A phosphodiesterase 4 (PDE4) inhibitor, amlexanox, reduces neuroinflammation and neuronal death after pilocarpine-induced seizure

Epilepsy, a complex neurological disorder, is characterized by recurrent seizures caused by aberrant electrical activity in the brain. Central to this study is the role of lysosomal dysfunction in epilepsy, which can lead to the accumulation of toxic substrates and impaired autophagy in neurons. Our focus is on phosphodiesterase-4 (PDE4), an enzyme that plays a crucial role in regulating intracellular cyclic adenosine monophosphate (cAMP) levels by converting it into adenosine monophosphate (AMP). In pathological states, including epilepsy, increased PDE4 activity contributes to a decrease in cAMP levels, which may exacerbate neuroinflammatory responses. We hypothesized that amlexanox, an anti-inflammatory drug and non-selective PDE4 inhibitor, could offer neuroprotection by addressing lysosomal dysfunction and mitigating neuroinflammation, ultimately preventing neuronal death in epileptic conditions. Our research utilized a pilocarpine-induced epilepsy animal model to investigate amlexanox's potential benefits. Administered intraperitoneally at a dose of 100 ​mg/kg daily following the onset of a seizure, we monitored its effects on lysosomal function, inflammation, neuronal death, and cognitive performance in the brain. Tissue samples from various brain regions were collected at predetermined intervals for a comprehensive analysis. The study's results were significant. Amlexanox effectively improved lysosomal function, which we attribute to the modulation of zinc's influx into the lysosomes, subsequently enhancing autophagic processes and decreasing the release of inflammatory factors. Notably, this led to the attenuation of neuronal death in the hippocampal region. Additionally, cognitive function, assessed through the modified neurological severity score (mNSS) and the Barnes maze test, showed substantial improvements after treatment with amlexanox. These promising outcomes indicate that amlexanox has potential as a therapeutic agent in the treatment of epilepsy and related brain disorders. Its ability to combat lysosomal dysfunction and neuroinflammation positions it as a potential neuroprotective intervention. While these findings are encouraging, further research and clinical trials are essential to fully explore and validate the therapeutic efficacy of amlexanox in epilepsy management.

Metabolic Adaptation and Cellular Stress Response As Targets for Cancer Therapy

Cancer cells, which divide indefinitely and without control, are frequently exposed to various stress factors but manage to adapt and survive. The mechanisms by which cancer cells maintain cellular homeostasis and exploit stress conditions are not yet clear. Here, we elucidate the roles of diverse cellular metabolism and its regulatory mechanisms, highlighting the essential role of metabolism in cellular composition and signal transduction. Cells respond to various stresses, including DNA damage, energy stress, and oxidative stress, thereby causing metabolic alteration. We provide profound insight into the adaptive mechanisms employed by cancer cells to ensure their survival among internal and external stressors through a comprehensive analysis of the correlation between metabolic alterations and cellular stress. Furthermore, this research establishes a robust framework for the development of innovative therapeutic strategies that specifically target the cellular adaptations of cancer cells.

Characterizing and controlling infrared phonon anomaly of bilayer graphene in optical-electrical force nanoscopy

We, for the first time, report the nanoscopic imaging study of anomalous infrared (IR) phonon enhancement of bilayer graphene, originated from the charge imbalance between the top and bottom layers, resulting in the enhancement of E1u mode of bilayer graphene near 0.2 eV. We modified the multifrequency atomic force microscope platform to combine photo-induced force microscope with electrostatic/Kelvin probe force microscope constituting a novel hybrid nanoscale optical-electrical force imaging system. This enables to observe a correlation between the IR response, doping level, and topographic information of the graphene layers. Through the nanoscale spectroscopic image measurements, we demonstrate that the charge imbalance at the graphene interface can be controlled by chemical (doping effect via Redox mechanism) and mechanical (triboelectric effect by the doped cantilever) approaches. Moreover, we can also diagnosis the subsurface cracks on the stacked few-layer graphene at nanoscale, by monitoring the strain-induced IR phonon shift. Our approach provides new insights into the development of graphene-based electronic and photonic devices and their potential applications.

Macrophage transcription factor TonEBP promotes systemic lupus erythematosus and kidney injury via damage-induced signaling pathways

Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by autoreactive B cells and dysregulation of many other types of immune cells including myeloid cells. Lupus nephritis (LN) is a common target organ manifestations of SLE. Tonicity-responsive enhancer-binding protein (TonEBP, also known as nuclear factor of activated T-cells 5 (NFAT5)), was initially identified as a central regulator of cellular responses to hypertonic stress and is a pleiotropic stress protein involved in a variety of immunometabolic diseases. To explore the role of TonEBP, we examined kidney biopsy samples from patients with LN. Kidney TonEBP expression was found to be elevated in these patients compared to control patients - in both kidney cells and infiltrating immune cells. Kidney TonEBP mRNA was elevated in LN and correlated with mRNAs encoding inflammatory cytokines and the degree of proteinuria. In a pristane-induced SLE model in mice, myeloid TonEBP deficiency blocked the development of SLE and LN. In macrophages, engagement of various toll-like receptors (TLRs) that respond to damage-associated molecular patterns induced TonEBP expression via stimulation of its promoter. Intracellular signaling downstream of the TLRs was dependent on TonEBP. Therefore, TonEBP can act as a transcriptional cofactor for NF-κB, and activated mTOR-IRF3/7 via protein-protein interactions. Additionally, TonEBP-deficient macrophages displayed elevated efferocytosis and animals with myeloid deficiency of TonEBP showed reduced Th1 and Th17 differentiation, consistent with macrophages defective in TLR signaling. Thus, our data show that myeloid TonEBP may be an attractive therapeutic target for SLE and LN.

Structure-Guided Development of Bivalent Aptamers Blocking SARS-CoV-2 Infection

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused devastation to human society through its high virulence, infectivity, and genomic mutations, which reduced the efficacy of vaccines. Here, we report the development of aptamers that effectively interfere with SARS-CoV-2 infection by targeting its spike protein, which plays a pivotal role in host cell entry of the virus through interaction with the viral receptor angiotensin-converting enzyme 2 (ACE2). To develop highly effective aptamers and to understand their mechanism in inhibiting viral infection, we determined the three-dimensional (3D) structures of aptamer/receptor-binding domain (RBD) complexes using cryogenic electron microscopy (cryo-EM). Moreover, we developed bivalent aptamers targeting two distinct regions of the RBD in the spike protein that directly interact with ACE2. One aptamer interferes with the binding of ACE2 by blocking the ACE2-binding site in RBD, and the other aptamer allosterically inhibits ACE2 by binding to a distinct face of RBD. Using the 3D structures of aptamer-RBD complexes, we minimized and optimized these aptamers. By combining the optimized aptamers, we developed a bivalent aptamer that showed a stronger inhibitory effect on virus infection than the component aptamers. This study confirms that the structure-based aptamer-design approach has a high potential in developing antiviral drugs against SARS-CoV-2 and other viruses.

PCSK9 modulates the Wnt/beta-catenin signaling pathway in myocardial ischemia/reperfusion injury

Background

Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a protein that affects cholesterol homeostasis. Recent research has found that PCSK9 has various effects on the heart that are unrelated to LDL cholesterol regulation. The Wnt/β-catenin signaling pathway plays a crucial role during heart development, and it is re-activated in response to cardiac injury. Low-density lipoprotein receptor-related proteins 5 (LRP5) act as co-receptors of Wnt ligands and are indispensable for Wnt/β-catenin signal transduction. However, it is not fully elucidated whether other members of the LDLR-superfamily may be targets of PCSK9.

Purpose

This study aimed to determine if LRP5 is a PCSK9 target, study the association between PCSK9 and Wnt/β-catenin signaling, and elucidate its effect on myocardial infarction in patients with ischemic cardiomyopathy.

Methods

The expression of Lrp5, phospho-β-catenin, total β-catenin was evaluated by western blot analysis, and the effects of overexpressed PCSK9 were tested under normoxia, hypoxia, or hypoxia/re-oxygenation (H/R) in mouse cardiomyocytes (HL-1). The transcriptional activity of β-catenin was assessed using the TOP-Flash/FOP-Flash luciferase reporter assay. In addition, the impact on various downstream targets of the Wnt/β-catenin signaling pathway was assessed using a quantitative real-time polymerase chain reaction. To examine whether PCSK9 regulates injury of cardiomyocytes in vivo, we subjected transgenic mice with cardiac-specific overexpression of PCSK9 (PCSK9 TG) and wild-type (WT) mice to either sham surgery or ischemia/reperfusion (I/R) surgery.

Results

Under hypoxic conditions, the Wnt/β-catenin signaling pathway-related genes were downregulated in HL-1 cells, as evidenced by lower Lrp5 and active phospho-β-catenin expression levels (0.5-fold, n=3, p<0.01). After H/R, the Wnt/β-catenin-related genes were recovered (1.5-fold, p<0.01) in the control group but not in the PCSK9 overexpressed group. In the luciferase reporter assay results, PCSK9 overexpression inhibited the recovery of β-catenin transcriptional activity after H/R, in contrast to the control group. Furthermore, mRNA levels of Axin2, Cyclin D1, which are the Wnt/β-catenin signaling downstream pathway targets, were down-regulated under hypoxia and recovered after H/R but did not recover in PCSK9 overexpressed cells. In the mouse I/R model, the overall protein levels of the Wnt/β-catenin signaling-related genes were down-regulated in PCSK9 TG mice compared to WT mice after I/R injury.

Conclusions

These results indicated that the regulation of PCSK9 is closely associated with the Wnt/β-catenin signaling pathway which may play a crucial role in damaged cardiomyocytes. It suggests that the regulation of PCSK9 could be a therapeutic target in patients with ischemic cardiomyopathy.

Funding Acknowledgement

Type of funding sources: None.

Prediction of response to cardiac resynchronization therapy using cardiac magnetic resonance imaging in non-ischemic dilated cardiomyopathy

Background

Cardiac resynchronization therapy (CRT) is a well-established therapy for symptomatic heart failure with reduced ejection fraction, but the response is different for individuals. Although many modalities have been conducted to predict CRT response, cardiac magnetic resonance (CMR) to predict CRT response has still insufficient usefulness.

Purpose

We determine whether the parameters including late gadolinium enhancement (LGE) identified in CMR could act as predictors of CRT response.

Methods

We retrospectively investigated 124 patients with non-ischemic dilated cardiomyopathy who underwent CMR before CRT implantation between Jan 2010 and July 2021 in a single center. CRT response was defined as a decrease in left ventricular end-systolic volume (LVESV) >15% on echocardiography after at least 3 months after CRT implantation.

Results

Among the study population (mean age 65.7±11.2 years, mean EF 25±6.5%, 50% of female), 85 (69%) patients were defined as CRT responder. The CRT responders had more left bundle branch block (LBBB) compared with non-responders [79 (92.9%) vs. 23 (59.0%), p<0.001], but there was a no difference of QRS duration (158.7 vs 165.0ms, p=0.054) between two groups. CMR analysis showed that there were no significant differences in the left ventricular (LV) chamber volume and LV ejection fraction between CRT-responder and non-responder. However, the right ventricular (RV) chamber volume was smaller (RV end-diastolic volume index, 86.3 vs 103.5 ml/m2, p=0.039; RV end-systolic volume index, 49.3 vs 68.5 ml/m2, p=0.013) and the RV ejection fraction (RVEF) was higher (46.9 vs 37.6%, p=0.002) in CRT-responders compared with non-responders. The LGE on CMR was more shown in non-responders than in CRT-responders [33 (84.6%) vs 45 (52.9%), p<0.001]. In CMR parameters, RV dysfunction (RVEF <45%) [Odds ratio (OR), 0.21 (0.05–0.93), p=0.045] and LGE [OR, 0.21 (0.05–0.58), p=0.01] were significantly associated with poor CRT response.

Conclusions

The presence of LGE and RV dysfunction on CMR were associated with poor CRT response in patients with non-ischemic dilated cardiomyopathy. Further investigation with CMR for pre-CRT patients is needed to support these results.

Funding Acknowledgement

Type of funding sources: None.

Genetic analysis of Korean non-ischemic dilated cardiomyopathy using next generation sequencing

Background

Non-ischemic dilated cardiomyopathy (NIDCM) is a genetic disorder that causes heart failure and life-threatening arrhythmia. However, there has been no study about the up-to-date genetic analysis for NIDCM in Korean. Therefore, we performed the genetic analysis of Korean NIDCM patients (pts) using next generation sequencing (NGS).

Methods

We analyzed clinical and echocardiographic data of 203 NIDCM in a single center from July 2017 to May 2020. All pts underwent NGS analysis with customized panel including 369 genes. Genetic variants were classified as pathogenic, likely pathogenic mutations or variants of uncertain significance regarding American College of Medical Genetics guideline.

Results

A total of 203 NIDCM pts (57±15 years old, 32.0% male, LVEF 28%) had NGS analysis. Thirty-seven (18.2%) pts had pathogenic or likely pathogenic mutations. The most prevalent mutated genes were TTN (n=16, 43.2%). TNNT2 (n=6, 16.2%), MYBPC3 (n=6, 16.2%) and MYH7 (n=3, 8.1%) mutated genes were common in the following order. The patients with positive panel mutation had no significant difference in initial LVEF (27% vs. 28%, p=0.216) and prevalence of atrial fibrillation (37.8% vs. 44.6%, p=0.454) compared with patients with negative panel mutation. During the median follow-up period of 40 months, there was no significant difference in composite outcome (all-cause death, heart transplantation, LVAD, heart failure re-admission, fatal arrhythmia) (35.3% vs. 32.2%, p=0.729) or presence of improved EF (≥10 points increase from baseline LVEF, and a second measurement of LVEF >40%) (41.2% vs. 50.0%, p=0.354) between the two groups.

Conclusion

This is the first study of NGS analysis in Korean NIDCM pts. We could find disease-related pathogenic or likely pathogenic mutations in 18.2% NIDCM patients. Further prospective, large study should be warranted to elucidate the effect of genetic mutation in clinical manifestation and prognosis of NIDCM in Korean population.

Funding Acknowledgement

Type of funding sources: None.

In-hospital glycemic variability and all-cause mortality in patients hospitalized with acute heart failure: analysis of the KorAHF registry

Introduction

Glycemic variability (GV) is known to be a poor prognostic marker in various diseases including cardiovascular disease.

Purpose

We investigated the association of GV with all-cause mortality in patients with acute heart failure (HF).

Methods

The Korean Acute Heart Failure registry enrolled patients hospitalized for acute HF from 2011 to 2014. Among survivors of the index hospitalization, we analyzed those who had ≥3 blood glucose measurements before discharge. Patients were divided into two groups based on their coefficient of variation (%CV) as an indicator of GV. We investigated all-cause mortality at 6 month and 1 year after discharge.

Results

The study analyzed 2,617 patients (median age 72 years, 53% male). During the median follow-up period of 11 months, 583 (22%) patients died. Compared to alive patients, patients who died had a significantly higher diabetes prevalence (46% vs. 41%, P=0.035) and higher %CV (31.0% vs. 27.5%, P<0.001). Kaplan-Meier curve analysis revealed that a high GV (%CV >21%) was associated with lower cumulative survival to all-cause death compared with a low GV (%CV ≤21%) (log-rank P<0.001). Multivariate Cox proportional analysis showed that a high GV was associated with an increased risk of 6-month mortality (hazard ratio [HR] 2.02, 95% CI 1.58–2.59, P<0.001) and one-year mortality (HR 1.57, 95% CI 1.29–1.91, P<0.001). The risk of high GV for one-year mortality was significant in non-diabetic patients (HR 1.98, 95% CI 1.55–2.53, P<0.001), but not in diabetic patients (HR 1.24, 95% CI 0.91–1.69, P=0.176; P-for-interaction=0.030).

Conclusion

A high GV (%CV >21%) before discharge was associated with all-cause mortality within 1 year, especially in non-diabetic acute HF patients.

Funding Acknowledgement

Type of funding sources: None.

The association between frailty and physical performance in elderly patients with heart failure

Background

Frailty is known to be an important prognostic indicator in heart failure (HF). The Korean version of the frail scale for Koreans (K-FRAIL) has been developed and verified. The purpose of this study is to analyze the relationship between the K-FRAIL scale and physical performance, including muscular fitness and aerobic capacity in patients with HF.

Methods

This study included 143 HF patients aged over 65 years from a single tertiary hospital. In these subjects, muscular fitness was assessed using the handgrip test and knee extensor strength measurement, and aerobic capacity was assessed by cardiopulmonary exercise test and 6-minute walk test. Frailty status was measured using the K-FRAIL questionnaire and was classified as robust (K-FRAIL scale: 0), prefrail (1–2), and frail (3–5).

Results

Mean age of participants with robust (N=37), prefrail (N=75), and frail (N=31) were 72.5, 73.5, and 76.3 years, respectively. There was no difference in sex and left ventricular ejection fraction (LVEF) among groups, but the estimated glomerular filtration rate (eGFR) was significantly lower as frailty status increased (75.6±17.2 vs. 70.0±20.5 vs. 56.1±23.7 mL/min/1.73 m2; P<0.001). Hand-grip strength and knee extensor muscle strength did not differ among groups. However, peak oxygen consumption (peak VO2; 22.8±5.0 vs. 19.3±4.6 vs. 16.9±4.7 mL/kg/min, P<0.001) and 6-min walk distance (458.4±68.2 vs. 404.5±92.3 vs. 311.2±120.5 m; p<0.001) significantly decreased according to frailty severity. In multivariate regression analysis adjusted for age, sex, haemoglobin, eGFR and LVEF, peak VO2 (β=−0.311; P=0.002) and 6-min walk distance (β=−0.384; P<0.001) showed a significant inverse association with the K-FRAIL scale. With the cut-off value from receiver-operating characteristic curve analysis, peak VO2 (hazard ratio, 5.08; p=0.023) and 6MWT (hazard ratio, 3.99; p=0.020) were independent predictor of frailty according to K-FRAIL scale.

Conclusion

In elderly HF patients, physical performance differs according to frailty status, peak VO2 and 6-min walk distance correlates with the K-FRAIL scale better than muscular fitness.

Funding Acknowledgement

Type of funding sources: None.

Dementia in individuals with severe hypercholesterolemia: Korean nationwide cohort study

Background

Dementia risk and benefit of lipid lowering in individuals with severe hypercholesterolemia has not been well studied. The aim of this study was to evaluate the risk of dementia and effect of lipid lowering in this population using nationwide cohort.

Methods

This study was performed using the National Health Insurance Service database of Korea. Among individuals who took health check-up and were followed-up, 1,584,401 were enrolled and analyzed. Study population were categorized to three groups with severe hypercholesterolemia according to LDL-C levels, >260, 225–259, and 190–224 mg/dL groups, and a control group (<160 mg/dL). Risks of incident dementia (all dementia, Alzheimer's disease, and vascular dementia) were compared. In the subgroup with new statin users, the effect of statins was further analyzed according to post-treatment LDL-C levels (<70, 70–99, 100–129, >130 mg/dL).

Results

In the median follow-up of 6.1 years, all dementia occurred up to 5.41/1000 person-year in the groups with severe hypercholesterolemia. Adjusted hazard ratios (aHRs) of all dementia in the groups ranged from 1.05 to 1.34 (p=0.023) and were dependent of LDL-C categories. Alzheimer's disease developed up to 4.94/1000 person-year and aHRs ranged from 1.04 to 1.38 (p=0.040) with the same pattern to all dementia. Vascular dementia occurred up to 0.59/100 person-year and aHRs ranged from 1.03 to 1.57 without significant difference according to LDL-C categories. In the median follow-up of 6.2 years in new statin users, aHRs were 0.69 to 0.92 for all dementia and 0.74 to 0.92 for Alzheimer's disease, and 0.53 to 1.15 for vascular dementia according to post-treatment LDL-C levels. However, the risk was not significantly related to the levels.

Conclusions

This study newly showed elevated risk of dementia, particularly Alzheimer's disease, in patients with severe hypercholesterolemia. The benefit of active lipid lowering on this neurological disease needs to be proven by further studies.

Funding Acknowledgement

Type of funding sources: Other. Main funding source(s): Korean Society of Lipid and Atherosclerosis; National Research Foundation of Korea

Serial high-sensitivity troponin T concentrations and long-term outcomes in patients with suspected acute coronary syndrome

Background

High-sensitivity troponin assays allow for accurate and rapid rule-in or rule-out of myocardial infarction (MI) among patients with acute-onset chest pain. However, prognostic implications of serial high-sensitivity troponin concentrations are unknown.

Purpose

To determine short- and long-term prognostic implications of high-sensitivity troponin T (hsTnT) concentrations and their changes from baseline, in patients with suspected acute coronary syndrome.

Methods

Retrospective cohort study based on Danish national registries. We identified all patients discharged from the hospital with either MI, unstable angina, suspected MI, or chest pain from January 2012 through December 2019 and merged these individuals with all records of two serial hsTnT measurements obtained ≤7 hours apart during the same hospitalization. The primary outcome was death at days 0–30 and 31–365. Prognostic implications of serial hsTnT were examined in accordance with the 2012 ESC algorithm stratifying patients for normal baseline concentrations and relative changes of 20% and 50% from baseline. In case of a normal baseline concentration, 20% and 50% of the upper reference level (14 ng/l) were used as thresholds instead, i.e., 3 ng/l and 7 ng/l, respectively. Absolute risks were calculated through multivariable logistic regression with average treatment effect modeling (G-formula).

Results

Complete data were available in 28,902 individuals (median age [25th-75th percentile] 65.2 [53.4–75.4] years, 11,632 [40.2%] women). Of these, 11,116 (38.5%) had a final diagnosis of MI, 1518 (5.3%) of unstable angina, and 16,268 (56.3%) of either suspected MI or chest pain. Median baseline hsTnT was 18 ng/l (25th-75th percentile, 10–69), second hsTnT 21 ng/l (25th-75th percentile, 10–248), relative hsTnT change 3.6% (25th-75th percentile, 0–66.7), and time between samples 4.0 hours (25th-75th percentile, 3.2–5.4). Most patients had either two normal hsTnT concentrations (9483, 32.8%) or two elevated hsTnT concentrations (18,235, 63.1%). At 30 days, 796 (2.8%) individuals had died, while an additional 1287 (4.6% of 30-day survivors) died between days 31–365. Baseline hsTnT and the relative hsTnT change both displayed a significant, non-linear association with death and interacted with each other (P<0.001). Tables 1 and 2 show the standardized, absolute risks of death (with 95% confidence intervals) from days 0–30 and from days 31–365, respectively. Patients with two normal hsTnT concentrations had very low mortality rates, irrespective of the magnitude of relative change. Conversely, patients with two elevated hsTnT concentrations consistently had high mortality rates.

Conclusions

This is the first study to assess both short- and long-term outcomes as a function of both baseline hsTnT and its change from first to second measurement. In general, patients with two normal hsTnT concentrations have an excellent prognosis while those with two elevated concentrations require scrutiny.

Funding Acknowledgement

Type of funding sources: None.

Impact of metformin on the all-cause mortality in diabetic patients hospitalized with acute heart failure

Introduction

Although the hypothesis that metformin is beneficial for diabetic patients with heart failure (HF) has been steadily raised, there have been no solid data on the efficacy of metformin in acute HF patients.

Purpose

We investigated the impact of metformin on all-cause mortality in hospitalized acute HF patients with type 2 diabetes.

Methods

The Korean Acute Heart Failure registry enrolled patients hospitalized for acute HF from 2011 to 2014. Among this cohort, we analyzed patients with diabetes. We investigated all-cause mortality at 1 year after discharge. Propensity score matching (1:1 matching) and Cox proportional hazard models were used to assess difference in all-cause mortality.

Results

The study analyzed 1,976 diabetic patients (median age 72 years, mean left ventricular ejection fraction (LVEF) 34%, 54.5% male). Among them, 712 (36%) patients were on metformin. After 1:1 propensity score matching, 1,424 patients (712 metformin users vs. 712 non-users) were analyzed. During the median follow-up period of 11 months, 146 (21%) metformin non-users died and 108 (15%) metformin users died. Kaplan-Meier curves showed a higher all-cause mortality rate in non-users than in metformin users (Log-rank P=0.0025). After adjustment for clinically relevant variables, metformin was associated with lower risk for all-cause mortality (HR 0.713, 95% CI 0.551–0.922, P=0.01). In subgroup analyses, metformin use was significantly associated with a lower all-cause mortality in higher eGFR group (≥60 ml/min/1.73 m2, HR 0.531, 95% CI 0.357–0.790, P=0.002), but not in lower eGFR group (<60 ml/min/1.73 m2, HR 0.905, 95% CI 0.643–1.275, P=0.569, P-for-interaction=0.033). There was no significant interaction of metformin use for all-cause mortality between the subgroups with LVEF ≤40% and LVEF >40% (P-for-interaction=0.906).

Conclusion

Metformin use was associated with a lower risk for 1-year all-cause mortality in diabetic acute HF patients, especially in high eGFR group.

Funding Acknowledgement

Type of funding sources: None.

Korean Red Pine (Pinus densiflora) Bark Extract Attenuates Aβ-Induced Cognitive Impairment by Regulating Cholinergic Dysfunction and Neuroinflammation

In this study, we investigated the anti-amnesic effect of Korean red pine (Pinus densiflora) bark extract (KRPBE) against amyloid beta_1-42 (Aβ_1-42)-induced neurotoxicity. We found that treatment with KRPBE improved the behavioral function in Aβ-induced mice, and also boosted the antioxidant system in mice by decreasing malondialdehyde (MDA) content, increasing superoxide dismutase (SOD) activities, and reducing glutathione (GSH) levels. In addition, KRPBE improved the cholinergic system by suppressing reduced acetylcholine (ACh) content while also activating acetylcholinesterase (AChE), regulating the expression of choline acetyltransferase (ChAT), postsynaptic density protein-95 (PSD-95), and synaptophysin. KRPBE also showed an ameliorating effect on cerebral mitochondrial deficit by regulating reactive oxygen species (ROS), mitochondrial membrane potential (MMP) and ATP levels. Moreover, KRPBE modulated the expression levels of neurotoxicity indicators Aβ and phosphorylated tau (p-tau) and inflammatory cytokines TNF-α, p-IκB-α, and IL-1β. Furthermore, we found that KRPBE improved the expression levels of neuronal apoptosis-related markers BAX and BCl-2 and increased the expression levels of BDNF and p-CREB. Therefore, this study suggests that KRPBE treatment has an anti-amnestic effect by modulating cholinergic system dysfunction and neuroinflammation in Aβ_1-42-induced cognitive impairment in mice.

Structural Integrity Preserving and Residue-Free Transfer of Large-Area Wrinkled Graphene onto Polymeric Substrates

Wrinkled graphene offers many advantageous features resulting from modifying the structural and physical properties as well as the chemical reactivity of graphene. However, its inadequate transferability to other substrates has limited its usability. This paper reports a roll-based clean transfer approach that enables the damage-free and contamination-free transfer of large-area wrinkled graphene onto polymeric substrates without compromising the integrity of wrinkle structures. The method implements the simultaneous imidazole-assisted etching and doping of chemical vapor-deposited graphene to fabricate multilayer graphene on a thermoplastic polystyrene (PS) substrate coated with a water-soluble poly(4-styrenesulfonic acid) (PSS) sacrificial layer via a roll-based transfer process. The compliant PSS layer affords the conformal contact between the PS substrate and graphene during the wrinkle formation process, enabling the controllable fabrication of graphene wrinkle structures on a large area. The water-soluble properties of PSS simplify the typically difficult separation of wrinkled graphene from the PS substrate after its transfer onto a target substrate. This improves the transferability of wrinkled graphene, rendering the transfer process solvent-free and residue-free. This work demonstrates the feasibility of the formulated method by transferring centimeter-scale wrinkled graphene onto currently used transparent flexible substrates (i.e., polyethylene terephthalate and polydimethylsiloxane). The results indicate that the transferred wrinkled graphene possesses the desirable combination of superior stretchability, optical transmittance, sheet resistance, and electromechanical stability, rendering its suitable application to transparent flexible and stretchable electronics.

New ABO intron 1 variant alleles

Unusual and discrepant ABO phenotypes are often due to genetic variants that lead to altered levels or activity of ABO transferases and consequently to altered expression of ABO antigens. This report describes eight genetic alterations found in 15 cases with reduced or undetectable expression of ABO antigens. Forward and reverse ABO grouping was performed by standard gel or tube methods. Adsorption-heat elution and saliva testing for H and A substances followed the AABB technical manual procedures. Genomic DNA extracted from whole blood was PCR-amplified to cover the entire ABO coding sequence, splice junctions, proximal promoter, and intron 1 enhancer. Amplification products were sequenced by next-generation or Sanger dideoxy methods, either directly or after cloning into a bacterial plasmid vector. Eight unreported alleles were found in the 15 cases analyzed. Alleles ABO*A(28+1C) and ABO*A(29-5G) harbor variants that alter the consensus sequence at the intron 1 donor and acceptor splice sites, respectively. The other alleles harbor variants that alter the consensus sequence at transcription factor-binding sites in the intron 1 enhancer: specifically, ABO*A(28+5792T), ABO*A(28+5859A), and ABO*A(28+5860G) at GATA-1 sites; ABO*B(28+5877T) and ABO*B(28+5878G) at a RUNX1 site; and ABO*A(28+5843A) at or near a C/EBP site. Molecular and serologic characterization of ABO alleles can help in their future identification and in the resolution of discrepancies.

Unusual and discrepant ABO phenotypes are often due to genetic variants that lead to altered levels or activity of ABO transferases and consequently to altered expression of ABO antigens. This report describes eight genetic alterations found in 15 cases with reduced or undetectable expression of ABO antigens. Forward and reverse ABO grouping was performed by standard gel or tube methods. Adsorption-heat elution and saliva testing for H and A substances followed the AABB technical manual procedures. Genomic DNA extracted from whole blood was PCR-amplified to cover the entire ABO coding sequence, splice junctions, proximal promoter, and intron 1 enhancer. Amplification products were sequenced by next-generation or Sanger dideoxy methods, either directly or after cloning into a bacterial plasmid vector. Eight unreported alleles were found in the 15 cases analyzed. Alleles ABO*A(28+1C) and ABO*A(29–5G) harbor variants that alter the consensus sequence at the intron 1 donor and acceptor splice sites, respectively. The other alleles harbor variants that alter the consensus sequence at transcription factor–binding sites in the intron 1 enhancer: specifically, ABO*A(28+5792T), ABO*A(28+5859A), and ABO*A(28+5860G) at GATA-1 sites; ABO*B(28+5877T) and ABO*B(28+5878G) at a RUNX1 site; and ABO*A(28+5843A) at or near a C/EBP site. Molecular and serologic characterization of ABO alleles can help in their future identification and in the resolution of discrepancies.

Increasing prevalence of diabetic peripheral angiopathy and complications in hospitalized patients in the United States

Objectives

We aim to assess prevalence of diabetes related peripheral arterial disease and associated outcomes in hospitalized patients in the United States.

Methods

Trends in hospitalizations in diabetic patients with PAD were determined using the 2003–2017 National Inpatient Sample database. Hospital outcomes including diabetic ulcer incidence, amputations, and revascularizations were analyzed.

Results

The analysis included 10,303,673 hospitalizations in diabetic patients with PAD (DMPAD) during the study period. Prevalence of PAD among patients with diabetes increased over time (p<0.001). The prevalence of foot ulcers in diabetics have also increased over time (p<0.001). The incidence of amputations in patients with diabetes showed a decreasing trend with increasing prevalence of revascularizations from 2003 to 2009. Since 2010 however, rising rates of amputations, both minor and major are seen, especially in younger populations (age 18–49). Hospital costs for amputations have increased ($6.6 billion in 2003 vs $ 14.8 billion in 2017) as well as the costs for revascularization (6.1 billion in 2003 vs $13 billion in 2017) during the study period (p<0.001).

Conclusions

In this analysis of patients with DMPAD, an alarming rate of disease prevalence and in-hospital limb outcomes, including costs, are realized in the current era.

Funding Acknowledgement

Type of funding sources: None.

Actinidia arguta Sprout as a Natural Antioxidant: Ameliorating Effect on Lipopolysaccharide-Induced Cognitive Impairment

Here, we investigated the prebiotic and antioxidant effects of Actinidia arguta sprout water extract (AASWE) on lipopolysaccharide (LPS)-induced cognitive deficit mice. AASWE increased viable cell count, titratable acidity, and acetic acid production in Lactobacillus reuteri strain and showed a cytoprotective effect on LPS-induced inflammation in HT-29 cells. We assessed the behavior of LPSinduced cognitive deficit mice using Y-maze, passive avoidance and Morris water maze tests and found that administration of AASWE significantly improved learning and memory function. The AASWE group showed antioxidant activity through downregulation of malondialdehyde levels and upregulation of superoxide dismutase levels in brain tissue. In addition, the AASWE group exhibited activation of the cholinergic system with decreased acetylcholinesterase activity in brain tissue. Furthermore, AASWE effectively downregulated inflammatory mediators such as phosphorylated- JNK, phosphorylated-NF-κB, TNF-α and interleukin-6. The major bioactive compounds of AASWE were identified as quercetin-3-O-arabinopyranosyl(1→2)-rhamnopyranosyl(1→6)-glucopyranose, quercetin-3-O-apiosyl(1→2)-galactoside, rutin, and 3-caffeoylquinic acid. Based on these results, we suggest that AASWE not only increases the growth of beneficial bacteria in the intestines, but also shows an ameliorating effect on LPS-induced cognitive impairment.

Large field-of-view nanometer-sectioning microscopy by using metal-induced energy transfer and biexponential lifetime analysis

Total internal reflection fluorescence (TIRF) microscopy, which has about 100-nm axial excitation depth, is the method of choice for nanometer-sectioning imaging for decades. Lately, several new imaging techniques, such as variable angle TIRF microscopy, supercritical-angle fluorescence microscopy, and metal-induced energy transfer imaging, have been proposed to enhance the axial resolution of TIRF. However, all of these methods use high numerical aperture (NA) objectives, and measured images inevitably have small field-of-views (FOVs). Small-FOV can be a serious limitation when multiple cells need to be observed. We propose large-FOV nanometer-sectioning microscopy, which breaks the complementary relations between the depth of focus and axial sectioning by using MIET. Large-FOV imaging is achieved with a low-magnification objective, while nanometer-sectioning is realized utilizing metal-induced energy transfer and biexponential fluorescence lifetime analysis. The feasibility of our proposed method was demonstrated by imaging nanometer-scale distances between the basal membrane of human aortic endothelial cells and a substrate.

Hwang et al. demonstrate that a high axial resolution can be achieved even with low numerical aperture (NA) objectives. They show the nano-profile of a basal cell membrane using metal-induced energy transfer and biexponential fluorescence lifetime analysis. The low-NA objective provides a larger field-of-view (FOV), thereby overcoming the limitations of a small FOV of the usually used high-NA objectives.

High-Resolution X-ray Photoelectron Spectroscopy of an IrO2(110) Film on Ir(100)

High-resolution X-ray photoelectron spectroscopy (XPS) and density functional theory (DFT) were used to characterize IrO₂(110) films on Ir(100) with stoichiometric as well as OH-rich terminations. Core-level Ir 4f and O 1s peaks were identified for the undercoordinated Ir and O atoms and bridging and on-top OH groups at the IrO₂(110) surfaces. Peak assignments were validated by comparison of the core-level shifts determined experimentally with those computed using DFT, quantitative analysis of the concentrations of surface species, and the measured variation of the Ir 4f peak intensities with photoelectron kinetic energy. We show that exposure of the IrO₂(110) surface to O₂ near room temperature produces a large quantity of on-top OH groups because of reaction of background H₂ with the surface. The peak assignments made in this study can serve as a foundation for future experiments designed to utilize XPS to uncover atomic-level details of the surface chemistry of IrO₂(110).

Factors Affecting Compliance With Weight-Bearing Restriction and the Amount of Weight-Bearing in the Elderly With Femur or Pelvic Fractures

OBJECTIVE

To determine the factors affecting the amount of weight-bearing during gait training in the elderly patients who underwent internal fixation after femur or pelvic fractures and how well they performed the weight-bearing restriction as directed by the physiatrist.

METHODS

In this retrospective chart review study, we measured the amount of weight-bearing on the affected side in 50 patients undergoing internal fixation surgery and rehabilitation after femur or pelvic fracture using a force plate. Patients receiving non-weight-bearing or partial weight-bearing education were considered to perform weight-bearing restriction well when the amount of weight-bearing was <50 lb. Furthermore, regression analysis was performed to determine the effects of postoperative complications, age, cognitive function, and pain on weightbearing restriction.

RESULTS

Variables affecting the amount of weight-bearing were age (r=0.581, p<0.001), weight-bearing education type (r=0.671, p<0.001), manual muscle strength of hip flexion on the non-affected side (r=-0.296, p=0.037), hip abduction (r=-0.326, p=0.021), knee extension (r=-0.374, p=0.007), ankle plantar flexion (r=-0.374, p=0.008), right hand grip strength (r=-0.535, p<0.001), Korean version of Mini-Mental State Examination (r=-0.496, p<0.001), Clinical Dementia Rating (r=0.308, p=0.03), and pain visual analog scale scores (r=0.318, p=0.024). The significant predictor of the amount of weight-bearing among these variables was age (β=0.448, p=0.001). The weight-bearing restriction adherence rate was significantly lower, at 22%, for patients aged ≥65 years as compared to 73% for those <65 years.

CONCLUSION

Age was a major variable affecting the amount of weight-bearing. Compliance with weight-bearing restriction was significantly lower in patients aged ≥65 years than in patients <65 years.

Molecular chemisorption of N2 on IrO2(110)

We investigated adsorption of N₂ on stoichiometric and O-rich IrO₂(110) surfaces using temperature programmed desorption (TPD) experiments and density functional theory (DFT) calculations. TPD shows that N₂ desorbs predominantly from the stoichiometric-IrO₂(110) surface in a well-defined peak at 270 K for N₂ coverages below about 0.5 ML and that a shoulder centered near 235 K develops in the N₂ TPD traces as the coverage approaches saturation, indicating that adsorbed N₂ molecules destabilize at high N₂ coverages. Experiments of N₂ adsorption onto O-rich IrO₂(110) surfaces provide evidence that N₂ adsorbs exclusively on the coordinatively unsaturated Ir atoms (Ir_cus) of the surface and that pre-adsorbed O-atoms ("on-top" oxygen) stabilize adsorbed N₂ molecules, causing the main N₂ TPD peak to shift toward higher temperature with increasing oxygen coverages. Consistent with prior results, our DFT calculations predict that an N₂ molecule preferentially adsorbs into an upright configuration on an Ir_cus atom of the IrO₂(110) surface and achieves a binding energy of about 100 kJ/mol. The computed binding energy agrees well with our experimental estimate of ∼90 kJ/mol for low N₂ coverages on stoichiometric IrO₂(110). The DFT calculations also quantitatively reproduce the observed stabilization of N₂ by co-adsorption on-top O-atoms and predict the destabilization of N₂ on IrO₂(110) as the N₂ adlayer becomes crowded at high coverages.

P5731Optimal blood pressure in diabetic hypertensive patients with overt proteinuria

Background

Evidence for the benefit of intensive blood pressure lowering in diabetic nephropathy is not clear at this time. The objective of this study was to demonstrate whether lower mean blood pressure (BP) in treated hypertensive patients with diabetic nephropathy is associated with better prognosis.

Methods

From the National Health Insurance Service (NHIS) Health Examination Database, diabetic hypertensive subjects with proteinuria between 2009 and 2010 were selected and followed-up until 2015 (N=8,663). Mean of the recorded systolic and diastolic BP during follow-up health examinations were stratified into five categories (SBP: <120, 120 to <130, 130 to <140, 140 to <150, and ≥150 mmHg; DBP: <70, 70 to <80, 80 to <90, 90 to <100, and ≥100 mmHg). All-cause death, myocardial infarction (MI), stroke, and renal outcome (progression to end stage renal disease or doubling of serum creatinine) were examined by Cox proportional hazard models with the propensity scores adjusted method.

Results

Compared to SBP of 130 to <140 mmHg, SBP of 120 to <130 mmHg was associated with lower risk of all-cause death (HR=0.78; 95% CI, 0.64–0.95), stroke (HR: 0.65; 95% CI, 0.45–0.94), and renal outcome (HR: 0.81; 95% CI, 0.68–0.97). SBP of <120 mmHg was associated with benefit for renal outcomes (HR: 0.69; 95% CI 0.55–0.88) but not with elevated risk of other outcomes. Compared to DBP of 80 to <90 mmHg, DBP of 70 to <80 mmHg were associated with lower risk of all-cause death (HR: 0.75; 95% CI, 0.64–0.88) but with higher risk of MI (HR: 1.52; 95% CI, 1.05–2.21). DBP of <70 mmHg was associated with reduced risk of all-cause death (HR: 0.79; 95% CI, 0.64–0.98).

Conclusion

In diabetic hypertensive subjects with overt proteinuria, deterioration of renal function decreased with decreasing SBP and the lowest risk of all-cause death and stroke were observed in SBP <130 mmHg. Low DBP was associated with low risk of all-cause death but there was a J curve phenomenon for MI in DBP of 70 to <80 mmHg.

P3555Lower native T1, extracellular volume and T2 on cardiac magnetic resonance imaging is related to more left ventricular reverse remodeling in nonischemic dilated cardiomyopathy

Introduction

Guideline-directed medical therapy can induce left ventricular reverse remodeling (LVRR) in nonischemic dilated cardiomyopathy (NIDCM). Some predictors for LVRR have been reported but, there were few studies about the relationship between cardiac magnetic resonance imaging (CMR) parameters and LVRR in NIDCM on optimal GDMT.

Methods

We retrospectively analyzed echocardiogram and CMR data of newly diagnosed 142 NIDCM patients (age: 57±16 years old, 71.8% male) in a single center from Jan 2012 to Dec 2017. NIDCM was defined as left ventricular ejection fraction (LVEF) <45% and the ischemic etiology was excluded by CMR, coronary angiography or coronary CT or SPECT scan. LVRR was defined as improvement in LVEF ≥10% during follow-up period (median 403 days).

Results

Baseline LVEF and LV end diastolic dimension (LVEDD) were 27±8% and 64±8 mm. There were 87 patients (61.3%) of LVRR in our cohort. In LVRR group, native T1 value was significantly lower (1326±66 for LVRR vs 1369±72ms, p<0.001), extracellular volume (ECV) was significantly lower (28.3±3.6 for LVRR vs 32.4±4.4%, p<0.001), and T2 value was significantly lower (49.6±4.6 for LVRR vs 52.1±5.4ms, p=0.004) compared with non-LVRR group. ECV was an independent predictor for LVRR after adjusting current LVRR predictors such as age, sex, LVEF, LVEDD, systolic blood pressure, heart rate and QRS duration (Odd ratio 0.706, 95% confidence interval 0.616–0.809, p<0.001).

Conclusion

Lower native T1, ECV and T2 on CMR is related to higher incidence of LVRR in NIDCM. Further larger prospective study should be warranted to confirm the relationship between CMR parameters and LVRR in NIDCM.

Artificial Synaptic Emulators Based on MoS2 Flash Memory Devices with Double Floating Gates

We fabricated MoS₂-based flash memory devices by stacking MoS₂ and hexagonal boron nitride (hBN) layers on an hBN/Au substrate and demonstrated that these devices can emulate various biological synaptic functions, including potentiation and depression processes, spike-rate-dependent plasticity, and spike-timing dependent plasticity. In particular, compared to a flash memory device prepared on an hBN substrate, the device fabricated on the hBN/Au exhibited considerably more symmetric and linear bidirectional gradual conductance change curves, which may be attributed to the device structure incorporating double floating gate. For the device on the hBN/Au, electron transfers may occur between the floating gate MoS₂ and Au, as well as between the floating gate MoS₂ and the channel MoS₂, allowing for more control over electron tunneling and injection. To test our hypothesis, we also fabricated a MoS₂-based flash memory device on an hBN/Pd substrate and found behavior similar to the device fabricated on hBN/Au. Our results demonstrate that flexible synaptic electronics may be implemented using MoS₂-based flash memory devices with double floating gates.

Optical performance of a dielectric-metal-dielectric antireflective absorber structure

The absorption of electromagnetic radiation by a planar structure, consisting of a three-layer dielectric-metal-dielectric coating on a metal backreflector, is analyzed. The conditions for total absorption are derived. Our analysis shows that, in contrast with bi-layer structures, the calculated layer thicknesses are feasible to fabricate for any metal. The proposed absorber design is of potential use in infrared, terahertz, and longer wavelength detectors and for radiant energy harvesting devices.

Astrocytic water channel aquaporin-4 modulates brain plasticity in both mice and humans: a potential gliogenetic mechanism underlying language-associated learning

The role of astrocytes in brain plasticity has not been extensively studied compared with that of neurons. Here we adopted integrative translational and reverse-translational approaches to explore the role of an astrocyte-specific major water channel in the brain, aquaporin-4 (AQP4), in brain plasticity and learning. We initially identified the most prevalent genetic variant of AQP4 (single nucleotide polymorphism of rs162008 with C or T variation, which has a minor allele frequency of 0.21) from a human database (n=60 706) and examined its functionality in modulating the expression level of AQP4 in an in vitro luciferase reporter assay. In the following experiments, AQP4 knock-down in mice not only impaired hippocampal volumetric plasticity after exposure to enriched environment but also caused loss of long-term potentiation after theta-burst stimulation. In humans, there was a cross-sectional association of rs162008 with gray matter (GM) volume variation in cortices, including the vicinity of the Perisylvian heteromodal language area (Sample 1, n=650). GM volume variation in these brain regions was positively associated with the semantic verbal fluency. In a prospective follow-up study (Sample 2, n=45), the effects of an intensive 5-week foreign language (English) learning experience on regional GM volume increase were modulated by this AQP4 variant, which was also associated with verbal learning capacity change. We then delineated in mice mechanisms that included AQP4-dependent transient astrocytic volume changes and astrocytic structural elaboration. We believe our study provides the first integrative evidence for a gliogenetic basis that involves AQP4, underlying language-associated brain plasticity.

Anatomy of STEM teaching in North American universities

National and local initiatives focused on the transformation of STEM teaching in higher education have multiplied over the last decade. These initiatives often focus on measuring change in instructional practices, but it is difficult to monitor such change without a national picture of STEM educational practices, especially as characterized by common observational instruments. We characterized a snapshot of this landscape by conducting the first large scale observation-based study. We found that lecturing was prominent throughout the undergraduate STEM curriculum, even in classrooms with infrastructure designed to support active learning, indicating that further work is required to reform STEM education. Additionally, we established that STEM faculty’s instructional practices can vary substantially within a course, invalidating the commonly-used teaching evaluations based on a one-time observation.

Although lecture is prominent throughout the undergraduate STEM curriculum, STEM faculty employ varied teaching practices within the same course.

Can simple tank changes benefit the welfare of laboratory zebrafish Danio rerio?

This study examined the effects of simple changes in the tank environment on the wellbeing of laboratory-maintained zebrafish Danio rerio. Groups of D. rerio were either housed in stable environments (where they were maintained in the same tanks throughout the study) or in environments subject to change (where they were periodically moved to novel but identical tanks) and the effects of these treatments on morphometry, reproductive success and aggressive behaviour assessed. No effect of simple tank changes was found on body condition, reproductive output or aggression, for the periods of time studied, indicating that more complex scenarios in housing tank conditions are required for significant welfare benefits for captive D. rerio.

Increasing chloride in rivers of the conterminous U.S. and linkages to potential corrosivity and lead action level exceedances in drinking water

Corrosion in water-distribution systems is a costly problem and controlling corrosion is a primary focus of efforts to reduce lead (Pb) and copper (Cu) in tap water. High chloride concentrations can increase the tendency of water to cause corrosion in distribution systems. The effects of chloride are also expressed in several indices commonly used to describe the potential corrosivity of water, the chloride-sulfate mass ratio (CSMR) and the Larson Ratio (LR). Elevated CSMR has been linked to the galvanic corrosion of Pb whereas LR is indicative of the corrosivity of water to iron and steel. Despite the known importance of chloride, CSMR, and LR to the potential corrosivity of water, monitoring of seasonal and interannual changes in these parameters is not common among water purveyors. We analyzed long-term trends (1992-2012) and the current status (2010-2015) of chloride, CSMR, and LR in order to investigate the short and long-term temporal variability in potential corrosivity of US streams and rivers. Among all sites in the trend analyses, chloride, CSMR, and LR increased slightly, with median changes of 0.9mgL^-1, 0.08, and 0.01, respectively. However, urban-dominated sites had much larger increases, 46.9mgL^-1, 2.50, and 0.53, respectively. Median CSMR and LR in urban streams (4.01 and 1.34, respectively) greatly exceeded thresholds found to cause corrosion in water distribution systems (0.5 and 0.3, respectively). Urbanization was strongly correlated with elevated chloride, CSMR, and LR, especially in the most snow-affected areas in the study, which are most likely to use road salt. The probability of Pb action-level exceedances (ALEs) in drinking water facilities increased along with raw surface water CSMR, indicating a statistical connection between surface water chemistry and corrosion in drinking water facilities. Optimal corrosion control will require monitoring of critical constituents reflecting the potential corrosivity in surface waters.

Ethyl acetate fraction from Hibiscus sabdariffa L. attenuates diabetes-associated cognitive impairment in mice

The ameliorating effects of the ethyl acetate fraction from Hibiscus sabdariffa L. (EFHS)² against diabetes mellitus (DM)³ and DM-induced cognitive impairment were investigated on streptozotocin (STZ)⁴-induced DM mice. The EFHS groups showed improved hyperglycemia and glucose tolerance compared to the STZ group. Furthermore, their liver and kidney function and lipid metabolic imbalance in the blood serum were effectively recovered. The EFHS groups significantly ameliorated STZ-induced cognitive impairment in Y-maze, passive avoidance, and Morris water maze (MWM)⁵ tests. The EFHS groups showed significant improvement in the antioxidant and cholinergic systems of the brain tissue. In addition, EFHS had an excellent ameliorating effect on protein expression levels from the tau hyperphosphorylation pathways, such as phospho-c-Jun N-terminal kinases (p-JNK),⁶ phospho-tau (p-tau),⁷ and cleaved poly (ADP-ribose) polymerase (c-PARP).⁸ The main compounds of EFHS were identified as various phenolic compounds, including hibiscus acid, caffeoylquinic acid (CQA)⁹ isomers, and quercetin derivates. Therefore, EFHS containing various physiologically active materials can potentially be used for improving DM-induced cognitive impairment via its antioxidant activity, improvement of the cholinergic system, and hyperphosphorylation tau signaling.

Highly stretchable fiber-based single-electrode triboelectric nanogenerator for wearable devices

In the proposed fiber-based single-electrode triboelectric nanogenerator (FSTENG), energy was generated from the contact between human skin and silicone rubber.

Stretchable Triboelectric Fiber for Self-powered Kinematic Sensing Textile

Stretchable fiber and yarn triboelectric nanogenerator are sought for such applications as wearable sensing system such as cloth communication devices, electronic textiles, and robotic sensory skin. Unfortunately, previously reported triboelectric fiber and yarn are difficult to have stretchable property. We introduce here a new type of stretchable and weavable triboelectric fibers with microdiameter dimensions. The stretchable triboelectric fibers can be reversibly stretched up to 50% in tensile direction while generating voltage output proportional to the applied tensile strain. The reversible distance change induced by the Poisson's ratio difference between the core fiber (silver-coated nylon/polyurethane) and the shell (wrinkled polyvinylidene fluoride-co-trifluoroethylene/carbon nanotube layer) during tensile deformation is the key working principle for electrical generation. Owing to exceptional structural stability, the stretchable triboelectric fibers show high performance retention after 10,000 times repeated stretching/releasing cycle. Furthermore, the stretchable triboelectric fibers are mechanically strong to be woven into a commercial textile for textile based sensors, which can detect magnitude as well as direction of the motion.

How Does Solvation Affect the Binding of Hydrophilic Amino Saccharides to Cucurbit[7]uril with Exceptional Anomeric Selectivity?

Cucurbit[7]uril (CB[7]) is known to bind strongly to hydrophilic amino saccharide guests with exceptional α-anomer selectivities under aqueous conditions. Single-crystal X-ray crystallography and computational methods were used to elucidate the reason behind this interesting phenomenon. The crystal structures of protonated galactosamine (GalN) and glucosamine (GluN) complexes confirm the inclusion of α anomers inside CB[7] and disclose the details of the host-guest binding. Whereas computed gas-phase structures agree with these crystal structures, gas-phase binding free energies show preferences for the β-anomer complexes over their α counterparts, in striking contrast to the experimental results under aqueous conditions. However, when the solvation effect is considered, the binding structures drastically change and the preference for the α anomers is recovered. The α anomers also tend to bind more tightly and leave less space in the CB[7] cavity toward inclusion of only one water molecule, whereas loosely bound β anomers leave more space toward accommodating two water molecules, with markedly different hydrogen-bonding natures. Surprisingly, entropy seems to contribute significantly to both anomeric discrimination and binding. This suggests that of all the driving factors for the strong complexation of the hydrophilic amino saccharide guests, water mediation plays a crucial role in the anomer discrimination.

A study to examine the relationship between metritis severity and depletion of oxytetracycline in plasma and milk after intrauterine infusion

Metritis is a frequent problem in postpartum dairy cows. Intrauterine therapy with the antimicrobial oxytetracycline (OTC) is often used, although this therapy has not been shown to be superior to systemic therapy. The objectives of this study were to (1) determine the plasma and milk concentrations of OTC following intrauterine infusion in postpartum dairy cows with varying degrees of metritis severity; (2) determine the depletion time of OTC in an attempt to provide veterinarians withdrawal guidelines, should they use this therapy; and (3) correlate metritis severity scores with OTC concentrations in plasma and milk. Our hypothesis was that cows with more severe metritis would have higher OTC concentrations in milk following intrauterine therapy. Thirty-two cows were selected to participate in the study after farm personnel had determined that they had metritis based on evaluation of vaginal discharge between 4 and 14 DIM, in accordance with the farm's treatment protocols. Metritis scores (1-4) were assigned based on a published scheme: 1 represented yellow-to-orange thick discharge or translucent mucus with no fetid smell; 2 represented blood-tinged vaginal mucus, slightly watery, with little or no fetid smell; 3 represented red to red/brown watery discharge with moderate fetid smell; and 4 represented red to red/brown watery discharge containing pieces of placenta and an intense fetid smell. Trial cows received a single treatment of 4g of OTC (approximately 6.7mg/kg) via intrauterine infusion. Blood samples were collected over 96h, and milk samples were collected before intrauterine therapy and 3 times a day for 4 d following infusion. Following treatment, OTC rapidly diffused to plasma and subsequently to milk. Maximum OTC concentrations in plasma and milk occurred within the first 24h following intrauterine infusion, and 25 of the 32 cows had detectable OTC concentrations in milk at 4 d after intrauterine infusion. Cows with clinical metritis (metritis severity scores of 3 or 4) at the initiation of treatment were significantly and positively correlated with higher milk OTC concentrations at the second [time (T)9 h; r=0.43], fourth (T25 h; r=0.42), and fifth milking following treatment (T33 h; r=0.38) compared with cows with normal vaginal discharge. We also observed a positive correlation between initial metritis score and milk maximum concentration (r=0.36) and milk area under the concentration curve (r=0.36). Given that intrauterine administration of OTC is an extra-label therapy, dairy producers should consult with their veterinarian to ensure that milk is being tested at or below the established tolerance for OTC. This will ensure that violative drug residues do not enter the human food supply.

A systematic review of commercial weight loss programmes' effect on glycemic outcomes among overweight and obese adults with and without type 2 diabetes mellitus

OBJECTIVE

We examined the glycemic benefits of commercial weight loss programmes as compared with control/education or counselling among overweight and obese adults with and without type 2 diabetes mellitus (T2DM).

METHODS

We searched MEDLINE, Cochrane Database of Systematic Reviews, and references cited by individual programmes. We included randomized controlled trials of ≥12 weeks duration. Two reviewers extracted information on study design, population characteristics, interventions, and mean changes in haemoglobin A1c and glucose.

RESULTS

We included 18 randomized controlled trials. Few trials occurred among individuals with T2DM. In this population, Jenny Craig reduced A1c at least 0.4% more than counselling at 12 months, Nutrisystem significantly reduced A1c 0.3% more than counselling at 6 months, and OPTIFAST reduced A1c 0.3% more than counselling at 6 months. Among individuals without T2DM, few studies evaluated glycemic outcomes, and when reported, most did not show substantial reductions.

DISCUSSION

Few trials have examined whether commercial weight loss programmes result in glycemic benefits for their participants, particularly among overweight and obese individuals without T2DM. Jenny Craig, Nutrisystem and OPTIFAST show promising glycemic lowering benefits for patients with T2DM, although additional studies are needed to confirm these conclusions. © 2016 World Obesity.

Efficacy of Pulsed Electromagnetic Therapy for Chronic Lower Back Pain: A Randomized, Double-blind, Placebo-controlled Study

This randomized, double-blind, placebo-controlled clinical trial studied the effectiveness of pulsed electromagnetic therapy (PEMT) in patients with chronic lower back pain. Active PEMT ( n = 17) or placebo treatment ( n = 19) was performed three times a week for 3 weeks. Patients were assessed using a numerical rating scale (NRS) and revised Oswestry disability scores for 4 weeks after therapy. PEMT produced significant pain reduction throughout the observation period compared with baseline values. The percentage change in the NRS score from baseline was significantly greater in the PEMT group than the placebo group at all three time-points measured. The mean revised Oswestry disability percentage after 4 weeks was significantly improved from the baseline value in the PEMT group, whereas there were no significant differences in the placebo group. In conclusion, PEMT reduced pain and disability and appears to be a potentially useful therapeutic tool for the conservative management of chronic lower back pain.

Correction: Triboelectric generator for wearable devices fabricated using a casting method

Correction for ‘Triboelectric generator for wearable devices fabricated using a casting method’ by Chang Jun Lee et al., RSC Adv., 2016, 6, 10094–10098.