Diabetes outcomes are influenced by host factors, settings, and care processes. We examined the association of data-driven integrated care assisted by information and communications technology (ICT) ...with clinical outcomes in type 2 diabetes in public and private healthcare settings.
The web-based Joint Asia Diabetes Evaluation (JADE) platform provides a protocol to guide data collection for issuing a personalized JADE report including risk categories (1-4, low-high), 5-year probabilities of cardiovascular-renal events, and trends and targets of 4 risk factors with tailored decision support. The JADE program is a prospective cohort study implemented in a naturalistic environment where patients underwent nurse-led structured evaluation (blood/urine/eye/feet) in public and private outpatient clinics and diabetes centers in Hong Kong. We retrospectively analyzed the data of 16,624 Han Chinese patients with type 2 diabetes who were enrolled in 2007-2015. In the public setting, the non-JADE group (n = 3,587) underwent structured evaluation for risk factors and complications only, while the JADE (n = 9,601) group received a JADE report with group empowerment by nurses. In a community-based, nurse-led, university-affiliated diabetes center (UDC), the JADE-Personalized (JADE-P) group (n = 3,436) received a JADE report, personalized empowerment, and annual telephone reminder for reevaluation and engagement. The primary composite outcome was time to the first occurrence of cardiovascular-renal diseases, all-site cancer, and/or death, based on hospitalization data censored on 30 June 2017. During 94,311 person-years of follow-up in 2007-2017, 7,779 primary events occurred. Compared with the JADE group (136.22 cases per 1,000 patient-years 95% CI 132.35-140.18), the non-JADE group had higher (145.32 95% CI 138.68-152.20; P = 0.020) while the JADE-P group had lower event rates (70.94 95% CI 67.12-74.91; P < 0.001). The adjusted hazard ratios (aHRs) for the primary composite outcome were 1.22 (95% CI 1.15-1.30) and 0.70 (95% CI 0.66-0.75), respectively, independent of risk profiles, education levels, drug usage, self-care, and comorbidities at baseline. We reported consistent results in propensity-score-matched analyses and after accounting for loss to follow-up. Potential limitations include its nonrandomized design that precludes causal inference, residual confounding, and participation bias.
ICT-assisted integrated care was associated with a reduction in clinical events, including death in type 2 diabetes in public and private healthcare settings.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Mutations affecting spliceosomal proteins are the most common mutations in patients with myelodysplastic syndromes (MDS), but their role in MDS pathogenesis has not been delineated. Here we report ...that mutations affecting the splicing factor SRSF2 directly impair hematopoietic differentiation in vivo, which is not due to SRSF2 loss of function. By contrast, SRSF2 mutations alter SRSF2’s normal sequence-specific RNA binding activity, thereby altering the recognition of specific exonic splicing enhancer motifs to drive recurrent mis-splicing of key hematopoietic regulators. This includes SRSF2 mutation-dependent splicing of EZH2, which triggers nonsense-mediated decay, which, in turn, results in impaired hematopoietic differentiation. These data provide a mechanistic link between a mutant spliceosomal protein, alterations in the splicing of key regulators, and impaired hematopoiesis.
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•Srsf2P95H/wild-type mice develop myelodysplasia but Srsf2-deficient mice do not•Proline 95 mutations change the RNA binding specificity of SRSF2•Mutant SRSF2 promotes an isoform of EZH2 that undergoes nonsense-mediated decay•Restoring EZH2 expression partially rescues hematopoiesis in Srsf2 mutant cells
Kim et al. report that myelodysplastic syndrome-associating SRSF2 mutations alter SRSF2’s sequence-specific RNA binding activity, leading to recurrent mis-splicing of key hematopoietic regulators such as EZH2 and impaired hematopoietic differentiation.
Induction of antigen-specific immune activation by the maturation of dendritic cells (DCs) is a strategy used for cancer immunotherapy. In this study, we find that FimH, which is an Escherichia coli ...adhesion portion, induces toll-like receptor 4-dependent and myeloid differentiation protein 2-independent DC maturation in mice in vivo. A combined treatment regimen with FimH and antigen promotes antigen-specific immune activation, including proliferation of T cells, production of IFN-γ and TNF-α, and infiltration of effector T cells into tumors, which consequently inhibits tumor growth in mice in vivo against melanoma and carcinoma. In addition, combined therapeutic treatment of anti-PD-L1 antibodies and FimH treatment efficiently inhibits CT26 tumor growth in BALB/c mice. Finally, FimH promotes human peripheral blood DC activation and syngeneic T-cell proliferation and activation. Taken together, these findings demonstrate that FimH can be a useful adjuvant for cancer immunotherapy.
Accumulation of sterols in membranes of the endoplasmic reticulum (ER) leads to the accelerated ubiquitination and proteasomal degradation of 3-hydroxy-3-methylglutaryl coenzyme A reductase, a ...rate-limiting enzyme in synthesis of cholesterol and nonsterol isoprenoids. This degradation results from sterol-induced binding of reductase to the Insig-1 or Insig-2 proteins of ER membranes. We previously reported that in immortalized human fibroblasts (SV-589 cells) Insig-1, but not Insig-2, recruits gp78, a membrane-bound RING-finger ubiquitin ligase. We now report that both Insig-1 and Insig-2 bind another membrane-bound RING-finger ubiquitin ligase called Trc8. Knockdown of either gp78 or Trc8 in SV-589 cells through RNA interference (RNAi) inhibited sterol-induced ubiquitination of reductase and inhibited sterol-induced degradation by 50–60%. The combined knockdown of gp78 and Trc8 produced a more complete inhibition of degradation (> 90%). Knockdown of gp78 led to a three to fourfold increase in levels of Trc8 and Insig-1 proteins, which opposed the inhibitory action of gp78. In contrast, knockdown of Trc8 had no effect on gp78 or Insig-1. The current results suggest that sterol-induced ubiquitination and proteasomal degradation of reductase is dictated by the complex interplay of at least four proteins: Insig-1, Insig-2, gp78, and Trc8. Variations in the concentrations of any one of these proteins may account for differences in cell- and/or tissue-specific regulation of reductase degradation.
A significant rise in the occurrence and severity of adverse reactions to several synthetic drugs has fueled considerable interest in natural product‐based therapeutics. In humans and animals, ...polysaccharides from marine microalgae and seaweeds have immunomodulatory effects. In addition, these polysaccharides may possess antiviral, anticancer, hypoglycemic, anticoagulant, and antioxidant properties. During inflammatory diseases, such as autoimmune diseases and sepsis, immunosuppressive molecules can serve as therapeutic agents. Similarly, molecules that participate in immune activation can induce immune responses against cancer and infectious diseases. We aim to discuss the chemical composition of the algal polysaccharides, namely alginate, fucoidan, ascophyllan, and porphyran. We also summarize their applications in the treatment of cancer, infectious disease, and inflammation. Recent applications of nanoparticles that are based on algal polysaccharides for the treatment of cancer and inflammatory diseases have also been addressed. In conclusion, these applications of marine algal polysaccharides could provide novel therapeutic alternatives for several diseases.
paradoxical teratogenic mechanism for retinoic acid Lee, Leo M. Y; Leung, Chun-Yin; Tang, Walfred W. C ...
Proceedings of the National Academy of Sciences - PNAS,
08/2012, Letnik:
109, Številka:
34
Journal Article
Recenzirano
Odprti dostop
Retinoic acid, an active metabolite of vitamin A, plays essential signaling roles in mammalian embryogenesis. Nevertheless, it has long been recognized that overexposure to vitamin A or retinoic acid ...causes widespread teratogenesis in rodents as well as humans. Although it has a short half-life, exposure to high levels of retinoic acid can disrupt development of yet-to-be formed organs, including the metanephros, the embryonic organ which normally differentiates into the mature kidney. Paradoxically, it is known that either an excess or a deficiency of retinoic acid results in similar malformations in some organs, including the mammalian kidney. Accordingly, we hypothesized that excess retinoic acid is teratogenic by inducing a longer lasting, local retinoic acid deficiency. This idea was tested in an established in vivo mouse model in which exposure to excess retinoic acid well before metanephric rudiments exist leads to failure of kidney formation several days later. Results showed that teratogen exposure was followed by decreased levels of Raldh transcripts encoding retinoic acid-synthesizing enzymes and increased levels of Cyp26a1 and Cyp26b1 mRNAs encoding enzymes that catabolize retinoic acid. Concomitantly, there was significant reduction in retinoic acid levels in whole embryos and kidney rudiments. Restoration of retinoic acid levels by maternal supplementation with low doses of retinoic acid following the teratogenic insult rescued metanephric kidney development and abrogated several extrarenal developmental defects. This previously undescribed and unsuspected mechanism provides insight into the molecular pathway of retinoic acid-induced teratogenesis.
Rationale
How striatal dopamine synthesis capacity (DSC) contributes to the pathogenesis of negative symptoms in first-episode schizophrenia (SZ) and delusional disorder (DD) has seldom been ...explored. As negative symptoms during active psychotic episodes can be complicated by secondary influences, such as positive symptoms, longitudinal investigations may help to clarify the relationship between striatal DSC and negative symptoms and differentiate between primary and secondary negative symptoms.
Objective
A longitudinal study was conducted to examine whether baseline striatal DSC would be related to negative symptoms at 3 months in first-episode SZ and DD patients.
Methods
Twenty-three first-episode age- and gender-matched patients (11 DD and 12 SZ) were consecutively recruited through an early intervention service for psychosis in Hong Kong. Among them, 19 (82.6%) patients (9 DD and 10 SZ) were followed up at 3 months. All patients received an
18
F-DOPA PET/MR scan at baseline.
Results
Baseline striatal DSC (
K
occ;30–60
) was inversely associated with negative symptoms at 3 months in first-episode SZ patients (
r
s
= − 0.80,
p
= 0.010). This association remained in SZ patients even when controlling for baseline negative, positive, and depressive symptoms, as well as cumulative antipsychotic dosage (
β
= − 0.69,
p
= 0.012). Such associations were not observed in first-episode DD patients. Meanwhile, the severity of negative symptoms at 3 months was associated with more positive symptoms in DD patients (
r
s
= 0.74,
p
= 0.010) and not in SZ patients.
Conclusions
These findings highlight the role of striatal DSC in negative symptoms upon resolution of active psychotic episodes among first-episode SZ patients. Baseline striatal dopamine activity may inform future symptom expression with important treatment implications.
Nonsaturating large magnetoresistance in semimetals Leahy, Ian A.; Lin, Yu-Ping; Siegfried, Peter E. ...
Proceedings of the National Academy of Sciences - PNAS,
10/2018, Letnik:
115, Številka:
42
Journal Article
Recenzirano
Odprti dostop
The rapidly expanding class of quantum materials known as topological semimetals (TSMs) displays unique transport properties, including a striking dependence of resistivity on applied magnetic field, ...that are of great interest for both scientific and technological reasons. So far, many possible sources of extraordinarily large nonsaturating magnetoresistance have been proposed. However, experimental signatures that can identify or discern the dominant mechanism and connect to available theories are scarce. Here we present the magnetic susceptibility (χ), the tangent of the Hall angle (tan θH
), along with magnetoresistance in four different nonmagnetic semimetals with high mobilities, NbP, TaP, NbSb₂, and TaSb₂, all of which exhibit nonsaturating large magnetoresistance (MR). We find that the distinctly different temperature dependences, χ(T), and the values of tan θH
in phosphides and antimonates serve as empirical criteria to sort the MR from different origins: NbP and TaP are uncompensated semimetals with linear dispersion, in which the nonsaturating magnetoresistance arises due to guiding center motion, while NbSb₂ and TaSb₂ are compensated semimetals, with a magnetoresistance emerging from nearly perfect charge compensation of two quadratic bands. Our results illustrate how a combination of magnetotransport and susceptibility measurements may be used to categorize the increasingly ubiquitous nonsaturating large magnetoresistance in TSMs.
Abstract
Motivation
Cancer classification based on gene expression profiles has provided insight on the causes of cancer and cancer treatment. Recently, machine learning-based approaches have been ...attempted in downstream cancer analysis to address the large differences in gene expression values, as determined by single-cell RNA sequencing (scRNA-seq).
Results
We designed cancer classifiers that can identify 21 types of cancers and normal tissues based on bulk RNA-seq as well as scRNA-seq data. Training was performed with 7398 cancer samples and 640 normal samples from 21 tumors and normal tissues in TCGA based on the 300 most significant genes expressed in each cancer. Then, we compared neural network (NN), support vector machine (SVM), k-nearest neighbors (kNN) and random forest (RF) methods. The NN performed consistently better than other methods. We further applied our approach to scRNA-seq transformed by kNN smoothing and found that our model successfully classified cancer types and normal samples.
Availability and implementation
Cancer classification by neural network.
Supplementary information
Supplementary data are available at Bioinformatics online.
Molecular programs involved in embryogenesis are frequently upregulated in oncogenic dedifferentiation and metastasis. However, their precise roles and regulatory mechanisms remain elusive. Here, we ...showed that CDK1 phosphorylation of TFCP2L1, a pluripotency‐associated transcription factor, orchestrated pluripotency and cell‐cycling in embryonic stem cells (ESCs) and was aberrantly activated in aggressive bladder cancers (BCs). In murine ESCs, the protein interactome and transcription targets of Tfcp2l1 indicated its involvement in cell cycle regulation. Tfcp2l1 was phosphorylated at Thr177 by Cdk1, which affected ESC cell cycle progression, pluripotency, and differentiation. The CDK1‐TFCP2L1 pathway was activated in human BC cells, stimulating their proliferation, self‐renewal, and invasion. Lack of TFCP2L1 phosphorylation impaired the tumorigenic potency of BC cells in a xenograft model. In patients with BC, high co‐expression of TFCP2L1 and CDK1 was associated with unfavorable clinical characteristics including tumor grade, lymphovascular and muscularis propria invasion, and distant metastasis and was an independent prognostic factor for cancer‐specific survival. These findings demonstrate the molecular and clinical significance of CDK1‐mediated TFCP2L1 phosphorylation in stem cell pluripotency and in the tumorigenic stemness features associated with BC progression.
Synopsis
Aberrant activation of pluripotency genes is frequently observed in tumors. Thr177‐phosphorylation of TFCP2L1 by CDK1 stimulates pluripotency and cell cycling in embryonic stem cells and stemness features of bladder cancers, potentiating the tumorigenesis and aggressive behavior of bladder cancer.
CDK1 phosphorylates TFCP2L1 at Thr177 in both murine embryonic stem cells (mESCs) and human bladder cancer cells.
Thr177 phosphorylation of TFCP2L1 by CDK1 is essential for pluripotency and cell cycle progression of mESCs via its ability to regulate cell cycle, pluripotency and developmental gene expression.
Activation of CDK1‐TFCP2L1 pathway enhances the stemness features and tumorigenesis of bladder cancer cells.
Activation of the CDK1‐TFCP2L1 cascade is associated with aggressive features of bladder cancer: high tumor grade, lymphovascular invasion, muscularis‐propria invasion, metastasis to distant organs, and low patient survival rates.
Aberrant activation of pluripotency genes is frequently observed in tumors. Thr177‐phosphorylation of TFCP2L1 by CDK1 stimulates pluripotency and cell cycling in embryonic stem cells and stemness features of bladder cancers, potentiating the tumorigenesis and aggressive behavior of bladder cancer.
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