If someone cares about you, you are more apt to come around: improving HIV care engagement by strengthening the patient-provider relationship.

Purpose:The patient-provider relationship is a central factor that can promote or hinder long-term engagement in care among people living with chronic illnesses. In this paper, we explore characteristics of the patient-provider relationship that facilitated or hindered engagement in care among patients receiving care at HIV specialty clinics. Patients and methods:We conducted 6 focus group discussions with a total of 43 well-retained and less well-retained HIV+ patients in San Francisco, Seattle, and Birmingham, to elicit a wide range of perspectives on engagement in HIV care. Borrowing from the field of psychotherapy, we examined patient-provider relationship characteristics through the lens of the therapeutic alliance, and with regard to their therapeutic efficacy and impact on patient engagement. Results:The majority of participants emphasized how a strong patient-provider relationship defined by trust, intimacy, and collaboration promoted engagement, while a weak patient-provider relationship impeded engagement. Conclusion:We discuss practical strategies and therapeutic techniques that may be helpful to providers in building strong patient-provider relationship and contend that a strong patient-provider relationship is crucial for patients to feel cared for during clinical encounters, which can promote long-term and sustained engagement in HIV care

Hepatic cell mobilization for protection against ischemic myocardial injury

The heart is capable of activating protective mechanisms in response to ischemic injury to support myocardial survival and performance. These mechanisms have been recognized primarily in the ischemic heart, involving paracrine signaling processes. Here, we report a distant cardioprotective mechanism involving hepatic cell mobilization to the ischemic myocardium in response to experimental myocardial ischemia–reperfusion (MI-R) injury. A parabiotic mouse model was generated by surgical skin-union of two mice and used to induce bilateral MI-R injury with unilateral hepatectomy, establishing concurrent gain- and loss-of-hepatic cell mobilization conditions. Hepatic cells, identified based on the cell-specific expression of enhanced YFP, were found in the ischemic myocardium of parabiotic mice with intact liver (0.2 ± 0.1%, 1.1 ± 0.3%, 2.7 ± 0.6, and 0.7 ± 0.4% at 1, 3, 5, and 10 days, respectively, in reference to the total cell nuclei), but not significantly in the ischemic myocardium of parabiotic mice with hepatectomy (0 ± 0%, 0.1 ± 0.1%, 0.3 ± 0.2%, and 0.08 ± 0.08% at the same time points). The mobilized hepatic cells were able to express and release trefoil factor 3 (TFF3), a protein mitigating MI-R injury as demonstrated in TFF3−/− mice (myocardium infarcts 17.6 ± 2.3%, 20.7 ± 2.6%, and 15.3 ± 3.8% at 1, 5, and 10 days, respectively) in reference to wildtype mice (11.7 ± 1.9%, 13.8 ± 2.3%, and 11.0 ± 1.8% at the same time points). These observations suggest that MI-R injury can induce hepatic cell mobilization to support myocardial survival by releasing TFF3

Development of Technologies and Test Formats for Credibility Assessment

From introduction: "Because Credibility Assessment is a relatively new and developing field there are different ways of describing it and what it encompasses. For ihe purposes of this paper Credibility Assessment is defined as the process of determining the reliability and validity of information, regardless of source. "(...

Suppression of inflammation and tissue damage by a hookworm recombinant protein in experimental colitis

Gastrointestinal parasites, hookworms in particular, have evolved to cause minimal harm to their hosts when present in small numbers, allowing them to establish chronic infections for decades. They do so by creating an immunoregulatory environment that promotes their own survival, but paradoxically also benefits the host by protecting against the onset of many inflammatory diseases. To harness the therapeutic value of hookworms without using live parasites, we have examined the protective properties of the recombinant protein anti-inflammatory protein (AIP)-1, secreted in abundance by hookworms within the intestinal mucosa, in experimental colitis. Colitic inflammation assessed by weight loss, colon atrophy, oedema, ulceration and necrosis, as well as abdominal adhesion was significantly suppressed in mice treated with a single intraperitoneal dose of AIP-1 at 1 mg kg(-1). Local infiltration of inflammatory cells was also significantly reduced, with minimal goblet cell loss and preserved mucosal architecture. Treatment with AIP-1 promoted the production of colon interleukin (IL)-10, transforming growth factor (TGF)-beta and thymic stromal lymphopoietin (TSLP), resulting in the suppression of tumour necrosis factor (TNF)-alpha, IL-13 and IL-17 A cytokines and granulocyte macrophage colony-stimulating factor (GM-CSF), CX motif chemokine ( CXCL)-11 and cyclooxygenase synthase (COX)-2 mRNA transcripts. AIP-1 promoted the accumulation of regulatory T cells in the colon likely allowing rapid healing of the colon mucosa. Hookworm recombinant AIP-1 is a novel therapeutic candidate for the treatment of inflammatory bowel diseases that can be explored for the prevention of acute inflammatory relapses, an important cause of colorectal cancer

Hyporheic Exchange and Water Chemistry of Two Arctic Tundra Streams of Contrasting Geomorphology

The North Slope of Alaska’s Brooks Range is underlain by continuous permafrost, but an active layer of thawed sediments develops at the tundra surface and beneath streambeds during the summer, facilitating hyporheic exchange. Our goal was to understand how active layer extent and stream geomorphology influence hyporheic exchange and nutrient chemistry. We studied two arctic tundra streams of contrasting geomorphology: a high-gradient, alluvial stream with riffle-pool sequences and a low-gradient, peat-bottomed stream with large deep pools connected by deep runs. Hyporheic exchange occurred to ~50 cm beneath the alluvial streambed and to only ~15 cm beneath the peat streambed. The thaw bulb was deeper than the hyporheic exchange zone in both stream types. The hyporheic zone was a net source of ammonium and soluble reactive phosphorus in both stream types. The hyporheic zone was a net source of nitrate in the alluvial stream, but a net nitrate sink in the peat stream. The mass flux of nutrients regenerated from the hyporheic zones in these two streams was a small portion of the surface water mass flux. Although small, hyporheic sources of regenerated nutrients help maintain the in-stream nutrient balance. If future warming in the arctic increases the depth of the thaw bulb, it may not increase the vertical extent of hyporheic exchange. The greater impacts on annual contributions of hyporheic regeneration are likely to be due to longer thawed seasons, increased sediment temperatures or changes in geomorphology

Flight validation of ground-based assessment for control power requirements at high angles of attack

A review is presented in viewgraph format of an ongoing NASA/U.S. Navy study to determine control power requirements at high angles of attack for the next generation high-performance aircraft. This paper focuses on recent flight test activities using the NASA High Alpha Research Vehicle (HARV), which are intended to validate results of previous ground-based simulation studies. The purpose of this study is discussed, and the overall program structure, approach, and objectives are described. Results from two areas of investigation are presented: (1) nose-down control power requirements and (2) lateral-directional control power requirements. Selected results which illustrate issues and challenges that are being addressed in the study are discussed including test methodology, comparisons between simulation and flight, and general lessons learned

De novo assembly of the cattle reference genome with single-molecule sequencing.

BackgroundMajor advances in selection progress for cattle have been made following the introduction of genomic tools over the past 10-12 years. These tools depend upon the Bos taurus reference genome (UMD3.1.1), which was created using now-outdated technologies and is hindered by a variety of deficiencies and inaccuracies.ResultsWe present the new reference genome for cattle, ARS-UCD1.2, based on the same animal as the original to facilitate transfer and interpretation of results obtained from the earlier version, but applying a combination of modern technologies in a de novo assembly to increase continuity, accuracy, and completeness. The assembly includes 2.7 Gb and is >250× more continuous than the original assembly, with contig N50 >25 Mb and L50 of 32. We also greatly expanded supporting RNA-based data for annotation that identifies 30,396 total genes (21,039 protein coding). The new reference assembly is accessible in annotated form for public use.ConclusionsWe demonstrate that improved continuity of assembled sequence warrants the adoption of ARS-UCD1.2 as the new cattle reference genome and that increased assembly accuracy will benefit future research on this species

The Effects of 11 Yr of CO2 Enrichment on Roots in a Florida Scrub-Oak Ecosystem

Uncertainty surrounds belowground plant responses to rising atmospheric CO2 because roots are difficult to measure, requiring frequent monitoring as a result of fine root dynamics and long-term monitoring as a result of sensitivity to resource availability. We report belowground plant responses of a scrub-oak ecosystem in Florida exposed to 11yr of elevated atmospheric CO2 using open-top chambers. We measured fine root production, turnover and biomass using minirhizotrons, coarse root biomass using ground-penetrating radar and total root biomass using soil cores. Total root biomass was greater in elevated than in ambient plots, and the absolute difference was larger than the difference aboveground. Fine root biomass fluctuated by more than a factor of two, with no unidirectional temporal trend, whereas leaf biomass accumulated monotonically. Strong increases in fine root biomass with elevated CO2 occurred after fire and hurricane disturbance. Leaf biomass also exhibited stronger responses following hurricanes. Responses after fire and hurricanes suggest that disturbance promotes the growth responses of plants to elevated CO2. Increased resource availability associated with disturbance (nutrients, water, space) may facilitate greater responses of roots to elevated CO2. The disappearance of responses in fine roots suggests limits on the capacity of root systems to respond to CO2 enrichment