The 6 minute walk in idiopathic pulmonary fibrosis: longitudinal changes and minimum important difference

The response characteristics of the 6 minute walk test (6MWT) in studies of idiopathic pulmonary fibrosis (IPF) are only poorly understood, and the change in walk distance that constitutes the minimum important difference (MID) over time is unknown

Tulsa Oklahoma Oktoberfest Tent Collapse Report

Background. On October 17, 2007, a severe weather event collapsed two large tents and several smaller tents causing 23 injuries requiring evacuation to emergency departments in Tulsa, OK. Methods. This paper is a retrospective analysis of the regional health system's response to this event. Data from the Tulsa Fire Department, The Emergency Medical Services Authority (EMSA), receiving hospitals and coordinating services were reviewed and analyzed. EMS patient care reports were reviewed and analyzed using triage designators assigned in the field, injury severity scores, and critical mortality. Results. EMT's and paramedics from Tulsa Fire Department and EMSA provided care at the scene under unified incident command. Of the 23 patients transported by EMS, four were hospitalized, one with critical spinal injury and one with critical head injury. One patient is still in ongoing rehabilitation. Discussion. Analysis of the 2007 Tulsa Oktoberfest mass casualty incident revealed rapid police/fire/EMS response despite challenges of operations at dark under severe weather conditions and the need to treat a significant number of injured victims. There were no fatalities. Of the patients transported by EMS, a minority sustained critical injuries, with most sustaining injuries amenable to discharge after emergency department care

Eight Weeks of Combined Exercise Training Induced Improvements in Insulin Sensitivity is Associated with Improvement in Aerobic Capacity, but not with Improvement in Strength.

A lifestyle compromised of predominantly sedentary behavior is a risk factor that promotes the development of metabolic syndrome. It has been demonstrated that individuals with blunted insulin sensitivity (IS) and metabolic flexibility (MF) tend to be more prone to develop the disease. An increase in physical activity is recommended in order to prevent cardiovascular disease and type 2 diabetes mellitus. PURPOSE: to determine whether healthy, sedentary, normoglycemic, Mexican American men without a family history of type 2 diabetes are able to improve IS and MF after participating in a combined (aerobic/resistance) exercise intervention. METHODS: Subjects (n=6; 21.83±0.8 years; BMI 28.92 ± 1.6 kg/m2), participated in 8 weeks of combined exercise training three times per week (35 minutes of aerobic training & 45 minutes of resistance training/session). Upper body 1 repetition maximum (1RM) was measured using the flat barbell bench press and lower body 1RM was measured using a back leg strength dynamometer. IS was assessed using the hyperinsulinemic euglycemic clamp (clamp). Insulin dose administered to each subject was set 80mU/m2/min. MF was assessed by determining change in RQ (ΔRQ) at the steady state of the clamp compared to RQ measured at baseline/resting. Participants were provided with standard diet 5 days before pre and post intervention testing in order to control for the effects of diet on insulin sensitivity. Body composition was measured using dual x-ray absorptiometry. RESULTS: IS improved significantly after the 8 weeks of combined exercise training (3.18±0.35 to 3.75±0.34 mg/kg EMBS/min, p=0.05). There was no significant improvement in MF (0.06±0.02 to 0.08±0.02 ∆RER, p=0.19). Body weight significantly increased (3.76%; 81.06±5.38 to 84.11±5.67 kg, p=0.01) with no change in fat mass and a trend to increase in fat free mas (2.8%; 55.92±2.77 to 57.5±2.38 kg, p=0.1). Upper body strength significantly increased (168.3±26.57 to 195±26.04 lb., p=0.001). Lower body strength increased (356.7±46.52 to 428.3±34.51 lb., p=0.02).VO2 max improved significantly (3.90±0.14 to 4.19±0.16 L/min, p=0.037). Improvement in IS was associated with an increase in VO2max (r=0.92, p=0.008) but not with the improvement in strength. Improvement in MF was significantly correlated with fasting glucose (r=-0.83, p=0.04), and an increase in lean mass (r=0.82, p=0.04). CONCLUSION: 8 weeks of combined exercise improves insulin sensitivity in healthy, sedentary, normoglycemic Hispanic men. Improvement in insulin sensitivity is associated with improvement in aerobic fitness but not gain in upper and lower body strength

Sorting live stem cells based on Sox2 mRNA expression.

PMCID: PMC3507951This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.While cell sorting usually relies on cell-surface protein markers, molecular beacons (MBs) offer the potential to sort cells based on the presence of any expressed mRNA and in principle could be extremely useful to sort rare cell populations from primary isolates. We show here how stem cells can be purified from mixed cell populations by sorting based on MBs. Specifically, we designed molecular beacons targeting Sox2, a well-known stem cell marker for murine embryonic (mES) and neural stem cells (NSC). One of our designed molecular beacons displayed an increase in fluorescence compared to a nonspecific molecular beacon both in vitro and in vivo when tested in mES and NSCs. We sorted Sox2-MB(+)SSEA1(+) cells from a mixed population of 4-day retinoic acid-treated mES cells and effectively isolated live undifferentiated stem cells. Additionally, Sox2-MB(+) cells isolated from primary mouse brains were sorted and generated neurospheres with higher efficiency than Sox2-MB(-) cells. These results demonstrate the utility of MBs for stem cell sorting in an mRNA-specific manner

Black Hole and Neutron Star Transients in Quiescence

We consider the X-ray luminosity difference between neutron star and black hole soft X-ray transients (NS and BH SXTs) in quiescence. The current observational data suggest that BH SXTs are significantly fainter than NS SXTs. The luminosities of quiescent BH SXTs are consistent with the predictions of binary evolution models for the mass transfer rate if (1) accretion occurs via an ADAF in these systems and (2) the accreting compact objects have event horizons. The luminosities of quiescent NS SXTs are not consistent with the predictions of ADAF models when combined with binary evolution models, unless most of the mass accreted in the ADAF is prevented from reaching the neutron star surface. We consider the possibility that mass accretion is reduced in quiescent NS SXTs because of an efficient propeller and develop a model of the propeller effect that accounts for the observed luminosities. We argue that modest winds from ADAFs are consistent with the observations while strong winds are probably not.Comment: LateX, 37 pages, 7 figures; Accepted for publication in The Astrophysical Journa

Teaching the Three E’s of Sustainability Through Service‐Learning in a Professional Program

Using seven established course design principles for effective service‐learning, this chapter discusses the lessons learned in teaching the three E’s of sustainability: environmental; economic; and (social) equity, in a professional program at an American Midwestern public university.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154652/1/tl20374_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154652/2/tl20374.pd

A public health response to the methamphetamine epidemic: the implementation of contingency management to treat methamphetamine dependence

BACKGROUND: In response to increases in methamphatemine-associated sexually transmitted diseases, the San Francisco Department of Public Health implemented a contingency management (CM) field program called the Positive Reinforcement Opportunity Project (PROP). METHODS: Methamphetamine-using men who have sex with men (MSM) in San Francisco qualified for PROP following expressed interest in the program, provision of an observed urine sample that tested positive for methamphetamine metabolites and self-report of recent methamphetamine use. For 12 weeks, PROP participants provided observed urine samples on Mondays, Wednesdays and Fridays and received vouchers of increasing value for each consecutive sample that tested negative to metabolites of methamphetamine. Vouchers were exchanged for goods and services that promoted a healthy lifestyle. No cash was provided. Primary outcomes included acceptability (number of enrollments/time), impact (clinical response to treatment and cost-effectiveness as cost per patient treated). RESULTS: Enrollment in PROP was brisk indicating its acceptability. During the first 10 months of operation, 143 men sought treatment and of these 77.6% were HIV-infected. Of those screened, 111 began CM treatment and averaged 15 (42%) methamphetamine-free urine samples out of a possible 36 samples during the 12-week treatment period; 60% completed 4 weeks of treatment; 48% 8 weeks and 30% 12 weeks. Across all participants, an average of $159 (SD =$165) in vouchers or 35.1% of the maximum possible ($453) was provided for these participants. The average cost per participant of the 143 treated was$800. CONCLUSION: Clinical responses to CM in PROP were similar to CM delivered in drug treatment programs, supporting the adaptability and effectiveness of CM to non-traditional drug treatment settings. Costs were reasonable and less than or comparable to other methamphetamine outpatient treatment programs. Further expansion of programs like PROP could address the increasing need for acceptable, feasible and cost-effective methamphetamine treatment in this group with exceptionally high rates of HIV-infection

The Small RNA Teg41 Regulates Expression of the Alpha Phenol-Soluble Modulins and Is Required for Virulence in \u3ci\u3eStaphylococcus aureus\u3c/i\u3e

Small RNAs (sRNAs) remain an understudied class of regulatory molecules in bacteria in general and in Gram-positive bacteria in particular. In the major human pathogen Staphylococcus aureus, hundreds of sRNAs have been identified; however, only a few have been characterized in detail. In this study, we investigate the role of the sRNA Teg41 in S. aureus virulence. We demonstrate that Teg41, an sRNA divergently transcribed from the locus that encodes the cytolytic alpha phenolsoluble modulin (αPSM) peptides, plays a critical role in αPSM production. Overproduction of Teg41 leads to an increase in αPSM levels and a corresponding increase in hemolytic activity from S. aureus cells and cell-free culture supernatants. To identify regions of Teg41 important for its function, we performed an in silico RNA-RNA interaction analysis which predicted an interaction between the 3= end of Teg41 and the αPSM transcript. Deleting a 24-nucleotide region from the S. aureus genome, corresponding to the 3= end of Teg41, led to a 10-fold reduction in αPSM-dependent hemolytic activity and attenuation of virulence in a murine abscess model of infection. Restoration of hemolytic activity in the Teg41Δ3= strain was possible by expressing full-length Teg41 in trans. Restoration of hemolytic activity was also possible by expressing the 3= end of Teg41, suggesting that this region of Teg41 is necessary and sufficient for αPSMdependent hemolysis. Our results show that Teg41 is positively influencing αPSM production, demonstrating for the first time regulation of the αPSM peptides by an sRNA in S. aureus

Generation of Functional CLL-Specific Cord Blood CTL Using CD40-Ligated CLL APC

PMCID: PMC3526610This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited