Association of angiotensin-converting enzyme inhibitor therapy and comorbidity in diabetes: results from the Vermont diabetes information system

<p>Abstract</p> <p>Background</p> <p>Angiotensin converting enzyme inhibitors (ACE inhibitors) reduce peripheral vascular resistance via blockage of angiotensin converting enzyme (ACE). ACE inhibitors are commonly used to treat congestive heart failure and high blood pressure, but other effects have been reported. In this study, we explored the association between ACE inhibitor therapy and the prevalence of comorbid conditions in adults with diabetes</p> <p>Methods</p> <p>We surveyed 1003 adults with diabetes randomly selected from community practices. Patients were interviewed at home and self-reported their personal and clinical characteristics including comorbidity. Current medications were obtained by direct observation of medication containers. We built logistic regression models with the history of comorbidities as the outcome variable and the current use of ACE inhibitors as the primary predictor variable. We adjusted for possible confounding by social (age, sex, alcohol drinking, cigarette smoking) and clinical factors (systolic blood pressure, body mass index (BMI), glycosolated hemoglobin (A1C), number of comorbid conditions, and number of prescription medications).</p> <p>Results</p> <p>ACE users reported a history of any cancer (except the non-life-threatening skin cancers) less frequently than non-users (10% <it>vs</it>. 15%; odd ratio = 0.59; 95% confidence interval [0.39, 0.89]; <it>P </it>= 0.01); and a history of stomach ulcers or peptic ulcer disease less frequently than non-users (12% <it>vs</it>. 16%, odd ratio = 0.70, [0.49, 1.01], <it>P </it>= 0.06). After correcting for potential confounders, ACE inhibitors remained significantly inversely associated with a personal history of cancer (odds ratio = 0.59, [0.39, 0.89]; <it>P </it>= 0.01) and peptic ulcer disease (odd ratio = 0.68, [0.46, 1.00], <it>P </it>= 0.05).</p> <p>Conclusion</p> <p>ACE inhibitor use is associated with a lower likelihood of a history of cancer and peptic ulcers in patients with diabetes. These findings are limited by the cross sectional study design, self-report of comorbid diagnoses, and lack of information on the timing and duration of ACE inhibitor use. Further research is needed to confirm these associations and understand their mechanisms.</p

Real-time time-domain fluorescence lifetime imaging including single-shot acquisition with a segmented optical image intensifier

Published versio

Silicon optical modulators for high data rate applications

Abstract In this work we describe the carrier depletion MZI modulators, slow wave structures for modulation enhancement and the QCSE modulator which are under development in the European HELIOS project and the UK Silicon Photonics project. Introduction High performance silicon optical modulators are key to many silicon based photonic applications. Over the previous decade the development seen in the performance of silicon optical modulators has been vast. Several routes to modulation have been used to overcome the lack of a strong electro optic effect in silicon. These include the plasma dispersion effect, III-V hybrid device fabrication, SiGe devices, Polymer and Strain induced electro-optic effects. Reported performances now regularly range from 10Gbit/s up to 40Gbit/s. HELIOS, which is a European FP7 funded project and the UK silicon photonics project (UKSP), funded by the EPSRC both involve the development of the different photonic components required to form photonic circuits with a range of functionality. Within both projects there is strong modulator activity with carrier depletion based modulation, QCSE modulation and structures to gain enhancement of the modulation effect under development. Carrier depletion modulation Optical modulators based upon free carrier depletion are widely regarded as being the simplest approach to achieve high performance modulation in silicon. They operate by reverse biasing a diode structure which is incorporated in or around an optical waveguide. The depletion of free carriers therefore interacts with the propagating light causing a change in phase through the plasma dispersion effect. Within the HELIOS project two phase modulators based upon this approach are under investigation using both PN and PIPIN diodes. Cross sectional diagrams of these devices are shown in figure 1. The first structure is based in silicon-on-insulator (SOI) of 220nm thickness. The waveguide section and the slab to one side is doped p type. The slab on the other side of the waveguide is then doped n type setting up a pn junction at the edge of the waveguide rib. The concentration of the n type doping is made larger than the p type doping such that the depletion region extends mainly into the waveguide during reverse bias. These lightly doped p and n type regions extend out to meet highly doped regions which in turn provide ohmic contacts to coplanar waveguide electrodes which are used to drive the device. The devic

A Toll-Like Receptor 2 Pathway Regulates the Ppargc1a/b Metabolic Co-Activators in Mice with Staphylococcal aureus Sepsis

Activation of the host antibacterial defenses by the toll-like receptors (TLR) also selectively activates energy-sensing and metabolic pathways, but the mechanisms are poorly understood. This includes the metabolic and mitochondrial biogenesis master co-activators, Ppargc1a (PGC-1α) and Ppargc1b (PGC-1β) in Staphylococcus aureus (S. aureus) sepsis. The expression of these genes in the liver is markedly attenuated inTLR2−/− mice and markedly accentuated in TLR4−/− mice compared with wild type (WT) mice. We sought to explain this difference by using specific TLR-pathway knockout mice to test the hypothesis that these co-activator genes are directly regulated through TLR2 signaling. By comparing their responses to S. aureus with WT mice, we found that MyD88-deficient and MAL-deficient mice expressed hepatic Ppargc1a and Ppargc1b normally, but that neither gene was activated in TRAM-deficient mice. Ppargc1a/b activation did not require NF-kβ, but did require an interferon response factor (IRF), because neither gene was activated in IRF-3/7 double-knockout mice in sepsis, but both were activated normally in Unc93b1-deficient (3d) mice. Nuclear IRF-7 levels in TLR2−/− and TLR4−/− mice decreased and increased respectively post-inoculation and IRF-7 DNA-binding at the Ppargc1a promoter was demonstrated by chromatin immunoprecipitation. Also, a TLR2-TLR4-TRAM native hepatic protein complex was detected by immunoprecipitation within 6 h of S. aureus inoculation that could support MyD88-independent signaling to Ppargc1a/b. Overall, these findings disclose a novel MyD88-independent pathway in S. aureus sepsis that links TLR2 and TLR4 signaling in innate immunity to Ppargc1a/b gene regulation in a critical metabolic organ, the liver, by means of TRAM, TRIF, and IRF-7

Syntheses and Electronic Properties of Rhodium(III) Complexes Bearing a Redox-Active Ligand

A series of rhodium(III) complexes of the redox-active ligand, H(L = bis(4-methyl-2-(1H-pyrazol-1-yl)phenyl)amido), was prepared, and the electronic properties were studied. Thus, heating an ethanol solution of commercial RhCl3·3H2O with H(L) results in the precipitation of insoluble [H(L)]RhCl3, 1. The reaction of a methanol suspension of [H(L)]RhCl3 with NEt4OH causes ligand deprotonation and affords nearly quantitative yields of the soluble, deep-green, title compound (NEt4)[(L)RhCl3]·H2O, 2·H2O. Complex 2·H2O reacts readily with excess pyridine, triethylphosphine, or pyrazine (pyz) to eliminate NEt4Cl and give charge-neutral complexes trans-(L)RhCl2(py), trans-3, trans-(L)RhCl2(PEt3), trans- 4, or trans-(L)RhCl2(pyz), trans-5, where the incoming Lewis base is trans- to the amido nitrogen of the meridionally coordinating ligand. Heating solutions of complexes trans-3 or trans-4 above about 100 °C causes isomerization to the appropriate cis-3 or cis-4. Isomerization of trans-5 occurs at a much lower temperature due to pyrazine dissociation. Cis-3 and cis- 5 could be reconverted to their respective trans- isomers in solution at 35 °C by visible light irradiation. Complexes [(L)Rh(py)2Cl](PF6), 6, [(L)Rh(PPh3)(py)Cl](PF6), 7, [(L)Rh(PEt3)2Cl](PF6), 8, and [(L)RhCl(bipy)](OTf = triflate), 9, were prepared from 2·H2O by using thallium(I) salts as halide abstraction agents and excess Lewis base. It was not possible to prepare dicationic complexes with three unidentate pyridyl or triethylphosphine ligands; however, the reaction between 2, thallium(I) triflate, and the tridentate 4′-(4-methylphenyl)-2,2′:6′,2″-terpyridine (ttpy) afforded a high yield of [(L)Rh(ttpy)]- (OTf)2, 10. The solid state structures of nine new complexes were obtained. The electrochemistry of the various derivatives in CH2Cl2 showed a ligand-based oxidation wave whose potential depended mainly on the charge of the complex, and to a lesser extent on the nature and the geometry of the other supporting ligands. Thus, the oxidation wave for 2 with an anionic complex was found at +0.27 V versus Ag/AgCl in CH2Cl2, while those waves for the charge-neutral complexes 3−5 were found between +0.38 to +0.59 V, where the cis- isomers were about 100 mV more stable toward oxidation than the trans- isomers. The oxidation waves for 6−9 with monocationic complexes occurred in the range +0.74 to 0.81 V while that for 10 with a dicationic complex occurred at +0.91 V. Chemical oxidation of trans-3, cis-3, and 8 afforded crystals of the singly oxidized complexes, [trans- (L)RhCl2(py)](SbCl6), cis-[(L)RhCl2(py)](SbCl4)·2CH2Cl2, and [(L)Rh(PEt3)2Cl](SbCl6)2, respectively. Comparisons of structural and spectroscopic features combined with the results of density functional theory (DFT) calculations between nonoxidized and oxidized forms of the complexes are indicative of the ligand-centered radicals in the oxidized derivatives

Using Combined Morphological, Allometric and Molecular Approaches to Identify Species of the Genus Raillietiella (Pentastomida)

Taxonomic studies of parasites can be severely compromised if the host species affects parasite morphology; an uncritical analysis might recognize multiple taxa simply because of phenotypically plastic responses of parasite morphology to host physiology. Pentastomids of the genus Raillietiella are endoparasitic crustaceans primarily infecting the respiratory system of carnivorous reptiles, but also recorded from bufonid anurans. The delineation of pentastomids at the generic level is clear, but the taxonomic status of many species is not. We collected raillietiellids from lungs of the invasive cane toad (Rhinella marina), the invasive Asian house gecko (Hemidactylus frenatus), and a native tree frog (Litoria caerulea) in tropical Australia, and employed a combination of genetic analyses, and traditional and novel morphological methods to clarify their identity. Conventional analyses of parasite morphology (which focus on raw values of morphological traits) revealed two discrete clusters in terms of pentastome hook size, implying two different species of pentastomes: one from toads and a tree frog (Raillietiella indica) and another from lizards (Raillietiella frenatus). However, these clusters disappeared in allometric analyses that took pentastome body size into account, suggesting that only a single pentastome taxon may be involved. Our molecular data revealed no genetic differences between parasites in toads versus lizards, confirming that there was only one species: R. frenatus. This pentastome (previously known only from lizards) clearly is also capable of maturing in anurans. Our analyses show that the morphological features used in pentastomid taxonomy change as the parasite transitions through developmental stages in the definitive host. To facilitate valid descriptions of new species of pentastomes, future taxonomic work should include both morphological measurements (incorporating quantitative measures of body size and hook bluntness) and molecular data

Climate Change and American Bullfrog Invasion: What Could We Expect in South America?

BACKGROUND: Biological invasion and climate change pose challenges to biodiversity conservation in the 21(st) century. Invasive species modify ecosystem structure and functioning and climatic changes are likely to produce invasive species' range shifts pushing some populations into protected areas. The American Bullfrog (Lithobates catesbeianus) is one of the hundred worst invasive species in the world. Native from the southeast of USA, it has colonized more than 75% of South America where it has been reported as a highly effective predator, competitor and vector of amphibian diseases. METHODOLOGY/PRINCIPAL FINDINGS: We modeled the potential distribution of the bullfrog in its native range based on different climate models and green-house gases emission scenarios, and projected the results onto South America for the years of 2050 and 2080. We also overlaid projected models onto the South American network of protected areas. Our results indicate a slight decrease in potential suitable area for bullfrog invasion, although protected areas will become more climatically suitable. Therefore, invasion of these sites is forecasted. CONCLUSION/SIGNIFICANCE: We provide new evidence supporting the vulnerability of the Atlantic Forest Biodiversity Hotspot to bullfrog invasion and call attention to optimal future climatic conditions of the Andean-Patagonian forest, eastern Paraguay, and northwestern Bolivia, where invasive populations have not been found yet. We recommend several management and policy strategies to control bullfrog invasion and argue that these would be possible if based on appropriate articulation among government agencies, NGOs, research institutions and civil society

Ensemble Models of Neutrophil Trafficking in Severe Sepsis

A hallmark of severe sepsis is systemic inflammation which activates leukocytes and can result in their misdirection. This leads to both impaired migration to the locus of infection and increased infiltration into healthy tissues. In order to better understand the pathophysiologic mechanisms involved, we developed a coarse-grained phenomenological model of the acute inflammatory response in CLP (cecal ligation and puncture)-induced sepsis in rats. This model incorporates distinct neutrophil kinetic responses to the inflammatory stimulus and the dynamic interactions between components of a compartmentalized inflammatory response. Ensembles of model parameter sets consistent with experimental observations were statistically generated using a Markov-Chain Monte Carlo sampling. Prediction uncertainty in the model states was quantified over the resulting ensemble parameter sets. Forward simulation of the parameter ensembles successfully captured experimental features and predicted that systemically activated circulating neutrophils display impaired migration to the tissue and neutrophil sequestration in the lung, consequently contributing to tissue damage and mortality. Principal component and multiple regression analyses of the parameter ensembles estimated from survivor and non-survivor cohorts provide insight into pathologic mechanisms dictating outcome in sepsis. Furthermore, the model was extended to incorporate hypothetical mechanisms by which immune modulation using extracorporeal blood purification results in improved outcome in septic rats. Simulations identified a sub-population (about of the treated population) that benefited from blood purification. Survivors displayed enhanced neutrophil migration to tissue and reduced sequestration of lung neutrophils, contributing to improved outcome. The model ensemble presented herein provides a platform for generating and testing hypotheses in silico, as well as motivating further experimental studies to advance understanding of the complex biological response to severe infection, a problem of growing magnitude in humans