Behavioral Self-management in an Inpatient Headache Treatment Unit: Increasing Adherence and Relationship to Changes in Affective Distress

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74935/1/j.1526-4610.2000.00057.x.pd

Low oxygen tension primes aortic endothelial cells to the reparative effect of tissue-protective cytokines

Erythropoietin (EPO) has both erythropoietic and tissue-protective properties. The EPO analogues carbamylated EPO (CEPO) and pyroglutamate helix B surface peptide (pHBSP) lack the erythropoietic activity of EPO but retain the tissue-protective properties that are mediated by a heterocomplex of EPO receptor (EPOR) and the β common receptor (βCR). We studied the action of EPO and its analogues in a model of wound healing where a bovine aortic endothelial cells (BAECs) monolayer was scratched and the scratch closure was assessed over 24 h under different oxygen concentrations. We related the effects of EPO and its analogues on repair to their effect on BAECs proliferation and migration (evaluated using a micro-Boyden chamber). EPO, CEPO and pHBSP enhanced scratch closure only at lower oxygen (5%), while their effect at atmospheric oxygen (21%) was not significant. The mRNA expression of EPOR was doubled in 5% compared to 21% oxygen, and this was associated with increased EPOR assessed by immunofluorescence and Western blot. By contrast βCR mRNA levels were similar in 5% and 21% oxygen. EPO and its analogues increased both BAECs proliferation and migration, suggesting that both may be involved in the reparative process. The priming effect of low oxygen tension on the action of tissue-protective cytokines may be of relevance to vascular disease, including atherogenesis and restenosis

Martian Atmospheric Temperature and Density Profiles During the First Year of NOMAD/TGO Solar Occultation Measurements

We present vertical profiles of temperature and density from solar occultation (SO) observations by the “Nadir and Occultation for Mars Discovery” (NOMAD) spectrometer on board the Trace Gas Orbiter during its first operational year, which covered the second half of Mars Year 34. We used calibrated transmittance spectra in 380 scans, and apply an in-house pre-processing to clean data systematics. Temperature and CO2 profiles up to about 90 km, with consistent hydrostatic adjustment, are obtained, after adapting an Earth-tested retrieval scheme to Mars conditions. Both pre-processing and retrieval are discussed to illustrate their performance and robustness. Our results reveal the large impact of the MY34 Global Dust Storm (GDS), which warmed the atmosphere at all altitudes. The large GDS aerosols opacity limited the sounding of tropospheric layers. The retrieved temperatures agree well with global climate models (GCM) at tropospheric altitudes, but NOMAD mesospheric temperatures are wavier and globally colder by 10 K in the perihelion season, particularly during the GDS and its decay phase. We observe a warm layer around 80 km during the Southern Spring, especially in the Northern Hemisphere morning terminator, associated to large thermal tides, significantly stronger than in the GCM. Cold mesospheric pockets, close to CO2 condensation temperatures, are more frequently observed than in the GCM. NOMAD CO2 densities show oscillations upon a seasonal trend that track well the latitudinal variations expected. Results uncertainties and suggestions to improve future data re-analysis are briefly discussed

Erythropoietin: A potent inducer of peripheral immuno/inflammatory modulation in autoimmune EAE

Background: Beneficial effects of short-term erythropoietin (EPO) theraphy have been demonstrated in several animal models of acute neurologic injury, including experimental autoimmune encephalomyelitis(EAE)-the animal model of multiple sclerosis. We have found that EPO treatment substantially reduces the acute clinical paralysis seen EAE mice and this improvements is accompanied by a large reduction in the mononuclear cell infiltration and downregulation of glial MHC class II expression within the inflamed CNS. Other reports have recently indicated that peripherally generated anti-inflammatory CD4 +Foxp3 3 regulatory T cells (Tregs) and the IL17-producing CD4+ T helper cell (Th17) subpopulations play key antagonistic roles in EAE pathogenesis. However, no information regardind the effects of EPO theraphy on the behavior of the general mononuclear-lymphocyte population, Tregs or Th17 cells in EAE has emerged. Methods and Findings: We first determined in vivo that EPO theraphy markedly suppressed MOG specific T cell proliferation and sharply reduced the number of reactive dendritic cells (CD11c positive) in EAE lumph modes during both inductive and later symptomatic phases of MOG 35-55 induced EAE. We then determined the effect in vivo of EPO on numbers of peripheral Treg cells and Th17 cells. We found that EPO treatment modulated immune balance in both the periphery and the inflamed spinal cord by promoting a large expansion in Treg cells, inhibiting Th17 polarization and abrogating proliferation of the antigen presenting dendritic cell population. Finally we utilized tissue culture assays to show that exposure to EPO in vitro similarly downregulated MOG-specific T cell proliferation and also greatly suppressed T cell production of pro-inflammatory cytokines. Conclusions: Taken together, our findings reveal an important new locus whereby EPO induces substantial long-term tissue protection in the host through signalling to several critical subsets of immune cells that reside in the peripheral lymphatic system.published_or_final_versio

The Use of Preoperative Epoetin-α in Revision Hip Arthroplasty

PURPOSE: To evaluate the efficacy of preoperative epoetin-α on the revision hip arthroplasty patient. We hypothesized that epoetin-α will reduce blood transfusion. A pertinent review of the literature is provided. METHODS: Forty-six patients were retrospectively reviewed. Sixteen patients received epoetin-α. Patients were case matched by age, preoperative hemoglobin, surgery, gender, and BMI. The clinical triggers for blood transfusion during or after the procedure were determined based on peri- and postoperative hemoglobin levels, ASA score, and/or clinical symptoms consistent with anemia. Blood salvage was not used. RESULTS: Blood transfusion and length of stay were decreased in the epoetin-α group. Hemoglobin in the intervention group increased from 12.0 to 14.5, preoperatively. Patients who received epoetin-α were 0.78 (RR=0.225) times as likely to receive a transfusion. Number Needed to Treat (NNT) to avoid one allogeneic transfusion was 1.84. Age, Gender, BMI, ASA, total and hidden blood loss, preoperative Iron supplements, preop Hct, preop PLT, PT, PTT, and INR were similar. One (6.0%) patient developed an uncomplicated deep venous thrombosis in the intervention group. CONCLUSIONS: The mildly anemic revision hip arthroplasty patient is at increased risk for transfusion. Epoetin-α increased preoperative hemoglobin counts and reduced transfusions in this study; it also decreased patient length of hospital stay likely allowing for an earlier readiness to resume normal activities and/or meet short-term milestones. A randomized study to evaluate the direct and indirect costs of such a treatment methodology in the mildly anemic revision patient may be warranted

Male/Female Is Not Enough: Adding Measures of Masculinity and Femininity to General Population Surveys

Survey research and sociological theory each provide insights into how and why people and groups act, think, and feel. Sociological theories identify what concepts are important for understanding and representing the social world. That is, sociological theories inform what to measure in surveys, and, to a certain extent, how to measure it. Survey research permits sociologists to carefully specify what is to be measured vis a vis sociological theory, setting surveys apart as a social research tool. It is this level of specification of concepts and measures that allow surveys to provide continued value at a time when “big data” proliferate. High quality survey measurement and estimation is necessary for sociologists to evaluate sociological theory among generalizable samples with well-developed questions, leading to further refinement and improvement of the theory and improved understanding of the social world. High quality surveys also provide insights into where sociological theories fail and where they must be adjusted for different subgroups, as well as basic insights into the prevalence of outcomes of interest. Together, sociological theory and survey methods produce insights about society that can inform decision-making and social policy. This mutually reinforcing relationship between sociological theory and survey methods requires sociological theory to evolve from insights obtained using survey methods and survey measurement to evolve with advances in in sociological theory. The measurement of sex and gender in surveys is one area where the development of survey measures has not kept pace with sociological theory and empirical, largely qualitative, findings. Contemporary gender theory sees sex and gender as separate concepts, both of which are important for understanding behaviors and outcomes. Yet, virtually all contemporary surveys measure sex as a binary “male” versus “female” categorization and fail to measure gender, ignoring important heterogeneity in gender identification that may exist within sex categories and any overlap that may occur across categories. Both gender scholars and survey researchers are potentially affected by this shortcoming of modern survey measurement. Gender scholars lose an important tool for assessing gender theories, especially on generalizable samples, risking conclusions that are specific to a small group of individuals rather than the population at large. Survey researchers risk producing theoretically obsolete data, limiting the utility of the data or potentially generating misleading conclusions. Survey data that fail to capture and reflect modern and complex understandings of our social realities also face increased risk of being replaced by “big data” such as administrative and social media data. Survey data that do reflect modern and complex understandings can bring value not available in administrative or other data and are therefore unlikely to be replaced. This paper is part of a growing chorus advocating for updates to how modern surveys measure sex and gender. We argue that the reliance on a single binary measure of sex (male or female) is out of step with current sociological understandings of sex and gender. In response, we propose and test a new theoretically-informed gradational measure of gender identification in a nationally representative mail survey. We evaluate whether respondents answer the gender measure and examine the reliability and predictive validity of the measure. In particular, we examine whether measuring gender gradationally adds explanatory value beyond sex on important social outcomes such as sexuality, childcare, grocery shopping, housework, working for pay, and military service. We also examine whether sex moderates the effect of gender identification in the ways that sociological theory would suggest on these outcomes

Strong Localized Pumping of Water Vapor to High Altitudes on Mars During the Perihelion Season

Here we present water vapor vertical profiles observed with the ExoMars Trace Gas Orbiter/Nadir and Occultation for MArs Discovery instrument during the perihelion and Southern summer solstice season (LS = 240°–300°) in three consecutive Martian Years 34, 35, and 36. We show the detailed latitudinal distribution of H2O at tangent altitudes from 10 to 120 km, revealing a vertical plume at 60°S–50°S injecting H2O upward, reaching abundance of about 50 ppmv at 100 km. We have observed this event repeatedly in the three Martian years analyzed, appearing at LS = 260°–280° and showing inter‐annual variations in the magnitude and timing due to long term effects of the Martian Year 34 Global Dust Storm. We provide a rough estimate of projected hydrogen escape of 3.2 × 109 cm−2 s−1 associated to these plumes, adding further evidence of the key role played by the perihelion season in the long term evolution of the planet's climate

A Distinct Layer of the Medulla Integrates Sky Compass Signals in the Brain of an Insect

Mass migration of desert locusts is a common phenomenon in North Africa and the Middle East but how these insects navigate is still poorly understood. Laboratory studies suggest that locusts are able to exploit the sky polarization pattern as a navigational cue. Like other insects locusts detect polarized light through a specialized dorsal rim area (DRA) of the eye. Polarization signals are transmitted through the optic lobe to the anterior optic tubercle (AOTu) and, finally, to the central complex in the brain. Whereas neurons of the AOTu integrate sky polarization and chromatic cues in a daytime dependent manner, the central complex holds a topographic representation of azimuthal directions suggesting a role as an internal sky compass. To understand further the integration of sky compass cues we studied polarization-sensitive (POL) neurons in the medulla that may be intercalated between DRA photoreceptors and AOTu neurons. Five types of POL-neuron were characterized and four of these in multiple recordings. All neurons had wide arborizations in medulla layer 4 and most, additionally, in the dorsal rim area of the medulla and in the accessory medulla, the presumed circadian clock. The neurons showed type-specific orientational tuning to zenithal polarized light and azimuth tuning to unpolarized green and UV light spots. In contrast to neurons of the AOTu, we found no evidence for color opponency and daytime dependent adjustment of sky compass signals. Therefore, medulla layer 4 is a distinct stage in the integration of sky compass signals that precedes the time-compensated integration of celestial cues in the AOTu

Water vapor vertical distribution on Mars during perihelion season of MY 34 and MY 35 with ExoMars‐TGO/NOMAD observations

The water vapor in the Martian atmosphere plays a significant role in the planet’s climate, being crucial in most of the chemical and radiative transfer processes. Despite its importance, the vertical distribution of H2O in the atmosphere has not still been characterized precisely enough. The recent ExoMars Trace Gas Orbiter (TGO) mission, with its Nadir and Occultation for MArs Discovery (NOMAD) instrument, has allowed us to measure the H2O vertical distribution with unprecedented resolution. Recent studies of vertical profiles have shown that high dust concentration in the atmosphere, in particular during dust storms, induces an efficient transport of the H2O to higher altitudes, from 40 km up to 80 km. We study the H2O vertical distribution in a subset of solar occultations during the perihelion of two Martian years (MYs), including the 2018 Global Dust Storm (GDS), in order to compare the same Martian season under GDS and non-GDS conditions. We present our state-of-the-art retrieval scheme, and we apply it to a combination of two diffraction orders, which permits sounding up to about 100 km. We confirm recent findings of H2O increasing at high altitudes during Ls = 190-205° in MY 34, reaching abundances of about 150 ppmv at 80 km in both hemispheres not found during the same period of MY 35. We found a hygropause’s steep rising during the GDS from 30 up to 80 km. Furthermore, strong supersaturation events have been identified at mesospheric altitudes even in presence of water ice layers retrieved by the IAA team