Mechanism of voltage sensing in Ca2+- and voltage-activated K+ (BK) channels.

In neurosecretion, allosteric communication between voltage sensors and Ca2+ binding in BK channels is crucially involved in damping excitatory stimuli. Nevertheless, the voltage-sensing mechanism of BK channels is still under debate. Here, based on gating current measurements, we demonstrate that two arginines in the transmembrane segment S4 (R210 and R213) function as the BK gating charges. Significantly, the energy landscape of the gating particles is electrostatically tuned by a network of salt bridges contained in the voltage sensor domain (VSD). Molecular dynamics simulations and proton transport experiments in the hyperpolarization-activated R210H mutant suggest that the electric field drops off within a narrow septum whose boundaries are defined by the gating charges. Unlike Kv channels, the charge movement in BK appears to be limited to a small displacement of the guanidinium moieties of R210 and R213, without significant movement of the S4.

Expression of Hv1 proton channels in myeloid-derived suppressor cells (MDSC) and its potential role in T cell regulation.

Myeloid-derived suppressor cells (MDSC) are a heterogeneous cell population with high immunosuppressive activity that proliferates in infections, inflammation, and tumor microenvironments. In tumors, MDSC exert immunosuppression mainly by producing reactive oxygen species (ROS), a process triggered by the NADPH oxidase 2 (NOX2) activity. NOX2 is functionally coupled with the Hv1 proton channel in certain immune cells to support sustained free-radical production. However, a functional expression of the Hv1 channel in MDSC has not yet been reported. Here, we demonstrate that mouse MDSC express functional Hv1 proton channel by immunofluorescence microscopy, flow cytometry, and Western blot, besides performing a biophysical characterization of its macroscopic currents via patch-clamp technique. Our results show that the immunosuppression by MDSC is conditional to their ability to decrease the proton concentration elevated by the NOX2 activity, rendering Hv1 a potential drug target for cancer treatment.

The voltage sensor is responsible for ΔpH dependence in Hv1 channels.

The dissipation of acute acid loads by the voltage-gated proton channel (Hv1) relies on regulating the channel's open probability by the voltage and the ΔpH across the membrane (ΔpH = pHex - pHin). Using monomeric Ciona-Hv1, we asked whether ΔpH-dependent gating is produced during the voltage sensor activation or permeation pathway opening. A leftward shift of the conductance-voltage (G-V) curve was produced at higher ΔpH values in the monomeric channel. Next, we measured the voltage sensor pH dependence in the absence of a functional permeation pathway by recording gating currents in the monomeric nonconducting D160N mutant. Increasing the ΔpH leftward shifted the gating charge-voltage (Q-V) curve, demonstrating that the ΔpH-dependent gating in Hv1 arises by modulating its voltage sensor. We fitted our data to a model that explicitly supposes the Hv1 voltage sensor free energy is a function of both the proton chemical and the electrical potential. The parameters obtained showed that around 60% of the free energy stored in the ΔpH is coupled to the Hv1 voltage sensor activation. Our results suggest that the molecular mechanism underlying the Hv1 ΔpH dependence is produced by protons, which alter the free-energy landscape around the voltage sensor domain. We propose that this alteration is produced by accessibility changes of the protons in the Hv1 voltage sensor during activation.

Size Matters: Free-Energy Calculations of Amino Acid Adsorption over Pristine Graphene.

There is still growing interest in graphene interactions with proteins, both for its possible biological applications and due to concerns over detrimental effects at the cellular level. As with any process involving proteins, an understanding of amino acid composition is desirable. In this work, we systematically studied the adsorption process of amino acids onto pristine graphene via rigorous free-energy calculations. We characterized the free energy, potential energy, and entropy of the adsorption of all proteinogenic amino acids. The energetic components were further separated into pair interaction contributions. A linear correlation was found between the free energy and the solvent accessible surface area change during adsorption (ΔSASAads) over pristine graphene and uncharged amino acids. Free energies over pristine graphene were compared with adsorption onto graphene oxide, finding an almost complete loss of the favorability of amino acid adsorption onto graphene. Finally, the correlation with ΔSASAads was used to successfully predict the free energy of adsorption of several penta-l-peptides in different structural states and sequences. Due to the relative ease of calculating the ΔSASAads compared to free-energy calculations, it could prove to be a cost-effective predictor of the free energy of adsorption for proteins onto nonpolar surfaces.

Health and economic impact associated with rheumatoid arthritis discharges: a cost analysis of a two-year cohort in Mexico.

BACKGROUND: Rheumatoid arthritis is a highly prevalent disease. Patients undergo various medical and pharmacological treatments, which have an economic impact on hospitals. The aim of this study was to estimate the direct economic costs of Mexican Social Security Institute (IMSS) resources used to provide healthcare to adult patients with rheumatoid arthritis in 2016-2017. METHODS: Data of patients aged > 18 years with Rheumatoid Arthritis (RA) were obtained from databases and public information sources to estimate the use of IMSS resources for the target population. Total costs were estimated by means of the macro-costing method, employing the diagnosis-related group (DRG). Each DRG of the IMSS was constructed with one of the diagnoses and the respective combination of clinical characteristics included in the ICD-9. This study was conducted from the national perspective of IMSS, the largest healthcare service administrator in the country. As such, it can be considered representative of the broader healthcare landscape in Mexico. RESULTS: The total cost per year of furnishing inpatient care to RA patients was found to be $170,099,794 MXN ($9,096,245.67 USD) for 2016 and $167,039,481 MXN ($8,932,592.57 USD) for 2017, implying an enormous economic impact on the government budget for Mexican public health services. CONCLUSIONS: Our results demonstrate that the direct costs of musculoskeletal and cardiovascular surgery represented the highest costs of RA in-hospital care at IMSS (the largest health institution in Mexico) in 2016 and 2017. Further studies are needed that include the cost of drugs and other indirect costs in addition to our results to get the most accurate approximation of the cost of living with RA.

Medical Devices with Embedded Sensor Systems: Design and Development Methodology for Start-Ups.

Embedded systems have become a key technology for the evolution of medical devices. However, the regulatory requirements that must be met make designing and developing these devices challenging. As a result, many start-ups attempting to develop medical devices fail. Therefore, this article presents a methodology to design and develop embedded medical devices while minimising the economic investment during the technical risk stages and encouraging customer feedback. The proposed methodology is based on the execution of three stages: Development Feasibility, Incremental and Iterative Prototyping, and Medical Product Consolidation. All this is completed in compliance with the applicable regulations. The methodology mentioned above is validated through practical use cases in which the development of a wearable device for monitoring vital signs is the most relevant. The presented use cases sustain the proposed methodology, for the devices were successfully CE marked. Moreover, ISO 13485 certification is obtained by following the proposed procedures.

Protein-Mediated Electroporation in a Cardiac Voltage-Sensing Domain Due to an nsPEF Stimulus.

This study takes a step in understanding the physiological implications of the nanosecond pulsed electric field (nsPEF) by integrating molecular dynamics simulations and machine learning techniques. nsPEF, a state-of-the-art technology, uses high-voltage electric field pulses with a nanosecond duration to modulate cellular activity. This investigation reveals a relatively new and underexplored phenomenon: protein-mediated electroporation. Our research focused on the voltage-sensing domain (VSD) of the NaV1.5 sodium cardiac channel in response to nsPEF stimulation. We scrutinized the VSD structures that form pores and thereby contribute to the physical chemistry that governs the defibrillation effect of nsPEF. To do so, we conducted a comprehensive analysis involving the clustering of 142 replicas simulated for 50 ns under nsPEF stimuli. We subsequently pinpointed the representative structures of each cluster and computed the free energy between them. We find that the selected VSD of NaV1.5 forms pores under nsPEF stimulation, but in a way that significant differs from the traditional VSD opening. This study not only extends our understanding of nsPEF and its interaction with protein channels but also adds a new effect to further study.

Trapping Charge Mechanism in Hv1 Channels (CiHv1).

The majority of voltage-gated ion channels contain a defined voltage-sensing domain and a pore domain composed of highly conserved amino acid residues that confer electrical excitability via electromechanical coupling. In this sense, the voltage-gated proton channel (Hv1) is a unique protein in that voltage-sensing, proton permeation and pH-dependent modulation involve the same structural region. In fact, these processes synergistically work in concert, and it is difficult to separate them. To investigate the process of Hv1 voltage sensor trapping, we follow voltage-sensor movements directly by leveraging mutations that enable the measurement of Hv1 channel gating currents. We uncover that the process of voltage sensor displacement is due to two driving forces. The first reveals that mutations in the selectivity filter (D160) located in the S1 transmembrane interact with the voltage sensor. More hydrophobic amino acids increase the energy barrier for voltage sensor activation. On the other hand, the effect of positive charges near position 264 promotes the formation of salt bridges between the arginines of the voltage sensor domain, achieving a stable conformation over time. Our results suggest that the activation of the Hv1 voltage sensor is governed by electrostatic-hydrophobic interactions, and S4 arginines, N264 and selectivity filter (D160) are essential in the Ciona-Hv1 to understand the trapping of the voltage sensor.

Mobile Health Technology in the Primary Prevention of Type 2 Diabetes: a Systematic Review.

PURPOSE OF REVIEW: The objective of this review was to summarize the current scientific evidence of mobile health technology in the primary prevention of type 2 diabetes in patients with prediabetes derived from randomized clinical trials. RECENT FINDINGS: Few randomized clinical trials are available using mobile health technologies in the prevention of type 2 diabetes. There is heterogeneity in regard to the main study outcomes, duration of interventions, and study findings. Inconsistent findings have been reported whether mobile health technologies are effective in reducing HbA1C levels or the incidence of type 2 diabetes in patients with prediabetes. However, results are promising that mobile health interventions may decrease body weight. Future study may consistently measure changes in glycemic indicators as well as develop elements that better address behavior changes.

On the effects of induced polarizability at the water-graphene interface via classical charge-on-spring models.

Molecular models of the water-graphene interaction are essential to describe graphene in condensed phases. Different challenges are associated with the generation of these models, in particular π-π and dispersion interactions; thus quantum and classical models have been developed and due to the numerical efficiency of the latter, they have been extensively employed. In this work, we have systematically studied, via molecular dynamics, two polarizable graphene models, denominated CCCP and CCCPD, employing the charge-on-spring model of the GROMOS forcefield, both being compatible with the polarizable water models COS/G2 and COS/D2, respectively. These models were compared with non-polarizable graphene and SPC water models. We focused the study on the water-graphene interface in two distinct systems and under the influence of an electric field: one composed of graphene immersed in water and the other composed of graphene with a water droplet above it. In the former, the orientation of water close to the graphene layer is affected by polarizable graphene in comparison to non-polarizable graphene. This effect is emphasised when an electric field is applied. In the latter, carbon polarizability reduced water contact angles, but graphene retained its hydrophobicity and the computed angles are within the experimental data. Given the significant extra computational cost, the use of polarizable models instead of the traditional fixed-charged approach for the graphene-water interaction may be justified when polarizability effects are relevant, for example, when applying relatively strong fields or in very anisotropic systems, such as the vacuum-bulk interface, as these models are more responsive to such conditions.

Embedded Sensor Systems in Medical Devices: Requisites and Challenges Ahead.

The evolution of technology enables the design of smarter medical devices. Embedded Sensor Systems play an important role, both in monitoring and diagnostic devices for healthcare. The design and development of Embedded Sensor Systems for medical devices are subjected to standards and regulations that will depend on the intended use of the device as well as the used technology. This article summarizes the challenges to be faced when designing Embedded Sensor Systems for the medical sector. With this aim, it presents the innovation context of the sector, the stages of new medical device development, the technological components that make up an Embedded Sensor System and the regulatory framework that applies to it. Finally, this article highlights the need to define new medical product design and development methodologies that help companies to successfully introduce new technologies in medical devices.

Aquaporin Gating: A New Twist to Unravel Permeation through Water Channels.

Aquaporins (AQPs) are small transmembrane tetrameric proteins that facilitate water, solute and gas exchange. Their presence has been extensively reported in the biological membranes of almost all living organisms. Although their discovery is much more recent than ion transport systems, different biophysical approaches have contributed to confirm that permeation through each monomer is consistent with closed and open states, introducing the term gating mechanism into the field. The study of AQPs in their native membrane or overexpressed in heterologous systems have experimentally demonstrated that water membrane permeability can be reversibly modified in response to specific modulators. For some regulation mechanisms, such as pH changes, evidence for gating is also supported by high-resolution structures of the water channel in different configurations as well as molecular dynamics simulation. Both experimental and simulation approaches sustain that the rearrangement of conserved residues contributes to occlude the cavity of the channel restricting water permeation. Interestingly, specific charged and conserved residues are present in the environment of the pore and, thus, the tetrameric structure can be subjected to alter the positions of these charges to sustain gating. Thus, is it possible to explore whether the displacement of these charges (gating current) leads to conformational changes? To our knowledge, this question has not yet been addressed at all. In this review, we intend to analyze the suitability of this proposal for the first time.

Entropy deepens loading chemical potentials of small alcohols by narrow carbon nanotubes.

Small alcohol confinement within narrow carbon nanotubes has been extensively and systematically studied via rigorous free-energy calculations. Employing molecular dynamics simulations, thermodynamic integration and thermodynamic cycling, the loading process of methanol and ethanol from aqueous solution into (6,6), (7,7) and (8,8) single-walled carbon nanotubes was computed and decomposed into its entropic and energetic terms. For all tubes and alcohols, loading is favoured from infinite dilution in water; for the same alcohol, wider tubes allow for the formation of a collective dipole which is cooperative in terms of electrostatics and reduce the rotational freedom of the loaded particles; narrow tubes only permit the formation of dipole-dipole dimers instead, with a (rotational) entropic gain that compensates for the loss of long-range dipole-dipole interactions. The latter renders deeper loading chemical potentials for narrower tubes when partitioning small alcohols from aqueous solution and it is a clear example of an entropy-energy compensation phenomenon.

Hospitalizations for viral respiratory infections in children under 2 years of age: epidemiology and in-hospital complications.

BACKGROUND: Viral respiratory infections (VRIs) are a frequent cause of hospitalization in children under 24 months of age. A history of prematurity or heart disease may be a risk factor for complications in patients hospitalized for VRI. The objective was to describe epidemiological data for children hospitalized for IRV and aged 1 to 24 months and to identify risk factors for the presence of in-hospital complications and mortality over a period of 5 years. METHODS: This was a cross-sectional study. Patients registered with VRI codes B974, J12, J120-J129X, J168, J17, J171, J178, J20, J203-J209, J21, J210, J211, J218, J219 (based on International Classification of Diseases [ICD-10]) from 2013 to 2017 were included. Three subanalyses were performed to compare [1] patients with pathological history (prematurity, bronchopulmonary dysplasia [BPD] and congenital heart disease [CHD]), [2] diagnoses (pneumonia, acute bronchitis, and acute bronchiolitis), and [3] admission to the pediatric intensive care unit. Days of hospital stay, in-hospital complications, invasive medical procedure and mortality were analyzed. STATISTICAL ANALYSIS: VRI hospitalization prevalence was described. For comparison between groups, Student's t-test, ANOVA and the Chi2 test were applied. To identify factors related to days of hospital stay, in-hospital complications and mortality, a linear and logistic regression model was performed. RESULTS: A total of 66,304 hospitalizations were reported. The average age was 14.7 weeks; hospitalization events were higher in winter (39%), followed by autumn (27.3%). A total of 371 (0.56%) patients died. A total of 7068 (10.6%) hospitalized patients with pathological histories were identified. The presence of BPD (coefficient = 1.6), CHD (coefficient = 1.2), diagnosis of pneumonia (coefficient = 1.2), in-hospital complications (coefficient = 2.1) and invasive medical procedures (coefficient = 15.7) were the most common factors that increased the length of hospital stay. Risk factors for in-hospital complications and mortality were invasive medical procedure (OR = 3.3 & 11.7), BPD (OR = 1.8 & 1.6), CHD (OR = 4.6 & 3.4) and diagnosis of pneumonia (OR = 1.8 & 4.2). CONCLUSIONS: Risk factors for morbidity and mortality in patients hospitalized for VRIs are BPD and CHD, diagnosis of pneumonia and invasive medical procedure.

Controlling ionic conductivity through transprotein electropores in human aquaporin 4: a non-equilibrium molecular-dynamics study.

Electroporation is a matter of intensive ongoing research interest, and a much-neglected topic in trans-membrane proteins, particularly in view of such promising potential applications in medicine and biotechnology. In particular, selected such novel and exciting applications are predicated on controlling ionic conductivity through electro-pores. Here, we scrutinise the mechanisms of ions' electric conductivity, by means of structural rearrangements, through quasi-stable electro-pores through human-AQP4 as a well-representative prototype of trans-membrane ionic conduction, achieving exquisite control over ionic permeability manipulated by the application of intense static electric fields.

Photovoltaic Energy Harvesting System Adapted for Different Environmental Operation Conditions: Analysis, Modeling, Simulation and Selection of Devices.

The present research work proposes a photovoltaic energy harvester and an appropriate direct current (DC)/DC converter for a harvesting system after the study of the devices and taking the operation conditions. Parameters such as power, efficiency and voltage are taken into account under different environment conditions of illumination and temperature in order to obtain the best possible response. For this reason, suitable metal-oxide semiconductor field-effect transistor (MOSFET), diode, coil, frequency, duty-cycle and load are selected and analyzed for a DC/DC converter with boost architecture.

Human aquaporin 4 gating dynamics under axially oriented electric-field impulses: A non-equilibrium molecular-dynamics study.

Human aquaporin 4 has been studied using non-equilibrium molecular dynamics simulations in the absence and presence of pulses of external electric fields. The pulses were 100 ns in duration and 0.005-0.015 V/Å in intensity acting along the pores' axes. Water diffusivity and the dipolar response of various residues of interest within the pores have been studied. Results show relatively little change in levels of water permeability per se within aquaporin channels during axially oriented field impulses, although care must be taken with regard to statistical certainty. However, the spatial variation of water permeability vis-à-vis electric-field intensity within the milieu of the channels, as revealed by heterogeneity in diffusivity-map gradients, indicates the possibility of somewhat enhanced diffusivity, owing to several residues being affected substantially by external fields, particularly for HIS 201 and 95 and ILE 93. This has the effect of increasing slightly intra-pore water diffusivity in the "pore-mouths" locale, albeit rendering it more spatially uniform overall vis-à-vis zero-field conditions (via manipulation of the selectivity filter).

Exploring the Membrane Potential of Simple Dual-Membrane Systems as Models for Gap-Junction Channels.

The conductance of ion channels can be modulated by a transmembrane potential difference, due to alterations on ion-mobility and also by changes in the pore structure. Despite the vast knowledge regarding the influence of voltage on transport properties of ion channels, little attention has been paid to describe, with atomic detail, the modulation of ionic transport in gap-junction channels (GJCs). Hence, molecular dynamics simulations were performed to explore the conductance of simple dual-membrane systems that account for the very basic features of GJCs. In doing so, we studied the influence of different charge distributions in the channel surface on these idealized systems under external electric fields, paying attention to the behavior of the electrostatic potential, ion density, ion currents, and equilibrium properties. Our results demonstrate that the incorporation of a charge distribution akin GJCs decreased anionic currents, favoring the transport of cationic species. Moreover, a thermodynamic characterization of ionic transport in these systems demonstrate the existence of a kinetic barrier that hinders anionic currents, reinforcing the role played by the internal arrangement of charges in GJCs. Overall, our results provide insights at the atomic scale on the effects of charge distributions over ionic transport, constituting a step forward into a better understanding of GJCs.

From dimers to collective dipoles: Structure and dynamics of methanol/ethanol partition by narrow carbon nanotubes.

Alcohol partitioning by narrow single-walled carbon nanotubes (SWCNTs) holds the promise for the development of novel nanodevices for diverse applications. Consequently, in this work, the partition of small alcohols by narrow tubes was kinetically and structurally quantified via molecular dynamics simulations. Alcohol partitioning is a fast process in the order of 10 ns for diluted solutions but the axial-diffusivity within SWCNT is greatly diminished being two to three orders of magnitude lower with respect to bulk conditions. Structurally, alcohols form a single-file conformation under confinement and more interestingly, they exhibit a pore-width dependent transition from dipole dimers to a single collective dipole, for both methanol and ethanol. Energetic analyses demonstrate that this transition is the result of a detailed balance between dispersion and electrostatics interactions, with the latter being more pronounced for collective dipoles. This transition fully modifies the reorientational dynamics of the loaded particles, generating stable collective dipoles that could find usage in signal-amplification devices. Overall, the results herein have shown distinct physico-chemical features of confined alcohols and are a further step towards the understanding and development of novel nanofluidics within SWCNTs.

Near-microsecond human aquaporin 4 gating dynamics in static and alternating external electric fields: Non-equilibrium molecular dynamics.

An extensive suite of non-equilibrium molecular-dynamics simulation has been performed for ∼0.85-0.9 µs of human aquaporin 4 in the absence and presence of externally applied static and alternating electric fields applied along the channels (in both axial directions in the static case, taken as the laboratory z-axis). These external fields were of 0.0065 V/Å (r.m.s.) intensity (of the same order as physiological electrical potentials); alternating fields ranged in frequency from 2.45 to 500 GHz. In-pore gating dynamics was studied, particularly of the relative propensities for "open" and "closed" states of the conserved arginines in the arginine/aromatic area (itself governed in no small part by external-field response of the dipolar alignment of the histidine-201 residue in the selectivity filter). In such a manner, the intimate connection of field-response governing "two-state" histidine states was established statistically and mechanistically. Given the appreciable size of the energy barriers for histidine-201 alignment, we have also performed non-equilibrium metadynamics/local-elevation of static fields applied along both directions to construct the free-energy landscape thereof in terms of external-field direction, elucidating the importance of field direction on energetics. We conclude from direct measurement of deterministic molecular dynamics in conjunction with applied-field metadynamics that the intrinsic electric field within the channel points along the +z-axis, such that externally applied static fields in this direction serve to "open" the channel in the selectivity-filter and the asparagine-proline-alanine region.