Health care professionals' experiences of pain management in the intensive care unit: a qualitative study

Despite the existence of evidence-based guidelines for the assessment and management of pain in the critical care setting, the prevalence of acute pain remains high. Inadequate pain management is associated with longer duration of mechanical ventilation, reduced capacity for rehabilitation and long-term psychological sequelae. This study aimed to describe the experiences of pain management from healthcare professionals working in intensive care units. Healthcare professionals were recruited from intensive care units in London, UK using a purposive sampling technique. Semi-structured interviews were transcribed verbatim. Transcripts were analysed using an inductive thematic analysis technique. Thirty participants were recruited from eight diverse intensive care units. Five themes were identified. First, there was a lack of consensus in pain assessment in the ICU where nursing staff described more knowledge and confidence of validated pain measures than physicians, and concerns over validity and usability were raised. Second, there was a universal perception of resource availability impacting the quality of pain management including high clinical workload, staff turnover and availability of certain pain management techniques. Third, acknowledgement of the importance of pain management was highest in those with experience of interacting with critical care survivors. Fourth, participants described their own emotional reaction to managing those in pain which influenced their learning. Finally, there was a perception that, due to the complexity of the intensive care unit population, pain was de-prioritised and there were conflicting views as to whether standardised analgosedation algorithms were useful. This study provides evidence to suggest interdisciplinary training, collaboratively designed decision-making tools, prioritisation initiatives and research priorities are areas that could be targeted to improve pain management in critical care.

Ligand structure and diluent nature in defining improved Am3+ and Cm3+ separation using diglycolamides: a combined solvent extraction and DFT study

Separation of Am3+ and Cm3+ is one of the most challenging yet unavoidable steps in the back end of the nuclear cycle. Various ligands evaluated for Am/Cm separation have their own merits and demerits, and not a single ligand has been uniquely proposed for this purpose. In the present work, we evaluated N,N,N',N'-tetra-n-octyldiglycolamide (TODGA) vis-à-vis N,N,N',N'-tetra-2-ethylhexyldiglycolamide (T2EHDGA) in combination with a hydrophilic 2,6-bis(1,2,4-triazinyl)pyridine (SO3PhBTP) derivative in the aqueous phase for the separation of Am3+ and Cm3+ from nitric acid medium. The results showed that marginal selectivity for Am3+ over Cm3+ was observed with T2EHDGA in the presence of SO3PhBTP, which was attributed to the difference in the entropy change for their extraction from both the temperature-dependent liquid-liquid extraction and computational studies.

3D bioprinting of human neural tissues with functional connectivity

Probing how human neural networks operate is hindered by the lack of reliable human neural tissues amenable to the dynamic functional assessment of neural circuits. We developed a 3D bioprinting platform to assemble tissues with defined human neural cell types in a desired dimension using a commercial bioprinter. The printed neuronal progenitors differentiate into neurons and form functional neural circuits within and between tissue layers with specificity within weeks, evidenced by the cortical-to-striatal projection, spontaneous synaptic currents, and synaptic response to neuronal excitation. Printed astrocyte progenitors develop into mature astrocytes with elaborated processes and form functional neuron-astrocyte networks, indicated by calcium flux and glutamate uptake in response to neuronal excitation under physiological and pathological conditions. These designed human neural tissues will likely be useful for understanding the wiring of human neural networks, modeling pathological processes, and serving as platforms for drug testing.

Transcriptional consequences of trisomy 21 on neural induction

Introduction

Down syndrome, caused by trisomy 21, is a complex developmental disorder associated with intellectual disability and reduced growth of multiple organs. Structural pathologies are present at birth, reflecting embryonic origins. A fundamental unanswered question is how an extra copy of human chromosome 21 contributes to organ-specific pathologies that characterize individuals with Down syndrome, and, relevant to the hallmark intellectual disability in Down syndrome, how trisomy 21 affects neural development. We tested the hypothesis that trisomy 21 exerts effects on human neural development as early as neural induction.

Methods

Bulk RNA sequencing was performed on isogenic trisomy 21 and euploid human induced pluripotent stem cells (iPSCs) at successive stages of neural induction: embryoid bodies at Day 6, early neuroectoderm at Day 10, and differentiated neuroectoderm at Day 17.

Results

Gene expression analysis revealed over 1,300 differentially expressed genes in trisomy 21 cells along the differentiation pathway compared to euploid controls. Less than 5% of the gene expression changes included upregulated chromosome 21 encoded genes at every timepoint. Genes involved in specific growth factor signaling pathways (WNT and Notch), metabolism (including oxidative stress), and extracellular matrix were altered in trisomy 21 cells. Further analysis uncovered heterochronic expression of genes.

Conclusion

Trisomy 21 impacts discrete developmental pathways at the earliest stages of neural development. The results suggest that metabolic dysfunction arises early in embryogenesis in trisomy 21 and may affect development and function more broadly.

3D Bioprinting of Human Neural Tissues with Functional Connectivity

Probing how the human neural networks operate is hindered by the lack of reliable human neural tissues amenable for dynamic functional assessment of neural circuits. We developed a 3D bioprinting platform to assemble tissues with defined human neural cell types in a desired dimension using a commercial bioprinter. The printed neuronal progenitors differentiate to neurons and form functional neural circuits in and between tissue layers with specificity within weeks, evidenced by the cortical-to-striatal projection, spontaneous synaptic currents and synaptic response to neuronal excitation. Printed astrocyte progenitors develop into mature astrocytes with elaborated processes and form functional neuron-astrocyte networks, indicated by calcium flux and glutamate uptake in response to neuronal excitation under physiological and pathological conditions. These designed human neural tissues will likely be useful for understanding the wiring of human neural networks, modeling pathological processes, and serving as platforms for drug testing.

Species-specific FMRP regulation of RACK1 is critical for prenatal cortical development

Fragile X messenger ribonucleoprotein 1 protein (FMRP) deficiency leads to fragile X syndrome (FXS), an autism spectrum disorder. The role of FMRP in prenatal human brain development remains unclear. Here, we show that FMRP is important for human and macaque prenatal brain development. Both FMRP-deficient neurons in human fetal cortical slices and FXS patient stem cell-derived neurons exhibit mitochondrial dysfunctions and hyperexcitability. Using multiomics analyses, we have identified both FMRP-bound mRNAs and FMRP-interacting proteins in human neurons and unveiled a previously unknown role of FMRP in regulating essential genes during human prenatal development. We demonstrate that FMRP interaction with CNOT1 maintains the levels of receptor for activated C kinase 1 (RACK1), a species-specific FMRP target. Genetic reduction of RACK1 leads to both mitochondrial dysfunctions and hyperexcitability, resembling FXS neurons. Finally, enhancing mitochondrial functions rescues deficits of FMRP-deficient cortical neurons during prenatal development, demonstrating targeting mitochondrial dysfunction as a potential treatment.

ISSCR standards for the use of human stem cells in basic research

The laboratory culture of human stem cells seeks to capture a cellular state as an in vitro surrogate of a biological system. For the results and outputs from this research to be accurate, meaningful, and durable, standards that ensure reproducibility and reliability of the data should be applied. Although such standards have been previously proposed for repositories and distribution centers, no widely accepted best practices exist for laboratory research with human pluripotent and tissue stem cells. To fill that void, the International Society for Stem Cell Research has developed a set of recommendations, including reporting criteria, for scientists in basic research laboratories. These criteria are designed to be technically and financially feasible and, when implemented, enhance the reproducibility and rigor of stem cell research.

Age-maintained human neurons demonstrate a developmental loss of intrinsic neurite growth ability

Injury to adult mammalian central nervous system (CNS) axons results in limited regeneration. Rodent studies have revealed a developmental switch in CNS axon regenerative ability, yet whether this is conserved in humans is unknown. Using human fibroblasts from 8 gestational-weeks to 72 years-old, we performed direct reprogramming to transdifferentiate fibroblasts into induced neurons (Fib-iNs), avoiding pluripotency which restores cells to an embryonic state. We found that early gestational Fib-iNs grew longer neurites than all other ages, mirroring the developmental switch in regenerative ability in rodents. RNA-sequencing and screening revealed ARID1A as a developmentally-regulated modifier of neurite growth in human neurons. These data suggest that age-specific epigenetic changes may drive the intrinsic loss of neurite growth ability in human CNS neurons during development. One-Sentence Summary: Directly-reprogrammed human neurons demonstrate a developmental decrease in neurite growth ability.

Altered patterning of trisomy 21 interneuron progenitors

Individuals with Down syndrome (DS; Ts21), the most common genetic cause of intellectual disability, have smaller brains that reflect fewer neurons at pre- and post-natal stages, implicating impaired neurogenesis during development. Our stereological analysis of adult DS cortex indicates a reduction of calretinin-expressing interneurons. Using Ts21 human induced pluripotent stem cells (iPSCs) and isogenic controls, we find that Ts21 progenitors generate fewer COUP-TFII+ progenitors with reduced proliferation. Single-cell RNA sequencing of Ts21 progenitors confirms the altered specification of progenitor subpopulations and identifies reduced WNT signaling. Activation of WNT signaling partially restores the COUP-TFII+ progenitor population in Ts21, suggesting that altered WNT signaling contributes to the defective development of cortical interneurons in DS.

Meta-Analysis of Down Syndrome Cortical Development Reveals Underdeveloped State of the Science

Neurodevelopmental impairment contributes to the hallmark cognitive disability in individuals with Down syndrome (DS, trisomy 21, T21). The appearance of cognitive deficits in infancy suggests that alterations emerge during the earliest stages of neural development and continue throughout the lifespan in DS. Neural correlates of intellectual and language function include cortical structures, specifically temporal and frontal lobes that are smaller in DS. Yet, despite increased understanding of the DS cognitive-behavioral phenotype in childhood, there is very little structural and histological information to help explain the deficits. Consequently, attempts to effectively design therapeutic targets or interventions are limited. We present a systematic review of published research on cortical development in DS that reveals a paucity of studies that rigorously identify cellular features that may underlie the gross morphological deficits of the developing DS brain. We assessed 115 published reports retrieved through PubMed and other sources and found that only 23 reported histological and/or immunohistochemical data to define cell composition affected in DS post-mortem brain. Further, our analysis reveals that many reports have limited samples sizes and few DS samples, making it difficult to draw conclusions that are generally applicable to the DS population. Thus, the lack of replication and limited number of studies indicate that more developmentally focused research, ideally using equal numbers of age-matched samples in analyses, is needed to elucidate the cellular nature of smaller brain size in DS.

ATase inhibition rescues age-associated proteotoxicity of the secretory pathway

Malfunction of autophagy contributes to the progression of many chronic age-associated diseases. As such, improving normal proteostatic mechanisms is an active target for biomedical research and a key focal area for aging research. Endoplasmic reticulum (ER)-based acetylation has emerged as a mechanism that ensures proteostasis within the ER by regulating the induction of ER specific autophagy. ER acetylation is ensured by two ER-membrane bound acetyltransferases, ATase1 and ATase2. Here, we show that ATase inhibitors can rescue ongoing disease manifestations associated with the segmental progeria-like phenotype of AT-1 sTg mice. We also describe a pipeline to reliably identify ATase inhibitors with promising druggability properties. Finally, we show that successful ATase inhibitors can rescue the proteopathy of a mouse model of Alzheimer's disease. In conclusion, our study proposes that ATase-targeting approaches might offer a translational pathway for many age-associated proteopathies affecting the ER/secretory pathway.

Chemically induced senescence in human stem cell-derived neurons promotes phenotypic presentation of neurodegeneration

Modeling age‐related neurodegenerative disorders with human stem cells are difficult due to the embryonic nature of stem cell‐derived neurons. We developed a chemical cocktail to induce senescence of iPSC‐derived neurons to address this challenge. We first screened small molecules that induce embryonic fibroblasts to exhibit features characteristic of aged fibroblasts. We then optimized a cocktail of small molecules that induced senescence in fibroblasts and cortical neurons without causing DNA damage. The utility of the “senescence cocktail” was validated in motor neurons derived from ALS patient iPSCs which exhibited protein aggregation and axonal degeneration substantially earlier than those without cocktail treatment. Our “senescence cocktail” will likely enhance the manifestation of disease‐related phenotypes in neurons derived from iPSCs, enabling the generation of reliable drug discovery platforms.

High Throughput Small Molecule Screen for Reactivation of FMR1 in Fragile X Syndrome Human Neural Cells

Fragile X syndrome (FXS) is the most common inherited cause of autism and intellectual disability. The majority of FXS cases are caused by transcriptional repression of the FMR1 gene due to epigenetic changes that are not recapitulated in current animal disease models. FXS patient induced pluripotent stem cell (iPSC)-derived gene edited reporter cell lines enable novel strategies to discover reactivators of FMR1 expression in human cells on a much larger scale than previously possible. Here, we describe the workflow using FXS iPSC-derived neural cell lines to conduct a massive, unbiased screen for small molecule activators of the FMR1 gene. The proof-of-principle methodology demonstrates the utility of human stem-cell-based methodology for the untargeted discovery of reactivators of the human FMR1 gene that can be applied to other diseases.

Numerical and Statistical Analysis of Dissipative and Heat Absorbing Graphene Maxwell Nanofluid Flow Over a Stretching Sheet

This paper is basically devoted to carry out an investigation regarding the unsteady flow of dissipative and heat absorbing hydromagnetic graphene Maxwell nanofluid over a linearly stretched sheet taking momentum and thermal slip conditions into account. Ethylene glycol is selected as a base fluid while graphene particles are considered as nanoparticles. The highly nonlinear mathematical model of the problem is converted into a set of nonlinear coupled differential equations by means of fitting similarity variables. Further, Runge-Kutta Fehlberg algorithms along with the shooting scheme are instigated to analyse the numerical solution. The variations in graphene Maxwell nanofluid velocity and temperature owing to different physical parameters have been demonstrated via numerous graphs whereas Nusselt number and skin friction coefficients are illustrated in numeric data form and are reported in different tables. In addition, a statistical method is implemented for multiple quadratic regression estimation analysis on the numerical figures of wall velocity gradient and local Nusselt number to establish the connection among heat transfer rate and physical parameters. Our numerical findings reveal that the magnetic field, unsteadiness, inclination angle of magnetic field and porosity parameters boost the graphene Maxwell nanofluid velocity while Maxwell parameter has a reversal impact on it. The regression analysis confers that Nusselt number is more prone to heat absorption parameter as compared to Eckert number. Finally, the numerical findings are compared with those of earlier published articles under restricted conditions to validate the numerical solution. The comparison of numerical findings shows an excellent conformity among the results.

Electron-phonon superconductivity in C-doped topological nodal-line semimetal Zr5Pt3: a muon spin rotation and relaxation (μSR) study

In the present work, we demonstrate that C-doped Zr₅Pt₃is an electron-phonon superconductor (with critical temperatureT_C= 3.8 K) with a nonsymmorphic topological Dirac nodal-line semimetal state, which we report here for the first time. The superconducting properties of Zr₅Pt₃C_0.5have been investigated by means of magnetization, resistivity, specific heat, and muon spin rotation and relaxation (μSR) measurements. We find that at low temperatures, the depolarization rate is almost constant and it can be well described by a single-bands-wave model with a superconducting gap of 2Δ(0)/k_BT_C= 3.84, somewhat higher than the value of BCS theory. From the transverse field μSR analysis, we estimate the London penetration depthλ_L= 469 nm, superconducting carrier densityn_s= 1.83 × 10²⁶ m^-3, and effective massm* = 1.428m_e. The zero field μSR confirms the absence of any spontaneous magnetic field in the superconducting ground state. In order to gain additional insights into the electronic ground state of C-doped Zr₅Pt₃, we also performed first-principles calculations within the framework of density functional theory (DFT). The observed homogenous electronic character of the Fermi surface as well as the mutual decrease ofT_Cand density of states at the Fermi level are consistent with the experimental findings of this study. However, the band structure reveals the presence of robust, gapless fourfold-degenerate nodal lines protected by 6₃screw rotations and glide mirror planes. Therefore, Zr₅Pt₃represents a novel, unprecedented condensed matter system to investigate the intricate interplay between superconductivity and topology.

Physiological Characterization and Transcriptomic Properties of GnRH Neurons Derived From Human Stem Cells

Gonadotropin-releasing hormone (GnRH) neurons in the hypothalamus play a key role in the regulation of reproductive function. In this study, we sought an efficient method for generating GnRH neurons from human embryonic and induced pluripotent stem cells (hESC and hiPSC, respectively). First, we found that exposure of primitive neuroepithelial cells, rather than neuroprogenitor cells, to fibroblast growth factor 8 (FGF8), was more effective in generating GnRH neurons. Second, addition of kisspeptin to FGF8 further increased the efficiency rates of GnRH neurogeneration. Third, we generated a fluorescent marker mCherry labeled human embryonic GnRH cell line (mCh-hESC) using a CRISPR-Cas9 targeting approach. Fourth, we examined physiological characteristics of GnRH (mCh-hESC) neurons: similar to GnRH neurons in vivo, they released the GnRH peptide in a pulsatile manner at ~60 min intervals; GnRH release increased in response to high potassium, kisspeptin, estradiol, and neurokinin B challenges; and injection of depolarizing current induced action potentials. Finally, we characterized developmental changes in transcriptomes of GnRH neurons using hESC, hiPSC, and mCh-hESC. The developmental pattern of transcriptomes was remarkably similar among the 3 cell lines. Collectively, human stem cell-derived GnRH neurons will be an important tool for establishing disease models to understand diseases, such as idiopathic hypothalamic hypogonadism, and testing contraceptive drugs.

Building the Future Therapies for Down Syndrome: The Third International Conference of the T21 Research Society

Research focused on Down syndrome has increased in the last several years to advance understanding of the consequences of trisomy 21 (T21) on molecular and cellular processes and, ultimately, on individuals with Down syndrome. The Trisomy 21 Research Society (T21RS) is the premier scientific organization for researchers and clinicians studying Down syndrome. The Third International Conference of T21RS, held June 6-9, 2019, in Barcelona, Spain, brought together 429 scientists, families, and industry representatives to share the latest discoveries on underlying cellular and molecular mechanisms of T21, define cognitive and behavioral challenges and better understand comorbidities associated with Down syndrome, including Alzheimer's disease and leukemia. Presentation of cutting-edge results in neuroscience, neurology, model systems, psychology, cancer, biomarkers and molecular and phar-ma-cological therapeutic approaches demonstrate the compelling interest and continuing advancement in all aspects of understanding and ameliorating conditions associated with T21.

Basal Forebrain Cholinergic Neurons: Linking Down Syndrome and Alzheimer's Disease

Down syndrome (DS, trisomy 21) is characterized by intellectual impairment at birth and Alzheimer’s disease (AD) pathology in middle age. As individuals with DS age, their cognitive functions decline as they develop AD pathology. The susceptibility to degeneration of a subset of neurons, known as basal forebrain cholinergic neurons (BFCNs), in DS and AD is a critical link between cognitive impairment and neurodegeneration in both disorders. BFCNs are the primary source of cholinergic innervation to the cerebral cortex and hippocampus, as well as the amygdala. They play a critical role in the processing of information related to cognitive function and are directly engaged in regulating circuits of attention and memory throughout the lifespan. Given the importance of BFCNs in attention and memory, it is not surprising that these neurons contribute to dysfunctional neuronal circuitry in DS and are vulnerable in adults with DS and AD, where their degeneration leads to memory loss and disturbance in language. BFCNs are thus a relevant cell target for therapeutics for both DS and AD but, despite some success, efforts in this area have waned. There are gaps in our knowledge of BFCN vulnerability that preclude our ability to effectively design interventions. Here, we review the role of BFCN function and degeneration in AD and DS and identify under-studied aspects of BFCN biology. The current gaps in BFCN relevant imaging studies, therapeutics, and human models limit our insight into the mechanistic vulnerability of BFCNs in individuals with DS and AD.

DSCAM/PAK1 pathway suppression reverses neurogenesis deficits in iPSC-derived cerebral organoids from patients with Down syndrome

Down syndrome (DS), caused by trisomy of chromosome 21, occurs in 1 of every 800 live births. Early defects in cortical development likely account for the cognitive impairments in DS, although the underlying molecular mechanism remains elusive. Here, we performed histological assays and unbiased single-cell RNA-Seq (scRNA-Seq) analysis on cerebral organoids derived from 4 euploid cell lines and from induced pluripotent stem cells (iPSCs) from 3 individuals with trisomy 21 to explore cell-type-specific abnormalities associated with DS during early brain development. We found that neurogenesis was significantly affected, given the diminished proliferation and decreased expression of layer II and IV markers in cortical neurons in the subcortical regions; this may have been responsible for the reduced size of the organoids. Furthermore, suppression of the DSCAM/PAK1 pathway, which showed enhanced activity in DS, using CRISPR/Cas9, CRISPR interference (CRISPRi), or small-molecule inhibitor treatment reversed abnormal neurogenesis, thereby increasing the size of organoids derived from DS iPSCs. Our study demonstrates that 3D cortical organoids developed in vitro are a valuable model of DS and provide a direct link between dysregulation of the DSCAM/PAK1 pathway and developmental brain defects in DS.

Balancing serendipity and reproducibility: Pluripotent stem cells as experimental systems for intellectual and developmental disorders

Reprogramming of somatic cells into induced pluripotent stem cells (iPSCs) and their differentiation into neural lineages is a revolutionary experimental system for studying neurological disorders, including intellectual and developmental disabilities (IDDs). However, issues related to variability and reproducibility have hindered translating preclinical findings into drug discovery. Here, we identify areas for improvement by conducting a comprehensive review of 58 research articles that utilized iPSC-derived neural cells to investigate genetically defined IDDs. Based upon these findings, we propose recommendations for best practices that can be adopted by research scientists as well as journal editors.

Antiferromagnetic Correlations in Strongly Valence Fluctuating CeIrSn

CeIrSn with a quasikagome Ce lattice in the hexagonal basal plane is a strongly valence fluctuating compound, as we confirm by hard x-ray photoelectron spectroscopy and inelastic neutron scattering, with a high Kondo temperature of T_{K}∼480  K. We report a negative in-plane thermal expansion α/T below 2 K, which passes through a broad minimum near 0.75 K. Volume and a-axis magnetostriction for B∥a are markedly negative at low fields and change sign before a sharp metamagnetic anomaly at 6 T. These behaviors are unexpected for Ce-based intermediate valence systems, which should feature positive expansivity. Rather they point towards antiferromagnetic correlations at very low temperatures. This is supported by muon spin relaxation measurements down to 0.1 K, which provide microscopic evidence for a broad distribution of internal magnetic fields. Comparison with isostructural CeRhSn suggests that these antiferromagnetic correlations emerging at T≪T_{K} result from geometrical frustration.

Opportunities, barriers, and recommendations in down syndrome research

BACKGROUND

Recent advances in medical care have increased life expectancy and improved the quality of life for people with Down syndrome (DS). These advances are the result of both pre-clinical and clinical research but much about DS is still poorly understood. In 2020, the NIH announced their plan to update their DS research plan and requested input from the scientific and advocacy community.

OBJECTIVE

The National Down Syndrome Society (NDSS) and the LuMind IDSC Foundation worked together with scientific and medical experts to develop recommendations for the NIH research plan.

METHODS

NDSS and LuMind IDSC assembled over 50 experts across multiple disciplines and organized them in eleven working groups focused on specific issues for people with DS.

RESULTS

This review article summarizes the research gaps and recommendations that have the potential to improve the health and quality of life for people with DS within the next decade.

CONCLUSIONS

This review highlights many of the scientific gaps that exist in DS research. Based on these gaps, a multidisciplinary group of DS experts has made recommendations to advance DS research. This paper may also aid policymakers and the DS community to build a comprehensive national DS research strategy.

The recovery of strontium from acidic medium using novel strontium selective extractant: An experimental and DFT study

In view of the limited solvent system known for the Sr²⁺ extraction from acidic media, extraction and recovery of ⁹⁰Sr from acidic medium using novel Octabenzyloxyoctakis[[[(N,N-diethylamino)carbonyl)]methyl]oxy]calix[8]arene (BOC8A) extractant in nitro alkane medium are presented in this paper. BOC8A and nitro alkanes have been synthesized and characterized by ¹H NMR, ¹³C NMR, FTIR and GC-MS techniques. Solvent composition of 0.01 M BOC8A in nitro octane (NO) has been optimized for substantial amount of extraction of strontium from feed acidity of 3.5-4 M nitric acid, (D_{3.5-4 M HNO3} = 7.1-7.8). Poor extraction of Pu⁴⁺, Ba²⁺, Na⁺ and UO₂²⁺ and negligible extraction of Am³⁺, Cs⁺, Ru³⁺, Nd³⁺, Zr²⁺ and trivalent lanthanides are observed. Ion dissociation mechanism was found to be operative involving an extractable complex having Sr²⁺, BOC8A and HNO₃ in a ratio of 1:1:2. About 99 % of Sr²⁺ from the loaded solvent was recovered with 0.01 M HNO₃. DFT calculations were used to predict the structures of free, protonated BOC8A and its complex with Sr²⁺. DFT result showed reorientation in conformation of BOC8A due to protonation resulting in the Sr²⁺ extraction from acidic medium with significantly high interaction energy between Sr²⁺ and diprotonated form of BOC8A.

Renal outcomes with the newer antidiabetes drugs: the era before and after CREDENCE

In 2008, the US Food and Drug Administration provided guidance for the evaluation of the cardiovascular safety of antidiabetes drugs. The newer antidiabetes drugs, approved after 2008, were therefore evaluated in long-term cardiovascular outcome trials, designed and powered for the assessment of cardiovascular safety. Accordingly, the primary endpoint of these trials was a cardiac composite endpoint. Since 2008, the data from various cardiovascular outcome trials have been reported, including SAVOR-TIMI 53 (saxagliptin), EXAMINE (alogliptin), TECOS (sitagliptin), CARMELINA (linagliptin), CAROLINA (linagliptin), ELIXA (lixisenatide), LEADER (liraglutide), EXSCEL (exenatide once-weekly), SUSTAIN-6 (injectable semaglutide), HARMONY Outcomes (albiglutide), REWIND (dulaglutide), PIONEER-6 (oral semaglutide), EMPA-REG OUTCOME (empagliflozin), the CANVAS Program (canagliflozin) and DECLARE-TIMI 53 (dapagliflozin). Some of these trials subsequently also published data on renal outcomes, although these were secondary or exploratory analyses. Dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists had beneficial effects on albuminuria, while sodium-glucose co-transporter-2 inhibitors additionally showed a positive effect on 'hard' renal outcomes. In contrast to the cardiovascular outcome trials, the renal outcome trial of canagliflozin, CREDENCE, assessed a hard renal endpoint as its primary endpoint and showed positive effects on these hard renal outcomes. In this review, we aim to highlight the renal outcome data from the cardiovascular outcome trials and the CREDENCE trial and understand the differences between their results. The post CREDENCE era would appear to reinforce the position of sodium-glucose co-transporter-2 inhibitors as drugs providing cardiorenal protection, in addition to their anti-glycaemic effects.

Identification of FMR1-regulated molecular networks in human neurodevelopment

RNA-binding proteins (RNA-BPs) play critical roles in development and disease to regulate gene expression. However, genome-wide identification of their targets in primary human cells has been challenging. Here, we applied a modified CLIP-seq strategy to identify genome-wide targets of the FMRP translational regulator 1 (FMR1), a brain-enriched RNA-BP, whose deficiency leads to Fragile X Syndrome (FXS), the most prevalent inherited intellectual disability. We identified FMR1 targets in human dorsal and ventral forebrain neural progenitors and excitatory and inhibitory neurons differentiated from human pluripotent stem cells. In parallel, we measured the transcriptomes of the same four cell types upon FMR1 gene deletion. We discovered that FMR1 preferentially binds long transcripts in human neural cells. FMR1 targets include genes unique to human neural cells and associated with clinical phenotypes of FXS and autism. Integrative network analysis using graph diffusion and multitask clustering of FMR1 CLIP-seq and transcriptional targets reveals critical pathways regulated by FMR1 in human neural development. Our results demonstrate that FMR1 regulates a common set of targets among different neural cell types but also operates in a cell type-specific manner targeting distinct sets of genes in human excitatory and inhibitory neural progenitors and neurons. By defining molecular subnetworks and validating specific high-priority genes, we identify novel components of the FMR1 regulation program. Our results provide new insights into gene regulation by a critical neuronal RNA-BP in human neurodevelopment.

Advancing Knowledge of Down Syndrome Brain Development and Function With Human Stem Cells

Our bodies are made up of over 250 specific cell types, and all initially arise from stem cells during embryonic development. Stem cells have two characteristics that make them unique: (1) they are pluripotent, meaning that they can differentiate into all cell types of the body, and (2) they are capable of self-renewal to generate more of themselves and are thus able to populate an organism. Human pluripotent stem cells were first isolated from human embryos twenty years ago ( Thomson et al., 1998 ) and more recently, technology to reprogram somatic cells, such as skin and blood, to induced pluripotent stem cells has emerged ( Park et al., 2008 ; Takahashi et al., 2007 ; Yu et al., 2007 ). Induced pluripotent stem cells, or iPSCs, are particularly valuable as disease specific iPSCs can be generated from individuals with specific genetic mutations diseases. Researchers have harnessed the power of stem cells to understand many aspects of developmental biology in model organisms (e.g. worms, mice) and more recently, in humans. Human stem cells in culture recapitulate development. For example, formation of the brain occurs prenatally and follows a specific pattern of timing and cell generation. Human stem cells in the culture dish follow a similar pattern when exposed to developmental cues and can thus be used to understand aspects of prenatal human brain development that are not accessible by other means. Disease-specific iPSCs are a valuable tool to model neural development in specific neurodevelopmental disorders like Down syndrome. Down syndrome is a classic developmental disorder; mistakes that are made during development of a particular organ system result in the characteristics of the disorder. In the brain, mistakes during prenatal brain development lead to intellectual disability. Trisomy 21 (Ts21) iPSCs generated from somatic cells of Down syndrome individuals may enable us to understand the mistakes made during Down syndrome brain development.

Investigation of superconducting gap structure in HfIrSi using muon spin relaxation/rotation

We have investigated the superconducting state of HfIrSi using magnetization, specific heat, muon spin rotation and relaxation ([Formula: see text]SR) measurements. Superconductivity was observed at [Formula: see text] K in both specific heat and magnetization measurements. From an analysis of the transverse-field [Formula: see text]SR data, it is clear that the temperature variation of superfluid density is well fitted by an isotropic Bardeen-Cooper-Schrieffer (BCS) type s-wave gap structure. The superconducting carrier density [Formula: see text] m^-3, the magnetic penetration depth, [Formula: see text] nm, and the effective mass, [Formula: see text], were calculated from the TF-[Formula: see text]SR data. Zero-field [Formula: see text]SR data for HfIrSi reveal the absence of any spontaneous magnetic moments below [Formula: see text], indicating that time-reversal symmetry (TRS) is preserved in the superconducting state of HfIrSi. Theoretical investigations suggest that the Hf and Ir atoms hybridize strongly along the c-axis, and that this is responsible for the strong three-dimensionality of this system which screens the Coulomb interaction. As a result, despite the presence of d-electrons in HfIrSi, these correlation effects are weakened, making the electron-phonon coupling more important.

Ir 5d-band derived superconductivity in LaIr3

The superconducting properties of rhombohedral LaIr₃ were examined using susceptibility, resistivity, heat capacity, and zero-field (ZF) and transverse-field (TF) muon spin relaxation and rotation ([Formula: see text]SR) measurements. The susceptibility and resistivity measurements confirm a superconducting transition below [Formula: see text] K. Two successive transitions are observed in the heat capacity data, one at [Formula: see text] K and a second at 1.2 K below [Formula: see text]. The heat capacity jump is [Formula: see text], which is lower than 1.43 expected for Bardeen-Cooper-Schrieffer (BCS) weak-coupling limit. TF-[Formula: see text]SR measurements reveal a fully gapped s-wave superconductivity with [Formula: see text], which is small compared to the BCS value of 3.56, suggesting weak-coupling superconductivity. The magnetic penetration depth, [Formula: see text], estimated from TF-[Formula: see text]SR gives [Formula: see text] nm, a superconducting carrier density [Formula: see text] carriers m^-3 and a carrier effective-mass enhancement factor [Formula: see text]. ZF-[Formula: see text]SR data show no evidence for any spontaneous magnetic fields below [Formula: see text], which demonstrates that time-reversal symmetry is preserved in the superconducting state of LaIr₃.

Plasticity of Synaptic Transmission in Human Stem Cell-Derived Neural Networks

Long-term potentiation and depression, inferred from analysis on brain slices, are considered the cellular processes underlying learning and memory formation. They have not so far been demonstrated in human stem cell-derived neurons. By expressing channelrhodopsin in hESCs-derived glutamate neurons and co-culturing them with GABA neurons, we found that blue light stimulation increased the frequency of miniature excitatory postsynaptic currents (mEPSCs) and decreased the ratio of paired pulse facilitation (PPF) in non-ChR2-expressing GABA neurons, indicating a facilitating action at the presynaptic terminals. When paired with postsynaptic depolarization, the repetitive stimulation significantly increased the amplitude of light-evoked EPSCs that persisted during the period, indicating long-term potentiation (LTP). In contrast, low-frequency light stimulation induced long-term depression (LTD). These effects were blocked by N-methyl-D-aspartic acid (NMDA) receptor antagonists, suggesting NMDA receptor-mediated synaptic plasticity in human neural networks. Furthermore, induced pluripotent stem cell (iPSC)-derived neurons of patient with Down syndrome showed absence of LTP or LTD. Thus, our platform offers a versatile model for assessing human neural plasticity under physiological and pathological conditions.

Mutations in GFAP Disrupt the Distribution and Function of Organelles in Human Astrocytes

How mutations in glial fibrillary acidic protein (GFAP) cause Alexander disease (AxD) remains elusive. We generated iPSCs from two AxD patients and corrected the GFAP mutations to examine the effects of mutant GFAP on human astrocytes. AxD astrocytes displayed GFAP aggregates, recapitulating the pathological hallmark of AxD. RNA sequencing implicated the endoplasmic reticulum, vesicle regulation, and cellular metabolism. Corroborating this analysis, we observed enlarged and heterogeneous morphology coupled with perinuclear localization of endoplasmic reticulum and lysosomes in AxD astrocytes. Functionally, AxD astrocytes showed impaired extracellular ATP release, which is responsible for attenuated calcium wave propagation. These results reveal that AxD-causing mutations in GFAP disrupt intracellular vesicle regulation and impair astrocyte secretion, resulting in astrocyte dysfunction and AxD pathogenesis.

Aberrant Calcium Signaling in Astrocytes Inhibits Neuronal Excitability in a Human Down Syndrome Stem Cell Model

Down syndrome (DS) is a genetic disorder that causes cognitive impairment. The staggering effects associated with an extra copy of human chromosome 21 (HSA21) complicates mechanistic understanding of DS pathophysiology. We examined the neuron-astrocyte interplay in a fully recapitulated HSA21 trisomy cellular model differentiated from DS-patient-derived induced pluripotent stem cells (iPSCs). By combining calcium imaging with genetic approaches, we discovered the functional defects of DS astroglia and their effects on neuronal excitability. Compared with control isogenic astroglia, DS astroglia exhibited more-frequent spontaneous calcium fluctuations, which reduced the excitability of co-cultured neurons. Furthermore, suppressed neuronal activity could be rescued by abolishing astrocytic spontaneous calcium activity either chemically by blocking adenosine-mediated signaling or genetically by knockdown of inositol triphosphate (IP₃) receptors or S100B, a calcium binding protein coded on HSA21. Our results suggest a mechanism by which DS alters the function of astrocytes, which subsequently disturbs neuronal excitability.

To understand how Down syndrome (DS) affects neural networks, Mizuno et al. used a DS-patient-derived stem cell model and calcium imaging to investigate the functional defects of DS astrocytes and their effects on neuronal excitability. Their study reveals that DS astroglia exhibited more frequent spontaneous calcium fluctuations, which impair neuronal excitability.

Intellectual and developmental disabilities research centers: Fifty years of scientific accomplishments

Progress in addressing the origins of intellectual and developmental disabilities accelerated with the establishment 50 years ago of the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health and associated Intellectual and Developmental Disabilities Research Centers. Investigators at these Centers have made seminal contributions to understanding human brain and behavioral development and defining mechanisms and treatments of disorders of the developing brain. ANN NEUROL 2019;86:332-343.

Using Human Neural Progenitor Cell Models to Conduct Large-Scale Drug Screens for Neurological and Psychiatric Diseases

High-throughput drug screen (HTS) has become a viable approach for new treatment discovery in human diseases. Advances in gene editing technology and human pluripotent stem cell differentiation techniques have expanded the capability of HTS to identify potential treatments for human diseases of the central nervous system. Here, we describe techniques to use a human patient-derived neural progenitor cell luciferase reporter line to screen a large small molecule library.

Regionally specified human pluripotent stem cell-derived astrocytes exhibit different molecular signatures and functional properties

Astrocytes display diverse morphologies in different regions of the central nervous system. Whether astrocyte diversity is attributable to developmental processes and bears functional consequences, especially in humans, is unknown. RNA-seq of human pluripotent stem cell-derived regional astrocytes revealed distinct transcript profiles, suggesting differential functional properties. This was confirmed by differential calcium signaling as well as effects on neurite growth and blood-brain barrier formation. Distinct transcriptional profiles and functional properties of human astrocytes generated from regionally specified neural progenitors under the same conditions strongly implicate the developmental impact on astrocyte diversity. These findings provide a rationale for renewed examination of regional astrocytes and their role in the pathogenesis of psychiatric and neurological disorders.

Unveiling spin-glass transition and antiferromagnetic order by μSR studies in spin-chain Sm2BaNiO5

We report the zero-field and longitudinal field muon spin relaxation studies in a spin-chain compound Sm₂BaNiO₅. Two magnetic transitions, that have not been previously detected by the heat capacity and magnetization measurements, are confirmed at 46 and 9 K. The antiferromagnetic order is suggested at 46 K. Analysis of the muon spin polarization unveils the spin-glass transition at 9 K. Time-field scaling relation of the muon spin polarization verifies the spin-spin autocorrelation function following the cut-off power law, which is approximated by the Ogielski form, as employed numerically for characterizing the spin-glasses.

Evidence of a Nodal Line in the Superconducting Gap Symmetry of Noncentrosymmetric ThCoC_{2}

The newly discovered noncentrosymmetric superconductor ThCoC_{2} exhibits numerous types of unconventional behavior in the field dependent heat capacity data. Here we present the first measurement of the gap symmetry of ThCoC_{2} by muon spin rotation and relaxation (μSR) measurements. The temperature dependence of the magnetic penetration depth measured using the transverse field μSR experiment reveals the evidence of a nodal pairing symmetry. To understand this finding, we carry out calculations of the superconducting pairing eigenvalue and eigenfunction (pairing symmetry) due to the spin-fluctuation mechanism by directly implementing the ab initio band structures. We find that the system possesses a single Fermi surface with considerable three dimensionality and a strong nesting along the k_{z} direction. Such nesting promotes a superconducting state with a cosk_{z}-like pairing symmetry with a prominent nodal line on the k_{z}=±π/2 plane. The result agrees well with the experimental data.

Complexation of U(VI) with Cucurbit[5]uril: Thermodynamic and Structural investigation in aqueous medium

The assessment of cucurbituril (CBn) for selective removal of actinides from nuclear waste streams requires comprehensive understanding of binding parameters and coordination of these complexes. The present work is the first experimental report on complexation of actinide ion with Cucurbit[5]uril (CB5) in solution. The thermodynamic parameters (ΔG, ΔH and ΔS) for complexation of CB5 with U(VI) in formic acid water medium were determined using microcalorimetry and UV-Vis spectroscopy. The enthalpy and entropy of complexation revealed the partial binding of U(VI) to CB5 portal. The partial binding was confirmed by spectroscopic techniques viz. extended X absorption fine structure spectroscopy (EXAFS), ¹H and ¹³C NMR. The EXAFS χ(r) versus r spectra for U-CB5 complex has been fitted from 1.4 to 3.5 Å with two oxygen shells and a carbon shell. The presence of three carbon atom in secondary shell shows the involvement of only three carbonyl oxygens directly bonding to U(VI) which is in contrast to that calculated from gas phase DFT calculation of unhydrated system. The combined effect of hydration and formic acid encapsulation led to the enhanced stability of partially bound U(VI) to CB5. In the present work the binding of formic acid has also been studied by fluorescence spectroscopy. ESI-MS data shows the unusual stabilization of U(VI) by CB5 in gas phase.

CRISPR/Cas9 editing of APP C-terminus attenuates β-cleavage and promotes α-cleavage

CRISPR/Cas9 guided gene-editing is a potential therapeutic tool, however application to neurodegenerative disease models has been limited. Moreover, conventional mutation correction by gene-editing would only be relevant for the small fraction of neurodegenerative cases that are inherited. Here we introduce a CRISPR/Cas9-based strategy in cell and animal models to edit endogenous amyloid precursor protein (APP) at the extreme C-terminus and reciprocally manipulate the amyloid pathway, attenuating APP-β-cleavage and Aβ production, while up-regulating neuroprotective APP-α-cleavage. APP N-terminus and compensatory APP-homologues remain intact, with no apparent effects on neurophysiology in vitro. Robust APP-editing is seen in human iPSC-derived neurons and mouse brains with no detectable off-target effects. Our strategy likely works by limiting APP and BACE-1 approximation, and we also delineate mechanistic events that abrogates APP/BACE-1 convergence in this setting. Our work offers conceptual proof for a selective APP silencing strategy.

Gene editing strategies are typically designed to correct mutant genes, but most neurodegenerative diseases are sporadic. Here the authors describe a strategy to selectively edit the C-terminus of APP and attenuate amyloid-β production, while upregulating neuroprotective α-cleavage.

Human Models Are Needed for Studying Human Neurodevelopmental Disorders

The analysis of animal models of neurological disease has been instrumental in furthering our understanding of neurodevelopment and brain diseases. However, animal models are limited in revealing some of the most fundamental aspects of development, genetics, pathology, and disease mechanisms that are unique to humans. These shortcomings are exaggerated in disorders that affect the brain, where the most significant differences between humans and animal models exist, and could underscore failures in targeted therapeutic interventions in affected individuals. Human pluripotent stem cells have emerged as a much-needed model system for investigating human-specific biology and disease mechanisms. However, questions remain regarding whether these cell-culture-based models are sufficient or even necessary. In this review, we summarize human-specific features of neurodevelopment and the most common neurodevelopmental disorders, present discrepancies between animal models and human diseases, demonstrate how human stem cell models can provide meaningful information, and discuss the challenges that exist in our pursuit to understand distinctively human aspects of neurodevelopment and brain disease. This information argues for a more thoughtful approach to disease modeling through consideration of the valuable features and limitations of each model system, be they human or animal, to mimic disease characteristics.

Magnetic structure and field-dependent magnetic phase diagram of Ni2In-type PrCuSi

The magnetic structure of the ternary equiatomic intermetallic compound PrCuSi is investigated using neutron powder diffraction experiments in 0 T as well as in external magnetic fields up to 2 T. The PrCuSi compound crystallizes in the hexagonal Ni₂In-type structure, in the space group P6₃/mmc. In this structure, cationic ordering of Cu and Si takes place. The antiferromagnetic phase transition in the Pr sublattice takes place at [Formula: see text] K in 0 T. Under an external magnetic field of 2 T, a field-induced ferromagnetic phase is observed. Magnetoelastic coupling is evidenced by an increase in the unit cell volume. Clear signatures of a mixed antiferromagnetic and ferromagnetic phase in weak, intermediate fields, 0.4-0.8 T, are obtained from the present study. Using the present set of experimental data, we construct the H  -  T phase diagram of PrCuSi.

Paving the Way for Therapy: The Second International Conference of the Trisomy 21 Research Society

In the last decade, a number of important research advances in different fields have allowed Down syndrome (DS) research to flourish, creating a time of both unparalleled opportunity and considerable challenge. Building a scientific framework that distills mechanisms involved in the developmental intellectual disability of DS as well as the early-onset component of Alzheimer disease and the several other comorbidities associated with the condition is a challenge that scientists are now tackling using novel technologies and multidisciplinary approaches. The Trisomy 21 Research Society (T21RS) was founded in 2014 to address these evolving needs and challenges. In June of 2017, the T21RS held its 2nd International Conference in Chicago, USA. With more than 200 scientists, advocates, people with DS, and family members in attendance, the meeting served as a forum for the discussion of the latest research and clinical advances as well as the most compelling needs of people with DS and their families.