Scarboroughweiss1985

This study sought to characterize urinary and plasma C-type natriuretic peptide (CNP) in acute decompensated heart failure (ADHF) to define their relationship with clinical variables and to determine whether urinary and plasma CNP together add prognostic value.

CNP is a protective hormone that is synthesized in the kidney and endothelium and possesses antiremodeling properties. Urinary and plasma CNP levels are elevated in pathophysiological conditions; however, their regulation and prognostic value in heart failure (HF) is unclear.

Urinary and plasma CNP were measured in 109 healthy subjects and 208 patients with ADHF; the 95th percentile of CNP values from healthy subjects established the normal contemporary cutoffs. Patients with ADHF were stratified based on urinary and plasma CNP levels for clinical characterization and the assessment of risk for adverse outcomes.

There was no significant correlation between urinary and plasma CNP in both cohorts. Urinary and plasma CNP were significantly elevated elevations in both provided independent prognostic value for predicting adverse outcomes.

The authors examined the relationship among high-sensitivity troponin-T (hs-TnT), outcomes, and treatment with sacubitril/valsartan in patients with heart failure (HF) and preserved ejection fraction (HFpEF).

hs-TnT is a marker of myocardial injury in HF.

The PARAGON-HF trial randomized 4,796 patients with HFpEF to sacubitril/valsartan or valsartan. We compared the risk of the composite outcome of cardiovascular death (CVD) and total HF hospitalization (HHF) according to hs-TnT. We also assessed the effect of allocated treatment on hs-TnT.

hs-TnT was available in 1,141 patients (24%) at run-in (median value 17ng/L) and 1,260 (26%) at randomization, with 58.3% having hs-TnT >14ng/L (upper limit of normal). During a median follow-up of 34months, there were 393 outcome events (82 CVD, 311 HHF). Adjusting for demographics, comorbidities, left ventricular ejection fraction (LVEF), and N-terminal pro b-type natriuretic peptide (NT-proBNP), log-hs-TnT at randomization was an independent predictor of the cisk of CVD/HHF, whereas hs-TnT decrease at 16 weeks led to lower subsequent risk of CVD/HHF compared with those who had persistently elevated values. Sacubitril/valsartan significantly reduced hs-TnT compared with valsartan. hs-TnT may be helpful in identifying patients with HFpEF who are more likely to benefit from sacubitril/valsartan.

This study assessed for treatment interactions by ejection fraction (EF) subgroup (≥45% [preserved EF (HFpEF); vs<45% [reduced EF; (HFrEF)]).

The REHAB-HF trial showed that an early multidomain rehabilitation intervention improved physical function, frailty, quality-of-life, and depression in older patients hospitalized with acute decompensated heart failure (ADHF).

Three-month outcomes were Short Physical Performance Battery (SPPB), 6-min walk distance (6MWD), and Kansas City Cardiomyopathy Questionnaire (KCCQ). Six-month end points included all-cause rehospitalization and death and a global rank of death, all-cause rehospitalization, and SPPB. Prespecified significance level for interaction was P≤ 0.1.

Among 349 total participants, 185 (53%) had HFpEF and 164 (47%) had HFrEF. Compared with HFrEF, HFpEF participants were more often women (61% vs 43%) and had significantly worse baseline physical function, frailty, quality of life, and depression. Although interaction P values for 3-month outcomes

Among older patients hospitalized with ADHF, compared with HFrEF those with HFpEF had significantly worse impairments at baseline and may derive greater benefit from the intervention. (A Trial of Rehabilitation Therapy in Older Acute Heart Failure Patients [REHAB-HF]; NCT02196038).The global livestock sector, particularly ruminants, contributes substantially to the total anthropogenic greenhouse gases. Management and dietary solutions to reduce enteric methane (CH4) emissions are extensively researched. Animal breeding that exploits natural variation in CH4 emissions is an additional mitigation solution that is cost-effective, permanent, and cumulative. We quantified the effect of including CH4 production in the Dutch breeding goal using selection index theory. The current Dutch national index contains 15 traits, related to milk yield, longevity, health, fertility, conformation and feed efficiency. From the literature, we obtained a heritability of 0.21 for enteric CH4 production, and genetic correlations of 0.4 with milk lactose, protein, fat and DM intake. Correlations between enteric CH4 production and other traits in the breeding goal were set to zero. When including CH4 production in the current breeding goal with a zero economic value, CH4 production increases each year by 1.5 g/2 years is required to achieve the desired reliability of 0.40 for the genomic prediction.Technological change has been a constant feature of livestock systems leading to the third agricultural 'green' revolution of the mid-20th century. Digital technologies are now leading us into the fourth agricultural revolution, where sustainable food production is supported by technologies that collect data useful for farm and supply chain performance improvement, along with task automation and compliance. However, the potential benefits of digital agricultural futures are uncertain and plagued by unrealized expectations of previous innovations. The aims of this paper are to articulate current trends in technology and livestock systems and anticipate future trajectories for Agriculture 4.0 in relation to meeting sustainability and animal welfare outcomes for livestock systems. We use a 'Futures Triangle' approach to review the role of technology in livestock systems. R788 Syk inhibitor The main findings are that previous work envisioning technological livestock futures have favoured pull of the future factors (techno-optimists) or weight of the past (techno-pessimists), rather than a balance of pull, push and weighting factors. Responsible Agriculture 4.0 innovation requires public-private collaboration of innovation system stakeholders, including policy makers, farmers, consumers, as well as technology developers, to enable development of transition pathways from a systems perspective. The use of responsible innovation processes, including anticipation on alternative futures, should also be built into innovation processes to support critical reflection on technological trajectories and related innovation system consequences, both desirable and undesirable.