Zhoucollins6123

Ltd on behalf of European Society of Cardiology.AIMS Hyperkalaemia and hypokalaemia are common in heart failure and associated with worse outcomes. However, the optimal potassium range is unknown. We sought to determine the optimal range of potassium in patients with heart failure and reduced ejection fraction (5.0 mmol/L were more common with lower estimated glomerular filtration rate and heart failure of longer duration and greater severity. The potassium level associated with the lowest hazard risk for mortality at 30 days, 12 months, and maximal follow-up was 4.2 mmol/L, and there was a steep increase in risk with both higher and lower potassium levels. In adjusted strata analyses, lower potassium was independently associated with all-cause mortality at 12 months and maximal follow-up, while higher potassium levels only increased risk at 30 days. CONCLUSION In this nationwide registry, the relationship between potassium and mortality was U-shaped, with an optimal potassium value of 4.2 mmol/L. After multivariable adjustment, hypokalaemia was associated with increased long-term mortality but hyperkalaemia was associated with increased short-term mortality. © 2020 The Authors. European Journal of Heart Failure © 2020 European Society of Cardiology.As one of the most promising intelligent materials, polymeric hydrogel actuators could produce reversible shape change upon external stimuli. Although complex shape deformation from 2D to 3D have been achieved, the realization of actuating behavior from 3D to 3D is still a significant challenge. Herein, an effective strategy to develop a novel bilayer hollow spherical hydrogel actuator is proposed. Through immersing a Ca2+ incorporated gelatin core into alginate solution, an ionic-strength-responsive alginate layer will be formed along the gelatin core via alginate-Ca2+ crosslinks, and then another thermo-responsive alginate-poly(2-(dimethylamino)ethyl methacrylate)(Alg-PDMAEMA) layer is introduced to achieve a bilayer hydrogel with ionic strength and temperature dual responsiveness. A hollow hydrogel capsule could be obtained if a spherical gelatin core is applied, and it could produce complex shape deformations from 3D to 3D upon the trigger of ionic strength and temperatures changes. The present work may offer new inspirations for the development of novel intelligent polymeric hydrogel actuators. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.AIMS Concomitant cardiac amyloidosis (CA) in severe aortic stenosis (AS) is difficult to recognize, since both conditions are associated with concentric left ventricular thickening. We aimed to assess type, frequency, screening parameters, and prognostic implications of CA in AS. METHODS AND RESULTS A total of 191 consecutive AS patients (81.2 ± 7.4 years; 50.3% female) scheduled for transcatheter aortic valve replacement (TAVR) were prospectively enrolled. Overall, 81.7% underwent complete assessment including echocardiography with strain analysis, electrocardiography (ECG), cardiac magnetic resonance imaging (CMR), 99m Tc-DPD scintigraphy, serum and urine free light chain measurement, and myocardial biopsy in immunoglobulin light chain (AL)-CA. Voltage/mass ratio (VMR; Sokolow-Lyon index on ECG/left ventricular mass index) and stroke volume index (SVi) were tested as screening parameters. Receiver operating characteristic curve, binary logistic regression, and Kaplan-Meier curve analyses were performed. CA was found in 8.4% of patients (n = 16); 15 had transthyretin (TTR)-CA and one AL-CA. While global longitudinal strain by echo did not reliably differentiate AS from CA-AS [area under the curve (AUC) 0.643], VMR as well as SVi showed good discriminative power (AUC 0.770 and 0.773, respectively), which was comparable to extracellular volume by CMR (AUC 0.756). Also, VMR and SVi were independently associated with CA by multivariate logistic regression analysis (P = 0.016 and P = 0.027, respectively). CA did not significantly affect survival 15.3 ± 7.9 months after TAVR (P = 0.972). CONCLUSION Both TTR- and AL-CA can accompany severe AS. Parameters solely based on ECG and echocardiography allow for the identification of the majority of CA-AS. In the present cohort, CA did not significantly worsen prognosis 15.3 months after TAVR. © 2020 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.Although difficulties with social relationships are key to autism spectrum disorder (ASD), no previous study has examined infant attachment security prior to ASD diagnosis. We prospectively assessed attachment security at 15 months in high-risk infants with later ASD (high-risk/ASD, n = 16), high-risk infants without later ASD (high-risk/no-ASD, n = 40), and low-risk infants without later ASD (low-risk/no-ASD, n = 39) using the Strange Situation Procedure. High-risk/ASD infants were disproportionately more likely to be classified as insecure (versus secure) and more likely to be classified as insecure-resistant (versus secure or avoidant) than high-risk/no-ASD and low-risk/no-ASD infants. High-risk infants with insecure-resistant attachments were over nine times more likely to receive an ASD diagnosis than high-risk infants with secure attachments. Insecure-resistant attachment in high-risk infants suggests a propensity toward negative affect with the parent in conditions of stress. Insecure-resistant attachment may prove useful as a potential early index of propensity toward ASD diagnosis in high-risk siblings, while insecure-resistant attachment in the context of emergent autism may contribute to difficulties experienced by children with ASD and their families. © 2020 John Wiley & Sons Ltd.BACKGROUND Memory is known to be the most common first symptom in Alzheimer's Disease. Assessing non-memory cognitive symptom development in Alzheimer's Disease is important for understanding disease progression and the potential identification of treatment-responsive subtypes. METHODS Data from the National Alzheimer Co-ordinating Center were examined. Logistic regression models were fitted evaluating development of judgement, language, visuospatial and attention symptoms at first and second visits to Alzheimer's Disease Centers. Predictors were age and prior symptoms, adjusting for symptom length and sex. The models were then refitted assessing APOE-ε4 effects. RESULTS Each decade reduction in presentation age increased the odds of language, visuospatial and attention symptom development at both visits by 8-18% (p less then 0.05, all tests), and judgement symptoms at second visit by 13% (p less then 0.05). learn more Prior symptoms were not equally predictive of symptom development. For example, having first-predominant language symptoms carried the lowest risk of developing other first-visit symptoms and having memory symptoms was a stronger predictor of developing judgement than other symptoms.