Aims/Introduction
It is not clear whether survival in kidney transplant recipients with pre‐transplant diabetes has improved over the past decades. We compared the rates of mortality and major ...adverse cardiovascular events (MACE) after renal transplantation in patients with and without pre‐transplant diabetes. Furthermore, we investigated whether transplant era and recipient age affected the association between diabetes status and adverse events.
Materials and Methods
This retrospective cohort study included 691 patients who underwent renal transplantation between 1994 and 2016 at a single tertiary center. We compared the incidences of post‐transplant mortality and four‐point MACE in patients with and without pre‐transplant diabetes using Kaplan–Meier analysis and the Cox proportional hazard model, and assessed the interactions between diabetes status and transplant era and recipient age.
Results
Of 691 kidney recipients, 143 (20.7%) had pre‐transplant diabetes. The mean follow‐up duration was 94.5 months. Kaplan–Meier analysis showed that patients with pre‐transplant diabetes had higher incidences of post‐transplant mortality and four‐point MACE compared with those without pre‐transplant diabetes (log–rank test, P < 0.001 for both). After adjusting for potential confounding factors, pre‐transplant diabetes was associated with an increased risk of post‐transplant mortality and four‐point MACE (hazard ratio 1.90, 95% confidence interval 1.05–3.44, P = 0.034; and hazard ratio 1.75; 95% confidence interval 1.02–3.00, P = 0.043, respectively). The associations between pre‐transplant diabetes status and all‐cause mortality and four‐point MACE were not affected by transplant era or recipient age.
Conclusions
Pre‐transplant diabetes remains a significant risk factor for mortality and four‐point MACE in kidney transplant recipients.
It is not clear whether survival in kidney transplant recipients with pre‐transplant diabetes has improved over the past decades. We compared the rates of mortality and major adverse cardiovascular events after kidney transplantation in patients with and without pre‐transplant diabetes. In this study, pre‐transplant diabetes remains a significant risk factor for mortality and four‐point major adverse cardiovascular events in kidney transplant recipients.
The miniaturization of ferroelectric devices in non-volatile memories requires the device to maintain stable switching behavior as the thickness scales down to nanometer scale, which requires the ...coercive field to be sufficiently large. Recently discovered metal-free perovskites exhibit advantages such as structural tunability and solution-processability, but they are disadvantaged by a lower coercive field compared to inorganic perovskites. Herein, we demonstrate that the coercive field (110 kV/cm) in metal-free ferroelectric perovskite MDABCO-NH
-(PF
)
(MDABCO = N-methyl-N'-diazabicyclo2.2.2octonium) is one order larger than MDABCO-NH
-I
(12 kV/cm) owing to the stronger intermolecular hydrogen bonding in the former. Using isotope experiments, the ferroelectric-to-paraelectric phase transition temperature and coercive field are verified to be strongly influenced by hydrogen bonds. Our work highlights that the coercive field of organic ferroelectrics can be tailored by tuning the strength of hydrogen bonding.
Twelve new sesterterpenes along with eight known sesterterpenes were isolated from the marine sponge
collected off the coast of Chuuk Island, the Federated State of Micronesia. Based upon a ...combination of spectroscopic and computational analyses, these compounds were determined to be eight glycine-bearing scalaranes (
-
), a 3-keto scalarane (
), two oxidized-furan-bearing scalaranes (
and
), and a salmahyrtisane (
). Several of these compounds exhibited weak antiproliferation against diverse cancer cell lines as well as moderate anti-angiogenesis activities. The antiproliferative activity of new compound
was found to be associated with G0/G1 arrest in the cell cycle.
Transcription factors with an APETELA2 (AP2) domain have been implicated in various cellular processes involved in plant development and stress responses. Of the 139 AP2 genes predicted in rice ...(Oryza sativa), we identified 42 genes in our current study that are induced by one or more stress conditions, including drought, high salinity, low temperature, and abscisic acid. Phylogenic analysis of these 42 stress-inducible AP2 genes revealed the presence of six subgroups (I-VI) with distinct signature motifs. Two genes, AP37 and AP59, representing subgroups I and II, respectively, were functionally characterized. Both genes were found to be induced upon 2 h of exposure to drought and high-salinity conditions but to differ in their expression profile upon exposure to low temperature and abscisic acid. The overexpression of AP37 and AP59 in rice under the control of the constitutive promoter OsCc1 increased the tolerance to drought and high salinity at the vegetative stage. Increased tolerance to low temperatures was observed only in OsCc1:AP37 plants. More importantly, the OsCc1:AP37 plants showed significantly enhanced drought tolerance in the field, which increased grain yield by 16% to 57% over controls under severe drought conditions, yet exhibited no significant difference under normal growth conditions. In contrast, grain yield in OsCc1:AP59 plants in the field was reduced by 23% to 43% compared with controls under both normal and drought stress conditions. Microarray experiments identified 10 and 38 genes that are up-regulated by AP37 and AP59, respectively, in addition to 37 genes that are commonly induced by both factors. Our results suggest that the AP37 gene has the potential to improve drought tolerance in rice without causing undesirable growth phenotypes.
C-repeat/dehydration-responsive element binding factors (CBF/DREBs) are a family of transcription factors that regulate freezing tolerance in Arabidopsis. As a step towards understanding the stress ...response of monocotyledonous plants, we isolated a barley gene HvCBF4 whose expression is induced by low-temperature stress. Transgenic over-expression of HvCBF4 in rice resulted in an increase in tolerance to drought, high-salinity and low-temperature stresses without stunting growth. Interestingly, under low-temperature conditions, the maximum photochemical efficiency of photosystem II in the dark-adapted state (Fv/Fm, where Fv is the variable fluorescence and Fm is the maximum fluorescence) in HvCBF4 plants was higher by 20% and 10% than that in non-transgenic and CBF3/DREB1A plants, respectively. Using the 60K Rice Whole Genome microarray, 15 rice genes were identified that were activated by HvCBF4. When compared with 12 target rice genes of CBF3/DREB1A, five genes were common to both HvCBF4 and CBF3/DREB1A, and 10 and seven genes were specific to HvCBF4 and CBF3/DREB1A, respectively. Interestingly, HvCBF4 did not activate Dip1 and Lip5, two important target genes of CBF3/DREB1A, in transgenic rice under normal growth conditions, but their expression was enhanced by HvCBF4 under low-temperature conditions. Our results suggest that CBF/DREBs of barley act differently from those of Arabidopsis in transgenic rice.
This article introduces a 192-Gb 896-GB/s 12-high stacked third-generation high-bandwidth memory (HBM3 DRAM) with low power consumption and high-reliability traits. New design schemes and features, ...including internal low-voltage signaling, center strobe calibration, through-silicon via (TSV) auto-calibration, a symbol-correcting in-DRAM ECC, and machine-learning-based layout optimization, allow large amounts of data transfers among the vertically stacked base and core dies with limited delay mismatch or SI degradation, as well as reduced power consumption from low-voltage swings. Experimental results confirm 896-GB/s bandwidth operations at 1.0-V voltage conditions with up to 15% improved power efficiency.
Five new manzamine alkaloids (1-5) and new salt forms of two known manzamines (6 and 7), along with seven known compounds (8-14) of the same structural class, were isolated from an Indonesian ...Acanthostrongylophora sp. sponge. On the basis of the results of combined spectroscopic analyses, the structure of kepulauamine A (1) was determined to possess an unprecedented pyrrolizine moiety, while others were functional group variants of known manzamines. These compounds exhibited weak cytotoxicity, moderate antibacterial activity, and mild inhibition against the enzyme isocitrate lyase.
Diabetes mellitus is a common and crucial metabolic complication in kidney transplantation. It is necessary to analyze the course of glucose metabolism in patients who already have diabetes after ...receiving a transplant. In this study, we investigated the changes in glucose metabolism after transplantation, and a detailed analysis was performed on some patients whose glycemic status improved.
The multicenter prospective cohort study was conducted between 1 April 2016 and 31 September 2018. Adult patients (aged 20 to 65 years) who received kidney allografts from living or deceased donors were included. Seventy-four subjects with pre-transplant diabetes were followed up for 1 year after kidney transplantation. Diabetes remission was defined as the results of the oral glucose tolerance test performed one year after transplantation and the presence or absence of diabetes medications. After 1-year post-transplant, 74 recipients were divided into the persistent diabetes group (n = 58) and the remission group (n = 16). Multivariable logistic regression was performed to identify clinical factors associated with diabetes remission.
Of 74 recipients, 16 (21.6%) showed diabetes remission after 1-year post-transplant. The homeostatic model assessment for insulin resistance numerically increased in both groups throughout the first year after transplantation and significantly increased in the persistent diabetes group. The insulinogenic index (IGI
) value significantly increased only in the remission group, and the IGI
value remained low in the persistent diabetes group. In univariate analysis, younger age, newly diagnosed diabetes before transplantation, low baseline hemoglobin A1c, and high baseline IGI
were significantly associated with remission of diabetes. After multivariate analysis, only newly diagnosed diabetes before transplantation and IGI
at baseline were associated with remission of diabetes (34.00 1.192-969.84,
= 0.039, and 17.625 1.412-220.001,
= 0.026, respectively).
In conclusion, some kidney recipients with pre-transplant diabetes have diabetes remission 1 year after transplantation. Our prospective study revealed that preserved insulin secretory function and newly diagnosed diabetes at the time of kidney transplantation were favorable factors for which glucose metabolism did not worsen or improve 1 year after kidney transplantation.
Many immunosuppressive drugs are prescribed as twice-daily dosing. A simplified once-daily dosing of immunosuppressive drug regimen may improve medication adherence. We investigated medication ...adherence of simplified once-daily immunosuppressive regimen consisting of extended-release tacrolimus, sirolimus, and corticosteroids along with the efficacy and safety of this regimen.
This study was a prospective, multicenter, controlled and cohort trial. Stable kidney transplant recipients who had received transplantation at least 3 months before the study enrollment were eligible for the study. Participants were required to fill-out the self-reported immunosuppressant therapy barrier scale (ITBS) questionnaire before and after the conversion. Other clinical laboratory parameters and adverse events were evaluated until 6 months post-conversion.
A total of 160 kidney recipients comprised the intention-to-treat population. The mean total ITBS score was 19.5 ± 4.0 at pre-conversion and 6 months after converting, the mean total ITBS score was 16.6 ± 3.6 (p < 0.001). Particularly, the ITBS scores of 4 questions related to the frequency of medication dosing were significantly different between pre-conversion and post-conversion. Only 1 patient (0.62%) was diagnosed as biopsy-confirmed acute rejection in the study period. There was no significant change in the mean estimated glomerular filtration rate after the conversion. Overall 95 patients (59.4%) had an adverse event and 28 patients (17.5%) had a serious adverse event. No graft loss and 1 death were reported.
Medication adherence after the conversion to the once-daily immunosuppressive regimen was significantly improved with no additional risks of efficacy failure or adverse events.
PDF
