Advanced one-pot deconstruction and valorization of lignocellulosic biomass into triacetic acid lactone using Rhodosporidium toruloides

BACKGROUND

Rhodosporidium toruloides is capable of co-utilization of complex carbon sources and robust growth from lignocellulosic hydrolysates. This oleaginous yeast is therefore an attractive host for heterologous production of valuable bioproducts at high titers from low-cost, deconstructed biomass in an economically and environmentally sustainable manner. Here we demonstrate this by engineering R. toruloides to produce the polyketide triacetic acid lactone (TAL) directly from unfiltered hydrolysate deconstructed from biomass with minimal unit process operations.

RESULTS

Introduction of the 2-pyrone synthase gene into R. toruloides enabled the organism to produce 2.4 g/L TAL from simple media or 2.0 g/L from hydrolysate produced from sorghum biomass. Both of these titers are on par with titers from other better-studied microbial hosts after they had been heavily engineered. We next demonstrate that filtered hydrolysates produced from ensiled sorghum are superior to those derived from dried sorghum for TAL production, likely due to the substantial organic acids produced during ensiling. We also demonstrate that the organic acids found in ensiled biomass can be used for direct synthesis of ionic liquids within the biomass pretreatment process, enabling consolidation of unit operations of in-situ ionic liquid synthesis, pretreatment, saccharification, and fermentation into a one-pot, separations-free process. Finally, we demonstrate this consolidation in a 2 L bioreactor using unfiltered hydrolysate, producing 3.9 g/L TAL.

CONCLUSION

Many steps involved in deconstructing biomass into fermentable substrate can be combined into a distinct operation, and directly fed to cultures of engineered R. toruloides cultures for subsequent valorization into gram per liter titers of TAL in a cost-effective manner.

Altered subcallosal and posterior cingulate cortex-based functional connectivity during smoking cue and mental simulation processing in smokers

BACKGROUND

Long-term cigarette smoking induces sensitization of incentive salience and conditioning of contextual cues which involves brain function alteration across multiple regions. Understanding how nicotine affects hub-based functional connectivities involved in affective and cognitive function can help us determine the treatment strategy for nicotine dependence.

METHOD

Functional MRI was conducted on 30 smokers and 30 non-smokers while mentally simulating neutral and smoking hand movements. Smoking cue and mental simulation processing-related changes in functional connectivity strengths of the subcallosal and posterior cingulate cortex (SCC and PCC) with major brain network nodes were examined.

RESULTS

Compared to non-smokers, smokers showed cue-induced SCC functional connectivities which were enhanced with the intraparietal sulcus and reduced with the medial prefrontal cortex. The PCC activation and functional connectivity enhancements with the anterior insula cortex and rostro-lateral prefrontal cortex was found during smoking mental simulation. The PCC-lateral prefrontal cortex functional connectivity correlated with nicotine dependence severity.

CONCLUSION

The present results demonstrate that smokers can be identified by cue-induced SCC functional connectivity strength decline and increment in the default mode and dorsal attention network nodes. However, nicotine dependence was associated with smoking mental simulation-related PCC-lateral prefrontal cortex functional connectivity strength, suggesting that the development of nicotine dependence may depend on the strength of coupling between the default mode network and the central executive network at the cognitive level.

Greenland records of aerosol source and atmospheric lifetime changes from the Eemian to the Holocene

The Northern Hemisphere experienced dramatic changes during the last glacial, featuring vast ice sheets and abrupt climate events, while high northern latitudes during the last interglacial (Eemian) were warmer than today. Here we use high-resolution aerosol records from the Greenland NEEM ice core to reconstruct the environmental alterations in aerosol source regions accompanying these changes. Separating source and transport effects, we find strongly reduced terrestrial biogenic emissions during glacial times reflecting net loss of vegetated area in North America. Rapid climate changes during the glacial have little effect on terrestrial biogenic aerosol emissions. A strong increase in terrestrial dust emissions during the coldest intervals indicates higher aridity and dust storm activity in East Asian deserts. Glacial sea salt aerosol emissions in the North Atlantic region increase only moderately (50%), likely due to sea ice expansion. Lower aerosol concentrations in Eemian ice compared to the Holocene are mainly due to shortened atmospheric residence time, while emissions changed little.

Past climate changes in Greenland ice were accompanied by large aerosol concentration changes. Here, the authors show that by correcting for transport effects, reliable source changes for biogenic aerosol from North America, sea salt aerosol from the North Atlantic, and dust from East Asian deserts can be derived.

Factors influencing on influenza vaccination and its trends of coverage in patients with diabetes in Korea: A population-based cross-sectional study

BACKGROUND

Influenza infection is a contagious disease and annual influenza vaccination is recommended to the patients with chronic diseases. Although diabetes is an indication for influenza vaccination, the global rate of influenza vaccination is insufficient. Therefore, our study aimed to elucidate influenza vaccination statuses among patients with diabetes and the related factors in Korea.

METHODS

A total of 32,268 subjects (4,540 with and 27,728 without diabetes) from the Korea National Health and Nutrition Examination Survey III-VI (2005-2015) were included. Socioeconomic factors and health-related factors were analyses for the relation of influenza vaccination by Student's t-test, the chi-squared test and a multivariate logistic regression analysis.

RESULTS

The influenza vaccination coverage rates were 50.0% in the diabetes mellitus (DM) group and 38.2% in the non-DM group. The trends in influenza vaccination rates during KNHANES III-VI were not significant in each group (P trend  =  0.24 in the DM group, 0.30 in the non-DM group). Socioeconomic (older age, female sex, higher family income, and medical aid insurance) and health-related factors (lack of risky alcohol consumption, obesity, and recent health check-ups) were associated with influenza vaccination among patients with DM.

CONCLUSIONS

The rate of influenza vaccination among patients with diabetes is insufficient in Korea. More efforts are needed to increase the influenza vaccination rates among vulnerable at-risk populations.

Factors Influencing Influenza Vaccination Among Patients With Chronic Obstructive Pulmonary Disease: A Population-Based Cross-sectional Study

This study aimed to investigate the factors associated with vaccination coverage among chronic obstructive pulmonary disease (COPD) patients in Korea using the fourth to the sixth Korean National Health and Nutrition Examination Surveys (KNHANES IV, V, VI). A total of 16 812 subjects aged 40 years and older who underwent spirometry and had an "influenza vaccination history" were analyzed. The vaccination rate of middle-aged (40-64 years) COPD patients was only 31.9%; whereas, the vaccination rate of elderly (65 years and older) COPD patients was 80.0%. The results of a multiple regression analysis indicated that older age (odds ratio [OR], 1.12; 95% confidence interval [95% CI], 1.09-1.14), poor self-rated health status (OR, 1.45; 95% CI, 1.14-1.95), regular health check-up (OR, 2.61; 95% CI, 1.93-3.51), married marital status (OR, 0.64; 95% CI, 0.42-0.96), and household income below average (OR, 0.72; 95% CI, 0.53-0.98) were associated with influenza vaccination. More attention and targeted interventions are required to improve the influenza vaccination rate of COPD patients.

Mental Health of the People with Hearing Impairment in Korea: A Population-Based Cross-Sectional Study

Background

The prevalence of hearing impairment is increasing and an association between hearing impairment and mental health has been reported. Our study aimed to determine the association between hearing impairment and mental health in Korea.

Methods

This was a cross-sectional study of data from the Korean National Health and Nutrition Examination Survey 2010–2013, with a sample size of 18,563 individuals (6,395 with hearing impairment and 12,168 without hearing impairment), aged ≥20 years.

Results

The female group with hearing impairment tended to have a higher rate of stress (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.11 to 1.56). The association between hearing impairment and depressive symptoms was higher in elderly males (OR, 1.60; 95% CI, 1.10 to 2.32), while the association of hearing impairment with suicide ideation was higher in elderly females (OR, 1.32; 95% CI, 1.00 to 1.75).

Conclusion

Elderly individuals with hearing impairment are easily susceptible to poor mental health status. Early targeted intervention to address mental health problems is recommended for people with hearing impairment.

Body Misperception and Its Associated Factors among Cancer Survivors in Korea

Background: As the number of cancer survivors is increasing, the importance of their healthcare management is becoming emphasized. For this purpose, appropriate recognition of the importance of body weight is necessary. This study concerned misconceptions about body weight and related factors among cancer patients. Methods: This cross-sectional study involved 1,159 participants who participated in the 2007-2012 Korean National Health and Nutrition Examination Survey. Self-reported questionnaires were used to assess cancer information, socioeconomic status, health behavior, and psychological factors. Results: Men had a higher rate of underestimation and a lower rate of overestimation of body weight than women (34.7% vs. 22.9%; 10.9% vs. 15.5%, respectively). Underestimation of body weight was positively associated with a self-assessment of being in poor health in men (OR 2.44, 95% CI 1.58- 3.75) and in elderly women (OR 3.70, 95% CI 2.44-5.23). Overestimation of body weight was positively associated with depression in men (OR 2.17, 95% CI 1.01-4.63) and a high educational level/high-income level and having tried to control weight in women (OR 1.92, 95% CI 1.16-3.18; OR 1.57, 95% CI 1.00-2.47; OR 3.24, 95% CI 1.82-5.77, respectively). Conclusions: Higher socioeconomic status (SES), depression, self-rated health status, age, and weight control trials were found to be associated with underestimation and overestimation of body weight in cancer survivors. From this study, it is evident that more efforts are needed to remove misperceptions and to develop healthy behavior for cancer survivors by various means.

Facility characteristics as independent prognostic factors of nursing home-acquired pneumonia

BACKGROUND/AIMS

Recently, the incidence of nursing home-acquired pneumonia (NHAP) has been increasing and is now the leading cause of death among nursing home residents. This study was performed to identify risk factors associated with NHAP mortality, focusing on facility characteristics.

METHODS

Data on all patients ≥ 70 years of age admitted with newly diagnosed pneumonia were reviewed. To compare the quality of care in nursing facilities, the following three groups were defined: patients who acquired pneumonia in the community, care homes, and care hospitals. In these patients, 90-day mortality was compared.

RESULTS

Survival analyses were performed in 282 patients with pneumonia. In the analyses, 90-day mortality was higher in patients in care homes (12.2%, 40.3%, and 19.6% in community, care homes, and care hospitals, respectively). Among the 118 NHAP patients, residence in a care home, structural lung diseases, treatment with inappropriate antimicrobial agents for accompanying infections, and a high pneumonia severity index score were risk factors associated with higher 90-day mortality. However, infection by potentially drug-resistant pathogens was not important.

CONCLUSIONS

Unfavorable institutional factors in care homes are important prognostic factors for NHAP.

Associations Between Periodontitis and Chronic Obstructive Pulmonary Disease: The 2010 to 2012 Korean National Health and Nutrition Examination Survey

BACKGROUND

The aim of this study is to examine whether oral hygiene and self-care, particularly in periodontal health, are associated with chronic obstructive pulmonary disease (COPD) in the Korean population.

METHODS

Data from the Korean National Health and Nutrition Examination Survey from 2010 to 2012 were used to assess the community periodontal index (CPI) of 5,878 participants (normal lung function: n = 5,181; obstructive spirometric pattern: n = 697) aged ≥40 years, who underwent spirometry.

RESULTS

Participants with COPD brushed their teeth less frequently and used the following less frequently: 1) dental floss and/or interdental brush; 2) mouthwash; and 3) electric toothbrush (P <0.001). Prevalence of periodontitis in patients with COPD (58.1%) was significantly higher than in those without COPD (34.0%, P <0.001). Number of teeth was significantly lower in patients with COPD compared with controls. Decayed-missing-filled tooth index was significantly lower in patients with COPD. This study shows risk of COPD by periodontal severity. Periodontitis (CPI 3 and 4) was associated in males with COPD after adjustment for: 1) age; 2) income; 3) education; 4) smoking; 5) alcohol consumption; 6) exercise; 7) body mass index; 8) toothbrushing frequency; 9) diabetes mellitus; and 10) number of teeth (CPI 3: relative risk [RR] = 1.38, 95% confidence interval [CI] = 1.12 to 2.05; CPI 4: RR = 1.23, 95% CI = 1.06 to 1.56).

CONCLUSION

Findings of this cross-sectional study suggest that COPD in males may be associated with severe periodontitis and indicates the importance of promoting dental care in patients with COPD.

Feasibility of high-pitch dual-source low-dose chest CT: Reduction of radiation and cardiac artifacts

PURPOSE

To compare the radiation dose and image quality, focused mainly on cardiac pulsation artifact, between high-pitch low-dose chest computed tomography (HP-LDCT) and standard low-dose chest CT (LDCT).

PATIENTS AND METHODS

One hundred patients underwent HP-LDCT (50 patients) or LDCT (50 patients). Scan parameters were the same except for the pitch and gantry rotation time: 3.0 vs. 1.2 and 0.28s vs. 0.5s, respectively. Objective image noise at five regions and subjective image quality, such as noise, artifacts, cardiac pulsation artifacts, and overall diagnostic acceptability, were evaluated using a five-point scale. The significance level for all tests was set at P<0.05.

RESULTS

The dose-length products (DLPs) with HP-LDCT and LDCT were 90.2±4.3mGycm and 103.1±6.4mGycm, respectively (P<0.01). DLP of HP-LDCT showed a 13% reduction versus LDCT. Objective image noise was not significantly different. Cardiac pulsation artifacts showed a significant reduction on HP-LDCT (P<0.01). Other subjective image quality parameters of HP-LDCT were similar to those of LDCT. The overall diagnostic acceptability of HP-LDCT was better than that of LDCT (P<0.01).

CONCLUSIONS

HP-LDCT showed a 13% mean radiation dose reduction with no deterioration in image quality due to cardiac pulsation artifacts.

Potentially Inappropriate Medications in the Elderly in Korean Long-Term Care Facilities

Background

Elderly residents of long-term care facilities are more vulnerable to being prescribed inappropriate medications because of the high incidence of co-medication in this population resulting from the presence of multiple chronic diseases and also age-related changes in pharmacokinetics and pharmacodynamics.

Objective

We evaluated the frequency of potentially inappropriate medications and factors influencing their frequency.

Methods

A retrospective cross-sectional study was conducted in 20 long-term care facilities located in the northwest regions of South Korea for 824 patients aged 65 years and older who were assessed between January and February of 2012. Potentially inappropriate medications were identified using the 2012 American Geriatric Society’s Beers Criteria. We assessed the relationship between the frequency of potentially inappropriate medications prescribed and patient age, sex, co-medications, comorbidity, activities of daily living, length of stay, grade of long-term care insurance for seniors, and the bed size and business type of the long-term care facility.

Results

Of the 529 participants who satisfied our inclusion criteria, 308 (58.2 %) had received at least one inappropriate medication according to the 2012 Beers Criteria. The most frequently prescribed classes of inappropriate medications were central nervous system drugs (58.7 %), anti-cholinergics (21.2 %), and cardiovascular medications (10.8 %). The most commonly used drugs were quetiapine (28.4 %), chlorpheniramine (15.8 %), risperidone (6.5 %), and zolpidem (5.8 %). Inappropriate medication use was associated with the number of co-medications and long-term care insurance grade 3, which means less dependence and a requirement of low-level care.

Conclusions

Central nervous system drugs (58.7 %) were the most prescribed class of inappropriate medications. Quetiapine was the drug most often given inappropriately (28.4 %). There was a relationship between inappropriate medication use and the number of co-medications. The frequency of inappropriate medication prescriptions was higher among patients whose long-term care insurance for seniors was grade 3, which means less dependence and a requirement of low-level care.

Effect of 1-palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol on Immune Functions in Healthy Adults in a Randomized Controlled Trial

We previously reported that 1-palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol (PLAG) accelerates hematopoiesis and has an improving effect on animal disease models such as sepsis and asthma. The effects of PLAG supplementation on immune modulation were assessed in healthy men and women. The objective was to evaluate the effects of PLAG supplementation on immune regulatory functions such as activities of immune cells and cytokine production. A randomized double blind placebo-controlled trial was conducted. Seventy-five participants were assigned to one of two groups; all participants had an appropriate number of white blood cells on the testing day. The PLAG group (n=27) received oral PLAG supplements and the control group (n=22) received oral soybean oil supplements. IL-4 and IL-6 production by peripheral blood mononuclear cells (PBMC) were lower (p<0.001 and p<0.001, respectively) with PLAG than with soybean oil. However, the production of IL-2 and IFN-γ by PBMC was unaltered with PLAG supplementation. The B cell proliferation decreased significantly in the PLAG group compared to the soybean oil control (p<0.05). The intake of PLAG in healthy adults for 4 weeks was deemed safe. These data suggest that PLAG has an immunomodulatory function that inhibits the excessive immune activity of immunological disorders such as atopic and autoimmune diseases. PLAG could improve the condition of these diseases safely as a health food supplement.

Relationship between Stage of Chronic Kidney Disease and Sarcopenia in Korean Aged 40 Years and Older Using the Korea National Health and Nutrition Examination Surveys (KNHANES IV-2, 3, and V-1, 2), 2008-2011

Background

Protein-energy wasting is common in patients with end-stage kidney disease. However, few studies have examined the relationship between early stages of chronic kidney disease (CKD) and sarcopenia.

Methods

We conducted a cross-sectional study based on data in the Korea National Health and Nutrition Examination Survey, 2008–2011. In total, 11,625 subjects aged 40 years or older who underwent dual-energy X-ray absorptiometry were analyzed. Sarcopenia was defined based on values of appendicular skeletal muscle mass as a percentage of body weight (ASM/Wt) two standard deviations below the gender-specific mean for young adults. Estimated glomerular filtration rates (eGFR) were calculated using the CKD-EPI equation.

Results

Mean age, body mass index (BMI), and HOMA-IR were higher and caloric intake, physical activity, and vitamin D level were lower in the sarcopenia groups in both men and women. As the stage of CKD increased, the prevalence of sarcopenia increased, even in the early stages of CKD (normal and CKD1, 2, and 3-5: 2.6%, 5.6%, and 18.1% in men and 5.3%, 7.1%, and 12.6% in women, respectively; p < 0.001). In addition, a correlation analysis showed that GFR and ASM/Wt had significant correlations in both men and women. Logistic regression analyses, after adjusting for age, BMI, caloric intake, log(physical activity), vitamin D level, and log(HOMA-IR), showed that the odds ratio for sarcopenia with respect to CKD 3–5 was 1.93 (95% CI = 1.02–3.68) in men but was not statistically significant in women.

Conclusions

The prevalence of sarcopenia was higher in elderly Korean patients with even mildly reduced kidney function. Stage of CKD was associated with an increased prevalence of sarcopenia in men but not women. Thus, we should evaluate the risk of sarcopenia and work to prevent it, even in patients with early CKD.

The association among three aspects of physical fitness and metabolic syndrome in a Korean elderly population

BACKGROUND

The purpose of current study is to evaluate the association between physical fitness level and the prevalence of metabolic syndrome (MS) in a Korean elderly population.

METHODS

A cross-sectional study measuring physical fitness and components of MS in a health promotion center of a general hospital for routine health check-ups. A total of 227 subjects >60 years old agreed to participate. A lifestyle questionnaire that included cigarette smoking, alcohol consumption, and physical activity was checked. Body weight, height, blood pressure, fasting glucose, total cholesterol, triglycerides, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, C-reactive protein, and glycated hemoglobin were measured. Muscular strength was assessed by measuring grasping power. Muscular endurance was evaluated using a sit-up test. Cardiopulmonary fitness was assessed via the Tecumseh step test (measuring hear rates at 1 min post-exercise).

RESULTS

The highest tertile muscular endurance group (sit-ups >15 in men, >10 in women) was 0.37 times less likely to have MS [95 % confidence interval (CI) 0.17-0.84; p = 0.036] compared to that in the lowest tertile group (<11 in men, 0 in women), and the highest tertile in the cardiopulmonary fitness group (heart rate at rest >91/min in men, >92/min in women) was 2.81 times more likely to have MS (95 % CI 1.27-6.18; p = 0.038) compared to that in the lowest tertile group (<81/min in men, <80/min in women).

CONCLUSIONS

Cardiopulmonary fitness and muscular endurance were related to MS in a Korean elderly population after adjusting for age, sex, current smoker, current alcohol drinking, and physical activity. Older adults should be encouraged to increase their cardiopulmonary fitness and muscular endurance.

Renal function is associated with bone mineral density and arterial stiffness in healthy postmenopausal women

BACKGROUND/AIMS

This study aimed to investigate the effect of renal function on bone mineral density (BMD) and arterial stiffness in postmenopausal women.

METHODS

This is a retrospective cross-sectional study. We studied 252 postmenopausal women who visited a health promotion center for a medical checkup. The estimated glomerular filtration rate (eGFR) was calculated using the Cockcroft-Gault (CG) formula and the modification of diet in renal disease (MDRD) formula. Areal BMD measurements were performed using dual-energy X-ray absorptiometry, and arterial stiffness was measured using the brachial-ankle pulse wave velocity (baPWV).

RESULTS

The eGFR according to the CG formula was significantly correlated with age, BMI, follicle-stimulating hormone, thyroid-stimulating hormone, high-density lipoprotein cholesterol, baPWV, and BMD at the lumbar spine, femoral neck, and total hip sites. However, the eGFR according to the MDRD formula was significantly correlated with age and baPWV but not with BMD at the lumbar spine, femoral neck, and total hip sites. Decreased renal function (eGFR <60 ml/min/1.73 m(2) according to the CG formula) was independently associated with decreased BMD at the femoral neck site and with increased baPWV (>1,500 cm/s) after adjusting for confounding variables.

CONCLUSION

Postmenopausal women with decreased renal function are more likely to have a decreased BMD and greater arterial stiffness.

Association between sarcopenia and metabolic syndrome in chronic obstructive pulmonary disease: the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2011

AIM

It is not clear whether the restrictive or obstructive pattern of spirometry is associated with metabolic syndrome. We investigated the associations between restrictive and obstructive spirometric patterns and metabolic risk factors using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Additionally, we investigated whether sarcopenia is associated with metabolic syndrome in patients with chronic obstructive pulmonary disease (COPD).

METHODS

Using data from KNHANES between 2008 and 2011, we enrolled 8,145 subjects (normal lung function: 6,077, obstructive spirometric pattern: 1,039, restrictive pattern: 1,029) aged ≥40 years who underwent anthropometric measurement, laboratory tests, spirometry and estimation of appendicular muscle mass. Sarcopenia was defined as an appendicular skeletal muscle mass divided by body weight squared <2 SD below the sex-specific mean for the young reference group.

RESULTS

Sarcopenia was found in 32.8% of male and 12.2% of female patients with COPD. The odds ratio (OR) of metabolic syndrome for the restrictive spirometric pattern in male was 1.29 (95% confidence interval [CI], 1.02-1.65), and that for obstructive pattern in males was 0.99 (95% CI, 0.79-1.26) after adjustments for covariables (female restrictive pattern (ORs, 1,45; 95% CI, 1.09-1.91) and female obstructive pattern (ORs 0.73; 95% CI, 0.49-1.09). After adjustment for other confounding factors, the risk of metabolic syndrome was higher in sarcopenic male (OR, 1.88; 95% CI, 1.27-2.77) with COPD than in those without sarcopenia.

CONCLUSIONS

The restrictive spirometric pattern is associated with metabolic syndrome, and sarcopenia may contribute to the risk of metabolic syndrome in male patients with COPD.

Relationship between serum ferritin levels and sarcopenia in Korean females aged 60 years and older using the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV-2, 3), 2008-2009

Context

It has been suggested that elevated serum ferritin is associated with several metabolic disorders. However, there is no reported study assessing any association between serum ferritin and sarcopenia despite the close relationship between sarcopenia and metabolic disorders.

Objective

We investigated whether serum ferritin was associated with sarcopenia in older Koreans.

Design and Setting

We conducted a cross-sectional study based on data acquired in the second and third years (2008–9) of the fourth Korean National Health and Nutrition Examination Survey.

Participants

In total, 952 men (mean age 69.0 years) and 1,380 women (mean age 69.3 years) aged 60 years and older completed a body composition study using dual energy X-ray absorptiometry.

Measurements

Serum ferritin levels were measured. Sarcopenia was defined as an appendicular skeletal mass as a percentage of body weight that was less than two standard deviations below the gender-specific mean for young adults.

Results

Serum ferritin levels were lower in women than in men. Women with sarcopenia showed a higher level of serum ferritin than women without sarcopenia (men: without sarcopenia 115.7 ng/mL and with sarcopenia 134.4 ng/mL vs. women: without sarcopenia 70.7 ng/mL and with sarcopenia 85.4 ng/mL). The prevalence of sarcopenia increased as the tertile of serum ferritin increased. However, statistical significance was only seen in elderly women (1^st tertile 6.3%, 2^nd tertile 8.0%, 3^rd tertile 12.0%; p = 0.008). Without adjustment, compared with those in the lowest tertile of serum ferritin level, participants in the highest tertile had an odds ratio of 2.02 (95% confidence interval = 1.26–3.23) for sarcopenia in women. After adjusting for known risk factors, the OR for sarcopenia was 1.74 (95% CI = 1.02–2.97) in women. There was no statistically significant association between sarcopenia and serum ferritin tertiles in men.

Conclusions

Elevated serum ferritin levels were associated with an increased prevalence of sarcopenia in women but not in men from a representative sample of elderly Koreans.

Comparison of severity predictive rules for hospitalised nursing home-acquired pneumonia in Korea: a retrospective observational study

Background:

Nursing home-acquired pneumonia (NHAP) is the leading cause of death among long-term care residents.

Aims:

To compare current scoring indices (NHAP model score, Pneumonia Severity Index (PSI), CURB-65 (confusion, urea nitrogen, respiratory rate, blood pressure, age >65 years) and SOAR (systolic blood pressure, oxygenation, age, respiratory rate)) in predicting mortality and admission to the intensive care unit (ICU) in patients with NHAP.

Methods:

This retrospective observational study was conducted between July 2008 and June 2011 using data from the Korean Nursing Home Networks. Two hundred and eight nursing home residents were hospitalised with pneumonia in one general hospital. The primary outcome measure was 30-day all-cause mortality. Secondary outcome measures were intensive respiratory or vasopressor support (IRVS), and severe pneumonia (ICU admission or IRVS).

Results:

PSI class V showed the highest Youden index (0.45), specificity (66.7%), positive predictive value (PPV, 40.0%), negative predictive value (NPV, 91.5%), and area under the curve (AUC, 0.73) for 30-day mortality. For severe pneumonia, PSI class V showed the highest Youden index (0.40), specificity (72.8%), PPV (62.2%), NPV (77.1%), and AUC (0.70). Similarly, PSI class V showed the highest Youden index (0.35), specificity (68.3%), PPV (51.1%), NPV (80.5%), and AUC (0.69) for IRVS.

Conclusions:

The PSI has superior discriminatory power in predicting all three clinical outcomes (30-day mortality, severe pneumonia, and IVRS) compared with the NHAP model score, CURB-65 and SOAR.

Enhanced gene transfer to pancreatic islets using glucagon-like peptide-1

OBJECTIVE

The efficient transfer of genes into intact islets is difficult since islets exist as clusters of differentiated cells with little replication potential. Cell proliferation in response to growth factors is known to be accompanied by loosening of cell-to-cell contacts and increasing paracellular permeability. In this study, we investigated whether gene delivery into intact islet cells was facilitated by modulating β-cell proliferation.

METHODS

Isolated rat islets were pretreated with glucagon-like peptide (GLP)-1 or human growth hormone for 24 hours, or with 300 mg/dL of glucose for 48 hours before transduction with a suboptimal dose of recombinant adenoviral vector expressing green fluorescent protein (GFP) and β-galactosidase (multiplicity of infection of 25). Transduction efficiency was assessed by measuring β-galactosidase activity and GFP expression using enzyme-linked immunosorbent assay, flow cytometry, and fluorescence microscopy. The numbers of 7-aminoactinomycin D-positive dead cells and 5-ethynyl-2-deoxyuridine (EdU)-positive proliferating cells were also monitored using flow cytometry and fluorescence microscopy.

RESULTS

The transduction efficiency of rat islet cells by a suboptimal dose of viral vector was significantly improved by GLP-1 pretreatment, accompanied by enhanced cell viability and cell proliferation. An increased GFP expression in islet cells after GLP-1 pretreatment was observed among the increased numbers of EdU-positive proliferating cells.

CONCLUSION

Pretreatment of rat islets with GLP-1 enhanced the transduction efficiency of an adenoviral vector, reducing viral dose burden while improving islet cell viability. From a therapeutic standpoint, genetic modification of pancreatic islets combined with GLP-1 pretreatment may be a promising option for ex vivo gene therapy prior to islet transplantation.

Carboxy-terminal provasopressin may predict prognosis in nursing home acquired pneumonia

BACKGROUND

This study compares biomarker (including procalcitonin, pro-ANP, and copeptin) levels to pneumonia severity scores to predict 30-day mortality in NHAP (nursing home acquired pneumonia) patients.

METHODS

Seventy three patients aged ≥ 65 y, admitted to general hospitals and who fulfilled the definition of NHAP were included in the study. Data collected at admission included age, gender, nursing home admission, coexisting illness, symptoms and clinical parameters (blood pressure, pulse rate, respiratory rate and status). Additional data collected included laboratory results, radiographic findings and outcome variables. Severity of pneumonia was evaluated using a prediction rule calculated by CURB-65 criteria (confusion, urea nitrogen, respiratory rate, blood pressure, age>65 y).

RESULTS

After adjustment for age, sex and CURB-65, copeptin (OR=5.60, 95% confidence interval (CI)=1.20-26.24) was associated with 30-day mortality in NHAP patients, while procalcitonin and pro-ANP were not. The areas under the receiver operating characteristic curves (AUCs) for CURB-65, in predicting mortality were 0.685 [95% CI 0.559-0.811], whereas copeptin showed slightly superior accuracy with an AUC of 0.698 (95% CI 0.568-0.827).

CONCLUSIONS

Among 3 biomakers, copeptin was the strongest predictor of 30-day mortality from NHAP. The pathophysiologic and clinical implications of this finding require further investigation.

Relationship between bilirubin and C-reactive protein

BACKGROUND

Epidemiologic studies have shown that serum total bilirubin is inversely related to an increased risk of coronary artery disease. However, the number of studies which have focused on the relationship between bilirubin and C-reactive protein (CRP), which is a marker reflecting chronic vascular inflammation, are limited.

METHOD

This cross-sectional study consisted of 2307 Korean adults who visited the Center for Health Promotion for a routine health check-up from January 2009 to December 2009.

RESULT

CRP level showed a declining tendency as total bilirubin increased according to total bilirubin quartiles. Negative relations of CRP with both total and direct bilirubin were found after adjustment of age, body mass index, hypertension, diabetes, hypercholesterolemia, cardiovascular disease, taking aspirin, smoking, alcohol drinking and regular exercise and total bilirubin or direct bilirubin.

CONCLUSIONS

This study found that elevation of the two types of bilirubin (total and direct) have a relationship with a low serum CRP level among apparently healthy Korean adults. It is hypothesized that a low serum CRP level may be due to the antioxidant and anti-inflammatory effects of bilirubin metabolism.

Nano-electromechanical switch-CMOS hybrid technology and its applications

Si-based CMOS technology is facing a serious challenge in terms of power consumption and variability. The increasing costs associated with physical scaling have motivated a search for alternative approaches. Hybridization of nano-electromechanical (NEM)-switch and Si-based CMOS devices has shown a theoretical feasibility for power management, but a huge technical gap must be bridged before a nanoscale NEM switch can be realized due to insufficient material development and the limited understanding of its reliability characteristics. These authors propose the use of a multilayer graphene as a nanoscale cantilever material for a nanoscale NEM switchwith dimensions comparable to those of the state-of-the-art Si-based CMOS devices. The optimal thickness for the multilayer graphene (about five layers) is suggested based on an analytical model. Multilayer graphene can provide the highest Young's modulus among the known electrode materials and a yielding strength that allows more than 15% bending. Further research on material screening and device integration is needed, however, to realize the promises of the hybridization of NEM-switch and Si-based CMOS devices.

Associations between combinations of body mass index plus non-alcoholic fatty liver disease and diabetes mellitus among Korean adults

The purpose of this study was to investigate associations between combinations of body mass index (BMI) categories plus non-alcoholic fatty liver disease (NAFLD) and diabetes mellitus (DM) among Korean adults. We prepared the data of 5665 subjects aged 20 years and over who had visited a health promotion center. We excluded 582 subjects as they had a viral or alcoholic liver disease. According to BMI-NAFLD status, the subjects were categorized as non-obese (BMI<25 kg/m2) without NAFLD (n=2568), obese (BMI≥25 kg/m2) without NAFLD (n=572), non-obese with NAFLD (n=748), or obese with NAFLD (n=1195). The prevalence of NAFLD was highest in the obese subjects with DM (87.9%). In non-obese and non-DM subjects, the prevalence of NAFLD was lowest (18.4%). After adjustment of age, gender, waist circumference, smoking status, alcohol drinking, regular exercise, the odd ratios for DM or DM plus impaired fasting glucose (IFG) of subjects with mild NAFLD regardless of obesity were almost 2-fold compared to non-obese subjects without NAFLD. Moreover, those of subjects with moderate or severe NAFLD regardless of obesity were about 4- fold. Clinicians and investigators need to pay attention to non-obese patients with fatty liver.

Serum osteocalcin is related to abdominal obesity in Korean obese and overweight men

BACKGROUND

Growing evidence suggests a link between body composition and serum osteocalcin. Here we examined such an association between serum osteocalcin and body composition in Korean obese men.

METHODS

Eighty-six men, aged 20 to 76 years, who visited the obesity clinic at the Division of Family Medicine, Severance hospital, Seoul, Korea were recruited for this study. Abdominal fat computed tomography (CT) scans were performed to measure the visceral fat area (VFA) and subcutaneous fat area (SFA).

RESULTS

Serum osteocalcin levels were negatively correlated with age, VFA, and VFA/SFA ratio. In addition, serum osteocalcin levels were significantly decreased in obese and overweight subjects with visceral obesity (12.7±3.2) compared to those without visceral obesity (18.6±4.9). Multiple regression analysis showed that serum osteocalcin levels were associated with VFA in obese and overweight men after adjustment for age, insulin resistance, current smoking, alcohol consumption and adiposity indices.

CONCLUSION

Osteocalcin was inversely related to visceral obesity in Korean obese and overweight men. These results suggest cross-talk between bone and adipose tissue.

Chemical compositions of subway particles in Seoul, Korea determined by a quantitative single particle analysis

A novel single particle analytical technique, low-Z particle electron probe X-ray microanalysis, was applied to characterize seasonal subway samples collected at a subway station in Seoul, Korea. For all 8 samples collected twice in each season, 4 major types of subway particles, based on their chemical compositions, are significantly encountered: Fe-containing; soil-derived; carbonaceous; and secondary nitrate and/or sulfate particles. Fe-containing particles are generated indoors from wear processes at rail-wheel-brake interfaces while the others may be introduced mostly from the outdoor urban atmosphere. Fe-containing particles are the most frequently encountered with relative abundances in the range of 61-79%. In this study, it is shown that Fe-containing subway particles almost always exist either as partially or fully oxidized forms in underground subway microenvironments. Their relative abundances of Fe-containing particles increase as particle sizes decrease. Relative abundances of Fe-containing particles are higher in morning samples than in afternoon samples because of heavier train traffic in the morning. In the summertime samples, Fe-containing particles are the most abundantly encountered, whereas soil-derived and nitrate/sulfate particles are the least encountered, indicating the air-exchange between indoor and outdoor environments is limited in the summer, owing to the air-conditioning in the subway system. In our work, it was observed that the relative abundances of the particles of outdoor origin vary somewhat among seasonal samples to a lesser degree, reflecting that indoor emission sources predominate.

Optimization of submerged culture condition for the production of mycelial biomass and exopolysaccharides by Agrocybe cylindracea

The optimization of submerged culture conditions and nutritional requirements was studied for the production of exopolysaccharide (EPS) from Agrocybe cylindracea ASI-9002 using the statistically based experimental design in a shake flask culture. Both maximum mycelial biomass and EPS were observed at 25 degrees C. The optimal initial pH for the production of mycelial biomass and EPS were found to be pH 4.0 and pH 6.0, respectively. Subsequently, optimum concentration of each medium component was determined using the orthogonal matrix method. The optimal combination of the media constituents for mycelial growth was as follows: maltose 80 g/l, Martone A-1 6 g/l, MgSO4 x 7H2O 1.4 g/l, and CaCl2 1.1 g/l; for EPS production: maltose 60 g/l, Martone A-1 6 g/l, MgSO4 x 7H2O 0.9 g/l, and CaCl2 1.1 g/l. Under the optimal culture condition, the maximum EPS concentration achieved in a 5-l stirred-tank bioreactor indicated 3.0 g/l, which is about three times higher than that at the basal medium.

Morphological and rheological properties of the three different species of basidiomycetes Phellinus in submerged cultures

AIMS

The objective of this work was to investigate the morphological and rheological properties in submerged culture of the three different basidiomycetes Phellinus (P. baumii, P. gilvus and P. linteus) that produce pharmacologically important exopolysaccharides (EPS).

METHODS AND RESULTS

In flask cultures, pH proved to be a critical factor affecting mycelial growth, morphological change and EPS production. The macroscopic morphologies observed under different pHs in flask cultures were also comparable: i.e. starfish-like pellets with a lesser extent of free mycelium appeared in P. baumii, whereas smooth pellets with higher amounts of free mycelium were observed in P. gilvus and P. linteus. The pelleted fermentations were further characterized in a 5-l stirred-tank fermenter by image analysis with respect to mean diameter, core area and pellet circularity. Phellinus baumii showed the largest pellet size (5.2 mm in diameter), whereas P. linteus had extremely small and spherical pellets. The culture broth of P. baumii and P. gilvus yielded extremely high apparent viscosities, ranging from 5 to 7 Pa s.

CONCLUSIONS

Three important species of Phellinus showed significantly different morphological and rheological properties. The morphological variation of the three Phellinus species was closely linked to EPS productivity and the apparent viscosity of the whole broth.

SIGNIFICANCE AND IMPACT OF THE STUDY

The morphological change in the three species of Phellinus was a good indicator for identifying cell activity for EPS production. Our finding may be beneficial for further optimization of other fungal fermentation processes for large-scale production of EPS.

Production and molecular characteristics of four groups of exopolysaccharides from submerged culture of Phellinus gilvus

AIMS

The objective of the present study was to determine the optimal culture conditions for the production of four groups of exopolysaccharides (EPSs) in Phellinus gilvus by submerged culture and to investigate their molecular properties by multi-angle laser-light scattering (MALLS) analysis.

METHODS AND RESULTS

The optimal temperature and initial pH for the production of both mycelial biomass and EPSs in P. gilvus by submerged flask cultures were found to be 30 degrees C and pH 9.0, respectively. Glucose and corn steep powder were the most suitable carbon and nitrogen source for both mycelial biomass and EPS production. Optimal medium composition was determined to be glucose 30 g l-1, corn steep powder 5 g l-1, MgSO4 1.23 g l-1, KH2PO4 0.68 g l-1, and K2HPO4 0.87 g l-1. Four groups of EPSs (Fr-I, II, III, and IV) were obtained from the culture filtrates by gel filtration chromatography on Sepharose CL-4B and characterized by size exclusion chromatography (SEC) coupled with MALLS. The weight average molar mass (Mw) of Fr-I, Fr-II, Fr-III and Fr-IV were determined to be 8.628 x 106 (+/-129 420), 1.045 x 106 (+/-19 855), 61.09 x 104 (+/-1244), and 33.55 x 104 (+/-134) g mol-1, respectively.

CONCLUSIONS

Under optimal culture conditions, the maximum EPS production in a 5-l stirred fermenter indicated 5.3 g l-1 after 11 days of fermentation. The SEC/MALLS analysis revealed that Fr-I, which has extremely high molecular weight, was presumably an aggregate of complex polysaccharides forming a compact globular shape; whereas Fr-II was nearly spherical, Fr-III and Fr-IV were rod-like chains in an aqueous solution.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first report on the production of high amounts of EPSs from liquid-culture of the basidiomycete, P. gilvus. The SEC/MALLS approach used in this study could be useful in providing greater insight into the characterization of the mushroom polysaccharides without carrying out elaborate fractionation procedures prior to analysis.

Effect of aeration and agitation on the production of mycelial biomass and exopolysaccharides in an enthomopathogenic fungus Paecilomyces sinclairii

AIMS

The objective of the present study was to investigate the influence of aeration rate and agitation intensity on the production of mycelial biomass and exopolysaccharide (EPS) in Paecilomyces sinclairii.

METHODS AND RESULTS

The P. sinclairii was cultivated under various aeration and agitation conditions in a 5 l stirred-tank bioreactor. The highest mycelial biomass (30.5 g l-1) and EPS production (11.5 g l-1) were obtained at a high aeration rate (3.5 v.v.m.) and at a high agitation speed (250 rev min-1). The apparent viscosities (6000-8000 cP) of fermentation broth increased rapidly towards the end of fermentations at high aeration and agitation conditions.

CONCLUSIONS

The high level of dissolved oxygen achieved at a high aeration rate (3.5 v.v.m.) associated with higher hyphal density eventually resulted in enhanced EPS production. Agitation intensity was also proved to be a critical factor influencing on both the mycelial biomass and EPS production: high agitation speeds up to 250 rev min-1 were preferred to the yields of biomass and EPS production.

SIGNIFICANCE AND IMPACT OF THE STUDY

The critical effects of aeration and agitation in the culture process of P. sinclairii were found, which is widely applicable to other kinds of basidiomycetes or ascomycetes in their submerged culture processes.

Production of red pigment by submerged culture of Paecilomyces sinclairii

AIMS

From a survey of submerged culture of edible mushrooms, a high pigment-producing fungus Paecilomyces sinclairii was selected and its optimal culture conditions investigated.

METHODS AND RESULTS

The optimal culture conditions for pigment production were as follows: inoculum age, 3 d; temperature, 25 degrees C; initial pH, 6.0; carbon source, 1.5% (w/v) soluble starch; nitrogen source, 1.5% (w/v) meat peptone. Although addition of 10 mmol l(-1) CaCl2 to the culture medium slightly increased pigment production, most of the bio-elements examined had no notable or detrimental effect on pigment production.

CONCLUSIONS

Under the optimal conditions obtained in the flask culture tested, a ninefold increase in pigment production (4.4 g l(-1)) was achieved using a 5(-l) batch fermenter. Paecilomyces sinclairii secreted water-soluble red pigment into the culture medium. The pigment colour was strongly dependent on the pH of the solution: red at pH 3-4, violet at pH 5-9 and pink at pH 10-12.

SIGNIFICANCE AND IMPACT OF THE STUDY

The high concentration of pigment (4.4 g l(-1)) produced by P. sinclairii demonstrates the possibility of commercial production of pigment by this strain, considering its relatively high production yield and light stability.

Effect of agitation intensity on the exo-biopolymer production and mycelial morphology in Cordyceps militaris

AIMS

The influence of agitation intensity on Cordyceps militaris morphology and exo-biopolymer production was investigated in a 5 litre stirred vessel using a six-blade Rushton turbine impeller.

METHODS AND RESULTS

The mycelial morphology of C. militaris was characterized by means of image analysis, which included mean diameter, circularity, roughness and compactness of the pellets. The morphological parameters of the pellets grown under different stirring conditions were significantly different, which correspondingly altered exo-biopolymer production yields.

CONCLUSIONS

The compactness of the pellets was found to be the most critical parameter affecting exo-biopolymer biosynthesis; more compact pellets were formed at 150 rev min(-1) with maximum exo-biopolymer production (15 g l(-1)).

SIGNIFICANCE AND IMPACT OF THE STUDY

The results of this study suggest that morphological change of pellets is a good indicator for identifying the cell activity for exo-biopolymer production.

Influence of nutritional conditions on the mycelial growth and exopolysaccharide production in Paecilomyces sinclairii

AIMS

The objective of the study was to optimize the submerged culture conditions for the production of exopolysaccharide from Paecilomyces sinclairii.

METHODS AND RESULTS

The optimal temperature and initial pH for exopolysaccharide production by Paecilomyces sinclairii in shake flask culture were found to be 30 degrees C and 6.0, respectively. Sucrose (60 g l(-1)) and corn steep powder (10 g l(-1)) were the most suitable carbon and nitrogen source for exopolysaccharide production.

CONCLUSIONS

Under optimal culture medium, the maximum exopolysaccharide concentration in a 5-l stirred-tank fermenter indicated 7.4 g l(-1), which was approximately three times higher than that in basal medium. The maximum specific growth rates (micro max) and yield coefficient (Y(P/S)) in the optimal culture medium was 0.16 h(-1) and 0.19, respectively.

SIGNIFICANCE AND IMPACT OF THE STUDY

The optimal culture conditions reported in this article can be widely applied to the processes for submerged cultures of other mushrooms.