Adults with Down syndrome have reduced cardiac response after light exercise testing

Objective

Physical fitness is reduced in adults with Down syndrome (DS). The present study was conducted to elucidate the exercise response in adults with DS.

Design

Case controlled before-after trial.

Setting

Residential centre for people with intellectual disabilities.

Participants

96 Adults with DS, 25 non-DS adults with an intellectual disability, 33 controls.

Interventions

Echocardiography to exclude heart defects and to measure cardiac index (CI) in the supine position, supine position with raised legs, and following ten knee bends.

Main outcome measure

Exercise testing

Results

At rest, mean CI was not significantly different between persons with DS and controls (2.3 vs. 2.4 l/min/m², p = 0.3). However, mean CI after exercise was significantly lower in DS (2.9 vs. 3.7 l/min/m², p < 0.001) and mean CI increase from rest to exercise was more than 50% lower in DS. On the contrary, CI after exercise was similar among controls and non-DS adults with an intellectual disability. Significantly lower stroke volumes in DS were found with insufficient heart rate response.

Conclusions

CI at rest was similar in adults with DS and controls; however persons with DS have a diminished cardiac response to exercise. Stroke volumes were significantly lower in DS during exercise and a compensated heightened heart rate was absent.     

Enzyme optimization: moving from blind evolution to statistical exploration of sequence-function space

Directed evolution is a powerful tool for the creation of commercially useful enzymes, particularly those approaches that are based on in vitro recombination methods, such as DNA shuffling. Although these types of search algorithms are extraordinarily efficient compared with purely random methods, they do not explicitly represent or interrogate the genotype-phenotype relationship and are essentially blind in nature. Recently, however, researchers have begun to apply multivariate statistical techniques to model protein sequence-function relationships and guide the evolutionary process by rapidly identifying beneficial diversity for recombination. In conjunction with state-of-the-art library generation methods, the statistical approach to sequence optimization is now being used routinely to create enzymes efficiently for industrial applications.     

Biogeography of the Purple Nonsulfur Bacterium Rhodopseudomonas palustris

The biogeography of the purple nonsulfur bacterium Rhodopseudomonas palustris on a local scale was investigated. Thirty clones of phototrophic bacteria were isolated from each of five unevenly spaced sampling locations in freshwater marsh sediments along a linear 10-m transect, and a total of 150 clones were characterized by BOX-PCR genomic DNA fingerprinting. Cluster analysis of 150 genomic fingerprints yielded 26 distinct genotypes, and 106 clones constituted four major genotypes that were repeatedly isolated. Representatives of these four major genotypes were tentatively identified as R. palustris based on phylogentic analyses of 16S rRNA gene sequences. The differences in the genomic fingerprint patterns among the four major genotypes were accompanied by differences in phenotypic characteristics. These phenotypic differences included differences in the kinetics of carbon source use, suggesting that there may be functional differences with possible ecological significance among these clonal linages. Morisita-Horn similarity coefficients (C_MH), which were used to compare the numbers of common genotypes found at pairs of sampling locations, showed that there was substantial similarity between locations that were 1 cm apart (C_MH, ≥0.95) but there was almost no similarity between locations that were ≥9 m apart (C_MH, ≤0.25). These calculations showed there was a gradual decrease in similarity among the five locations as a function of distance and that clones of R. palustris were lognormally distributed along the linear 10-m transect. These data indicate that natural populations of R. palustris are assemblages of genetically distinct ecotypes and that the distribution of each ecotype is patchy.     

Molecular packing and intermolecular contacts of sickling deer type III hemoglobin

The X-ray structure of sickling deer type III hemoglobin, solved by the molecular replacement method and refined to an R value of ~25%, has been used to determine the mode of molecular packing and the residues involved in the intermolecular contacts between the hemoglobin tetramers in the crystalline state. The molecules pack in linear arrays (“fibrils”), with adjacent fibrils displaced ~27 Å from one another along the long axis of the arrays. A view down this axis shows an hexagonal network of six fibrils surrounding a central solvent cavity (each hexameric unit is termed a fiber) with adjacent fibers sharing a common wall of fibrils. Contacts less than 5 Å are observed between the following subunits of different molecules: α₁α′₁, α₁α′₂, α₁β′₁, α₁β′₂, α₂β′₁, α₂β′₂, β₂β′₂, in which the primes refer to adjacent molecules.     

DEUCALION GEN. NOV. AND ANISOSCHIZUS GEN. NOV. (CERAMIACEAE,CERAMIALES), TWO NEW PROPAGULE-FORMING RED ALGAE FROM SOUTHERN AUSTRALIA1

Two new propagule-farming red algae from southern Australia, Deucalion levringii (Lindauer) gen. et comb. nov. and Anisoschizus propaguli gen. et sp. nov., are described and defined largely on their development in laboratory culture. Deucalion is included in the tribe Compsothamnieae on the basis of its subapical procarp and alternate distichous branching. It differs from the other genera included in that tribe in that it produces 3-celled propagules, polysporangia, a subapical cell of the fertile axis which bears 3 pericentral cells, and an apparently post-fertilization involucre which develops from the hypogenous and sub-hypogenous cells of the fertile axis. Its gametophyte morphology has been elucidated in culture, as only sporophytes are known from the field. Gametophytes do not appear to produce propagules. Anisoschizus is provisionally included in the tribe Spermothamnieae on the basis of its subdichotomous branching, possession of a prostrate system and the production of polysporangia. It differs from the other genera of the tribe in the production of 2-celled propagules. Observations on the germination of the “monosporangia” of Mazoyerella arachnoidea and Monosporus spp. indicate that they are analagous to the propagules of Deucalion and Anisoschizus. The nature of these propagules and their role in recycling the parent plant are discussed and contrasted with true monosporangia. It is recommended that Monosporus be maintained as a form genus containing representatives from more than one tribe, as exemplified by plants from Lord Howe I. provisionally identified as M. indicus Boergesen which have both prostrate and erect, as opposed to only erect, axes.     

Vasoplegia after implantation of a continuous flow left ventricular assist device: incidence,outcomes and predictors

Background

Vasoplegia after routine cardiac surgery is associated with severe postoperative complications and increased mortality. It is also prevalent in patients undergoing implantation of pulsatile flow left ventricular assist devices (LVAD). However, less is known regarding vasoplegia after implantation of newer generations of continuous flow LVADs (cfLVAD). We aim to report the incidence, impact on outcome and predictors of vasoplegia in these patients.

Methods

Adult patients scheduled for primary cfLVAD implantation were enrolled into a derivation cohort (n?=?118, 2006–2013) and a temporal validation cohort (n?=?73, 2014–2016). Vasoplegia was defined taking into consideration low mean arterial pressure and/or low systemic vascular resistance, preserved cardiac index and high vasopressor support. Vasoplegia was considered after bypass and the first 48?h of ICU stay lasting at least three consecutive hours. This concept of vasoplegia was compared to older definitions reported in the literature in terms of the incidence of postoperative vasoplegia and its association with adverse outcomes. Logistic regression was used to identify independent predictors. Their ability to discriminate patients with vasoplegia was quantified by the area under the receiver operating characteristic curve (AUC).

Results

The incidence of vasoplegia was 33.1% using the unified definition of vasoplegia. Vasoplegia was associated with increased ICU length-of-stay (10.5 [6.9–20.8] vs 6.1 [4.6–10.4] p?=?0.002), increased ICU-mortality (OR 5.8, 95% CI 1.9–18.2) and one-year-mortality (OR 3.9, 95% CI 1.5–10.2), and a higher incidence of renal failure (OR 4.3, 95% CI 1.8–10.4). Multivariable analysis identified previous cardiothoracic surgery, preoperative dopamine administration, preoperative bilirubin levels and preoperative creatinine clearance as independent preoperative predictors of vasoplegia. The resultant prediction model exhibited a good discriminative ability (AUC 0.80, 95% CI 0.71–0.89, p?<? 0.01). Temporal validation resulted in an AUC of 0.74 (95% CI 0.61–0.87, p?<? 0.01).

Conclusions

In the era of the new generation of cfLVADs, vasoplegia remains a prevalent (33%) and critical condition with worse short-term outcomes and survival. We identified previous cardiothoracic surgery, preoperative treatment with dopamine, preoperative bilirubin levels and preoperative creatinine clearance as independent predictors.

     

New species, observations, and a list of new records of brown algae (Phaeophyceae) from the Hawaiian Islands

Two new species of brown algae (Phaeophyceae), Padina moffittiana Abbott et Huisman, sp. nov. and Cutleria irregularis Abbott et Huisman, sp. nov., are described from the Hawaiian Islands (between 19°04′N, 155°35′W and 28°25′N, 178°20′W). In addition, the new combination Cutleria canariensis is proposed for Aglaozonia canariensis. New observations are presented on Nereia intricata Yamada, a species described 67 years ago and known only from its type specimen. New records of a further 14 species are given for the Hawaiian Islands. These 17 taxa bring the total number of species of brown algae recorded for the Hawaiian Islands to 55, an increase of 28%. Of the 15 new records, two are recent ‘accidental’ introductions: Dictyota flabellata (Collins) Setchell et Gardner and Sargassum muticum (Yendo) Fensholt from California. Six records are notable because of their great distances from previously known collections: Nereia intricata Yamada from the Ryukyu Is., Japan; Discosporangium mesarthrocarpum (Meneghini) Hauck, from the Adriatic, Mediterranean, warm Atlantic and southern Australia; Distromium flabellatum Womersley, Spatoglossum macrodontum J. Agardh, and Sporochnus moorei Harvey, from Australia; Desmarestia ligulata (Lightfoot) Lamouroux from temperate and colder waters in the Pacific and Atlantic. A comparison with some Japanese species of Padina confirms that Padina japonica Yamada should be subsumed with Padina sanctae‐crucis Børgesen, as proposed earlier.