Appendicular lean mass and fracture risk assessment: implications for FRAX® and sarcopenia

The vast majority of current sarcopenia definitions use DXA-derived appendicular lean mass (DXA ALM) as an approximation of muscle mass. However, there is increasing evidence that ALM is poorly predictive of incident fractures. In this editorial, we describe findings from several cohorts suggesting that DXA ALM gives only limited information on the risk of incident fracture, and that in the US MrOS, WHI and Health ABC cohorts, accounting for femoral neck bone mineral density may entirely remove ALM-fracture associations. These observations raise important questions about the role of DXA ALM both in sarcopenia definitions and as a potential input variable for FRAX. We conclude that DXA ALM is unlikely to be a useful addition to the FRAX tool, but that other means of estimating muscle mass, such as those derived from creatine dilution or peripheral quantitative CT, might offer more value for fracture risk assessment.

Structural and functional study for tRNA cleavage by Glycine o-phenanthroline CuII complex, [CuCl(phen)(gly)]∙4H2O

The o-phenanthroline gly Cu(II) complex, [CuCl(phen)(gly)]∙4H₂O 1, has been prepared and structurally characterized. The transfer RNA binding and degradation properties of complex 1 have been investigated by UV-vis spectroscopy, cyclic voltammetry (CV), capillary electrophoresis (CE) and atomic force microscopy (AFM) methods. The results showed that 1 can efficiently cleave tRNA in the physiological conditions (pH 7.0, and 37 °C), and has a digestion coefficient nearly up to 100% within 75 h. AFM image for 1/RNA exhibited arrayed tandem repetitions of tRNA segments. This study is targeting the destruction of the high-order structures of genetic biomacromolecules which paves an important way to novel materials for the decontamination of microorganisms (e.g., bacteria and viruses).

The roles of astrocyte in the brain pathologies following ischemic stroke

Aim: In this work, we systematically explored the physiological functions of astrocytes and their roles following ischemic stroke, additionally, the potential therapy strategy targeting the astrocytes was also discussed. Methods: This work searched the PubMed database (including MEDLINE) until 14 Feb 2018, and furthermore, the studies were identified through cross-referencing and by consulting the experts in this field. Results: This study indicated that the astrocytes can not only play harmful roles following ischemic stroke through release of inflammatory factors and formation of glial scar but also have protective effects through quenching glutamate excitotoxicity and maintaining the clearance function of glymphatic system in brain. Conclusion: Owing to their important roles in physiological functions of brain and in the pathological conditions following ischemic stroke, the astrocytes might be a potential but promising therapeutic target for treating the ischemic stroke in the future.

Iron(ii) coordination polymer catalysed hydroboration of ketones

Catalytic hydroboration of ketones with pinacolborane was achieved with a 2D iron(ii) coordination polymer (CP) of a divergent 4,2';6',4''-terpyridine (tpy) derivative under mild conditions with high efficiency. This solid iron catalyst system is more active towards the hydroboration of ketones than that of aldehydes, displaying a different trend of reactivity from known homogeneous iron hydroboration catalysts.

[Role of aquaporin-4 in the change of interstitial fluid drainage in Alzheimer's disease]

OBJECTIVE

To observe the characteristics of the interstitial fluid (ISF) drainage in the Alzheimer's disease (AD) rats through magnetic resonance imaging (MRI) tracer gadolinium-diethylene triamine pentacetic acid (Gd-DTPA)spread in the brain extracellular space (ECS) and to discuss the role of aquaporin-4 (Aqp4) in the AD.

METHODS

Wild type SD rats (300-350 g) and Aqp4 gene knock out (Aqp4^-/-) SD rats (300-350g) were divided into Sham group, AD group, Aqp4^-/--Sham group and Aqp4^-/--AD group. Sham group and Aqp4^-/--Sham group were injected with saline by intraperitoneal each day for 6 weeks, and the AD group and Aqp4^-/--AD group were injected with D-galactose by intraperitoneal each day for 6 weeks. MRI tracer Gd-DTPA (10 mmol/L, 2 μL) was injected into the hippocampus of the rats. MRI scan was performed at the end of 0.5 h, 1.5 h, 1 h, 2 h, and 3 h to observe the dynamic distribution of the Gd-DTPA in the hippocampus and the diffusion rate D^*, clearance rate k' and half-life t_1/2 measured.

RESULTS

The diffusion rate D* in Sham group was (2.66±0.36)×10^-6 mm2/s, the diffusion rate D^* in AD group was (2.72±0.62)×10-6 mm²/s, the diffusion rate D^* in Aqp4^-/--Sham group was (2.75±0.47)×10^-6 mm²/s, the diffusion rate D^* in Aqp4^-/--AD group was (2.802±0.55)×10^-6 mm²/s, and there was no statistically significant difference in the four groups (One-Way ANOVA, P>0.05).The clearance rate k' in Sham group was (4.57±0.14)×10^-4/s, the clearance rate k' in AD group was (3.68±0.22)×10^-4/s, the clearance rate k' in Aqp4^-/--Sham group was (3.17±0.16)×10^-4/s, the clearance rate k' in Aqp4^-/--AD group was (2.59±0.19)×10^-4/s, and there was significant difference in the four groups (One-Way ANOVA, P<0.05). The half-life t_1/2 in Sham group was (0.67±0.12) h, the half-life t_1/2 in AD group was (0.88±0.08) h, the half-life t_1/2 in Aqp4^-/--Sham group was (1.12±0.15) h, the half-life t_1/2 in Aqp4^-/--AD group was (1.58±0.11) h, and there was significance difference in the four groups(one-way ANOVA,P<0.05).

CONCLUSION

The ISF drainage is slow after AD and the loss of Aqp4 in the AD makes the ISF drainage obviously slow down, Aqp4 plays an important role in AD to remove the metabolism of waste out of the brain.

Costs of potentially inappropriate medication use in residential aged care facilities

Background

The potential harms of some medications may outweigh their potential benefits (inappropriate medication use). Despite recommendations to avoid the use of potentially inappropriate medications (PIMs) in older adults, the prevalence of PIM use is high in different settings including residential aged care. However, it remains unclear what the costs of these medications are in this setting. The main objective of this study was to determine the costs of PIMs in older adults living in residential care. A secondary objective was to examine if there was a difference in costs of PIMs in a home-like model of residential care compared to an Australian standard model of care.

Methods

Participants included 541 participants from the Investigation Services Provided in the Residential Environment for Dementia (INSPIRED) Study. The INSPIRED study is a cross-sectional study of 17 residential aged care facilities in Australia. 12 month medication costs were determined for the participants and PIMs were identified using the 2015 updated Beers Criteria for older adults.

Results

Of all of the medications dispensed in 1 year, 15.9% were PIMs and 81.4% of the participants had been exposed to a PIM. Log-linear models showed exposure to a PIM was associated with higher total medication costs (Adjusted β = 0.307, 95% CI 0.235 to 0.379, p < 0.001). The mean proportion (±SD) of medication costs that were spent on PIMs in 1 year was 17.5% (±17.8) (AUD$410.89 ± 479.45 per participant exposed to a PIM). The largest PIM costs arose from proton-pump inhibitors (34.4%), antipsychotics (21.0%) and benzodiazepines (18.7%). The odds of incurring costs from PIMs were 52% lower for those residing in a home-like model of care compared to a standard model of care.

Conclusions

The use of PIMs for older adults in residential care facilities is high and these medications represent a substantial cost which has the potential to be lowered. Further research should investigate whether medication reviews in this population could lead to potential cost savings and improvement in clinical outcomes. Adopting a home-like model of residential care may be associated with reduced prevalence and costs of PIMs.

Electronic supplementary material

The online version of this article (10.1186/s12877-018-0704-8) contains supplementary material, which is available to authorized users.

Zinc and multivitamin supplementation have contrasting effects on infant iron status: a randomized, double-blind, placebo-controlled clinical trial

BACKGROUND/OBJECTIVES

Zinc (Zn) supplementation adversely affects iron status in animal and adult human studies, but few trials have included young infants. The objective of this study was to determine the effects of Zn and multivitamin (MV) supplementation on infant hematologic and iron status.

SUBJECTS/METHODS

In a double-blind RCT, Tanzanian infants were randomized to daily, oral Zn, MV, Zn and MV or placebo treatment arms at the age of 6 weeks of life. Hemoglobin concentration (Hb) and red blood cell indices were measured at baseline and at 6, 12 and 18 months of age. Plasma samples from 589 infants were examined for iron deficiency (ID) at 6 months.

RESULTS

In logistic regression models, Zn treatment was associated with greater odds of ID (odds ratio (OR) 1.8 (95% confidence interval (CI) 1.0-3.3)) and MV treatment was associated with lower odds (OR 0.49 (95% CI 0.3-0.9)). In Cox models, MV was associated with a 28% reduction in risk of severe anemia (hazard ratio (HR)=0.72 (95% CI 0.56-0.94)) and a 26% reduction in the risk of severe microcytic anemia (HR=0.74 (0.56-0.96)) through 18 months. No effects of Zn on risk of anemia were seen. Infants treated with MV alone had higher mean Hb (9.9 g/dl (95% CI 9.7-10.1)) than those given placebo (9.6 g/dl (9.4-9.8)) or Zn alone (9.6 g/dl (9.4-9.7)).

CONCLUSIONS

MV treatment improved iron status in infancy, whereas Zn worsened iron status but without an associated increase in risk for anemia. Infants in long-term Zn supplementation programs at risk for ID may benefit from screening and/or the addition of a MV supplement.

Team-based learning: assessing the impact on anatomy teaching in People's Republic of China

OBJECTIVES

In this study, the effects of team-based learning (TBL) method on the anatomy course for students in People's Republic of China were assessed.

METHODS

The students were randomly divided into the traditional lecture-based teaching group (traditional learning [TL] group, 99 students) and TBL teaching group (98 students). The TBL method required the students to prepare the assigned content in advance and discuss some specific topics in small groups. The test scores and questionnaire were applied to evaluate the effects of the two methods.

RESULTS

The students in TBL group had higher examination scores (81.70±8.53 vs 74.41±8.27, F[1,195] =124.6, p<0.01). The ratios of students with excellent (13.27% vs 9.09%, χ²[1] =4.00, p=0.041) and good scores (25.51% vs 16.16%, χ²[1] =4.85, p=0.027) were markedly increased in the TBL than the TL group, and the ratio of students who had just managed to pass was decreased (17.34% vs 32.33% in TL group, χ²[1] =5.91, p=0.015). The students in TBL group significantly achieved some improvement in mutual communication ability (χ²[1] =7.54, p=0.006), expression ability (χ²[1] =4.930, p=0.026), generalization capacity (χ²[1] =4.08, p=0.043), cooperative ability cultivation (χ²[1] =5.04, p=0.024), knowledge extension (χ²[1] =4.50, p=0.034), and enthusiasm mobilization (χ²[1] =4.27, p=0.039).

CONCLUSION

TBL could improve not only the test scores of the students, but also their study enthusiasm, initiative learning ability, communication ability, and team awareness.

Interesting fluorine anion water clusters [F−·(H2O)n] in metal complex crystals

Three crystalline complexes containing fluorine anion water cluster were reported. The fluoride anions and water molecules are H-bonded to each other in an alternating fashion within the fluoride–water hybrid cluster, where a fluoride anion plays the important role.

Vitamin A maintains the airway epithelium in a murine model of asthma by suppressing glucocorticoid-induced leucine zipper

BACKGROUND

The effects of glucocorticoids (GCs) on the repair of the airway epithelium in asthma are controversial, and we previously reported that the GC dexamethasone (Dex) inhibits the repair of human airway epithelial cells and that this process is mediated by glucocorticoid-induced leucine zipper (GILZ) through MAPK-ERK signaling in vitro. Vitamin A (VA) is involved in the regulation of the MAPK-ERK pathway but has not been widely supplied during asthma treatment. It is unclear whether VA attenuates the negative regulation of GILZ on the MAPK-ERK pathway and maintains airway epithelium integrity during asthma treatment.

METHODS

Female BALB/c mice were sensitized and challenged with ovalbumin (OVA) and subsequently treated with Dex, VA or intranasal inhalation of adenovirus sh-GILZ vectors. Indexes of airway epithelium integrity, including pathological alterations, pulmonary EGFR expression and airway hyperresponsiveness (AHR), were then measured. The expression of GILZ and key components of activated MAPK-ERK signals (p-Raf-1, p-MEK, and p-Erk1/2) were also detected.

RESULTS

Dex failed to relieve OVA-induced asthma airway epithelium injury, as assessed through H&E staining, EGFR expression and AHR. Moreover, in the OVA-challenged mice treated with Dex, GLIZ expression was increased, whereas the ratios of p-Raf-1/Raf-1, p-MEK/MEK and p-Erk1/2/Erk1/2 were significantly decreased. Further study indicated that GILZ expression was decreased and that the ratios of p-Raf-1/Raf-1, p-MEK/MEK and p-Erk1/2/Erk1/2 were up-regulated in the GILZ-silenced OVA-challenged mice and VA-fed OVA-challenged mice, independent of Dex treatment. The airway epithelium integrity of the OVA-challenged mice was maintained by treatment with both VA and Dex.

CONCLUSIONS

Vitamin A maintained the Dex-treated asthma airway epithelium via the down-regulation of GILZ expression and the activation MAPK-ERK signaling, and these effects might contribute to improving the effects of GC therapeutics on asthma.

Pre-natal and post-natal exposure to pet ownership and lung function in children: The Seven Northeastern Cities Study

To evaluate the association between pre-natal and post-natal exposure to pet ownership and lung function in children, a cross-sectional study named Seven Northeastern Cities (SNEC) study was conducted. In this study, children's lung function including the forced expiratory volume in 1 second (FEV₁ ), forced vital capacity (FVC), maximal mid-expiratory flow (MMEF), and peak expiratory flow (PEF) were measured by spirometers, and pet ownership situations were collected by questionnaire. Analyzed by multiple logistic regression and generalized linear modeling, we found that for all subjects, pet exposure in the first 2 years of life was significantly associated with lung function impairment of FVC<85% predicted (adjusted odds ratio [aOR]=1.28; 95% confidence interval [CI]: 1.01, 1.63). For current pet exposure, the increased odds of lung function impairment ranged from 35% (aOR=1.35; 95%CI: 1.12, 1.62) for FVC<85% predicted to 57% (aOR=1.57; 95%CI: 1.29, 1.93) for FEV₁ <85% predicted. The in utero exposure was not related to lung function impairment. Compared with other pets, higher odds were observed among children with dogs. When stratified by gender, girls with current pet exposure were more likely to have lung function impairment than boys. It implies self-reported exposures to pets were negatively associated with lung function among the children under study.

Ibrutinib modulates the immunosuppressive CLL microenvironment through STAT3-mediated suppression of regulatory B-cell function and inhibition of the PD-1/PD-L1 pathway

Ibrutinib, a covalent inhibitor of Bruton Tyrosine Kinase (BTK), is approved for treatment of patients with relapsed/refractory or treatment-naïve chronic lymphocytic leukemia (CLL). Besides directly inhibiting BTK, ibrutinib possesses immunomodulatory properties through targeting multiple signaling pathways. Understanding how this ancillary property of ibrutinib modifies the CLL microenvironment is crucial for further exploration of immune responses in this disease and devising future combination therapies. Here, we investigated the mechanisms underlying the immunomodulatory properties of ibrutinib. In peripheral blood samples collected prospectively from CLL patients treated with ibrutinib monotherapy, we observed selective and durable downregulation of PD-L1 on CLL cells by 3 months post-treatment. Further analysis showed that this effect was mediated through inhibition of the constitutively active signal transducer and activator of transcription 3 (STAT3) in CLL cells. Similar downregulation of PD-1 was observed in CD4+ and CD8+ T cells. We also demonstrated reduced interleukin (IL)-10 production by CLL cells in patients receiving ibrutinib, which was also linked to suppression of STAT3 phosphorylation. Taken together, these findings provide a mechanistic basis for immunomodulation by ibrutinib through inhibition of the STAT3 pathway, critical in inducing and sustaining tumor immune tolerance. The data also merit testing of combination treatments combining ibrutinib with agents capable of augmenting its immunomodulatory effects.