Messina (\u3cem\u3eMelilotus siculus\u3c/em\u3e)–A New Pasture Legume for Saltland

Messina (Melilotus siculus ((Turra) Vitman ex B.D. Jacks)) is a new annual pasture legume for saltland in temperate Australia and regions of the world that experience Mediterranean climates. Messina has greater tolerance to the combined stresses of salinity and water-logging than existing commercial pasture legumes. Coupled with desirable agronomic traits these characteristics give messina the capacity to rehabilitate saltland and increase productivity on land where existing legumes fail. This paper reviews the agronomic perform-ance of messina in relation to top soil salinity levels

Mechanical signal influence on mesenchymal stem cell fate is enhanced by incorporation of refractory periods into the loading regimen

Mechanical signals of both low and high intensity are inhibitory to fat and anabolic to bone in vivo, and have been shown to directly affect mesenchymal stem cell pools from which fat and bone precursors emerge. To identify an idealized mechanical regimen which can regulate MSC fate, low intensity vibration (LIV; < 10 microstrain, 90 Hz) and high magnitude strain (HMS; 20,000 microstrain, 0.17 Hz) were examined in MSC undergoing adipogenesis. Two × twenty minute bouts of either LIV or HMS suppressed adipogenesis when there was at least a 1 hour refractory period between bouts; this effect was enhanced when the rest period was extended to 3 hours. Mechanical efficacy to inhibit adipogenesis increased with additional loading bouts if a refractory period was incorporated. Mechanical suppression of adipogenesis with LIV involved inhibition of GSK3β with subsequent activation of β-catenin as has been shown for HMS. These data indicate that mechanical biasing of MSC lineage selection is more dependent on event scheduling than on load magnitude or duration. As such, a full day of rest should not be required to “reset” the mechanical responsiveness of MSCs, and suggests that incorporating several brief mechanical challenges within a 24 hour period may improve salutary endpoints in vivo. That two diverse mechanical inputs are enhanced by repetition after a refractory period suggests that rapid cellular adaptation can be targeted

Mechanically Induced Focal Adhesion Assembly Amplifies Anti-Adipogenic Pathways in Mesenchymal Stem Cells

The fate of pluripotent mesenchymal stem cells (MSC) is determined through integration of chemical, spatial, and physical signals. The suppression of MSC adipogenesis by mechanical stimuli, which requires Akt-induced inhibition of glycogen synthase kinase 3β (GSK3β) with β-catenin activation, can be enhanced by repetitive dosing within a single day. Here, we demonstrate that reapplication of cyclic strain within a 24-hour period leads to amplification of both Akt activation and its subsequent inhibition of GSK3β, such that total cycle number can be reduced while still inhibiting adipogenesis. Amplification of Akt signaling is facilitated by a dynamic restructuring of the cell in response to mechanical signals, as evidenced by a transient increase in focal adhesion (FA) number and increased RhoA activity. Preventing FA assembly or development of tension blocks activation of Akt by mechanical signals, but not by insulin. This indicates that the FA infrastructure is essential to the physical, but not necessarily the chemical, sensitivity, and responsiveness of the cell. Exploiting the transient nature of cytoskeletal remodeling may represent a process to enhance cell responsiveness to mechanical input and ultimately define the fate of MSCs with a minimal input

Bone marrow fat accumulation accelerated by high fat diet is suppressed by exercise

Marrow adipose tissue (MAT), associated with skeletal fragility and hematologic insufficiency, remains poorly understood and difficult to quantify. We tested the response of MAT to high fat diet (HFD) and exercise using a novel volumetric analysis, and compared it to measures of bone quantity. We hypothesized that HFD would increase MAT and diminish bone quantity, while exercise would slow MAT acquisition and promote bone formation. Eight week-old female C57BL/6 mice were fed a regular (RD) or HFD, and exercise groups were provided voluntary access to running wheels (RD-E, HFD-E). Femoral MAT was assessed by μCT (lipid binder osmium) using a semi-automated approach employing rigid co-alignment, regional bone masks and was normalized for total femoral volume (TV) of the bone compartment. MAT was 2.6-fold higher in HFD relative to RD mice. Exercise suppressed MAT in RD-E mice by more than half compared with RD. Running similarly inhibited MAT acquisition in HFD mice. Exercise significantly increased bone quantity in both diet groups. Thus, HFD caused significant accumulation of MAT; importantly running exercise limited MAT acquisition while promoting bone formation during both diets. That MAT is exquisitely responsive to diet and exercise, and its regulation by exercise appears to be inversely proportional to effects on exercise induced bone formation, is relevant for an aging and sedentary population

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Gray, Bobbe interview for the Miami Valley College of Nursing and Health Oral History Project

Donna Miles Curry and Natasha Clinton interviewed Bobbe Gray about the history of the Doctor of Nursing Practice program at Wright State University. In the interview Dr. Gray recalls her education and experiences in addition to the history of the DNP program

Holland, Cindra interview for the Miami Valley College of Nursing and Health Oral History Project

Donna Miles Curry, Stacy Harris, and Natasha Clinton interviewed Cindra Holland about the history of the Doctor of Nursing Practice program at Wright State University. In the interview Dr. Holland discusses her education as well as attending the DNP program

Enhancing Nursing Education with Remote Access Laboratories

Abstractâ??Given the vast coverage area and dispersed population centres in which nursing professionals practice in Australia, Remote Access Laboratory (RAL) based learning activities would seem to be an ideal match. However while they are commonplace in engineering faculties; in other disciplines such activities are not widely used. This may well be due to the intricacies of these practicals not being as straightforward and readily reproducible as typical physics or science experiments. In our chosen case, the safe practice of intravenous pump driver operations and related clinical reasoning skills are important components for the training of both registered nurses and nursing students. The aim of this research project is to develop and trial remote access technologies that enable nursing students to test their knowledge, skills, and clinical reasoning with intravenous infusion pump drivers. This has been possible by extending the concept of RAL from a physical and tangible experiment, to more conceptual experimentation in any form conducted remotely. In such a context clinical reasoning becomes possible. This paper discusses a prototype system that has been built with collaborative input from the Faculty of Engineering and Surveying and the Department of Nursing and Midwifery. An initial evaluation with a group of nursing students has been completed to assess if such activities can assist with the training of student nurses. Previous work has identified the need to scaffold learning activities that rely on RAL technology; the key conclusion in this paper is that in the context of nursing this has to be taken a step further. RAL activities here require contextualisation to become an effective learning tool

Linking sleep duration and obesity among black and white US adults

AIMS: The effect of race/ethnicity on the risk of obesity associated with short or long sleep durations is largely unknown. This study assessed whether the sleep–obesity link differentially affects black and whites. METHODS: Analysis was based on data obtained from 29,818 adult American respondents from the 2005 National Health Interview Survey, a cross-sectional household interview survey. RESULTS: Multivariate-adjusted odds ratios for obesity associated with short sleep (≤6 h) among blacks and whites were 1.98 (95% CI: 1.69–2.30) and 1.20 (95% CI: 1.10–1.31), respectively, and with long sleep (≥9 h) for blacks and whites were 1.48 (95% CI: 1.14–1.93) and 0.77 (95% CI: 0.67–0.89), respectively (all p < 0.001). CONCLUSION: Race/ethnicity may have significantly influenced the likelihood of reporting obesity associated with short and long sleep durations. Relative to white respondents, an excess of 78% of black respondents showed increased obesity odds associated with short sleep. Black long sleepers also showed increased odds for obesity, but white long sleepers may be at a reduced obesity risk

Telephone-delivered behavioral intervention among blacks with sleep apnea and metabolic syndrome: study protocol for a randomized controlled trial

BACKGROUND: Lack of adherence to recommended treatment for obstructive sleep apnea remains an ongoing public health challenge. Despite evidence that continuous positive airway pressure (CPAP) is effective and improves overall quality of life, adherence with the use of CPAP in certain racial/ethnic groups, especially blacks, is suboptimal. Evidence indicates that the incidence and prevalence of obstructive sleep apnea are higher among blacks, relative to whites, and blacks are less likely to adhere to recommended treatment compared with other racial/ethnic groups. METHODS: Using a two-arm randomized controlled design, this study will evaluate the effectiveness of a culturally and linguistically tailored telephone-delivered intervention to promote adherence to physician-recommended sleep apnea assessment and treatment among blacks with metabolic syndrome, versus an attention-control arm. The intervention is designed to foster adherence to recommended sleep apnea care using the stages-of-change model. The intervention will be delivered entirely over the telephone. Participants in the intervention arm will receive 10 phone calls to address challenges and barriers to recommended care. Outcomes will be assessed at baseline, and at 6- and 12-months post-randomization. DISCUSSION: This tailored behavioral intervention will improve adherence to sleep apnea assessment and treatment among blacks with metabolic syndrome. We expect to demonstrate that this intervention modality is feasible in terms of time and cost and can be replicated in populations with similar racial/ethnic backgrounds. TRIAL REGISTRATION: The study is registered at clinicaltrials.gov NCT01946659 (February 2013