An acute eccentric exercise increases circulating myomesin 3 fragments

Discovery of blood biomarkers to evaluate exercise-induced muscle damage have attracted many researchers and coaches. This study aimed to determine changes in circulating myomesin 3 fragments as a novel biomarker for exercise-induced muscle damage. Nine healthy males performed 10 sets of 40 repetitions of one-leg calf-raise exercise by the load corresponding to the half of their body weight. Muscle symptoms were evaluated by a visual analog scale (VAS). Blood samples were collected before and 2, 4, 24, 48, 72, and 96 h post-exercise. Plasma myomesin 3 fragments levels were significantly increased at 96 h after the eccentric exercise. The myomesin 3 fragments levels were correlated with other biomarkers of muscle damage and the muscle symptoms. These results suggest that the circulating myomesin 3 fragments levels are potential biomarkers reflecting eccentric exercise-induced muscle damage.

Development and Validation of a Multidimensional Frailty Scale for Clinical Geriatric Assessment

OBJECTIVES

This study aims to develop a multidimensional frailty assessment tool including physical, psychological, and social frailty and to examine its psychometric property in a clinical setting.

METHODS

Through a literature review and gathered expert perspectives, the Korean Frailty Scale (KFS, 0-6 points) was developed with six questions about weight loss, self-assessment of health status, energy loss, fatigue, social network, and support. The psychometric property was then validated in community-dwelling older adults using the Korean Frailty and Aging Cohort Survey (2016-2019). Receiver operator characteristic (ROC) analyses determined optimal cutoff scores for frail, pre-frail, and robust. The predictive validity for mortality, hospitalization, fall events, and disability, such as declines in activities of daily living (ADL) and instrumental activities of daily living (IADL) was assessed after adjusting for age, sex, education level, household income, body-mass index, smoking status, alcohol consumption, physical activity, marital status, current employment, and residence.

RESULTS

The 2,923 participants (mean age: 76.0±3.9 years, female: 52.2%) were categorized into frail (≥3 points, 21.1%), pre-frail (1-2 points, 50.2%) and robust (0 points, 28.7%) groups. Sensitivity (88.3%), specificity (91.6%), and the area under the ROC curve (0.730) for the frail group were sufficient to be accepted as a new frailty scale. The frail group had increased risk of falling (relative risk [RR]: 1.810, 95% confidence interval: 1.354-2.420), mortality (hazard ratio, 6.596, 1.802-24.137), and IADL decline (RR, 1.638, 1.231-2.178).

CONCLUSION

The KFS is a new multidimensional frailty scale for clinical geriatric assessment that was confirmed as effective for predicting adverse health outcomes in Korean community-dwelling older adults.

Spatial Distribution and Prognostic Implications of Tumor-Infiltrating FoxP3- CD4+ T Cells in Biliary Tract Cancer

PURPOSE

The clinical implications of tumor-infiltrating T cell subsets and their spatial distribution in biliary tract cancer (BTC) patients treated with gemcitabine plus cisplatin were investigated.

MATERIALS AND METHODS

A total of 52 BTC patients treated with palliative gemcitabine plus cisplatin were included. Multiplexed immunohistochemistry was performed on tumor tissues, and immune infiltrates were separately analyzed for the stroma, tumor margin, and tumor core.

RESULTS

The density of CD8+ T cells, FoxP3- CD4+ helper T cells, and FoxP3+ CD4+ regulatory T cells was significantly higher in the tumor margin than in the stroma and tumor core. The density of LAG3- or TIM3-expressing CD8+ T cell and FoxP3- CD4+ helper T cell infiltrates was also higher in the tumor margin. In extrahepatic cholangiocarcinoma, there was a higher density of T cell subsets in the tumor core and regulatory T cells in all regions. A high density of FoxP3- CD4+ helper T cells in the tumor margin showed a trend toward better progression-free survival (PFS) (p=0.092) and significantly better overall survival (OS) (p=0.012). In multivariate analyses, a high density of FoxP3- CD4+ helper T cells in the tumor margin was independently associated with favorable PFS and OS.

CONCLUSION

The tumor margin is the major site for the active infiltration of T cell subsets with higher levels of LAG3 and TIM3 expression in BTC. The density of tumor margin-infiltrating FoxP3- CD4+ helper T cells may be associated with clinical outcomes in BTC patients treated with gemcitabine plus cisplatin.

Consensus on Components of Frailty Using the Delphi Method: Korean Frailty and Aging Cohort Study

BACKGROUND

The concept of frailty has been suggested to comprise physical, mental, and social phenotypes. However, there is no general consensus about the appropriate components for assessing frailty.

OBJECTIVES

The purpose of this study was to reach consensus on components of frailty assessment using the Delphi process.

METHODS

To achieve consensus on the definition of frailty, a modified Delphi method was used. Geriatric and gerontologic experts were selected from various fields. The detailed components of frailty were composed of data from the Korean Frailty and Aging Cohort Study. Establishing consensus and collecting opinions from experts were conducted using a modified Delphi method.

RESULTS

Overall, nine domains with 14 components of frailty assessment were accepted. There was consensus on the necessity of a broad phenotype including physical, mental, and social frailty.

CONCLUSIONS

Consensus on the components of a frailty assessment in a clinical setting is achieved through the Delphi process to establish a new tool of frailty assessment.

E-cigarettes and health risks: more to the flavor than just the name

The growing interest in regulating flavored E-liquids must incorporate understanding of the "flavoring profile" of each E-liquid-which flavorings (flavoring chemicals) are present and at what concentrations not just focusing on the flavor on the label. We investigated the flavoring profile of 10 different flavored E-liquids. We assessed bronchial epithelial cell viability and apoptosis, phagocytosis of bacteria and apoptotic cells by macrophages after exposure to E-cigarette vapor extract (EVE). We validated our data in normal human bronchial epithelial cells (NHBE) and alveolar macrophages (AM) from healthy donors. We also assessed cytokine release and validated in the saliva from E-cigarette users. Increased necrosis/apoptosis (16.1-64.5% apoptosis) in 16HBE cells was flavor dependent, and NHBEs showed an increased susceptibility to flavors. In THP-1 differentiated macrophages phagocytosis was also flavor dependent, with AM also showing increased susceptibility to flavors. Further, Banana and Chocolate were shown to reduce surface expression of phagocytic target recognition receptors on alveolar macrophages. Banana and Chocolate increased IL-8 secretion by NHBE, whereas all 4 flavors reduced AM IL-1β secretion, which was also reduced in the saliva of E-cigarette users compared with healthy controls. Flavorant profiles of E-liquids varied from simple 2 compound mixtures to complex mixtures containing over a dozen flavorants. E-liquids with high benzene content, complex flavoring profiles, high chemical concentration had the greatest impacts. The Flavorant profile of E-liquids is key to disruption of the airway status quo by increasing bronchial epithelial cell apoptosis, causing alveolar macrophage phagocytic dysfunction, and altering airway cytokines.

Clinical features and predictors of masked uncontrolled hypertension: from Korean ambulatory blood pressure monitoring (Korabp) registry

Background

Clinical characteristics of patients with masked uncontrolled hypertension (MUCH) are poorly defined, and few studies have reported on clinical predictors of MUCH. We investigated demographic, lifestyle, clinical and blood pressure (BP) characteristics in patients with MUCH and proposed a prediction model for MUCH.

Method

We analyzed 2044 subjects taking antihypertensive medication enrolled in the Korean Ambulatory Blood Pressure Monitoring (Kor-ABP) registry, who were categorized into controlled hypertension (n=481, normal office BP, normal 24-hour ABP), pseudo-uncontrolled hypertension (n=131, high office BP, normal 24-hour ABP), MUCH (n=380, normal office BP, high 24-hour ABP), and sustained uncontrolled hypertension (n=1,052; high office BP and high 24-hour ABP).

Result

The prevalence of MUCH increased with office systolic BP (SBP) and diastolic BP (DBP), whereas it was not associated with the numbers of antihypertensive drugs. But in patients with a high office SBP (≥130 mmHg), the prevalence of MUCH increased with decreasing numbers of antihypertensive drugs (interaction p=0.008; Figure 1A). Multiple logistic regression analysis identified high office SBPs and DBPs, prior stroke, dyslipidemia and single anti-hypertensive agent use as independent predictors of MUCH (Table 1). A prediction model using these predictors showed a high diagnostic accuracy (C-index 0.833) and a goodness of fit for the presence of MUCH (Figure 1B).

Conclusion

MUCH is associated with the borderline increase in office BP and the underuse of anti-hypertensive drugs as well as dyslipidemia and prior stroke, which underscores the importance of achieving the optimal BP control level in the high risk patients. The proposed model would accurately predict MUCH in patients with controlled office BP.

Figure 1

Funding Acknowledgement

Type of funding source: None

Abrupt CO2 release to the atmosphere under glacial and early interglacial climate conditions

Pulse-like carbon dioxide release to the atmosphere on centennial time scales has only been identified for the most recent glacial and deglacial periods and is thought to be absent during warmer climate conditions. Here, we present a high-resolution carbon dioxide record from 330,000 to 450,000 years before present, revealing pronounced carbon dioxide jumps (CDJ) under cold and warm climate conditions. CDJ come in two varieties that we attribute to invigoration or weakening of the Atlantic meridional overturning circulation (AMOC) and associated northward and southward shifts of the intertropical convergence zone, respectively. We find that CDJ are pervasive features of the carbon cycle that can occur during interglacial climate conditions if land ice masses are sufficiently extended to be able to disturb the AMOC by freshwater input.

Lymph node size and its association with nodal metastasis in ductal adenocarcinoma of the pancreas

Background

Although lymph node metastasis is a poor prognostic factor in patients with pancreatic ductal adenocarcinoma (PDAC), our understanding of lymph node size in association with PDAC is limited. Increased nodal size in preoperative imaging has been used to detect node metastasis. We evaluated whether lymph node size can be used as a surrogate preoperative marker of lymph node metastasis.

Methods

We assessed nodal size and compared it to the nodal metastatic status of 200 patients with surgically resected PDAC. The size of all lymph nodes and metastatic nodal foci were measured along the long and short axis, and the relationships between nodal size and metastatic status were compared at six cutoff points.

Results

A total of 4,525 lymph nodes were examined, 9.1% of which were metastatic. The mean size of the metastatic nodes (long axis, 6.9±5.0 mm; short axis, 4.3±3.1 mm) was significantly larger than that of the non-metastatic nodes (long axis, 5.0±4.0 mm; short axis, 3.0±2.0 mm; all p<.001). Using a 10 mm cutoff, the sensitivity, specificity, positive predictive value, overall accuracy, and area under curve was 24.8%, 88.0%, 17.1%, 82.3%, and 0.60 for the long axis and 7.0%, 99.0%, 40.3%, 90.6%, and 0.61 for the short axis, respectively.

Conclusions

The metastatic nodes are larger than the non-metastatic nodes in PDAC patients. However, the difference in nodal size was too small to be identified with preoperative imaging. The performance of preoperative radiologic imaging to predict lymph nodal metastasis was not good. Therefore, nodal size cannot be used a surrogate preoperative marker of lymph node metastasis.

Maturation of the Human Cerebral Cortex During Adolescence: Myelin or Dendritic Arbor?

Previous in vivo studies revealed robust age-related variations in structural properties of the human cerebral cortex during adolescence. Neurobiology underlying these maturational phenomena is largely unknown. Here we employ a virtual-histology approach to gain insights into processes associated with inter-regional variations in cortical microstructure and its maturation, as indexed by magnetization transfer ratio (MTR). Inter-regional variations in MTR correlate with inter-regional variations in expression of genes specific to pyramidal cells (CA1) and ependymal cells; enrichment analyses indicate involvement of these genes in dendritic growth. On the other hand, inter-regional variations in the change of MTR during adolescence correlate with inter-regional profiles of oligodendrocyte-specific gene expression. Complemented by a quantitative hypothetical model of the contribution of surfaces associated with dendritic arbor (1631 m2) and myelin (48 m2), these findings suggest that MTR signals are driven mainly by macromolecules associated with dendritic arbor while maturational changes in the MTR signal are associated with myelination.

0413 The Influence of Community Environment Exposure and Individual Health Behavior on Insufficient Sleep

Introduction

Short sleep duration is associated with the risk of various chronic diseases, and it has been hypothesized to influence health behaviors and environmental exposure such as green space and noise. However, little studies have explored this relationship, especially with the consideration of the integrated environment information. The purpose of this study is to examine the influence of environmental exposure and individuals’ health behavior on sleep duration.

Methods

We examined aggregate national-level datasets regarding health information, noise, and green space. Sleep, health behavior, and socio-demographic variables were derived from 500 cities data, and the unit of analysis was the prevalence of each variable in the census tract. The insufficient sleep was calculated by the percentage of the population who had less than 7 hours of sleep in the census block. Spatial analysis was performed for green space and noise measurement; both values were calculated within the community activity space, which is a combined area with the census urban area and census place to examine the potential activity space. Multiple linear regression analysis was performed to model the relationship.

Results

The final sample was 29,610 census tracts from 497 cities, and the average median age of each census tract was 36.02±7.085. 36.64% of insufficient sleep was reported from the entire sample. The model (R2=0.804) indicate that green space (β=-.053, p&lt;.001) and natural noise (β=-.029, p&lt;.001) has negatively associated with insufficient sleep; while, smoker (β=.374, p&lt;.001), binge drinker (β=.105, p&lt;.001), no leisure physical activity time (β=.111, p&lt;.001), and artificial noise (β=.034, p&lt;.001) has positive association with insufficient sleep.

Conclusion

The results indicate that a better environment source in the community mitigates the insufficient sleep population as well as individual health behavior. Further studies are needed, however, to fully disentangle the association between sleep duration and sleep quality associated with other environmental exposure.

Support

N/A

0379 Green Space Exposure and Sleep Duration Among Supplemental Nutrition Assistance Program Participants

Introduction

Emerging empirical evidence suggests green space exposure is protective against insufficient sleep. Limited studies exist, however, exploring the relationship between greenspace exposure and sleep among low income populations in the United States.

Methods

Using a sample of Supplemental Nutrition Assistance Program (SNAP) participants (n=104) recruited from Champaign County, Illinois, we examined the relationship between self-reported sleep duration and exposure to green space. Sleep duration was determined using the question, “On average, how many hours did you sleep each night during the past 4 weeks?” Green space exposure was determined using satellite imagery from the National Aeronautic Space Administration (NASA) normalized difference vegetation index (NDVI). An NDVI score was assigned to each participant based on residential geo-referenced data. Multiple linear regression was performed in SPSS to explore the relationship between self-reported sleep duration and green space.

Results

Higher number of hours of sleep within a 24-hour period was positively associated with higher scores for greenspace exposure (β=0.091, P=0.02), controlling for age, gender, smoking status, education, alcohol consumption, and sleep quality. Sleep duration was negatively associated with age (β=-0.03, P=0.007), but positively associated with sleep quality (β=0.856, P=0.008).

Conclusion

In a sample of SNAP participants, exposure to green space was associated with more hours of sleep per night. Additional studies with larger, and more geographically diverse samples of low income adults are needed to determine whether this relationship is robust.

Support

USDA UNC/DUKE BECR Center