Ginseng-derived panaxadiol ameliorates STZ-induced type 1 diabetes through inhibiting RORγ/IL-17A axis.

Retinoic-acid-receptor-related orphan receptor γ (RORγ) is a major transcription factor for proinflammatory IL-17A production. Here, we revealed that the RORγ deficiency protects mice from STZ-induced Type 1 diabetes (T1D) through inhibiting IL-17A production, leading to improved pancreatic islet ß cell function, thereby uncovering a potential novel therapeutic target for treating T1D. We further identified a novel RORγ inverse agonist, ginseng-derived panaxadiol, which selectively inhibits RORγ transcriptional activity with a distinct cofactor recruitment profile from known RORγ ligands. Structural and functional studies of receptor-ligand interactions reveal the molecular basis for a unique binding mode for panaxadiol in the RORγ ligand-binding pocket. Despite its inverse agonist activity, panaxadiol induced the C-terminal AF-2 helix of RORγ to adopt a canonical active conformation. Interestingly, panaxadiol ameliorates mice from STZ-induced T1D through inhibiting IL-17A production in a RORγ-dependent manner. This study demonstrates a novel regulatory function of RORγ with linkage of the IL-17A pathway in pancreatic ß cells, and provides a valuable molecule for further investigating RORγ functions in treating T1D.

Influence of Huangqin Decoction on the immune function and fecal microbiome of chicks after experimental infection with Escherichia coli O78.

Huangqin Decoction (HQD), a traditional Chinese medicine formula from the Shang Han Lun written by Zhang Zhongjing, has been used in China for nearly two thousand years. According to the traditional Chinese medicine and previous literature, HQD has the effect of clearing heat, removing toxins, relieving diarrhea and pain. Therefore, HQD was used to prevent or cure many diseases, such as inflammation, diarrhea, malaria, and other acute or chronic gastrointestinal diseases. The effect of HQD, one-herb-absent HQD treatments and enrofloxacin (ENR) on the average daily gain (ADG), mortality rates, visceral index and toll-like receptors (TLRs), inflammatory factors and intestinal microflora in E. coli O78-inoculated chicks were investigated. HQD supplementation increased ADG and reduced the mortality rates caused by E. coli challenge, decreased the heart, liver, bursa of Fabricius (BF) and spleen index. HQD supplementation decreased the serum lysozyme (LZM), IL-1ß, TNF-α, IL-10, IL-6 level, down-regulated the mRNA expression of TLR4, -5 and -15 in the spleen by E. coli challenged chicks, and up-regulated the mRNA expression of TLR4, -5 and -15 in BF. At the phylum level, HQD supplementation reversed the increase of Operational Taxonomic Unit (OTUs), decreased the relative abundance of harmful bacteria Proteobacteria, increased the relative abundance of probiotic bacteria Bacteroidetes and Firmicutes. At the genus level, HQD decreased the relative abundance of harmful bacteria Escherichia-Shigella and Pseudomonas. It means that HQD treatment reversed the change of the gut microbiota structure. Compared with HQD, HQD-DZ and HQD-HQ increased the mortality rates. HQD-HQ decreased the ADG and liver index. HQD-GC decreased the spleen index. All herb-absent increased the serum IL-6, but only the HQD-HQ and HQD-SY increased the serum TNF-α. All herb-absent did not activate the TLRs signaling pathways in spleen and BF of chicks. The harmful bacteria Escherichia-Shigella were increased in HQD-HQ and HQD-DZ treatments. HQD-DZ treatment also increased the level of Proteobacteria. The results showed that dietary supplementation with HQD, by down-regulating the mRNA expression of TLR4, -5 and -15 in the spleen, further decreasing the serum LZM and IL-1ß, TNF-α, IL-10, IL-6 level, improves the immune function and reverses the change of fecal microbiome in chicks challenged with E. coli. In herb-absent supplementation, the results showed that SY and DZ play a key role in reducing the levels of inflammatory factors and keeping fecal microbiome balance respectively. More importantly, HQ is indispensable in HQD, not only play a key role in reducing the level of inflammatory factors, but also in keeping the balance of fecal microflora.

Spiritual distress of patients living with cancer in Northern Vietnam.

BACKGROUND: Literature on the spirituality of cancer patients has been mainly focused on the experiences of western patients. Few studies explore the experience of Asian cancer patients, while no spiritual study on cancer patients has been conducted in Vietnam. PURPOSE: The purpose of this study was to survey the spiritual distress of cancer patients at two general hospitals in northern Vietnam. METHODS: This was a quantitative survey with a cross-sectional design. This study used purposive sampling with a fitting the inclusion criteria, alongside the Spiritual Distress Scale-Vietnam version (SDS-V). The data was collected by an investigator in two general hospitals in northern Vietnam. The study received approval from two research councils. RESULTS: The results demonstrated that the demographics of cancer patients in the study reflected the national data of Vietnam. Regarding the four exploratory dimensions, more than 50% of cancer patients expressed feeling hardship and sorrow, most did not feel loneliness, most patients reported a good relationship with others and God, while the majority of were afraid to discuss death. CONCLUSIONS: Due to impact of aging and poverty on the sample patients, further studies into the interconnectivity between economics and the spiritual health status of patients is recommended. Additionally, since the 132 Vietnamese cancer patients reported a positive relationship with others and God, healthcare professionals should study effective strategies to apply the above strengths in easing hardships for future cancer patients.

[The Effectiveness of a Mindfulness-Based Intervention in Reducing Relocation Anxiety and Promoting Adaptation in Older People With Diabetes].

BACKGROUND: Relocating from home to a long-term facility is frequently a stressful event for older persons with diabetes. Therefore, it is important that nurses have available an intervention program that effectively reduces relocation anxiety and promotes adaptation in this population. PURPOSE: To evaluate the effectiveness of a mindfulness-based intervention in reducing relocation anxiety and promoting adaptation in older persons with diabetes. METHODS: Four long-term care facilities in Kaohsiung City were selected as the study sites. Residents of these facilities who had diabetes and who had moved in within the previous year were recruited as participants using a simple random-sampling method. The experimental group (n = 34) received a 9-week mindfulness-based intervention and the control group (n = 32) received routine diabetes care and maintained their normal daily routine. Outcome measurements included a demographic datasheet, the Taiwanese version of the State Anxiety Inventory, and the individual mental factors subscale of the elderly adaptation problem scale. These measures were administered at baseline and upon completion of the intervention. RESULTS: Thirty participants in each group completed the study. The mean differences between the baseline and post-test scores in the experimental group for relocation anxiety (t = 5.15, p < .01) and adaptation (t = -5.57, p < .01) were both significant. Among the participants who tested positive for relocation anxiety at pretest (a mean score > 30.13; 83.3% of the participants), those in the experimental group reported a more significant decrease (p < .05) in relocation anxiety at posttest than their control group peers. Among the participants who tested as having poor adaptation pretest (a mean scores < 45.62; 71.7% of the participants), those in the experimental group reported a more significant improvement (p < .05) in adaptation at posttest than their control group peers. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The results indicate that the 9-week intervention has the potential to help older people with diabetes improve their relocation anxiety and adaptation. This study may be used as a reference to improve emotional distress among residents of long-term care facilities.

Effect of a mindfulness programme for long-term care residents with type 2 diabetes: A cluster randomised controlled trial measuring outcomes of glycaemic control, relocation stress and depression.

AIMS: The aim of this study was to determine physical, behavioural and psychosocial effects of a newly developed mindfulness programme for older adults with type 2 diabetes relocating to long-term care facility. BACKGROUND: Taiwan is viewed as an "aged society" with significant proportion of the population living in a long-term care facility. Approximately one third of residents living in long-term care facilities have been diagnosed with type 2 diabetes, and disruption to management of their glycaemic levels is at risk for up to one year after relocating to a long-term care facility. DESIGN: A cluster randomised controlled trial was used to examine the effects of a newly developed mindfulness programme on outcomes of glycaemic levels, relocation stress and depression. METHODS: A total of 140 participants were recruited from six long-term care facilities in Southern Taiwan. A mindfulness programme was delivered over 9 weeks and consisted of meditations, education and exercise techniques that were delivered by a Registered Nurse trained in mindfulness strategies. Participants in the control group received routine care as provided in the facilities, including routine check-ups at diabetes clinics as necessary. Data were analysed by Johnson-Neyman technique and generalised estimating equations. RESULTS: In total, 120 residents completed the study. The majority of patients were female (64.8%), and 83.5% of the sample were financially supported by their children. The results showed significant improvements in glycated haemoglobin (HbA1c), relocation stress (Wald χ2  = 78.91) and depression (Wald χ2  = 45.70) between groups. In the intervention group, the mean of HbA1c levels showed 16.4% reduction (Mean differences = 1.3; SD = 0.3). However, there were no significant differences in relocation stress and depression within groups. CONCLUSION: The results provided positive effects of the mindfulness programme for older people with diabetes moving into long-term care facilities. The programme will assist in future planning for diabetes care in long-term care facilities. IMPLICATIONS FOR PRACTICE: To incorporate the mindfulness program into existing diabetes education programs for older people living in LTCFs. Further investigation on the sustainability of the mindfulness program is warranted.

Investigation on Thermally Induced Efficiency Roll-Off: Toward Efficient and Ultrabright Quantum-Dot Light-Emitting Diodes.

Quantum-dot light-emitting diodes (QLEDs) with high brightness have potential application in lighting and display. The high brightness is realized at high current density (J). However, at high J, the efficiency drops significantly, thereby limiting the achievable brightness. This notorious phenomenon has been known as efficiency roll-off, which is likely caused by the Auger- and/or thermal-induced emission quenching. In this work, we show that the Joule heat generated during device operation significantly affects the roll-off characteristics of QLEDs. To realize ultrabright and efficient QLEDs, the thermal stability of QDs is improved by replacing the conventional oleic acid ligands with 1-dodecanethiol. By further using a substrate with high thermal conductivity, the Joule heat generated at high J is effectively dissipated. Because of the effective thermal management, thermal-induced emission quenching is significantly suppressed, and consequently, the QLEDs exhibit a high external quantum efficiency (EQE) of 16.6%, which is virtually droop-free over a wide range of brightness (e.g., EQE = 16.1% @ 105 cd/m2 and 140 mA/cm2). Moreover, due to the reduced efficiency roll-off and enhanced heat dissipation, the demonstrated QLEDs can be operated at a very high J up to 3885 mA/cm2, thus enabling the devices to exhibit a record-high brightness of 1.6 × 106 cd/m2 and a lumen density of 500 lm/cm2. Our work demonstrates the significance of thermal management for the development of droop-free and ultrabright QLED devices for a wide variety of applications including lighting, transparent display, projection display, outdoor digital signage, and phototherapy.

Study on the nutritional value and ruminal degradation characteristics of fermented waste vinegar residue by N. sitophila.

Chemical composition and rumen degradability of waste vinegar residue (WVR) as roughage feed used for mutton sheep were evaluated in this work. Compared with the unfermented WVR, the WVR fermented by N. sitophila had more (P < 0.01) ash, crude protein (CP), and true protein (TP), less (P < 0.01) ether extract (EE), and significantly more carotenoid by about 27 times. But the contents of dry matter (DM), crude fiber (CF), neutral detergent fiber (NDF), and acid detergent fiber (ADF) had no obvious differences (P > 0.05) between unfermented and fermented WVR. The results suggested that the nutritional value of fermented WVR was higher for mutton sheep as roughage feed than that of unfermented WVR. The effective degradability (ED) of DM was higher (P < 0.05) in sheep with fermented WVR-based diet. The ED of CP and NDF of fermented WVR was reduced (P < 0.01) compared with the unfermented WVR. The results further suggested that the fermentation improved the degradability of WVR, and the rumen degradability of protein by ruminal flora decreased in fermented WVR, saving more protein for the sheep post-ruminal digestion and absorption. Furthermore, the results presented here clearly indicated the potential of fermented WVR by N. sitophila as an unconventional and functional feedstuff with rich carotenoid for ruminants, which could reduce WVR discharge in vinegar brewing industry and improve ruminant production. This work laid a foundation for the development of ruminant carotenoid functional feed.

The effect of yoga exercise on improving depression, anxiety, and fatigue in women with breast cancer: a randomized controlled trial.

BACKGROUND: Depression, anxiety, and fatigue are among the most significant problems that influence the quality of life of patients with breast cancer who receive adjuvant chemotherapy. Although evidence has shown yoga to decrease anxiety, depression, and fatigue in patients with cancer, few studies on the effects of yoga have targeted patients with breast cancer. Yoga interventions should be tested to promote the psychological and physical health of women with breast cancer. PURPOSE: This study examines the effectiveness of an 8-week yoga exercise program in promoting the psychological and physical health of women with breast cancer undergoing adjuvant chemotherapy in terms of depression, anxiety, and fatigue. METHODS: A sample of 60 women with nonmetastatic breast cancer was recruited. Participants were randomly assigned into either the experimental group (n = 30) or the control group (n = 30). A 60-minute, twice-per-week yoga exercise was implemented for 8 weeks as the intervention for the participants in the experimental group. The control group received standard care only. RESULTS: Analysis using the Johnson-Neyman procedure found that the yoga exercise reduced overall fatigue and the interference of fatigue in everyday life for the experimental group participants. Significant reductions were obtained after 4 weeks of intervention participation for those experimental group patients with relatively low starting baseline values (baseline item mean value < 3.31 and 3.22, respectively) and after 8 weeks for most patients (approximately 75%) with moderate starting baseline values (baseline item mean value < 7.30 and 5.34, respectively). The 8-week intervention did not significantly improve the levels of depression (F = 1.29, p > .05) or anxiety (F = 2.7, p > .05). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The 8-week yoga exercise program developed in this study effectively reduced fatigue in patients with breast cancer but did not reduce depression or anxiety. Oncology nurses should strengthen their clinical health education and apply yoga to reduce the fatigue experienced by patients with breast cancer who undergo adjuvant chemotherapy.

[The use of music intervention in nursing practice for elderly dementia patients: a systematic review].

BACKGROUND: Although music therapy is now applied widely as an intervention for elderly dementia patients, the effectiveness of this therapy is not yet well understood. PURPOSE: This study conducts a systematic review of clinical studies that address the effectiveness of music therapy in elderly dementia patients. METHODS: Databases including MEDLINE, Cochrane Library, ProQuest, EBMR, CINAHL, and CEPS were searched for relevant articles published between 2004 and 2013 using the key words "music" or "music therapy" with "dementia". An initial 272 original articles were identified. Applying inclusion criteria and excluding duplications left 18 articles that used randomized controlled trials to assess the effectiveness of music therapy in elderly participants for further analysis and synthesis. RESULTS: Music therapy was found effective at improving cognitive functions, mental symptoms, and eating problems. However, this therapy was not found effective at improving irritable behavior. Type of music and method of presentation were the most important factors affecting results. Most studies (61.1%) used songs familiar to ÷ favored by the participants; most studies delivered 30-minute interventions twice weekly; and most studies used a therapy duration of 6 hours. Finally, most studies (77.8%) had music therapy sessions performed by either music therapists or trained healthcare providers. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This study supports that music therapy is an effective nursing intervention for elderly dementia patients. The authors hope that findings are a helpful reference for clinical nurses to develop practical music therapy procedures and protocols.

Zinc deficiency increases platelet oxidative stress in nephrectomized rats.

We previously reported that reduced platelet endogenous antioxidant enzymes activities are related to the low plasma zinc level in patients with end-stage renal failure (ESRF). In this study, we attempt to evaluate whether dietary zinc deprivation reduces the activities of endogenous antioxidant and then enhances oxidative stress in the unstimulated platelet of normal and 5/6 nephrectomized (Nx) rats because increased platelet oxidative stress is suggested to involve in the incidence of thrombotic and atherosclerotic diseases. Male Sprague-Dawley rats (n = 48) were fed a zinc-deficient diet and deionized distilled water for 1 week to induce reduction of plasma zinc level. Half of the rats continued on this diet for 4 weeks as zinc-deplete group, and the other half were maintained on the same diet but with zinc-supplemented water (120 mg/L zinc sulfate solution) to correct the reduction of plasma zinc level as zinc-replete group. Half of each group underwent 5/6 Nx, while the other half underwent sham operation. Another 12 normal rats were fed standard rat chow (containing 23.4% protein and 50 ppm zinc) and drank deionized distilled water as normal control rats. In zinc-deplete rats including sham-operated and 5/6 Nx rats exhibited lower endogenous antioxidant enzymes activities such as reduced glutathione (GSH), superoxide dismutase (SOD), and glutathione peroxidase (GPX) and higher malondialdehyde (MDA) levels than normal control rats in the unstimulated platelets. However, in zinc-replete rats including sham-operated and 5/6 Nx rats have a normal endogenous antioxidant enzymes activity and normal MDA levels in the unstimulated platelets. We suggest that in uremia, the low plasma zinc level may be a risk factor for thrombotic and atherosclerotic diseases because it reduces the activities of endogenous antioxidant enzymes and increases oxidative stress in the unstimulated platelet.

Absent effect of zinc deficiency on the oxidative stress of erythrocytes in chronic uremic rats.

Both anemia and zinc deficiency are commonly observed in patients with chronic uremia. Oxidative stress of red blood cells (RBC) has been suggested to participate in the development of anemia in these patients with chronic uremia due to reduced life span of RBC. Whether zinc deficiency aggravates the effect of oxidative stress on RBC of chronic uremia is still not understood. We thus performed the study to determine the influence of zinc deficiency on the oxidative stress of RBC in uremic rats. Zinc deficiency was induced by long-term dietary zinc deficiency. Five-sixth nephrectomy (5/6 Nx) was used to produce chronic uremia. Experiment was carried out in the following five groups: normal control (NL), chronic uremia (Nx), chronic uremia + dietary zinc deficiency (Nx-D), Nx-D + zinc supplement (Nx-DZ) and Chronic uremia + pair-fed (Nx-PF). Osmotic fragility and lipid peroxidation of RBC were used to evaluate the oxidative stress of RBC. Five weeks after 5/6 nephrectomy (Nx), 5/6 Nx rats present a syndrome of uremia to elevate the levels of plasma creatinine and urea, and reduce the level of plasma zinc (1.12 +/- 0.08 vs 1.35 +/- 0.05 ug/ml). But they does not find to produce anemia and to increase osmotic fragility and lipid peroxidation in RBC. Dietary zinc deficiency in Nx-D group produced severe anorexia and reduced plasma zinc and selenium levels and the activity of RBC-GPX. Yet in Nx-D rats, osmotic fragility and susceptibility of lipid peroxidation in red cells did not increase, because of the increase of plasma copper level (1.85 +/- 0.3 vs 1.41 +/- 0.05 microg/ml) and RBC-SOD activity (1.95 +/- 0.27 vs 0.78 +/- 0.05 unit/g Hb). Zinc supplement in Nx-D rats (Nx-DZ group) recovered the appetite and normalized the levels of plasma zinc, copper and selenium. Food restriction in 5/6 Nx rats (Nx-PF group) decreased plasma copper level and increased osmotic fragility of RBC and elevated the susceptibility of lipid peroxidation after stressing RBC with H2O2 Because Nx-PF rats presented a lower RBC-SOD activity (0.44 +/- 0.11 vs 0.78 +/- 0.05 unit/g Hb) and a lower plasma copper level. We further found a positive relationship (r=0. 802,p<0.01) between plasma copper level and RBC-SOD activity in normal and uremic rats. This study suggests that RBC-SOD activity may play an important role in preventing RBC oxidative stress. Plasma copper level may be a marker of RBC-SOD activity. We conclude, in chronic uremia, zinc deficiency doses not result in RBC oxidative stress as plasma copper level is normal, but may affect the absorption of intestinal nutrition.