RESUMO
INTRODUCTION: Timing to resume feeds after percutaneous endoscopic gastrostomy (PEG) placement continues to vary among US trauma surgeons. The purpose of this study was to assess differences in meeting nutritional therapy goals and adverse outcomes with early versus late enteral feeding after PEG placement. METHODS: This retrospective review included 364 trauma and burn patients who underwent PEG placement. Data included patient characteristics, time to initiate feeds, rate feeds were resumed, % feed volume goals on postoperative days 0-7, and complications. Statistical analysis was performed comparing two groups (feeds ≤ 6 h versus > 6 h) and three subgroups (< 4 h, 4-6 h, ≥ 6 h) based on data quartiles. Chi-square/Fisher's exact test, independent-samples t-test, and one-way analysis of variance were used to analyze the data. RESULTS: Mean time to initiate feeds after PEG was 5.48 ± 4.79 h. Burn patients received early feeds in a larger proportion. A larger proportion of trauma patients received late feeds. The mean % of goal feed volume met on postoperative day 0 was higher in the early feeding group versus the late (P < 0.001). There were no differences in adverse events, even after subgroup analysis of those who received feeds < 4 h after PEG placement. CONCLUSIONS: Patients with early initiation of feeds after PEG placement achieve a higher percentage of goals on day 0 without an increased rate of adverse events. Unfortunately, patients routinely fall short of their target tube feeding goals.
Assuntos
Nutrição Enteral , Gastrostomia , Humanos , Queimaduras/cirurgia , Nutrição Enteral/métodos , Estudos Retrospectivos , Fatores de Tempo , Ferimentos e Lesões/cirurgiaRESUMO
Despite the well-documented safety concerns and effect on quality of life, there does not yet exist a wide-reaching framework that links the etiologies of swallowing disorders to the potential short- and long-term outcomes in the context of International Classification of Functioning, Disability and Health (ICF). This paper introduces an expert-reviewed conceptual framework to highlight common etiologies of dysphagia as well as integrate immediate outcomes of dysphagia with long-term outcomes of dysphagia in terms of medical problems, health-related quality of life, functional effect, and psychosocial features. It also outlines the potential cyclical nature of long-term dysphagia outcomes perpetuating the original dysphagia. This framework serves to inform clinicians of important dysphagic outcomes and to bring awareness to long-term outcomes that should be monitored by health care professionals, caregivers, or people with dysphagia.
RESUMO
As an alternative and complementary approach to Cas9-based genome editing, Cas12a has not been widely used in mammalian cells largely due to its strict requirement for the TTTV protospacer adjacent motif (PAM) sequence. Here, we report that Mb3Cas12a (Moraxella bovoculi AAX11_00205) can efficiently edit the mouse genome based on the TTV PAM sequence with minimal numbers of large on-target deletions or insertions. When TTTV PAM sequence-targeting CRISPR (cr)RNAs of 23 nt spacers are used, >70% of the founders obtained are edited. Moreover, the use of Mb3Cas12a tagged to monomeric streptavidin (mSA) in conjunction with biotinylated DNA donor template leads to high knock-in efficiency in two-cell mouse embryos, with 40% of founders obtained containing the desired knock-in sequences.
Assuntos
Repetições Palindrômicas Curtas Agrupadas e Regularmente Espaçadas , Edição de Genes , Animais , Sistemas CRISPR-Cas/genética , Camundongos , Moraxella , RNARESUMO
Comment on "A microRNA cluster in the Fragile-X region expressed during spermatogenesis targets FMR1" by Ramaiah et al.
Assuntos
MicroRNAs , Animais , Proteína do X Frágil da Deficiência Intelectual , Regulação da Expressão Gênica , Masculino , Camundongos , Espermatogênese , EspermatogôniasRESUMO
Autophagy plays critical roles in the maintenance of endothelial cells in response to cellular stress caused by blood flow. There is growing evidence that both cell adhesion and cell detachment can modulate autophagy, but the mechanisms responsible for this regulation remain unclear. Immunoglobulin and proline-rich receptor-1 (IGPR-1) is a cell adhesion molecule that regulates angiogenesis and endothelial barrier function. In this study, using various biochemical and cellular assays, we demonstrate that IGPR-1 is activated by autophagy-inducing stimuli, such as amino acid starvation, nutrient deprivation, rapamycin, and lipopolysaccharide. Manipulating the IκB kinase ß activity coupled with in vivo and in vitro kinase assays demonstrated that IκB kinase ß is a key serine/threonine kinase activated by autophagy stimuli and that it catalyzes phosphorylation of IGPR-1 at Ser220 The subsequent activation of IGPR-1, in turn, stimulates phosphorylation of AMP-activated protein kinase, which leads to phosphorylation of the major pro-autophagy proteins ULK1 and Beclin-1 (BECN1), increased LC3-II levels, and accumulation of LC3 punctum. Thus, our data demonstrate that IGPR-1 is activated by autophagy-inducing stimuli and in response regulates autophagy, connecting cell adhesion to autophagy. These findings may have important significance for autophagy-driven pathologies such cardiovascular diseases and cancer and suggest that IGPR-1 may serve as a promising therapeutic target.
Assuntos
Proteínas Quinases Ativadas por AMP/metabolismo , Autofagia , Antígenos CD28/metabolismo , Adesão Celular , Motivos de Aminoácidos , Animais , Autofagia/efeitos dos fármacos , Proteína Homóloga à Proteína-1 Relacionada à Autofagia/metabolismo , Proteína Beclina-1/metabolismo , Antígenos CD28/química , Antígenos CD28/genética , Adesão Celular/efeitos dos fármacos , Células HEK293 , Humanos , Quinase I-kappa B/deficiência , Quinase I-kappa B/genética , Quinase I-kappa B/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Lipopolissacarídeos/farmacologia , Microscopia de Fluorescência , Proteínas Associadas aos Microtúbulos/metabolismo , Fosforilação/efeitos dos fármacos , Primatas , RNA Guia de Cinetoplastídeos/metabolismo , Sirolimo/farmacologia , Especificidade por SubstratoRESUMO
Ceftriaxone, a regularly used antibiotic for broad-spectrum coverage, is a rare cause of hemolytic anemia. Patients may present with truncal pain, nausea, vomiting, and an acute drop in hemoglobin within 48 hours of administration. Prompt recognition and initiation of treatment are essential. We describe a case of a 65-year-old woman being treated for osteomyelitis who developed hemolytic anemia, disseminated intravascular coagulation, and multi-system organ failure after being de-escalated from cefepime to ceftriaxone.
RESUMO
Despite rapid evolution across eutherian mammals, the X-linked miR-506 family miRNAs are located in a region flanked by two highly conserved protein-coding genes (Slitrk2 and Fmr1) on the X chromosome. Intriguingly, these miRNAs are predominantly expressed in the testis, suggesting a potential role in spermatogenesis and male fertility. Here, we report that the X-linked miR-506 family miRNAs were derived from the MER91C DNA transposons. Selective inactivation of individual miRNAs or clusters caused no discernable defects, but simultaneous ablation of five clusters containing nineteen members of the miR-506 family led to reduced male fertility in mice. Despite normal sperm counts, motility and morphology, the KO sperm were less competitive than wild-type sperm when subjected to a polyandrous mating scheme. Transcriptomic and bioinformatic analyses revealed that these X-linked miR-506 family miRNAs, in addition to targeting a set of conserved genes, have more targets that are critical for spermatogenesis and embryonic development during evolution. Our data suggest that the miR-506 family miRNAs function to enhance sperm competitiveness and reproductive fitness of the male by finetuning gene expression during spermatogenesis.
RESUMO
Despite rapid evolution across eutherian mammals, the X-linked MIR-506 family miRNAs are located in a region flanked by two highly conserved protein-coding genes (SLITRK2 and FMR1) on the X chromosome. Intriguingly, these miRNAs are predominantly expressed in the testis, suggesting a potential role in spermatogenesis and male fertility. Here, we report that the X-linked MIR-506 family miRNAs were derived from the MER91C DNA transposons. Selective inactivation of individual miRNAs or clusters caused no discernible defects, but simultaneous ablation of five clusters containing 19 members of the MIR-506 family led to reduced male fertility in mice. Despite normal sperm counts, motility, and morphology, the KO sperm were less competitive than wild-type sperm when subjected to a polyandrous mating scheme. Transcriptomic and bioinformatic analyses revealed that these X-linked MIR-506 family miRNAs, in addition to targeting a set of conserved genes, have more targets that are critical for spermatogenesis and embryonic development during evolution. Our data suggest that the MIR-506 family miRNAs function to enhance sperm competitiveness and reproductive fitness of the male by finetuning gene expression during spermatogenesis.
Assuntos
MicroRNAs , Sêmen , Masculino , Animais , Camundongos , Sêmen/metabolismo , Espermatogênese/genética , Espermatozoides/metabolismo , Testículo/metabolismo , MicroRNAs/genética , MicroRNAs/metabolismo , Mamíferos/genéticaRESUMO
Preserving and regulating cellular homeostasis in the light of changing environmental conditions or developmental processes is of pivotal importance for single cellular and multicellular organisms alike. To counteract an imbalance in cellular homeostasis transcriptional programs evolved, called the heat shock response, unfolded protein response, and integrated stress response, that act cell-autonomously in most cells but in multicellular organisms are subjected to cell-nonautonomous regulation. These transcriptional programs downregulate the expression of most genes but increase the expression of heat shock genes, including genes encoding molecular chaperones and proteases, proteins involved in the repair of stress-induced damage to macromolecules and cellular structures. Sixty-one years after the discovery of the heat shock response by Ferruccio Ritossa, many aspects of stress biology are still enigmatic. Recent progress in the understanding of stress responses and molecular chaperones was reported at the 12th International Symposium on Heat Shock Proteins in Biology, Medicine and the Environment in the Old Town Alexandria, VA, USA from 28th to 31st of October 2023.
Assuntos
Proteínas de Choque Térmico , Medicina , Biologia , Proteínas de Choque Térmico/metabolismo , Resposta ao Choque Térmico/genética , Chaperonas Moleculares/metabolismoRESUMO
Background: Multi-voxel neuro-reinforcement has been shown to selectively reduce amygdala reactivity in response to feared stimuli, but the precise mechanisms supporting these effects are still unknown. The current pilot study seeks to identify potential intermediaries of change using functional brain connectivity at rest. Methods: Individuals (N = 11) diagnosed with at least two animal subtype specific phobias took part in a double-blind multi-voxel neuro-reinforcement clinical trial targeting one of two phobic animals, with the untargeted animal as placebo control. Changes in whole-brain resting state functional connectivity from pre-treatment to post-treatment were measured using group ICA. These changes were tested to see if they predicted the previously observed decreases in amygdala reactivity in response to images of target phobic animals. Results: A common functional connectivity network overlapping with the visual network was identified in resting state data pre-treatment and post-treatment. Significant increases in functional connectivity in this network from pre-treatment to post-treatment were found in higher level visual and cognitive processing regions of the brain. Increases in functional connectivity in these regions also significantly predicted decreases in task-based amygdala reactivity to targeted phobic animals following multi-voxel neuro-reinforcement. Specifically, greater increases of functional connectivity pre-treatment to post-treatment were associated with greater decreases of amygdala reactivity to target phobic stimuli pre-treatment to post-treatment. Conclusions: These findings provide preliminary evidence that multi-voxel neuro-reinforcement can induce persisting functional connectivity changes in the brain. Moreover, these changes in functional connectivity were not limited to the direct area of neuro-reinforcement, suggesting neuro-reinforcement may change how the targeted region interacts with other brain regions. Identification of these brain regions represent a first step towards explaining the underlying mechanisms of change in previous multi-voxel neuro-reinforcement studies. Future research should seek to replicate these effects in a larger sample size to further assess their role in the effects observed from multi-voxel neuro-reinforcement.
RESUMO
To date, close to 100 canonical monoclonal antibody drugs have been approved by the FDA; furthermore, a number of antibody-derived therapeutics in nontraditional formats have reached late development stages and the market, and many more are being evaluated in early-stage development. To better reflect this trend and to set up a framework for forward thinking, we herein introduce the concept of AntibodyPlus, embracing any therapeutics with an antibody component. AntibodyPlus therapeutics contain effector modules, in the form of small molecules, nucleic acids, proteins or even cells, to enhance their therapeutic activities against cancer, virus infection and other diseases. In this short review, we discuss historic perspective and current status of therapeutic antibody development, and the scope and categories of AntibodyPlus therapeutics along with their advantages, applications and challenges. We also present several examples that highlight their design principles, potentials and future trends.
RESUMO
The X-linked miR-465 cluster is highly expressed in the testis, sperm, newborn ovary, and blastocysts as well as in 8-16 cell embryos. However, the physiological role of the miR-465 cluster is still largely unknown. This study aims to dissect the role of the miR-465 cluster in murine development. Despite abundant expression in the testis, ablation of the miR-465 miRNA cluster using CRISPR-Cas9 did not cause infertility. Instead, a skewed sex ratio biased toward males (60% males) was observed among miR-465 KO mice. Further analyses revealed that the female conceptuses selectively degenerated as early as embryonic day 8.5 (E8.5). Small RNA deep sequencing, qPCR, and in situ hybridization analyses revealed that the miRNAs encoded by the miR-465 cluster were mainly localized to the extraembryonic tissue/developing placenta. RNA-seq analyses identified altered mRNA transcriptome characterized by the dysregulation of numerous critical placental genes, e.g., Alkbh1, in the KO conceptuses at E7.5. Taken together, this study showed that the miR-465 cluster is required for normal female placental development, and ablation of the miR-465 cluster leads to a skewed sex ratio with more males (~60%) due to selective degeneration and resorption of the female conceptuses.
Assuntos
MicroRNAs , Razão de Masculinidade , Animais , Feminino , Masculino , Camundongos , MicroRNAs/genética , Placenta/metabolismo , Gravidez , Testículo/metabolismo , TranscriptomaRESUMO
Thirty four (34) of the total US FDA approved 103 therapeutic antibody drugs, accounts for one third of the total approved mAbs, are formulated with high protein concentration (100 mg/mL or above) which are the focus of this article. The highest protein concentration of these approved mAbs is 200 mg/mL. The dominant administration route is subcutaneous (76%). Our analysis indicates that it may be rational to implement a platform formulation containing polysorbate, histidine and sucrose to accelerate high concentration formulation development for antibody drugs. Since 2015, the FDA approval numbers are significantly increased which account for 76% of the total approval numbers, i.e., 26 out of 34 highly concentrated antibodies. Thus, we believe that the high concentration formulations of antibody drugs will be the future trend of therapeutic antibody formulation development, regardless of the challenges of highly concentrated protein formulations.
RESUMO
Psychologists and philosophers who pose moral dilemmas to understand moral judgment typically specify outcomes as certain to occur in them. This contrasts with real-life moral decision-making, which is almost always infused with probabilities (e.g., the probability of a given outcome if an action is or is not taken). Seven studies examine sensitivity to the size and location of shifts in probabilities of outcomes that would result from action in moral dilemmas. We find that moral judgments differ between actions that result in an equal increase in probability of harm (equal size), but have different end-states (e.g., an increase in harm probability from 25% to 50% or from 50% to 75%). This deviation from expected value is robust under separate evaluation, and increases when the comparison between shifts is made explicit under simultaneous evaluation. Consistent with the centrality of perceived harm in some models of moral judgment, perceived harm partially mediates sensitivity to location of harm probability shift. Unlike for shifts in harm probabilities, participants are insensitive to the location of shifts in probability of beneficial outcomes. They are also insensitive to the location of shifts in probability of analogous monetary losses and gains, suggesting an asymmetry between harm and benefit in moral reasoning, as well as an asymmetry between moral and monetary decision-making more broadly. Implications for normative philosophical theory and moral psychological theory, as well as practical applications, are discussed.
Assuntos
Tomada de Decisões , Princípios Morais , Teoria Ética , Humanos , Julgamento , ProbabilidadeRESUMO
Diabetic cardiomyopathy (DCM) is a major cause of morbidity and mortality in diabetic patients. Reactive oxygen species (ROS) produced by oxidative stress play an important role in the development of DCM. DCM involves abnormal energy metabolism, thereby reducing energy production. Exercise has been reported to be effective in protecting the heart against ROS accumulation during the development of DCM. We hypothesize that the AMPK/PGC-1α axis may play a crucial role in exercise-induced bioenergetic metabolism and aerobic respiration on oxidative stress parameters in the development of diabetic cardiomyopathy. Using a streptozotocin/high-fat diet mouse to generate a diabetic model, our aim was to evaluate the effects of exercise on the cardiac function, mitochondrial oxidative capacity, mitochondrial function, and cardiac expression of PGC-1α. Mice fed a high-fat diet were given MO-siPGC-1α or treated with AMPK inhibitor. Mitochondrial structure and effects of switching between the Warburg effect and aerobic respiration were analysed. Exercise improved blood pressure and systolic dysfunction in diabetic mouse hearts. The beneficial effects of exercise were also observed in a mitochondrial function study, as reflected by an enhanced oxidative phosphorylation level, increased membrane potential, and decreased ROS level and oxygen consumption. On the other hand, depletion of PGC-1α attenuated the effects of exercise on the enhancement of mitochondrial function. In addition, PGC-1α may be responsible for reversing the Warburg effect to aerobic respiration, thus enhancing mitochondrial metabolism and energy homoeostasis. In this study, we demonstrate the protective effects of exercise on shifting energy metabolism from fatty acid oxidation to glucose oxidation in an established diabetic stage. These data suggest that exercise is effective at ameliorating diabetic cardiomyopathy by improving mitochondrial function and reducing metabolic disturbances.
Assuntos
Diabetes Mellitus Experimental , Diabetes Mellitus Tipo 2 , Cardiomiopatias Diabéticas , Mitocôndrias Cardíacas/fisiologia , Condicionamento Físico Animal , Proteínas Quinases Ativadas por AMP , Trifosfato de Adenosina/metabolismo , Animais , Pressão Sanguínea , Células Cultivadas , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/fisiopatologia , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/fisiopatologia , Cardiomiopatias Diabéticas/metabolismo , Cardiomiopatias Diabéticas/fisiopatologia , Metabolismo Energético , Glucose/metabolismo , Homeostase , Ácido Láctico/metabolismo , Masculino , Potencial da Membrana Mitocondrial , Camundongos Endogâmicos C57BL , Miócitos Cardíacos/metabolismo , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Função Ventricular EsquerdaRESUMO
We report experiments in which wavelength-parallel spectral polarimetry technology is used for measurement of the frequency-dependent polarization mode dispersion (PMD) vector. Experiments have been performed using either a grating spectral disperser, configured to provide 13.6 GHz spectral resolution over a 14 nm optical bandwidth, or a virtually imaged phased array spectral disperser, configured for 1.6 GHz spectral resolution over a 200 GHz band. Our results indicate that the spectral polarimetry data obtained via this approach are of sufficient quality to permit accurate extraction of the PMD spectrum. The wavelength-parallel spectral polarimetry approach allows data acquisition within a few milliseconds.
RESUMO
BACKGROUND: Transposable elements (TEs) make up > 50% of the human genome, and the majority of retrotransposon insertions are truncated and many are located in introns. However, the effects of retrotransposition on the host genes remain incompletely known. RESULTS: We report here that insertion of a chimeric L1 (cL1), but not IAP solo LTR, into intron 6 of Axin1 using CRIPSR/Cas9 induced the kinky tail phenotype with ~ 80% penetrance in heterozygous Axin cL1 mice. Both penetrant (with kinky tails) and silent (without kinky tails) Axin cL1 mice, regardless of sex, could transmit the phenotype to subsequent generations with similar penetrance (~ 80%). Further analyses revealed that a longer Axin1 transcript isoform containing partial cL1-targeted intron was present in penetrant, but absent in silent and wild type mice, and the production of this unique Axin1 transcript appeared to correlate with altered levels of an activating histone modification, H3K9ac. CONCLUSIONS: The mechanism for Axin cL1 mice is different from those previously identified in mice with spontaneous retrotransposition of IAP, e.g., Axin Fu and A vy , both of which have been associated with DNA methylation changes. Our data suggest that Axin1 locus is sensitive to genetic and epigenetic alteration by retrotransposons and thus, ideally suited for studying the effects of new retrotransposition events on target gene function in mice.
RESUMO
We demonstrate a Fourier pulse-shaper-based differential group delay (DGD) emulator which can be programmed to possess arbitrary user-specified frequency dependent DGD profile. The DGD produced can be up to 400ps range with <1ps accuracy. Generated frequency-dependent DGD profiles are in excellent agreement with numerical simulations.
RESUMO
We describe a novel wavelength-parallel polarimeter operating in the light-wave band that measures the complete state of polarization of 256 wavelengths in parallel within 20 ms (software-limited), with the potential for submillisecond operation. By use of fast switching ferroelectric liquid crystals in conjunction with an InGaAs arrayed detector, selection and wavelength-parallel detection of individual polarization components can be achieved within approximately 150 microseconds. This instrument offers unprecedented sensing capability that is relevant to the compensation of polarization-related impairments in high-speed light-wave communications.
RESUMO
Conifers possess inducible terpenoid defense systems. These systems are associated with the formation of traumatic resin ducts (TRD) and are underpinned by enhanced gene expression and activity of terpene synthases (TPS), enzymes responsible for oleoresin formation. We first determined that Sitka spruce (Picea sitchensis [Bong.] Carriere) had the capacity for TRD formation by mechanically wounding representative trees. We then proceeded to investigate whether the white pine weevil (Pissodes strobi Peck.), a stem-boring insect, can influence the expression of genes encoding monoterpene synthases (mono-tps) in Sitka spruce. We went on to compare this response with the effects of a simulated insect attack by drill wounding. A significant increase in mono-tps transcript level was observed in the leaders of lateral branches of weevil-attacked and mechanically wounded trees. In this study, weevils induced a more rapid enhancement of mono-tps gene expression. A full-length Sitka spruce mono-tps cDNA (PsTPS2) was isolated, expressed in Escherichia coli, and functionally identified as (-)-pinene synthase. The recombinant (-)-pinene synthase catalyzes the formation of (-)-alpha-pinene and (-)-beta-pinene, both of which are known constituents of stem oleoresin in Sitka spruce and increase in abundance after weevil attack. These data suggest that increased (-)-pinene synthase gene expression is an important element of the direct defense system deployed in Sitka spruce after insect attack.