Game-based training to improve the compliance of hospital pharmacy operators with handwashing guidelines

INTRODUCTION

Good hand hygiene techniques (HHTs), like those of the World Health Organization (WHO), prevent microbial contamination of aseptic preparations. The objective of this study was to assess the efficacy of a game-based training (GBT) tool (the Handtastic Box) to improve the compliance of hospital pharmacy operators (HPOs) with handwashing guidelines.

METHODS

A camera recorded handwashing by HPOs for 1 month before the training day, for 1 month after the training day (M1), and between month 1 and month 3 (M2&3). Movements were scored as fully executed, partially executed or not executed. Compliance rates of each HPO with HHTs were compared between observation periods. During 1-h training sessions, pairs of HPO trainees watched handwashing videos and noted which of five guideline steps was missing. They examined wooden hands with areas stained with fluorescein under ultraviolet light to find the hand showing the matching contamination.

RESULTS

The mean compliance score for nine HPOs increased from 44.6% (before training, N=32 videos) to 86.7% (M1, N=40) to 82.5% (M2&3, N=45). Compliance with every step improved from before training to M1 and generally stabilized in M2&3, except for the fingertip washing step which dropped significantly in M2&3.

DISCUSSION

To the authors' knowledge, this is the first study to assess the efficacy of a GBT tool to improve HPO compliance with the WHO HHTs. The tool improved handwashing scores significantly, and maintained them at the same level for 3 months after training. The separate results for each step highlight the need to train every movement.

CONCLUSION

This GBT tool successfully improved compliance with the WHO HHTs for 3 months. This training could be used for other healthcare professionals.

The Wood equation allows consistent fitting of individual antibody-response profiles of Zika virus or SARS-CoV-2 infected patients

Antibody kinetic curves obtained during a viral infection are often fitted using aggregated patient data, hiding the heterogeneity of individual humoral immune responses. Individual antibody responses can be modeled using the Wood equation and grouped according to their profile. Such modeling takes into account several important kinetic parameters, such as the day when antibody detection becomes positive [daypos], the day of the maximal response [daymax], the maximum antibody level [levelmax], and the day when antibody detection becomes negative [dayneg]. Potential associations between these profiles and studied factors can then be tested.

Modulation of cardiac cAMP signaling by AMPK and its adjustments in pressure overload-induced myocardial dysfunction in rat and mouse

The beta-adrenergic system is a potent stimulus for enhancing cardiac output that may become deleterious when energy metabolism is compromised as in heart failure. We thus examined whether the AMP-activated protein kinase (AMPK) that is activated in response to energy depletion may control the beta-adrenergic pathway. We studied the cardiac response to beta-adrenergic stimulation of AMPKα2-/- mice or to pharmacological AMPK activation on contractile function, calcium current, cAMP content and expression of adenylyl cyclase 5 (AC5), a rate limiting step of the beta-adrenergic pathway. In AMPKα2-/- mice the expression of AC5 (+50%), the dose response curve of left ventricular developed pressure to isoprenaline (p<0.001) or the response to forskolin, an activator of AC (+25%), were significantly increased compared to WT heart. Similarly, the response of L-type calcium current to 3-isobutyl-l-methylxanthine (IBMX), a phosphodiesterase inhibitor was significantly higher in KO (+98%, p<0.01) than WT (+57%) isolated cardiomyocytes. Conversely, pharmacological activation of AMPK by 5-aminoimidazole-4-carboxamide riboside (AICAR) induced a 45% decrease in AC5 expression (p<0.001) and a 40% decrease of cAMP content (P<0.001) as measured by fluorescence resonance energy transfer (FRET) compared to unstimulated rat cardiomyocytes. Finally, in experimental pressure overload-induced cardiac dysfunction, AMPK activation was associated with a decreased expression of AC5 that was blunted in AMPKα2-/- mice. The results show that AMPK activation down-regulates AC5 expression and blunts the beta-adrenergic cascade. This crosstalk between AMPK and beta-adrenergic pathways may participate in a compensatory energy sparing mechanism in dysfunctional myocardium.

Phosphodiesterase 8 governs cAMP/PKA-dependent reduction of L-type calcium current in human atrial fibrillation: a novel arrhythmogenic mechanism

AIMS

Atrial fibrillation (AF) is associated with altered cAMP/PKA signaling and an AF-promoting reduction of L-type Ca2+-current (ICa,L), the mechanisms of which are poorly understood. Cyclic-nucleotide phosphodiesterases (PDEs) degrade cAMP and regulate PKA-dependent phosphorylation of key calcium-handling proteins, including the ICa,L-carrying Cav1.2α1C subunit. The aim was to assess whether altered function of PDE type-8 (PDE8) isoforms contributes to the reduction of ICa,L in persistent (chronic) AF (cAF) patients.

METHODS AND RESULTS

mRNA, protein levels, and localization of PDE8A and PDE8B isoforms were measured by RT-qPCR, western blot, co-immunoprecipitation and immunofluorescence. PDE8 function was assessed by FRET, patch-clamp and sharp-electrode recordings. PDE8A gene and protein levels were higher in paroxysmal AF (pAF) vs. sinus rhythm (SR) patients, whereas PDE8B was upregulated in cAF only. Cytosolic abundance of PDE8A was higher in atrial pAF myocytes, whereas PDE8B tended to be more abundant at the plasmalemma in cAF myocytes. In co-immunoprecipitation, only PDE8B2 showed binding to Cav1.2α1C subunit which was strongly increased in cAF. Accordingly, Cav1.2α1C showed a lower phosphorylation at Ser1928 in association with decreased ICa,L in cAF. Selective PDE8 inhibition increased Ser1928 phosphorylation of Cav1.2α1C, enhanced cAMP at the subsarcolemma and rescued the lower ICa,L in cAF, which was accompanied by a prolongation of action potential duration at 50% of repolarization.

CONCLUSION

Both PDE8A and PDE8B are expressed in human heart. Upregulation of PDE8B isoforms in cAF reduces ICa,L via direct interaction of PDE8B2 with the Cav1.2α1C subunit. Thus, upregulated PDE8B2 might serve as a novel molecular mechanism of the proarrhythmic reduction of ICa,L in cAF.

Nearshore bathymetry and seafloor property studies from Space lidars: CALIPSO and ICESat-2

In shallow nearshore waters, seafloor heights and properties can be accurately measured by the current generation of space-based elastic backscatter lidars: CALIOP, flying aboard the CALIPSO satellite and ATLAS aboard ICESat-2. CALIOP's 532 nm volume depolarization ratios, together with the ratios of the attenuated backscatter coefficients measured at 532 nm and 1064 nm, can efficiently distinguish optically shallow waters from nearby land surfaces and deep oceans. ATLAS's high vertical resolution photon measurements can accurately determine seafloor depths in shallow water bodies, characterize seafloor reflectance, and provide assessments of ocean biomass concentrations in the intervening water column. By adding bathymetry, seafloor optical properties (e.g., reflectance, depolarization ratio and attenuated backscatter), and nighttime observations, space lidar measurements obtained in nearshore waters can provide a wealth of unique information to complement existing satellite-based ocean color remote sensing capabilities. The results reported here demonstrate the feasibility of using satellite lidars for nearshore seafloor ecosystem analyses, which in turn provide critical insights for studies of coastal navigation and seabed topography changes due to disasters, as well as the temporal and spatial morphological evolution of coastal systems.

Apport de la microscopie 2-photon (M2P) dans l’exploration des mécanismes immunitaires après infection par le virus de la grippe d’un modèle murin

Introduction

Même si depuis 18 mois, le SARS-Cov2 a fait disparaître toute trace des virus respiratoires hivernaux historiques, les virus de la grippe, responsables de plusieurs pandémies durant le 20^e siècle et d’une mortalité non négligeable, restent un sujet d’étude d’actualité. De nombreux travaux ont étudié la réaction immune innée post infection grippale mais sous un angle quantitatif en terme cellulaire et cytokinique. Le développement de technologie de microscopie moderne permettant d’étudier un organe entier en profondeur en conservant une excellente résolution mérite d’être évaluée. Peu de données sont disponibles sur l’intérêt de la M2P dans l’exploration du poumon et aucune sur son intérêt dans l’exploration des mécanismes immunitaires post infection grippale. Le but de ce travail est donc d’étudier l’intérêt de la M2P dans l’exploration des dommages structurales pulmonaires et du recrutement cellulaire après infection par le virus de la grippe d’un modèle murin.

Méthodes

Nous avons infecté des souris C57bl/6 J génétiquement modifiées, dont les cellules CD11C+ expriment une protéine fluorescente jaune, par voie inhalée avec Influenzavirus (adapté à la souris) auquel la protéine NS1 a été couplée à une protéine fluorescente rouge. En plus de cette fluorescente endogène, nous avons utilisé un Ac anti F4/80 couplé à une protéine fluorescente bleue pour visualiser les macrophages. Nous avons ensuite étudié les poumons à jour 1, 2, 3, 4, 5 post infection en cytométrie en flux pour quantification cellulaire, dosage cytokinique et exploration en M2P. Nous avons développé un protocole d’imagerie M2P Intravital ex vivo pour évaluer le trafficking cellulaire.

Résultats

M2P a permis de mettre en évidence des dommages structuraux pulmonaires, de localiser les sites infectés, d’étudier les interactions cellulaires et d’étudier l’évolution dans le temps post infection. Ces résultats enrichissent et complètent les données quantitatives déjà publiées (cytométrie) et permettent d’étudier dans le temps la cinétique et la localisation des lésions et du recrutement cellulaire. De plus, le protocole d’imagerie Intravitale ex vivo a été mis au point.

Conclusion

En complément des analyses usuelles (cytométrie en flux, dosage cytokines…), M2P est donc une technologie pertinente et prometteuse dans les études précliniques en infectiologie respiratoire nous a permis de décrire une base physiopathologique de référence pour de futures études notamment d’impact des traitements anti-viraux ou anti-inflammatoires.

[A check-list in order to optimise the deployment of computerized medicine cabinets in a hospital: An essential support]

In the medication management process, storage methods constitute a step at risk of errors that needs to be secured. As part of an institutional project, computerized medicine cabinets (CMC) have been deployed in our hospital's emergency and intensive care units. In order to meet the requirements of the certification, the deployment of CMC in all care units has been decided. Each deployment includes many steps and involves several trades that must be coordinated. We decided to formalize these steps in the form of a checklist. Two pharmacists listed all the tasks required to install a CMC. They were ordered chronologically, and a person responsible for each step is proposed. All those involved in the installation of CMC in the care units validated the checklist. The checklist is broken down into 13 major steps, from the assessment of the need to the installation of CMC in the care units. Before installation, several months are required, particularly in terms of the delivery time of the CMC. Support and training for the pharmacy technicians and caregivers are essential to ensure the teams enrolment. By better implying and empowering all intervenants, directed by the pharmacist, the checklist provides to dynamise and to frame the CMC deployment. Moreover, it contributes to save time and to improve the management of every ongoing deployments.

Spatiotemporal AMPKα2 deletion in mice induces cardiac dysfunction, fibrosis and cardiolipin remodeling associated with mitochondrial dysfunction in males only

Background

The AMP-activated protein kinase (AMPK) is a major regulator of cellular energetics which plays key role in acute metabolic response and in long-term adaptation to stress. Recent works have also suggested non-metabolic effects.

Methods

To decipher AMPK roles in the heart, we generated a cardio-specific inducible model of gene deletion of the main cardiac catalytic subunit of AMPK (Ampkα2) in mice. This allowed us to avoid the eventual impact of AMPK-KO in peripheral organs.

Results

Cardio-specific Ampkα2 deficiency led to a progressive left ventricular systolic dysfunction and the development of cardiac fibrosis in males. We observed a reduction in complex I-driven respiration without change in mitochondrial mass or in vitro complex I activity, associated with a rearrangement of the cardiolipins and reduced integration of complex I into the electron transport chain supercomplexes. Strikingly, none of these defects were present in females. Interestingly, suppression of estradiol signaling by ovariectomy partially mimicked the male sensitivity to AMPK loss, notably the cardiac fibrosis and the rearrangement of cardiolipins, but not the cardiac function that remained protected.

Conclusion

Our results confirm the close link between AMPK and cardiac mitochondrial function, but also highlight links with cardiac fibrosis. Importantly, we show that AMPK is differently involved in these processes in males and females, which may have clinical implications for the use of AMPK activators in the treatment of heart failure.

AMPK is a metabolic sensor of cellular energy which regulates energy homeostasis.

We generated a cardiac-specific inducible deletion of Ampkα2 and demonstrated that this deletion induces mild cardiac dysfunction in male only.

Cardiac dysfunction observed in males was associated with cardiac fibrosis and cardiac cardiolipin remodeling that are not seen in females.

Although no significant cardiac function alteration was noticed in ovariectomized female Ampkα2ciKO mice, these latter exhibited cardiac fibrosis and mild cardiolipins remodeling.

Our results show a higher dependence on AMPK signaling fibrosis and cardiolipin biosynthesis/maturation in males, either due to the absence of female hormones protection or/and to the action of male hormones. This may contribute to the known difference in cardiovascular risk and outcome between sexes.

Mapping genetic changes in the cAMP-signaling cascade in human atria

AIM

To obtain a quantitative expression profile of the main genes involved in the cAMP-signaling cascade in human control atria and in different cardiac pathologies.

METHODS AND RESULTS

Expression of 48 target genes playing a relevant role in the cAMP-signaling cascade was assessed by RT-qPCR. 113 samples were obtained from right atrial appendages (RAA) of patients in sinus rhythm (SR) with or without atrium dilation, paroxysmal atrial fibrillation (AF), persistent AF or heart failure (HF); and left atrial appendages (LAA) from patients in SR or with AF. Our results show that right and left atrial appendages in donor hearts or from SR patients have similar expression values except for AC7 and PDE2A. Despite the enormous chamber-dependent variability in the gene-expression changes between pathologies, several distinguishable patterns could be identified. PDE8A, PI3Kγ and EPAC2 were upregulated in AF. Different phosphodiesterase (PDE) families showed specific pathology-dependent changes.

CONCLUSION

By comparing mRNA-expression patterns of the cAMP-signaling cascade related genes in right and left atrial appendages of human hearts and across different pathologies, we show that 1) gene expression is not significantly affected by cardioplegic solution content, 2) it is appropriate to use SR atrial samples as controls, and 3) many genes in the cAMP-signaling cascade are affected in AF and HF but only few of them appear to be chamber (right or left) specific.

TOPIC

Genetic changes in human diseased atria.

TRANSLATIONAL PERSPECTIVE

The cyclic AMP signaling pathway is important for atrial function. However, expression patterns of the genes involved in the atria of healthy and diseased hearts are still unclear. We give here a general overview of how different pathologies affect the expression of key genes in the cAMP signaling pathway in human right and left atria appendages. Our study may help identifying new genes of interest as potential therapeutic targets or clinical biomarkers for these pathologies and could serve as a guide in future gene therapy studies.

Influence of symptom frequency and severity on hip abductor strength and endurance in individuals with patellofemoral pain

OBJECTIVE

To compare clinical measures of hip abductor strength and endurance of individuals with patellofemoral pain with more severe symptoms to those with less severe symptoms.

DESIGN

Cross-sectional.

SETTINGS

Laboratory.

PARTICIPANTS

Sixty participants with patellofemoral pain were divided three times into 2 groups according to three symptomatology criteria: functional capacity, pain frequency and pain severity.

MAIN OUTCOME MEASURES

Isometric strength evaluated using a hand-held dynamometer, endurance using maximum number of repetitions and maximum holding time, functional capacity using the Anterior Knee Pain Scale, pain frequency using a 2-category scale ("Less frequent" = 1-2 times a week; "More frequent" = >3 times a week) and pain severity using Numeric Pain Rating Scales.

RESULTS

Participants with more frequent symptoms and with more severe pain were significantly weaker (10%, p = 0.04 and 16%, p = 0.001, respectively), and had less isometric (17%, p = 0.02 and 24%, p = 0.002, respectively) and dynamic (13%, p = 0.02 and 23%, p = 0.007, respectively) endurance compared to those with less pronounced symptoms.

CONCLUSION

Our study highlighted that hip abductor strength and endurance deficits are more pronounced in individuals with more severe and frequent pain.

Endoplasmic reticulum stress induces cardiac dysfunction through architectural modifications and alteration of mitochondrial function in cardiomyocytes

Aims

Endoplasmic reticulum (ER) stress has recently emerged as an important mechanism involved in the pathogenesis of cardiovascular diseases. However, the molecular mechanisms by which ER stress leads to cardiac dysfunction remain poorly understood.

Methods and results

In this study, we evaluated the early cardiac effects of ER stress induced by tunicamycin (TN) in mice. Echocardiographic analysis indicated that TN-induced ER stress led to a significant impairment of the cardiac function. Electron microscopic observations revealed that ultrastructural changes of cardiomyocytes in response to ER stress manifested extensively at the level of the reticular membrane system. Smooth tubules of sarcoplasmic reticulum in connection with short sections of rough ER were observed. The presence of rough instead of smooth reticulum was increased at the interfibrillar space, at the level of dyads, and in the vicinity of mitochondria. At the transcriptional level, ER stress resulted in a substantial decrease in the expression of the major regulator of mitochondrial biogenesis PGC-1α and of its targets NRF1, Tfam, CS, and COXIV. At the functional level, ER stress also induced an impairment of mitochondrial Ca2+ uptake, an alteration of mitochondrial oxidative phosphorylation, and a metabolic remodelling characterized by a shift from fatty acid to glycolytic substrate consumption.

Conclusions

Our findings show that ER stress induces cytoarchitectural and metabolic alterations in cardiomyocytes and provide evidences that ER stress could represent a primary mechanism that contributes to the impairment of energy metabolism reported in most cardiac diseases.

Placental production of progestins is fully effective in villous cytotrophoblasts and increases with the syncytiotrophoblast formation

Placental syncytiotrophoblast (ST) is considered as the main placental endocrine tissue secreting progesterone, a steroid essential for maintenance of pregnancy. However, each step of progestins production has been poorly investigated in villous cytotrophoblast (VCT) regarding ST formation. We aimed to characterize progestins production during human differentiation of VCT into ST. VCTs were isolated from term placenta and cultivated, with or without forskolin (FSK), to stimulate trophoblast differentiation. Secreted progestins concentrations were determined by immuno-assay and Gas Chromatography-tandem mass spectrometry. Intracellular expression of cholesterol transporter and enzymes involved in steroidogenesis were studied by immunofluorescence, western-blot, and RT-qPCR. Progesterone and pregnenolone are produced by VCT and their secretion increases with VCT differentiation while 17-hydroxyprogesterone concentration remains undetectable. HSD3B1 enzyme expression increases whereas MLN64, the cholesterol placental mitochondrial transporter and P450SCC expressions do not. FSK induces progestins production. Progestins placental synthesis is effective since VCT and increases with ST formation thanks to mitochondria.

P6276Impact of the cardiac specific deletion of AMPKalpha2 on the contractile and metabolic phenotype of the heart in male and female mice

Introduction

Mitochondrial dysfunction plays a major role in the Heart Failure (HF) pathophysiology.The AMP activated protein kinase (AMPK) is activated by a high AMP-ADP/ATP ratio and regulates a number of metabolic pathways. Many studies have highlighted a protective role of AMPK in HF, but its relevance to cardiac tissue, its metabolic part and its sex specificity are not well established.

Purpose

Then, the aim of this study is to determine the role of AMPK in the healthy and failing heart in male and female mice.

Methods

We developed and validated a mouse strain with an adult-inducible cardiac-specific deletion of AMPKα2, the major cardiac isoform, using the Cre-Lox system (40mg/kg tamoxifen injection on two consecutive days at adult age). At four months after the deletion, cardiac contractility, morphology and metabolism were studied in control and KO mice from both sexes.

Results

We observed only in male KO mice a decrease of left ventricular ejection fraction (−10%), an increase of the total fibrosis (+64%) and defects in mitochondrial structures. Male KO mice also showed a reduced (−28%) mitochondrial respiration via complex I associated with a different cardiolipin species distribution.

Conclusion

Our results reveal in adult healthy hearts, a sex-specificity in the effects of AMPKα2 deletion, leading to impaired contractile function related to metabolic and non-metabolic alterations only in male mice.

Identification of optimal reference genes for transcriptomic analyses in normal and diseased human heart

Aims

Quantitative real-time RT-PCR (RT-qPCR) has become the method of choice for mRNA quantification, but requires an accurate normalization based on the use of reference genes showing invariant expression across various pathological conditions. Only few data exist on appropriate reference genes for the human heart. The objective of this study was to determine a set of suitable reference genes in human atrial and ventricular tissues, from right and left cavities in control and in cardiac diseases.

Methods and results

We assessed the expression of 16 reference genes (ACTB, B2M, GAPDH, GUSB, HMBS, HPRT1, IPO8, PGK1, POLR2A, PPIA, RPLP0, TBP, TFRC, UBC, YWHAZ, 18S) in tissues from: right and left ventricles from healthy controls and heart failure (HF) patients; right-atrial tissue from patients in sinus rhythm with (SRd) or without (SRnd) atrial dilatation, patients with paroxysmal (pAF) or chronic (cAF) atrial fibrillation or with HF; and left-atrial tissue from patients in SR or cAF. Consensual analysis (by geNorm and Normfinder algorithms, BestKeeper software tool and comparative delta-Ct method) of the variability scores obtained for each reference gene expression shows that the most stably expressed genes are: GAPDH, GUSB, IPO8, POLR2A, and YWHAZ when comparing either right and left ventricle or ventricle from healthy controls and HF patients; GAPDH, IPO8, POLR2A, PPIA, and RPLP0 when comparing either right and left atrium or right atria from all pathological groups. ACTB, TBP, TFRC, and 18S genes were identified as the least stable.

Conclusions

The overall most stable reference genes across different heart cavities and disease conditions were GAPDH, IPO8, POLR2A and PPIA. YWHAZ or GUSB could be added to this set for some specific experiments. This study should provide useful guidelines for reference gene selection in RT-qPCR studies in human heart.

[Interval between two smear tests for cervical cancer screening and characteristics of women with a short interval: Study in the department of Isère]

AIMS

In France, guidelines for cervical cancer screening recommend that women between the ages of 25-65 have a smear test performed once every three years. However, some women are screened significantly more frequently. In this study, we used a data-driven approach as opposed to a traditional hypothesis-driven approach to characterise the population of women who are screened more frequently than advised.

METHODS

Data came from an organised cervical cancer screening programme of a French department in the Alps (Isère). We retrospectively selected women aged between 25 to 65 years old who had at least two smear tests during the follow up period (2011-2015). We used a data-driven clustering approach to compare the population of over-screened women with other populations. We then performed a descriptive analysis of the over-screened population using univariate (Chi² test) and multivariate (logistic regression) methods.

RESULTS

A total of 10,000 patients were randomly chosen from a population of 54,073. In our univariate analysis, women in the over-screened population were significantly younger, participated less in organised screening, were more likely to be followed by a gynaecologist and had more smear test results showing inflammation than the other populations. Patient location (urban v.s. rural area) was not significant for this population. The multivariate analysis confirmed these results.

CONCLUSION

This data-driven approach based on an unsupervised learning method enables us to more accurately characterise the over-screened population. These data invite to improve communication with the youngest women and the gynecologists to recall the benefit of an interval between two normal smears complying with the recommendations. This approach could help to improve the prevention and have a real impact on this Public Health issue.

Cardioprotective reperfusion strategies differentially affect mitochondria: Studies in an isolated rat heart model of donation after circulatory death (DCD)

Donation after circulatory death (DCD) holds great promise for improving cardiac graft availability; however, concerns persist regarding injury following warm ischemia, after donor circulatory arrest, and subsequent reperfusion. Application of preischemic treatments is limited for ethical reasons; thus, cardioprotective strategies applied at graft procurement (reperfusion) are of particular importance in optimizing graft quality. Given the key role of mitochondria in cardiac ischemia-reperfusion injury, we hypothesize that 3 reperfusion strategies-mild hypothermia, mechanical postconditioning, and hypoxia, when briefly applied at reperfusion onset-provoke mitochondrial changes that may underlie their cardioprotective effects. Using an isolated, working rat heart model of DCD, we demonstrate that all 3 strategies improve oxygen-consumption-cardiac-work coupling and increase tissue adenosine triphosphate content, in parallel with increased functional recovery. These reperfusion strategies, however, differentially affect mitochondria; mild hypothermia also increases phosphocreatine content, while mechanical postconditioning stimulates mitochondrial complex I activity and reduces cytochrome c release (marker of mitochondrial damage), whereas hypoxia upregulates the expression of peroxisome proliferator-activated receptor-gamma coactivator (regulator of mitochondrial biogenesis). Characterization of the role of mitochondria in cardioprotective reperfusion strategies should aid in the identification of new, mitochondrial-based therapeutic targets and the development of effective reperfusion strategies that could ultimately facilitate DCD heart transplantation.

Estrogens, Estrogen Receptors Effects on Cardiac and Skeletal Muscle Mitochondria

Mitochondria are unique organelles present in almost all cell types. They are involved not only in the supply of energy to the host cell, but also in multiple biochemical and biological processes like calcium homeostasis, production, and regulation of reactive oxygen species (ROS), pH control, or cell death. The importance of mitochondria in cell biology and pathology is increasingly recognized. Being maternally inherited, mitochondria exhibit a tissue-specificity, because most of the mitochondrial proteins are encoded by the nuclear genome. This renders them exquisitely well-adapted to the physiology of the host cell. It is thus not surprising that mitochondria show a sexual dimorphism and that they are also prone to the influence of sex chromosomes and sex hormones. Estrogens affect mitochondria through multiple processes involving membrane and nuclear estrogen receptors (ERs) as well as more direct effects. Moreover, estrogen receptors have been identified within mitochondria. The effects of estrogens on mitochondria comprise protein content and specific activity of mitochondrial proteins, phospholipid content of membranes, oxidant and anti-oxidant capacities, oxidative phosphorylation, and calcium retention capacities. Herein we will briefly review the life cycle and functions of mitochondria, the importance of estrogen receptors and the effects of estrogens on heart and skeletal muscle mitochondria.

CALIPSO (IIR-CALIOP) Retrievals of Cirrus Cloud Ice Particle Concentrations

A new satellite remote sensing method is described whereby the sensitivity of thermal infrared wave resonance absorption to small ice crystals is exploited to estimate cirrus cloud ice particle number concentration N, effective diameter De, and ice water content IWC. This method uses co-located observations from the Infrared Imaging Radiometer (IIR) and from the CALIOP (Cloud and Aerosol Lidar with Orthogonal Polarization) lidar aboard the CALIPSO (Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation) polar orbiting satellite, employing IIR channels at 10.6 μm and 12.05 μm. Using particle size distributions measured over several flights of the TC4 (Tropical Composition, Cloud and Climate Coupling) and the mid-latitudes SPARTICUS (Small Particles in Cirrus) field campaigns, we show for the first time that N/IWC is tightly related to βeff; the ratio of effective absorption optical depths at 12.05 μm and 10.6 μm. Relationships developed from in situ aircraft measurements are applied to βeff derived from IIR measurements to retrieve N. This satellite remote sensing method is constrained by measurements of βeff from the IIR and is by essence sensitive to the smallest ice crystals. Retrieval uncertainties are discussed, including uncertainties related to in situ measurement of small ice crystals (D < 15 µm), which are studied through comparisons with IIR βeff. The method is applied here to single-layered semi-transparent clouds having a visible optical depth between about 0.3 and 3, where cloud base temperature is ≤ 235 K. Two years of CALIPSO data have been analyzed for the years 2008 and 2013, with the dependence of cirrus cloud N and De on altitude, temperature, latitude, season (winter vs. summer) and topography (land vs. ocean) described. The results for the mid-latitudes show a considerable dependence on season. In the high latitudes, N tends to be highest and De smallest, whereas the opposite is true for the tropics. The frequency of occurrence of these relatively thick cirrus clouds exhibited a strong seasonal dependence in the high latitudes, with the occurrence frequency during Arctic winter being at least twice that of any other season. Processes that could potentially explain some of these micro-and macroscopic cloud phenomena are discussed.

Anthropogenic Aerosol Indirect Effects in Cirrus Clouds

We have implemented a parameterization for forming ice in large-scale cirrus clouds that accounts for the changes in updrafts associated with a spectrum of waves acting within each time step in the model. This allows us to account for the frequency of homogeneous and heterogeneous freezing events that occur within each time step of the model and helps to determine more realistic ice number concentrations as well as changes to ice number concentrations. The model is able to fit observations of ice number at the lowest temperatures in the tropical tropopause but is still somewhat high in tropical latitudes with temperatures between 195°K and 215°K. The climate forcings associated with different representations of heterogeneous ice nuclei (IN or INPs) are primarily negative unless large additions of IN are made, such as when we assumed that all aircraft soot acts as an IN. However, they can be close to zero if it is assumed that all background dust can act as an INP irrespective of how much sulfate is deposited on these particles. Our best estimate for the forcing of anthropogenic aircraft soot in this model is -0.2 ± 0.06 W/m2, while that from anthropogenic fossil/biofuel soot is -0.093 ± 0.033 W/m2. Natural and anthropogenic open biomass burning leads to a net forcing of -0.057 ± 0.05 W/m2.

CALIPSO IIR Version 2 Level 1b calibrated radiances: analysis and reduction of residual biases in the Northern Hemisphere

Version 2 of the Level 1b calibrated radiances of the Imaging Infrared Radiometer (IIR) on board the Cloud-Aerosol Lidar and Infrared Satellite Observation (CALIPSO) satellite has been released recently. This new version incorporates corrections of small but systematic seasonal calibration biases previously revealed in Version 1 data products mostly north of 30° N. These biases of different amplitudes in the three IIR channels 8.65 µm (IIR1), 10.6 µm (IIR2), and 12.05 µm (IIR3) were made apparent by a striping effect in images of IIR inter-channel brightness temperature differences (BTDs) and through seasonal warm biases of nighttime IIR brightness temperatures in the 30-60° N latitude range. The latter were highlighted through observed and simulated comparisons with similar channels of the Moderate Resolution Imaging Spectroradiometer (MODIS) on board the Aqua spacecraft. To characterize the calibration biases affecting Version 1 data, a semi-empirical approach is developed, which is based on the in-depth analysis of the IIR internal calibration procedure in conjunction with observations such as statistical comparisons with similar MODIS/Aqua channels. Two types of calibration biases are revealed: an equalization bias affecting part of the individual IIR images and a global bias affecting the radiometric level of each image. These biases are observed only when the temperature of the instrument increases, and they are found to be functions of elapsed time since night-to-day transition, regardless of the season. Correction coefficients of Version 1 radiances could thus be defined and implemented in the Version 2 code. As a result, the striping effect seen in Version 1 is significantly attenuated in Version 2. Systematic discrepancies between nighttime and daytime IIR-MODIS BTDs in the 30-60° N latitude range in summer are reduced from 0.2 K in Version 1 to 0.1 K in Version 2 for IIR1-MODIS29. For IIR2-MODIS31 and IIR3-MODIS32, they are reduced from 0.4 K to close to zero, except for IIR3-MODIS32 in June, where the night-minus-day difference is around -0.1 K.

CALIPSO Lidar Calibration at 532 nm: Version 4 Nighttime Algorithm

Data products from the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) on board Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO) were recently updated following the implementation of new (version 4) calibration algorithms for all of the level 1 attenuated backscatter measurements. In this work we present the motivation for and the implementation of the version 4 nighttime 532 nm parallel channel calibration. The nighttime 532 nm calibration is the most fundamental calibration of CALIOP data, since all of CALIOP's other radiometric calibration procedures - i.e., the 532 nm daytime calibration and the 1064 nm calibrations during both nighttime and daytime - depend either directly or indirectly on the 532 nm nighttime calibration. The accuracy of the 532 nm nighttime calibration has been significantly improved by raising the molecular normalization altitude from 30-34 km to 36-39 km to substantially reduce stratospheric aerosol contamination. Due to the greatly reduced molecular number density and consequently reduced signal-to-noise ratio (SNR) at these higher altitudes, the signal is now averaged over a larger number of samples using data from multiple adjacent granules. As well, an enhanced strategy for filtering the radiation-induced noise from high energy particles was adopted. Further, the meteorological model used in the earlier versions has been replaced by the improved MERRA-2 model. An aerosol scattering ratio of 1.01 ± 0.01 is now explicitly used for the calibration altitude. These modifications lead to globally revised calibration coefficients which are, on average, 2-3% lower than in previous data releases. Further, the new calibration procedure is shown to eliminate biases at high altitudes that were present in earlier versions and consequently leads to an improved representation of stratospheric aerosols. Validation results using airborne lidar measurements are also presented. Biases relative to collocated measurements acquired by the Langley Research Center (LaRC) airborne high spectral resolution lidar (HSRL) are reduced from 3.6% ± 2.2% in the version 3 data set to 1.6% ± 2.4 % in the version 4 release.

Nicotinamide Riboside Preserves Cardiac Function in a Mouse Model of Dilated Cardiomyopathy

BACKGROUND

Myocardial metabolic impairment is a major feature in chronic heart failure. As the major coenzyme in fuel oxidation and oxidative phosphorylation and a substrate for enzymes signaling energy stress and oxidative stress response, nicotinamide adenine dinucleotide (NAD⁺) is emerging as a metabolic target in a number of diseases including heart failure. Little is known on the mechanisms regulating homeostasis of NAD⁺ in the failing heart.

METHODS

To explore possible alterations of NAD⁺ homeostasis in the failing heart, we quantified the expression of NAD⁺ biosynthetic enzymes in the human failing heart and in the heart of a mouse model of dilated cardiomyopathy (DCM) triggered by Serum Response Factor transcription factor depletion in the heart (SRF^HKO) or of cardiac hypertrophy triggered by transverse aorta constriction. We studied the impact of NAD⁺ precursor supplementation on cardiac function in both mouse models.

RESULTS

We observed a 30% loss in levels of NAD⁺ in the murine failing heart of both DCM and transverse aorta constriction mice that was accompanied by a decrease in expression of the nicotinamide phosphoribosyltransferase enzyme that recycles the nicotinamide precursor, whereas the nicotinamide riboside kinase 2 (NMRK2) that phosphorylates the nicotinamide riboside precursor is increased, to a higher level in the DCM (40-fold) than in transverse aorta constriction (4-fold). This shift was also observed in human failing heart biopsies in comparison with nonfailing controls. We show that the Nmrk2 gene is an AMP-activated protein kinase and peroxisome proliferator-activated receptor α responsive gene that is activated by energy stress and NAD⁺ depletion in isolated rat cardiomyocytes. Nicotinamide riboside efficiently rescues NAD⁺ synthesis in response to FK866-mediated inhibition of nicotinamide phosphoribosyltransferase and stimulates glycolysis in cardiomyocytes. Accordingly, we show that nicotinamide riboside supplementation in food attenuates the development of heart failure in mice, more robustly in DCM, and partially after transverse aorta constriction, by stabilizing myocardial NAD⁺ levels in the failing heart. Nicotinamide riboside treatment also robustly increases the myocardial levels of 3 metabolites, nicotinic acid adenine dinucleotide, methylnicotinamide, and N1-methyl-4-pyridone-5-carboxamide, that can be used as validation biomarkers for the treatment.

CONCLUSIONS

The data show that nicotinamide riboside, the most energy-efficient among NAD precursors, could be useful for treatment of heart failure, notably in the context of DCM, a disease with few therapeutic options.

Beneficial effects of exercise training in heart failure are lost in male diabetic rats

Exercise training has been demonstrated to have beneficial effects in patients with heart failure (HF) or diabetes. However, it is unknown whether diabetic patients with HF will benefit from exercise training. Male Wistar rats were fed either a standard (Sham, n = 53) or high-fat, high-sucrose diet ( n = 66) for 6 mo. After 2 mo of diet, the rats were already diabetic. Rats were then randomly subjected to either myocardial infarction by coronary artery ligation (MI) or sham operation. Two months later, heart failure was documented by echocardiography and animals were randomly subjected to exercise training with treadmill for an additional 8 wk or remained sedentary. At the end, rats were euthanized and tissues were assayed by RT-PCR, immunoblotting, spectrophotometry, and immunohistology. MI induced a similar decrease in ejection fraction in diabetic and lean animals but a higher premature mortality in the diabetic group. Exercise for 8 wk resulted in a higher working power developed by MI animals with diabetes and improved glycaemia but not ejection fraction or pathological phenotype. In contrast, exercise improved the ejection fraction and increased adaptive hypertrophy after MI in the lean group. Trained diabetic rats with MI were nevertheless able to develop cardiomyocyte hypertrophy but without angiogenic responses. Exercise improved stress markers and cardiac energy metabolism in lean but not diabetic-MI rats. Hence, following HF, the benefits of exercise training on cardiac function are blunted in diabetic animals. In conclusion, exercise training only improved the myocardial profile of infarcted lean rats fed the standard diet. NEW & NOTEWORTHY Exercise training is beneficial in patients with heart failure (HF) or diabetes. However, less is known of the possible benefit of exercise training for HF patients with diabetes. Using a rat model where both diabetes and MI had been induced, we showed that 2 mo after MI, 8 wk of exercise training failed to improve cardiac function and metabolism in diabetic animals in contrast to lean animals.

Development of a Double-Antigen Microsphere Immunoassay for Simultaneous Group and Serotype Detection of Bluetongue Virus Antibodies

Bluetongue viruses (BTV) are arboviruses responsible for infections in ruminants. The confirmation of BTV infections is based on rapid serological tests such as enzyme-linked immunosorbent assays (ELISAs) using the BTV viral protein 7 (VP7) as antigen. The determination of the BTV serotype by serological analyses could be only performed by neutralization tests (VNT) which are time-consuming and require BSL3 facilities. VP2 protein is considered the major serotype-defining protein of BTV. To improve the serological characterization of BTV infections, the recombinant VP7 and BTV serotype 8 (BTV-8) VP2 were synthesized using insect cells expression system. The purified antigens were covalently bound to fluorescent beads and then assayed with 822 characterized ruminant sera from BTV vaccinations or infections in a duplex microsphere immunoassay (MIA). The revelation step of this serological duplex assay was performed with biotinylated antigens instead of antispecies conjugates to use it on different ruminant species. The results demonstrated that MIA detected the anti-VP7 antibodies with a high specificity as well as a competitive ELISA approved for BTV diagnosis, with a better efficiency for the early detection of the anti-VP7 antibodies. The VP2 MIA results showed that this technology is also an alternative to VNT for BTV diagnosis. Comparisons between the VP2 MIA and VNT results showed that VNT detects the anti-VP2 antibodies in an early stage and that the VP2 MIA is as specific as VNT. This novel immunoassay provides a platform for developing multiplex assays, in which the presence of antibodies against multiple BTV serotypes can be detected simultaneously.

Hydrolysis-condensation reactions of diethylphosphato-ethyltriethoxysilane involved in organic–inorganic talc-like hybrid synthesis: liquid and solid-state NMR investigations

Organic–inorganic hybrids having a talc-like structure: (RSi)₄Mg₃O₈(OH)₂.

Re-Emergence of Bluetongue Virus Serotype 8 in France, 2015

At the end of August 2015, a ram located in central France (department of Allier) showed clinical signs suggestive of BTV (Bluetongue virus) infection. However, none of the other animals located in the herd showed any signs of the Bluetongue disease. Laboratory analyses identified the virus as BTV serotype 8. The viro and sero prevalence intraherd were 2.4% and 8.6% in sheep and 18.3% and 42.9% in cattle, respectively. Phylogenetic studies showed that the sequences of this strain are closely related to another BTV-8 strain that has circulated in France in 2006-2008. The origin of the outbreak is unclear but it may be assumed that the BTV-8 has probably circulated at very low prevalence (possibly in livestock or wildlife) since its first emergence in 2007-2008.

[Discharge from hospital: how to improve continuity of medical care?]

Early readmission is the major success indicator of the transition between hospital and home. Patients admitted with heart failure reach a 20% rate. Potentially avoidable readmissions, defined as unpredictable and related to a known condition during index hospitalization, represent the improvement margin. For these latter, implementation of specific interventions can be effective. Complex interventions on transition, including several modalities and seeking to encourage patient autonomy seem more effective than others. We describe two models: a pragmatic one developed in a regional hospital, and a more complex one developed in a university hospital during the LEAR-HF study. In both cases, it is imperative to work on "medical liability": should it extend beyond discharge up to the threshold of the private practice?

Sex-specific cardiac cardiolipin remodelling after doxorubicin treatment

Background

Imbalance in lipid metabolism and membrane lipid homeostasis has been observed in numerous diseases including heart failure and cardiotoxicity. Growing evidence links phospholipid alterations especially cardiolipins (CLs) to defects in mitochondrial function and energy metabolism in heart failure. We have shown recently that doxorubicin cardiotoxicity is more severe in male than female Wistar rats. We aimed to study whether this sex specificity is linked to differences in cardiac phospholipid profiles.

Results

Adult male and female rats were injected 2 mg/kg doxorubicin weekly for 7 weeks. Cardiac phospholipid molecular species were determined by liquid chromatography coupled with mass spectrometry fragmentation (LC)/MSⁿ. Sex difference in phosphatidylethanolamine and phosphatidylcholine species containing docosahexaenoic and docosapentaenoic acyl chains was observed, females having more than males. In both sexes, doxorubicin induced an important loss of the main CL(18:2)₄, while the level of monolysocardiolipin MLCL(18:2)₃ remained stable. However, a severe remodelling appeared in treated rats with the longest CL acyl chains in doxorubicin-treated females, which might compensate for the loss of tetra-linoleoyl CL. The level of oxidized cardiolipin was not particularly increased after doxorubicin treatment. Finally, expression of genes involved in the biosynthesis of fatty acid appeared to be decreased in doxorubicin-treated males.

Conclusions

These results emphasize for the first time the cardiac remodelling in the phospholipid classes after doxorubicin treatment. These observations suggest that doxorubicin has a sex-specific impact on the heart phospholipidome especially on cardiolipin, an essential mitochondrial lipid. Further studies are needed to better understand the roles of lipids in the anthracycline cardiotoxicity and sex differences, but phospholipid cardioprotection seems a valuable new additive therapeutic strategy for anthracycline cardiotoxicity.

Electronic supplementary material

The online version of this article (doi:10.1186/s13293-015-0039-5) contains supplementary material, which is available to authorized users.