Evaluating emotional distress and health-related quality of life in patients with heart failure and their family caregivers:Testing dyadic dynamics using the Actor-Partner Interdependence Model

Purpose: 1) To compare levels of emotional symptoms and health-related quality of life between patients with heart failure and their family caregivers; and 2) to examine whether patients’ and caregivers’ emotional symptoms were associated with their own, as well as their partner’s health-related quality of life. Method: In this cross-sectional study, 41 patients-caregiver dyads (78% male patients, aged 68.6 years; and 83% female caregivers, aged 65.8 years) completed all nine dimensions of the Brief Symptom Inventory and the Minnesota Living with Heart failure Questionnaire. Dyadic data were analysed for 6 sub-scales of the Brief Symptom Inventory, using the Actor–Partner Interdependence Model. Results: There were no statistically significant differences in emotional symptoms and health-related quality of life between patients with heart failure and their caregivers. Patients’ and caregivers’ emotional symptoms were associated with their own health-related quality of life. Caregivers’ anxiety, phobic anxiety, obsession-compulsion, depression and hostility negatively influenced their partner’s (i.e. the patient’s) health-related quality of life. There were no partner effects of patients’ emotional symptoms on the health-related quality of life of caregivers. Conclusions: The results of this study suggest that patients may be particularly vulnerable to the emotional distress, i.e. thoughts, impulses and actions of their caregivers. It may be possible to improve patients’ health-related quality of life by targeting specific detrimental emotional symptoms of caregivers

Potential pharmacological chaperones targeting cancer-associated MCL-1 and Parkinson disease-associated α-synuclein

Pharmacological chaperones are small molecules that bind to proteins and stabilize them against thermal denaturation or proteolytic degradation, as well as assist or prevent certain protein-protein assemblies. These activities are being exploited for the development of treatments for diseases caused by protein instability and/or aberrant protein-protein interactions, such as those found in certain forms of cancers and neurodegenerative diseases. However, designing or discovering pharmacological chaperones for specific targets is challenging because of the relatively featureless protein target surfaces, the lack of suitable chemical libraries, and the shortage of efficient high-throughput screening methods. In this study, we attempted to address all these challenges by synthesizing a diverse library of small molecules that mimic protein α-helical secondary structures commonly found in protein-protein interaction surfaces. This was accompanied by establishing a facile "on-bead" high-throughput screening method that allows for rapid and efficient discovery of potential pharmacological chaperones and for identifying novel chaperones/inhibitors against a cancer-associated protein, myeloid cell leukemia 1 (MCL-1), and a Parkinson disease-associated protein, α-synuclein. Our data suggest that the compounds and methods described here will be useful tools for the development of pharmaceuticals for complex-disease targets that are traditionally deemed "undruggable.

Enzymatic Production and Biological Activities of Cellobio-oligosaccharides from Lignocellulose

Cellulose is the most abundant biopolymer in nature and is the major component of lignocellulosic biomass. It has potential to produce not only glucose but value¨Cadded products such as cellobiose and oligosaccharides. Typically, enzymatic hydrolysis of cellulose produces glucose and a small amount of cellobiose. Modification of cellulase solutions altered ratio of glucose to cellobiose produced. The addition of glucose oxidase, gluconolactone, or gluconic acid significantly increased the amount of cellobiose remaining at the end of cellulose hydrolysis. Addition of glucose oxidase resulted in cellobiose being 23.7% of the product sugars from pure cellulose and 14.1% from ligonocellulose (sugarcane bagasse). The presence of gluconolactone in the reaction mixture increased cellobiose to 31.3% of the sugars from cellulose and 15.8% from bagasse. The presence of gluconic acid changed the cellobiose to 21.9% of the sugars from cellulose and 13.2% from bagasse. In order to produce cellobio-oligosaccharides, a dextransucrase from Leuconostoc mesenteroides B-512FMCM was employed to catalyze the transglycosylation reaction between cellobiose and sucrose. The major cellobio-oligosaccharides were the trisaccharides, ¦Á-D-glucopyranosyl-(1¡ú2)-cellobiose and ¦Á-D-glucopyranosyl-(1¡ú6)-cellobiose. Cellobio-oligosaccharides have valuable functional properties as potential antifungal and anticariogenic agents, and an ¦Á-glucosidase inhibitor

Mechanical unloading activates FoxO3 to trigger Bnip3‐dependent cardiomyocyte atrophy

BACKGROUND: Mechanical assist device therapy has emerged recently as an important and rapidly expanding therapy in advanced heart failure, triggering in some patients a beneficial reverse remodeling response. However, mechanisms underlying this benefit are unclear. METHODS AND RESULTS: In a model of mechanical unloading of the left ventricle, we observed progressive myocyte atrophy, autophagy, and robust activation of the transcription factor FoxO3, an established regulator of catabolic processes in other cell types. Evidence for FoxO3 activation was similarly detected in unloaded failing human myocardium. To determine the role of FoxO3 activation in cardiac muscle in vivo, we engineered transgenic mice harboring a cardiomyocyte‐specific constitutively active FoxO3 mutant (caFoxO3(flox);αMHC‐Mer‐Cre‐Mer). Expression of caFoxO3 triggered dramatic and progressive loss of cardiac mass, robust increases in cardiomyocyte autophagy, declines in mitochondrial biomass and function, and early mortality. Whereas increases in cardiomyocyte apoptosis were not apparent, we detected robust increases in Bnip3 (Bcl2/adenovirus E1B 19‐kDa interacting protein 3), an established downstream target of FoxO3. To test the role of Bnip3, we crossed the caFoxO3(flox);αMHC‐Mer‐Cre‐Mer mice with Bnip3‐null animals. Remarkably, the atrophy and autophagy phenotypes were significantly blunted, yet the early mortality triggered by FoxO3 activation persisted. Rather, declines in cardiac performance were attenuated by proteasome inhibitors. Consistent with involvement of FoxO3‐driven activation of the ubiquitin‐proteasome system, we detected time‐dependent activation of the atrogenes program and sarcomere protein breakdown. CONCLUSIONS: In aggregate, these data point to FoxO3, a protein activated by mechanical unloading, as a master regulator that governs both the autophagy‐lysosomal and ubiquitin‐proteasomal pathways to orchestrate cardiac muscle atrophy

Factors associated with emergency among older adults at the emergency department in South Korea

Older adults\u27 emergency departments (EDs) visits increase globally. Since the patterns of older adults\u27 EDs usage differed from other age groups, identifying their risk factors related to emergency would be beneficial. Chest pain, dizziness, dyspnea and hypoalbuminemia were related to emergency in EDs visits by older adults in South Korea

Symptom management strategies with Tai Chi for stroke rehabilitation

Session presented on Saturday, July 25, 2015: Cerebrovascular disease is a major global conceRNThe individuals with stroke would suffer from disease associated symptoms which influence their functioning in everyday life. These symptom clusters were usually known to be sharing similar underlying mechanisms. It is clear that the development of effective stroke rehabilitation involves interdisciplinary team approach to manage physical, social, cognitive, and psychological functioning in this population. Tai Chi is a low intense aerobic exercise, characterized by continuous movements that embrace the mind, body, and spirit. Tai Chi addresses the integration and balance of mind and body using the fundamental principles of slow, smooth, and continuous movement control, and the transfer of body weight while maintaining an upright and relaxed posture. The characteristics of seated Tai Chi shares the common Tai Chi principles while being modified to adjust the movements for wheelchair bound patients. The purpose of this symposium, consisting of three sessions, is to present the scientific evidence for the use of Tai Chi as a new approach of stroke rehabilitation. The first session will present symptom clusters of stroke patients by rehabilitation stages, followed by Introduction of seated Tai Chi as a new approach for stroke rehabilitation, and finally the last session will present the pilot study on the effect of seated Tai Chi on physical functioning among individuals with stroke. Audience participatory session to practice together few movements of seated Tai Chi and Q&A session will be followed at the end of the symposium

Compatibility between Teachers Beliefs and Those of Students with Varying Proficiency Levels Concerning Korean Language Learning

This study aims to explore language learning beliefs of Korean language learners from three different levels of proficiency and then compare their beliefs with those of language teachers who are native speakers of Korean. A total of 126 participants (ninety nine students and 27 teachers) were asked to fill out a questionnaire, the Beliefs about Language Learning Inventory (BALLI). The findings show that the students from the three levels of proficiency hold many similar beliefs on language learning, but they also hold some different beliefs. The analysis of an ANOVA and a Post-hoc revealed that the mean differences for certain items were statistically significant among the three groups. Also, the findings revealed that the students and the teachers maintain different beliefs, and the analysis of a t-test for the two groups showed that some differences between the two groups are statistically significant. These findings yield some points for teachers to contemplate with a view to promoting students motivation and language learning

Design and Analysis Methods for Cluster Randomized Trials with Pair-Matching on Baseline Outcome: Reduction of Treatment Effect Variance

Cluster randomized trials (CRT) are comparative studies designed to evaluate interventions where the unit of analysis and randomization is the cluster but the unit of observation is individuals within clusters. Typically such designs involve a limited number of clusters and thus the variation between clusters is left uncontrolled. Experimental designs and analysis strategies that minimize this variance are required. In this work we focus on the CRT with pre-post intervention measures. By incorporating the baseline measure into the analysis, we can effectively reduce the variance of the treatment effect. Well known methods such as adjustment for baseline as a covariate and analysis of differences of pre and post measures are two ways to accomplish this. An alternate way of incorporating baseline measures in the data analysis is to order the clusters on baseline means and pairmatch the two clusters with the smallest means, pair-match the next two, and so on. Our results show that matching on baseline helps to control the between cluster variation when there is a high correlation between the pre-post measures. Six cases of designs and analysis are evaluated by comparing the variance of the treatment effect and the power of related hypothesis tests. We observed that - given our assumptions - the adjusted analysis for baseline as a covariate without pair-matching is the best choice in terms of variance. Future work may reveal that other matching schemes that reflect the natural clustering of experimental units could reduce the variance and increase the power over the standard methods

Evaluating perceptions of self-efficacy and quality of life in patients having coronary artery bypass grafting and their family caregivers

Background Self-efficacy is a critical factor for quality of life in patients who undergo coronary artery bypass grafting, as well as for their family caregivers. However, there is lack of knowledge about whether patients' self-efficacy and caregivers' perceptions of patient self-efficacy are associated with quality of life in patient and caregiver dyads. Objectives The aims of this study were to compare self-efficacy and quality of life between patients and family caregivers and to examine whether patients' and caregivers' perceptions of patient self-efficacy were associated with their own and their partner's quality of life in patient and caregiver dyads who were waiting for patients' coronary artery bypass grafting. Methods In this cross-sectional study, 84 dyads (85% male patients and 87% female caregivers) completed the Cardiac Self-efficacy Scale, which consists of self-efficacy for controlling symptoms and self-efficacy for maintaining function subscales, and the Short-Form 12 Health Survey for quality of life. Data were analyzed using the Actor-Partner Interdependence Model. Results Caregivers rated patient self-efficacy for maintaining function higher than did patients themselves and caregivers' perceptions were positively correlated with patients' physical health. Patients' self-efficacy for maintaining function exhibited an actor effect on their own mental health. There were no other actor or partner effects of self-efficacy on quality of life. Conclusions Differences between patients' and caregivers' perceptions of patient self-efficacy for maintaining function should be addressed before surgery to reduce discordance. Patients' self-efficacy for maintaining function was associated with their own quality of life. There was no partner (relationship) effect of self-efficacy on quality of life. More research is needed in this area