Depressive symptoms in asymptomatic stage B heart failure with Type II diabetic mellitus.

BackgroundThe presence of concomitant Type II diabetic mellitus (T2DM) and depressive symptoms adversely affects individuals with symptomatic heart failure (HF).HypothesisIn presymptomatic stage B HF, this study hypothesized the presence of greater inflammation and depressive symptoms in T2DM as compared to non-T2DM Stage B patients.MethodsThis cross-sectional study examined clinical parameters, inflammatory biomarkers, and depressive symptoms in 349 T2DM and non-T2DM men with asymptomatic stage B HF (mean age 66.4 years ±10.1; range 30-91).ResultsFewer diabetic HF patients had left ventricular (LV) systolic dysfunction (P < .05) although more had LV diastolic dysfunction (P < .001). A higher percentage of T2DM HF patients were taking ACE-inhibitors, beta-blockers, calcium channel blockers, statins, and diuretics (P values < .05). T2DM HF patients had higher circulating levels of interleukin-6 (IL-6) (P < .01), tumor necrosis factor-alpha (P < .01), and soluble ST2 (sST2) (P < .01) and reported more somatic/affective depressive symptoms (Beck Depression Inventory II) (P < .05) but not cognitive/affective depressive symptoms (P = .20). Among all patients, in a multiple regression analysis predicting presence of somatic/affective depressive symptoms, sST2 (P = .026), IL-6 (P = .010), B-type natriuretic peptide (P = .016), and sleep (Pittsburgh Sleep Quality Index [P < .001]) were significant predictors (overall model F = 15.39, P < .001, adjusted R2 = .207).ConclusionsSomatic/affective but not cognitive/affective depressive symptoms are elevated in asymptomatic HF patients with T2DM patients. Linkages with elevated inflammatory and cardiac relevant biomarkers suggest shared pathophysiological mechanisms among T2DM HF patients with somatic depression, and these conditions are responsive to routine interventions, including behavioral. Copyright © 2019 John Wiley & Sons, Ltd

Anglo-American relations in south America during the second world war and post-war economic planning

This thesis examines relations between the United States and Great Britain in South America between 1939 and 1945. It does so in the broader context of the economic planning for the post-war world undertaken by the US and Britain during the Second World War. Traditional interpretations of Anglo-American post-war economic planning have tended to focus on a process whereby the Franklin D. Roosevelt administration advocated a multilateral system, based on equality of access to markets and raw materials. Doubting Britain’s ability to compete successfully in such a system, the British government baulked at the US proposal and clung to its autarkic structures constructed during the interwar years. This thesis argues that relations between the US and Britain in South America followed a different and more complex pattern. In this region it was in fact Britain that eventually took the lead in advocating multilateralism. This policy was adopted following a lengthy evaluation of British policy in Latin America, which concluded that multilateralism represented the surest means of protecting British interests in South America. The US, on the other hand, demonstrated exclusionary tendencies in its policy toward Latin America, which threatened the successful implementation of a global economic system based on multilateralism. In explaining this divergence from multilateralism in the Roosevelt administration’s post-war economic planning, this thesis pays particular attention to the influence of different factions, both within the administration and in the broader US political and business establishment. By exploring Anglo-American relations in this previously neglected region, this thesis contributes toward a greater understanding of the broader process of post-war economic planning that took place between the US and Britain during the Second World War.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

ING116070: a study of the pharmacokinetics and antiviral activity of dolutegravir in cerebrospinal fluid in HIV-1-infected, antiretroviral therapy-naive subjects.

BackgroundDolutegravir (DTG), a once-daily, human immunodeficiency virus type 1 (HIV-1) integrase inhibitor, was evaluated for distribution and antiviral activity in cerebrospinal fluid (CSF).MethodsING116070 is an ongoing, single-arm, open-label, multicenter study in antiretroviral therapy-naive, HIV-1-infected adults. Subjects received DTG (50 mg) plus abacavir/lamivudine (600/300 mg) once daily. The CSF and plasma (total and unbound) DTG concentrations were measured at weeks 2 and 16. The HIV-1 RNA levels were measured in CSF at baseline and weeks 2 and 16 and in plasma at baseline and weeks 2, 4, 8, 12, and 16.ResultsThirteen white men enrolled in the study; 2 withdrew prematurely, 1 because of a non-drug-related serious adverse event (pharyngitis) and 1 because of lack of treatment efficacy. The median DTG concentrations in CSF were 18 ng/mL (range, 4-23 ng/mL) at week 2 and 13 ng/mL (4-18 ng/mL) at week 16. Ratios of DTG CSF to total plasma concentration were similar to the unbound fraction of DTG in plasma. Median changes from baseline in CSF (n = 11) and plasma (n = 12) HIV-1 RNA were -3.42 and -3.04 log10 copies/mL, respectively. Nine of 11 subjects (82%) had plasma and CSF HIV-1 RNA levels <50 copies/mL and 10 of 11 (91%) had CSF HIV-1 RNA levels <2 copies/mL at week 16.ConclusionsThe DTG concentrations in CSF were similar to unbound plasma concentrations and exceeded the in vitro 50% inhibitory concentration for wild-type HIV (0.2 ng/mL), suggesting that DTG achieves therapeutic concentrations in the central nervous system. The HIV-1 RNA reductions were similar in CSF and plasma. Clinical Trials Registration. NCT01499199

Comparative analysis of pesticide effects on natural enemies in western orchards: A synthesis of laboratory bioassay data

Pesticides are commonly used for pest management in apple, pear and walnut orchards in the western U.S. and may disrupt biological control of secondary pests in these crops. A comparative analysis was made of results obtained from a series of laboratory bioassays of acute mortality and life table response experiments to estimate lethal and sublethal effects of eight pesticides on seven natural enemy species through use of stage-structured population models. Even though a number of the pesticides tested were reduced-risk products, all of them with the exception of copper plus mancozeb and chlorantraniliprole, caused more than 80% acute mortality of at least one life stage of at least one of the natural enemy species at a full field-rate concentration and could thus be considered moderately harmful according to the International Organization for Biological Control classification for laboratory bioassays. Important sublethal effects included reductions in daily fecundity and egg fertility. From integration of the lethal and sublethal effects in matrix models, the mean of the estimated intrinsic rates of increase for natural enemy species was negative for exposure to cyantraniliprole, lambda-cyhalothrin and spinetoram, but positive and not significantly different from the control for exposure to chlorantraniliprole, copper plus mancozeb, novaluron, and sulfur. For comparisons among pesticides, there appears to be considerable variation in response among natural enemy species that can only be represented effectively from a full life table response experiment and a population-level endpoint, whereas among natural enemy species, their population-level response to the range of pesticides tested could frequently be represented by acute adult mortality alone

Impact of previous hepatitis B infection on the clinical outcomes from chronic hepatitis C? A population-level analysis

Chronic coinfection with hepatitis C virus (HCV) and hepatitis B virus (HBV) is associated with adverse liver outcomes. The clinical impact of previous HBV infection on liver disease in HCV infection is unknown. We aimed at determining any association of previous HBV infection with liver outcomes using antibodies to the hepatitis B core antigen (HBcAb) positivity as a marker of exposure. The Scottish Hepatitis C Clinical Database containing data for all patients attending HCV clinics in participating health boards was linked to the HBV diagnostic registry and mortality data from Information Services Division, Scotland. Survival analyses with competing risks were constructed for time from the first appointment to decompensated cirrhosis, hepatocellular carcinoma (HCC) and liver‐related mortality. Records of 8513 chronic HCV patients were included in the analyses (87 HBcAb positive and HBV surface antigen [HBsAg] positive, 1577 HBcAb positive and HBsAg negative, and 6849 HBcAb negative). Multivariate cause‐specific proportional hazards models showed previous HBV infection (HBcAb positive and HBsAg negative) significantly increased the risks of decompensated cirrhosis (hazard ratio [HR]: 1.29, 95% CI: 1.01‐1.65) and HCC (HR: 1.64, 95% CI: 1.09‐2.49), but not liver‐related death (HR: 1.02, 95% CI: 0.80‐1.30). This is the largest study to date showing an association between previous HBV infection and certain adverse liver outcomes in HCV infection. Our analyses add significantly to evidence which suggests that HBV infection adversely affects liver health despite apparent clearance. This has important implications for HBV vaccination policy and indications for prioritization of HCV therapy

Influence of solvent polarity on the structure of drop-cast electroactive tetra(aniline)-surfactant thin films

The structure of drop-cast thin films of an electroactive oligomer–surfactant complex can be tuned through variation of solvent polarity.</p

Brief report: Characteristics of antidepressant use in patients with heart failure

Paul J Mills1, Joel E Dimsdale1, Suzi Hong1, Geoffrey Van Den Brande2, Laura Redwine2, Barry H Greenberg2, Thomas Rutledge11Department of Psychiatry; 2Department of Medicine, University of California San Diego, La Jolla, CA, USABackground: Depression is common in heart failure (HF), but there is little data on the characteristics of antidepressant use in patients with HF.Objective: To survey basic information on antidepressant prescription characteristics, use, effectiveness, and follow-up.Methods: Observational study in two outpatient cardiology clinics of 37 NYHA class I&amp;ndash;IV HF patients taking antidepressant medication.Results: Thirty-one percent of prescriptions for antidepressants were obtained from psychiatrists, 58% from primary care physicians, and 8% from cardiologists. The majority of patients (87%) reported regularly taking their antidepressant medication as prescribed, however 48% reported never having had the dosage of their antidepressant medication adjusted. Only 53% of the patients reported that the medication had helped their mood &amp;ldquo;almost entirely&amp;rdquo; or &amp;ldquo;mostly&amp;rdquo; back to normal since starting their antidepressants, while the remaining patients reported that their mood was only &amp;ldquo;halfway&amp;rdquo; or &amp;ldquo;somewhat&amp;rdquo; back to normal or that the medication had not helped their depression at all. Among a subset of 10 patients who completed the Beck Depression (BDI) inventory, 6 still had depressed mood (BDI&amp;nbsp;&amp;ge; 10).Conclusion: The findings from this survey study provide insight into the characteristics of antidepressant use in patients with HF and argue for better follow up of HF patients who are prescribed antidepressants.Keywords: heart failure, antidepressant medication, adherence, effectivenes

Plant-Derived Biomaterials: A Review of 3D Bioprinting and Biomedical Applications

The pursuit of appropriate, biocompatible materials is one of the primary challenges in translational bioprinting. The requirement to refine a biomaterial into a bioink places additional demands on the criteria for candidate biomaterials. The material must enable extrusion as a liquid bioink and yet be capable of maintaining its shape in the post-printing phase to yield viable tissues, organs and biological materials. Plant-derived biomaterials show great promise in harnessing both the natural strength of plant microarchitecture combined with their natural biological roles as supporters of cell growth. The aim of this review article is to outline the most widely used biomaterials derived from land plants and marine algae: nanocellulose, pectin, starch, alginate, agarose, fucoidan, and carrageenan, with an in-depth focus on nanocellulose and alginate. The properties that render these materials as promising bioinks for three dimensional bioprinting is herein discussed alongside their potential in 3D bioprinting for tissue engineering, drug delivery, wound healing, and implantable medical devices

Safely Managed On-Site Sanitation: A National Assessment of Sanitation Services and Potential Fecal Exposure in Indonesia.

Sustainable Development Goal target 6.2 calls for universal access to adequate and equitable sanitation, setting a more ambitious standard for 'safely managed sanitation services'. On-site sanitation systems (e.g., septic tanks) are widely used in low- and middle-income countries (LMICs). However, the lack of indicators for assessing fecal exposure risks presents a barrier to monitoring safely managed services. Furthermore, geographic diversity and frequency of disasters require a more nuanced approach to risk-informed decision-making. Taking Indonesia as an example, the purpose of this paper is to provide insights into current status and practices for on-site sanitation services in the contexts of LMICs. Using a dataset from a national socio-economic survey (n = 295,155) coupled with village census (n = 83,931), we assessed (1) household sanitation practices across Indonesia stratified by city-level population density and meteorological factors, (2) factors associated with septic tank emptying practice, and (3) inequalities in potential fecal exposure as measured by population density and WASH access by wealth quintile. We found a high reliance on on-site sanitation facilities (80.0%), almost half of which are assumed to be 'uncontained' septic tanks and one in ten facilities discharging untreated waste directly into the environment. The most densely populated areas had the highest rates of septic tank emptying, though emptying rates were just 17.0%, while in the lowest population density group, emptying was rarely reported. Multivariate regression analysis demonstrated an association between flooding and drought occurrence and septic tank emptying practice. Higher groundwater usage for drinking among poorer households suggests unsafe sanitation may disproportionally affect the poor. Our study underscores the urgent need to strengthen the monitoring of on-site sanitation in LMICs by developing contextualized standards. Furthermore, the inequalities in potential fecal exposure require greater attention and tailored support mechanisms to ensure the poorest gain access to safely managed sanitation services

Synthesis, Characterization, and Crystal Structure of the (η5-C5Ph5)Cr(CO)3 Radical

The reaction between Cr(CO)6 and Na(C5Ph5 ) in refluxing diglyme yields [Na(diglyme)3/2][(C5Ph5)Cr(CO)3], 1. Metathesis of 1 with [Ph3P=N=PPh3 ]Cl in CH2Cl2 yields [Ph3P=N=PPh3][(C5Ph5)Cr(CO)3], 2. Oxidation of 1 by AgBF4 in cold THF under an argon atmosphere produces (C5Ph5)Cr(CO)3, 3. Complexes 2 and 3 form a redox pair connected by a quasireversible one-electron process, E0 = -0.69 V vs ferrocene in CH2Cl2, E0 = -0.50 V in CH3CN, ks = 0.12 cm/s. ESR spectra of (C5Ph5)Cr(CO)3 in toluene at 90 K gave a rhombic g-tensor with components 2.1366, 2.0224, and 1.9953, consistent with the expected low-spin d5 electronic configuration. The largest g-tensor component was significantly temperature dependent, suggesting an equilibrium between conformations with 2A´ and 2A˝ ground states. Crystal structures of [Ph3P=N=PPh3][(C5Ph5)Cr(CO)3] and (C5Ph5)Cr(CO)3 were obtained