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Nahle S, Lutet-Toti C, Namikawa Y, Piet MH, Brion A, Peyroche S, Suzuki M, Marin F, Rousseau M. Organic Matrices of Calcium Carbonate Biominerals Improve Osteoblastic Mineralization. Mar Biotechnol (NY) 2024:10.1007/s10126-024-10316-w. [PMID: 38652191 DOI: 10.1007/s10126-024-10316-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/10/2024] [Indexed: 04/25/2024]
Abstract
Many organisms incorporate inorganic solids into their tissues to improve functional and mechanical properties. The resulting mineralized tissues are called biominerals. Several studies have shown that nacreous biominerals induce osteoblastic extracellular mineralization. Among them, Pinctada margaritifera is well known for the ability of its organic matrix to stimulate bone cells. In this context, we aimed to study the effects of shell extracts from three other Pinctada species (Pinctada radiata, Pinctada maxima, and Pinctada fucata) on osteoblastic extracellular matrix mineralization, by using an in vitro model of mouse osteoblastic precursor cells (MC3T3-E1). For a better understanding of the Pinctada-bone mineralization relationship, we evaluated the effects of 4 other nacreous mollusks that are phylogenetically distant and distinct from the Pinctada genus. In addition, we tested 12 non-nacreous mollusks and one extra-group. Biomineral shell powders were prepared, and their organic matrix was partially extracted using ethanol. Firstly, the effect of these powders and extracts was assessed on the viability of MC3T3-E1. Our results indicated that neither the powder nor the ethanol-soluble matrix (ESM) affected cell viability at low concentrations. Then, we evaluated osteoblastic mineralization using Alizarin Red staining and we found a prominent MC3T3-E1 mineralization mainly induced by nacreous biominerals, especially those belonging to the Pinctada genus. However, few non-nacreous biominerals were also able to stimulate the extracellular mineralization. Overall, our findings validate the remarkable ability of CaCO3 biomineral extracts to promote bone mineralization. Nevertheless, further in vitro and in vivo studies are needed to uncover the mechanisms of action of biominerals in bone.
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Affiliation(s)
- Sarah Nahle
- Jean Monnet University Saint-Étienne, INSERM, Mines Saint Etienne, SAINBIOSE U1059, Saint-Étienne, France
| | - Camille Lutet-Toti
- Biogeosciences Laboratory, UMR CNRS-EPHE 6282, University of Burgundy, Dijon, France
- Dipartimento di Chimica "Giacomo Ciamician", Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Yuto Namikawa
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo, 113-8657, Japan
| | - Marie-Hélène Piet
- UMR 7365 CNRS-University of Lorraine, Molecular Engineering & Articular Pathophysiology (IMoPA), Vandœuvre-lès-Nancy, France
| | - Alice Brion
- Laboratory of Genome Structure and Instability, National Museum of Natural History (MNHN), INSERM, U1154, CNRS UMR7196, Paris, France
| | - Sylvie Peyroche
- Jean Monnet University Saint-Étienne, INSERM, Mines Saint Etienne, SAINBIOSE U1059, Saint-Étienne, France
| | - Michio Suzuki
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo, 113-8657, Japan
| | - Frédéric Marin
- Biogeosciences Laboratory, UMR CNRS-EPHE 6282, University of Burgundy, Dijon, France
| | - Marthe Rousseau
- Jean Monnet University Saint-Étienne, INSERM, Mines Saint Etienne, SAINBIOSE U1059, Saint-Étienne, France.
- UMR5510 MATEIS, CNRS, University of Lyon, INSA-Lyon, Lyon, France.
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Létocart AJ, Svensson RB, Mabesoone F, Charleux F, Marin F, Dermigny Q, Magnusson SP, Couppé C, Grosset JF. Structure and function of Achilles and patellar tendons following moderate slow resistance training in young and old men. Eur J Appl Physiol 2024:10.1007/s00421-024-05461-y. [PMID: 38649478 DOI: 10.1007/s00421-024-05461-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 03/05/2024] [Indexed: 04/25/2024]
Abstract
The aim of this study was to investigate the effect of aging and resistance training with a moderate load on the size and mechanical properties of the patellar (PT) and Achilles tendon (AT) and their associated aponeuroses; medial gastrocnemius (MG) and vastus lateralis (VL). Young (Y55; 24.8 ± 3.8 yrs, n = 11) and old men (O55; 70.0 ± 4.6 yrs, n = 13) were assigned to undergo a training program (12 weeks; 3 times/week) of moderate slow resistance training [55% of one repetition maximum (RM)] of the triceps surae and quadriceps muscles. Tendon dimensions were assessed using 1.5 T magnetic resonance imaging before and after 12 weeks. AT and PT cross sectional area (CSA) were determined every 10% of tendon length. Mechanical properties of the free AT, MG aponeurosis, PT, and VL aponeurosis were assessed using ultrasonography (deformation) and tendon force measurements. CSA of the AT but not PT was greater in O55 compared with Y55. At baseline, mechanical properties were generally lower in O55 than Y55 for AT, MG aponeurosis and VL aponeurosis (Young's modulus) but not for PT. CSA of the AT and PT increased equally in both groups following training. Further, for a given force, stiffness and Young's modulus also increased equally for VL aponeurosis and AT, for boths groups. The present study highlights that except for the PT, older men have lower tendon (AT, MG aponeurosis, and VL aponeurosis) mechanical properties than young men and 12-weeks of moderate slow resistance training appears sufficient to improve tendon size and mechanical adaptations in both young and older men. New and Noteworthy: These novel findings suggest that short-term moderate slow resistance training induces equal improvements in tendon size and mechanics regardless of age.
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Affiliation(s)
- Adrien J Létocart
- UMR CNRS 7338 Biomécanique et Bioingénierie, Sorbonne Universités, Université de Technologie de Compiègne, 60205, Compiègne Cedex, France.
| | - René B Svensson
- Department of Physical and Occupational Therapy, Bispebjerg-Frederiksberg Hospitals, Copenhagen, Denmark
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Frédéric Marin
- UMR CNRS 7338 Biomécanique et Bioingénierie, Sorbonne Universités, Université de Technologie de Compiègne, 60205, Compiègne Cedex, France
| | - Quentin Dermigny
- UMR CNRS 7338 Biomécanique et Bioingénierie, Sorbonne Universités, Université de Technologie de Compiègne, 60205, Compiègne Cedex, France
| | - S Peter Magnusson
- Department of Physical and Occupational Therapy, Bispebjerg-Frederiksberg Hospitals, Copenhagen, Denmark
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Couppé
- Department of Physical and Occupational Therapy, Bispebjerg-Frederiksberg Hospitals, Copenhagen, Denmark
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jean-François Grosset
- UMR CNRS 7338 Biomécanique et Bioingénierie, Sorbonne Universités, Université de Technologie de Compiègne, 60205, Compiègne Cedex, France.
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Lutet-Toti C, Da Silva Feliciano M, Debrosse N, Thomas J, Plasseraud L, Marin F. Diverting the Use of Hand-Operated Tablet Press Machines to Bioassays: A Novel Protocol to Test 'Waste' Insoluble Shell Matrices. Methods Protoc 2024; 7:30. [PMID: 38668137 DOI: 10.3390/mps7020030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/21/2024] [Accepted: 03/26/2024] [Indexed: 04/29/2024] Open
Abstract
To mineralize their shells, molluscs secrete a complex cocktail of proteins-collectively defined as the calcifying shell matrix-that remains occluded in the exoskeleton. Nowadays, protein extracts from shells are recognized as a potential source of bioactive substances, among which signalling molecules, bactericides or protease inhibitors offer the most tangible perspectives in applied sciences, health, and aquaculture. However, one technical obstacle in testing the activity of shell extracts lies in their high insolubility. In this paper, we present a protocol that circumvents this impediment. After an adapted shell protein extraction and the production of two organic fractions-one soluble, one insoluble-we employ a hand-operated tablet press machine to generate well-calibrated tablets composed of 100% insoluble shell matrix. FT-IR monitoring of the quality of the tablets shows that the pressure used in the press machine does not impair the molecular properties of the insoluble extracts. The produced tablets can be directly tested in different biological assays, such as the bactericidal inhibition zone assay in Petri dish, as illustrated here. Diverting the use of the hand-operated tablet press opens new perspectives in the analysis of insoluble shell matrices, for discovering novel bioactive components.
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Affiliation(s)
- Camille Lutet-Toti
- UMR CNRS-uB-EPHE 6282 'Biogéosciences', Université de Bourgogne, 21000 Dijon, France
- Dipartimento di Chimica "Giacomo Ciamician", Alma Mater Studiorum Università di Bologna, 40126 Bologna, Italy
| | | | - Nelly Debrosse
- UMR CNRS-uB-EPHE 6282 'Biogéosciences', Université de Bourgogne, 21000 Dijon, France
| | - Jérôme Thomas
- UMR CNRS-uB-EPHE 6282 'Biogéosciences', Université de Bourgogne, 21000 Dijon, France
| | - Laurent Plasseraud
- Institut de Chimie Moléculaire de l'Université de Bourgogne, ICMUB UMR CNRS-uB 6302, 21000 Dijon, France
| | - Frédéric Marin
- UMR CNRS-uB-EPHE 6282 'Biogéosciences', Université de Bourgogne, 21000 Dijon, France
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Giraudet C, Moiroud C, Beaumont A, Gaulmin P, Hatrisse C, Azevedo E, Denoix JM, Ben Mansour K, Martin P, Audigié F, Chateau H, Marin F. Development of a Methodology for Low-Cost 3D Underwater Motion Capture: Application to the Biomechanics of Horse Swimming. Sensors (Basel) 2023; 23:8832. [PMID: 37960531 PMCID: PMC10647488 DOI: 10.3390/s23218832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023]
Abstract
Hydrotherapy has been utilized in horse rehabilitation programs for over four decades. However, a comprehensive description of the swimming cycle of horses is still lacking. One of the challenges in studying this motion is 3D underwater motion capture, which holds potential not only for understanding equine locomotion but also for enhancing human swimming performance. In this study, a marker-based system that combines underwater cameras and markers drawn on horses is developed. This system enables the reconstruction of the 3D motion of the front and hind limbs of six horses throughout an entire swimming cycle, with a total of twelve recordings. The procedures for pre- and post-processing the videos are described in detail, along with an assessment of the estimated error. This study estimates the reconstruction error on a checkerboard and computes an estimated error of less than 10 mm for segments of tens of centimeters and less than 1 degree for angles of tens of degrees. This study computes the 3D joint angles of the front limbs (shoulder, elbow, carpus, and front fetlock) and hind limbs (hip, stifle, tarsus, and hind fetlock) during a complete swimming cycle for the six horses. The ranges of motion observed are as follows: shoulder: 17 ± 3°; elbow: 76 ± 11°; carpus: 99 ± 10°; front fetlock: 68 ± 12°; hip: 39 ± 3°; stifle: 68 ± 7°; tarsus: 99 ± 6°; hind fetlock: 94 ± 8°. By comparing the joint angles during a swimming cycle to those observed during classical gaits, this study reveals a greater range of motion (ROM) for most joints during swimming, except for the front and hind fetlocks. This larger ROM is usually achieved through a larger maximal flexion angle (smaller minimal angle of the joints). Finally, the versatility of the system allows us to imagine applications outside the scope of horses, including other large animals and even humans.
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Affiliation(s)
- Chloé Giraudet
- Laboratoire de BioMécanique et BioIngénierie (UMR CNRS 7338), Centre of Excellence for Human and Animal Movement Biomechanics (CoEMoB), Université de Technologie de Compiègne (UTC), Alliance Sorbonne Université, 60200 Compiègne, France; (C.G.); (K.B.M.)
| | - Claire Moiroud
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (C.M.); (A.B.); (P.G.); (C.H.); (J.-M.D.); (H.C.)
| | - Audrey Beaumont
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (C.M.); (A.B.); (P.G.); (C.H.); (J.-M.D.); (H.C.)
| | - Pauline Gaulmin
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (C.M.); (A.B.); (P.G.); (C.H.); (J.-M.D.); (H.C.)
| | - Chloé Hatrisse
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (C.M.); (A.B.); (P.G.); (C.H.); (J.-M.D.); (H.C.)
- Univ Lyon, Univ Gustave Eiffel, Univ Claude Bernard Lyon 1, LBMC UMR_T 9406, 69622 Lyon, France
| | - Emeline Azevedo
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (C.M.); (A.B.); (P.G.); (C.H.); (J.-M.D.); (H.C.)
| | - Jean-Marie Denoix
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (C.M.); (A.B.); (P.G.); (C.H.); (J.-M.D.); (H.C.)
| | - Khalil Ben Mansour
- Laboratoire de BioMécanique et BioIngénierie (UMR CNRS 7338), Centre of Excellence for Human and Animal Movement Biomechanics (CoEMoB), Université de Technologie de Compiègne (UTC), Alliance Sorbonne Université, 60200 Compiègne, France; (C.G.); (K.B.M.)
| | - Pauline Martin
- LIM France, Chemin Fontaine de Fanny, 24300 Nontron, France
| | - Fabrice Audigié
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (C.M.); (A.B.); (P.G.); (C.H.); (J.-M.D.); (H.C.)
| | - Henry Chateau
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (C.M.); (A.B.); (P.G.); (C.H.); (J.-M.D.); (H.C.)
| | - Frédéric Marin
- Laboratoire de BioMécanique et BioIngénierie (UMR CNRS 7338), Centre of Excellence for Human and Animal Movement Biomechanics (CoEMoB), Université de Technologie de Compiègne (UTC), Alliance Sorbonne Université, 60200 Compiègne, France; (C.G.); (K.B.M.)
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Macaire C, Hanne-Poujade S, De Azevedo E, Denoix JM, Coudry V, Jacquet S, Bertoni L, Tallaj A, Audigié F, Hatrisse C, Hébert C, Martin P, Marin F, Chateau H. Asymmetry Thresholds Reflecting the Visual Assessment of Forelimb Lameness on Circles on a Hard Surface. Animals (Basel) 2023; 13:3319. [PMID: 37958073 PMCID: PMC10650068 DOI: 10.3390/ani13213319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
The assessment of lameness in horses can be aided by objective gait analysis tools. Despite their key role of evaluating a horse at trot on a circle, asymmetry thresholds have not been determined for differentiating between sound and lame gait during this exercise. These thresholds are essential to distinguish physiological asymmetry linked to the circle from pathological asymmetry linked to lameness. This study aims to determine the Asymmetry Indices (AIs) with the highest power to discriminate between a group of sound horses and a group of horses with consistent unilateral lameness across both circle directions, as categorized by visual lameness assessment conducted by specialist veterinarians. Then, thresholds were defined for the best performing AIs, based on the optimal sensitivity and specificity. AIs were calculated as the relative comparison between left and right minima, maxima, time between maxima and upward amplitudes of the vertical displacement of the head and the withers. Except the AI of maxima difference, the head AI showed the highest sensitivity (≥69%) and the highest specificity (≥81%) for inside forelimb lameness detection and the withers AI showed the highest sensitivity (≥72%) and the highest specificity (≥77%) for outside forelimb lameness detection on circles.
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Affiliation(s)
- Claire Macaire
- Labcom LIM-ENVA, LIM France, 24300 Nontron, France; (C.M.)
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France
- Laboratoire de BioMécanique et BioIngénierie (UMR CNRS 7338), Centre of Excellence for Human and Animal Movement Biomechanics (CoEMoB), Université de Technologie de Compiègne (UTC), Alliance Sorbonne Université, 60200 Compiègne, France
| | | | - Emeline De Azevedo
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France
| | - Jean-Marie Denoix
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France
| | - Virginie Coudry
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France
| | - Sandrine Jacquet
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France
| | - Lélia Bertoni
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France
| | - Amélie Tallaj
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France
| | - Fabrice Audigié
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France
| | - Chloé Hatrisse
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France
| | - Camille Hébert
- Labcom LIM-ENVA, LIM France, 24300 Nontron, France; (C.M.)
| | - Pauline Martin
- Labcom LIM-ENVA, LIM France, 24300 Nontron, France; (C.M.)
| | - Frédéric Marin
- Laboratoire de BioMécanique et BioIngénierie (UMR CNRS 7338), Centre of Excellence for Human and Animal Movement Biomechanics (CoEMoB), Université de Technologie de Compiègne (UTC), Alliance Sorbonne Université, 60200 Compiègne, France
| | - Henry Chateau
- CIRALE, USC 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France
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Khurshid B, Lesniewska E, Polacchi L, L'Héronde M, Jackson DJ, Motreuil S, Thomas J, Bardeau JF, Wolf SE, Vielzeuf D, Perrin J, Marin F. In situ mapping of biomineral skeletal proteins by molecular recognition imaging with antibody-functionalized AFM tips. Acta Biomater 2023; 168:198-209. [PMID: 37490960 DOI: 10.1016/j.actbio.2023.07.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 07/27/2023]
Abstract
Spatial localizing of skeletal proteins in biogenic minerals remains a challenge in biomineralization research. To address this goal, we developed a novel in situ mapping technique based on molecular recognition measurements via atomic force microscopy (AFM), which requires three steps: (1) the development and purification of a polyclonal antibody elicited against the target protein, (2) its covalent coupling to a silicon nitride AFM tip ('functionalization'), and (3) scanning of an appropriately prepared biomineral surface. We applied this approach to a soluble shell protein - accripin11 - recently identified as a major component of the calcitic prisms of the fan mussel Pinna nobilis [1]. Multiple tests reveal that accripin11 is evenly distributed at the surface of the prisms and also present in the organic sheaths surrounding the calcitic prisms, indicating that this protein is both intra- and inter-crystalline. We observed that the adhesion force in transverse sections is about twice higher than in longitudinal sections, suggesting that accripin11 may exhibit preferred orientation in the biomineral. To our knowledge, this is the first time that a protein is localized by molecular recognition atomic force microscopy with antibody-functionalized tips in a biogenic mineral. The 'pros' and 'cons' of this methodology are discussed in comparison with more 'classical' approaches like immunogold. This technique, which leaves the surface to analyze clean, might prove useful for clinical tests on non-pathological (bone, teeth) or pathological (kidney stone) biomineralizations. Studies using implants with protein-doped calcium phosphate coating can also benefit from this technology. STATEMENT OF SIGNIFICANCE: Our paper deals with an unconventional technical approach for localizing proteins that are occluded in biominerals. This technique relies on the use of molecular recognition atomic force microscopy with antibody-functionalized tips. Although such approach has been employed in other system, this is the very first time that it is developed for biominerals. In comparison to more classical approaches (such as immunogold), AFM microscopy with antibody-functionalized tips allows higher magnification and keeps the scanned surface clean for other biophysical characterizations. Our method has a general scope as it can be applied in human health, for non-pathological (bone, teeth) and pathological (kidney stone) biomineralizations as well as for bone implants coated with protein-doped calcium phosphate.
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Affiliation(s)
- Benazir Khurshid
- Laboratoire Biogéosciences, UMR CNRS-EPHE 6282, University of Burgundy, Dijon, France; Synchrotron SOLEIL, Beamline ANATOMIX, Saint-Aubin, Gif-sur-Yvette, France
| | - Eric Lesniewska
- Laboratoire Interdisciplinaire Carnot de Bourgogne (ICB), UMR CNRS 6303, University of Burgundy, Dijon, France
| | - Luca Polacchi
- IPANEMA, USR3461, CNRS/MCC, Saint-Aubin, Gif-sur-Yvette, France; CR2P UMR7207, Muséum National d'Histoire Naturelle, Paris, France
| | - Maëva L'Héronde
- IPANEMA, USR3461, CNRS/MCC, Saint-Aubin, Gif-sur-Yvette, France
| | - Daniel J Jackson
- Department of Geobiology, Georg-August University of Göttingen, Göttingen, Germany
| | - Sébastien Motreuil
- Laboratoire Biogéosciences, UMR CNRS-EPHE 6282, University of Burgundy, Dijon, France
| | - Jérôme Thomas
- Laboratoire Biogéosciences, UMR CNRS-EPHE 6282, University of Burgundy, Dijon, France
| | | | - Stephan E Wolf
- Institute of Glass and Ceramics, Dpt. Materials Science & Engineering, Friedrich-Alexander-University, Erlangen, Germany
| | | | - Jonathan Perrin
- Synchrotron SOLEIL, Beamline ANATOMIX, Saint-Aubin, Gif-sur-Yvette, France
| | - Frédéric Marin
- Laboratoire Biogéosciences, UMR CNRS-EPHE 6282, University of Burgundy, Dijon, France.
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7
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Marin F, Churazov E, Khabibullin I, Ferrazzoli R, Di Gesu L, Barnouin T, Di Marco A, Middei R, Vikhlinin A, Costa E, Soffitta P, Muleri F, Sunyaev R, Forman W, Kraft R, Bianchi S, Donnarumma I, Petrucci PO, Enoto T, Agudo I, Antonelli LA, Bachetti M, Baldini L, Baumgartner WH, Bellazzini R, Bongiorno SD, Bonino R, Brez A, Bucciantini N, Capitanio F, Castellano S, Cavazzuti E, Chen CT, Ciprini S, De Rosa A, Del Monte E, Di Lalla N, Doroshenko V, Dovčiak M, Ehlert SR, Evangelista Y, Fabiani S, Garcia JA, Gunji S, Hayashida K, Heyl J, Ingram A, Iwakiri W, Jorstad SG, Kaaret P, Karas V, Kitaguchi T, Kolodziejczak JJ, Krawczynski H, La Monaca F, Latronico L, Liodakis I, Maldera S, Manfreda A, Marinucci A, Marscher AP, Marshall HL, Massaro F, Matt G, Mitsuishi I, Mizuno T, Negro M, Ng CY, O'Dell SL, Omodei N, Oppedisano C, Papitto A, Pavlov GG, Peirson AL, Perri M, Pesce-Rollins M, Pilia M, Possenti A, Poutanen J, Puccetti S, Ramsey BD, Rankin J, Ratheesh A, Roberts OJ, Romani RW, Sgrò C, Slane P, Spandre G, Swartz D, Tamagawa T, Tavecchio F, Taverna R, Tawara Y, Tennant AF, Thomas NE, Tombesi F, Trois A, Tsygankov SS, Turolla R, Vink J, Weisskopf MC, Wu K, Xie F, Zane S. X-ray polarization evidence for a 200-year-old flare of Sgr A . Nature 2023:10.1038/s41586-023-06064-x. [PMID: 37344593 DOI: 10.1038/s41586-023-06064-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/07/2023] [Indexed: 06/23/2023]
Abstract
The centre of the Milky Way Galaxy hosts a black hole with a solar mass of about 4 million (Sagittarius A* (Sgr A)) that is very quiescent at present with a luminosity many orders of magnitude below those of active galactic nuclei1. Reflection of X-rays from Sgr A* by dense gas in the Galactic Centre region offers a means to study its past flaring activity on timescales of hundreds and thousands of years2. The shape of the X-ray continuum and the strong fluorescent iron line observed from giant molecular clouds in the vicinity of Sgr A* are consistent with the reflection scenario3-5. If this interpretation is correct, the reflected continuum emission should be polarized6. Here we report observations of polarized X-ray emission in the direction of the molecular clouds in the Galactic Centre using the Imaging X-ray Polarimetry Explorer. We measure a polarization degree of 31% ± 11%, and a polarization angle of -48° ± 11°. The polarization angle is consistent with Sgr A* being the primary source of the emission, and the polarization degree implies that some 200 years ago, the X-ray luminosity of Sgr A* was briefly comparable to that of a Seyfert galaxy.
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Affiliation(s)
- Frédéric Marin
- Université de Strasbourg, CNRS, Observatoire Astronomique de Strasbourg, UMR 7550, Strasbourg, France.
| | - Eugene Churazov
- Max Planck Institute for Astrophysics, Garching, Germany
- Space Research Institute of the Russian Academy of Sciences, Moscow, Russia
| | - Ildar Khabibullin
- Max Planck Institute for Astrophysics, Garching, Germany
- Space Research Institute of the Russian Academy of Sciences, Moscow, Russia
- Universitäts-Sternwarte, Fakultät für Physik, Ludwig-Maximilians-Universität München, Munich, Germany
| | | | | | - Thibault Barnouin
- Université de Strasbourg, CNRS, Observatoire Astronomique de Strasbourg, UMR 7550, Strasbourg, France
| | | | - Riccardo Middei
- Space Science Data Center, Agenzia Spaziale Italiana, Rome, Italy
- INAF Osservatorio Astronomico di Roma, Monte Porzio Catone, Italy
| | - Alexey Vikhlinin
- Space Research Institute of the Russian Academy of Sciences, Moscow, Russia
- Center for Astrophysics, Harvard & Smithsonian, Cambridge, MA, USA
| | - Enrico Costa
- INAF Istituto di Astrofisica e Planetologia Spaziali, Rome, Italy
| | - Paolo Soffitta
- INAF Istituto di Astrofisica e Planetologia Spaziali, Rome, Italy
| | - Fabio Muleri
- INAF Istituto di Astrofisica e Planetologia Spaziali, Rome, Italy
| | - Rashid Sunyaev
- Max Planck Institute for Astrophysics, Garching, Germany
- Space Research Institute of the Russian Academy of Sciences, Moscow, Russia
| | - William Forman
- Center for Astrophysics, Harvard & Smithsonian, Cambridge, MA, USA
| | - Ralph Kraft
- Center for Astrophysics, Harvard & Smithsonian, Cambridge, MA, USA
| | - Stefano Bianchi
- Dipartimento di Matematica e Fisica, Università degli Studi Roma Tre, Rome, Italy
| | | | | | | | - Iván Agudo
- Instituto de Astrofísica de Andalucía-CSIC, Granada, Spain
| | - Lucio A Antonelli
- Space Science Data Center, Agenzia Spaziale Italiana, Rome, Italy
- INAF Osservatorio Astronomico di Roma, Monte Porzio Catone, Italy
| | | | - Luca Baldini
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Pisa, Italy
- Dipartimento di Fisica, Università di Pisa, Pisa, Italy
| | | | | | | | - Raffaella Bonino
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, Turin, Italy
- Dipartimento di Fisica, Università degli Studi di Torino, Turin, Italy
| | - Alessandro Brez
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Pisa, Italy
| | - Niccolò Bucciantini
- INAF Osservatorio Astrofisico di Arcetri, Florence, Italy
- Dipartimento di Fisica e Astronomia, Università degli Studi di Firenze, Sesto Fiorentino, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Firenze, Sesto Fiorentino, Italy
| | - Fiamma Capitanio
- INAF Istituto di Astrofisica e Planetologia Spaziali, Rome, Italy
| | | | | | - Chien-Ting Chen
- Science and Technology Institute, Universities Space Research Association, Huntsville, AL, USA
| | - Stefano Ciprini
- Space Science Data Center, Agenzia Spaziale Italiana, Rome, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma "Tor Vergata", Rome, Italy
| | | | - Ettore Del Monte
- INAF Istituto di Astrofisica e Planetologia Spaziali, Rome, Italy
| | - Niccolò Di Lalla
- Department of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA, USA
| | - Victor Doroshenko
- Institut für Astronomie und Astrophysik, Universität Tübingen, Tübingen, Germany
| | - Michal Dovčiak
- Astronomical Institute of the Czech Academy of Sciences, Prague 4, Czech Republic
| | | | - Yuri Evangelista
- INAF Istituto di Astrofisica e Planetologia Spaziali, Rome, Italy
| | - Sergio Fabiani
- INAF Istituto di Astrofisica e Planetologia Spaziali, Rome, Italy
| | | | | | | | - Jeremy Heyl
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Adam Ingram
- School of Mathematics, Statistics and Physics, Newcastle University, Newcastle upon Tyne, UK
| | - Wataru Iwakiri
- Department of Physics, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
- International Center for Hadron Astrophysics, Chiba University, Chiba, Japan
| | - Svetlana G Jorstad
- Institute for Astrophysical Research, Boston University, Boston, MA, USA
- Department of Astrophysics, St. Petersburg State University, St Petersburg, Russia
| | - Philip Kaaret
- NASA Marshall Space Flight Center, Huntsville, AL, USA
- Department of Physics and Astronomy, University of Iowa, Iowa City, IA, USA
| | - Vladimir Karas
- Astronomical Institute of the Czech Academy of Sciences, Prague 4, Czech Republic
| | | | | | - Henric Krawczynski
- Physics Department and McDonnell Center for the Space Sciences, Washington University in St. Louis, St Louis, MO, USA
| | - Fabio La Monaca
- INAF Istituto di Astrofisica e Planetologia Spaziali, Rome, Italy
| | - Luca Latronico
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, Turin, Italy
| | - Ioannis Liodakis
- Finnish Centre for Astronomy with ESO, University of Turku, Turku, Finland
| | - Simone Maldera
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, Turin, Italy
| | - Alberto Manfreda
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Pisa, Italy
| | | | - Alan P Marscher
- Institute for Astrophysical Research, Boston University, Boston, MA, USA
| | - Herman L Marshall
- MIT Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Francesco Massaro
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, Turin, Italy
- Dipartimento di Fisica, Università degli Studi di Torino, Turin, Italy
| | - Giorgio Matt
- Dipartimento di Matematica e Fisica, Università degli Studi Roma Tre, Rome, Italy
| | - Ikuyuki Mitsuishi
- Graduate School of Science, Division of Particle and Astrophysical Science, Nagoya University, Nagoya, Japan
| | - Tsunefumi Mizuno
- Hiroshima Astrophysical Science Center, Hiroshima University, Higashi-Hiroshima, Japan
| | - Michela Negro
- University of Maryland, Baltimore County, Baltimore, MD, USA
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
- Center for Research and Exploration in Space Science and Technology, NASA/GSFC, Greenbelt, MD, USA
| | - C-Y Ng
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Nicola Omodei
- Department of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA, USA
| | - Chiara Oppedisano
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, Turin, Italy
| | | | - George G Pavlov
- Department of Astronomy and Astrophysics, Pennsylvania State University, University Park, PA, USA
| | - Abel L Peirson
- Department of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA, USA
| | - Matteo Perri
- Space Science Data Center, Agenzia Spaziale Italiana, Rome, Italy
- INAF Osservatorio Astronomico di Roma, Monte Porzio Catone, Italy
| | | | - Maura Pilia
- INAF Osservatorio Astronomico di Cagliari, Selargius, Italy
| | | | - Juri Poutanen
- Department of Physics and Astronomy, University of Turku, Turku, Finland
| | | | | | - John Rankin
- INAF Istituto di Astrofisica e Planetologia Spaziali, Rome, Italy
| | - Ajay Ratheesh
- INAF Istituto di Astrofisica e Planetologia Spaziali, Rome, Italy
| | - Oliver J Roberts
- Science and Technology Institute, Universities Space Research Association, Huntsville, AL, USA
| | - Roger W Romani
- Department of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA, USA
| | - Carmelo Sgrò
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Pisa, Italy
| | - Patrick Slane
- Center for Astrophysics, Harvard & Smithsonian, Cambridge, MA, USA
| | - Gloria Spandre
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Pisa, Italy
| | - Doug Swartz
- Science and Technology Institute, Universities Space Research Association, Huntsville, AL, USA
| | | | | | - Roberto Taverna
- Dipartimento di Fisica e Astronomia, Università degli Studi di Padova, Padua, Italy
| | - Yuzuru Tawara
- Graduate School of Science, Division of Particle and Astrophysical Science, Nagoya University, Nagoya, Japan
| | | | | | - Francesco Tombesi
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma "Tor Vergata", Rome, Italy
- Dipartimento di Fisica, Università degli Studi di Roma "Tor Vergata", Rome, Italy
- Department of Astronomy, University of Maryland, College Park, MD, USA
| | - Alessio Trois
- INAF Osservatorio Astronomico di Cagliari, Selargius, Italy
| | - Sergey S Tsygankov
- Department of Physics and Astronomy, University of Turku, Turku, Finland
| | - Roberto Turolla
- Dipartimento di Fisica e Astronomia, Università degli Studi di Padova, Padua, Italy
- Mullard Space Science Laboratory, University College London, Dorking, UK
| | - Jacco Vink
- Anton Pannekoek Institute for Astronomy & GRAPPA, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Kinwah Wu
- Mullard Space Science Laboratory, University College London, Dorking, UK
| | - Fei Xie
- INAF Istituto di Astrofisica e Planetologia Spaziali, Rome, Italy
- Guangxi Key Laboratory for Relativistic Astrophysics, School of Physical Science and Technology, Guangxi University, Nanning, China
| | - Silvia Zane
- Mullard Space Science Laboratory, University College London, Dorking, UK
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8
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Ranfagni A, Marino F, Marin F. Spectral Analysis of Quantum Field Fluctuations in a Strongly Coupled Optomechanical System. Phys Rev Lett 2023; 130:193601. [PMID: 37243649 DOI: 10.1103/physrevlett.130.193601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/02/2023] [Accepted: 04/19/2023] [Indexed: 05/29/2023]
Abstract
With a levitodynamics experiment in the strong and coherent quantum optomechanical coupling regime, we demonstrate that the oscillator acts as a broadband quantum spectrum analyzer. The asymmetry between positive and negative frequency branches in the displacement spectrum traces out the spectral features of the quantum fluctuations in the cavity field, which are thus explored over a wide spectral range. Moreover, in our two-dimensional mechanical system the quantum backaction, generated by such vacuum fluctuations, is strongly suppressed in a narrow spectral region due to a destructive interference in the overall susceptibility.
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Affiliation(s)
- A Ranfagni
- Dipartimento di Fisica e Astronomia, Università di Firenze, via Sansone 1, I-50019 Sesto Fiorentino (FI), Italy
- European Laboratory for Non-Linear Spectroscopy (LENS), via Carrara 1, I-50019 Sesto Fiorentino (FI), Italy
- INFN, Sezione di Firenze, via Sansone 1, I-50019 Sesto Fiorentino (FI), Italy
| | - F Marino
- INFN, Sezione di Firenze, via Sansone 1, I-50019 Sesto Fiorentino (FI), Italy
- CNR-INO, largo Enrico Fermi 6, I-50125 Firenze, Italy
| | - F Marin
- Dipartimento di Fisica e Astronomia, Università di Firenze, via Sansone 1, I-50019 Sesto Fiorentino (FI), Italy
- European Laboratory for Non-Linear Spectroscopy (LENS), via Carrara 1, I-50019 Sesto Fiorentino (FI), Italy
- INFN, Sezione di Firenze, via Sansone 1, I-50019 Sesto Fiorentino (FI), Italy
- CNR-INO, largo Enrico Fermi 6, I-50125 Firenze, Italy
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9
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Sarhan FR, Olivetto M, Ben Mansour K, Neiva C, Colin E, Choteau B, Marie JP, Testelin S, Marin F, Dakpé S. Quantified analysis of facial movement: A reference for clinical applications. Clin Anat 2023; 36:492-502. [PMID: 36625484 DOI: 10.1002/ca.23999] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 12/21/2022] [Accepted: 12/24/2022] [Indexed: 01/11/2023]
Abstract
Most techniques for evaluating unilateral impairments in facial movement yield subjective measurements. The objective of the present study was to define a reference dataset and develop a visualization tool for clinical assessments. In this prospective study, a motion capture system was used to quantify facial movements in 30 healthy adults and 2 patients. We analyzed the displacements of 105 reflective markers placed on the participant's face during five movements (M1-M5). For each marker, the primary endpoint was the maximum amplitude of displacement from the static position (M0) in an analysis of variance. The measurement precision was 0.1 mm. Significant displacements of markers were identified for M1-M5, and displacement patterns were defined. The patients and age-matched healthy participants were compared with regard to the amplitude of displacement. We created a new type of radar plot to visually represent the diagnosis and facilitate effective communication between medical professionals. In proof-of-concept experiments, we collected quantitative data on patients with facial palsy and created a patient-specific radar plot. Our new protocol for clinical facial motion capture ("quantified analysis of facial movement," QAFM) was accurate and should thus facilitate the long-term clinical follow-up of patients with facial palsy. To take account of the limitations affecting the comparison with the healthy side, we created a dataset of healthy facial movements; our method might therefore be applicable to other conditions in which movements on one or both sides of the face are impaired. The patient-specific radar plot enables clinicians to read and understand the results rapidly.
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Affiliation(s)
- François-Régis Sarhan
- UR 7516 CHIMERE, Université de Picardie Jules Verne, Amiens, France.,Maxillofacial Surgery Department, CHU Amiens-Picardie, Amiens, France.,Institut Faire Faces, CHU Amiens-Picardie, Amiens, France.,Physiotherapy School, CHU Amiens-Picardie, Amiens, France
| | - Matthieu Olivetto
- UR 7516 CHIMERE, Université de Picardie Jules Verne, Amiens, France.,Maxillofacial Surgery Department, CHU Amiens-Picardie, Amiens, France.,Institut Faire Faces, CHU Amiens-Picardie, Amiens, France
| | - Khalil Ben Mansour
- UMR CNRS 7338, Biomécanique et Bioingénierie, Université de Technologie de Compiègne, Sorbonne Université, Compiègne, France
| | - Cécilia Neiva
- Maxillofacial Surgery Department, Hôpital Necker APHP, Paris, France
| | - Emilien Colin
- UR 7516 CHIMERE, Université de Picardie Jules Verne, Amiens, France.,Maxillofacial Surgery Department, CHU Amiens-Picardie, Amiens, France.,Institut Faire Faces, CHU Amiens-Picardie, Amiens, France
| | - Baptiste Choteau
- Maxillofacial Surgery Department, CHU Amiens-Picardie, Amiens, France.,UMR CNRS 7338, Biomécanique et Bioingénierie, Université de Technologie de Compiègne, Sorbonne Université, Compiègne, France
| | - Jean-Paul Marie
- Otorhinolaryngology and Head and Neck Surgery, CHU Rouen Normandie, Hôpital Charles-Nicolles, Rouen, France.,EA3830 GRHV, Université de Rouen Normandie, Rouen, France
| | - Sylvie Testelin
- UR 7516 CHIMERE, Université de Picardie Jules Verne, Amiens, France.,Maxillofacial Surgery Department, CHU Amiens-Picardie, Amiens, France.,Institut Faire Faces, CHU Amiens-Picardie, Amiens, France
| | - Frédéric Marin
- UMR CNRS 7338, Biomécanique et Bioingénierie, Université de Technologie de Compiègne, Sorbonne Université, Compiègne, France
| | - Stéphanie Dakpé
- UR 7516 CHIMERE, Université de Picardie Jules Verne, Amiens, France.,Maxillofacial Surgery Department, CHU Amiens-Picardie, Amiens, France.,Institut Faire Faces, CHU Amiens-Picardie, Amiens, France
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10
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Tanguy D, Rametti-Lacroux A, Bouzigues A, Saracino D, Le Ber I, Godefroy V, Morandi X, Jannin P, Levy R, Batrancourt B, Migliaccio R, Azuar C, Dubois B, Lecouturier K, Araujo CM, Janvier E, Jourdain A, Rametti-Lacroux A, Coriou S, Brochard VB, Gaudebout C, Ferrand-Verdejo J, Bonnefous L, Pochan-Leva F, Jeanne L, Joulié M, Provost M, Renaud R, Hachemi S, Guillemot V, Bendetowicz D, Carle G, Socha J, Pineau F, Marin F, Liu Y, Mullot P, Mousli A, Blossier A, Visentin G, Tanguy D, Godefroy V, Sezer I, Boucly M, Cabrol-Douat B, Odobez R, Marque C, Tessereau-Barbot D, Raud A, Funkiewiez A, Chamayou C, Cognat E, Le Bozec M, Bouzigues A, Le Du V, Bombois S, Simard C, Fulcheri P, Guitton H, Peltier C, Lejeune FX, Jorgensen L, Mariani LL, Corvol JC, Valero-Cabre A, Garcin B, Volle E, Le Ber I, Migliaccio R, Levy R. Behavioural disinhibition in frontotemporal dementia investigated within an ecological framework. Cortex 2023; 160:152-166. [PMID: 36658040 DOI: 10.1016/j.cortex.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 09/29/2022] [Accepted: 11/09/2022] [Indexed: 12/29/2022]
Abstract
Disinhibition is a core symptom in behavioural variant frontotemporal dementia (bvFTD) particularly affecting the daily lives of both patients and caregivers. Yet, characterisation of inhibition disorders is still unclear and management options of these disorders are limited. Questionnaires currently used to investigate behavioural disinhibition do not differentiate between several subtypes of disinhibition, encompass observation biases and lack of ecological validity. In the present work, we explored disinhibition in an original semi-ecological situation, by distinguishing three categories of disinhibition: compulsivity, impulsivity and social disinhibition. First, we measured prevalence and frequency of these disorders in 23 bvFTD patients and 24 healthy controls (HC) in order to identify the phenotypical heterogeneity of disinhibition. Then, we examined the relationships between these metrics, the neuropsychological scores and the behavioural states to propose a more comprehensive view of these neuropsychiatric manifestations. Finally, we studied the context of occurrence of these disorders by investigating environmental factors potentially promoting or reducing them. As expected, we found that patients were more compulsive, impulsive and socially disinhibited than HC. We found that 48% of patients presented compulsivity (e.g., repetitive actions), 48% impulsivity (e.g., oral production) and 100% of the patients group showed social disinhibition (e.g., disregards for rules or investigator). Compulsivity was negatively related with emotions recognition. BvFTD patients were less active if not encouraged in an activity, and their social disinhibition decreased as activity increased. Finally, impulsivity and social disinhibition decreased when patients were asked to focus on a task. Summarising, this study underlines the importance to differentiate subtypes of disinhibition as well as the setting in which they are exhibited, and points to stimulating area for non-pharmacological management.
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Affiliation(s)
- Delphine Tanguy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - Armelle Rametti-Lacroux
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Arabella Bouzigues
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Dario Saracino
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtriѐre, Department of Neurology, IM2A, Paris, France
| | - Isabelle Le Ber
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtriѐre, Department of Neurology, IM2A, Paris, France
| | - Valérie Godefroy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Xavier Morandi
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - Pierre Jannin
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - Richard Levy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France; AP-HP, Groupe Hospitalier Pitié-Salpêtriѐre, Department of Neurology, IM2A, Paris, France
| | - Bénédicte Batrancourt
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France.
| | - Raffaella Migliaccio
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, FrontLab, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtriѐre, Department of Neurology, IM2A, Paris, France.
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11
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Imrani L, Boudaoud S, Lahaye C, Moreau C, Ghezal M, Ben Manaa S, Doulazmi M, Laforêt J, Marin F, Kinugawa K. High-density Surface Electromyography as Biomarker of Muscle Aging. J Gerontol A Biol Sci Med Sci 2023; 78:25-33. [PMID: 35876634 DOI: 10.1093/gerona/glac143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Indexed: 01/31/2023] Open
Abstract
Sarcopenia is a muscle disease with adverse changes that increase throughout the lifetime but with different chronological scales between individuals. Addressing "early muscle aging" is becoming a critical issue for prevention. Through the CHRONOS study, we demonstrated the ability of the high-density surface electromyography (HD-sEMG), a noninvasive, wireless, portable technology, to detect both healthy muscle aging and accelerated muscle aging related to a sedentary lifestyle, one of the risk factors of sarcopenia. The HD-sEMG signals were analyzed in 91 healthy young, middle-aged, and old subjects (25-75 years) distributed according to their physical activity status (82 active and 9 sedentary; International Physical Activity Questionnaire) and compared with current methods for muscle evaluation, including muscle mass (dual-energy X-ray absorptiometry [DXA], ultrasonography), handgrip strength, and physical performance. The HD-sEMG signals were recorded from the rectus femoris during sit-to-stand trials, and 2 indexes were analyzed: muscular contraction intensity and muscle contraction dynamics. The clinical parameters did not differ significantly across the aging and physical activity levels. Inversely, the HD-sEMG indexes were correlated to age and were different significantly through the age categories of the 82 active subjects. They were significantly different between sedentary subjects aged 45-54 years and active ones at the same age. The HD-sEMG indexes of sedentary subjects were not significantly different from those of older active subjects (≥55 years). The muscle thicknesses evaluated using ultrasonography were significantly different between the 5 age decades but did not show a significant difference with physical activity. The HD-sEMG technique can assess muscle aging and physical inactivity-related "early aging," outperforming clinical and DXA parameters.
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Affiliation(s)
- Loubna Imrani
- Université de Technologie de Compiègne (UTC), CNRS UMR 7338 Biomechanics and Bioengineering, Centre de Recherche de Royallieu- Alliance Sorbonne Université, Compiegne, France
| | - Sofiane Boudaoud
- Université de Technologie de Compiègne (UTC), CNRS UMR 7338 Biomechanics and Bioengineering, Centre de Recherche de Royallieu- Alliance Sorbonne Université, Compiegne, France
| | - Clément Lahaye
- Université Clermont Auvergne, INRAE UMR 1019 Human Nutrition Research Unit, CRNH Auvergne, CHU Clermont-Ferrand, Geriatrics Department, Clermont-Ferrand, France
| | - Caroline Moreau
- Sorbonne Université, CNRS, UMR Biological Adaptation and Aging, AP-HP, Charles Foix Hospital, Functional Exploration Unit for Older Patients, Ivry-sur-Seine, France
| | - Myriam Ghezal
- Sorbonne Université, CNRS, UMR Biological Adaptation and Aging, AP-HP, Charles Foix Hospital, Functional Exploration Unit for Older Patients, Ivry-sur-Seine, France
| | - Safa Ben Manaa
- Sorbonne Université, CNRS, UMR Biological Adaptation and Aging, AP-HP, Charles Foix Hospital, Functional Exploration Unit for Older Patients, Ivry-sur-Seine, France
| | - Mohamed Doulazmi
- Sorbonne University, CNRS, UMR 8256 Biological Adaptation and Aging, Paris, France
| | - Jérémy Laforêt
- Université de Technologie de Compiègne (UTC), CNRS UMR 7338 Biomechanics and Bioengineering, Centre de Recherche de Royallieu- Alliance Sorbonne Université, Compiegne, France
| | - Frédéric Marin
- Université de Technologie de Compiègne (UTC), CNRS UMR 7338 Biomechanics and Bioengineering, Centre de Recherche de Royallieu- Alliance Sorbonne Université, Compiegne, France
| | - Kiyoka Kinugawa
- Sorbonne Université, CNRS, UMR Biological Adaptation and Aging, AP-HP, Charles Foix Hospital, Functional Exploration Unit for Older Patients, Ivry-sur-Seine, France
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12
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Debiais-Thibaud M, Marin F, Marcellini S. Editorial: The evolution of biomineralization in metazoans. Front Genet 2023; 13:1092695. [PMID: 36685829 PMCID: PMC9848429 DOI: 10.3389/fgene.2022.1092695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023] Open
Affiliation(s)
- Mélanie Debiais-Thibaud
- Institut des Sciences de l’Evolution de Montpellier, ISEM, Univ Montpellier, CNRS, IRD, EPHE, Montpellier, France,*Correspondence: Mélanie Debiais-Thibaud, ; Frédéric Marin, ; Sylvain Marcellini,
| | - Frédéric Marin
- Laboratoire Biogéosciences, UMR CNRS-EPHE 6282, Université de Bourgogne—Franche-Comté, Dijon, France,*Correspondence: Mélanie Debiais-Thibaud, ; Frédéric Marin, ; Sylvain Marcellini,
| | - Sylvain Marcellini
- Laboratory of Development and Evolution (LADE), University of Concepción, Concepción, Chile,*Correspondence: Mélanie Debiais-Thibaud, ; Frédéric Marin, ; Sylvain Marcellini,
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando JIL, Bosch X, Sinha A, Vidal P, Izquierdo M, Marin F, Esteve-Pastor MA, Tello-Montoliu A, Lopez-Garcia C, Rivera-Caravaca JM, Gil-Pérez P, Nicolas-Franco S, Keituqwa I, Farhan HA, Silva L, Blasco A, Escudier JM, Ortega J, Zamorano JL, Sanmartin M, Pereda DC, Rincon LM, Gonzalez P, Casado T, Sadeghipour P, Lopez-Sendon JL, Manjavacas AMI, Marin LAM, Sotelo LR, Rodriguez SOR, Bueno H, Martin R, Maruri R, Moreno G, Moris C, Gudmundsdottir I, Avanzas P, Ayesta A, Junco-Vicente A, Cubero-Gallego H, Pascual I, Sola NB, Rodriguez OA, Malagon L, Martinez-Basterra J, Arizcuren AM, Indolfi C, Romero J, Calleja AG, Fuertes DG, Crespín Crespín M, Bernal FJC, Ojeda FB, Padron AL, Cabeza MM, Vargas CM, Yanes G, Kitai T, Gonzalez MJG, Gonzalez Gonzalez J, Jorge P, De La Fuente B, Bermúdez MG, Perez-Lopez CMB, Basiero AB, Ruiz AC, Pamias RF, Chamero PS, Mirrakhimov E, Hidalgo-Urbano R, Garcia-Rubira JC, Seoane-Garcia T, Arroyo-Monino DF, Ruiz AB, Sanz-Girgas E, Bonet G, Rodríguez-López J, Scardino C, De Sousa D, Gustiene O, Elbasheer E, Humida A, Mahmoud H, Mohamed A, Hamid E, Hussein S, Abdelhameed M, Ali T, Ali Y, Eltayeb M, Philippe F, Ali M, Almubarak E, Badri M, Altaher S, Alla MD, Dellborg M, Dellborg H, Hultsberg-Olsson G, Marjeh YB, Abdin A, Erglis A, Alhussein F, Mgazeel F, Hammami R, Abid L, Bahloul A, Charfeddine S, Ellouze T, Canpolat U, Oksul M, Muderrisoglu H, Popovici M, Karacaglar E, Akgun A, Ari H, Ari S, Can V, Tuncay B, Kaya H, Dursun L, Kalenderoglu K, Tasar O, Kalpak O, Kilic S, Kucukosmanoglu M, Aytekin V, Baydar O, Demirci Y, Gürsoy E, Kilic A, Yildiz Ö, Arat-Ozkan A, Sinan UY, Dagva M, Gungor B, Sekerci SS, Zeren G, Erturk M, Demir AR, Yildirim C, Can C, Kayikcioglu M, Yagmur B, Oney S, Xuereb RG, Sabanoglu C, Inanc IH, Ziyrek M, Sen T, Astarcioglu MA, Kahraman F, Utku O, Celik A, Surmeli AO, Basaran O, Ahmad WAW, Demirbag R, Besli F, Gungoren F, Ingabire P, Mondo C, Ssemanda S, Semu T, Mulla AA, Atos JS, Wajid I, Appelman Y, Al Mahmeed WAR, Atallah B, Bakr 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L, Sindelarova S, Tousek F, Warda HM, Ghaly I, Habiba S, Habib A, Gergis MN, Bahaa H, Samir A, Taha HSE, Adel M, Algamal HM, Mamdouh M, Shaker AF, Shokry K, Konsoah A, Mostafa AM, Ibrahim A, Imam A, Hafez B, Zahran A, Abdelhamid M, Mahmoud K, Mostafa A, Samir A, Abdrabou M, Kamal A, Sallam S, Ali A, Maghraby K, Atta AR, Saad A, Ali M, Lotman EM, Lubi R, Kaljumäe H, Uuetoa T, Kiitam U, Durier C, Ressencourt O, El Din AA, Guiatni A, Bras ML, Mougenot E, Labeque JN, Banos JL, Capendeguy O, Mansourati J, Fofana A, Augagneur M, Bahon L, Pape AL, Batias-Moreau L, Fluttaz A, Good F, Prieur F, Boiffard E, Derien AS, Drapeau I, Roy N, Perret T, Dubreuil O, Ranc S, Rio S, Bonnet JL, Bonnet G, Cuisset T, Deharo P, Mouret JP, Spychaj JC, Blondelon A, Delarche N, Decalf V, Guillard N, Hakme A, Roger MP, Biron Y, Druelles P, Loubeyre C, Lucon A, Hery P, Nejjari M, Digne F, Huchet F, Neykova A, Tzvetkov B, Larrieu M, Quaino G, Armangau P, Sauguet A, Bonfils L, Dumonteil N, Fajadet J, Farah B, Honton B, Monteil B, Philippart R, Tchetche D, Cottin M, Petit F, Piquart A, Popovic B, Varlot J, Maisuradze D, Sagirashvili E, Kereselidze Z, Totladze L, Ginturi T, Lagvilava D, Hamm C, Liebetrau C, Haas M, Hamm C, Koerschgen T, Weferling M, Wolter JS, Maier K, Nickenig G, Sedaghat A, Zachoval C, Lampropoulos K, Mpatsouli A, Sakellaropoulou A, Tyrovolas K, Zibounoumi N, Argyropoulos K, Toulgaridis F, Kolyviras A, Tzanis G, Tzifos V, Milkas A, Papaioannou S, Kyriazopoulos K, Pylarinou V, Kontonassakis I, Kotakos C, Kourgiannidis G, Ntoliou P, Parzakonis N, Pipertzi A, Sakalidis A, Ververeli CL, Kafkala K, Sinanis T, Diakakis G, Grammatikopoulos K, Papoutsaki E, Patialiatos T, Mamaloukaki M, Papadaki ST, Kanellos IE, Antoniou A, Tsinopoulos G, Goudis C, Giannadaki M, Daios S, Petridou M, Skantzis P, Koukis P, Dimitriadis F, Savvidis M, Styliadis I, Sachpekidis V, Pilalidou A, Stamatiadis N, Fotoglidis A, Karakanas A, Ruzsa Z, Becker D, Nowotta F, Gudmundsdottir I, Libungan B, Skuladottir FB, Halldorsdottir H, Shetty R, Iyengar S, Bs C, G S, Lakshmana S, S R, Tripathy N, Sinha A, Choudhary B, Kumar A, Kumar A, Raj R, Roy RS, Dharma S, Siswanto BB, Farhan HA, Yaseen IF, Al-Zaidi M, Dakhil Z, Amen S, Rasool B, Rajeeb A, Amber K, Ali HH, Al-Kinani T, Almyahi MH, Al-Obaidi F, Masoumi G, Sadeghi M, Heshmat-Ghahdarijani K, Roohafza H, Sarrafzadegan N, Shafeie M, Teimouri-Jervekani Z, Noori F, Kyavar M, Sadeghipour P, Firouzi A, Alemzadeh-Ansari MJ, Ghadrdoost B, Golpira R, Ghorbani A, Ahangari F, Salarifar M, Jenab Y, Biria A, Haghighi S, Mansouri P, Yadangi S, Kornowski R, Orvin K, Eisen A, Oginetz N, Vizel R, Kfir H, Pasquale GD, Casella G, Cardelli LS, Filippini E, Zagnoni S, Donazzan L, Ermacora D, Indolfi C, Polimeni A, Curcio A, Mongiardo A, De Rosa S, Sorrentino S, Spaccarotella C, Landolina M, Marino M, Cacucci M, Vailati L, Bernabò P, Montisci R, Meloni L, Marchetti MF, Biddau M, Garau E, Barbato E, Morisco C, Strisciuglio T, Canciello G, Lorenzoni G, Casu G, Merella P, Novo G, D'Agostino A, Di Lisi D, Di Palermo A, Evola S, Immordino F, Rossetto L, Spica G, Pavan D, Mattia AD, Belfiore R, Grandis U, Vendrametto F, Spagnolo C, Carniel L, Sonego E, Gaudio C, Barillà F, Biccire FG, Bruno N, Ferrari I, Paravati V, Torromeo C, Galasso G, Peluso A, Prota C, Radano I, Benvenga RM, Ferraioli D, Anselmi M, Frigo GM, Sinagra G, Merlo M, Perkan A, Ramani F, Altinier A, Fabris E, Rinaldi M, Usmiani T, Checco L, Frea S, Mussida M, Matsukawa R, Sugi K, Kitai T, Furukawa Y, Masumoto A, Miyoshi Y, Nishino S, Assembekov B, Amirov B, Chernokurova Y, Ibragimova F, Mirrakhimov E, Ibraimova A, Murataliev T, Radzhapova Z, Uulu ES, Zhanyshbekova N, Zventsova V, Erglis A, Bondare L, Zaliunas R, Gustiene O, Dirsiene R, Marcinkeviciene J, Sakalyte G, Virbickiene A, Baksyte G, Bardauskiene L, Gelmaniene R, Salkauskaite A, Ziubryte G, Kupstyte-Kristapone N, Badariene J, Balciute S, Kapleriene L, Lizaitis M, Marinskiene J, Navickaite A, Pilkiene A, Ramanauskaite D, Serpytis R, Silinskiene D, Simbelyte T, Staigyte J, Philippe F, Degrell P, Camus E, Ahmad WAW, Kassim ZA, Xuereb RG, Buttigieg LL, Camilleri W, Pllaha E, Xuereb S, Popovici M, Ivanov V, Plugaru A, Moscalu V, Popovici I, Abras M, Ciobanu L, Litvinenco N, Fuior S, Dumanschi C, Ivanov M, Danila T, Grib L, Filimon S, Cardaniuc L, Batrinac A, Tasnic M, Cozma C, Revenco V, Sorici G, Dagva M, Choijiljav G, Dandar E, Khurelbaatar MU, Tsognemekh B, Appelman Y, Den Hartog A, Kolste HJT, Van Den Buijs D, Van'T Hof A, Pustjens T, Houben V, Kasperski I, Ten Berg J, Azzahhafi J, Bor W, Yin DCP, Mbakwem A, Amadi C, Kushimo O, Kilasho M, Oronsaye E, Bakracheski N, Bashuroska EK, Mojsovska V, Tupare S, Dejan M, Jovanoska J, Razmoski D, Marinoski T, Antovski A, Jovanovski Z, Kocho S, Markovski R, Ristovski V, Samir AB, Biserka S, Kalpak O, Peovska IM, Taleska BZ, Pejkov H, Busljetik O, Zimbakov Z, Grueva E, Bojovski I, Tutic M, Poposka L, Vavlukis M, Al-Riyami A, Nadar SK, Abdelmottaleb W, Ahmed S, Mujtaba MS, 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S, Popescu MI, Cozma A, Babes EE, Rus M, Ardelean A, Larisa R, Moisi M, Ban E, Buzle A, Filimon G, Dobreanu D, Lupu S, Mitre A, Rudzik R, Sus I, Opris D, Somkereki C, Mornos C, Petrescu L, Betiu A, Volcescu A, Ioan O, Luca C, Maximov D, Mosteoru S, Pascalau L, Roman C, Brie D, Crisan S, Erimescu C, Falnita L, Gaita D, Gheorghiu M, Levashov S, Redkina M, Novitskii N, Dementiev E, Baglikov A, Zateyshchikov D, Zubova E, Rogozhina A, Salikov A, Nikitin I, Reznik EV, Komissarova MS, Shebzukhova M, Shitaya K, Stolbova S, Larina V, Akhmatova F, Chuvarayan G, Arefyev MN, Averkov OV, Volkova AL, Sepkhanyan MS, Vecherko VI, Meray I, Babaeva L, Goreva L, Pisaryuk A, Potapov P, Teterina M, Ageev F, Silvestrova G, Fedulaev Y, Pinchuk T, Staroverov I, Kalimullin D, Sukhinina T, Zhukova N, Ryabov V, Kruchinkina E, Vorobeva D, Shevchenko I, Budyak V, Elistratova O, Fetisova E, Islamov R, Ponomareva E, Khalaf H, Shaimaa AA, Kamal W, Alrahimi J, Elshiekh A, Balghith M, Ahmed A, Attia N, Jamiel AA, Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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14
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Macaire C, Hanne-Poujade S, De Azevedo E, Denoix JM, Coudry V, Jacquet S, Bertoni L, Tallaj A, Audigié F, Hatrisse C, Hébert C, Martin P, Marin F, Chateau H. Investigation of Thresholds for Asymmetry Indices to Represent the Visual Assessment of Single Limb Lameness by Expert Veterinarians on Horses Trotting in a Straight Line. Animals (Basel) 2022; 12:ani12243498. [PMID: 36552418 PMCID: PMC9774792 DOI: 10.3390/ani12243498] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/02/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Defining whether a gait asymmetry should be considered as lameness is challenging. Gait analysis systems now provide relatively accurate objective data, but their interpretation remains complex. Thresholds for discriminating between horses that are visually assessed as being lame or sound, as well as thresholds for locating the lame limb with precise sensitivity and specificity are essential for accurate interpretation of asymmetry measures. The goal of this study was to establish the thresholds of asymmetry indices having the best sensitivity and specificity to represent the visual single-limb lameness assessment made by expert veterinarians as part of their routine practice. Horses included in this study were evaluated for locomotor disorders at a clinic and equipped with the EQUISYM® system using inertial measurement unit (IMU) sensors. Visual evaluation by expert clinicians allocated horses into five groups: 49 sound, 62 left forelimb lame, 67 right forelimb lame, 23 left hindlimb lame, and 23 right hindlimb lame horses. 1/10 grade lame horses were excluded. Sensors placed on the head (_H), the withers (_W), and the pelvis (_P) provided vertical displacement. Relative difference of minimal (AI-min) and maximal (AI-max) altitudes, and of upward (AI-up) and downward (AI-down) amplitudes between right and left stance phases were calculated. Receiver operating characteristic (ROC) curves discriminating the sound horses from each lame limb group revealed the threshold of asymmetry indice associated with the best sensitivity and specificity. AI-up_W had the best ability to discriminate forelimb lame horses from sound horses with thresholds (left: -7%; right: +10%) whose sensitivity was greater than 84% and specificity greater than 88%. AI-up_P and AI-max_P discriminated hindlimb lame horses from sound horses with thresholds (left: -7%; right: +18% and left: -10%; right: +6%) whose sensitivity was greater than 78%, and specificity greater than 82%. Identified thresholds will enable the interpretation of quantitative data from lameness quantification systems. This study is mainly limited by the number of included horses and deserves further investigation with additional data, and similar studies on circles are warranted.
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Affiliation(s)
- Claire Macaire
- LIM France, Labcom LIM-ENVA, 24300 Nontron, France
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CIRALE, 94700 Maisons-Alfort, France
- Laboratoire de BioMécanique et BioIngénierie (UMR CNRS 7338), Centre of Excellence for Human and Animal Movement Biomechanics (CoEMoB), Université de Technologie de Compiègne (UTC), Alliance Sorbonne Université, 60200 Compiègne, France
- Correspondence:
| | | | - Emeline De Azevedo
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CIRALE, 94700 Maisons-Alfort, France
| | - Jean-Marie Denoix
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CIRALE, 94700 Maisons-Alfort, France
| | - Virginie Coudry
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CIRALE, 94700 Maisons-Alfort, France
| | - Sandrine Jacquet
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CIRALE, 94700 Maisons-Alfort, France
| | - Lélia Bertoni
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CIRALE, 94700 Maisons-Alfort, France
| | - Amélie Tallaj
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CIRALE, 94700 Maisons-Alfort, France
| | - Fabrice Audigié
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CIRALE, 94700 Maisons-Alfort, France
| | - Chloé Hatrisse
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CIRALE, 94700 Maisons-Alfort, France
| | | | | | - Frédéric Marin
- Laboratoire de BioMécanique et BioIngénierie (UMR CNRS 7338), Centre of Excellence for Human and Animal Movement Biomechanics (CoEMoB), Université de Technologie de Compiègne (UTC), Alliance Sorbonne Université, 60200 Compiègne, France
| | - Henry Chateau
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CIRALE, 94700 Maisons-Alfort, France
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15
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Timmerman I, Macaire C, Hanne-Poujade S, Bertoni L, Martin P, Marin F, Chateau H. A Pilot Study on the Inter-Operator Reproducibility of a Wireless Sensors-Based System for Quantifying Gait Asymmetries in Horses. Sensors (Basel) 2022; 22:9533. [PMID: 36502233 PMCID: PMC9740227 DOI: 10.3390/s22239533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/18/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Repeatability and reproducibility of any measuring system must be evaluated to assess possible limitations for its use. The objective of this study was to establish the repeatability and the inter-operator reproducibility of a sensors-based system (EQUISYM®) for quantifying gait asymmetries in horses.. Seven wireless IMUs were placed on the head, the withers, the pelvis, and the 4 cannon bones on three horses, by four different operators, four times on each horse, which led to a total of 48 repetitions randomly assigned. Data were collected along three consecutive days and analysed to calculate total variance, standard deviation and the variance attributable to the operator on multiple asymmetry variables. Maximal percentage of variance due to the operator (calculated out of the total variance) was 5.3% and was related to the sensor placed on the head. The results suggest a good reproducibility of IMU-based gait analysis systems for different operators repositioning the system and repeating the same measurements at a succession of time intervals. Future studies will be useful to confirm that inter-operator reproducibility remains valid in larger groups and on horses with different degrees of locomotor asymmetry.
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Affiliation(s)
- Iris Timmerman
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CIRALE, 94700 Maisons-Alfort, France
| | - Claire Macaire
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CIRALE, 94700 Maisons-Alfort, France
- LIM France, Labcom LIM-ENVA, 24300 Nontron, France
- Laboratoire de BioMécanique et BioIngénierie (UMR CNRS 7338), Centre of Excellence for Human and Animal Movement Biomechanics (CoEMoB), Université de Technologie de Compiègne (UTC), Alliance Sorbonne Université, 60200 Compiègne, France
| | | | - Lélia Bertoni
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CIRALE, 94700 Maisons-Alfort, France
| | | | - Frédéric Marin
- Laboratoire de BioMécanique et BioIngénierie (UMR CNRS 7338), Centre of Excellence for Human and Animal Movement Biomechanics (CoEMoB), Université de Technologie de Compiègne (UTC), Alliance Sorbonne Université, 60200 Compiègne, France
| | - Henry Chateau
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CIRALE, 94700 Maisons-Alfort, France
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16
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Khurshid B, Jackson DJ, Engilberge S, Motreuil S, Broussard C, Thomas J, Immel F, Harrington MJ, Crowley PB, Vielzeuf D, Perrin J, Marin F. Molecular characterization of accripin11, a soluble shell protein with an acidic C-terminus, identified in the prismatic layer of the Mediterranean fan mussel Pinna nobilis (Bivalvia, Pteriomorphia). FEBS Open Bio 2022; 13:10-25. [PMID: 36219517 PMCID: PMC9808598 DOI: 10.1002/2211-5463.13497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/23/2022] [Accepted: 10/10/2022] [Indexed: 01/07/2023] Open
Abstract
We have identified a novel shell protein, accripin11, as a major soluble component of the calcitic prisms of the fan mussel Pinna nobilis. Initially retrieved from a cDNA library, its full sequence is confirmed here by transcriptomic and proteomic approaches. The sequence of the mature protein is 103 residues with a theoretical molecular weight of 11 kDa and is moderately acidic (pI 6.74) except for its C-terminus which is highly enriched in aspartic acid. The protein exhibits a peculiar cysteine pattern in its central domain. The full sequence shares similarity with six other uncharacterized molluscan shell proteins from the orders Ostreida, Pteriida and Mytilida, all of which are pteriomorphids and produce a phylogenetically restricted pattern of nacro-prismatic shell microstructures. This suggests that accripin11 is a member of a family of clade-specific shell proteins. A 3D model of accripin11 was predicted with AlphaFold2, indicating that it possesses three short alpha helices and a disordered C-terminus. Recombinant accripin11 was tested in vitro for its ability to influence the crystallization of CaCO3 , while a polyclonal antibody was able to locate accripin11 to prismatic extracts, particularly in the acetic acid-soluble matrix. The putative functions of accripin11 are further discussed in relation to shell biomineralization.
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Affiliation(s)
- Benazir Khurshid
- Laboratoire Biogéosciences, UMR CNRS‐EPHE 6282Université de Bourgogne – Franche‐ComtéDijonFrance,Synchrotron SOLEILBeamline ANATOMIXGif‐sur‐YvetteFrance
| | | | - Sylvain Engilberge
- Structural Biology GroupEuropean Synchrotron Radiation FacilityGrenobleFrance
| | - Sébastien Motreuil
- Laboratoire Biogéosciences, UMR CNRS‐EPHE 6282Université de Bourgogne – Franche‐ComtéDijonFrance
| | | | - Jérôme Thomas
- Laboratoire Biogéosciences, UMR CNRS‐EPHE 6282Université de Bourgogne – Franche‐ComtéDijonFrance
| | - Françoise Immel
- Chrono‐Environnement, UMR 6249 CNRSUniversité de Bourgogne Franche‐ComtéBesançonFrance
| | | | - Peter B. Crowley
- School of Biological and Chemical SciencesNational University of IrelandGalwayIreland
| | | | | | - Frédéric Marin
- Laboratoire Biogéosciences, UMR CNRS‐EPHE 6282Université de Bourgogne – Franche‐ComtéDijonFrance
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17
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Taverna R, Turolla R, Muleri F, Heyl J, Zane S, Baldini L, González-Caniulef D, Bachetti M, Rankin J, Caiazzo I, Di Lalla N, Doroshenko V, Errando M, Gau E, Kırmızıbayrak D, Krawczynski H, Negro M, Ng M, Omodei N, Possenti A, Tamagawa T, Uchiyama K, Weisskopf MC, Agudo I, Antonelli LA, Baumgartner WH, Bellazzini R, Bianchi S, Bongiorno SD, Bonino R, Brez A, Bucciantini N, Capitanio F, Castellano S, Cavazzuti E, Ciprini S, Costa E, De Rosa A, Del Monte E, Di Gesu L, Di Marco A, Donnarumma I, Dovčiak M, Ehlert SR, Enoto T, Evangelista Y, Fabiani S, Ferrazzoli R, Garcia JA, Gunji S, Hayashida K, Iwakiri W, Jorstad SG, Karas V, Kitaguchi T, Kolodziejczak JJ, La Monaca F, Latronico L, Liodakis I, Maldera S, Manfreda A, Marin F, Marinucci A, Marscher AP, Marshall HL, Matt G, Mitsuishi I, Mizuno T, Ng SCY, O’Dell SL, Oppedisano C, Papitto A, Pavlov GG, Peirson AL, Perri M, Pesce-Rollins M, Pilia M, Poutanen J, Puccetti S, Ramsey BD, Ratheesh A, Romani RW, Sgrò C, Slane P, Soffitta P, Spandre G, Tavecchio F, Tawara Y, Tennant AF, Thomas NE, Tombesi F, Trois A, Tsygankov SS, Vink J, Wu K, Xie F. Polarized x-rays from a magnetar. Science 2022; 378:646-650. [DOI: 10.1126/science.add0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Magnetars are neutron stars with ultra-strong magnetic fields, which can be observed in x-rays. Polarization measurements could provide information on their magnetic fields and surface properties. We observe polarized x-rays from the magnetar 4U 0142+61 using the Imaging X-ray Polarimetry Explorer, finding a linear polarization degree of 13.5 ± 0.8% averaged over the 2 to 8 keV band. The polarization changes with energy: the degree is 15.0 ± 1.0% at 2 to 4 keV, drops below the instrumental sensitivity around 4 to 5 keV, and rises to 35.2 ± 7.1% at 5.5 to 8 keV. The polarization angle also changes by 90° around 4 to 5 keV. These results are consistent with a model in which thermal radiation from the magnetar surface is reprocessed by scattering off charged particles in the magnetosphere.
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Affiliation(s)
- Roberto Taverna
- Department of Physics and Astronomy, University of Padova, Padova I-35131, Italy
| | - Roberto Turolla
- Department of Physics and Astronomy, University of Padova, Padova I-35131, Italy
- Mullard Space Science Laboratory, University College London, Holmbury St Mary Dorking RH5 6NT, UK
| | - Fabio Muleri
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Roma I-00133, Italy
| | - Jeremy Heyl
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
| | - Silvia Zane
- Mullard Space Science Laboratory, University College London, Holmbury St Mary Dorking RH5 6NT, UK
| | - Luca Baldini
- Dipartimento di Fisica Enrico Fermi, Università di Pisa, Pisa I-56127, Italy
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Pisa, Pisa I-56127, Italy
| | - Denis González-Caniulef
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
| | - Matteo Bachetti
- Osservatorio Astronomico di Cagliari, INAF, Selargius I-09047, Italy
| | - John Rankin
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Roma I-00133, Italy
| | - Ilaria Caiazzo
- Theoretical AstroPhysics Including Relativity and Cosmology, Caltech, Pasadena, CA 91125, USA
| | - Niccolò Di Lalla
- Deparment of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA 94305, USA
| | - Victor Doroshenko
- Institut für Astronomie und Astrophysik, Universität Tübingen, Tübingen 72076, Germany
| | - Manel Errando
- Physics Department and McDonnell Center for the Space Sciences, Washington University, St. Louis, MO 63130, USA
| | - Ephraim Gau
- Physics Department and McDonnell Center for the Space Sciences, Washington University, St. Louis, MO 63130, USA
| | - Demet Kırmızıbayrak
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
| | - Henric Krawczynski
- Physics Department and McDonnell Center for the Space Sciences, Washington University, St. Louis, MO 63130, USA
| | - Michela Negro
- University of Maryland, Baltimore County, Baltimore, MD 21250, USA
- NASA Goddard Space Flight Center (GSFC), Greenbelt, MD 20771, USA
- Center for Research and Exploration in Space Science and Technology, NASA/GSFC, Greenbelt, MD 20771, USA
| | - Mason Ng
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Nicola Omodei
- Deparment of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA 94305, USA
| | - Andrea Possenti
- Osservatorio Astronomico di Cagliari, INAF, Selargius I-09047, Italy
| | - Toru Tamagawa
- RIKEN Cluster for Pioneering Research, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Tokyo University of Science, 1-3 Kagurazaka, Shinjuku, Tokyo 162-8601, Japan
| | - Keisuke Uchiyama
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Tokyo University of Science, 1-3 Kagurazaka, Shinjuku, Tokyo 162-8601, Japan
| | | | - Ivan Agudo
- Instituto de Astrofísica de Andalucía, 18008 Granada, Spain
| | - Lucio A. Antonelli
- Osservatorio Astronomico di Roma, INAF, Monte Porzio Catone 00040, Italy
- Space Science Data Center (SSDC), Agenzia Spaziale Italiana (ASI), Roma 00133, Italy
| | | | - Ronaldo Bellazzini
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Pisa, Pisa I-56127, Italy
| | - Stefano Bianchi
- Dipartimento di Matematica e Fisica, Università degli Studi Roma Tre, Roma 00146, Italy
| | | | - Raffaella Bonino
- INFN Sezione di Torino, Torino 10125, Italy
- Dipartimento di Fisica, Università degli Studi di Torino, Torino 10125, Italy
| | - Alessandro Brez
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Pisa, Pisa I-56127, Italy
| | - Niccolò Bucciantini
- Osservatorio Astrofisico di Arcetri, INAF, Firenze 50125, Italy
- Dipartimento di Fisica e Astronomia, Università degli Studi di Firenze, Sesto Fiorentino 50019, Italy
- INFN Sezione di Firenze, Sesto Fiorentino 50019, Italy
| | - Fiamma Capitanio
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Roma I-00133, Italy
| | - Simone Castellano
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Pisa, Pisa I-56127, Italy
| | | | - Stefano Ciprini
- Space Science Data Center (SSDC), Agenzia Spaziale Italiana (ASI), Roma 00133, Italy
- INFN Sezione di Roma Tor Vergata, Roma 00133, Italy
| | - Enrico Costa
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Roma I-00133, Italy
| | - Alessandra De Rosa
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Roma I-00133, Italy
| | - Ettore Del Monte
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Roma I-00133, Italy
| | | | - Alessandro Di Marco
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Roma I-00133, Italy
| | | | - Michal Dovčiak
- Astronomical Institute of the Czech Academy of Sciences, 14100 Praha 4, Czech Republic
| | - Steven R. Ehlert
- NASA Marshall Space Flight Center (MSFC), Huntsville, AL 35812, USA
| | - Teruaki Enoto
- RIKEN Cluster for Pioneering Research, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Yuri Evangelista
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Roma I-00133, Italy
| | - Sergio Fabiani
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Roma I-00133, Italy
| | - Riccardo Ferrazzoli
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Roma I-00133, Italy
| | | | - Shuichi Gunji
- Yamagata University, 1-4-12 Kojirakawa-machi, Yamagata-shi 990-8560, Japan
| | | | - Wataru Iwakiri
- Department of Physics, Chuo University, 1-13-27 Kasuga, Bunkyo-ku, Tokyo 112-8551, Japan
| | - Svetlana G. Jorstad
- Institute for Astrophysical Research, Boston University, Boston, MA 02215, USA
- Laboratory of Observational Astrophysics, St. Petersburg University, St. Petersburg 199034, Russia
| | - Vladimir Karas
- Astronomical Institute of the Czech Academy of Sciences, 14100 Praha 4, Czech Republic
| | - Takao Kitaguchi
- RIKEN Cluster for Pioneering Research, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | | | - Fabio La Monaca
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Roma I-00133, Italy
| | | | - Ioannis Liodakis
- Finnish Centre for Astronomy with the European Southern Observatory, University of Turku, 20014 Turku, Finland
| | | | - Alberto Manfreda
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Pisa, Pisa I-56127, Italy
| | - Frédéric Marin
- Observatoire Astronomique de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France
| | | | - Alan P. Marscher
- Institute for Astrophysical Research, Boston University, Boston, MA 02215, USA
| | - Herman L. Marshall
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Giorgio Matt
- Dipartimento di Matematica e Fisica, Università degli Studi Roma Tre, Roma 00146, Italy
| | - Ikuyuki Mitsuishi
- Division of Particle and Astrophysical Science, Graduate School of Science, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8602, Japan
| | - Tsunefumi Mizuno
- Hiroshima Astrophysical Science Center, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 739-8526, Japan
| | - Stephen C.-Y. Ng
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | | | | | - Alessandro Papitto
- Osservatorio Astronomico di Roma, INAF, Monte Porzio Catone 00040, Italy
| | - George G. Pavlov
- Department of Astronomy and Astrophysics, Pennsylvania State University, University Park, PA 16801, USA
| | - Abel L. Peirson
- Deparment of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA 94305, USA
| | - Matteo Perri
- Osservatorio Astronomico di Roma, INAF, Monte Porzio Catone 00040, Italy
- Space Science Data Center (SSDC), Agenzia Spaziale Italiana (ASI), Roma 00133, Italy
| | | | - Maura Pilia
- Osservatorio Astronomico di Cagliari, INAF, Selargius I-09047, Italy
| | - Juri Poutanen
- Department of Physics and Astronomy, University of Turku, 20014 Turku, Finland
- Space Research Institute of the Russian Academy of Sciences, Moscow 117997, Russia
| | - Simonetta Puccetti
- Space Science Data Center (SSDC), Agenzia Spaziale Italiana (ASI), Roma 00133, Italy
| | - Brian D. Ramsey
- NASA Marshall Space Flight Center (MSFC), Huntsville, AL 35812, USA
| | - Ajay Ratheesh
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Roma I-00133, Italy
| | - Roger W. Romani
- Deparment of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA 94305, USA
| | - Carmelo Sgrò
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Pisa, Pisa I-56127, Italy
| | - Patrick Slane
- Center for Astrophysics, Harvard & Smithsonian, Cambridge, MA 02138, USA
| | - Paolo Soffitta
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), Roma I-00133, Italy
| | - Gloria Spandre
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Pisa, Pisa I-56127, Italy
| | | | - Yuzuru Tawara
- Division of Particle and Astrophysical Science, Graduate School of Science, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8602, Japan
| | - Allyn F. Tennant
- NASA Marshall Space Flight Center (MSFC), Huntsville, AL 35812, USA
| | | | - Francesco Tombesi
- Dipartimento di Fisica, Università degli Studi di Roma Tor Vergata, Roma 00133, Italy
| | - Alessio Trois
- Osservatorio Astronomico di Cagliari, INAF, Selargius I-09047, Italy
| | - Sergey S. Tsygankov
- Department of Physics and Astronomy, University of Turku, 20014 Turku, Finland
- Space Research Institute of the Russian Academy of Sciences, Moscow 117997, Russia
| | - Jacco Vink
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - Kinwah Wu
- Mullard Space Science Laboratory, University College London, Holmbury St Mary Dorking RH5 6NT, UK
| | - Fei Xie
- Guangxi Key Laboratory for Relativistic Astrophysics, School of Physical Science and Technology, Guangxi University, Nanning 530004, China
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18
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Krawczynski H, Muleri F, Dovčiak M, Veledina A, Rodriguez Cavero N, Svoboda J, Ingram A, Matt G, Garcia JA, Loktev V, Negro M, Poutanen J, Kitaguchi T, Podgorný J, Rankin J, Zhang W, Berdyugin A, Berdyugina SV, Bianchi S, Blinov D, Capitanio F, Di Lalla N, Draghis P, Fabiani S, Kagitani M, Kravtsov V, Kiehlmann S, Latronico L, Lutovinov AA, Mandarakas N, Marin F, Marinucci A, Miller JM, Mizuno T, Molkov SV, Omodei N, Petrucci PO, Ratheesh A, Sakanoi T, Semena AN, Skalidis R, Soffitta P, Tennant AF, Thalhammer P, Tombesi F, Weisskopf MC, Wilms J, Zhang S, Agudo I, Antonelli LA, Bachetti M, Baldini L, Baumgartner WH, Bellazzini R, Bongiorno SD, Bonino R, Brez A, Bucciantini N, Castellano S, Cavazzuti E, Ciprini S, Costa E, De Rosa A, Del Monte E, Di Gesu L, Di Marco A, Donnarumma I, Doroshenko V, Ehlert SR, Enoto T, Evangelista Y, Ferrazzoli R, Gunji S, Hayashida K, Heyl J, Iwakiri W, Jorstad SG, Karas V, Kolodziejczak JJ, La Monaca F, Liodakis I, Maldera S, Manfreda A, Marscher AP, Marshall HL, Mitsuishi I, Ng CY, O’Dell SL, Oppedisano C, Papitto A, Pavlov GG, Peirson AL, Perri M, Pesce-Rollins M, Pilia M, Possenti A, Puccetti S, Ramsey BD, Romani RW, Sgrò C, Slane P, Spandre G, Tamagawa T, Tavecchio F, Taverna R, Tawara Y, Thomas NE, Trois A, Tsygankov S, Turolla R, Vink J, Wu K, Xie F, Zane S. Polarized x-rays constrain the disk-jet geometry in the black hole x-ray binary Cygnus X-1. Science 2022; 378:650-654. [DOI: 10.1126/science.add5399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A black hole x-ray binary (XRB) system forms when gas is stripped from a normal star and accretes onto a black hole, which heats the gas sufficiently to emit x-rays. We report a polarimetric observation of the XRB Cygnus X-1 using the Imaging X-ray Polarimetry Explorer. The electric field position angle aligns with the outflowing jet, indicating that the jet is launched from the inner x-ray emitting region. The polarization degree is 4.01 ± 0.20% at 2 to 8 kiloelectronvolts, implying that the accretion disk is viewed closer to edge-on than the binary orbit. The observations reveal that hot x-ray emitting plasma is spatially extended in a plane perpendicular to the jet axis, not parallel to the jet.
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Affiliation(s)
- Henric Krawczynski
- Department of Physics and McDonnell Center for the Space Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Fabio Muleri
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), 00133 Roma, Italy
| | - Michal Dovčiak
- Astronomical Institute of the Czech Academy of Sciences, 14100 Praha 4, Czech Republic
| | - Alexandra Veledina
- Department of Physics and Astronomy, 20014 University of Turku, Turku, Finland
- Nordic Institute for Theoretical Physics (Nordita), Kungliga Tekniska Högskolan (KTH) Royal Institute of Technology and Stockholm University, SE-106 91 Stockholm, Sweden
- Space Research Institute of the Russian Academy of Sciences, Moscow 117997, Russia
| | - Nicole Rodriguez Cavero
- Department of Physics and McDonnell Center for the Space Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Jiri Svoboda
- Astronomical Institute of the Czech Academy of Sciences, 14100 Praha 4, Czech Republic
| | - Adam Ingram
- School of Mathematics, Statistics, and Physics, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Giorgio Matt
- Dipartimento di Matematica e Fisica, Università degli Studi Roma Tre, 00146 Roma, Italy
| | - Javier A. Garcia
- Division of Physics, Mathematics and Astronomy, California Institute of Technology, Pasadena, CA 91125, USA
| | - Vladislav Loktev
- Department of Physics and Astronomy, 20014 University of Turku, Turku, Finland
| | - Michela Negro
- Center for Space Sciences and Technology, University of Maryland, Baltimore County, Baltimore, MD 21250, USA
- NASA Goddard Space Flight Center (GSFC), Greenbelt, MD 20771, USA
- Center for Research and Exploration in Space Science and Technology, NASA GSFC, Greenbelt, MD 20771, USA
| | - Juri Poutanen
- Department of Physics and Astronomy, 20014 University of Turku, Turku, Finland
- Space Research Institute of the Russian Academy of Sciences, Moscow 117997, Russia
| | - Takao Kitaguchi
- Rikagaku Kenkyūjyo (RIKEN) Cluster for Pioneering Research, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Jakub Podgorný
- Astronomical Institute of the Czech Academy of Sciences, 14100 Praha 4, Czech Republic
- Observatoire Astronomique de Strasbourg, Unité Mixte de Recherche 7550, Centre national de la recherche scientifique, Université de Strasbourg, 67000 Strasbourg, France
- Astronomical Institute, Charles University, 18000 Prague, Czech Republic
| | - John Rankin
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), 00133 Roma, Italy
| | - Wenda Zhang
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100101, China
| | - Andrei Berdyugin
- Department of Physics and Astronomy, 20014 University of Turku, Turku, Finland
| | - Svetlana V. Berdyugina
- Leibniz-Institut für Sonnenphysik, 79104 Freiburg, Germany
- Istituto Ricerche Solari (IRSOL) Aldo e Cele Daccò, Faculty of Informatics, Università della Svizzera italiana, 6605 Locarno, Switzerland
- Euler Institute, Faculty of Informatics, Università della Svizzera italiana, 6962 Lugano, Switzerland
| | - Stefano Bianchi
- Dipartimento di Matematica e Fisica, Università degli Studi Roma Tre, 00146 Roma, Italy
| | - Dmitry Blinov
- Institute of Astrophysics, Foundation for Research and Technology–Hellas, 71110 Heraklion, Greece
- Department of Physics, University of Crete, 70013 Heraklion, Greece
| | - Fiamma Capitanio
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), 00133 Roma, Italy
| | - Niccolò Di Lalla
- Department of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA 94305, USA
| | - Paul Draghis
- Department of Astronomy, University of Michigan, Ann Arbor, MI 48109, USA
| | - Sergio Fabiani
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), 00133 Roma, Italy
| | - Masato Kagitani
- School of Sciences, Tohoku University, Aoba-ku, 980-8578 Sendai, Japan
| | - Vadim Kravtsov
- Department of Physics and Astronomy, 20014 University of Turku, Turku, Finland
| | - Sebastian Kiehlmann
- Institute of Astrophysics, Foundation for Research and Technology–Hellas, 71110 Heraklion, Greece
- Department of Physics, University of Crete, 70013 Heraklion, Greece
| | - Luca Latronico
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, 10125 Torino, Italy
| | | | - Nikos Mandarakas
- Institute of Astrophysics, Foundation for Research and Technology–Hellas, 71110 Heraklion, Greece
- Department of Physics, University of Crete, 70013 Heraklion, Greece
| | - Frédéric Marin
- Observatoire Astronomique de Strasbourg, Unité Mixte de Recherche 7550, Centre national de la recherche scientifique, Université de Strasbourg, 67000 Strasbourg, France
| | | | - Jon M. Miller
- Department of Astronomy, University of Michigan, Ann Arbor, MI 48109, USA
| | - Tsunefumi Mizuno
- Hiroshima Astrophysical Science Center, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 739-8526, Japan
| | - Sergey V. Molkov
- Space Research Institute of the Russian Academy of Sciences, Moscow 117997, Russia
| | - Nicola Omodei
- Department of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA 94305, USA
| | - Pierre-Olivier Petrucci
- Institut de Planétologie et d’Astrophysique de Grenoble (IPAG), Université Grenoble Alpes, Centre national de la recherche scientifique, 38000 Grenoble, France
| | - Ajay Ratheesh
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), 00133 Roma, Italy
| | - Takeshi Sakanoi
- School of Sciences, Tohoku University, Aoba-ku, 980-8578 Sendai, Japan
| | - Andrei N. Semena
- Space Research Institute of the Russian Academy of Sciences, Moscow 117997, Russia
| | - Raphael Skalidis
- Institute of Astrophysics, Foundation for Research and Technology–Hellas, 71110 Heraklion, Greece
- Department of Physics, University of Crete, 70013 Heraklion, Greece
| | - Paolo Soffitta
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), 00133 Roma, Italy
| | | | - Phillipp Thalhammer
- Dr. Karl Remeis Observatory, Erlangen Centre for Astroparticle Physics, Universität Erlangen-Nürnberg, 96049 Bamberg, Germany
| | - Francesco Tombesi
- Dipartimento di Fisica, Università degli Studi di Roma “Tor Vergata,” 00133 Roma, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma “Tor Vergata,” 00133 Roma, Italy
- Department of Astronomy, University of Maryland, College Park, MD 20742, USA
| | | | - Joern Wilms
- Dr. Karl Remeis Observatory, Erlangen Centre for Astroparticle Physics, Universität Erlangen-Nürnberg, 96049 Bamberg, Germany
| | - Sixuan Zhang
- Hiroshima Astrophysical Science Center, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 739-8526, Japan
| | - Iván Agudo
- Instituto de Astrofísica de Andalucía, 18008 Granada, Spain
| | - Lucio A. Antonelli
- INAF Osservatorio Astronomico di Roma, 00078 Monte Porzio Catone, Roma, Italy
- Space Science Data Center, ASI, 00133 Roma, Italy
| | - Matteo Bachetti
- INAF Osservatorio Astronomico di Cagliari, 09047 Selargius, Cagliari, Italy
| | - Luca Baldini
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, 56127 Pisa, Italy
- Dipartimento di Fisica, Università di Pisa, 56127 Pisa, Italy
| | | | - Ronaldo Bellazzini
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, 56127 Pisa, Italy
| | | | - Raffaella Bonino
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, 10125 Torino, Italy
- Dipartimento di Fisica, Università degli Studi di Torino, 10125 Torino, Italy
| | - Alessandro Brez
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, 56127 Pisa, Italy
| | - Niccolò Bucciantini
- INAF Osservatorio Astrofisico di Arcetri, 50125 Firenze, Italy
- Dipartimento di Fisica e Astronomia, Università degli Studi di Firenze, 50019 Sesto Fiorentino, Firenze, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Firenze, 50019 Sesto Fiorentino, Firenze, Italy
| | - Simone Castellano
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, 56127 Pisa, Italy
| | | | - Stefano Ciprini
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma “Tor Vergata,” 00133 Roma, Italy
- Space Science Data Center, ASI, 00133 Roma, Italy
| | - Enrico Costa
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), 00133 Roma, Italy
| | - Alessandra De Rosa
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), 00133 Roma, Italy
| | - Ettore Del Monte
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), 00133 Roma, Italy
| | | | - Alessandro Di Marco
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), 00133 Roma, Italy
| | | | - Victor Doroshenko
- Space Research Institute of the Russian Academy of Sciences, Moscow 117997, Russia
- Institut für Astronomie und Astrophysik, Universität Tübingen, 72076 Tübingen, Germany
| | | | - Teruaki Enoto
- Rikagaku Kenkyūjyo (RIKEN) Cluster for Pioneering Research, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Yuri Evangelista
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), 00133 Roma, Italy
| | - Riccardo Ferrazzoli
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), 00133 Roma, Italy
| | - Shuichi Gunji
- Department of Physics, Yamagata University, 1-4-12 Kojirakawa-machi, Yamagata-shi 990-8560, Japan
| | - Kiyoshi Hayashida
- Department of Earth and Space Science, Osaka University, 1-1 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Jeremy Heyl
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Wataru Iwakiri
- Department of Physics, Faculty of Science and Engineering, Chuo University, 1-13-27 Kasuga, Bunkyo-ku, Tokyo 112-8551, Japan
| | - Svetlana G. Jorstad
- Institute for Astrophysical Research, Boston University, Boston, MA 02215, USA
- Department of Astrophysics, St. Petersburg State University, Petrodvoretz, 198504 St. Petersburg, Russia
| | - Vladimir Karas
- Astronomical Institute of the Czech Academy of Sciences, 14100 Praha 4, Czech Republic
| | | | - Fabio La Monaca
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), 00133 Roma, Italy
| | - Ioannis Liodakis
- Finnish Centre for Astronomy with the European Southern Observatory (ESO), 20014 University of Turku, Turku, Finland
| | - Simone Maldera
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, 10125 Torino, Italy
| | - Alberto Manfreda
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, 56127 Pisa, Italy
| | - Alan P. Marscher
- Institute for Astrophysical Research, Boston University, Boston, MA 02215, USA
| | - Herman L. Marshall
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Ikuyuki Mitsuishi
- Division of Particle and Astrophysical Science, Graduate School of Science, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8602, Japan
| | - Chi-Yung Ng
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Chiara Oppedisano
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, 10125 Torino, Italy
| | - Alessandro Papitto
- INAF Osservatorio Astronomico di Roma, 00078 Monte Porzio Catone, Roma, Italy
| | - George G. Pavlov
- Department of Astronomy and Astrophysics, Pennsylvania State University, University Park, PA 16802, USA
| | - Abel L. Peirson
- Department of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA 94305, USA
| | - Matteo Perri
- INAF Osservatorio Astronomico di Roma, 00078 Monte Porzio Catone, Roma, Italy
- Space Science Data Center, ASI, 00133 Roma, Italy
| | | | - Maura Pilia
- INAF Osservatorio Astronomico di Cagliari, 09047 Selargius, Cagliari, Italy
| | - Andrea Possenti
- INAF Osservatorio Astronomico di Cagliari, 09047 Selargius, Cagliari, Italy
| | | | - Brian D. Ramsey
- NASA Marshall Space Flight Center, Huntsville, AL 35812, USA
| | - Roger W. Romani
- Department of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA 94305, USA
| | - Carmelo Sgrò
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, 56127 Pisa, Italy
| | - Patrick Slane
- Center for Astrophysics, Harvard & Smithsonian, Cambridge, MA 02138, USA
| | - Gloria Spandre
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, 56127 Pisa, Italy
| | - Toru Tamagawa
- Astronomical Institute, Charles University, 18000 Prague, Czech Republic
| | | | - Roberto Taverna
- Dipartimento di Fisica e Astronomia, Università degli Studi di Padova, 35131 Padova, Italy
| | - Yuzuru Tawara
- Division of Particle and Astrophysical Science, Graduate School of Science, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi 464-8602, Japan
| | | | - Alessio Trois
- INAF Osservatorio Astronomico di Cagliari, 09047 Selargius, Cagliari, Italy
| | - Sergey Tsygankov
- Department of Physics and Astronomy, 20014 University of Turku, Turku, Finland
- Space Research Institute of the Russian Academy of Sciences, Moscow 117997, Russia
| | - Roberto Turolla
- Dipartimento di Fisica e Astronomia, Università degli Studi di Padova, 35131 Padova, Italy
- Mullard Space Science Laboratory, University College London, Holmbury St Mary, Dorking, Surrey RH5 6NT, UK
| | - Jacco Vink
- Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - Kinwah Wu
- Mullard Space Science Laboratory, University College London, Holmbury St Mary, Dorking, Surrey RH5 6NT, UK
| | - Fei Xie
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica (INAF), 00133 Roma, Italy
- Guangxi Key Laboratory for Relativistic Astrophysics, School of Physical Science and Technology, Guangxi University, Nanning 530004, China
| | - Silvia Zane
- Mullard Space Science Laboratory, University College London, Holmbury St Mary, Dorking, Surrey RH5 6NT, UK
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19
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Moulart M, Olivier N, Giovanelli Y, Marin F. Subjective assessment of a lumbar exoskeleton's impact on lower back pain in a real work situation. Heliyon 2022; 8:e11420. [DOI: 10.1016/j.heliyon.2022.e11420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/26/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
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20
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Marin F, Warmerdam E, Marin Z, Ben Mansour K, Maetzler W, Hansen C. Scoring the Sit-to-Stand Performance of Parkinson's Patients with a Single Wearable Sensor. Sensors (Basel) 2022; 22:8340. [PMID: 36366038 PMCID: PMC9654014 DOI: 10.3390/s22218340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/24/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
Monitoring disease progression in Parkinson's disease is challenging. Postural transfers by sit-to-stand motions are adapted to trace the motor performance of subjects. Wearable sensors such as inertial measurement units allow for monitoring motion performance. We propose quantifying the sit-to-stand performance based on two scores compiling kinematics, dynamics, and energy-related variables. Three groups participated in this research: asymptomatic young participants (n = 33), senior asymptomatic participants (n = 17), and Parkinson's patients (n = 20). An unsupervised classification was performed of the two scores to differentiate the three populations. We found a sensitivity of 0.4 and a specificity of 0.96 to distinguish Parkinson's patients from asymptomatic subjects. In addition, seven Parkinson's patients performed the sit-to-stand task "ON" and "OFF" medication, and we noted the scores improved with the patients' medication states (MDS-UPDRS III scores). Our investigation revealed that Parkinson's patients demonstrate a wide spectrum of mobility variations, and while one inertial measurement unit can quantify the sit-to-stand performance, differentiating between PD patients and healthy adults and distinguishing between "ON" and "OFF" periods in PD patients is still challenging.
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Affiliation(s)
- Frédéric Marin
- Laboratoire de BioMécanique et BioIngénierie (UMR CNRS 7338), Centre of Excellence for Human and Animal Movement Biomechanics (CoEMoB), Université de Technologie de Compiègne (UTC), Alliance Sorbonne Université, 60200 Compiègne, France
| | - Elke Warmerdam
- Department of Neurology, Kiel University, 24105 Kiel, Germany
| | - Zoé Marin
- Faculty of Computer Science or Communication Systems, Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - Khalil Ben Mansour
- Laboratoire de BioMécanique et BioIngénierie (UMR CNRS 7338), Centre of Excellence for Human and Animal Movement Biomechanics (CoEMoB), Université de Technologie de Compiègne (UTC), Alliance Sorbonne Université, 60200 Compiègne, France
| | - Walter Maetzler
- Department of Neurology, Kiel University, 24105 Kiel, Germany
| | - Clint Hansen
- Department of Neurology, Kiel University, 24105 Kiel, Germany
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21
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Ding WY, Proietti M, Romiti GF, Vitolo M, Fawzy AM, Boriani G, Marin F, Blomstrom-Lundqvist C, Potpara TS, Fauchier L, Lip GYH. Impact of ABC pathway adherence in high-risk patients with atrial fibrillation: an analysis from the ESC-EHRA EORP-AF long-term general registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The impact of Atrial Fibrillation Better Care (ABC) pathway adherence among high-risk subgroups of patients with atrial fibrillation (AF), ie. those with chronic kidney disease (CKD), advanced age and/or prior thromboembolism remains unknown. We evaluated the impact of ABC pathway adherence on clinical outcomes in these high-risk AF patients.
Methods
The EORP-AF General Long-Term Registry is a prospective, observational registry from 250 centres across 27 European countries. High-risk patients were defined as those with either CKD (eGFR <60 mL/min/1.73 m2), older age (≥75 years) and/or prior thromboembolism. The primary outcome was a composite event of all-cause death, any thromboembolism and acute coronary syndrome, evaluated according to ABC pathway adherence.
Results
A total of 6646 patients with AF were included (median age was 70 [IQR 61–77] years; 40.2% females). There were 3304 (54.2%) `high risk' patients with either CKD (n=1750), older age (n=2236) or prior thromboembolism (n=728). Among these there were 924 (28.0%) managed as adherent to ABC.
At 2-year follow-up, a total of 966 (14.5%) patients reported the primary outcome. The incidence of the primary outcome was significantly lower in high-risk patients managed as adherent to ABC pathway (IRR 0.53 [95% CI, 0.43–0.64]). Consistent results were obtained in the individual subgroups [Table]. Using multivariable Cox proportional hazards analysis, ABC adherence in the high-risk cohort was independently associated with a lower risk of primary outcome (aHR 0.64 [95% CI, 0.51–0.80]), as well as in the CKD (aHR 0.51 [95% CI, 0.37–0.70]) and elderly subgroups (aHR 0.69 [95% CI, 0.53–0.90]). Overall, there was greater reduction in the risk of primary outcome as more ABC criteria were fulfilled, both in the overall high-risk patients, as well as in the individual subgroups [Figure].
Conclusion
In a large, contemporary European AF cohort there was a significant proportion of high-risk patients. Among these, a low prevalence of integrated care, as assessed by adherence to ABC pathway, was found. Nonetheless, a clinical management adherent to the ABC pathway was associated with a significant reduction in the risk of adverse outcomes, the benefits of which were more significant with increasing number of ABC criteria adherent.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- W Y Ding
- University of Liverpool , Liverpool , United Kingdom
| | | | | | - M Vitolo
- University of Liverpool , Liverpool , United Kingdom
| | - A M Fawzy
- University of Liverpool , Liverpool , United Kingdom
| | - G Boriani
- Modena Polyclinic Modena University Hospital , Modena , Italy
| | - F Marin
- University of Murcia , Murcia , Spain
| | | | | | - L Fauchier
- University Hospital of Tours , Tours , France
| | - G Y H Lip
- University of Liverpool , Liverpool , United Kingdom
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22
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Escolar Conesa A, Esteve Pastor MA, Roldan Schilling V, Rivera Caravaca JM, Gil Perez P, Gonzalez Lozano E, Taboada Martin R, Arribas Leal JM, De La Morena Valenzuela G, Saura Espin D, Oliva Sandoval MJ, Pinar Bermudez E, Garcia De Lara J, Marin F. Clinical and prognosis assessment of Atrial Fibrillation patients with significant valvular disease. Validation of the EHRA valve classification (Evaluated Heartvalves. Rheumatic or Artificial). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Historically, the definition of valvular heart disease in atrial fibrillation (AF) patients has been inconsistent. For this reason, in 2017 the EHRA proposed a more accurate classification, classifing AF patients in EHRA I (AF patients with mechanical prostheses or moderate/severe rheumatic mitral stenosis), EHRA II (includes the presence of significant valve disease, bioprosthetic valve replacement, TAVR – Transcatheter Aortic Valve Replacement – or mitraclip) and EHRA III (absence of valve involvement).
Purpose
The objective was to evaluate the prevalence of valve involvement in AF patients, clinical characteristics and adverse outcomes according to new EHRA classification, focusing in the EHRA II vs EHRA III comparison.
Methods
Observational, multicenter, retrospective study of stable anticoagulated AF patients was performed. Clinical, echocardiographic, demographic characteristics and adverse events after 2 years of follow-up were collected according to EHRA II vs EHRA III groups.
Results
981 patients were analyzed: 755 (76.9%) classified as EHRA II [440 (56.8%) with native valve involvement, 134 (17.8%) with surgical biological prostheses and 181 (23.4%) with TAVR] and 226 (23.1%) as EHRAIII. Higher comorbidity profile was observed in the different EHRA II subgroups compared to patients with EHRA III (Table 1). After 2 years of follow-up, the occurrence of adverse events was higher in EHRA-II than EHRA III patients (Figure 1). In the Cox analysis, weo bserved that patients with native valve involvement and TAVR had up to 3 times higher risk of mortality [HR 3.32, (95% CI 1.88–5.85; p<0.001)], 2 times higher risk of Heart Failure [HR 2.14, (95 CI 1.30–3.5; p<0.001)] and MACE [HR 2.01, (95% CI 1.14–3.52; p<0.015)] than EHRA III patients.
Conclusion
The prevalence of valve involvement in patients with AF is high. Only 23% of AF patients did not present any valve disease. Patients with native valve involvement or TAVR had a high burden of comorbidities and cardiovascular risk factors. Patients with native involvement and TAVR also showed an 2.5-fold increased risk of adverse events during the follow-up. These findings highlight the increased risk related with the presence of valve disease in patients with AF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Escolar Conesa
- Virgen of the Arrixaca University Clinical Hospital, Cardiology , El Palmar , Spain
| | - M A Esteve Pastor
- Virgen of the Arrixaca University Clinical Hospital, Cardiology , El Palmar , Spain
| | - V Roldan Schilling
- Morales Meseguer University General Hospital, Hematology , Murcia , Spain
| | - J M Rivera Caravaca
- Virgen of the Arrixaca University Clinical Hospital, Cardiology , El Palmar , Spain
| | - P Gil Perez
- Virgen of the Arrixaca University Clinical Hospital, Cardiology , El Palmar , Spain
| | - E Gonzalez Lozano
- Virgen of the Arrixaca University Clinical Hospital, Clinical Pharmacology , El Palmar , Spain
| | - R Taboada Martin
- Virgen of the Arrixaca University Clinical Hospital, Cardiac Surgery , El Palmar , Spain
| | - J M Arribas Leal
- Virgen of the Arrixaca University Clinical Hospital, Cardiac Surgery , El Palmar , Spain
| | | | - D Saura Espin
- Virgen of the Arrixaca University Clinical Hospital, Cardiology , El Palmar , Spain
| | - M J Oliva Sandoval
- Virgen of the Arrixaca University Clinical Hospital, Cardiology , El Palmar , Spain
| | - E Pinar Bermudez
- Virgen of the Arrixaca University Clinical Hospital, Cardiology , El Palmar , Spain
| | - J Garcia De Lara
- Virgen of the Arrixaca University Clinical Hospital, Cardiology , El Palmar , Spain
| | - F Marin
- Virgen of the Arrixaca University Clinical Hospital, Cardiology , El Palmar , Spain
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Bonini N, Proietti M, Romiti GF, Vitolo M, Fawzy AM, Ding WY, Fauchier L, Marin F, Nabauer M, Potpara TS, Dan GA, Boriani GA, Lip GYH. ABC adherence and impact of optimal medical therapy in heart failure patients with atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heart failure (HF) has close association with atrial fibrillation (AF). The ESC guideline recommended Atrial fibrillation Better care (ABC) pathway aims to reduce major cardiovascular adverse outcomes with an integrated care approach. Optimal medical treatment (OMT) represents the cornerstone in HF management.
Purpose
To investigate the variables affecting OMT treatment and its impact, in conjunction with ABC pathway adherence (vs non-adherence, ie.no ABC), in a large contemporary cohort of European AF patients with HF enrolled in the ESC-EHRA EORP-AF General Long-Term Registry.
Methods
OMT was defined as treatment with Angiotensin-converting-enzyme inhibitors (ACE-i)/ Angiotensin receptor blockers (ARBs) with Beta-Blockers and/or Mineralocorticoid receptor antagonists (MRAs), and compared to non-OMT adherence (“no OMT”). A logistic regression analysis explored factors associated with OMT adherence. We identified three patient groups: (i) HF with no OMT/no ABC; (ii) HF with OMT/no ABC; (iii) HF with OMT/ABC. Primary outcome was a composite outcome of all-cause death and major adverse cardiac events (MACE).
Results
Among the original 11096 patients enrolled, 9857 (88.8%) were included in this analysis. Among these, 3819 (38.7%) had HF. Compared to non HF patients, those with HF were older, more likely female, had more comorbidities and higher thromboembolic risk. OMT prevalence was 2228/3819 (58.3%), while ABC adherence was 23.3%.
On logistic multivariable regression, increasing age, higher BMI and higher frailty index were associated with OMT adherence, while male sex, anemia, renal disease and EHRA II–IV were inversely associated with OMT adherence. According to three HF groups, the rates of composite outcome progressively decreased (HF with no OMT/no ABC 26.4%; HF with OMT/no ABC 24%, HF with OMT/ABC 19%; p<0.001). Kaplan Meier curve showed progressively lower cumulative risk for the composite outcome across the three groups with the lowest risk among HF patients with OMT/ABC (Log-rank: p=0.002) [Figure 1]. Adjusted Cox regression analysis showed that when compared to HF with no OMT/no ABC group, there was a progressively lower risk with OMT and/or ABC adherence (HF with OMT/no ABC: HR 0.81 [95% CI, 0.64–1.02]; HF with OMT/ABC: HR 0.68 [95% CI, 0.5–0.92]).
Conclusions
After two years of follow-up, in a large contemporary cohort of European AF patients with HF, OMT adherence was suboptimal, being influenced by several clinical factors, determining a low adherence to the ABC pathway. OMT alone showed a non-significant reduction in composite outcome events. Conversely HF patients managed with OMT in the context of ABC pathway adherence showed the best reduction in risk of adverse outcomes.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Since the start of EORP, the following companies have supported the programme: Abbott Vascular Int. (2011–2021), Amgen Cardiovascular (2009–2018), AstraZeneca (2014–2021), Bayer (2009–2018), Boehringer Ingelheim (2009–2019), Boston Scientific (2009–2012), The Bristol Myers Squibb and Pfizer Alliance (2011–2016), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2011–2017), Edwards (2016–2019), Gedeon Richter Plc. (2014–2017), Menarini Int. Op. (2009–2012), MSD-Merck & Co. (2011–2014), Novartis Pharma AG (2014–2020), ResMed (2014–2016), Sanofi (2009–2011), SERVIER (2010–2021), and Vifor (2019–2022). - I agree that this information can be anonymised and then used for statistical purposes only
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Affiliation(s)
- N Bonini
- University of Liverpool , Liverpool , United Kingdom
| | | | - G F Romiti
- Sapienza University of Rome , Rome , Italy
| | - M Vitolo
- University of Modena and Reggio Emilia , Modena , Italy
| | - A M Fawzy
- University of Liverpool , Liverpool , United Kingdom
| | - W Y Ding
- University of Liverpool , Liverpool , United Kingdom
| | - L Fauchier
- University Hospital of Tours , Tours , France
| | - F Marin
- Virgen of the Arrixaca University Hospital , Murcia , Spain
| | - M Nabauer
- Ludwig Maximilians University , Munich , Germany
| | | | - G A Dan
- University of Bucharest Carol Davila , Bucharest , Romania
| | - G A Boriani
- University of Modena and Reggio Emilia , Modena , Italy
| | - G Y H Lip
- University of Liverpool , Liverpool , United Kingdom
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24
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Proietti M, Romiti GF, Vitolo M, Bonini N, Fawzy AM, Ding WY, Fauchier L, Marin F, Nabauer M, Potpara TS, Dan GA, Boriani G, Lip GYH. Features of clinical complexity in european patients with atrial fibrillation: a report from the ESC-EHRA EORP atrial fibrillation general long-term registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
There is increasing concern regarding the burden of clinical complexity, beyond thromboembolic risk, in patients with atrial fibrillation (AF). Also, clinical complexity is heterogenous and entails differential impact on the patients' clinical course.
Purpose
To explore different complexity features in AF patients in determining differences in clinical management and outcomes.
Methods
We analyzed patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Features of complexity were analysed in the context of the following high-risk groups: i) only CHA2DS2-VASc ≥2; ii) history of stroke/bleeding; iii) chronic kidney disease (creatinine clearance <60 mL/min, CKD); iv) frail (frailty index ≥0.25); v) ≥2 criteria. All these groups were compared to a low-risk group (CHA2DS2-VASc 0–1). We examined use of oral anticoagulant (OAC) and the risks of a composite outcome of all-cause death and major adverse cardiovascular events.
Results
A total of 10285 patients (mean [SD] age 68.8 [11.5] years, 4107 [39.9%] females) were included in the analysis. Of these, 3944 (38.3%) had only CHA2DS2-VASc ≥2; 412 (4.0%); history of stroke/bleeding; 1480 (14.4%) CKD; 1007 (9.8%) were frail; 1315 (12.8%) had ≥2 criteria; and 2127 (20.7%) were low-risk. After adjustment for age, sex, type of AF and EHRA score, compared to low-risk patients, all the other groups were associated with OAC prescription but with progressively lower odds ratio, while those ≥2 criteria which were least likely prescribed with OAC (Table 1).
After a mean (SD) 634.5 (223.0) days of follow-up, a total of 1432 events were recorded. After adjustment for confounders, Cox regression analysis found that all the complexity groups were associated with a higher risk of the composite outcome across the groups (Figure 1). In patients with available data about ABC (Atrial fibrillation Better Care) pathway adherence, the latter adherence was associated a significant incidence rate reduction (IRR) compared to non-ABC adherence in those with ≥2 criteria of clinical complexity (IRR 0.46, 95% CI 0.30–0.71), and in the CKD complexity group (IRR 0.57, 95% CI 0.41–0.81).
Conclusions
In a large contemporary cohort of European AF patients, features of clinical complexity affect differently prescriptions of OAC. All the subgroups of clinical complexity were associated with a higher risk of adverse outcomes, which were reduced by adherence to ABC pathway.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Since the start of EORP, the following companies have supported the programme: Abbott Vascular Int. (2011–2021), Amgen Cardiovascular (2009–2018), AstraZeneca (2014–2021), Bayer (2009–2018), Boehringer Ingelheim (2009–2019), Boston Scientific (2009–2012), The Bristol Myers Squibb and PfizerAlliance (2011–2016), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2011–2017), Edwards (2016–2019), Gedeon Richter Plc. (2014–2017), Menarini Int. Op. (2009–2012), MSD-Merck & Co. (2011–2014), Novartis Pharma AG (2014–2020), ResMed (2014–2016), Sanofi (2009–2011), SERVIER (2010–2021), and Vifor (2019–2022).
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Affiliation(s)
- M Proietti
- University of Milan, Department of Clinical Sciences and Community Health , Milan , Italy
| | - G F Romiti
- Sapienza University of Rome, Department of Translational and Precision Medicine , Rome , Italy
| | - M Vitolo
- University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neural Sciences , Modena , Italy
| | - N Bonini
- University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neural Sciences , Modena , Italy
| | - A M Fawzy
- University of Liverpool, Liverpool Centre for Cardiovascular Sciences , Liverpool , United Kingdom
| | - W Y Ding
- University of Liverpool, Liverpool Centre for Cardiovascular Sciences , Liverpool , United Kingdom
| | - L Fauchier
- University Hospital of Tours , Tours , France
| | - F Marin
- University of Murcia , Murcia , Spain
| | - M Nabauer
- Ludwig-Maximilians University , Munich , Germany
| | | | - G A Dan
- University of Medicine and Pharmacy Carol Davila , Bucharest , Romania
| | - G Boriani
- University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neural Sciences , Modena , Italy
| | - G Y H Lip
- University of Liverpool, Liverpool Centre for Cardiovascular Sciences , Liverpool , United Kingdom
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25
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Rivera-Caravaca JM, Serna MJ, Lopez-Galvez R, Lip GYH, Marin F, Roldan V. Longitudinal changes in CHA2DS2-VASc and HAS-BLED scores are superior to baseline score values for predicting ischemic stroke and major bleeding in atrial fibrillation patients. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Stroke and bleeding risks in atrial fibrillation (AF) are often assessed at baseline, as a “one-off” evaluation. However, these baseline values are usually applied to predict outcomes many years later, and therefore lack the consideration that the risk is not static.
Purpose
Our aim was to investigate if dynamic changes of CHA2DS2-VASc and HAS-BLED over time have an effect on the prediction of stroke and bleeding risks.
Methods
We included AF patients who were stable while taking vitamin K antagonists (INR 2.0–3.0) for 6 months attending a tertiary hospital (May 2007-December 2007). During 6-years of follow-up, ischemic strokes/transient ischemic attacks (TIAs), major bleeds, and all-cause deaths were recorded. CHA2DS2-VASc and HAS-BLED were recalculated every 2-years, and their predictive abilities were tested for outcomes in periods of 2-years (from year 0 to 2, year 2 to 4 and year 4 to 6).
Results
1361 patients (693 [50.9%] females, median age 76 [IQR 71–81] years, mean CHA2DS2-VASc and HAS-BLED of 4.0±1.7 and 2.9±1.2, respectively) were included. The predictive ability for ischemic stroke/TIA of the baseline CHA2DS2-VASc for 2-years events was 0.662 (0.637–0.688, p<0.001). Compared to the baseline CHA2DS2-VASc, the CHA2DS2-VASc re-calculated at 2-years presented significantly higher predictive ability for ischemic stroke/TIA during the period 2–4 years (c-indexes: 0.701 [0.675–0.727] vs. 0.604 [0.576–0.631], p<0.001). Integrated discrimination improvement (IDI) and net reclassification improvement (NRI) showed an improvement in sensitivity of 0.014 (p<0.001) and a better reclassification (0.677, p<0.001). Similarly, the CHA2DS2-VASc re-calculated at 4-years yielded significantly better predictive performance for ischemic stroke/TIA during the period 4–6 years in comparison to the baseline CHA2DS2-VASc (c-indexes: 0.761 [0.734–0.786] vs. 0.682 [0.653–0.710], p=0.026). Again, IDI reported an improvement (IDI = 0.030, p<0.001) and there was an important enhance of the reclassification ability (NRI = 0.757, p<0.001).
The c-index of the baseline HAS-BLED for events at 2-years was 0.744 (0.720–0.767, p<0.001). At 2-years, the re-calculated HAS-BLED score showed higher predictive ability compared to the baseline HAS-BLED during the period 2–4 year (c-indexes: 0.709 [0.680–0.738] vs. 0.663 [0.632–0.693], p=0.003). Accordingly, IDI and NRI demonstrated significant improvements for the re-calculated HAS-BLED compared to baseline (IDI = 0.016, p=0.001; NRI = 0.444, p<0.001). For major bleeding during the period 4–6 years, the c-index of the HAS-BLED score re-calculated at 4-years was non-significantly different to baseline HAS-BLED at baseline (0.631 [0.601–0.660] vs. 0.623 [0.593–0.652], p=0.751), although showed a slight enhance in sensitivity (IDI = 0.009, p=0.018).
Conclusions
In AF patients, stroke and bleeding risks are dynamic and change over time. The CHA2DS2-VASc and HAS-BLED scores should be regularly reassessed.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by the Spanish Ministry of Economy, Industry, and Competitiveness, through the Instituto de Salud Carlos III after independent peer review (research grant: PI17/01375 co-financed by the European Regional Development Fund)
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Affiliation(s)
- J M Rivera-Caravaca
- Virgen de la Arrixaca University Clinical Hospital, University of Murcia , Murcia , Spain
| | - M J Serna
- Morales Meseguer University General Hospital, Hematology and Clinical Oncology , Murcia , Spain
| | - R Lopez-Galvez
- Virgen de la Arrixaca University Clinical Hospital, University of Murcia , Murcia , Spain
| | - G Y H Lip
- Liverpool Heart and Chest Hospital, University of Liverpool, Liverpool Center for Cardiovascular Siences , Liverpool , United Kingdom
| | - F Marin
- Virgen de la Arrixaca University Clinical Hospital, University of Murcia , Murcia , Spain
| | - V Roldan
- Morales Meseguer University General Hospital, Hematology and Clinical Oncology , Murcia , Spain
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26
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Romiti GF, Proietti M, Vitolo M, Bonini N, Fawzy AM, Ding WY, Fauchier L, Marin F, Nabauer M, Dan GA, Potpara T, Boriani G, Lip GYH. Impact of the atrial fibrillation better care pathway in clinically complex patients with atrial fibrillation: a report from the ESC-EHRA EORP-AF General Long-Term Registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The “Atrial fibrillation Better Care” (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We analyzed the impact of the ABC pathway in a contemporary cohort of clinically complex AF patients.
Methods
From the ESC-EHRA EORP-AF General Long-Term Registry, we analyzed clinically complex AF patients, defined as the presence of frailty (according to a 40-items Frailty Index), multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on the risk of all-cause death, major adverse cardiovascular events (MACEs) and the composite outcome of all-cause death and MACE was analyzed through Cox-regression analyses, and delay of event (DoE) analyses; number needed to treat (NNT) was also estimated at 1 year of follow-up.
Results
Among 9,966 AF patients, 8,289 (92.3%) were clinically complex. Risk of all outcomes was higher among clinically complex patient. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.71, 95% CI 0.57–0.89), major adverse cardiovascular events (MACEs, aHR: 0.68, 95% CI 0.53–0.87) and composite outcome (aHR: 0.69, 95% CI: 0.57–0.84). Using cluster analysis, we identified a high clinical complexity group of AF patients. Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.73, 95% CI 0.55–0.96) and composite outcome (aHR: 0.69, 95% CI 0.57–0.84) in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all-cause death (Figure 1), MACEs, and composite outcome in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the NNTs for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome.
Conclusions
An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes amongst clinically complex AF patients.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Since the start of EORP, several companies have supported the programme with unrestricted grants.
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Affiliation(s)
- G F Romiti
- University of Liverpool , Liverpool , United Kingdom
| | - M Proietti
- University of Milan, Department of Clinical Sciences and Community Health , Milan , Italy
| | - M Vitolo
- University of Modena and Reggio Emilia, Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences , Modena , Italy
| | - N Bonini
- University of Modena and Reggio Emilia, Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences , Modena , Italy
| | - A M Fawzy
- University of Liverpool , Liverpool , United Kingdom
| | - W Y Ding
- University of Liverpool , Liverpool , United Kingdom
| | - L Fauchier
- Centre Hospitalier Universitaire Trousseau, Service de Cardiologie , Tours , France
| | - F Marin
- Virgen de la Arrixaca University Clinical Hospital, Department of Cardiology , Murcia , Spain
| | - M Nabauer
- Ludwig-Maximilians University, Department of Cardiology , Munich , Germany
| | - G A Dan
- Colentina University Hospital, University of Medicine “Carol Davila” , Bucharest , Romania
| | - T Potpara
- School of Medicine, Belgrade University , Belgrade , Serbia
| | - G Boriani
- University of Modena and Reggio Emilia, Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences , Modena , Italy
| | - G Y H Lip
- University of Liverpool , Liverpool , United Kingdom
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27
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Vitolo M, Proietti M, Bonini N, Romiti GF, Fauchier L, Marin F, Nabauer M, Potpara TS, Dan GA, Kalarus Z, Tavazzi L, Maggioni AP, Lane DA, Lip GYH, Boriani G. Factors associated with progression of atrial fibrillation and impact on all-cause mortality: an ancillary analysis from the ESC-EHRA EURObservational Research Programme in Atrial Fibrillation General. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Paroxysmal atrial fibrillation (AF) often shows a natural progression towards more sustained forms of the arrhythmia. Real-world data on clinical factors associated to AF progression and its impact on long-term outcome are limited.
Purpose
To investigate the factors associated with progression of AF and its impact on all-cause mortality in a contemporary cohort of European AF patients
Methods
We analyzed patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Patients with paroxysmal AF at baseline or first detected AF who underwent successful cardioversion were included. Patients with known rhythm status at 1-year were then stratified into two groups: (i) No AF progression and (ii) AF progression (as defined by transition to persistent or permanent AF). All-cause mortality at 2-year of follow-up was the primary outcome of the analysis.
Results
A total of 2688 patients were included (median age 67 years, interquartile range [IQR] 60–75, females 44.7%, CHA2DS2VASc score median 3 [1–4], HASBLED median 1 [1–2]). After 1-year of follow-up 2094 (77.9%) patients showed no AF progression while 594 (22.1%) developed AF progression. On multivariable logistic regression analysis, no physical activity (odds ratio [OR] 1.35, 95% confidence interval [CI] 1.02–1.78), valvular heart disease (OR 1.63, 95% CI 1.23–2.15), left atrium diameter (OR 1.03, 95% CI 1.01–1.05) and left ventricular ejection fraction (OR 0.98, 95% CI 0.97–1.00) were independently associated with AF progression at 1-year. At the end of 2-year of follow-up, death occurred in 80/2621 (3.1%) patients. Kaplan-Meier analysis showed a lower cumulative survival from all-cause mortality in patients with AF progression compared to non-progression AF patients (Log Rank p=0.01, Figure 1). On multivariable Cox regression analysis, adjusted for age, sex, heart failure, coronary artery disease, hypertensions, diabetes mellitus, previous thromboembolic events, peripheral artery disease, chronic kidney disease and use of oral anticoagulants, patients with AF progression had an independently higher risk for all-cause mortality (adjusted hazard ratio [aHR] 1.77, 95% CI 1.09–2.89).
Conclusions
In a contemporary cohort of European AF patients, a substantial number of patients progressed to sustained AF within 1 year. Clinical factors related to atrial structural remodeling were independently associated with arrhythmia progression. AF progression was associated with an increased risk of all-cause mortality.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Since the start of EORP, the following companies have supported the programme: Abbott Vascular Int. (2011–2021), Amgen Cardiovascular (2009–2018), AstraZeneca (2014–2021), Bayer (2009–2018), Boehringer Ingelheim (2009–2019), Boston Scientific (2009–2012), The Bristol Myers Squibb and Pfizer Alliance (2011–2016), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2011–2017), Edwards (2016–2019), Gedeon Richter Plc. (2014–2017), Menarini Int. Op. (2009–2012), MSD-Merck & Co. (2011–2014), Novartis Pharma AG (2014–2020), ResMed (2014–2016), Sanofi (2009–2011), SERVIER (2010–2021), and Vifor (2019–2022).
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Affiliation(s)
- M Vitolo
- Modena Polyclinic Modena University Hospital , Modena , Italy
| | - M Proietti
- University of Milan, Department of Clinical Sciences and Community Health , Milan , Italy
| | - N Bonini
- Modena Polyclinic Modena University Hospital , Modena , Italy
| | - G F Romiti
- Sapienza University of Rome , Rome , Italy
| | - L Fauchier
- University Hospital of Tours , Tours , France
| | - F Marin
- University of Murcia , Murcia , Spain
| | - M Nabauer
- Ludwig Maximilians University , Munich , Germany
| | - T S Potpara
- University Belgrade Medical School , Belgrade , Serbia
| | - G A Dan
- University of Bucharest , Bucharest , Romania
| | - Z Kalarus
- Silesian Center for Heart Diseases (SCHD) , Zabrze , Poland
| | - L Tavazzi
- Maria Cecilia Hospital , Cotignola , Italy
| | | | - D A Lane
- University of Liverpool, Liverpool Centre for Cardiovascular Science , Liverpool , United Kingdom
| | - G Y H Lip
- University of Liverpool, Liverpool Centre for Cardiovascular Science , Liverpool , United Kingdom
| | - G Boriani
- Modena Polyclinic Modena University Hospital , Modena , Italy
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Bonini N, Proietti M, Romiti GF, Vitolo M, Fawzy AM, Ding YD, Fauchier L, Marin F, Nabauer M, Potpara TS, Dan GA, Boriani G, Lip GYH. Heart failure and cardiovascular outcomes in european patients with atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Heart failure (HF) has an intimate bidirectional association with atrial fibrillation (AF). Few data are available about the impact of HF phenotypes (HF with preserved ejection fraction, HFpEF; HF with mildly reduced ejection fraction, HFmrEF; HF with reduced ejection fraction, HFrEF) as predictors for adverse outcomes in AF patients.
Purpose
To investigate the association of HFpEF, HFmrEF and HFrEF with adverse outcomes in a large contemporary cohort of European AF patients and evaluate the effect of EF throughout its entire spectrum.
Methods
We analyzed patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. HF patients were categorized according the three phenotypes and compared to those without HF (“non HF”). Main outcome was a composite outcome of all-cause death and major adverse cardiac events (MACE).
Results
Among the original 11,096 AF patients enrolled, 9857 (88.8%) were included in this analysis (median age 71 years, interquartile range [IQR 63–77], 40.1% females) with median EF 55% [IQR 45–61%] and CHA2DS2-VASc 3 [2–4]). In this cohort, 5935 (60.2%) were non HF patients, and 3240 (32.9%) had HF patients (with HF status and EF values data available). Accordingly, 1662 (51.2%) were categorized as HFpEF; 523 (14.1%) were HFmrEF; and 1235 (35.1%) were HFrEF.
After a median follow-up of 731 days [IQR 690–748], the composite outcome was significantly higher throughout HF categories (HFpEF 19.0%, HFmrEF 21.8% and HFrEF 29.6%, compared to non HF 10.7%; p<0.001). In a fully adjusted multivariate Cox regression, HF phenotypes were associated with a progressively higher risk for the composite outcome (HFpEF HR 1.45 [95% CI, 1.23–1.70]; HFmrEF HR 1.82 [95% CI, 1.45–2.3]; HFrEF HR 2.51 [95% CI, 2.14–2.95], when compared to non HF patients). Considering EF in its continuous spectrum, an adjusted regression curve analysis found that progressively lower EF was associated with a progressively higher risk for the composite outcome, both in HF and overall AF patients (Figure 1, left and right panel, respectively).
Conclusions
Over a two-years follow-up, in a large contemporary cohort of European AF patients, HF phenotypes were associated with a progressively higher risk for adverse outcomes. Lower EF values increased the risk of adverse outcomes both in HF patients and overall AF patients, irrespective of HF phenotype status.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Since the start of EORP, the following companies have supported the programme: Abbott Vascular Int. (2011–2021), Amgen Cardiovascular (2009–2018), AstraZeneca (2014–2021), Bayer (2009–2018), Boehringer Ingelheim (2009–2019), Boston Scientific (2009–2012), The Bristol Myers Squibb and Pfizer Alliance (2011–2016), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2011–2017), Edwards (2016–2019), Gedeon Richter Plc. (2014–2017), Menarini Int. Op. (2009–2012), MSD-Merck & Co. (2011–2014), Novartis Pharma AG (2014–2020), ResMed (2014–2016), Sanofi (2009–2011), SERVIER (2010–2021), and Vifor (2019–2022).
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Affiliation(s)
- N Bonini
- University of Liverpool , Liverpool , United Kingdom
| | | | - G F Romiti
- Sapienza University of Rome , Rome , Italy
| | - M Vitolo
- University of Modena and Reggio Emilia , Modena , Italy
| | - A M Fawzy
- University of Liverpool , Liverpool , United Kingdom
| | - Y D Ding
- University of Liverpool , Liverpool , United Kingdom
| | - L Fauchier
- University Hospital of Tours , Tours , France
| | - F Marin
- Virgen de la Arrixaca University Clinical Hospital , Murcia , Spain
| | - M Nabauer
- Ludwig Maximilians University , Munich , Germany
| | | | - G A Dan
- University of Bucharest Carol Davila , Bucharest , Romania
| | - G Boriani
- University of Modena and Reggio Emilia , Modena , Italy
| | - G Y H Lip
- University of Liverpool , Liverpool , United Kingdom
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29
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Rivera-Caravaca JM, Zazo-Luengo B, Martinez-Montesinos L, Lopez-Galvez R, Garcia-Tomas L, Lip GYH, Marin F, Roldan V. Multimorbidity, frailty and malnutrition: moving beyond traditional risk factors for risk assessment in atrial fibrillation. The Murcia Atrial Fibrillation Project II. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The management of atrial fibrillation (AF) has evolved over the last decade with a more towards a more multidisciplinary, integrated and holistic approach. However, several conditions that may influence the prognosis and management of AF patients are still under-recognised.
Purpose
Our aim was to investigate if multimorbidity, frailty and malnutrition are associated with the risk of worse clinical outcomes in patients with recent diagnosis of AF starting oral anticoagulation (OAC) therapy.
Methods
Prospective cohort study including outpatients newly diagnosed with AF starting vitamin K antagonist (VKA) therapy from July 1, 2016 to June 30, 2018. Morbidity was assessed with the crude number of comorbidities. Frailty was assessed with the Clinical Frailty Scale (CFS). Nutrition status was assessed with the Controlling Nutritional Status (CONUT) score. During 2-years of follow-up, we recorded all ischemic strokes/transient ischemic attacks (TIAs), major bleeds (according to the 2005 International Society on Thrombosis and Haemostasis criteria), and all-cause deaths.
Results
We included 1050 patients (540 [51.4%] females, median age 77 [IQR 70–83] years), with median CHA2DS2-VASc of 4 [IQR 3–5] and median HAS-BLED of 2 [IQR 2–3]. The median crude number of comorbidities was 3 [IQR 2–5], whereas the median CFS and CONUT score were 2 [IQR 2–3] and 2 [IQR 1–3], respectively. The crude number of comorbidities, CFS and CONUT score demonstrated a significant positive correlation (p<0.001 for all correlations). After adjusting for several risk factors (age, sex, hypertension, diabetes, previous stroke, vascular disease, heart failure, chronic kidney disease, dyslipidemia, sleep apnoea, hepatic disease, and cancer), the CFS was independently associated with major bleeding (adjusted HR 1.25, 95% CI 1.07–1.45) and all-cause mortality (aHR 1.20, 95% CI 1.09–1.32). The crude number of comorbidities (aHR 1.30, 95% CI 1.14–1.49) was also associated with major bleeding, and the CONUT score (aHR 1.25, 95% CI 1.15–1.35) was associated with all-cause mortality. Any frailty degree (i.e CFS ≥5) was associated with a 3-fold higher risk of major bleeding (aHR 3.04, 95% CI 1.67–5.52) and a 2-fold higher risk of death (aHR 2.04, 95% CI 1.39–3.01), whereas the moderate/severe malnutrition (i.e. CONUT ≥5) was an independent risk factor for ischemic stroke/TIA and (aHR 2.25, 95% CI 1.11–4.56) and death (aHR 3.21, 95% CI 2.14–4.83) (Figures 1 and 2).
Conclusions
Frailty and malnutrition are important risk factors for bleeding, stroke and mortality in AF. The frailty degree and nutritional status should be assessed in all AF patients in order to address them properly and provide a truly integrated management.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by the Spanish Ministry of Economy, Industry, and Competitiveness, through the Instituto de Salud Carlos III after independent peer review (research grant: PI17/01375 co-financed by the European Regional Development Fund)
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Affiliation(s)
- J M Rivera-Caravaca
- Virgen de la Arrixaca University Clinical Hospital, University of Murcia , Murcia , Spain
| | - B Zazo-Luengo
- Morales Meseguer University General Hospital, Hematology and Clinical Oncology , Murcia , Spain
| | - L Martinez-Montesinos
- Morales Meseguer University General Hospital, Hematology and Clinical Oncology , Murcia , Spain
| | - R Lopez-Galvez
- Virgen de la Arrixaca University Clinical Hospital, University of Murcia , Murcia , Spain
| | - L Garcia-Tomas
- Morales Meseguer University General Hospital, Hematology and Clinical Oncology , Murcia , Spain
| | - G Y H Lip
- Liverpool Heart and Chest Hospital, University of Liverpool, Liverpool Center for Cardiovascular Siences , Liverpool , United Kingdom
| | - F Marin
- Virgen de la Arrixaca University Clinical Hospital, University of Murcia , Murcia , Spain
| | - V Roldan
- Morales Meseguer University General Hospital, Hematology and Clinical Oncology , Murcia , Spain
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30
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Anguita Gamez M, Esteban A, Bonilla JL, Garcia M, Bernal JL, Del Prado N, Fernandez Perez C, Gomez Doblas JJ, Perez Villacastin J, Marin F, Elola FJ, Anguita Sanchez M. Clinical features and short-term prognosis in the very elderly, >90 year-old, patients hospitalized with heart failure. A population-based study (2016–2019). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heart failure (HF) is a main health problem in western countries, and a major cause of hospitalizations and death, particularly in older people. Few data are available about clinical features and prognosis of very old patients, those aged 90 or more years.
Purpose
To analyse the clinical features and short-term prognosis (in-hospital mortality and 30-day readmission rate) of patients aged 90 or more years hospitalized with HF in Spain in the last years.
Methods
We conducted a retrospective analysis of patients discharged with an ICD-10 main diagnosis of HF from the Spanish National Health System (SNHS) public hospitals between 2016 and 2019, using as source of data the Minimum Basic Data Set of the SNHS. A comparison of clinical profile, in-hospital mortality and 30-day cardiovascular readmission rate between patients aged 75 to 89 years and those with 90 or more years was performed.
Results
From 2016 to 2019, 354,792 episodes of people older than 74-year and principal diagnosis of HF were included, being 59.2% female. Mean age of the whole population was 85.2±5.5 years, crude in-hospital mortality rate was 12.7% and crude cardiovascular 30-day readmission rate, 11.8%. The very older patients' subgroup (90 or more year-old) comprised 78.777 patients (22.2%). Table 1 shows the differences in clinical features between these patients and those aged 75 to 89 (77.8%). Patients aged 90 or more years were female in a higher proportion and showed a higher prevalence of cognitive impairment and renal failure, but a lower prevalence of most comorbidities (coronary artery revascularization, valve heart disease, cancer, diabetes mellitus, chronic liver disease). The diagnosis of previous myocardial infarction, stroke and systemic hypertension was similar in both groups (Table 1). Crude 30-day cardiovascular readmission rate was slightly but significantly lower in the oldest subgroup (10.9% vs 12%, p<0.001), while crude in-hospital mortality was higher (18.5% vs 11%, p<0.001).
Conclusions
Patients aged 90 or more years represents almost a fourth part of elderly patients hospitalized with HF in Spain within the last years. In general, prevalence of comorbidities and associated heart disease was similar or lower, but in-hospital mortality was twice higher, as compared with less older patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - A Esteban
- University Hospital Severo Ochoa, Cardiology , Leganes , Spain
| | - J L Bonilla
- Hospital San Juan de la Cruz, Cardiology , Ubeda , Spain
| | - M Garcia
- Interhospital Foundation for Cardiovascular Research, Fundacion IMAS , Madrid , Spain
| | - J L Bernal
- Interhospital Foundation for Cardiovascular Research, Fundacion IMAS , Madrid , Spain
| | - N Del Prado
- Interhospital Foundation for Cardiovascular Research, Fundacion IMAS , Madrid , Spain
| | - C Fernandez Perez
- Interhospital Foundation for Cardiovascular Research, Fundacion IMAS , Madrid , Spain
| | - J J Gomez Doblas
- Virgin of Victory University Hospital, Cardiology , Malaga , Spain
| | | | - F Marin
- University Hospital Virgen de la Arrixaca, Cardiology , Murcia , Spain
| | - F J Elola
- Interhospital Foundation for Cardiovascular Research, Fundacion IMAS , Madrid , Spain
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31
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Lopez-Galvez R, Rivera-Caravaca JM, Mandaglio-Collados D, Martinez CM, Carpes M, Lahoz A, Hernandez-Romero D, Orenes-Pinero E, Lopez-Garcia C, Roldan V, Arribas JM, Canovas S, Lip GYH, Marin F. The ideal environment for the development of postcardiac surgery atrial fibrillation: evidence for endothelial activation and poor cell-cell interaction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The development of post-operative atrial fibrillation (POAF) after cardiac surgeryis associated with pre-existing endothelial activation and systemic inflammation due to adhesion and transmigration of leukocytes into the interstitium. The electrical remodelling associated with AF causes changes in connexins, resulting in ineffective electrical coupling between cells and thus ineffective cell-cell communication.There is also an association between the inflammatory state, and the presence of cardiac fibrosis, oxidative stress and myocyte apoptosis.
Purpose
Our aim was to investigate the pathophysiologicaland regulatory mechanisms of AF through endothelial activation and inflammatory status, as well as cell-cell interactions (connexins) in relation to POAF amongst a cohort of patients undergoing cardiac surgery.
Methods
We studied prospective patients who underwent CABG (52.9%) or cardiac valve (47.1%) surgery without previous documented AF. Patients with permanent AF who underwent CABG or cardiac valve surgery were also included as positive controls. Plasma samples were collected at baseline and 24 hours after surgery, to assess the impact of surgery. To detect endothelial activation, vascular cell adhesion protein-1 (VCAM-1 (CD106)) was evaluated by ELISA assay in plasma samples. Expression of connexin 40 and 43 were measured by inmunohistochemistry in atrial tissue samples.
Results
We included 117 patients (75.2% males, median age 67 [IQR 59.5–73.0] years), of whom17 (14.5%) patients had permanent AF; 27 (23.1%) developed POAF and 73 (62.4%) had no AF detected.
We found higher baseline VCAM-1 levels versus 24-hour samples overall (p=0.001). When comparing groups, baseline VCAM-1 levels were higher in patients with permanent AF compared to non-AF (p=0.035); and in permanent AF compared to POAF (p=0.049). VCAM-1 levels at 24h followed the same trends between permanent AF and non-AF (p=0.001), and permanent AF versus POAF (p=0.013) (Table 1). VCAM-1 levels over the third tertile (i.e.>49.77 ng/ml) increased the risk of AF almost 3-fold (OR 2.85, 95% CI 1.06–7.70; p=0.039). There was a significant decrease in the expression of connexion 40 in patients with AF (ie. patients with permanent AF or POAF) compared to non-AF patients (1.00 [0.50–2.31] vs. 2.48 [1.94–3.00], p=0.044), while connexin 43 was non-significantly different (1.07 [0.41–1.75] vs. 2.00 [0.63–2.25], p=0.289) (Table 2).
Conclusions
VCAM-1 levels were upregulated in patients with permanent AF and POAF compared to patients without AF, and remained higher even after surgery, thus demonstrating a relevantendothelial activation. The pro-inflammatory state presented in these patients with AF, along with decreased connexin 40 expression impacting cell-to-cell conduction, suggests a potential combination for atrial remodelling and incident AF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Lopez-Galvez
- Virgin of the Arrixaca University Clinical Hospital, Department of Cardiology, University of Murcia, CIBERCV , Murcia , Spain
| | - J M Rivera-Caravaca
- Virgin of the Arrixaca University Clinical Hospital, Department of Cardiology, University of Murcia, CIBERCV , Murcia , Spain
| | - D Mandaglio-Collados
- Virgin of the Arrixaca University Clinical Hospital, Department of Cardiology, University of Murcia, CIBERCV , Murcia , Spain
| | - C M Martinez
- Virgin of the Arrixaca University Clinical Hospital, Instituto Murciano de Investigaciόn Biosanitaria (IMIB-Arrixaca) , Murcia , Spain
| | - M Carpes
- Virgin of the Arrixaca University Clinical Hospital, Instituto Murciano de Investigaciόn Biosanitaria (IMIB-Arrixaca) , Murcia , Spain
| | - A Lahoz
- Virgin of the Arrixaca University Clinical Hospital, Cardiovascular Surgery Service, Instituto Murciano de Investigaciόn Biosanitaria (IMIB-Arrixaca) , Murcia , Spain
| | - D Hernandez-Romero
- University of Murcia, Departament of Legal and Forensic Medicine , Murcia , Spain
| | - E Orenes-Pinero
- Virgin of the Arrixaca University Clinical Hospital, Proteomic Unit, Instituto Murciano de Investigaciones Biosanitarias (IMIB-Arrixaca) , Murcia , Spain
| | - C Lopez-Garcia
- Virgin of the Arrixaca University Clinical Hospital, Department of Cardiology, University of Murcia, CIBERCV , Murcia , Spain
| | - V Roldan
- University Hospital Morales Meseguer, Department of Hematology and Clinical Oncology, Instituto Murciano de Investigaciόn Biosanitaria , Murcia , Spain
| | - J M Arribas
- Virgin of the Arrixaca University Clinical Hospital, Cardiovascular Surgery Service, Instituto Murciano de Investigaciόn Biosanitaria (IMIB-Arrixaca) , Murcia , Spain
| | - S Canovas
- Virgin of the Arrixaca University Clinical Hospital, Cardiovascular Surgery Service, Instituto Murciano de Investigaciόn Biosanitaria (IMIB-Arrixaca) , Murcia , Spain
| | - G Y H Lip
- Liverpool Heart and Chest Hospital, Liverpool Centre for Cardiovascular Science, University of Liverpool , Liverpool , United Kingdom
| | - F Marin
- Virgin of the Arrixaca University Clinical Hospital, Department of Cardiology, University of Murcia, CIBERCV , Murcia , Spain
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32
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Esteban Fernandez A, Anguita M, Bonilla JL, Anguita M, Ruesgas R, Molina M, Garcia M, Bernal JL, Del Prado N, Fernandez Perez C, Marin F, Perez Villacastin J, Gomez Doblas JJ, Fernandez Rozas I, Elola FJ. 1-year hospital readmissions due to cardiovascular causes after a heart failure episode in elderly patients in Spain. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The prevalence of heart failure (HF) increases with age, one of the leading causes of hospitalization and death in the elderly. However, there are little data about the long-term readmission rate of elderly patients after an episode of HF admission in Spain.
Purpose
Study 1-year hospital readmissions due to cardiovascular causes in patients ≥75 years discharged to a hospital due to HF in Spain.
Methods
We performed a retrospective analysis of the Minumum basic dataset of Spain, including all episodes of HF discharged from public hospitals in Spain between 2016 and 2019. The codification was made with ICD-10. We selected patients ≥75 years with HF as the principal diagnosis. We analyzed predictors of readmissions 365 days after the index episode of HF hospitalization with Poisson regression.
Results
236,463 index episodes of HF in>75 years were included. 59.1% were female, and the mean age was 85 (SD 5.6) years. 35.0% had HF-pef, 4.3% HF-ref, and 60.7% had unknown LVEF HF.
39.6% of patients had at least one readmission (mean 1.7 readmissions by year for these patients), with no differences in sex or age. Patients with non-cardiovascular comorbidities (renal failure, chronic lung disorders, and severe hematological disorders) as well as coronary atherosclerosis and diabetes were more likely to be readmitted (Table 1).
Conclusions
After a hospital discharge for HF in patients ≥75 years, the crude ratio of readmission due to cardiovascular causes at 1-year was 39.6%. Readmissions were more likely in patients with non-cardiovascular comorbidities, predominantly renal, hematological, and chronic respiratory disorders, and those with diabetes and coronary atherosclerosis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - M Anguita
- University Hospital Reina Sofia , Cordoba , Spain
| | - J L Bonilla
- Hospital San Juan de la Cruz , Ubeda , Spain
| | - M Anguita
- Hospital Clinico San Carlos , Madrid , Spain
| | - R Ruesgas
- Severo Ochoa Hospital , Leganes , Spain
| | - M Molina
- Severo Ochoa Hospital , Leganes , Spain
| | | | | | | | | | - F Marin
- Virgen of the Arrixaca University Hospital , Murcia , Spain
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33
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Fezzi S, Castaldi G, Widmann M, Marin F, Galli V, Ruzzarin A, Pesarini G, Scarsini R, Pighi M, Tavella D, Ribichini F. Spontaneous, independent, single-center renal denervation registry of a resistant hypertension multidisciplinary team. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Uncontrolled resistant hypertension (URH) is defined as PAS ≥140mmHg despite the adherence to at least 3 maximally tolerated doses of antihypertensive medications. In the adult population URH is a common condition with a prevalence that ranges between 10–15% and is related with poor prognosis and higher risk of major adverse cardiovascular events.
Renal sympathetic denervation (RDN) has recently proved efficacy in different hypertensive subsets of patients. However, patients with chronic kidney disease (CKD) IIIB-V stages (i.e. glomerular filtrate rate <45 ml/min) have been systematically excluded from randomized clinical trials (RCT).
Purpose
To evaluate the safety and the efficacy of RDN in a daily practice population of patients with URH on top of medical therapy, including patients with renal function impairment (GFR<45ml/min).
Methods
Consecutive unselected patients with URH undergoing RDN were enrolled. Indication of RDN was assessed in a multidisciplinary team involving cardiologist, nephrologist and hypertension specialists, after secondary forms of hypertension had been excluded. Efficacy was defined as the inter-individual change of office (OBP) and ambulatory blood pressure monitoring (ABPM) at 3, 6 and 12 months after RDN. Safety as the absence of any device-related major complication (BARC classification), end-stage renal disease, stroke, acute myocardial infarction and any cause of death within 1 month of the procedure. Safety and efficacy profile was assessed in patients with an estimated GFR below 45 ml/min/1.73 m2.
Results
Seventy-two patients underwent RDN for URH from 2012 to 2022. The population presented with multiple comorbidities and target organ damage: almost 50% were smoker, 43% diabetic, 33% PAD, 25% CAD and 60% CKD. Isolated systolic hypertension prevalence was 53%. The average number of antihypertensive medications at baseline was 5.3±1.1. Baseline OBP and ABPM were 158.8/86.6±23.4/15.3 mmHg and 151.4/87.6±18.8/14.2 mmHg, respectively. The vast majority of the procedures were performed with tetrapolar radio-frequency catheter (91.7%), with 37.3±14.3 number of ablations per procedure. The average amount of contrast medium was 72.1±38.1 ml. At 12-month follow-up a significant reduction of office and ambulatory systolic BP, respectively by −15.66±29.73 mmHg (P<0.01) and by −11.3±23.1mmHg (P<0.05), was noticed. BP reduction at 12-month follow-up among patients with eGFR <45 ml/min was similar to that obtained in patients with higher eGFR. No major complications were observed and renal function was stable up to 12 months, even in patients with lowest eGFR at baseline.
Conclusion(s)
RDN is safe and feasible in patients with URH on top of medical therapy, even in a high-risk CKD population with multiple comorbidities. Our experience underlines the central role of multidisciplinary team evaluation for the targeted management of uncontrolled resistant hypertension.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Fezzi
- Integrated University Hospital of Verona , Verona , Italy
| | - G Castaldi
- Integrated University Hospital of Verona , Verona , Italy
| | - M Widmann
- Integrated University Hospital of Verona , Verona , Italy
| | - F Marin
- Integrated University Hospital of Verona , Verona , Italy
| | - V Galli
- Integrated University Hospital of Verona , Verona , Italy
| | - A Ruzzarin
- Integrated University Hospital of Verona , Verona , Italy
| | - G Pesarini
- Integrated University Hospital of Verona , Verona , Italy
| | - R Scarsini
- Integrated University Hospital of Verona , Verona , Italy
| | - M Pighi
- Integrated University Hospital of Verona , Verona , Italy
| | - D Tavella
- Integrated University Hospital of Verona , Verona , Italy
| | - F Ribichini
- Integrated University Hospital of Verona , Verona , Italy
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34
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Peltier C, Lejeune FX, Jorgensen LGT, Rametti-Lacroux A, Tanguy D, Godefroy V, Bendetowicz D, Carle G, Cognat E, Bombois S, Migliaccio R, Levy R, Marin F, Batrancourt B. A temporal classification method based on behavior time series data in patients with behavioral variant of frontotemporal dementia and apathy. J Neurosci Methods 2022; 376:109625. [PMID: 35653896 DOI: 10.1016/j.jneumeth.2022.109625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 04/22/2022] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Caroline Peltier
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; Centre des Sciences du Goût et de l'Alimentation (CSGA), ChemoSens Platform, AgroSup Dijon, CNRS, INRAE, University of Bourgogne Franche-Comté, PROBE Research Infrastructure, Dijon, France
| | - François-Xavier Lejeune
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Lars G T Jorgensen
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Armelle Rametti-Lacroux
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Delphine Tanguy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Valérie Godefroy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - David Bendetowicz
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Guilhem Carle
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Emmanuel Cognat
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Stéphanie Bombois
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Raffaella Migliaccio
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; AP-HP, Hôpital de la Pitié Salpêtrière, Department of Neurology, Center of excellence of neurodegenerative disease (CoEN), Institute of Memory and Alzheimer's Disease (IM2A), F-75013 Paris, France
| | - Richard Levy
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France; AP-HP, Hôpital de la Pitié Salpêtrière, Department of Neurology, Center of excellence of neurodegenerative disease (CoEN), Institute of Memory and Alzheimer's Disease (IM2A), F-75013 Paris, France
| | - Frédéric Marin
- Centre of Excellence for Human and Animal Movement Biomechanics (CoEMoB), Laboratoire de BioMécanique et BioIngénierie (UMR CNRS 7338), Université de Technologie de Compiègne (UTC), Alliance Sorbonne Université, 60200 Compiègne, France
| | - Bénédicte Batrancourt
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France.
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35
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Ajili W, Tovani CB, Fouassier J, de Frutos M, Laurent GP, Bertani P, Djediat C, Marin F, Auzoux-Bordenave S, Azaïs T, Nassif N. Inorganic phosphate in growing calcium carbonate abalone shell suggests a shared mineral ancestral precursor. Nat Commun 2022; 13:1496. [PMID: 35314701 PMCID: PMC8938516 DOI: 10.1038/s41467-022-29169-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 02/17/2022] [Indexed: 01/30/2023] Open
Abstract
The presence of phosphate from different origins (inorganic, bioorganic) is found more and more in calcium carbonate-based biominerals. Phosphate is often described as being responsible for the stabilization of the transient amorphous calcium carbonate phase. In order to specify the composition of the mineral phase deposited at the onset of carbonated shell formation, the present study investigates, down to the nanoscale, the growing shell from the European abalone Haliotis tuberculata, using a combination of solid state nuclear magnetic resonance, scanning transmission electron microscope and spatially-resolved electron energy loss spectroscopy techniques. We show the co-occurrence of inorganic phosphate with calcium and carbonate throughout the early stages of abalone shell formation. One possible hypothesis is that this first-formed mixed mineral phase represents the vestige of a shared ancestral mineral precursor that appeared early during Evolution. In addition, our findings strengthen the idea that the final crystalline phase (calcium carbonate or phosphate) depends strongly on the nature of the mineral-associated proteins in vivo. Phosphate involvement in calcium carbonate biominerals raises questions on biomineralisation pathways. Here, the authors explore the presence of phosphate in the growing shell of the European abalone and suggest a shared mixed mineral ancestral precursor with final crystal phase being selected by mineral-associated proteins.
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36
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Gilbert PUPA, Bergmann KD, Boekelheide N, Tambutté S, Mass T, Marin F, Adkins JF, Erez J, Gilbert B, Knutson V, Cantine M, Hernández JO, Knoll AH. Biomineralization: Integrating mechanism and evolutionary history. Sci Adv 2022; 8:eabl9653. [PMID: 35263127 PMCID: PMC8906573 DOI: 10.1126/sciadv.abl9653] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Calcium carbonate (CaCO3) biomineralizing organisms have played major roles in the history of life and the global carbon cycle during the past 541 Ma. Both marine diversification and mass extinctions reflect physiological responses to environmental changes through time. An integrated understanding of carbonate biomineralization is necessary to illuminate this evolutionary record and to understand how modern organisms will respond to 21st century global change. Biomineralization evolved independently but convergently across phyla, suggesting a unity of mechanism that transcends biological differences. In this review, we combine CaCO3 skeleton formation mechanisms with constraints from evolutionary history, omics, and a meta-analysis of isotopic data to develop a plausible model for CaCO3 biomineralization applicable to all phyla. The model provides a framework for understanding the environmental sensitivity of marine calcifiers, past mass extinctions, and resilience in 21st century acidifying oceans. Thus, it frames questions about the past, present, and future of CaCO3 biomineralizing organisms.
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Affiliation(s)
- Pupa U. P. A. Gilbert
- Departments of Physics, Chemistry, Geoscience, and Materials Science, University of Wisconsin-Madison, Madison, WI 53706, USA
- Chemical Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
- Corresponding author. (P.U.P.A.G.); (A.H.K.)
| | - Kristin D. Bergmann
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Nicholas Boekelheide
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Sylvie Tambutté
- Centre Scientifique de Monaco, Department of Marine Biology, 98000 Monaco, Principality of Monaco
| | - Tali Mass
- University of Haifa, Marine Biology Department, Mt. Carmel, Haifa 31905, Israel
| | - Frédéric Marin
- Université de Bourgogne–Franche-Comté (UBFC), Laboratoire Biogéosciences, UMR CNRS 6282, Bâtiment des Sciences Gabriel, 21000 Dijon, France
| | - Jess F. Adkins
- Geological and Planetary Sciences, California Institute of Technology, MS 100-23, Pasadena, CA 91125, USA
| | - Jonathan Erez
- The Hebrew University of Jerusalem, Institute of Earth Sciences, Jerusalem 91904, Israel
| | - Benjamin Gilbert
- Energy Geoscience Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
- Department of Earth and Planetary Science, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Vanessa Knutson
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA
| | - Marjorie Cantine
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Goethe-Universität Frankfurt, 60438 Frankfurt am Main, Germany
| | - Javier Ortega Hernández
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA
| | - Andrew H. Knoll
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA
- Corresponding author. (P.U.P.A.G.); (A.H.K.)
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37
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Liodakis I, Marscher AP, Agudo I, Berdyugin AV, Bernardos MI, Bonnoli G, Borman GA, Casadio C, Casanova V, Cavazzuti E, Rodriguez Cavero N, Di Gesu L, Di Lalla N, Donnarumma I, Ehlert SR, Errando M, Escudero J, García-Comas M, Agís-González B, Husillos C, Jormanainen J, Jorstad SG, Kagitani M, Kopatskaya EN, Kravtsov V, Krawczynski H, Lindfors E, Larionova EG, Madejski GM, Marin F, Marchini A, Marshall HL, Morozova DA, Massaro F, Masiero JR, Mawet D, Middei R, Millar-Blanchaer MA, Myserlis I, Negro M, Nilsson K, O’Dell SL, Omodei N, Pacciani L, Paggi A, Panopoulou GV, Peirson AL, Perri M, Petrucci PO, Poutanen J, Puccetti S, Romani RW, Sakanoi T, Savchenko SS, Sota A, Tavecchio F, Tinyanont S, Vasilyev AA, Weaver ZR, Zhovtan AV, Antonelli LA, Bachetti M, Baldini L, Baumgartner WH, Bellazzini R, Bianchi S, Bongiorno SD, Bonino R, Brez A, Bucciantini N, Capitanio F, Castellano S, Ciprini S, Costa E, De Rosa A, Del Monte E, Di Marco A, Doroshenko V, Dovčiak M, Enoto T, Evangelista Y, Fabiani S, Ferrazzoli R, Garcia JA, Gunji S, Hayashida K, Heyl J, Iwakiri W, Karas V, Kitaguchi T, Kolodziejczak JJ, La Monaca F, Latronico L, Maldera S, Manfreda A, Marinucci A, Matt G, Mitsuishi I, Mizuno T, Muleri F, Ng SCY, Oppedisano C, Papitto A, Pavlov GG, Pesce-Rollins M, Pilia M, Possenti A, Ramsey BD, Rankin J, Ratheesh A, Sgró C, Slane P, Soffitta P, Spandre G, Tamagawa T, Taverna R, Tawara Y, Tennant AF, Thomas NE, Tombesi F, Trois A, Tsygankov S, Turolla R, Vink J, Weisskopf MC, Wu K, Xie F, Zane S. Polarized blazar X-rays imply particle acceleration in shocks. Nature 2022; 611:677-681. [PMID: 36418451 PMCID: PMC9684068 DOI: 10.1038/s41586-022-05338-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/12/2022] [Indexed: 11/24/2022]
Abstract
Most of the light from blazars, active galactic nuclei with jets of magnetized plasma that point nearly along the line of sight, is produced by high-energy particles, up to around 1 TeV. Although the jets are known to be ultimately powered by a supermassive black hole, how the particles are accelerated to such high energies has been an unanswered question. The process must be related to the magnetic field, which can be probed by observations of the polarization of light from the jets. Measurements of the radio to optical polarization-the only range available until now-probe extended regions of the jet containing particles that left the acceleration site days to years earlier1-3, and hence do not directly explore the acceleration mechanism, as could X-ray measurements. Here we report the detection of X-ray polarization from the blazar Markarian 501 (Mrk 501). We measure an X-ray linear polarization degree ΠX of around 10%, which is a factor of around 2 higher than the value at optical wavelengths, with a polarization angle parallel to the radio jet. This points to a shock front as the source of particle acceleration and also implies that the plasma becomes increasingly turbulent with distance from the shock.
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Affiliation(s)
- Ioannis Liodakis
- grid.1374.10000 0001 2097 1371Finnish Centre for Astronomy with ESO, FI-20014, University of Turku, Turku, Finland
| | - Alan P. Marscher
- grid.189504.10000 0004 1936 7558Institute for Astrophysical Research, Boston University, Boston, MA USA
| | - Iván Agudo
- grid.450285.e0000 0004 1793 7043Instituto de Astrofísica de Andalucía, IAA-CSIC, Glorieta de la Astronomía s/n, Granada, Spain
| | - Andrei V. Berdyugin
- grid.1374.10000 0001 2097 1371Department of Physics and Astronomy, University of Turku, Turku, Finland
| | - Maria I. Bernardos
- grid.450285.e0000 0004 1793 7043Instituto de Astrofísica de Andalucía, IAA-CSIC, Glorieta de la Astronomía s/n, Granada, Spain
| | - Giacomo Bonnoli
- grid.450285.e0000 0004 1793 7043Instituto de Astrofísica de Andalucía, IAA-CSIC, Glorieta de la Astronomía s/n, Granada, Spain ,grid.450217.5INAF Osservatorio Astronomico di Brera, Merate (LC), Italy
| | - George A. Borman
- Crimean Astrophysical Observatory RAS, P/O Nauchny, Nauchnij, Crimea
| | - Carolina Casadio
- grid.4834.b0000 0004 0635 685XInstitute of Astrophysics, Foundation for Research and Technology - Hellas, Voutes, Heraklion, Greece ,grid.8127.c0000 0004 0576 3437Department of Physics, University of Crete, Heraklion, Greece
| | - Víctor Casanova
- grid.450285.e0000 0004 1793 7043Instituto de Astrofísica de Andalucía, IAA-CSIC, Glorieta de la Astronomía s/n, Granada, Spain
| | - Elisabetta Cavazzuti
- grid.423784.e0000 0000 9801 3133Agenzia Spaziale Italiana, Via del Politecnico snc, Roma, Italy
| | - Nicole Rodriguez Cavero
- grid.4367.60000 0001 2355 7002Physics Department and McDonnell Center for the Space Sciences, Washington University in St Louis, St Louis, MO USA
| | - Laura Di Gesu
- grid.423784.e0000 0000 9801 3133Agenzia Spaziale Italiana, Via del Politecnico snc, Roma, Italy
| | - Niccoló Di Lalla
- grid.168010.e0000000419368956Department of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA USA
| | - Immacolata Donnarumma
- grid.423784.e0000 0000 9801 3133Agenzia Spaziale Italiana, Via del Politecnico snc, Roma, Italy
| | - Steven R. Ehlert
- grid.419091.40000 0001 2238 4912NASA Marshall Space Flight Center, Huntsville, AL USA
| | - Manel Errando
- grid.4367.60000 0001 2355 7002Physics Department and McDonnell Center for the Space Sciences, Washington University in St Louis, St Louis, MO USA
| | - Juan Escudero
- grid.450285.e0000 0004 1793 7043Instituto de Astrofísica de Andalucía, IAA-CSIC, Glorieta de la Astronomía s/n, Granada, Spain
| | - Maya García-Comas
- grid.450285.e0000 0004 1793 7043Instituto de Astrofísica de Andalucía, IAA-CSIC, Glorieta de la Astronomía s/n, Granada, Spain
| | - Beatriz Agís-González
- grid.450285.e0000 0004 1793 7043Instituto de Astrofísica de Andalucía, IAA-CSIC, Glorieta de la Astronomía s/n, Granada, Spain
| | - César Husillos
- grid.450285.e0000 0004 1793 7043Instituto de Astrofísica de Andalucía, IAA-CSIC, Glorieta de la Astronomía s/n, Granada, Spain
| | - Jenni Jormanainen
- grid.1374.10000 0001 2097 1371Finnish Centre for Astronomy with ESO, FI-20014, University of Turku, Turku, Finland ,grid.1374.10000 0001 2097 1371Department of Physics and Astronomy, University of Turku, Turku, Finland
| | - Svetlana G. Jorstad
- grid.189504.10000 0004 1936 7558Institute for Astrophysical Research, Boston University, Boston, MA USA ,grid.15447.330000 0001 2289 6897Laboratory of Observational Astrophysics, St Petersburg University, St Petersburg, Russia
| | - Masato Kagitani
- grid.69566.3a0000 0001 2248 6943Graduate School of Sciences, Tohoku University, Sendai, Japan
| | - Evgenia N. Kopatskaya
- grid.15447.330000 0001 2289 6897Astronomical Institute, St Petersburg State University, St Petersburg, Russia
| | - Vadim Kravtsov
- grid.1374.10000 0001 2097 1371Department of Physics and Astronomy, University of Turku, Turku, Finland
| | - Henric Krawczynski
- grid.4367.60000 0001 2355 7002Physics Department and McDonnell Center for the Space Sciences, Washington University in St Louis, St Louis, MO USA
| | - Elina Lindfors
- grid.1374.10000 0001 2097 1371Finnish Centre for Astronomy with ESO, FI-20014, University of Turku, Turku, Finland
| | - Elena G. Larionova
- grid.15447.330000 0001 2289 6897Astronomical Institute, St Petersburg State University, St Petersburg, Russia
| | - Grzegorz M. Madejski
- grid.168010.e0000000419368956Kavli Institute for Particle Astrophysics and Cosmology, Stanford University and SLAC, Menlo Park, CA USA
| | - Frédéric Marin
- grid.440483.f0000 0000 9383 4469Université de Strasbourg, CNRS, Observatoire Astronomique de Strasbourg, UMR 7550, Strasbourg, France
| | - Alessandro Marchini
- grid.9024.f0000 0004 1757 4641Department of Physical Sciences, Earth and Environment, Astronomical Observatory, University of Siena, Siena, Italy
| | - Herman L. Marshall
- grid.116068.80000 0001 2341 2786MIT Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA USA
| | - Daria A. Morozova
- grid.15447.330000 0001 2289 6897Astronomical Institute, St Petersburg State University, St Petersburg, Russia
| | - Francesco Massaro
- grid.470222.10000 0004 7471 9712Istituto Nazionale di Fisica Nucleare, , Sezione di Torino, Torino, Italy ,grid.7605.40000 0001 2336 6580Dipartimento di Fisica, Universitá degli Studi di Torino, Torino, Italy
| | | | - Dimitri Mawet
- grid.20861.3d0000000107068890California Institute of Technology, Pasadena, CA USA
| | - Riccardo Middei
- grid.423784.e0000 0000 9801 3133Space Science Data Center, Agenzia Spaziale Italiana, Roma, Italy ,grid.463298.20000 0001 2168 8201INAF Osservatorio Astronomico di Roma, Monte Porzio Catone (RM), Italy
| | | | | | - Michela Negro
- Center for Research and Exploration in Space Science and Technology (CRESST), Greenbelt, MD USA ,grid.266673.00000 0001 2177 1144Department of Physics and Center for Space Sciences and Technology, University of Maryland Baltimore County, Baltimore, MD USA
| | - Kari Nilsson
- grid.1374.10000 0001 2097 1371Finnish Centre for Astronomy with ESO, FI-20014, University of Turku, Turku, Finland
| | - Stephen L. O’Dell
- grid.419091.40000 0001 2238 4912NASA Marshall Space Flight Center, Huntsville, AL USA
| | - Nicola Omodei
- grid.168010.e0000000419368956Department of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA USA
| | - Luigi Pacciani
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy
| | - Alessandro Paggi
- grid.470222.10000 0004 7471 9712Istituto Nazionale di Fisica Nucleare, , Sezione di Torino, Torino, Italy ,grid.7605.40000 0001 2336 6580Dipartimento di Fisica, Universitá degli Studi di Torino, Torino, Italy ,grid.436940.cINAF-Osservatorio Astrofisico di Torino, Pino Torinese, Italy
| | | | - Abel L. Peirson
- grid.168010.e0000000419368956Department of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA USA
| | - Matteo Perri
- grid.423784.e0000 0000 9801 3133Space Science Data Center, Agenzia Spaziale Italiana, Roma, Italy ,grid.463298.20000 0001 2168 8201INAF Osservatorio Astronomico di Roma, Monte Porzio Catone (RM), Italy
| | | | - Juri Poutanen
- grid.1374.10000 0001 2097 1371Department of Physics and Astronomy, University of Turku, Turku, Finland ,grid.426428.e0000 0004 0405 8736Space Research Institute of the Russian Academy of Sciences, Moscow, Russia
| | - Simonetta Puccetti
- grid.423784.e0000 0000 9801 3133Agenzia Spaziale Italiana, Via del Politecnico snc, Roma, Italy
| | - Roger W. Romani
- grid.168010.e0000000419368956Department of Physics and Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA USA
| | - Takeshi Sakanoi
- grid.69566.3a0000 0001 2248 6943Graduate School of Sciences, Tohoku University, Sendai, Japan
| | - Sergey S. Savchenko
- grid.15447.330000 0001 2289 6897Astronomical Institute, St Petersburg State University, St Petersburg, Russia ,grid.4886.20000 0001 2192 9124Special Astrophysical Observatory, Russian Academy of Sciences, Nizhnii Arkhyz, Russia ,grid.437494.90000 0000 9168 8058Pulkovo Observatory, St Petersburg, Russia
| | - Alfredo Sota
- grid.450285.e0000 0004 1793 7043Instituto de Astrofísica de Andalucía, IAA-CSIC, Glorieta de la Astronomía s/n, Granada, Spain
| | | | - Samaporn Tinyanont
- grid.205975.c0000 0001 0740 6917University of California Santa Cruz, Santa Cruz, CA USA
| | - Andrey A. Vasilyev
- grid.15447.330000 0001 2289 6897Astronomical Institute, St Petersburg State University, St Petersburg, Russia
| | - Zachary R. Weaver
- grid.189504.10000 0004 1936 7558Institute for Astrophysical Research, Boston University, Boston, MA USA
| | - Alexey V. Zhovtan
- Crimean Astrophysical Observatory RAS, P/O Nauchny, Nauchnij, Crimea
| | - Lucio A. Antonelli
- grid.423784.e0000 0000 9801 3133Space Science Data Center, Agenzia Spaziale Italiana, Roma, Italy ,grid.463298.20000 0001 2168 8201INAF Osservatorio Astronomico di Roma, Monte Porzio Catone (RM), Italy
| | - Matteo Bachetti
- grid.437052.70000 0001 0096 8079INAF Osservatorio Astronomico di Cagliari, Selargius (CA), Italy
| | - Luca Baldini
- grid.470216.6Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Pisa, Italy ,grid.5395.a0000 0004 1757 3729Dipartimento di Fisica, Universitá di Pisa, Pisa, Italy
| | - Wayne H. Baumgartner
- grid.419091.40000 0001 2238 4912NASA Marshall Space Flight Center, Huntsville, AL USA
| | - Ronaldo Bellazzini
- grid.470216.6Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Pisa, Italy
| | - Stefano Bianchi
- grid.8509.40000000121622106Dipartimento di Matematica e Fisica, Universitá degli Studi Roma Tre, Roma, Italy
| | - Stephen D. Bongiorno
- grid.419091.40000 0001 2238 4912NASA Marshall Space Flight Center, Huntsville, AL USA
| | - Raffaella Bonino
- grid.470222.10000 0004 7471 9712Istituto Nazionale di Fisica Nucleare, , Sezione di Torino, Torino, Italy ,grid.7605.40000 0001 2336 6580Dipartimento di Fisica, Universitá degli Studi di Torino, Torino, Italy
| | - Alessandro Brez
- grid.470216.6Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Pisa, Italy
| | - Niccoló Bucciantini
- grid.426239.80000 0000 9176 4495INAF Osservatorio Astrofisico di Arcetri, Firenze, Italy ,grid.8404.80000 0004 1757 2304Dipartimento di Fisica e Astronomia, Universitá degli Studi di Firenze, Sesto Fiorentino (FI), Italy ,grid.470204.5Q30265285Istituto Nazionale di Fisica Nucleare, Sezione di Firenze, Sesto Fiorentino (FI), Italy
| | - Fiamma Capitanio
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy
| | - Simone Castellano
- grid.470216.6Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Pisa, Italy
| | - Stefano Ciprini
- grid.423784.e0000 0000 9801 3133Space Science Data Center, Agenzia Spaziale Italiana, Roma, Italy ,grid.470219.9Istituto Nazionale di Fisica Nucleare, Sezione di Roma Tor Vergata, Roma, Italy
| | - Enrico Costa
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy
| | - Alessandra De Rosa
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy
| | - Ettore Del Monte
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy
| | - Alessandro Di Marco
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy
| | - Victor Doroshenko
- grid.426428.e0000 0004 0405 8736Space Research Institute of the Russian Academy of Sciences, Moscow, Russia ,grid.10392.390000 0001 2190 1447Institut für Astronomie und Astrophysik, Tübingen, Germany
| | - Michal Dovčiak
- grid.423799.20000 0004 0385 3578Astronomical Institute of the Czech Academy of Sciences, Ondřejov, Czech Republic
| | - Teruaki Enoto
- grid.7597.c0000000094465255RIKEN Cluster for Pioneering Research, Saitama, Japan
| | - Yuri Evangelista
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy
| | - Sergio Fabiani
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy
| | - Riccardo Ferrazzoli
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy
| | - Javier A. Garcia
- grid.20861.3d0000000107068890California Institute of Technology, Pasadena, CA USA
| | - Shuichi Gunji
- grid.268394.20000 0001 0674 7277Yamagata University, Yamagata-shi, Japan
| | | | - Jeremy Heyl
- grid.17091.3e0000 0001 2288 9830University of British Columbia, Vancouver, British Columbia Canada
| | - Wataru Iwakiri
- grid.443595.a0000 0001 2323 0843Department of Physics, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - Vladimir Karas
- grid.423799.20000 0004 0385 3578Astronomical Institute of the Czech Academy of Sciences, Ondřejov, Czech Republic
| | - Takao Kitaguchi
- grid.7597.c0000000094465255RIKEN Cluster for Pioneering Research, Saitama, Japan
| | | | - Fabio La Monaca
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy
| | - Luca Latronico
- grid.470222.10000 0004 7471 9712Istituto Nazionale di Fisica Nucleare, , Sezione di Torino, Torino, Italy
| | - Simone Maldera
- grid.470222.10000 0004 7471 9712Istituto Nazionale di Fisica Nucleare, , Sezione di Torino, Torino, Italy
| | - Alberto Manfreda
- grid.470216.6Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Pisa, Italy
| | - Andrea Marinucci
- grid.423784.e0000 0000 9801 3133Agenzia Spaziale Italiana, Via del Politecnico snc, Roma, Italy
| | - Giorgio Matt
- grid.8509.40000000121622106Dipartimento di Matematica e Fisica, Universitá degli Studi Roma Tre, Roma, Italy
| | - Ikuyuki Mitsuishi
- grid.27476.300000 0001 0943 978XGraduate School of Science, Division of Particle and Astrophysical Science, Nagoya University, Nagoya, Japan
| | - Tsunefumi Mizuno
- grid.257022.00000 0000 8711 3200Hiroshima Astrophysical Science Center, Hiroshima University, Hiroshima, Japan
| | - Fabio Muleri
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy
| | - Stephen C.-Y. Ng
- grid.194645.b0000000121742757Department of Physics, University of Hong Kong, Pokfulam, Hong Kong
| | - Chiara Oppedisano
- grid.470222.10000 0004 7471 9712Istituto Nazionale di Fisica Nucleare, , Sezione di Torino, Torino, Italy
| | - Alessandro Papitto
- grid.463298.20000 0001 2168 8201INAF Osservatorio Astronomico di Roma, Monte Porzio Catone (RM), Italy
| | - George G. Pavlov
- grid.29857.310000 0001 2097 4281Department of Astronomy and Astrophysics, Pennsylvania State University, University Park, PA USA
| | | | - Maura Pilia
- grid.437052.70000 0001 0096 8079INAF Osservatorio Astronomico di Cagliari, Selargius (CA), Italy
| | - Andrea Possenti
- grid.437052.70000 0001 0096 8079INAF Osservatorio Astronomico di Cagliari, Selargius (CA), Italy
| | - Brian D. Ramsey
- grid.419091.40000 0001 2238 4912NASA Marshall Space Flight Center, Huntsville, AL USA
| | - John Rankin
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy
| | - Ajay Ratheesh
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy
| | - Carmelo Sgró
- grid.470216.6Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Pisa, Italy
| | - Patrick Slane
- grid.455754.20000 0001 1781 4754Center for Astrophysics, Harvard & Smithsonian, Cambridge, MA USA
| | - Paolo Soffitta
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy
| | - Gloria Spandre
- grid.470216.6Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Pisa, Italy
| | - Toru Tamagawa
- grid.7597.c0000000094465255RIKEN Cluster for Pioneering Research, Saitama, Japan
| | - Roberto Taverna
- grid.5608.b0000 0004 1757 3470Dipartimento di Fisica e Astronomia, Universitá degli Studi di Padova, Padova, Italy
| | - Yuzuru Tawara
- grid.27476.300000 0001 0943 978XGraduate School of Science, Division of Particle and Astrophysical Science, Nagoya University, Nagoya, Japan
| | - Allyn F. Tennant
- grid.419091.40000 0001 2238 4912NASA Marshall Space Flight Center, Huntsville, AL USA
| | - Nicolas E. Thomas
- grid.419091.40000 0001 2238 4912NASA Marshall Space Flight Center, Huntsville, AL USA
| | - Francesco Tombesi
- grid.6530.00000 0001 2300 0941Dipartimento di Fisica, Universitá degli Studi di Roma Tor Vergata, Roma, Italy
| | - Alessio Trois
- grid.437052.70000 0001 0096 8079INAF Osservatorio Astronomico di Cagliari, Selargius (CA), Italy
| | - Sergey Tsygankov
- grid.1374.10000 0001 2097 1371Department of Physics and Astronomy, University of Turku, Turku, Finland ,grid.426428.e0000 0004 0405 8736Space Research Institute of the Russian Academy of Sciences, Moscow, Russia
| | - Roberto Turolla
- grid.5608.b0000 0004 1757 3470Dipartimento di Fisica e Astronomia, Universitá degli Studi di Padova, Padova, Italy ,grid.83440.3b0000000121901201Mullard Space Science Laboratory, University College London, Dorking, UK
| | - Jacco Vink
- grid.7177.60000000084992262Anton Pannekoek Institute for Astronomy & GRAPPA, University of Amsterdam, Amsterdam, the Netherlands
| | - Martin C. Weisskopf
- grid.419091.40000 0001 2238 4912NASA Marshall Space Flight Center, Huntsville, AL USA
| | - Kinwah Wu
- grid.83440.3b0000000121901201Mullard Space Science Laboratory, University College London, Dorking, UK
| | - Fei Xie
- grid.466835.a0000 0004 1776 2255INAF Istituto di Astrofisica e Planetologia Spaziali, Roma, Italy ,grid.256609.e0000 0001 2254 5798Guangxi Key Laboratory for Relativistic Astrophysics, School of Physical Science and Technology, Guangxi University, Nanning, China
| | - Silvia Zane
- grid.83440.3b0000000121901201Mullard Space Science Laboratory, University College London, Dorking, UK
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38
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Shinzato C, Takeuchi T, Yoshioka Y, Tada I, Kanda M, Broussard C, Iguchi A, Kusakabe M, Marin F, Satoh N, Inoue M. Whole-Genome Sequencing Highlights Conservative Genomic Strategies of a Stress-Tolerant, Long-Lived Scleractinian Coral, Porites australiensis Vaughan, 1918. Genome Biol Evol 2021; 13:6456307. [PMID: 34878117 PMCID: PMC8691061 DOI: 10.1093/gbe/evab270] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 12/13/2022] Open
Abstract
Massive corals of the genus Porites, common, keystone reef builders in the Indo-Pacific Ocean, are distinguished by their relative stress tolerance and longevity. In order to identify genetic bases of these attributes, we sequenced the complete genome of a massive coral, Porites australiensis. We developed a genome assembly and gene models of comparable quality to those of other coral genomes. Proteome analysis identified 60 Porites skeletal matrix protein genes, all of which show significant similarities to genes from other corals and even to those from a sea anemone, which has no skeleton. Nonetheless, 30% of its skeletal matrix proteins were unique to Porites and were not present in the skeletons of other corals. Comparative genomic analyses showed that genes widely conserved among other organisms are selectively expanded in Porites. Specifically, comparisons of transcriptomic responses of P. australiensis and Acropora digitifera, a stress-sensitive coral, reveal significant differences in regard to genes that respond to increased water temperature, and some of the genes expanded exclusively in Porites may account for the different thermal tolerances of these corals. Taken together, widely shared genes may have given rise to unique biological characteristics of Porites, massive skeletons and stress tolerance.
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Affiliation(s)
- Chuya Shinzato
- Atmosphere and Ocean Research Institute, The University of Tokyo, Kashiwa, Chiba, Japan
| | - Takeshi Takeuchi
- Marine Genomics Unit, Okinawa Institute of Science and Technology Graduate University, Onna, Okinawa, Japan
| | - Yuki Yoshioka
- Atmosphere and Ocean Research Institute, The University of Tokyo, Kashiwa, Chiba, Japan.,Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa, Chiba, Japan
| | - Ipputa Tada
- Department of Genetics, SOKENDAI (Graduate University for Advanced Studies), Mishima, Shizuoka, Japan
| | - Miyuki Kanda
- DNA Sequencing Section, Okinawa Institute of Science and Technology Graduate University, Onna, Okinawa, Japan
| | | | - Akira Iguchi
- Geological Survey of Japan, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan
| | | | - Frédéric Marin
- Biogéosciences, Bâtiment des Sciences Gabriel, Université de Bourgogne, Dijon, France
| | - Noriyuki Satoh
- Marine Genomics Unit, Okinawa Institute of Science and Technology Graduate University, Onna, Okinawa, Japan
| | - Mayuri Inoue
- Division of Earth Science, Graduate School of Natural Science and Technology, Okayama University, Japan
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39
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Esteve Pastor M, Marin F, Anguita M, Sanmartin M, Rafols C, Arribas Ynsaurriaga F, Baron Esquivas G, Barrios V, Cosin Sales J, Freixa Pamias R, Perez Cabeza A, Vazquez Rodriguez JM, Lekuona Goya I. 2MACE score predicts cardiovascular adverse events in real-world atrial fibrillation patients under rivaroxaban therapy. Data from EMIR study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial Fibrillation (AF) patients have higher risk of major adverse cardiovascular events (MACEs). In 2015, the 2MACE score (2 points for metabolic syndrome and age ≥75, and 1 point for myocardial infarction [MI] or revascularization, congestive heart failure [ejection fraction ≤40%] and thromboembolism [stroke or transient ischemic attack]) was described to stratify cardiovascular risk and 2MACE≥3 was related with high risk of MACE in AF patients but a long-term validation in prospective patients under direct anticoagulants has not been performed yet.
The aim of this study was to analyse the incidence of cardiovascular events and to validate the 2MACE score as predictor of MACEs.
Methods
EMIR study [acronym from 'Estudio observacional para la identificaciόn de los factores de riesgo asociados a eventos cardiovasculares Mayores en pacientes con fIbrilaciόn auricular no valvular tratados con un anticoagulante oral directo (Rivaroxaban)'] was an observational, multicenter, post-authorization and prospective study that involved AF patients under oral anticoagulation with rivaroxaban at least 6 months before enrolment. We analyzed baseline clinical characteristics and adverse events after 2.5 years of follow up: annual incidence of thromboembolic events, MACE (composite of nonfatal MI, coronary revascularization and cardiac death) and cardiovascular mortality were analyzed.
Results
We analyzed 1,433 patients (55.5% women, mean 74.2±9.7 years). 385 (26.9%) patients had 2MACE score ≥3 and of those high-risk patients, 42.1% had previous coronary disease, 12.5% had previous peripheral artery disease, 40.7% had diabetes mellitus, 39% heart failure and 50% had chronic kidney disease (GFR<60 ml/min). After 2.5 (2.2–2.6) years of follow-up, we observed patients with 2MACE score ≥3 had higher rate of adverse events (Table), specially of higher rate of cardiovascular mortality and MACE. Patients with 2MACE score ≥3 had RR 4.09 (2.59–6.45; p<0.001) for MACE. Indeed, patients with 2MACE score ≥3 had around 6-fold risk of cardiovascular death due heart failure than patients with 2MACE score <3 (0.17%/year vs 1.09%/year; p=0.003). 2MACE score had suitable predictive performance for MACE (AUC 0.638 [(0.534–0.742); p=0.010).
Conclusion
In a Real-world AF patients under rivaroxaban therapy from EMIR registry, the 2MACE score is a good predictor of long-term cardiovascular events, MACE and major bleeding. A 2MACE score ≥3 categorize patients at “high-risk” with almost 4-fold risk of MACE in a long-term follow-up.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Bayer Hispania S.L. Table 1. Adverse events according to 2MACE
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Affiliation(s)
- M Esteve Pastor
- Hospital Clinico Univeristario Virgen de la Arrixaca, IMIB Arrixaca, CIBER-CV, Spain, Murcia, Spain
| | - F Marin
- Hospital Clinico Univeristario Virgen de la Arrixaca, IMIB Arrixaca, CIBER-CV, Spain, Murcia, Spain
| | - M Anguita
- University Hospital Reina Sofia, Cordoba, Spain
| | | | - C Rafols
- Bayer Hispania S.L., Medical Affairs Department, Sant Joan Despí, Spain
| | | | | | - V Barrios
- Hospital Ramon y Cajal, Madrid, Spain
| | - J Cosin Sales
- University Hospital Arnau de Vilanova, Valencia, Spain
| | - R Freixa Pamias
- Hospital Sant Joan Despi Moises Broggi, Sant Joan Despi (Barcelona), Spain
| | - A Perez Cabeza
- University Hospital Virgen de la Victoria, Malaga, Spain
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40
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Marin F, Rivera-Caravaca J, Anguita Sanchez M, Sanmartin Fernandez M, Rafols C, Roldan V, Recalde E, Freixa Pamias R, Lekuona Goya I, Vazquez Rodriguez J, Perez Cabeza A. Predictors of adverse clinical outcomes in atrial fibrillation patients with concomitant renal impairment under rivaroxaban therapy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) increases the risk of stroke and mortality, and concomitant renal impairment confers a worse prognosis. However, those factors that may limit the use of direct-acting oral anticoagulants in AF patients with renal impairment have not been further investigated, as they confer a higher risk of adverse events in this patient population.
Purpose
To investigate predictors of adverse clinical outcomes in AF patients with renal impairment who were treated with rivaroxaban.
Methods
The EMIR study is an observational, multicenter study including patients with AF treated with rivaroxaban for at least the previous 6 months. During 2.5 years of follow-up, the occurrence of thromboembolic events (the composite of isquemic stroke, transient ischemic attack, systemic embolism and myocardial infarction [MI]), major bleeding (ISTH definition) and major adverse cardiovascular events (MACE: fatal/non-fatal MI, myocardial revascularization and cardiovascular death) were recorded. For the present analysis, creatinine clearance (CrCl) was estimated by using the Cockroft-Gault equation and renal impairment was defined as a CrCl <60 mL/min.
Results
1433 patients were included (44.5% female; mean age 74.2±9.7 years), of which 498 (35.1%) had CrCl <60 mL/min. The mean CHA2DS2-VASc and HAS-BLED were 3.5±1.5 and 1.6±1.0, respectively. During the follow-up, 7 (1.4%) patients with CrCl <60 mL/min suffered a thromboembolic event, 16 (3.2%) suffered major bleeding, and 19 (3.8%) suffered a MACE. Compared to patients with normal renal function, patients with CrCl <60 mL/min showed a higher annual rate of major bleeding (0.62%/year vs. 1.87%/year; p=0.003) and MACE (0.62%/year vs. 1.97%/year; p=0.002). Multivariate analyses demonstrated that the CHA2DS2-VASc score (OR 1.84; 95% CI 1.11–3.07) was associated with a higher risk of thromboembolic events; whereas the HAS-BLED score (OR 2.25; 95% CI 1.41–3.59) and any dependency level (OR 3.42; 95% CI 1.17–9.98) were associated with a higher risk of major bleeding; and male sex (OR 3.55; 95% CI 1.08–11.63) and heart failure (OR 4.67; 95% CI 1.62–13.51) with a higher risk of MACE. The use of antiplatelet agents was also independently associated with an increased risk of thromboembolic events and MACE (OR 12.28; 95% CI 2.50–60.18; and OR 8.72; 95% CI 2.86–26.59; respectively).
Conclusions
Rivaroxaban showed excellent results in moderate renal impairment. However, the annual rate of major bleeding and MACE was higher in AF patients with impaired renal function. In patients with AF and renal impairment, male sex, the presence of heart failure, dependency, the concomitant use of antiplatelets, and greater comorbidity according to the CHA2DS2-VASc and HAS-BLED, were associated with higher risk of adverse clinical outcomes.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Bayer
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Affiliation(s)
- F Marin
- Hospital Clínico Univeristario Virgen de la Arrixaca, Cardiology, Murcia, Spain
| | - J.M Rivera-Caravaca
- Hospital Clínico Univeristario Virgen de la Arrixaca, Cardiology, Murcia, Spain
| | | | | | - C Rafols
- Bayer Hispania, Barcelona, Spain
| | - V Roldan
- University Hospital Morales Meseguer, University of Murcia, Murcia, Spain
| | - E Recalde
- Centro Médico San Juan de Dios, Barakaldo, Spain
| | | | | | | | - A Perez Cabeza
- University Hospital Virgen de la Victoria, Malaga, Spain
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Ding W, Proietti M, Boriani G, Marin F, Blomstrom-Lundqvist C, Fauchier L, Potpara T, Lip G. Digoxin vs. beta-blocker therapy in atrial fibrillation: analysis from the ESC-EHRA EORP Atrial Fibrillation General Long-Term (AFGen LT) Registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
There is a long-standing and unresolved controversy over the effects of digoxin on mortality. Furthermore, there is scarce evidence comparing the use of digoxin to beta-blocker in the general population with atrial fibrillation (AF). In this study, we aimed to evaluate the effects of digoxin over beta-blocker therapy among patients with AF.
Methods
Patients from the EORP-AF General Long-Term Registry with AF who were treated with either digoxin or beta-blocker were included. All patients were over 18 years old and had documented evidence of AF within 12 months prior to enrolment. The outcomes of interest were all-cause mortality, cardiovascular (CV) mortality, non-CV mortality and number of patients with unplanned hospitalisation (total and AF-related). These were recorded until the last known follow-up available.
Results
Of 6377 patients, 549 (8.6%) and 5828 (91.4%) were treated with digoxin and beta-blockers, respectively. Patients in the digoxin group were older (73 vs. 71 years, p<0.001) with reduced renal function (eGFR 65.4 vs. 68.7 mL/min/1.73m2, p=0.002), and had (in general) greater burden of comorbidities in terms of chronic kidney disease, chronic obstructive pulmonary disease, heart failure, hypertension and peripheral artery disease. Nonetheless, the use of anticoagulation therapy was comparable between both groups (p=0.112).
Over 24 months follow-up, there were 550 (8.6%) all-cause mortality and 1304 (23.6%) patients with unplanned emergency hospitalisation. Digoxin use was associated with increased all-cause mortality (hazard ratio [HR] 1.90 [95% CI, 1.48–2.44]), both from CV and non-CV causes (CV: HR 2.21 [95% CI, 1.49–3.26]); non-CV: HR 1.70 [95% CI, 1.04–2.79]). There was no statistical difference in terms of unplanned emergency hospitalisation (HR 0.99 [95% CI, 0.80–1.21]) and AF-related hospitalisation (HR 0.78 [95% CI, 0.58–1.06]) between both groups.
Using multivariable cox regression analysis, digoxin compared to beta-blocker therapy was independently linked to increased all-cause mortality (HR 1.52 [95% CI, 1.11–2.09]) and CV mortality (HR 1.82 [95% CI, 1.11–2.97]), but was not related to non-CV mortality (HR 1.31 [95% CI, 0.71–2.41]), emergency hospitalisation (HR 0.91 [95% CI, 0.71–1.16]) or AF-related hospitalisation (HR 0.88 [95% CI, 0.62–1.24]), after adjustment for known risk factors.
Conclusion
We demonstrated that the use of digoxin was independently associated with excess all-cause mortality, driven by CV death, but was non-inferior to beta-blocker in terms of preventing unplanned emergency or AF-related hospitalisation, after accounting for important risk factors.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- W.Y Ding
- University of Liverpool, Liverpool, United Kingdom
| | | | - G Boriani
- University of Modena & Reggio Emilia, Modena, Italy
| | - F Marin
- University of Murcia, Murcia, Spain
| | | | - L Fauchier
- University Hospital of Tours, Tours, France
| | | | - G.Y.H Lip
- University of Liverpool, Liverpool, United Kingdom
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42
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Malavasi VL, Vitolo M, Proietti M, Fauchier L, Marin F, Nabauer M, Potpara TS, Dan GA, Kalarus Z, Lane DA, Lip GYH, Boriani G. Impact of malignancy on outcomes in European patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in Atrial Fibrillation General Long-Term Registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Management of patients with atrial fibrillation (AF) and malignancy is a clinical challenge given the paucity of evidence supporting the appropriate clinical management.
Purpose
To evaluate the outcomes of patients with active or prior malignancy in a large contemporary cohort of European AF patients.
Methods
We analyzed patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. We stratified the population into three categories (i) No Malignancy (NoM) (ii) Prior Malignancy (PriorM) and (iii) Active Malignancy (ActM). The primary outcome for this analysis was all-cause death among the three groups. The association between anticoagulant treatment, all-cause death and haemorrhagic events was also evaluated.
Results
Among the original 11 096 AF patients enrolled, 10 383 were included in this analysis (median age 71 years (interquartile range [IQR] 63–77, males 59.7%). Of these, 9 597 (92.4%) were NoM patients, 577 (5.6%) PriorM and 209 (2%) ActM. Patients with malignancy (prior or active) had a higher median age, median CHA2DS2-VASc and HAS-BLED scores, compared to patients without malignancy (p<0.001). Lack of anticoagulation (AC) prescription occurred more commonly in ActM (21.5%) as compared with the other groups (PriorM 10.1% vs NoM 12.8%, p<0.001). In case of AC treatment, patients with ActM were treated more frequently with heparins (ActM 8.1% vs PriorM 2.4% vs NoM 2%, p<0.001).
After a median follow-up of 730 days [IQR 692–749], 982 (9.5%) patients died. Among all deaths, the proportion of cardiovascular death was different according to the three groups (40.0% in NoM, 26.0% in PrioM and 22.2% in ActM, p=0.002). For all cause-death, Kaplan-Meier analysis showed a progressively higher cumulative risk in the PriorM and ActM groups compared to NoM patients (Figure 1).
On multivariable Cox regression analysis, adjusted for CHA2DS2-VASc score, use of AC, type of AF and chronic kidney disease, ActM group was independently associated with a higher risk for all cause death (hazard ratio [HR] 2.90, 95% confidence interval [CI] 2.23–3.76) while PriorM group was not.
Among PriorM and NoM patients, multivariable adjusted Cox regression analysis found that the use of any AC was independently associated with a lower risk for all-cause death (HR 0.36, 95% CI 0.19–0.66; HR 0.66, 95% CI 0.54–0.81). No significant association between AC and all-cause death was found for ActM patients.
Conclusions
In a large contemporary cohort of European AF patients, active malignancy was found to be independently associated with all-cause death. Use of any AC was associated with a lower risk for all-cause death in patients with no malignancies and with prior malignancies, but with no significant association amongst patients with active malignancies.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Since the start of EORP, the following companies have supported the programme: Abbott Vascular Int. (2011–2021), Amgen Cardiovascular (2009–2018), AstraZeneca (2014–2021), Bayer (2009–2018), Boehringer Ingelheim (2009–2019), Boston Scientific (2009–2012), The Bristol Myers Squibb and Pfizer Alliance (2011–2016), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2011–2017), Edwards (2016–2019), Gedeon Richter Plc. (2014–2017), Menarini Int. Op. (2009–2012), MSD-Merck & Co. (2011–2014), Novartis Pharma AG (2014–2020), ResMed (2014–2016), Sanofi (2009–2011), SERVIER (2010–2021), and Vifor (2019–2022). Figure 1. Kaplan-Meier for all-cause death
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Affiliation(s)
- V L Malavasi
- University of Modena & Reggio Emilia, Modena, Italy
| | - M Vitolo
- University of Modena & Reggio Emilia, Modena, Italy
| | - M Proietti
- University of Milan, Department of Clinical Sciences and Community Health, Milan, Italy
| | - L Fauchier
- University Hospital of Tours, Tours, France
| | - F Marin
- Hospital Universitario Virgen Arrixaca, Murcia, Spain
| | - M Nabauer
- Ludwig Maximilians University Hospital, Munich, Germany
| | - T S Potpara
- University Belgrade Medical School, Belgrade, Serbia
| | - G A Dan
- Colentina University Hospital, Bucharest, Romania
| | - Z Kalarus
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - D A Lane
- University of Liverpool, Liverpool, United Kingdom
| | - G Y H Lip
- University of Liverpool, Liverpool, United Kingdom
| | - G Boriani
- University of Modena & Reggio Emilia, Modena, Italy
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Esteve Pastor M, Marin F, Anguita M, Sanmartin M, Rafols C, Roldan V, Perez C, Barrios V, Lekuona Goya I, Perez Cabeza A, Cosin Sales J. Oral anticoagulation therapy with rivaroxaban in elderly patients with atrial fibrillation. Results from EMIR study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) in elderly patients increases both bleeding and thromboembolic risks. Elderly patients benefit as much from anticoagulation therapy with positive net clinical benefit. However, there have been few studies that focused on the efficacy and safety of direct oral anticoagulants in elderly patients.
The aim of this subanalysis from EMIR study was to assess the effectiveness of rivaroxaban in patients older than 75 years old.
Methods
EMIR Study (acronym from 'Estudio observacional para la identificaciόn de los factores de riesgo asociados a eventos cardiovasculares Mayores en pacientes con fIbrilaciόn auricular no valvular tratados con un anticoagulante oral directo (Rivaroxaban)') was an observational, multicenter, post-authorization and prospective study that involved AF patients under oral anticoagulation with rivaroxaban at least 6 months before enrolment. We analyzed baseline clinical characteristics and adverse events after 2.5 years of follow up.
Results
We analyzed 1,433 patients with median age of 74.7 (67.7–81.6). Of them 691 (48.2%) were ≥75 years. Elderly patients had higher prevalence of cardiovascular risk factors such previous stroke (16.8% vs 8.5%; p<0.001), heart failure (25.0% vs 20.6%; p<0.001), higher CHA2DS2-VASc (4.4±1.3 vs 2.7±1.2; p<0.001) and HAS-BLED (1.9±1.0 vs 1.2±1.0; p<0.001) scores. After 2.5 (2.2–2.6) years of follow-up, we observed low rate of adverse events in patients under rivaroxaban therapy. We observed higher rate of adverse events in elderly population for thromboembolic events (1.13%/year vs 0.36%/year; p=0.017) and major bleeding events (1.80%/year vs 0.36%/year; p<0.001) but those adverse rates were lower than expected according to previous studies (i.e. ROCKET-AF trial, rivaroxaban group had 4.86%/year of major bleeding or in XANTUS study was 3.2%/year of major bleeding in patients >75 years). We did not observe differences between groups from MACE (1.13%/year vs 1.01%/year; p=0.875) or cardiovascular death (0.86%/year vs 0.42%/year; p=0.170).
Conclusion
In real-world elderly population, rivaroxaban showed higher rates of thromboembolic and major bleeding events in elderly patients but with annual rates lower than expected according to previous studies like ROCKET-AF or XANTUS. Similar annual rates in elderly were observed for MACE and cardiovascular mortality than in younger patients, being rivaroxaban a good therapeutic alternative even for the elderly.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Bayer Hispania S.L.
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Affiliation(s)
- M Esteve Pastor
- Hospital Clinico Univeristario Virgen de la Arrixaca, IMIB Arrixaca, CIBER-CV, Spain, Murcia, Spain
| | - F Marin
- Hospital Clinico Univeristario Virgen de la Arrixaca, IMIB Arrixaca, CIBER-CV, Spain, Murcia, Spain
| | - M Anguita
- University Hospital Reina Sofia, Cordoba, Spain
| | | | - C Rafols
- Bayer Hispania S.L., Medical Affairs Department, Sant Joan Despí, Spain
| | - V Roldan
- University Hospital Morales Meseguer, Murcia, Spain
| | - C Perez
- General Hospital of Jerez, Cadiz, Spain
| | - V Barrios
- Hospital Ramon y Cajal, Madrid, Spain
| | | | - A Perez Cabeza
- University Hospital Virgen de la Victoria, Malaga, Spain
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Ding W, Proietti M, Boriani G, Marin F, Blomstrom-Lundqvist C, Fauchier L, Potpara T, Lip G. Clinical application of the novel 4S-AF scheme for the characterisation of patients with atrial fibrillation: a report from the ESC-EHRA EORP Atrial Fibrillation General Long-Term (AFGen LT) registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Current classification systems recommended by major international guidelines are based on a single domain of atrial fibrillation (AF): temporal pattern, symptom severity or underlying comorbidity. Lack of integration between these various elements limits our approach to patients with AF and acts as a barrier against the delivery of better holistic care. The 4S-AF classification scheme was recently introduced as a means for the characterisation of patients with AF. It comprises of 4 domains: stroke risk (St), symptoms (Sy), severity of AF burden (Sb) and substrate (Su). We sought to examine the implementation of the 4S-AF scheme in the EORP-AF General Long-Term Registry and effects of individual domains on outcomes in AF.
Methods
Patients with AF from 250 centres across 27 participating European countries were included. All patients were over 18 years old and had electrocardiographic confirmation of AF within 12 months prior to enrolment. Data on demographics and comorbidities were collected at baseline. Individual domains of the 4S-AF scheme were assessed using the CHA2DS2-VASc score (St), European Heart Rhythm Association classification (Sy), temporal classification of AF (Sb), and cardiovascular risk factors and the degree of left atrial enlargement (Su). Each of these domains were used during multivariable cox regression analysis.
Results
A total of 6321 patients were included in the present analysis, corresponding to 57.0% of the original cohort of 11096 patients. The median age of patients was 70 (interquartile range [IQR] 62–77) years with 2615 (41.4%) females. Among these patients, 528 (8.4%) had low stroke risk (St=0), 3002 (47.5%) no or mild symptoms (Sy=0), 2558 (40.5%) newly diagnosed or paroxysmal AF (Sb=0), and 322 (5.1%) no cardiovascular risk factors or left atrial enlargement (Su=0).
Median follow-up was 24 months. Using multivariable cox regression analysis, independent predictors of all-cause mortality were (St) (adjusted hazard ratio [aHR] 8.21 [95% CI, 2.60–25.9]), (Sb) (aHR 1.21 [95% CI, 1.08–1.35]) and (Su) (aHR 1.27 [95% CI, 1.14–1.41]). For cardiovascular mortality and any thromboembolic event, only (Su) (aHR 1.73 [95% CI, 1.45–2.06]) and (Sy) (aHR 1.29 [95% CI, 1.00–1.66]) were statistically important, respectively. None of the domains were independently linked to ischaemic stroke or major bleeding.
Conclusion
Overall, we demonstrated that the 4S-AF scheme may be used to provide clinical characterisation of patients with AF using routinely collected data, and each of the domains within the 4S-AF scheme were independently associated with adverse long-term outcomes of all-cause mortality, cardiovascular mortality and/or any thromboembolic event.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- W.Y Ding
- University of Liverpool, Liverpool, United Kingdom
| | | | - G Boriani
- University of Modena & Reggio Emilia, Modena, Italy
| | - F Marin
- University of Murcia, Murcia, Spain
| | | | - L Fauchier
- University Hospital of Tours, Tours, France
| | | | - G.Y.H Lip
- University of Liverpool, Liverpool, United Kingdom
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Ding W, Rivera-Caravaca J, Marin F, Roldan V, Lip G. Stroke risk based on classification of atrial fibrillation: real-world vs clinical trial. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The most widely accepted clinical classification of atrial fibrillation (AF) is according to temporal rhythm-based patterns, reflecting the notion that most patients initially suffer from transient episodes that prolong over time due to atrial substrate remodelling as the disease progresses. Therefore, it may be speculated that patients with extended episodes of “continuous” AF (persistent, long-standing persistent and permanent AF) may be at higher risk of stroke complications compared to paroxysmal AF (pAF). However, the risk of stroke according to clinical classification of AF remains poorly defined. In this study, we assessed the impact of AF type on stroke risk in patients with AF from “real-world” and “clinical trial” cohorts.
Methods
Post-hoc analysis of patient-level data from the Murcia AF Project and AMADEUS trial. All patients were anticoagulated. Patients were grouped into those with pAF and non-pAF. pAF was defined as AF that terminates spontaneously or with intervention within seven days of onset. Non-pAF was defined as AF that lasted longer than seven days, including persistent, long-standing persistent and permanent AF subtypes. Study endpoint was the incidence rate of ischaemic stroke. A modified CHA2DS2-VAS“c” score that applied one additional point for a “c” criterion of continuous AF (i.e. non-pAF) was calculated.
Results
5,917 patients were included; 1,361 (23.0%) real-world and 4,556 (77.0%) clinical trial. Real-world patients had a median age of 76 (interquartile range [IQR] 71–81) years with 51.3% females compared to a median age of 71 (IQR 64–77) years with 33.5% females among clinical trial participants. Baseline demographics were comparable in both groups in the real-world cohort but clinical trial participants with non-pAF were older, predominantly male and had more comorbidities compared to those with pAF.
Crude stroke rates were comparable between the groups in real-world patients (incidence rate ratio [IRR] 0.72 [95% CI, 0.37–1.28], p=0.259) though clinical trial participants with non-pAF (vs. pAF) had a significantly higher crude rate of stroke events (IRR 4.66 [95% CI, 2.41–9.48], p<0.001). Using multivariable cox regression analysis, AF type was not independently associated with stroke risk in the real-world (adjusted hazard ratio [HR] 1.41 [95% CI, 0.80–2.50], p=0.239) and clinical trial (adjusted HR 1.17 [95% CI, 0.62–2.20], p=0.621) cohorts, after accounting for known risk factors using the CHA2DS2-VASc score. Using receiver operating characteristic curves analysis, we found no significant improvement in the CHA2DS2-VAS“c” compared to CHA2DS2-VASc score in either cohort (p>0.05).
Conclusion
Overall, there was no association between the temporal rhythm-based patterns of AF and stroke risk among anticoagulated patients, suggesting that this should not be a consideration when assessing the need for anticoagulation in AF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- W.Y Ding
- University of Liverpool, Liverpool, United Kingdom
| | | | - F Marin
- University of Murcia, Murcia, Spain
| | - V Roldan
- University of Murcia, Murcia, Spain
| | - G.Y.H Lip
- University of Liverpool, Liverpool, United Kingdom
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Anguita Sanchez M, Ruiz Ortiz M, Marin F, Sanmartin M, Rafols C, Masjuan J, Urena I, Baron Esquivias G, Lekuona I, Perez Cabeza A, Vazquez Rodriguez J. Incidence of cardiovascular events in patients with atrial fibrillation anticoagulated with rivaroxaban after 2.5 years of follow-up: not all is stroke or bleeding. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Atrial fibrillation (AF) is not a benign arrhythmia, but is associated with an increase in mortality, above all related to the risk of suffering thromboembolic events, mainly stroke. The use of oral anticoagulants (OAC) reduces this risk, but increases the risk of serious bleeding. The DOACs have been shown to be superior to the classic vitamin K antagonists (VKAs). It is not as well known whether AF is associated with an increase in other serious cardiac events.
Purpose
The objective of this analysis was to assess the incidence of stroke, major bleeding, total mortality and major adverse cardiac events [MACE, defined as cardiac mortality (including death for coronary events, progressive heart failure death and sudden cardiac death), coronary revascularization, myocardial infarction] in a contemporary series of patients with AF anticoagulated with rivaroxaban.
Methods
To do this, we have analyzed a series of 1,433 patients with AF, anticoagulated with rivaroxaban for at least the previous 6 months, consecutively included in the first half of year 2017 in 79 Spanish centers (EMIR study), and followed for 2.5 years.
Results
Mean age was 74.2±9.7 years, 44.5% being women. Prevalence of diabetes was 27.1%, chronic renal failure 16.1%, coronary heart disease 16.4% and heart failure 22.7%. 2MACE score was 1.8±1.4, CHA2DS2-VASc was 3.5±1.5 and HAS-BLED 1.6±1.0. 77.1% of patients received 20 mg/ day of rivaroxaban and 22.9% 15 mg/day. After a follow-up of 2.5 years, the annual rate (events/100 patients/year) of myocardial infarction was 0.16 (all non-STEMI), coronary revascularization 0.28, cardiac death 0.63 (sudden 0.16, heart failure 0.41, other 0.06), overall MACE 1.07 and overall mortality 2.73, while the incidence of stroke was 0.57 / 100 patients / year (ischemic 0.35, haemorrhagic 0.22) and major bleeding 1.04 (gastrointestinal 0.63, intracranial 0.28).
Conclusion
In a current series of patients with AF anticoagulated with rivaroxaban, the incidence of embolic and hemorrhagic complications and mortality are low, while the incidence of serious cardiac events is significant, being overall similar to that of stroke and major bleeding. Attention must be paid to the prevention and diagnosis of these problems.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Bayer Hispania
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Affiliation(s)
| | - M Ruiz Ortiz
- University Hospital Reina Sofia, Cardiology, Cordoba, Spain
| | - F Marin
- University Hospital Virgen de la Arrixaca, Cardiology, Murcia, Spain
| | - M Sanmartin
- University Hospital Ramon y Cajal, Cardiology, Madrid, Spain
| | - C Rafols
- Bayer Hispania, Medical Department, Barcelona, Spain
| | - J Masjuan
- University Hospital Ramon y Cajal, Neurology, Madrid, Spain
| | - I Urena
- Hospital Morales Meseguer, Cardiology, Murcia, Spain
| | | | - I Lekuona
- University Hospital Galdacano, Cardiology, Bilbao, Spain
| | - A Perez Cabeza
- University Hospital Virgen de la Victoria, Cardiology, Malaga, Spain
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Ramos-Silva P, Wall-Palmer D, Marlétaz F, Marin F, Peijnenburg KTCA. Evolution and biomineralization of pteropod shells. J Struct Biol 2021; 213:107779. [PMID: 34474158 DOI: 10.1016/j.jsb.2021.107779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/06/2021] [Accepted: 08/08/2021] [Indexed: 01/19/2023]
Abstract
Shelled pteropods, known as sea butterflies, are a group of small gastropods that spend their entire lives swimming and drifting in the open ocean. They build thin shells of aragonite, a metastable polymorph of calcium carbonate. Pteropod shells have been shown to experience dissolution and reduced thickness with a decrease in pH and therefore represent valuable bioindicators to monitor the impacts of ocean acidification. Over the past decades, several studies have highlighted the striking diversity of shell microstructures in pteropods, with exceptional mechanical properties, but their evolution and future in acidified waters remains uncertain. Here, we revisit the body-of-work on pteropod biomineralization, focusing on shell microstructures and their evolution. The evolutionary history of pteropods was recently resolved, and thus it is timely to examine their shell microstructures in such context. We analyse new images of shells from fossils and recent species providing a comprehensive overview of their structural diversity. Pteropod shells are made of the crossed lamellar and prismatic microstructures common in molluscs, but also of curved nanofibers which are proposed to form a helical three-dimensional structure. Our analyses suggest that the curved fibres emerged before the split between coiled and uncoiled pteropods and that they form incomplete to multiple helical turns. The curved fibres are seen as an important trait in the adaptation to a planktonic lifestyle, giving maximum strength and flexibility to the pteropod thin and lightweight shells. Finally, we also elucidate on the candidate biomineralization genes underpinning the shell diversity in these important indicators of ocean health.
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Affiliation(s)
- Paula Ramos-Silva
- Plankton Diversity and Evolution, Naturalis Biodiversity Center, the Netherlands.
| | - Deborah Wall-Palmer
- Plankton Diversity and Evolution, Naturalis Biodiversity Center, the Netherlands
| | - Ferdinand Marlétaz
- Centre for Life's Origins and Evolution, Department of Genetics, Evolution and Environment, University College London, United Kingdom
| | - Frédéric Marin
- University of Burgundy-Franche-Comté, Laboratoire Biogéosciences UMR CNRS 6282, France
| | - Katja T C A Peijnenburg
- Plankton Diversity and Evolution, Naturalis Biodiversity Center, the Netherlands; Department of Freshwater and Marine Ecology, Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, the Netherlands
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Takeuchi T, Fujie M, Koyanagi R, Plasseraud L, Ziegler-Devin I, Brosse N, Broussard C, Satoh N, Marin F. The 'Shellome' of the Crocus Clam Tridacna crocea Emphasizes Essential Components of Mollusk Shell Biomineralization. Front Genet 2021; 12:674539. [PMID: 34168677 PMCID: PMC8217771 DOI: 10.3389/fgene.2021.674539] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/13/2021] [Indexed: 01/31/2023] Open
Abstract
Molluscan shells are among the most fascinating research objects because of their diverse morphologies and textures. The formation of these delicate biomineralized structures is a matrix-mediated process. A question that arises is what are the essential components required to build these exoskeletons. In order to understand the molecular mechanisms of molluscan shell formation, it is crucial to identify organic macromolecules in different shells from diverse taxa. In the case of bivalves, however, taxon sampling in previous shell proteomics studies are focused predominantly on representatives of the class Pteriomorphia such as pearl oysters, edible oysters and mussels. In this study, we have characterized the shell organic matrix from the crocus clam, Tridacna crocea, (Heterodonta) using various biochemical techniques, including SDS-PAGE, FT-IR, monosaccharide analysis, and enzyme-linked lectin assay (ELLA). Furthermore, we have identified a number of shell matrix proteins (SMPs) using a comprehensive proteomics approach combined to RNA-seq. The biochemical studies confirmed the presence of proteins, polysaccharides, and sulfates in the T. crocea shell organic matrix. Proteomics analysis revealed that the majority of the T. crocea SMPs are novel and dissimilar to known SMPs identified from the other bivalve species. Meanwhile, the SMP repertoire of the crocus clam also includes proteins with conserved functional domains such as chitin-binding domain, VWA domain, and protease inhibitor domain. We also identified BMSP (Blue Mussel Shell Protein, originally reported from Mytilus), which is widely distributed among molluscan shell matrix proteins. Tridacna SMPs also include low-complexity regions (LCRs) that are absent in the other molluscan genomes, indicating that these genes may have evolved in specific lineage. These results highlight the diversity of the organic molecules – in particular proteins – that are essential for molluscan shell formation.
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Affiliation(s)
- Takeshi Takeuchi
- Marine Genomics Unit, Okinawa Institute of Science and Technology Graduate University, Onna, Okinawa, Japan
| | - Manabu Fujie
- DNA Sequencing Section, Okinawa Institute of Science and Technology Graduate University, Onna, Okinawa, Japan
| | - Ryo Koyanagi
- DNA Sequencing Section, Okinawa Institute of Science and Technology Graduate University, Onna, Okinawa, Japan
| | - Laurent Plasseraud
- Institut de Chimie Moléculaire de l'Université de Bourgogne, UMR CNRS 6302, Faculté des Sciences Mirande, Université de Bourgogne - Franche-Comté (UBFC), Dijon, France
| | - Isabelle Ziegler-Devin
- LERMAB, Faculté des Sciences et Technologies - Campus Aiguillettes, Université de Lorraine, Vandoeuvre-Lès-Nancy, France
| | - Nicolas Brosse
- LERMAB, Faculté des Sciences et Technologies - Campus Aiguillettes, Université de Lorraine, Vandoeuvre-Lès-Nancy, France
| | - Cédric Broussard
- 3P5 Proteomic Platform, Cochin Institute, University of Paris, INSERM U1016, CNRS UMR 8104, Paris, France
| | - Noriyuki Satoh
- Marine Genomics Unit, Okinawa Institute of Science and Technology Graduate University, Onna, Okinawa, Japan
| | - Frédéric Marin
- UMR CNRS 6282 Biogéosciences, Bâtiment des Sciences Gabriel, Université de Bourgogne - Franche-Comté (UBFC), Dijon, France
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Sapone M, Martin P, Ben Mansour K, Chateau H, Marin F. The Protraction and Retraction Angles of Horse Limbs: An Estimation during Trotting Using Inertial Sensors. Sensors (Basel) 2021; 21:s21113792. [PMID: 34070859 PMCID: PMC8199102 DOI: 10.3390/s21113792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/27/2021] [Accepted: 05/27/2021] [Indexed: 01/11/2023]
Abstract
The protraction and retraction angles of horse limbs are important in the analysis of horse locomotion. This study explored two methods from an IMU positioned on the canon bone of eight horses to estimate these angles. Each method was based on a hypothesis in order to define the moment corresponding with the verticality of the canon bone: (i) the canon bone is in a vertical position at 50% of the stance phase or (ii) the verticality of the canon bone corresponds with the moment when the horse’s withers reach their lowest point. The measurements were carried out on a treadmill at a trot and compared with a standard gold method based on motion capture. For the measurement of the maximum protraction and retraction angles, method (i) had average biases (0.7° and 1.7°) less than method (ii) (−1.3° and 3.7°). For the measurement of the protraction and retraction angles during the stance phase, method (i) had average biases (4.1° and −3.3°) higher to method (ii) (2.1° and −1.3°). This study investigated the pros and cons of a generic method (i) vs. a specific method (ii) to determine the protraction and retraction angles of horse limbs by a single IMU.
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Affiliation(s)
- Marie Sapone
- Université de Technologie de Compiègne, UMR CNRS 7338 BioMécanique et BioIngénierie, Alliance Sorbonne Université, 60200 Compiègne, France; (K.B.M.); (F.M.)
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CWD-VetLab, 94700 Maisons-Alfort, France; (P.M.); (H.C.)
- LIM France, Chemin Fontaine de Fanny, 24300 Nontron, France
- Correspondence:
| | - Pauline Martin
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CWD-VetLab, 94700 Maisons-Alfort, France; (P.M.); (H.C.)
- LIM France, Chemin Fontaine de Fanny, 24300 Nontron, France
| | - Khalil Ben Mansour
- Université de Technologie de Compiègne, UMR CNRS 7338 BioMécanique et BioIngénierie, Alliance Sorbonne Université, 60200 Compiègne, France; (K.B.M.); (F.M.)
| | - Henry Chateau
- Ecole Nationale Vétérinaire d’Alfort, USC INRAE-ENVA 957 BPLC, CWD-VetLab, 94700 Maisons-Alfort, France; (P.M.); (H.C.)
| | - Frédéric Marin
- Université de Technologie de Compiègne, UMR CNRS 7338 BioMécanique et BioIngénierie, Alliance Sorbonne Université, 60200 Compiègne, France; (K.B.M.); (F.M.)
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Proietti M, Vitolo M, Harrison S, Lane DA, Fauchier L, Marin F, Nabauer M, Potpara TS, Dan GA, Boriani G, Lip GYH. Impact on outcomes in Europe: a cluster analysis from the ESC-EHRA EORP AF general long-term registry. Europace 2021. [DOI: 10.1093/europace/euab116.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
ESC-EHRA EORP AF General Long-Term Registry Investigators
Introduction
Data derived from recent observational studies in atrial fibrillation (AF) show how the complexity of the clinical phenotype, beyond baseline thromboembolic risk, can increase risk of major adverse outcomes. Importantly, risk factors tend to occur in clusters, rather than occur individually in isolation.
Aims
To describe AF patients’ clinical phenotypes among a large contemporary European AF cohort and to analyse the differential impact of these clinical phenotypes on the occurrence of major adverse outcomes.
Methods
We performed a hierarchical cluster analysis based on Ward’s Method and using Squared Euclidean Distance using 22 clinical covariates. All variables were considered as binary. Examining the distances between cluster coefficients and by visual inspection of the dendrogram produced we identified the optimal number of clusters. Patients with data available for all 22 variables were included. We considered occurrence of cardiovascular events and all-cause death.
Results
Among the original 11096 patients included, 9363 (84.4%) were available for this analysis. The cluster analysis identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients with prevalent noncardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients mainly admitted for first detected and paroxysmal AF with low prevalence of concomitant conditions; Cluster 3 (n = 2955; 31.6%) included patients with high prevalence of permanent AF, cardiac risk factors and comorbidities. Thromboembolic and bleeding risks were higher in Cluster 3 and progressively lower in Cluster 1 and Cluster 2 (both p < 0.001). Use of oral anticoagulant was significantly lower for Cluster 2 (83.2% vs. 86.5% and 86.7% in Cluster 1 and Cluster 3, respectively; p < 0.001). Over a mean follow-up of 22.5 (SD5.5) months, Cluster 3 had the highest rate of both cardiovascular events (10.0%) and all-cause death (13.2%), compared with Cluster 1 (6.6% and 9.4%, respectively) and Cluster 2 (3.7% and 3.8%, respectively) (both p < 0.001). Kaplan-Meier curves (Figure) show that Cluster 2 (green line) had the lowest cumulative risk of outcomes; risk was progressively higher in Cluster 1 (orange line) and Cluster 3 (yellow line). A Cox multivariable regression analysis, adjusted for type of AF, symptomatic status, CHA2DS2-VASc score and use of oral anticoagulants, showed that both Cluster 3 and Cluster 1 were associated with a significantly increased risk of cardiovascular events (HR: 1.80, 95%CI: 1.39-2.33 and HR: 1.40, 95%CI: 1.09-1.80, respectively) and all-cause death (HR: 1.80, 95%CI: 1.40-2.30 and HR: 1.66, 95%CI: 1.30-2.11) compared to Cluster 2.
Conclusions
In European AF patients, three main clinical clusters were identified, those with non-cardiac comorbidities, low risk and cardiac comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of cardiovascular events and all-cause death. Abstract Figure. Kaplan-Meier Curves for Outcomes
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Affiliation(s)
| | - M Vitolo
- University of Modena & Reggio Emilia, Modena, Italy
| | - S Harrison
- University of Liverpool, Liverpool Centre for Cardiovascular Science, Liverpool, United Kingdom of Great Britain & Northern Ireland
| | - DA Lane
- University of Liverpool, Liverpool Centre for Cardiovascular Science, Liverpool, United Kingdom of Great Britain & Northern Ireland
| | - L Fauchier
- University Hospital of Tours, Tours, France
| | - F Marin
- Hospital Universitario Virgen Arrixaca, Murcia, Spain
| | - M Nabauer
- Ludwig Maximilians University Hospital, Munich, Germany
| | - TS Potpara
- University of Belgrade, Belgrade, Serbia
| | - GA Dan
- Colentina University Hospital, Bucharest, Romania
| | - G Boriani
- University of Modena & Reggio Emilia, Modena, Italy
| | - GYH Lip
- University of Liverpool, Liverpool Centre for Cardiovascular Science, Liverpool, United Kingdom of Great Britain & Northern Ireland
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