Showing papers by "University of Louisville published in 2022"

Cardiovascular Effects of Particulate Air Pollution

Abstract: Inhalation of fine particulate matter (PM 2.5 ), produced by the combustion of fossil fuels, is an important risk factor for cardiovascular disease. Exposure to PM 2.5 has been linked to increases in blood pressure, thrombosis, and insulin resistance. It also induces vascular injury and accelerates atherogenesis. Results from animal models corroborate epidemiological evidence and suggest that the cardiovascular effects of PM 2.5 may be attributable, in part, to oxidative stress, inflammation, and the activation of the autonomic nervous system. Although the underlying mechanisms remain unclear, there is robust evidence that long-term exposure to PM 2.5 is associated with premature mortality due to heart failure, stoke, and ischemic heart disease.

Apixaban: Alternative Anticoagulation for HeartMate 3 Ventricular Assist Device

Abstract: Patients with left ventricular assist devices currently require long-term anticoagulation with warfarin. Warfarin requires frequent blood tests and is associated with adverse events when not in the therapeutic range. Apixaban is a possible alternative that is potentially better for compliance and requires no additional testing. The purpose of this study was to compare adverse events in patients with a HeartMate 3 LVAD receiving apixaban versus warfarin. Thirty-five patients underwent HM3 implantation between January 01, 2016 to January 31, 2021. The groups compared were apixaban (n = 15, 43%) and warfarin (n = 20, 57%). All patients received 325 mg aspirin daily. Stroke, bleeding, and death were identified as primary outcomes after LVAD implant. Univariate nonparametric statistical analysis was performed. The median duration of treatment with apixaban was 148 days (37–606 days). The groups were comparable in terms of age (56 vs. 54 years), gender (male, 85% vs. 75%), and renal function (Cr 1.5 vs. 1.4). The apixaban group had significantly higher mean pulmonary artery pressure (41 vs. 34, p = 0.03) and there were more (p < 0.05) ischemic cardiomyopathy and INTERMACS profile >3 in the warfarin group. At 6 months, thrombotic complications and death were not different between the groups. The two deaths in the apixaban group were from right heart failure. The apixaban group had clinically lower rates of bleeding complications (5% vs. 30%). The adverse events of bleeding, stroke, and death were similar in HM3 patients receiving warfarin or apixaban. Apixaban may be a safe alternative anticoagulant therapy in HM 3 LVAD patients.

Recombinant Human Bone Morphogenetic Protein–2 Use in Adult Spinal Deformity Surgery: Comparative Analysis and Healthcare Utilization at 24 Months’ Follow-up:

Abstract: Study Design:Retrospective cohort study.Objective:Recombinant human bone morphogenetic protein–2 (rhBMP-2) is used to achieve fusion in adult spinal deformity (ASD) surgery. Our aim was to investig...

F4/80hi Resident Macrophages Contribute to Cisplatin-Induced Renal Fibrosis

Abstract: In Brief Visual Abstract Export Background Cisplatin-induced kidney injury remains a major obstacle in utilizing cisplatin as a chemotherapeutic for solid-organ cancers. Thirty percent of patients treated with cisplatin develop acute kidney injury (AKI), and even patients who do not develop AKI are at risk for long-term declines in kidney function and development of chronic kidney disease (CKD). Modeling cisplatin-induced kidney injury in mice has revealed that repeated low doses of cisplatin lead to development of kidney fibrosis. This model can be used to examine AKI-to-CKD transition processes. Macrophages play a role in some of these processes, including immune response, wound healing, and tissue remodeling. Depleting macrophage populations in the kidney reduced fibrosis development in other models of renal fibrosis. Methods We used either C57BL/6 mice with a Ccr2 genetic knockout or liposome encapsulated clodronate (Clodrosome) to deplete macrophage populations during repeated 9 mg/kg cisplatin treatments. We assessed how immune cell populations were altered in the blood and kidney of these mice and how these alterations affected development of renal fibrosis and kidney injury. Results We found that Clodrosome treatment decreased collagen deposition, myofibroblast accumulation, and inflammatory cytokine production, whereas Ccr2 genetic knockout had no effect on these markers after cisplatin treatment. Additionally, Ccr2−/− mice had decreased levels of F4/80lo infiltrating macrophages in the kidney after cisplatin treatments, but Clodrosome treatment depleted F4/80hi resident and CD206+ M2 macrophages. Conclusions These data suggest that Clodrosome depletion of F4/80hi and M2 macrophages in the kidney attenuates development of renal fibrosis after repeated low doses of cisplatin. Key Points Long-term effects of cisplatin are understudied. This study is the first to examine the role of macrophages in cisplatin-induced fibrosis. Depletion of kidney-resident macrophages ameliorated cisplatin-induced fibrosis, whereas depletion of infiltrating macrophages had no effect. This study highlights a pathogenic role for kidney-resident M2 macrophages in the development of fibrosis with repeated nephrotoxic injury.

Circulating MicroRNAs, Polychlorinated Biphenyls, and Environmental Liver Disease in the Anniston Community Health Survey

Abstract: Polychlorinated biphenyl (PCB) exposures have been associated with liver injury in human cohorts, and steatohepatitis with liver necrosis in model systems. MicroRNAs (miRs) maintain cellular homeostasis and may regulate the response to environmental stress.We tested the hypothesis that specific miRs are associated with liver disease and PCB exposures in a residential cohort.Sixty-eight targeted hepatotoxicity miRs were measured in archived serum from 734 PCB-exposed participants in the cross-sectional Anniston Community Health Survey. Necrotic and other liver disease categories were defined by serum keratin 18 (K18) biomarkers. Associations were determined between exposure biomarkers (35 ortho-substituted PCB congeners) and disease biomarkers (highly expressed miRs or previously measured cytokines), and Ingenuity Pathway Analysis was performed.The necrotic liver disease category was associated with four up-regulated miRs (miR-99a-5p, miR-122-5p, miR-192-5p, and miR-320a) and five down-regulated miRs (let-7d-5p, miR-17-5p, miR-24-3p, miR-197-3p, and miR-221-3p). Twenty-two miRs were associated with the other liver disease category or with K18 measurements. Eleven miRs were associated with 24 PCBs, most commonly congeners with anti-estrogenic activities. Most of the exposure-associated miRs were associated with at least one serum hepatocyte death, pro-inflammatory cytokine or insulin resistance bioarker, or with both. Within each biomarker category, associations were strongest for the liver-specific miR-122-5p. Pathways of liver toxicity that were identified included inflammation/hepatitis, hyperplasia/hyperproliferation, cirrhosis, and hepatocellular carcinoma. Tumor protein p53 and tumor necrosis factor α were well integrated within the top identified networks.These results support the human hepatotoxicity of environmental PCB exposures while elucidating potential modes of PCB action. The MiR-derived liquid liver biopsy represents a promising new technique for environmental hepatology cohort studies. https://doi.org/10.1289/EHP9467.

Around the Sine Addition Law and d’Alembert’s Equation on Semigroups

Abstract: We treat several related trigonometric functional equations on semigroups. First we make a small improvement to the description of solutions of the sine addition law $$f(xy) = f(x)g(y) + g(x)f(y)$$ for $$f,g:S \rightarrow {{\mathbb {C}}}$$ , where S is a semigroup. Next we solve the partial Pexiderization $$f(xy) = g(x)h(y) + h(x)g(y)$$ for $$f,g,h:M \rightarrow {{\mathbb {C}}}$$ , where M is a monoid. Our main result is the solution of the partially Pexiderized d’Alembert-type equation $$f(x\sigma (y)) + h(\tau (y)x) = 2f(x)k(y)$$ for $$f,g,h,k:M \rightarrow {{\mathbb {C}}}$$ , where $$\sigma ,\tau $$ are involutive automorphisms of M. The solutions of the latter two equations were given by Ng, Zhao, and Lin assuming that M is a group, then by the author assuming that the monoid M is either regular or generated by its squares. Here we find that new solutions appear on monoids that are neither regular nor generated by their squares. In addition we give the continuous solutions of all three functional equations on topological semigroups/monoids.

Regional Division and Its Criteria of Mining Fractures Based on Overburden Critical Failure

Abstract: Mining fracture is the key factor in realizing water-conservation mining, stability evaluation of coal mining subsidence areas, and accurate restoration of the surface eco-environment. To clarify, the evolution and distribution of mining fractures, based on the key strata theory and the mining degree of overburden failure, the contact state of rock stratum after overburden critical failure was analyzed, the formation mechanism of “saddle shaped” water conducting fracture zone was revealed, and the permanent mining fractures were determined to be primarily concentrated in the overburden structure at the boundary of the working face. According to the shear test of sandstone in the fracture zone, the damage degree of the rock sample was positively correlated with shear stress, and the overburden structure exhibited no instability. Based on the distribution of mining fractures, the fracture zone was divided into the original fracture, tensile fracture, structural void, and void compaction areas in the horizontal direction. The structural void area had the largest residual deformation in the goaf. A regional division method based on overburden critical failure was proposed and applied in engineering by using surface movement monitoring. The results showed that the surface subsidence near the boundary of working face was greater than that in the middle, and the residual surface deformation in the goaf was closely related to the mining time, which has long-term characteristics. The rationality of the regional division method of mining fractures was also verified.

Applying Machine Learning and Time-Series Analysis on Sentinel-1A SAR/InSAR for Characterizing Arctic Tundra Hydro-Ecological Conditions

Abstract: Synthetic aperture radar (SAR) is a widely used tool for Earth observation activities. It is particularly effective during times of persistent cloud cover, low light conditions, or where in situ measurements are challenging. The intensity measured by a polarimetric SAR has proven effective for characterizing Arctic tundra landscapes due to the unique backscattering signatures associated with different cover types. However, recently, there has been increased interest in exploiting novel interferometric SAR (InSAR) techniques that rely on both the amplitude and absolute phase of a pair of acquisitions to produce coherence measurements, although the simultaneous use of both intensity and interferometric coherence in Arctic tundra image classification has not been widely tested. In this study, a time series of dual-polarimetric (VV, VH) Sentinel-1 SAR/InSAR data collected over one growing season, in addition to a digital elevation model (DEM), was used to characterize an Arctic tundra study site spanning a hydrologically dynamic coastal delta, open tundra, and high topographic relief from mountainous terrain. SAR intensity and coherence patterns based on repeat-pass interferometry were analyzed in terms of ecological structure (i.e., graminoid, or woody) and hydrology (i.e., wet, or dry) using machine learning methods. Six hydro-ecological cover types were delineated using time-series statistical descriptors (i.e., mean, standard deviation, etc.) as model inputs. Model evaluations indicated SAR intensity to have better predictive power than coherence, especially for wet landcover classes due to temporal decorrelation. However, accuracies improved when both intensity and coherence were used, highlighting the complementarity of these two measures. Combining time-series SAR/InSAR data with terrain derivatives resulted in the highest per-class F1 score values, ranging from 0.682 to 0.955. The developed methodology is independent of atmospheric conditions (i.e., cloud cover or sunlight) as it does not rely on optical information, and thus can be regularly updated over forthcoming seasons or annually to support ecosystem monitoring.

Analysis of OpenStreetMap Data Quality for Selected Counties in Poland in Terms of Sustainable Development

Abstract: One potential source of geospatial open data for monitoring sustainable development goals (SDG) indicators is OpenStreetMap (OSM). The purpose of this paper is to provide a comprehensive evaluation of the spatial data quality elements of OSM against the national official data—the database of topographic objects at a scale of 1:10,000. Such spatial data quality elements as location accuracy, data completeness and attribute compatibility were analysed. In the conducted OpenStreetMap tests, basic land-cover classes such as roads, railroads, river network, buildings, surface waters and forests were analysed. The test area of the study consisted of five counties in Poland, which differ in terms of location, relief, surface area and degree of urbanization. The best results of the quality of OSM spatial data were obtained for highly urbanized areas with developed infrastructure and a high degree of affluence. The highest degree of completeness of OSM linear and area objects in the studied counties was acquired in Piaseczyński County (82%). The lowest degree of completeness of the line and area objects of OSM in the studied counties was obtained in the Ostrowski County (51%). The calculated correlation coefficient between the quality of OSM data and the income per capita in the county was 0.96. The study complements the previous research results in the field of quantitative analysis of the quality of OSM data, and the obtained results confirm their dependence on the geometric type of the analysed objects and characteristics of test areas, i.e., in this case counties in Poland. The obtained results of OSM data quality analysis indicate that OSM data may provide strong support for other spatial data, including official and state data. OSM stores significant amounts of geospatial data with relatively high data quality that can be a valuable source for monitoring some SDG indicators.

Clinical results and patient-reported outcomes following robotic-assisted primary total knee arthroplasty

Abstract: Aims The aim of this study was to report patient and clinical outcomes following robotic-assisted total knee arthroplasty (RA-TKA) at multiple institutions with a minimum two-year follow-up. Methods This was a multicentre registry study from October 2016 to June 2021 that included 861 primary RA-TKA patients who completed at least one pre- and postoperative patient-reported outcome measure (PROM) questionnaire, including Forgotten Joint Score (FJS), Knee Injury and Osteoarthritis Outcomes Score for Joint Replacement (KOOS JR), and pain out of 100 points. The mean age was 67 years (35 to 86), 452 were male (53%), mean BMI was 31.5 kg/m 2 (19 to 58), and 553 (64%) cemented and 308 (36%) cementless implants. Results There were significant improvements in PROMs over time between preoperative, one- to two-year, and > two-year follow-up, with a mean FJS of 17.5 (SD 18.2), 70.2 (SD 27.8), and 76.7 (SD 25.8; p < 0.001); mean KOOS JR of 51.6 (SD 11.5), 85.1 (SD 13.8), and 87.9 (SD 13.0; p < 0.001); and mean pain scores of 65.7 (SD 20.4), 13.0 (SD 19.1), and 11.3 (SD 19.9; p < 0.001), respectively. There were eight superficial infections (0.9%) and four revisions (0.5%). Conclusion RA-TKA demonstrated consistent clinical results across multiple institutions with excellent PROMs that continued to improve over time. With the ability to achieve target alignment in the coronal, axial, and sagittal planes and provide intraoperative real-time data to obtain balanced gaps, RA-TKA demonstrated excellent clinical outcomes and PROMs in this patient population. Cite this article: Bone Jt Open 2022;3(7):589–595.

Use of Impella in Patients Listed for Heart Transplantation

Abstract: The new United Network for Organ Sharing (UNOS) policy has resulted in a significantly higher number of temporary mechanical circulatory support device usage such as extracorporeal membrane oxygenation, Impella, and intra-aortic balloon pump due to provision of higher priority with their use while on the waiting list. We aimed to identify Impella use in patients awaiting heart transplantation and temporal changes in its usage. The UNOS database was queried between years 2015 and 2019 for patients aged greater than or equal to 18 years, listed to undergo heart transplantation. A total of 378 patients had Impella support while listed for heart transplantation. Impella use skyrocketed from 2015 (1%) to 2019 (4%, p < 0.01). The most substantial increase in Impella use occurred after the UNOS policy change. The patients listed on Impella support after the policy change had significantly lower waiting time (median 12 days vs. 45 days, p < 0.01). More patients with Impella were directly transplanted (80% vs. 56%, p < 0.01) after the policy change, had significantly lower waitlist mortality (25% vs. 13%, p < 0.01) and fewer converted to a durable support (13% vs. 3%). The translatability (likelihood for receiving organs faster) was significantly improved after the policy change. A multivariable Cox regression model showed that post-transplant survival of Impella patients was not adversely affected after the policy change (hazard ratio = 0.9; p = 0.8). This increase in Impella use represents a substantial change in practice patterns of listing and managing patients on the heart transplant waiting list.