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• In ICD patients, a reduced executive function predicted 12-month cardiac events. • Longer time after implant also affected 12-month cardiac events. • Healthcare providers need to regularly evaluate executive function in routine care. Post-implant recovery in patients with implantable cardioverter-defibrillators (ICDs) is often compromised because of reduced physical and psycho-cognitive function and poor health perception, leading to short event-free survival. To examine the effects of psychocognitive function, health perception, and ICD-related factors on 12-month cardiac events among ICD patients. Using a prospective study design, ICD patients underwent baseline assessment and were followed for 12 months to assess cardiac events. Cardiac events occurred in 14 patients (18.9%) (N = 74: age, 58 years; primary ICDs, 45.9%). Time after ICD implant (odds ratio [OR] = 1.002; p =.028) and executive function (OR = 1.021; p =.027) were significant predictors of 12-month cardiac events, while other physical and psychological indices were not. Reduced executive function and longer time after implant predicted the events. Healthcare professionals need to assess executive function and provide treatment and support to improve executive function. [ABSTRACT FROM AUTHOR]

Patients with heart failure (HF) have not been considered as major beneficiaries of advance directives (ADs). We analyzed factors affecting the preferences for the adoption of ADs by patients with HF and their caregivers. Seventy-one patient (mean age: 68 years)–caregiver (mean age: 55 years) dyads were enrolled during clinic visits for routine care at a single institution and completed questionnaires during in-person visits. Cohen's kappa coefficients and generalized estimating equation models were used to analyze the data. The agreement on dyadic perspectives for aggressive treatments was poor or fair, whereas agreement relative to hospice care was moderate (k = 0.42, 95% confidence interval = 0.087–0.754). Both patients and caregivers demonstrated poor knowledge of ADs and similar levels of perceived benefits and barriers to advance care planning. However, the caregivers had more positive attitudes toward ADs than patients. Patients and caregivers who were older and/or males had greater odds of preferring aggressive treatments and/or hospice care. Further, those with depressive symptoms had lower odds of preferring hospice care. The dyadic agreement was moderately high only for hospice care preferences. Both patients and caregivers demonstrated knowledge of shortfalls regarding ADs. Timely AD discussions could increase dyadic agreement and enhance informed and shared decision-making regarding medical care. [ABSTRACT FROM AUTHOR]

• BG showed possessed the inhibitory ability of DPPH and ABTS. • BG could improve RE-induced oxidative stress in the esophagus of rats. • BG may be more effective than RG in rat reflux esophagitis model. • BG effected of that the inactivation of NF-κB by blocking the degradation of IκBα. • BG led to the suppression of the release of proinflammatory cytokines. The present study was conducted to determine whether black garlic (BG) which is aged by pectinase treatment with high hydrostatic pressure processing has the protective effects in experimental model of acute reflux esophagitis (RE). BG was orally administered at a dose of 100 mg/kg body weight 2 h prior to induction of RE, and the effects were compared with those of raw garlic (RG). Esophageal pathological changes were analyzed using gross and histological examinations. The anti-oxidant and inflammatory protein levels were determined using western blotting. Moreover, RE-induced histological change was markedly suppressed by BG rather than RG. The reduced catalase was increased significantly by BG supplementation; however, superoxide dismutase levels showed a tendency to increase in the esophagus. Overall, the ameliorative effects of BG were superior to those when RG. These data reveal that that BG treatment ameliorates the development of esophagitis via regulation of NF-κB mediated inflammation. [ABSTRACT FROM AUTHOR]

Abstract Cooling radiant ceiling panel (CRCP) systems have been increasingly applied to modern buildings, owing to high thermal comfort, energy-saving potential, and integration with building design. Currently, the cooling capacity of CRCP is generally evaluated for the closed-type CRCP, wherein the overall ceiling surface is covered with ceiling panels. However, there have been few previous studies on the evaluation of the cooling capacity for open-type CRCP, which are installed with openings (void areas) between adjacent ceiling panels. This study was conducted to verify the hypothesis that the open-type CRCP can enhance cooling capacity by utilizing the cooled plenum air moving through the opening. If the plenum air is cooled by the upper surface of ceiling panels and descends to the conditioned space, it can contribute to increasing the convective heat transfer and cooling capacity. A simulation model for open-type CRCP was developed and validated against the mock-up experiment. Using the simulation model, the cooling capacity of the open-type CRCP was evaluated with respect to the opening area and panel layout. The results showed that the open-type CRCP could provide 54–80% (average 64%) higher nominal cooling capacity than conventional closed-type CRCP. The enhanced cooling capacity may lead to reduction in construction costs and energy consumption, because panel installation area could be reduced and the water temperature can be increased to provide the required cooling capacity. The results of this study would be able to offer fundamental data about cooling capacity of open-type CRCP. Highlights • The cooling capacity of open-type CRCPs was evaluated with a numerical method. • The developed simulation model of open-type CRCPs was validated through mock-up experiments. • The relation between the cooling capacity and design parameters of open-type CRCPs was analyzed. • Open-type CRCPs provided 54–80% higher nominal cooling capacity than closed-type CRCPs. • More cooling capacity can be obtained with a larger opening area and a distributed panel layout. [ABSTRACT FROM AUTHOR]

As the airtightness of a building envelope gets higher to achieve energy efficiency, the necessity of appropriate ventilation for residential buildings is continually increasing. Many residential buildings are equipped with energy recovery ventilators (ERV) for energy-efficient ventilation; however, the ERVs are usually operated by occupants' manual control, which often leads to insufficient or unnecessary ventilation. Because it is difficult to operate an ERV during nighttime, when occupants cannot control the system, a residential building can suffer from poor indoor air quality and increasing condensation risks. Herein, a CO 2 -based ventilation control strategy was implemented in an existing ERV system for residential buildings. Considering that most ERV systems operate with a central control, the appropriate CO 2 sensor location (or representative room) was investigated in a mock-up residential building. Comparative experiments were conducted to evaluate the control performances in terms of indoor air quality (CO 2 control performance) and fan energy consumption. Experimental results showed that a living-room-based control can maintain an overall CO 2 concentration in the entire space at acceptable levels. It was also shown that a living-room-based control resulted in reduced ventilation energy if the CO 2 dispersed through open bedroom doors. The CO 2 -based ventilation control was modified to mitigate the condensation risk while minimizing the possibility of fan noise or cold draught. Through mock-up experiments on a modified CO 2 -based ventilation control, it was shown that CO 2 concentrations can be maintained at acceptable levels and condensation risks can be mitigated even when the outdoor temperature decreases to −15 °C. [ABSTRACT FROM AUTHOR]

Background There is limited evidence on the degree of cognitive impairment and its association with physical functional capacity among patients with heart failure (HF) in Korea. Objectives In this study, we compared cognitive impairment between patients with HF and community-dwelling participants with non-HF medical conditions (medical participants) and its association with physical functional capacity. Methods We conducted a cross-sectional comparative study and assessed the neuropsychological cognitive status (Seoul Neuropsychological Screening Battery) and physical functional capacity (Duke Activity Status Index) of patients with HF and medical participants using face-to-face interviews. Results One hundred and eighteen patients with HF (age, 65.45 ± 9.38 years; men, 57.6%; left ventricular ejection fraction, 34.93 ± 8.72%) and 83 medical participants (age, 66.02 ± 8.28 years; men, 47.0%) were included. Using seventh-percentile medical participant Z-scores as cutoffs, memory and executive function were worse in patients with HF than in medical participants: immediate (35.0% vs. 6.0%) and delayed recall memory (34.5% vs. 8.4%), and executive function (28.6% vs. 6.0%). Independent of age, sex, education, comorbidity, and HF status, executive function was a significant predictor of physical functional capacity (b = 1.82, p = .021). Conclusions More patients with HF had impaired memory and executive function, which were associated with their physical functional capacities. [ABSTRACT FROM AUTHOR]

Although several studies have conducted maternal transfer of individual PBDE congener in experimental animals, there is a paucity of research on differences in maternal transfer of PBDE congeners. The purpose of the study was to investigate and compare placental and lactational transfer of BDE 47, -209 and its metabolites in rat dam-offspring pairs following repeated administration of BDE 47 and -209. 13 C-BDE 47, BDE 209 and its debrominated congeners were detected both in dam serum and offspring body, which indicates that PBDEs can be maternally transferred. In addition, BDE 196 and -197 appeared in offspring body earlier than in maternal serum, which suggests that debromination can be occur in offspring body. BDE 209 increased in both dam and offspring while levels of 13 C-BDE 47 was not increased in dam serum. 13C-BDE 47 seems to be stored in breast milk rather than in maternal serum, which can be assumed through the drastic increase of the congener in suckling pups. The magnitude of lactational transfer of the administered congeners was greater than that of placental transfer. And 13 C-BDE 47 was relatively more transferred to suckling pups than BDE 209 through breastfeeding. [ABSTRACT FROM AUTHOR]

Purpose The goal of this study was to evaluate whether the blood pressure–lowering efficacy of fimasartan/amlodipine combination therapy was superior to that of fimasartan monotherapy after 8 weeks of treatment in patients with hypertension who had failed to respond adequately to fimasartan monotherapy. Methods This trial was a randomized, double-blind, multicenter, Phase III clinical study. Patients who failed to respond after 4 weeks of treatment with 60 mg daily of fimasartan (sitting systolic blood pressure [SiSBP]) ≥140 mm Hg) were randomized to receive either daily fimasartan 60 mg or fimasartan/amlodipine 60 mg/10 mg. The primary efficacy end point was the change in SiSBP from baseline to week 8. Secondary end points included the change in SiSBP from baseline to week 4, the changes in sitting diastolic blood pressure from baseline to weeks 4 and 8, and the response rate (SiSBP <140 mm Hg or decrease in SiSBP ≥20 mm Hg) or control rate (SiSBP <140 mm Hg) at week 8. Treatment-emergent adverse events were also assessed. Findings Of 143 patients randomized to treatment, 137 patients who had available efficacy data were analyzed. The mean age of patients was 59.1 (8.9) years, and 100 (73.0%) were male. Baseline SiSBP and sitting diastolic blood pressure were 150.6 (9.2) mm Hg and 91.7 (8.6) mm Hg, respectively. In the fimasartan/amlodipine combination group, a greater reduction in SiSBP from baseline to week 8 was observed compared with the fimasartan group (7.8 [13.3] mm Hg in the fimasartan group vs 20.5 [14.6] mm Hg in the fimasartan/amlodipine group; P < 0.0001). This reduction was observed after 4 weeks. The mean SiSBP changes from baseline to week 4 were 8.1 (15.8) mm Hg in the fimasartan group and 20.1 (14.7) mm Hg in the fimasartan/amlodipine group ( P < 0.0001). At week 8, the response rate was significantly higher in the fimasartan/amlodipine (82.1%) group than in the fimasartan (32.9%) group ( P < 0.0001). The control rate at week 8 was also higher in the fimasartan/amlodipine (79.1%) group than in the fimasartan (31.4%) group ( P < 0.0001). Adverse drug reactions were observed in 9 patients (6.3%), with no significant differences between treatment groups. There were no serious adverse events associated with the study drugs. Implications Fimasartan/amlodipine combination therapy exhibited superior efficacy in reducing blood pressure, with no increase in adverse drug reactions, compared with fimasartan monotherapy. ClinicalTrials.gov identifier: NCT02152306. [ABSTRACT FROM AUTHOR]

In the past couple of decades, literature in pediatric neurology and clinical genetics has identified hundreds of monogenic disorders that can masquerade as infantile cerebral palsy (CP). Accurate and prompt diagnosis in such cases may be challenging due to several reasons. There are commercial multigene CP panels, but their diagnostic yield is often limited compared with exome sequencing because of diverse etiologies that may mimic CP. We report one such case where a patient with spastic hemiplegia underwent a long diagnostic journey before genetic diagnosis was established with exome sequencing and appropriate management was started. TTC19 -related mitochondrial complex III deficiency is an ultrarare disorder of energy metabolism that presents with bilateral lesions in the basal ganglia and a degenerative neuropsychiatric phenotype. [ABSTRACT FROM AUTHOR]

Parabens are common chemicals used as preservatives in foods, cosmetics, and personal care products. Although transdermal exposure to parabens occurs, studies on human pharmacokinetics (PK) following dermal exposure to parabens are scarce. In this study, the PK following dermal exposure to parabens was determined and compared with our previous findings on oral exposure. A paraben mixture cream containing 0.8% deuterated methyl-, ethyl-, and propylparaben (MeP-d 4 0.26%; EtP-d 4 0.26%, and PrP-d 4 0.28%) was dermally applied to the whole arm of five male volunteers at a dose of 24 g/person over 30 min. Blood and urine samples were collected at several intervals over the course of 48 h to measure the levels of MeP-d 4 , EtP-d 4 , and PrP-d 4 and their conjugated metabolites using HPLC-MS/MS. As a result of non-compartmental analysis, the average peak values of total (sum of conjugated and unconjugated metabolites) MeP-d 4 , EtP-d 4, and PrP-d 4 were reached at 7.8 h, 10.5 h, and 5.3 h, indicating a slower absorption rate compared to that of oral exposure (<2 h). The terminal elimination half-lives of MeP-d 4 , EtP-d 4 , and PrP-d 4 were 12.2 h, 12.0 h, and 9.3 h, respectively. Fractional urinary excretion (F ue) of total MeP-d 4 , EtP-d 4 , and PrP-d 4 was 1.7%, 2.3%, and 1.9%, respectively. The F ue of total and unconjugated PrP-d 4 following dermal exposure was five times lower and three times higher, respectively, compared with those after oral exposure, suggesting that PrP is relatively less metabolized to the conjugated form after dermal exposure. Taken together, dermal exposure to paraben leads to a longer apparent half-life and results in higher proportions of biologically active unconjugated parabens in the systemic circulation as compared to oral exposure. This study provides insights into the kinetic properties of parabens and their metabolites in humans. [Display omitted] • Paraben exposure from cosmetic use has been confirmed. • Dermal exposure to MeP, EtP, and PrP led to a long apparent half-life. • The urinary excretion fraction (F ue) after dermal exposure ranged from 1.7 to 2.3%. • Dermal exposure led to a high biologically active unconjugated paraben proportion. [ABSTRACT FROM AUTHOR]

Carcinoembryonic antigen-related cell adhesion molecule 6 (CEACAM6) plays a crucial role in tumorigenesis of lung cancer. However, the therapeutic potential for anti CEACAM6 monoclonal antibody (mAb) has only been limitedly explored. Here, we evaluate the therapeutic potential of naked anti CEACAM6 mAb against lung adenocarcinoma. Clone 8F5, recognizing B domain of CEACAM6, is established by immunizing A549 cells and screening for clones double positive for A549 and CEACAM6-Fc recombinant protein. We found that 85.7% of 70 resected lung adenocarcinoma tissue sections were positive for CEACAM6, whereas all squamous cell carcinoma examined were negative. A549 cells with high levels of CEACAM6 demonstrated more aggressive growth nature and showed increased paclitaxel chemosensitivity upon 8F5 binding. Treatment with 8F5 to A549 decreased cellular CEACAM6 expression and reversed anoikis resistance. 8F5 also decreased cellular status of Akt phosphorylation and increased apoptosis via caspase activation. In a mouse model of lung adenocarcinoma with xenotransplanted A549 cells, 8F5 treatment alone demonstrated 40% tumor growth inhibition. When combined with paclitaxel treatment, 8F5 markedly enhanced tumor growth inhibition, up to 80%. In summary, we demonstrate that anti CEACAM6 mAb is an effective therapeutic treatment for lung adenocarcinoma whose effect is further enhanced by combined treatment with paclitaxel. [ABSTRACT FROM AUTHOR]