Text Message Intervention for Latino Adults To Improve Diabetes Outcomes in an Urban Free Clinic Setting

Introduction: This text message intervention sought to help patients at a free clinic in the Southeastern U.S. that have uncontrolled diabetes (DM) (A1C \u3e or = 7) improve their DM clinical and behavioral outcomes, and thereby help them to live healthier, more hopeful and productive lives as they deal daily with this chronic illness. Eight weeks of educational text messages were sent to help improve DM care and outcomes. Method: Free clinic patient Latino adults with DM (n=25) pre-post one group design. Results: Statistically significant results (p \u3c .05) were seen in three (SKILLD, p=.001, DSES, p = .000, and SDSCA, p = .042) of the four tools/surveys administered. A1C improvements were significant from the pre-intervention (M = 9.10, SD = 1.51) and the trended post-intervention values/results (M=8.26, SD = 1.29, t [21] = 2.79, p = .0110). Discussion: Does personalized communication, education and follow up for patients at the free clinic improve diabetes knowledge, self-efficacy and self-care? This text message intervention shows great promise to improve outcomes for diabetes self-management

Submarine eruption-fed and resedimented pumice-rich facies: the Dogashima Formation (Izu Peninsula, Japan)

In the Izu Peninsula (Japan), the Pliocene pumice-rich Dogashima Formation (4.55?±?0.87 Ma) displays exceptional preservation of volcaniclastic facies that were erupted and deposited in a below wave-base marine setting. It includes high-concentration density current deposits that contain clasts that were emplaced hot, indicating an eruption-fed origin. The lower part of the Dogashima 2 unit consists of a very thick sequence (&lt;12 m) of massive grey andesite breccia restricted to the base of a submarine channel, gradationally overlain by pumice breccia, which is widespread but much thinner and finer in the overbank setting. These two breccias share similar mineralogy and crystal composition and are considered to be co-magmatic and derived from the destruction of a submarine dome by an explosive, pumice-forming eruption. The two breccias were deposited from a single, explosive eruption-fed, sustained, sea floor-hugging, water-supported, high-concentration density current in which the clasts were sorted according to their density. At the rim of the channel, localised good hydraulic sorting of clasts and stratification in the pumice breccia are interpreted to reflect local current expansion and unsteadiness rather than to be the result of hydraulic sorting of clasts during fall from a submarine eruption column and/or umbrella plume. A bimodal coarse (&gt;1 m) pumice- and ash-rich bed overlying the breccias may be derived from delayed settling of pyroclasts from suspension. In Dogashima 1 and 2, thick cross- and planar-bedded facies composed of sub-rounded pumice clasts are intercalated with eruption-fed facies, implying inter-eruptive mass-wasting on the flank of a submarine volcano, and reworking and resedimentation by high-energy tractional currents in a below wave-base environment.<br/

Grain-size distribution of volcaniclastic rocks 2: Characterizing grain size and hydraulic sorting

Quantification of the grain size distribution of sediments allows interpretation of processes of transport and deposition. Jutzeler et al. (2012) developed a technique to determine grain size distribution of consolidated clastic rocks using functional stereology, allowing direct comparison between unconsolidated sediments and rocks. Here, we develop this technique to characterize hydraulic sorting and infer transport and deposition processes. We compare computed grain size and sorting of volcaniclastic rocks with field-based characteristics of volcaniclastic facies for which transport and depositional mechanisms have been inferred. We studied pumice-rich, subaqueous facies of volcaniclastic rocks from the Oligocene Ohanapecosh Formation (Ancestral Cascades, Washington, USA), Pliocene Dogashima Formation (Izu Peninsula, Honshu, Japan), Miocene Manukau Subgroup (Northland, New Zealand) and the Quaternary Sierra La Primavera caldera (Jalisco State, Mexico). These sequences differ in bed thickness, grading and abundance of matrix. We propose to evaluate grain size and sorting of volcaniclastic deposits by values of their modes, matrix proportion (< 2 mm; F-1) and D16, instead of median diameter (D50) and standard deviation parameters. F-1 and D16 can be uniformly used to characterize and compare sieving and functional stereology data. Volcaniclastic deposits typically consist of mixtures of particles that vary greatly in density and porosity. Hydraulic sorting ratios can be used to test whether inferred density of mixed clast populations of pumice and dense clasts are hydraulically sorted with each other, considering various types of transport under water. Evaluation of this ratio for our samples shows that most studied volcaniclastic facies are deposited by settling from density currents, and that basal dense clast breccia are emplaced by shear rolling. These hydraulic sorting ratios can be applied to any type of clastic rocks, and indifferently on consolidated and unconsolidated samples

Temperature dependence of spatially heterogeneous dynamics in a model of viscous silica

Molecular dynamics simulations are performed to study spatially heterogeneous dynamics in a model of viscous silica above and below the critical temperature of the mode coupling theory, $T_{MCT}$. Specifically, we follow the evolution of the dynamic heterogeneity as the temperature dependence of the transport coefficients shows a crossover from non-Arrhenius to Arrhenius behavior when the melt is cooled. It is demonstrated that, on intermediate time scales, a small fraction of oxygen and silicon atoms are more mobile than expected from a Gaussian approximation. These highly mobile particles form transient clusters larger than that resulting from random statistics, indicating that dynamics are spatially heterogeneous. An analysis of the clusters reveals that the mean cluster size is maximum at times intermediate between ballistic and diffusive motion, and the maximum size increases with decreasing temperature. In particular, the growth of the clusters continues when the transport coefficients follow an Arrhenius law. These findings imply that the structural relaxation in silica cannot be understood as a statistical bond breaking process. Though the mean cluster sizes for silica are at the lower end of the spectrum of values reported in the literature, we find that spatially heterogeneous dynamics in strong and fragile glass formers are similar on a qualitative level. However, different from results for fragile liquids, we show that correlated particle motion along quasi one-dimensional, string-like paths is of little importance for the structural relaxation in this model of silica, suggesting that string-like motion is suppressed by the presence of covalent bonds.Comment: 13 pages, 11 figure

Adverse mandibular bone effects associated with kidney disease are only partially corrected with bisphosphonate and/or calcium treatment

Bone Biology Laboratory http://www.iupui.edu/~bonelab/ Department of Anatomy and Cell Biology Indiana University School of Medicine Department of Biomedical Engineering IUPUIBackground/Aims: Patients with chronic kidney disease (CKD) have high prevalence of periodontal disease that may predispose to tooth loss and inflammation. The goal of this study was to test the hypotheses that a genetic rat model of progressive CKD would exhibit altered oral bone properties and that treatment with either bisphosphonates or calcium could attenuate these adverse changes. Methods: At 25 weeks of age, rats were treated with zoledronate, calcium gluconate, or their combination for 5 or 10 weeks. Mandible bone properties were assessed using micro-computed tomography to determine bone volume (BV/TV) and cementenamel junction to alveolar crest distance (CEJ-AC). Results: Untreated CKD animals had significantly lower BV/TV at both 30 (-5%) and 35 (-14%) weeks of age and higher CEJ-AC (+27 and 29%) compared to normal animals. CKD animals had significantly higher PTH compared to normal animals yet similar levels of C-reactive protein. Zoledronate-treatment normalized BV/TV over the first 5 weeks but this benefit was lost by 10 weeks. Calcium treatment, alone or in combination with zoledronate, was effective in normalizing BV/TV at both time points. Neither zoledronate nor calcium was able to correct the higher CEJ-AC caused by CKD. Calcium, but not zoledronate, significantly reduced serum parathyroid hormone (PTH) while neither treatment affected C-reactive protein. Conclusions: 1) this progressive animal model of chronic kidney disease shows a clear mandibular skeletal phenotype consistent with periodontitis, 2) the periodontitis is not associated with systemic inflammation as measured by C-reactive protein, and 3) reducing PTH has positive effects on the mandible phenotype.This work was supported by NIH grant (AR058005). We would like to thank Dr. Xianming Chen, Mr. Alex Carr and Mr. Drew Brown for their assistance with the biochemical assays, breeding colony and micro CT scanning/analysis, respectively

Effect of ovariectomy on the progression of chronic kidney disease-mineral bone disorder (CKD-MBD) in female Cy/+ rats

Male Cy/+ rats have shown a relatively consistent pattern of progressive kidney disease development that displays multiple key features of late stage chronic kidney disease-mineral bone disorder (CKD-MBD), specifically the development of cortical bone porosity. However, progression of disease in female Cy/+ rats, assessed in limited studies, is more heterogeneous and to date has failed to show development of the CKD-MBD phenotype, thus limiting their use as a practical model of progressive CKD-MBD. Animal and human studies suggest that estrogen may be protective against kidney disease in addition to its established protective effect on bone. Therefore, in this study, we aimed to determine the effect of ovariectomy (OVX) on the biochemical and skeletal manifestations of CKD-MBD in Cy/+ female rats. We hypothesized that OVX would accelerate development of the biochemical and skeletal features of CKD-MBD in female Cy/+ rats, similar to those seen in male Cy/+ rats. Female Cy/+ rats underwent OVX (n = 8) or Sham (n = 8) surgery at 15 weeks of age. Blood was collected every 5 weeks post-surgery until 35 weeks of age, when the rats underwent a 4-day metabolic balance, and the tibia and final blood were collected at the time of sacrifice. OVX produced the expected changes in trabecular and cortical parameters consistent with post-menopausal disease, and negative phosphorus balance compared with Sham. However, indicators of CKD-MBD were similar between OVX and Sham (similar kidney weight, plasma blood urea nitrogen, creatinine, creatinine clearance, phosphorus, calcium, parathyroid hormone, and no cortical porosity). Contrary to our hypothesis, OVX did not produce evidence of development of the CKD-MBD phenotype in female Cy/+ rats

N-acetylcysteine (NAC), an anti-oxidant, does not improve bone mechanical properties in a rat model of progressive chronic kidney disease-mineral bone disorder

Individuals with chronic kidney disease have elevated levels of oxidative stress and are at a significantly higher risk of skeletal fracture. Advanced glycation end products (AGEs), which accumulate in bone and compromise mechanical properties, are known to be driven in part by oxidative stress. The goal of this study was to study effects of N-acetylcysteine (NAC) on reducing oxidative stress and improving various bone parameters, most specifically mechanical properties, in an animal model of progressive CKD. Male Cy/+ (CKD) rats and unaffected littermates were untreated (controls) or treated with NAC (80 mg/kg, IP) from 30 to 35 weeks of age. Endpoint measures included serum biochemistries, assessments of systemic oxidative stress, bone morphology, and mechanical properties, and AGE levels in the bone. CKD rats had the expected phenotype that included low kidney function, elevated parathyroid hormone, higher cortical porosity, and compromised mechanical properties. NAC treatment had mixed effects on oxidative stress markers, significantly reducing TBARS (a measure of lipid peroxidation) while not affecting 8-OHdG (a marker of DNA oxidation) levels. AGE levels in the bone were elevated in CKD animals and were reduced with NAC although this did not translate to a benefit in bone mechanical properties. In conclusion, NAC failed to significantly improve bone architecture/geometry/mechanical properties in our rat model of progressive CKD

Changes in skeletal collagen crosslinks and matrix hydration in high and low turnover chronic kidney disease

Chronic kidney disease (CKD) increases fracture risk. The results of this work point to changes in bone collagen and bone hydration as playing a role in bone fragility associated with CKD. INTRODUCTION: Clinical data have documented a clear increase in fracture risk associated with chronic kidney disease (CKD). Preclinical studies have shown reductions in bone mechanical properties although the tissue-level mechanisms for these differences remain unclear. The goal of this study was to assess collagen cross-links and matrix hydration, two variables known to affect mechanical properties, in animals with either high- or low-turnover CKD. METHODS: At 35 weeks of age (>75 % reduction in kidney function), the femoral diaphysis of male Cy/+ rats with high or low bone turnover rates, along with normal littermate (NL) controls, were assessed for collagen cross-links (pyridinoline (Pyd), deoxypyridinoline (Dpd), and pentosidine (PE)) using a high-performance liquid chromatography (HPLC) assay as well as pore and bound water per volume (pw and bw) using a 1H nuclear magnetic resonance (NMR) technique. Material-level biomechanical properties were calculated based on previously published whole bone mechanical tests. RESULTS: Cortical bone from animals with high-turnover disease had lower Pyd and Dpd cross-link levels (-21 % each), lower bw (-10 %), higher PE (+71 %), and higher pw (+46 %) compared to NL. Animals with low turnover had higher Dpd, PE (+71 %), and bw (+7 %) along with lower pw (-60 %) compared to NL. Both high- and low-turnover animals had reduced material-level bone toughness compared to NL animals as determined by three-point bending. CONCLUSIONS: These data document an increase in skeletal PE with advanced CKD that is independent of bone turnover rate and inversely related to decline in kidney function. Although hydration changes occur in both high- and low-turnover disease, the data suggest that nonenzymatic collagen cross-links may be a key factor in compromised mechanical properties of CKD.This work was supported by National Institutes of Health grants AR58005 (SM), DL100093 (CN), AR063157 (JSN), and the Indiana Clinical Translational Science Institute grant TR000162 (CN). The cross-link analysis is the result of work supported with resources and the use of facilities at the VA Tennessee Valley Healthcare System. All authors were involved in the design, conduct and analyses of the study. The authors would like to thank Drew Brown, Shannon Roy, and Kali O’Neill for technical assistance. We would also like to acknowledge the late Dr. Vincent H. Gattone II (1951-2013), who was instrumental in developing this animal model

Parathyroid suppression therapy normalizes chronic kidney disease-induced elevations in cortical bone vascular perfusion: a pilot study

Patients with chronic kidney disease (CKD) have accelerated bone loss, vascular calcification and abnormal biochemistries, together contributing to an increased risk of cardiovascular disease and fracture-associated mortality. Despite evidence of vascular pathologies and dysfunction in CKD, our group has shown that cortical bone tissue perfusion is higher in a rat model of high-turnover CKD. The goal of the present study was to test the hypothesis that parathyroid hormone (PTH) suppressive interventions would normalize cortical bone vascular perfusion in the setting of CKD. In two separate experiments, 35-week old CKD animals and their normal littermates, underwent intra-cardiac fluorescent microsphere injection to assess the effect of 10 weeks of PTH suppression (Experiment 1: calcium supplementation, Experiment 2: calcimimetic treatment) on alterations in bone tissue perfusion. In Experiment 1, CKD animals had serum blood urea nitrogen (BUN) and PTH levels significantly higher than NL (+182% and +958%; p<0.05). CKD+Ca animals had BUN levels that were similar to CKD, while PTH levels were significantly lower and comparable to NL. Both femoral cortex (+220%, p=0.003) and tibial cortex (+336, p=0.005) tissue perfusion were significantly higher in CKD animals when compared to NL; perfusion was normalized to those of NL in CKD+Ca animals. MicroCT analysis of the proximal tibia cortical porosity showed a trend toward higher values in CKD (+401%; p=0.017) but not CKD+Ca (+111%; p = 0.38) compared to NL. Experiment 2, using an alternative method of PTH suppression, showed similar results as those of Experiment 1. These data demonstrate that PTH-suppression based interventions normalize cortical bone perfusion in the setting of CKD.This work was supported by a United States (U.S.) Department of Veterans Affairs grant (BX003025) to MRA. MWA was supported by F30 DK115162 and T32 AR065971 during separate portions of this work. KP-2326 was provided through a material transfer agreement with Amgen