Toll-like receptor 4 in experimental kidney transplantation: early mediator of endogenous danger signals

The role of toll-like receptors (TLRs) has been described in the pathogenesis of renal ischemia/reperfusion injury, but data on the expression and function of TLR4 during renal allograft damage are still scarce. We analyzed the expression of TLR4 in an experimental rat model 6 and 28 days after allogeneic kidney transplantation in comparison to control rats and rats after syngeneic transplantation. On day 6, a significant induction in TLR4 expression - restricted to the glomerular compartment - was found in acute rejecting allografts only. TLR4 expression strongly correlated with renal function, and TLR4 induction was accompanied by a significant increase in CC chemokine expression within the graft as well as in urinary CC chemokine excretion. TLR4 induction may be caused by an influx of macrophages as well as TLR4-expressing intrinsic renal cells. Fibrinogen deposition in renal allografts correlated with renal TLR4 expression and may act as a potent stimulator of chemokine release via TLR4 activation. This study provides, for the first time, data about the precise intrarenal localization and TLR4 induction after experimental kidney transplantation. It supports the hypothesis that local TLR4 activation by endogenous ligands may be one pathological link from unspecific primary allograft damage to subsequent chemokine release, infiltration and activation of immune cells leading to deterioration of renal function and induction of renal fibrosis. Copyright (c) 2012 S. Karger AG, Base

Adolescent Healthcare Brokering: Prevalence, Experience, Impact, and Opportunities

BACKGROUND: Limited health literacy disproportionately affects those with limited English proficiency (LEP). Parents with LEP might rely on their adolescent children to interpret health information. We call this adolescent health care brokering. This study uncovers the prevalence of brokering, kinds of tasks, emotional and academic impact, and desired support. METHODS: We invited 165 students from health classes (in a community in which 29.8% are foreign-born and 53.4% speak another language at home) to complete a survey. We used IBM SPSS to calculate descriptive statistics. RESULTS: Of the 159 who received parental consent and assented, 54.1% (n=86) assist with healthcare tasks. When brokering, 80.2% (n=69) translate. Most common tasks were talking to a doctor, reading prescriptions, and searching on the Internet. Participants were most confident reading prescriptions and talking to a doctor and least confident finding healthcare services. Among brokers, 29.1% (n=24) missed school; 33.7% did not complete homework. They most wanted to learn about filling out insurance forms and talking to doctors. CONCLUSIONS: Despite assurances that children are not permitted to interpret, adolescents are acting as healthcare brokers. The impact can be academic and emotional. Findings indicate a need for further research and support for adolescents who want to learn about healthcare tasks

The Adolescent Health Care Broker – Adolescents Interpreting for Family Members and Themselves in Health Care

Parents with limited English proficiency might rely on their adolescent children to interpret health information. We call this adolescent healthcare brokering. Using a mixed-methods, transformative research approach rooted in grounded theory, we sought to answer these questions: (a) “What is happening? What are people doing?” and (b) “What do these stories indicate? What might they suggest about social justice?” High school students from a community in which 53.4% speak another language at home were invited to participate in a survey and focus groups. Of 238 survey participants, 57.5% (n=137) indicated they assisted with healthcare tasks. When doing so, 81.7% (n=112) translated. Common tasks were reading prescriptions and talking to doctors. While some participants cited negative emotions associated with brokering, the net emotion was positive. Focus groups (n=11) revealed that tasks varied broadly in complexity and type, emotional experiences were dichotomous, and access to interpreting services and other supports was inconsistent

Spring plankton dynamics in the Eastern Bering Sea, 1971-2050 : mechanisms of interannual variability diagnosed with a numerical model

A new planktonic ecosystem model was constructed for the Eastern Bering Sea based on observations from the 2007-2010 BEST/BSIERP (Bering Ecosystem Study/Bering Sea Integrated Ecosystem Research Program) field program. When run with forcing from a data-assimilative ice-ocean hindcast of 1971-2012, the model performs well against observations of spring bloom time evolution (phytoplankton and microzooplankton biomass, growth and grazing rates, and ratios among new, regenerated, and export production). On the southern middle shelf (57°N, station M2), the model replicates the generally inverse relationship between ice-retreat timing and spring bloom timing known from observations, and the simpler direct relationship between the two that has been observed on the northern middle shelf (62°N, station M8). The relationship between simulated mean primary production and mean temperature in spring (15 February to 15 July) is generally positive, although this was found to be an indirect relationship which does not continue to apply across a future projection of temperature and ice cover in the 2040s. At M2, the leading direct controls on total spring primary production are found to be advective and turbulent nutrient supply, suggesting that mesoscale, wind-driven processes - A dvective transport and storminess - may be crucial to long-term trends in spring primary production in the southeastern Bering Sea, with temperature and ice cover playing only indirect roles. Sensitivity experiments suggest that direct dependence of planktonic growth and metabolic rates on temperature is less significant overall than the other drivers correlated with temperature described above

Traditional and Nontraditional Cardiovascular Risk Factors and Estimated Risk for Coronary Artery Disease in Renal Transplant Recipients: A Single-Center Experience

Background/Aims: The prevalence of cardiovascular disease in renal transplant recipients is markedly higher than in the general population due to the high prevalence of traditional cardiovascular risk factors, renal transplant function impairment and treatment with immunosuppressive drugs that affect blood pressure, cholesterol and blood glucose levels. Methods: Cross-sectional analysis using our renal transplant clinic cohort investigating (1) the cardiovascular risk factors present in this cohort, and (2) estimating their impact on the risk of coronary artery disease (CAD) by using the Framingham algorithm. Results: Control of modifiable cardiovascular risk factors in 231 renal transplant recipients is suboptimal, i.e. 47.2% of patients are hypertensive, 10.3% actively smoke, 39.4% have serum cholesterol concentrations >200 mg/dl, and 19.7% have diabetes mellitus. Blood pressure, age, hyperlipidemia, smoking and diabetes modulate the estimated CAD risk in males and females. Furthermore, a short time period (less than 1 year) since transplantation and increased serum creatinine levels negatively influenced the CAD risk in this patient population. Conclusion: According to current guidelines, the control of modifiable cardiovascular risk factors in renal transplant recipients is suboptimal. The decreasing CAD risk over time after transplantation may be due to the reduction of immunosuppressive drugs with time and survival bias

Supernova Remnants and Star Formation in the Large Magellanic Cloud

It has often been suggested that supernova remnants (SNRs) can trigger star formation. To investigate the relationship between SNRs and star formation, we have examined the known sample of 45 SNRs in the Large Magellanic Cloud to search for associated young stellar objects (YSOs) and molecular clouds. We find seven SNRs associated with both YSOs and molecular clouds, three SNRs associated with YSOs but not molecular clouds, and eight SNRs near molecular clouds but not associated with YSOs. Among the 10 SNRs associated with YSOs, the association between the YSOs and SNRs can be either rejected or cannot be convincingly established for eight cases. Only two SNRs have YSOs closely aligned along their rims; however, the time elapsed since the SNR began to interact with the YSOs' natal clouds is much shorter than the contraction timescales of the YSOs, and thus we do not see any evidence of SNR-triggered star formation in the LMC. The 15 SNRs that are near molecular clouds may trigger star formation in the future when the SNR shocks have slowed down to <45 km/s. We discuss how SNRs can alter the physical properties and abundances of YSOs.Comment: 24 pages, 5 figures, 1 table, Accepted for publication in the August 2010 edition of the Astronomical Journa

Dust in the bright supernova remnant N49 in the LMC

We investigate the dust associated with the supernova remnant (SNR) N49 in the Large Magellanic Cloud (LMC) as observed with the Herschel Space Observatory. N49 is unusually bright because of an interaction with a molecular cloud along its eastern edge. We have used PACS and SPIRE to measure the far IR flux densities of the entire SNR and of a bright region on the eastern edge of the SNR where the SNR shock is encountering the molecular cloud. Using these fluxes supplemented with archival data at shorter wavelengths, we estimate the dust mass associated with N49 to be about 10 Msun. The bulk of the dust in our simple two-component model has a temperature of 20-30 K, similar to that of nearby molecular clouds. Unfortunately, as a result of the limited angular resolution of Herschel at the wavelengths sampled with SPIRE, the uncertainties are fairly large. Assuming this estimate of the dust mass associated with the SNR is approximately correct, it is probable that most of the dust in the SNR arises from regions where the shock speed is too low to produce significant X-ray emission. The total amount of warm 50-60 K dust is ~0.1 or 0.4 Msun, depending on whether the dust is modeled in terms of carbonaceous or silicate grains. This provides a firm lower limit to the amount of shock heated dust in N49.Comment: accepted by the Astronomy & Astrophysics Lette

Spectral Correlation in Incommensurate Multi-Walled Carbon Nanotubes

We investigate the energy spectra of clean incommensurate double-walled carbon nanotubes, and find that the overall spectral properties are described by the so-called critical statistics of Anderson metal-insulator transition. In the energy spectra, there exist three different regimes characterized by Wigner-Dyson, Poisson, and semi-Poisson distributions. This feature implies that the electron transport in incommensurate multi-walled nanotubes can be either diffusive, ballistic, or intermediate between them, depending on the position of the Fermi energy.Comment: final version to appear in Phys. Rev. Let

The temporal response of the length of a partially stratified estuary to changes in river flow and tidal amplitude

Author Posting. © American Meteorological Society, 2009. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Journal of Physical Oceanography 39 (2009): 915-933, doi:10.1175/2008JPO3933.1.The temporal response of the length of a partially mixed estuary to changes in freshwater discharge Qf and tidal amplitude UT is studied using a 108-day time series collected along the length of the Hudson River estuary in the spring and summer of 2004 and a long-term (13.4 yr) record of Qf, UT, and near-surface salinity. When Qf was moderately high, the tidally averaged length of the estuary L5, here defined as the distance from the mouth to the up-estuary location where the vertically averaged salinity is 5 psu, fluctuated by more than 47 km over the spring–neap cycle, ranging from 28 to >75 km. During low flow periods, L5 varied very little over the spring–neap cycle and approached a steady length. The response is quantified and compared to predictions of a linearized model derived from the global estuarine salt balance. The model is forced by fluctuations in Qf and UT relative to average discharge Qo and tidal amplitude UTo and predicts the linear response time scale τ and the steady-state length Lo for average forcing. Two vertical mixing schemes are considered, in which 1) mixing is proportional to UT and 2) dependence of mixing on stratification is also parameterized. Based on least squares fits between L5 and estuary length predicted by the model, estimated τ varied by an order of magnitude from a period of high average discharge (Qo = 750 m3 s−1, τ = 4.2 days) to a period of low discharge (Qo = 170 m3 s−1, τ = 40.4 days). Over the range of observed discharge, Lo Qo−0.30±0.03, consistent with the theoretical scaling for an estuary whose landward salt flux is driven by vertical estuarine exchange circulation. Estimated τ was proportional to the discharge advection time scale (LoA/Qo, where A is the cross-sectional area of the estuary). However, τ was 3–4 times larger than the theoretical prediction. The model with stratification-dependent mixing predicted variations in L5 with higher skill than the model with mixing proportional to UT. This model provides insight into the time-dependent response of a partially stratified estuary to changes in forcing and explains the strong dependence of the amplitude of the spring–neap response on freshwater discharge. However, the utility of the linear model is limited because it assumes a uniform channel, and because the underlying dynamics are nonlinear, and the forcing Qf and UT can undergo large amplitude variations. River discharge, in particular, can vary by over an order of magnitude over time scales comparable to or shorter than the response time scale of the estuary.This study was generously funded by Hudson River Foundation Grant 005/03A and NSF Grant OCE-0452054. Lerczak also received partial support from the Woods Hole Center for Oceans and Human Health, NSF Grant OCE-0430724 and NIEHS Grant 1-P50-ES012742-01