties that defy conventional wisdom. While the NHSE and its intriguing impact on band topology and dynamics have been observed in classical or photonic systems, their demonstration in a quantum gas system remains elusive. Here we report the experimental realization of a dissipative Aharonov-Bohm chain-non-Hermitian topological model with NHSE-in the momentum space of a two-component Bose-Einstein condensate. We identify signatures of the NHSE in the condensate dynamics, and perform Bragg spectroscopy to resolve topological edge states against a background of localized bulk states. Our Letter sets the stage for further investigation on the interplay of many-body statistics and interactions with the NHSE, and is a significant step forward in the quantum control and simulation of non-Hermitian physics.

PMID:36018690 | DOI:10.1103/PhysRevLett.129.070401

Phys Rev Lett. 2022 Aug 5;129(6):068101. doi: 10.1103/PhysRevLett.129.068101.

ABSTRACT

Fluctuations of synaptic weights, among many other physical, biological, and ecological quantities, are driven by coincident events of two “parent” processes. We propose a multiplicative shot-noise model that can capture the behaviors of a broad range of such natural phenomena, and analytically derive an approximation that accurately predicts its statistics. We apply our results to study the effects of a multiplicative synaptic plasticity rule that was recently extracted from measurements in physiological conditions. Using mean-field theory analysis and network simulations, we investigate how this rule shapes the connectivity and dynamics of recurrent spiking neural networks. The multiplicative plasticity rule is shown to support efficient learning of input stimuli, and it gives a stable, unimodal synaptic-weight distribution with a large fraction of strong synapses. The strong synapses remain stable over long times but do not “run away.” Our results suggest that the multiplicative shot-noise offers a new route to understand the tradeoff between flexibility and stability in neural circuits and other dynamic networks.

PMID:36018633 | DOI:10.1103/PhysRevLett.129.068101

JMIR Pediatr Parent. 2022 Aug 26;5(3):e34721. doi: 10.2196/34721.

ABSTRACT

BACKGROUND: To prevent adolescents from initiating alcohol and other drug use and reduce the associated harms, effective strategies need to be implemented. Despite their availability, effective school-based programs and evidence-informed parental guidelines are not consistently implemented. The Positive Choices alcohol and other drug prevention initiative and website was launched to address this research and practice gap. The intended end users were school staff, parents, and school students. An 8-month postlaunch evaluation of the website showed that end users generally had positive feedback on the website’s usability, and following its use, most of them would consider the evidence base and effectiveness of drug education resources. This study extends this initial evaluation by examining the effectiveness and impact of the Positive Choices initiative over a 3-year period.

OBJECTIVE: Guided by the five dimensions of the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework, the study assessed the impact of the Positive Choices initiative in increasing awareness and implementation of evidence-based drug prevention.

METHODS: Data were collected between 2017 and 2019, using web-based evaluation and community awareness surveys. Data from the surveys were merged to examine reach, effectiveness, adoption, implementation, and maintenance using descriptive statistics. Google Analytics was used to further understand the reach of the website. The System Usability Scale was used to measure website usability. In addition, inductive analysis was used to assess the participants’ feedback about Positive Choices.

RESULTS: A total of 5 years after launching, the Positive Choices website has reached 1.7 million users. A national Australian campaign increased awareness from 8% to 14% among school staff and from 15% to 22% among parents after the campaign. Following a brief interaction with the website, most participants, who were not already following the recommended strategies, reported an intention to shift toward evidence-based practices. The System Usability Scale score for the website was good for both user groups. The participants intended to maintain their use of the Positive Choices website in the future. Both user groups reported high level of confidence in communicating about topics related to alcohol and other drugs. Participants’ suggestions for improvement informed a recent website update.

CONCLUSIONS: The Positive Choices website has the capacity to be an effective strategy for disseminating evidence-based drug prevention information and resources widely. The findings highlight the importance of investing in ongoing maintenance and promotion to enhance awareness of health websites. With the increased use and acceptability of health education websites, teams should ensure that websites are easy to navigate, are engaging, use simple language, contain evidence-informed resources, and are supported by ongoing promotional activities.

PMID:36018617 | DOI:10.2196/34721

Ann Bot. 2022 Aug 26:mcac110. doi: 10.1093/aob/mcac110. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Upscaling carbon allocation requires knowledge of the variability at the scales at which data are collected and applied. Trees exhibit different growth rates and timings of wood formation. However, the factors explaining these differences remain undetermined, making samplings and estimations of the growth dynamics a complicated task, habitually based on technical rather than statistical reasons. This study explored the variability in xylem phenology among 159 balsam firs (Abies balsamea (L.) Mill.).

METHODS: Wood microcores were collected weekly from April to October 2018 in a natural stand in Quebec, Canada, to detect cambial activity and wood formation timings. We tested spatial autocorrelation, tree size, and cell production rates as explanatory variables of xylem phenology. We assessed sample size and margin of error for wood phenology assessment at different confidence levels.

KEY RESULTS: Xylem formation lasted between 40 and 110 days, producing between 12 and 93 cells. No effect of spatial proximity or size of individuals was detected on the timings of xylem phenology. Trees with larger cell production rates showed a longer growing season, starting xylem differentiation earlier and ending later. A sample size of 23 trees produced estimates of xylem phenology at a confidence level of 95% with a margin of error of one week.

CONCLUSIONS: This study highlighted the high variability in the timings of wood formation among trees within an area of 1 km 2. The correlation between the number of new xylem cells and the growing season length suggests a close connection between the processes of wood formation and carbon sequestration. However, the causes of the observed differences in xylem phenology remain partially unresolved. We point out the need to carefully consider sample size while assessing xylem phenology to explore the reasons underlying this variability and to allow reliable upscaling of carbon allocation in forests.

PMID:36018569 | DOI:10.1093/aob/mcac110