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Liang X, Hou X, Bouhamdan M, Sun Y, Song Z, Rajagopalan C, Jiang H, Wei HG, Song J, Yang D, Guo Y, Zhang Y, Mou H, Zhang J, Chen YE, Sun F, Jin JP, Zhang K, Xu J. Sotagliflozin attenuates liver-associated disorders in cystic fibrosis rabbits. JCI Insight 2024; 9:e165826. [PMID: 38358827 DOI: 10.1172/jci.insight.165826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/09/2024] [Indexed: 02/17/2024] Open
Abstract
Mutations in the cystic fibrosis (CF) transmembrane conductance regulator (CFTR) gene lead to CF, a life-threating autosomal recessive genetic disease. While recently approved Trikafta dramatically ameliorates CF lung diseases, there is still a lack of effective medicine to treat CF-associated liver disease (CFLD). To address this medical need, we used a recently established CF rabbit model to test whether sotagliflozin, a sodium-glucose cotransporter 1 and 2 (SGLT1/2) inhibitor drug that is approved to treat diabetes, can be repurposed to treat CFLD. Sotagliflozin treatment led to systemic benefits to CF rabbits, evidenced by increased appetite and weight gain as well as prolonged lifespan. For CF liver-related phenotypes, the animals benefited from normalized blood chemistry and bile acid parameters. Furthermore, sotagliflozin alleviated nonalcoholic steatohepatitis-like phenotypes, including liver fibrosis. Intriguingly, sotagliflozin treatment markedly reduced the otherwise elevated endoplasmic reticulum stress responses in the liver and other affected organs of CF rabbits. In summary, our work demonstrates that sotagliflozin attenuates liver disorders in CF rabbits and suggests sotagliflozin as a potential drug to treat CFLD.
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Affiliation(s)
- Xiubin Liang
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Xia Hou
- Department of Physiology, and
| | | | - Yifei Sun
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Zhenfeng Song
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan, USA
| | | | | | | | - Jun Song
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Dongshan Yang
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Yanhong Guo
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Yihan Zhang
- The Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Hongmei Mou
- The Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jifeng Zhang
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Y Eugene Chen
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Fei Sun
- Department of Physiology, and
| | | | - Kezhong Zhang
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Jie Xu
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, Ann Arbor, Michigan, USA
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Wu Q, Liang X, Hou X, Song Z, Bouhamdan M, Qiu Y, Koike Y, Rajagopalan C, Wei HG, Jiang H, Hish G, Zhang J, Chen YE, Jin JP, Xu J, Zhang K, Sun F. Cystic fibrosis rabbits develop spontaneous hepatobiliary lesions and CF-associated liver disease (CFLD)-like phenotypes. PNAS Nexus 2023; 2:pgac306. [PMID: 36712930 PMCID: PMC9832953 DOI: 10.1093/pnasnexus/pgac306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
Cystic fibrosis (CF) is an autosomal recessive genetic disease affecting multiple organs. Approximately 30% CF patients develop CF-related liver disease (CFLD), which is the third most common cause of morbidity and mortality of CF. CFLD is progressive, and many of the severe forms eventually need liver transplantation. The mechanistic studies and therapeutic interventions to CFLD are unfortunately very limited. Utilizing the CRISPR/Cas9 technology, we recently generated CF rabbits by introducing mutations to the rabbit CF transmembrane conductance regulator (CFTR) gene. Here we report the liver phenotypes and mechanistic insights into the liver pathogenesis in these animals. CF rabbits develop spontaneous hepatobiliary lesions and abnormal biliary secretion accompanied with altered bile acid profiles. They exhibit nonalcoholic steatohepatitis (NASH)-like phenotypes, characterized by hepatic inflammation, steatosis, and fibrosis, as well as altered lipid profiles and diminished glycogen storage. Mechanistically, our data reveal that multiple stress-induced metabolic regulators involved in hepatic lipid homeostasis were up-regulated in the livers of CF-rabbits, and that endoplasmic reticulum (ER) stress response mediated through IRE1α-XBP1 axis as well as NF-κB- and JNK-mediated inflammatory responses prevail in CF rabbit livers. These findings show that CF rabbits manifest many CFLD-like phenotypes and suggest targeting hepatic ER stress and inflammatory pathways for potential CFLD treatment.
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Affiliation(s)
- Qingtian Wu
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Xiubin Liang
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Xia Hou
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Zhenfeng Song
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Mohamad Bouhamdan
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Yining Qiu
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Yui Koike
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Carthic Rajagopalan
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Hong-Guang Wei
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Hong Jiang
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Gerry Hish
- Laboratory Animal Resources, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Jifeng Zhang
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Y Eugene Chen
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Jian-Ping Jin
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Jie Xu
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Kezhong Zhang
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Fei Sun
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI 48201, USA
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Chen S, Roberts MA, Chen CY, Markmiller S, Wei HG, Yeo GW, Granneman JG, Olzmann JA, Ferro-Novick S. VPS13A and VPS13C Influence Lipid Droplet Abundance. Contact (Thousand Oaks) 2022; 5:25152564221125613. [PMID: 36147729 PMCID: PMC9491623 DOI: 10.1177/25152564221125613] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/06/2022] [Indexed: 11/16/2022]
Abstract
Lipid transfer proteins mediate the exchange of lipids between closely apposed membranes at organelle contact sites and play key roles in lipid metabolism, membrane homeostasis, and cellular signaling. A recently discovered novel family of lipid transfer proteins, which includes the VPS13 proteins (VPS13A-D), adopt a rod-like bridge conformation with an extended hydrophobic groove that enables the bulk transfer of membrane lipids for membrane growth. Loss of function mutations in VPS13A and VPS13C cause chorea acanthocytosis and Parkinson's disease, respectively. VPS13A and VPS13C localize to multiple organelle contact sites, including endoplasmic reticulum (ER) - lipid droplet (LD) contact sites, but the functional roles of these proteins in LD regulation remains mostly unexplored. Here we employ CRISPR-Cas9 genome editing to generate VPS13A and VPS13C knockout cell lines in U-2 OS cells via deletion of exon 2 and introduction of an early frameshift. Analysis of LD content in these cell lines revealed that loss of either VPS13A or VPS13C results in reduced LD abundance under oleate-stimulated conditions. These data implicate two lipid transfer proteins, VPS13A and VPS13C, in LD regulation.
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Affiliation(s)
- Shuliang Chen
- Department of Cellular and Molecular
Medicine, University of California San
Diego, La Jolla, CA, USA
| | - Melissa A. Roberts
- Department of Molecular and Cell
Biology, University of California,
Berkeley, CA, USA
- Department of Nutritional Sciences and
Toxicology, University of California,
Berkeley, CA, USA
| | - Chun-Yuan Chen
- Department of Cellular and Molecular
Medicine, University of California San
Diego, La Jolla, CA, USA
| | - Sebastian Markmiller
- Department of Cellular and Molecular
Medicine, University of California San
Diego, La Jolla, CA, USA
| | - Hong-Guang Wei
- Center for Integrative Metabolic and
Endocrine Research, Wayne State University School of
Medicine, Detroit, MI, USA
| | - Gene W. Yeo
- Department of Cellular and Molecular
Medicine, University of California San
Diego, La Jolla, CA, USA
| | - James G. Granneman
- Center for Integrative Metabolic and
Endocrine Research, Wayne State University School of
Medicine, Detroit, MI, USA
| | - James A. Olzmann
- Department of Molecular and Cell
Biology, University of California,
Berkeley, CA, USA
- Department of Nutritional Sciences and
Toxicology, University of California,
Berkeley, CA, USA
- Chan Zuckerberg Biohub, San Francisco,
CA, USA
| | - Susan Ferro-Novick
- Department of Cellular and Molecular
Medicine, University of California San
Diego, La Jolla, CA, USA
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He JQ, Chen JT, Li JH, Chen WZ, Liang XY, Huang HY, Wei HG, Huang WY, Wang JL, Lin M, Yang PK, Chen XY, Liu XZ. [Drug-resistant gene polymorphisms in Plasmodium falciparum isolated from Bioko Island, Equatorial Guinea in 2018 and 2019]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2021; 33:396-400. [PMID: 34505447 DOI: 10.16250/j.32.1374.2021128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the genetic polymorphisms of Plasmodium falciparum multidrug resistance protein 1 (PfMDR1), chloroquine resistance transporter (PfCRT) and Kelch 13 (PfK13) genes in Bioko Island, Equatorial Guinea, so as to provide insights into the development of the malaria control strategy in local areas. METHODS A total of 85 peripheral blood samples were collected from patients with Plasmodium falciparum infections in Bioko Island, Equatorial Guinea in 2018 and 2019, and genomic DNA was extracted. The PfMDR1, PfCRT and PfK13 genes were amplified using a nested PCR assay. The amplification products were sequenced, and the gene sequences were aligned. RESULTS There were no mutations associated with artemisinin resistance in PfK13 gene in Bioko Island, Equatorial Guinea, while drug-resistant mutations were detected in PfMDR1 and PfCRT genes, and the proportions of PfMDR1_N86Y, PfMDR1_Y184F and PfCRT_K76T mutations were 35.29% (30/85), 72.94% (62/85) and 24.71% (21/85), respectively. CONCLUSIONS There are mutations in PfMDR1, PfCRT and PfK13 genes in P. falciparum isolates from Bioko Island, Equatorial Guinea.
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Affiliation(s)
- J Q He
- Department of Laboratory Medicine, Humen Hospital of Dongguan City, Guangdong Province, Dongguan 523000, China
- The Chinese Medical Aid Team to the Republic of Equatorial Guinea, Guangdong Province, China
| | - J T Chen
- The Chinese Medical Aid Team to the Republic of Equatorial Guinea, Guangdong Province, China
- Department of Laboratory Medicine, Huizhou Central Hospital, Guangdong Province, China
| | - J H Li
- The Chinese Medical Aid Team to the Republic of Equatorial Guinea, Guangdong Province, China
- Department of Laboratory Medicine, Shijie Hospital, Dongguan City, Guangdong Province, China
| | - W Z Chen
- Chaozhou People's Hospital Affiliated to Shantou University, China
| | - X Y Liang
- Department of Laboratory Medicine, Huizhou Central Hospital, Guangdong Province, China
- Chaozhou People's Hospital Affiliated to Shantou University, China
| | - H Y Huang
- Chaozhou People's Hospital Affiliated to Shantou University, China
| | - H G Wei
- School of Laboratory Medicine, Youjiang Medical University for Nationalities, China
| | - W Y Huang
- School of Laboratory Medicine, Youjiang Medical University for Nationalities, China
| | - J L Wang
- School of Laboratory Medicine, Youjiang Medical University for Nationalities, China
| | - M Lin
- Chaozhou People's Hospital Affiliated to Shantou University, China
- School of Laboratory Medicine, Youjiang Medical University for Nationalities, China
| | - P K Yang
- Chaozhou People's Hospital Affiliated to Shantou University, China
| | - X Y Chen
- Chaozhou People's Hospital Affiliated to Shantou University, China
| | - X Z Liu
- Chaozhou People's Hospital Affiliated to Shantou University, China
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Xu J, Livraghi-Butrico A, Hou X, Rajagopalan C, Zhang J, Song J, Jiang H, Wei HG, Wang H, Bouhamdan M, Ruan J, Yang D, Qiu Y, Xie Y, Barrett R, McClellan S, Mou H, Wu Q, Chen X, Rogers TD, Wilkinson KJ, Gilmore RC, Esther CR, Zaman K, Liang X, Sobolic M, Hazlett L, Zhang K, Frizzell RA, Gentzsch M, O'Neal WK, Grubb BR, Chen YE, Boucher RC, Sun F. Phenotypes of CF rabbits generated by CRISPR/Cas9-mediated disruption of the CFTR gene. JCI Insight 2021; 6:139813. [PMID: 33232302 PMCID: PMC7821608 DOI: 10.1172/jci.insight.139813] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 11/18/2020] [Indexed: 12/20/2022] Open
Abstract
Existing animal models of cystic fibrosis (CF) have provided key insights into CF pathogenesis but have been limited by short lifespans, absence of key phenotypes, and/or high maintenance costs. Here, we report the CRISPR/Cas9-mediated generation of CF rabbits, a model with a relatively long lifespan and affordable maintenance and care costs. CF rabbits supplemented solely with oral osmotic laxative had a median survival of approximately 40 days and died of gastrointestinal disease, but therapeutic regimens directed toward restoring gastrointestinal transit extended median survival to approximately 80 days. Surrogate markers of exocrine pancreas disorders were found in CF rabbits with declining health. CFTR expression patterns in WT rabbit airways mimicked humans, with widespread distribution in nasal respiratory and olfactory epithelia, as well as proximal and distal lower airways. CF rabbits exhibited human CF–like abnormalities in the bioelectric properties of the nasal and tracheal epithelia. No spontaneous respiratory disease was detected in young CF rabbits. However, abnormal phenotypes were observed in surviving 1-year-old CF rabbits as compared with WT littermates, and these were especially evident in the nasal respiratory and olfactory epithelium. The CF rabbit model may serve as a useful tool for understanding gut and lung CF pathogenesis and for the practical development of CF therapeutics.
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Affiliation(s)
- Jie Xu
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan (UM) Medical Center, Ann Arbor, Michigan, USA
| | | | | | | | - Jifeng Zhang
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan (UM) Medical Center, Ann Arbor, Michigan, USA
| | - Jun Song
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan (UM) Medical Center, Ann Arbor, Michigan, USA
| | | | | | - Hui Wang
- Department of Oncology, Karmanos Cancer Institute
| | | | - Jinxue Ruan
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan (UM) Medical Center, Ann Arbor, Michigan, USA
| | - Dongshan Yang
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan (UM) Medical Center, Ann Arbor, Michigan, USA
| | - Yining Qiu
- Center for Molecular Medicine and Genetics, and
| | - Youming Xie
- Department of Oncology, Karmanos Cancer Institute
| | - Ronald Barrett
- Department of Anatomy and Cell Biology, Wayne State University (WSU) School of Medicine, Detroit, Michigan, USA
| | - Sharon McClellan
- Department of Anatomy and Cell Biology, Wayne State University (WSU) School of Medicine, Detroit, Michigan, USA
| | - Hongmei Mou
- Mucosal Immunology & Biology Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | | | - Troy D Rogers
- Marsico Lung Institute, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Kristen J Wilkinson
- Marsico Lung Institute, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Rodney C Gilmore
- Marsico Lung Institute, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Charles R Esther
- Marsico Lung Institute, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Khalequz Zaman
- Department of Pediatrics, Case Western Research University School of Medicine, Cleveland, Ohio, USA
| | - Xiubin Liang
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan (UM) Medical Center, Ann Arbor, Michigan, USA
| | | | - Linda Hazlett
- Department of Anatomy and Cell Biology, Wayne State University (WSU) School of Medicine, Detroit, Michigan, USA
| | | | - Raymond A Frizzell
- Department of Pediatrics and Cell Biology, University of Pittsburgh, Pittsburgh, Pennsylvnia, USA
| | - Martina Gentzsch
- Marsico Lung Institute, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Wanda K O'Neal
- Marsico Lung Institute, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Barbara R Grubb
- Marsico Lung Institute, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Y Eugene Chen
- Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan (UM) Medical Center, Ann Arbor, Michigan, USA
| | - Richard C Boucher
- Marsico Lung Institute, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
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Chen YT, Wei HG, Li SG. [Surgical treatment and curative effect observation of vascular malformations in the adult floor of the mouth and pharyngeal space]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:1953-1956. [PMID: 29798273 DOI: 10.13201/j.issn.1001-1781.2016.24.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Indexed: 11/12/2022]
Abstract
Objective:To investigate the effect of surgical treatment of vascular malformation in the adult floor of the mouth and pharyngeal space. Method:Collect 12 cases of vascular malformation from the floor of the mouth and pharyngeal space.All of them were checked out of the different degrees of tongue elevation and dysphagia and to carry out the excision of vascular malformation with lingual nerve and hypoglossal nerve preservation. Result:The lesion reduction degree of 10 cases of patients were Ⅳ class(excellent), theoher 2 cases were Ⅲ class(good). Hematoma at the bottom of the mouth after operation were not happened. Follow-up 0.5-3 years,tongue deviation appeared in 1 cases of postoperation. After 6 months of follow-up, the tongue is in the middle when it put out, functional recovery,no tongue muscle atrophy,no tongue movement disorder in the rest of the patients,no obvious recurrence of vascular malformations, no swallowing disorder in all patients. Conclusion:It would be obtained ideal therapeutic effect with surgical treatment in the adult vascular malformations of the floor of the mouth and pharyngeal space.It would be the key to the success of surgery with protecting the lingual nerve and hypoglossal nerve and controlling bleeding.
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Affiliation(s)
- Y T Chen
- Oral and Maxillofacial Plastic Surgery,Foshan Hospital Affiliated to Southern Medical University,Foshan
| | - H G Wei
- Oral and Maxillofacial Plastic Surgery,Foshan Hospital Affiliated to Southern Medical University,Foshan
| | - S G Li
- Oral and Maxillofacial Plastic Surgery,Foshan Hospital Affiliated to Southern Medical University,Foshan
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Brambrink E, Wei HG, Barbrel B, Audebert P, Benuzzi-Mounaix A, Boehly T, Endo T, Gregory CD, Kimura T, Kodama R, Ozaki N, Park HS, Koenig M. Direct density measurement of shock-compressed iron using hard x rays generated by a short laser pulse. Phys Rev E Stat Nonlin Soft Matter Phys 2009; 80:056407. [PMID: 20365083 DOI: 10.1103/physreve.80.056407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Indexed: 05/29/2023]
Abstract
We present the application of short-pulse laser-driven hard x rays (>40 keV) for the direct density measurement of iron compressed by a laser-driven shock. By using an on-shot calibration of the spectral absorption, we are able to obtain line densities with 5%-10% precision, although the x-ray source is not monochromatic. We also discuss possibilities for increasing the precision, which would be an improvement for equation of state measurements.
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Affiliation(s)
- E Brambrink
- LULI, Ecole Polytechnique, UPMC Université Paris 06, 91128 Palaiseau, France.
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Abstract
The emergency department (ED) visit provides an opportunity for patient education. Many ED patients have poor access to regular health care, including patient education. Accreditation standards, legal considerations, and cost-efficiency concerns encourage the clinician to implement formal patient education in the ED. More importantly, published clinical studies evaluating patient education in both the ED and comparable settings support the hypothesis that ED-based patient education improves outcomes. The article discusses considerations for instructional material, highlights challenges to ED-based patient education, and suggests possibilities for future research.
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Affiliation(s)
- H G Wei
- Weill Medical College of Cornell University, New York, NY, USA
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9
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Wei HG, Riel E, Czeisler CA, Dijk DJ. Attenuated amplitude of circadian and sleep-dependent modulation of electroencephalographic sleep spindle characteristics in elderly human subjects. Neurosci Lett 1999; 260:29-32. [PMID: 10027692 DOI: 10.1016/s0304-3940(98)00851-9] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Sleep spindles are 12-15 Hz electroencephalographic (EEG) oscillations characteristic of non-rapid eye movement (non-REM) sleep. Sleep EEG recordings (total 252 episodes; duration, 9 h 20 min each) distributed across the circadian cycle were analyzed in eight young and eight elderly human subjects. In the young subjects, sleep spindle amplitude, frequency, duration and incidence displayed significant circadian modulation, with the highest spindle incidence and amplitude and the lowest spindle frequency coincident with circadian phases associated with times of habitual sleep. In the elderly subjects, overall amplitude, duration, and incidence were reduced, and only spindle frequency exhibited a detectable circadian modulation. The results demonstrate that a circadian process modulates sleep spindle characteristics and that the strength of this circadian modulation is reduced with age.
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Affiliation(s)
- H G Wei
- Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115, USA
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