Shiga-toxin E. coli Hemolytic Uremic Syndrome: review of management and long-term outcome

Purpose of Review: We review the pathophysiology of Shiga-Toxin Enteropathogenic–Hemolytic Uremic Syndrome (STEC-HUS), strategies to ameliorate or prevent evolution of STEC-HUS, management and the improved recognition of long-term adverse outcomes. Recent Findings: Following on from the preclinical evidence of a role for the complement system in STEC-HUS, the use of complement blocking agents has been the major focus of most recent clinical research. Novel therapies to prevent or lessen HUS have yet to enter the clinical arena. The long-term outcomes of STEC-HUS, similarly to other causes of AKI, are not as benign as previously thought. Summary: Optimizing supportive care in STEC-HUS is the only current recommended treatment. The administration of early isotonic fluids may reduce the severity and duration of STEC-HUS. The role of complement blockade in the management of STEC-HUS remains unclear. The long-term sequelae from STEC-HUS are significant and patients with apparent full renal recovery remain at risk

Pulmonary function is associated with distal aortic calcium, not proximal aortic distensibility. MESA lung study

Forced expiratory volume in one second strongly predicts mortality from cardiovascular disease. FEV1 has been associated with aortic stiffness a strong independent predictor of cardiovascular mortality. However, the anatomical site and possible mechanisms linking aortic stiffness and lung function are unknown. We therefore examined if FEV1 and CT percent emphysema were associated with calcification of the abdominal aorta or reduced distensibility of the proximal thoracic aorta.The Multi-Ethnic Study of Atherosclerosis (MESA) measured aortic calcification on cardiac and abdominal CT scans and proximal aortic distensibility using magnetic resonance among participants aged 45–84 years without clinical cardiovascular disease. Spirometry was measured following ATS/ERS guidelines and percent emphysema was measured in the lung fields of cardiac CT scans. Multivariate analyses adjusted for age, sex, race/ethnicity and cardiovascular risk factors. Of 1,917 participants with aortic distensibility measures, 13% were current and 38% were former smokers. Eighteen percent had airflow limitation without asthma. FEV1 was associated with the extent of distal aortic calcification (0.76; 95%CI 0.60–0.97, p = 0.02) but not proximal aortic calcification or proximal aortic distensibility (−0.04 mmHg−1; 95%CI −0.16–0.09 mmHg−1, p = 0.60). Percent emphysema was associated with neither measure. FEV1 was associated with severity of distal aortic calcification where it was present independently of smoking and other cardiovascular risk factors but not with distensibility or calcification of the proximal aorta

Universality in D-brane Inflation

We study the six-field dynamics of D3-brane inflation for a general scalar potential on the conifold, finding simple, universal behavior. We numerically evolve the equations of motion for an ensemble of more than 7 \times 10^7 realizations, drawing the coefficients in the scalar potential from statistical distributions whose detailed properties have demonstrably small effects on our results. When prolonged inflation occurs, it has a characteristic form: the D3-brane initially moves rapidly in the angular directions, spirals down to an inflection point in the potential, and settles into single-field inflation. The probability of N_{e} e-folds of inflation is a power law, P(N_{e}) \propto N_{e}^{-3}, and we derive the same exponent from a simple analytical model. The success of inflation is relatively insensitive to the initial conditions: we find attractor behavior in the angular directions, and the D3-brane can begin far above the inflection point without overshooting. In favorable regions of the parameter space, models yielding 60 e-folds of expansion arise approximately once in 10^3 trials. Realizations that are effectively single-field and give rise to a primordial spectrum of fluctuations consistent with WMAP, for which at least 120 e-folds are required, arise approximately once in 10^5 trials. The emergence of robust predictions from a six-field potential with hundreds of terms invites an analytic approach to multifield inflation.Comment: 28 pages, 9 figure

A Statistical Approach to Multifield Inflation: Many-field Perturbations Beyond Slow Roll

We study multifield contributions to the scalar power spectrum in an ensemble of six-field inflationary models obtained in string theory. We identify examples in which inflation occurs by chance, near an approximate inflection point, and we compute the primordial perturbations numerically, both exactly and using an array of truncated models. The scalar mass spectrum and the number of fluctuating fields are accurately described by a simple random matrix model. During the approach to the inflection point, bending trajectories and violations of slow roll are commonplace, and 'many-field' effects, in which three or more fields influence the perturbations, are often important. However, in a large fraction of models consistent with constraints on the tilt the signatures of multifield evolution occur on unobservably large scales. Our scenario is a concrete microphysical realization of quasi-single-field inflation, with scalar masses of order $H$, but the cubic and quartic couplings are typically too small to produce detectable non-Gaussianity. We argue that our results are characteristic of a broader class of models arising from multifield potentials that are natural in the Wilsonian sense.Comment: 39 pages, 17 figures. References added. Matches version published in JCA

Inflation on an Open Racetrack

We present a variant of warped D-brane inflation by incorporating multiple sets of holomorphically-embedded D7-branes involved in moduli stabilization with extent into a warped throat. The resultant D3-brane motion depends on the D7-brane configuration and the relative position of the D3-brane in these backgrounds. The non-perturbative moduli stabilization superpotential takes the racetrack form, but the additional D3-brane open string moduli dependence provides more flexibilities in model building. For concreteness, we consider D3-brane motion in the warped deformed conifold with the presence of multiple D7-branes, and derive the scalar potential valid for the entire throat. By explicit tuning of the microphysical parameters, we obtain inflationary trajectories near an inflection point for various D7-brane configurations. Moreover, the open racetrack potential admits approximate Minkowski vacua before uplifting. We demonstrate with a concrete D-brane inflation model where the Hubble scale during inflation can exceed the gravitino mass. Finally, the multiple sets of D7-branes present in this open racetrack setup also provides a mechanism to stabilize the D3-brane to metastable vacua in the intermediate region of the warped throat.Comment: 29 pages, 15 figures, pre-print number and references adde

Accidental Inflation in the Landscape

We study some aspects of fine tuning in inflationary scenarios within string theory flux compactifications and, in particular, in models of accidental inflation. We investigate the possibility that the apparent fine-tuning of the low energy parameters of the theory needed to have inflation can be generically obtained by scanning the values of the fluxes over the landscape. Furthermore, we find that the existence of a landscape of eternal inflation in this model provides us with a natural theory of initial conditions for the inflationary period in our vacuum. We demonstrate how these two effects work in a small corner of the landscape associated with the complex structure of the Calabi-Yau manifold P^4_[1,1,1,6,9] by numerically investigating the flux vacua of a reduced moduli space. This allows us to obtain the distribution of observable parameters for inflation in this mini-landscape directly from the fluxes.Comment: 40 pages, 11 figure

Making things happen : a model of proactive motivation

Being proactive is about making things happen, anticipating and preventing problems, and seizing opportunities. It involves self-initiated efforts to bring about change in the work environment and/or oneself to achieve a different future. The authors develop existing perspectives on this topic by identifying proactivity as a goal-driven process involving both the setting of a proactive goal (proactive goal generation) and striving to achieve that proactive goal (proactive goal striving). The authors identify a range of proactive goals that individuals can pursue in organizations. These vary on two dimensions: the future they aim to bring about (achieving a better personal fit within one’s work environment, improving the organization’s internal functioning, or enhancing the organization’s strategic fit with its environment) and whether the self or situation is being changed. The authors then identify “can do,” “reason to,” and “energized to” motivational states that prompt proactive goal generation and sustain goal striving. Can do motivation arises from perceptions of self-efficacy, control, and (low) cost. Reason to motivation relates to why someone is proactive, including reasons flowing from intrinsic, integrated, and identified motivation. Energized to motivation refers to activated positive affective states that prompt proactive goal processes. The authors suggest more distal antecedents, including individual differences (e.g., personality, values, knowledge and ability) as well as contextual variations in leadership, work design, and interpersonal climate, that influence the proactive motivational states and thereby boost or inhibit proactive goal processes. Finally, the authors summarize priorities for future researc

Warped Wilson Line DBI Inflation

We propose a novel inflationary scenario in string theory in which the inflaton field is a 'Wilson line' degree of freedom in the worldvolume of a probe Dp-brane, in a warped flux compactification. Kinetic terms for Wilson line fields on the world volume of a D-brane take a nonstandard Dirac-Born-Infeld (DBI) form. Thus, we work in the framework of DBI inflation. This extends the original slow roll Wilson line inflationary scenario, where only the quadratic piece was considered. Warped DBI Wilson line inflation offers an attractive alternative to ordinary (position field) DBI inflation, inasmuch as observational and theoretical constraints get considerably relaxed. Besides the standard large non-Gaussianities in DBI scenarios, it is also possible to achieve an observable amount of gravitational waves.Comment: v3: Typos corrected, Published in JCAP; 21 page

A passion for respect: On understanding the role of human needs and morality

In the present paper, we stress the importance of the concept respect in a wide variety of social settings and provide a working definition of this concept by emphasizing how respect relates to the act of communicating full recognition to other people on the dimensions of belongingness and morality. Subsequently, in two separate parts, we discuss why respect is so desired and valued. The first part looks at respect as a means to fulfil important human social concerns (“respect as a means to an end”). The second part looks at the potential moral underpinnings of respect and thus interprets “respect as an end in itself.” Finally, it is suggested that both reasons to value respect explain respect effects as a function of the working selfconcept that is salient (i.e., pragmatic versus idealistic self)

A passion for respect: On understanding the role of human needs and morality

In the present paper, we stress the importance of the concept respect in a wide variety of social settings and provide a working definition of this concept by emphasizing how respect relates to the act of communicating full recognition to other people on the dimensions of belongingness and morality. Subsequently, in two separate parts, we discuss why respect is so desired and valued. The first part looks at respect as a means to fulfil important human social concerns (“respect as a means to an end”). The second part looks at the potential moral underpinnings of respect and thus interprets “respect as an end in itself.” Finally, it is suggested that both reasons to value respect explain respect effects as a function of the working selfconcept that is salient (i.e., pragmatic versus idealistic self)