Exploring the mechanism of ShenGui capsule in treating heart failure based on network pharmacology and molecular docking: A review.

ShenGui capsule (SGC), as a herbal compound, has significant effects on the treatment of heart failure (HF), but its mechanism of action is unclear. In this study, we aimed to explore the potential pharmacological targets and mechanisms of SGC in the treatment of HF using network pharmacology and molecular docking approaches. Potential active ingredients of SGC were obtained from the traditional Chinese medicine systems pharmacology database and analysis platform database and screened by pharmacokinetic parameters. Target genes of HF were identified by comparing the toxicogenomics database, GeneCards, and DisGeNET databases. Protein interaction networks and gene-disorder-target networks were constructed using Cytoscape for visual analysis. Gene ontology and Kyoto Encyclopedia of Genes and Genomes were also performed to identify protein functional annotations and potential target signaling pathways through the DAVID database. CB-DOCK was used for molecular docking to explore the role of IL-1ß with SGC compounds. Sixteen active ingredients in SGC were screened from the traditional Chinese medicine systems pharmacology database and analysis platform, of which 36 target genes intersected with HF target genes. Protein-protein interactions suggested that each target gene was closely related, and interleukin-1ß (IL-1ß) was identified as Hub gene. The network pharmacology analysis suggested that these active ingredients were well correlated with HF. Kyoto Encyclopedia of Genes and Genomes enrichment analysis suggested that target genes were highly enriched in pathways such as inflammation. Molecular docking results showed that IL-1ß binds tightly to SGC active components. This experiment provides an important research basis for the mechanism of action of SGC in the treatment of HF. In this study, the active compounds of SGC were found to bind IL-1ß for the treatment of heart failure.

Weak transport of atmospheric water-insoluble particulate carbon from South Asia to the inner Tibetan Plateau in the monsoon season.

Carbonaceous particles play a crucial role in atmospheric radiative forcing. However, our understanding of the behavior and sources of carbonaceous particles in remote regions remains limited. The Tibetan Plateau (TP) is a typical remote region that receives long-range transport of carbonaceous particles from severely polluted areas such as South Asia. Based on carbon isotopic compositions (Δ14C/δ13C) of water-insoluble particulate carbon (IPC) in total suspended particle (TSP), PM2.5, and precipitation samples collected during 2020-22 at the Nam Co Station, a remote site in the inner TP, the following results were achieved: First, fossil fuel contributions (ffossil) to IPC in TSP samples (28.60 ± 9.52 %) were higher than that of precipitation samples (23.11 ± 8.60 %), and it is estimated that the scavenging ratio of IPC from non-fossil fuel sources was around 2 times that from fossil fuel combustion during the monsoon season. The ffossil of IPC in both TSP and PM2.5 samples peaked during the monsoon season. Because heavy precipitation during the monsoon season scavenges large amounts of long-range transported carbonaceous particles, the contribution of local emissions from the TP largely outweighs that from South Asia during this season. The results of the IPC source apportionment based on Δ14C and δ13C in PM2.5 samples showed that the highest contribution of liquid fossil fuel combustion also occurred in the monsoon season, reflecting increased human activities (e.g., tourism) on the TP during this period. The results of this study highlight the longer lifetime of fossil fuel-sourced IPC in the atmosphere than that of non-fossil fuel sources in the inner TP and the importance of local emissions from the TP during the monsoon season. The findings provide new knowledge for model improvement and mitigation of carbonaceous particles.

Principle and design of clinical efficacy observation of extracorporeal cardiac shock wave therapy for patients with myocardial ischemia-reperfusion injury: A prospective randomized controlled trial protocol.

BACKGROUND: Acute ST-segment elevation myocardial infarction (STEMI) remains a serious life threatening event with a poor prognosis due to myocardial ischemia/reperfusion injury despite coronary revascularization. Extracorporeal cardiac shock wave (ECSW) is a safe, effective and non-invasive new method for the treatment of cardiovascular diseases. The current results show that extracorporeal cardiac shock wave provides a new treatment option for patients with severe and advanced coronary heart disease. However, there are relatively few clinical studies on the application of in vitro cardiac shock waves in patients with myocardial ischemia-reperfusion injury. We hypothesized that extracorporeal cardiac shock therapy would also be effective in reducing clinical endpoints in patients with STEMI reperfusion. OBJECTIVE: This study is order to provide a new therapeutic method for patients with myocardial ischemia-reperfusion injury and reveal the possible mechanism of ECSW for ischemia-reperfusion injury. METHODS AND MATERIALS: CEECSWIIRI is a single-center, prospective randomized controlled trial that plans to enroll 102 eligible patients with acute ST-segment elevation myocardial infarction reperfusion. Eligible patients with STEMI reperfusion will be randomly divided into external cardiac shock therapy (ECSW) trial group and blank control group. The blank control group will receive optimal drug therapy, and the experimental group will receive optimal drug therapy combined with ECSW. The shock wave treatment plan will be 3-month therapy, specifically 1 week of treatment per month, 3 weeks of rest, 3 times of ECSW in each treatment week, respectively on the first day, the third day and the fifth day of the treatment week, lasting for 3 months and follow-up for 2 years. The primary endpoint will be to assess the 2-year improvement in all-cause death, re-hospitalization due to cardiovascular disease, major unintentional cerebrovascular events, including cardiogenic death, myocardial infarction, heart failure, arrhythmia, emergency coronary revascularization, and stroke in patients with STEMI reperfusion. Secondary endpoints will include improvements in angina pectoris, quality of life, cardiac structure and function, coronary microcirculation, and endothelial progenitor cell-derived miR-140-3p in relation to survival outcomes. TRIAL REGISTRATION NUMBER: ClinicalTrial.gov.org PRS:NCT05624203; Date of registration: November 12, 2022.

Significant spatial variations of the atmospheric environment at remote site of the Tibetan Plateau - a case study on major ions of precipitation around Nam Co station.

Remote region is normally considered a receptor of long-range transported pollutants. Monitoring stations are important platforms for investigating the atmospheric environment of remote regions. However, the potential contribution of very local sources around these stations may produce important influences on its atmospheric environment, which is still barely studied. In this study, major ions of precipitation were investigated simultaneously at a typical remote station (Nam Co station) and other sites nearby on the Tibetan Plateau (TP) - the so-called "The Third Pole" in the world. The results showed that despite low values compared to those of other remote regions, the concentrations of major ions in precipitation of Nam Co station (e.g., Ca2+: 32.71 µeq/L; [Formula: see text]: 1.73 µeq/L) were significantly higher than those at a site around 2.2 Km away (Ca2+: 11.47 µeq/L; [Formula: see text]: 0.64 µeq/L). This provides direct evidence that atmospheric environment at Nam Co station is significantly influenced by mineral dust and pollutants emitted from surface soil and anthropogenic pollutants of the station itself. Therefore, numbers of other related data reported on the station are influenced. For example, the aerosol concentration and some anthropogenic pollutants reported on Nam Co station should be overestimated. Meanwhile, it is suggested that it is cautious in selecting sites for monitoring the atmospheric environment at the remote station to reduce the potential influence from local sources.

Increased CaMKII activation and contrast changes of cardiac ß1-and ß3-Adrenergic signaling pathways in a humanized angiotensinogen model of hypertension.

Aims: Upregulation of Ca2+/calmodulin-dependent protein kinase II (CaMKII) contributes to the pathogenesis of cardiovascular disease, including hypertension. Transgenic rats expressing the human angiotensinogen gene [TGR (hAGT)L1623] are a new novel humanized model of hypertension that associates with declines in cardiac contractile function and ß-adrenergic receptor (AR) reserve. The molecular mechanisms are unclear. We tested the hypothesis that in TGR (hAGT)L1623 rats, left ventricular (LV) myocyte CaMKIIδ and ß3-AR are upregulated, but ß1-AR is down-regulated, which are important causes of cardiac dysfunction and ß-AR desensitization. Main methods: We compared LV myocyte CaMKIIδ, CaMKIIδ phosphorylation (at Thr287) (pCaMKIIδ), and ß1-and ß3-AR expressions and determined myocyte functional and [Ca2+]I transient ([Ca2+]iT) responses to ß-AR stimulation with and without pretreatment of myocytes using an inhibitor of CaMKII, KN-93 (10-6 M, 30 min) in male Sprague Dawley (SD; N = 10) control and TGR (hAGT)L1623 (N = 10) adult rats. Key findings: Hypertension in TGR (hAGT)L1623 rats was accompanied by significantly increased LV myocyte ß3-AR protein levels and reduced ß1-AR protein levels. CaMKIIδ phosphorylation (at Thr287), pCaMKIIδ was significantly increased by 35%. These changes were followed by significantly reduced basal cell contraction (dL/dtmax), relaxation (dR/dtmax), and [Ca2+]iT. Isoproterenol (10-8 M) produced significantly smaller increases in dL/dtmax, dR/dtmax, and [Ca2+]iT. Moreover, only in TGR (hAGT)L1623 rats, pretreatment of LV myocytes with KN-93 (10-6 M, 30 min) fully restored normal basal and isoproterenol-stimulated myocyte contraction, relaxation, and [Ca2+]iT. Significance: LV myocyte CaMKIIδ overactivation with associated contrast changes in ß3-AR and ß1-AR may be the key molecular mechanism for the abnormal contractile phenotype and ß-AR desensitization in this humanized model of hypertension.

[Corrigendum] CDCA5 promotes the progression of prostate cancer by affecting the ERK signalling pathway.

Subsequently to the publication of the above paper, an interested reader drew to the authors' attention that a pair of the data panels showing the results of Transwell invasion assays (specifically, the 'C4­2 / shCON' and the PC­3 / CON panels) featured in Fig. 3F on p. 927 contained overlapping sections, such that data that were intended to show the results from differently performed experiments appeared to have been derived from the same original source. The authors were able to re­examine their original data files, and realized that this figure had been inadverently assembled incorrectly. The revised version of Fig. 3, containing the correct representative image of the PC­3shCON group, is shown on the next page. The authors also noted that the statistics in Fig. 3G remained correct, and did not require correction on account of the error made in assembling this figure. Similarly, note that the correction made to this figure does not affect the overall conclusions reported in the paper. The authors are grateful to the Editor of Oncology Reports for allowing them the opportunity to publish this Corrigendum, and all the authors agree with its publication. They also apologize to the readership for any inconvenience caused. [Oncology Reports 45: 921­932, 2021; DOI: 10.3892/or.2021.7920].

Organocatalytic intramolecular (4 + 2) annulation of enals with ynamides: atroposelective synthesis of axially chiral 7-aryl indolines.

Catalytic enantioselective transformation of alkynes has become a powerful tool for the synthesis of axially chiral molecules. Most of these atroposelective reactions of alkynes rely on transition-metal catalysis, and the organocatalytic approaches are largely limited to special alkynes which act as the precursors of Michael acceptors. Herein, we disclose an organocatalytic atroposelective intramolecular (4 + 2) annulation of enals with ynamides. This method allows the efficient and highly atom-economical preparation of various axially chiral 7-aryl indolines in generally moderate to good yields with good to excellent enantioselectivities. Computational studies were carried out to elucidate the origins of regioselectivity and enantioselectivity. Furthermore, a chiral phosphine ligand derived from the synthesized axially chiral 7-aryl indoline was proven to be potentially applicable to asymmetric catalysis.

Copper-catalyzed enantioselective diyne cyclization via C(sp2)-O bond cleavage.

The functionalization of etheric C-O bonds via C-O bond cleavage is an attractive strategy for the construction of C-C and C-X bonds in organic synthesis. However, these reactions mainly involve C(sp3)-O bond cleavage, and a catalyst-controlled highly enantioselective version is extremely challenging. Here, we report a copper-catalyzed asymmetric cascade cyclization via C(sp2)-O bond cleavage, allowing the divergent and atom-economic synthesis of a range of chromeno[3,4-c]pyrroles bearing a triaryl oxa-quaternary carbon stereocenter in high yields and enantioselectivities. Importantly, this protocol not only represents the first [1,2]-Stevens-type rearrangement via C(sp2)-O bond cleavage, but also constitutes the first example of [1,2]-aryl migration reactions via vinyl cations.

Cost-effective and controllable synthesis of isomalto/malto-polysaccharides from ß-cyclodextrin by combined action of cyclodextrinase and 4,6-α-glucanotransferase GtfB.

Isomalto/malto-polysaccharides (IMMPs) derived from malto-oligosaccharides such as maltoheptaose (G7) are elongated non-branched gluco-oligosaccharides produced by 4,6-α-glucanotransferase (GtfB). However, G7 is expensive and cumbersome to produce commercially. In this study, a cost-effective enzymatic process for IMMPs synthesis is developed that utilizes the combined action of cyclodextrinase from Palaeococcus pacificus (PpCD) and GtfB-ΔN from Limosilactobacillus reuteri 121 to convert ß-cyclodextrin into IMMPs with a maximum yield (16.19 %, w/w). The purified IMMPs synthesized by simultaneous or sequential treatments, designated as IMMP-Sim and IMMP-Seq, possess relatively high contents of α-(1 â†’ 6) glucosidic linkages. By controlling the release of G7 and smaller malto-oligosaccharides by PpCD, IMMP-Seq was obtained of DP varying from 12.9 to 29.5. Enzymatic fingerprinting revealed different linkage-type distribution of α-(1 â†’ 6) linked segments with α-(1 â†’ 4) segments embedded at the reducing end and middle part. The proportion of α-(1 â†’ 6) segments containing the non-reducing end was 56.76 % for IMMP-Sim but 28.98 % for IMMP-Seq. Addition of G3 or G4 as specific acceptors resulted in IMMPs exhibiting low polydispersity. This procedure can be applied as a novel bioprocess that does not require costy high-purity malto-oligosaccharides and with control of the average DP of IMMPs by adjusting the substrate composition.

Construction of Axially Chiral Arylpyrroles via Atroposelective Diyne Cyclization.

Axially chiral biaryls widely exist in natural products and pharmaceuticals and are used as chiral ligands and catalysts in asymmetric synthesis. Compared to the well-established axially chiral 6-membered biaryl skeletons, examples of 5-membered biaryls have been quite scarce, and mono-substituted 3-arylpyrrole atropisomers have not been reported. Here, we disclose a copper-catalyzed atroposelective diyne cyclization for the construction of a range of axially chiral arylpyrrole biaryls in good to excellent yields with generally excellent enantioselectivities via oxidation and X-H insertion of vinyl cations. Importantly, this protocol not only represents the first synthesis of mono-substituted 3-arylpyrrole atropisomers, but also constitutes the first example of atroposelective diyne cyclization and the first atropisomer construction via vinyl cations. Theoretical calculations further support the mechanism of vinyl cation-involved cyclization and elucidate the origin of enantioselectivity.

Calmodulin-dependent protein kinase II activation promotes kidney mesangial expansion in streptozotocin-induced diabetic mice.

Calcium-calmodulin-dependent protein kinase II (CaMKII) is upregulated in diabetes mellitus (DM), leading to the overproduction of collagen in the myocardium. We hypothesized that CaMKII plays a role in the development of diabetic nephropathy (DN). Streptozotocin (STZ) injection into FVB wild-type mice led to mild mesangial matrix expansion, reproducing an essential feature of early human DN. Mesangial matrix measurements were performed on trichrome-stained paraffin sections using a trainable segmentation method based on WEKA (Waikato Environment for Knowledge Analysis) Image J-Fiji plugin (TWS plugin), and the electron micrographs of the whole glomeruli stitched from individual 4800x partial glomerular images. Both methods demonstrated that the statistically significant mesangial matrix expansion seen in the diabetic mice was prevented by chronic pretreatment with KN-93, a small molecule CaMKII inhibitor. This study indicates a role for CaMKII in the development of mesangial alterations in diabetes and suggests a possible new therapeutic target.

Importance of local non-fossil sources to carbonaceous aerosols at the eastern fringe of the Tibetan Plateau, China: Δ14C and δ13C evidences.

Carbonaceous particles are an important radiative forcing agent in the atmosphere, with large temporal and spatial variations in their concentrations and compositions, especially in remote regions. This study reported the Δ14C and δ13C of total carbon (TC) and water-insoluble particulate carbon (IPC) of the total suspended particles (TSP) and PM2.5 at a remote site of the eastern Tibetan Plateau (TP), a region that is influenced by heavy air pollution from Southwest China. The average organic carbon and elemental carbon concentrations of TSP samples in this study were 3.20 ± 2.38 µg m-3 and 0.68 ± 0.67 µg m-3, respectively, with low and high values in summer and winter, respectively. The fossil fuel contributions of TC in TSP and PM2.5 samples were 18.91 ± 7.22% and 23.13 ± 12.52%, respectively, both of which were far lower than that in Southwest China, indicating the importance of non-fossil contributions from local sources. The δ13C of TC in TSP samples of the study site was -27.06 ± 0.96‰, which is between the values of long-range transported sources (e.g., Southwest China) and local biomass combustion emissions. Therefore, despite the contribution from the long-range transport of particles, aerosols emitted from local biomass combustion also have an important influence on carbonaceous particles at the study site. The findings of this work can be applied to other remote sites on the eastern TP and should be considered in related research in the future.

Composition and sources of heavy metals in aerosol at a remote site of Southeast Tibetan Plateau, China.

Knowledge of the elemental composition of aerosols at remote sites is important for evaluating the influence of anthropogenic activities. In this study, the elemental composition and sources of total suspended particles (TSP) at Yaze, a remote site in the southeastern Tibetan Plateau (TP), were investigated. The results showed that the mean elemental concentrations at Yaze were relatively low compared with those in other areas of the TP. Seasonal variations in the studied elements was characterized by low and high concentrations during the monsoon and non-monsoon periods, respectively. The enrichment factors (EFs) for some heavy metals at Yaze were slightly higher than those at Nam Co station (inland TP) but much lower than those at Mt. Yulong (southeastern TP) and in the Indian megacity of Delhi, indicating fewer anthropogenic influences at the study site relative to sites close to severely polluted regions. For the studied elements, three major sources were identified: crustal origins (e.g., Al and Fe), anthropogenic origins (e.g., Zn and Cd) and mixed origins (e.g., As and Bi). Further analysis by potential source contribution functions showed that the local TP was the primary source for elements of crustal origins. Correspondingly, the typical heavy metals were mainly attributed to pollution emitted from anthropogenic activities and transported over long-range from both South and Southeast Asia. This work demonstrates the transport of heavy metals from external sources to remote sites in the southeastern TP. These results are also useful for interpreting the historical profiles of heavy metals in the ice cores of the TP.

Deciphering external chain length and cyclodextrin production with starch catalyzed by cyclodextrin glycosyltransferase.

Cyclodextrins (CDs) are yielded by cyclodextrin glycosyltransferase (CGTase) using starches or their derivatives as substrates. However, how starch fine structure affects it production is still ambiguous. This study aimed to decipher the relevance between the external chain length (ECL) and CD production. The waxy maize starch was hydrolyzed by ß-amylase to prepare starchy substrates with regular gradient ECL for CGTase. The HPAEC results reflected that ß-amylolysis lower the starch chain fractions with DP range of 13-24 by 30%, while the fractions with DP < 6 promoted by 30%. The molecular weight distribution and iodine binding results reflected that this process had limited impact on overall starch molecular size parameters. After CGTase conversion, it is interesting to find that the ECL was positively correlated with CD contents, which also has a high consistency among α-CD, ß-CD, and γ-CD. This research would provide a favorable perspective for CD production improvement.

Overestimation of anthropogenic contribution of heavy metals in precipitation than those of aerosol samples due to different treatment methods.

Due to increased anthropogenic activities in recent decades, many heavy metal elements have been emitted into the atmosphere and transported to remote regions. The Enrichment factors (EFs) is a normally used method for evaluating the source of heavy metal elements. However, because of some flaws of this method (e.g., higher solubility of heavy metals elements than reference elements in dilute acid), the anthropogenic contributions of some heavy metal elements in the precipitation sample were overestimated. To address this issue, EFs of heavy metal elements of aerosol, precipitation and snowpit samples in a typical remote area of the Tibetan Plateau (TP) were compared. The results showed that the EF values of many heavy metal elements in precipitation and snowpit samples were close to that of aerosol samples treated with dilute acid but usually much higher than those of totally dissolved aerosol samples. Moreover, EF values of most heavy metal elements in the ice core at the margin of the TP were higher than those at central TP, indicating that signal of long-range transport anthropogenic emitted heavy metal elements is weak and may be covered by natural mineral dust sources at glacier region. Therefore, the threshold EF values for determining anthropogenic sources of heavy metal elements in precipitation and ice core samples should be higher than those of aerosols. This study provides new knowledge on investigating anthropogenic sources of heavy metals in precipitation samples at both the TP and other regions of the world.

Job burnout is associated with slow improvement of quality of life in the employees after a first episode of acute coronary syndrome: A hospital-based longitudinal study in China.

OBJECTIVE: This study investigated the association between job burnout and quality of life (QoL) after acute coronary syndrome (ACS) in a Chinese sample. METHODS: This was a one-year longitudinal study. Participants included patients with a first episode of ACS who were still employed. The Copenhagen Burnout Inventory (CBI) assessed job burnout before discharge, and QoL was assessed using the Medical Outcome Study 8-Items Short Form Health Survey (SF-8) and the Seattle Angina Questionnaire (SAQ) before discharge (baseline), at one month, six months and 12 months after discharge. Generalized estimating equations determined the association between job burnout and longitudinal changes of QoL. RESULTS: All participants were assigned to either a "low job burnout" group (n = 70) or a "high job burnout" group (n = 50), based on the upper quartile of job burnout scores. Longitudinally over 1-year follow-up period, the scores of the SF-8 and SAQ among patients with a high level of burnout were lower than those in the low job burnout group. Job burnout was significantly associated with lower physical and mental health (SF-8), as well as greater physical limitation and lower treatment satisfaction (SAQ) over time. CONCLUSION: Job burnout at baseline predicted slow improvement of QoL after ACS in a Chinese working sample.

Effect of albumin and CYP2B6 polymorphisms on exposure of efavirenz: A population pharmacokinetic analysis in Chinese HIV-infected adults.

BACKGROUND: Efavirenz is a vital component used to treat HIV-1 infection. Nevertheless, it shows large between-subject variability, which affects both its therapeutic response and adverse effects. OBJECTIVE: To investigate the impact of gene polymorphisms and non-genetic factors on the variability of efavirenz pharmacokinetics and to propose the optimal dose regimens. METHODS: A total of 769 plasma samples from 376 HIV-infected Han Chinese outpatients were collected to develop a population pharmacokinetic model using NONMEM software. The impact of patient demographics, laboratory tests, concomitant medication, and genetic polymorphisms of CYP2B6 and ABCB1 on efavirenz pharmacokinetics were explored. According to the final model, the model-informed dose optimization was conducted. RESULTS: The pharmacokinetics of efavirenz was characterized by a one-compartment model with first-order absorption and elimination. The typical values of the estimated apparent oral clearance, volume of distribution, and absorption rate constant in the final model were 9.44 L/h, 200 L, and 0.727 h - 1, respectively. Efavirenz clearance was significantly influenced by CYP2B6 variants, including rs2099361, rs3745274, and rs2279343, along with albumin and weight. The volume of distribution was affected by albumin and weight. Based on the CYP2B6 polymorphisms of patients, the recommended daily doses of efavirenz were 100 mg for CYP2B6 slow metabolizers, 400 or 600 mg for intermediate metabolizers, and 800 or 1000 mg for extensive metabolizers. CONCLUSIONS: Polymorphisms of CYP2B6, along with albumin and weight, resulted as the predictors of efavirenz pharmacokinetic variability, which could be used in prescribing optimal efavirenz doses.

External Evaluation of Vancomycin Population Pharmacokinetic Models at Two Clinical Centers.

Background: Numerous vancomycin population pharmacokinetic models in neonates have been published; however, their predictive performances remain unknown. This study aims to evaluate their external predictability and explore the factors that might affect model performance. Methods: Published population pharmacokinetic models in neonates were identified from the literature and evaluated using datasets from two clinical centers, including 171 neonates with a total of 319 measurements of vancomycin levels. Predictive performance was assessed by prediction- and simulation-based diagnostics and Bayesian forecasting. Furthermore, the effect of model structure and a number of identified covariates was also investigated. Results: Eighteen published pharmacokinetic models of vancomycin were identified after a systematic literature search. Using prediction-based diagnostics, no model had a median prediction error of ≤ ± 15%, a median absolute prediction error of ≤30%, and a percentage of prediction error that fell within ±30% of >50%. A simulation-based visual predictive check of most models showed there were large deviations between observations and simulations. After Bayesian forecasting with one or two prior observations, the predicted performance improved significantly. Weight, age, and serum creatinine were identified as the most important covariates. Moreover, employing a maturation model based on weight and age as well as nonlinear model to incorporate serum creatinine level significantly improved predictive performance. Conclusion: The predictability of the pharmacokinetic models for vancomycin is closely related to the approach used for modeling covariates. Bayesian forecasting can significantly improve the predictive performance of models.

High Job Burnout Predicts Low Heart Rate Variability in the Working Population after a First Episode of Acute Coronary Syndrome.

(1) Background: Job burnout may affect the prognosis of patients with acute coronary syndrome (ACS) through mechanisms involving heart rate variability (HRV). However, no study has yet examined those potential associations. Hence, we conducted the present study to investigate this issue. (2) Method: Participants included patients who presented with a first episode of ACS and who were employed. The Copenhagen Burnout Inventory (CBI) was used to assess job burnout. Twenty-four-hour ambulatory electrocardiography recorded HRV on four occasions, i.e., during the hospitalization and follow-ups at one, six, and 12 months, respectively. (3) Results: A total of 120 participants who at least completed three Holter examinations throughout the study were enrolled in the final analysis. Job burnout scores at baseline were inversely associated with LnSDNN, LnTP, LnHF, LnLF, LnULF, and LnVLF during the consequent one-year follow-up. Each 1 SD increase in job burnout scores predicted a decline ranging from 0.10 to 0.47 in the parameters described above (all p < 0.05), and all relationships were independent of numerous confounders, including anxiety and depression. (4) Conclusion: High job burnout predicted reduced HRV parameters during the one-year period post-ACS in the working population.

Population pharmacokinetics and individual analysis of daptomycin in kidney transplant recipients.

BACKGROUND: Little is known about the population pharmacokinetics (PPK) of daptomycin in kidney transplant patients. The present study established a pharmacokinetic model for daptomycin in kidney transplant patients in China and examinee the important factors affecting the pharmacokinetic parameters of daptomycin. METHODS: The study population included 49 kidney transplant patients with 537 daptomycin concentrations. The PPK model of daptomycin was developed using a nonlinear mixed-effects model, a two-compartment structural model, and a mixed residual error model. The stability and predictive ability of the final model were evaluated based on bootstrapping, visual prediction checks and normalized prediction distribution errors. RESULTS: Glomerular filtration rate (GFR) and total body weight significantly affected clearance, and body weight influenced the central volume of distribution. The average clearance of the population was 0.316 L/h, the central volume of distribution was 6.04 L, the intercompartmental clearance was 2.31 L/h, and the peripheral volume of distribution was 2.46 L. Based on the established model and the target of area under curve (AUC0-24h)/minimum inhibition concentration (MIC) ≥666, we developed a recommended dose regimen for kidney transplant patients according to their renal function and weight. The daily doses were 4.0±0.31, 4.7±0.36, 5.1±0.40, 5.5±0.43, 5.8±0.45, and 6.1±0.48 mg/kg when the GFRs were 15, 30, 45, 60, 75, and 90 ml/min/1.73 m2, respectively. CONCLUSION: This study provides a reference for individualized daptomycin administration in kidney transplant recipients, and it is a valuable resource for improving the treatment effect and reducing the toxic effects of daptomycin.