Differential effects on inhibition of cholesterol absorption by plant stanol and plant sterol esters in apoE−/− mice

Aims 'Functional foods'; supplemented with plant sterol esters (PSE) and plant stanol esters (PSA) are therapeutic options for the management of hypercholesterolaemia. However, their effects on blood monocytes, endothelial function, atherogenesis, and sterol tissue concentrations are poorly understood. Methods and results Male apoE−/− mice (n= 30) were randomized to three different diets for 6 weeks (n= 10 per group): high-cholesterol (1.25%) western-type diet (WTD), WTD + 2% PSE, and WTD + 2% PSA. Both supplements reduced serum cholesterol. WTD + PSE resulted in increased plant sterol serum concentrations and increased inflammatory Ly-6C(high) monocyte numbers. WTD + PSA increased plant stanol serum concentrations and Ly-6C-monocyte numbers, but decreased vascular superoxide release, lipid hydroperoxides, and inflammatory cytokines in aortic tissue, in plasma, and in circulating monocytes. Despite reduced serum cholesterol concentrations, both supplements impaired endothelial vasodilation compared with WTD. WTD + PSA reduced the development of atherosclerotic lesions compared with WTD alone (12.7 ± 3.7 vs. 28.3 ± 3.5%), and WTD + PSE was less effective (17.5 ± 3.7%). WTD + PSE and WTD + PSA reduced the cholesterol content in the liver, but not in the brain. However, WTD + PSE and WTD + PSA increased plant sterol and plant stanol concentrations in the liver as well as in the brain. Conclusion PSE and PSA supplementation reduced serum cholesterol, but increased plant sterol and plant stanol concentrations. Elevated levels of PSE and PSA were associated with endothelial dysfunction and increased central nervous system depositions. Atherosclerotic lesion retardation was more pronounced in WTD + PSA, coinciding with higher regenerative monocyte numbers, decreased oxidative stress, and decreased inflammatory cytokines compared with WTD + PSE

Language Medical Students Use to Comfort Patients Through Difficult Discussions

MERA Abstract Language medical students use to comfort patients through difficult discussions. AUTHORS Zayna Qaissi, BA Candidate; Emily J Noonan, PhD, MA; Laura A. Weingartner, PhD, MS BACKGROUND Comforting communication supports patient satisfaction. Examining how medical students approach potentially sensitive topics can help educators identify strategies that improve the quality of care. The purpose of this study was to examine verbal approaches that student-physicians use to put patients at ease. METHODS Seventy-five medical students were observed in standardized patient encounters. We assessed how students provided comfort by transcribing interview recordings and observing how students addressed the patients’ mental health, sexual history, and a death in the family. All videotaped interviews were rated with a checklist based on the number of important medical aspects for each case. RESULTS Students used different strategies to put patients at ease. Students introduced the sexual history through other topics such as social history (50%) or told the patient directly that the sexual history will be discussed (26%). Many emphasized the importance of the sexual history to the patient’s health and normalized the discussion. Other students (44%) delved into the sexual history abruptly without transitioning. Discussing past mental health issues, students showed empathy by acknowledging health improvement, discussing feelings and concerns, acknowledging stress, or apologizing (31%) to the patient. Empathetic responses to a death in the patient’s family also included apologies (30%) or easing commentary, but most responses were filler words, such as “okay” and “wow” (54%). DISCUSSION This study identified approaches and gaps in the ways students ease patients to promote a smooth flow of information between the patient and the student Focusing on empathetic behaviors is important for enhancing patient care.https://ir.library.louisville.edu/uars/1052/thumbnail.jp

Prevalence Of Mental Health History Intake By Medical Trainees

BACKGROUND: In the US, 1 in 5 adults experiences a mental illness. Over 9.8 million adults and youths have serious suicidal thoughts, and LGBTQ+ communities experience an even greater burden of mental health disparities. Mental illness is often recognized late by providers, which prevents timely and effective treatment. METHODS: We estimated the frequency and response of healthcare trainees asking about mental health using video-recorded standardized patient interviews conducted by third-year medical students (M3s). Standardized patients are trained to give out specific health history information only when prompted by the student. Students had 30 minutes to complete new patient interviews in a primary care setting. RESULTS: Among a sample of 38 M3s, 60% discussed mental health for an average of 1.3 minutes. Only 26% of these students followed up about a mental health treatment plan. After the mental health disclosure by patients, students responded, I am sorry to hear that (30%), frowned (22%), or offered support and resources to the patient (17%). Not all trainees elicited whether a patient identified as LGBTQ+ or connected patient identity with mental health support. DISCUSSION: We document how mental health histories may not be identified in primary care settings. Many disclosures were also prompted by providers asking about previous hospitalizations rather than mental health specifically. We thus recommend routine mental health history intake for new patients establishing care. Trainees may benefit from comparing interpersonal skills, like empathetic responses between providers and patients, and connecting LGBTQ+ patient identity and terminology to support patients\u27 mental health needs.https://ir.library.louisville.edu/uars/1015/thumbnail.jp

Extinction and Distance to Anomalous X-ray Pulsars from X-ray Scattering Halos

We analyze the X-ray scattering halos around three Galactic Anomalous X-ray Pulsars (AXPs) in order to constrain the distance and the optical extinction of each source. We obtain surface brightness distributions from EPIC-pn data obtained with XMM-Newton, compare the profiles of different sources, and fit them with a model based on the standard theory of X-ray scattering by dust grains, both for a uniform distribution of dust along the line of sight, and for dust distributions constrained by previous measurements. Somewhat surprisingly, we find that for all three sources, the uniform distribution reproduces the observed surface brightness as well as or better than the distributions that are informed by previous constraints. Nevertheless, the inferred total dust columns are robust, and serve to confirm that previous measurements based on interstellar edges in high-resolution X-ray spectra and on modelling of broad-band X-ray spectra were reliable. Specifically, we find Av ~= 4, 6, and 8 mag for 4U 0142+61, 1E 1048.1-5937, and 1RXS J170849.0-400910, respectively. For 1E 1048.1-5937, this is well in excess of the extinction expected towards a HI bubble along the line of sight, thus casting further doubt on the suggested association with the source.Comment: 8 pages, 6 figure

Discovery of superthermal hydroxyl (OH) in the HH211 outflow

We present a 5-37 micron infrared spectrum obtained with the Spitzer Space Telescope toward the southeastern lobe of the young protostellar outflow HH211. The spectrum shows an extraordinary sequence of OH emission lines arising in highly excited rotational levels up to an energy E/k~28200K above the ground level. This is, to our knowledge, by far the highest rotational excitation of OH observed outside Earth. The spectrum also contains several pure rotational transitions of H2O (v=0), H2 (v=0) S(0) to S(7), HD (v=0) R(3) to R(6), and atomic fine-structure lines of [Fe II], [Si II], [Ne II], [S I], and [Cl I]. The origin of the highly excited OH emission is most likely the photodissociation of H2O by the UV radiation generated in the terminal outflow shock of HH211.Comment: ApJ Letters, in pres

Perspectives on Interstellar Dust Inside and Outside of the Heliosphere

Measurements by dust detectors on interplanetary spacecraft appear to indicate a substantial flux of interstellar particles with masses exceeding 10^{-12}gram. The reported abundance of these massive grains cannot be typical of interstellar gas: it is incompatible with both interstellar elemental abundances and the observed extinction properties of the interstellar dust population. We discuss the likelihood that the Solar System is by chance located near an unusual concentration of massive grains and conclude that this is unlikely, unless dynamical processes in the ISM are responsible for such concentrations. Radiation pressure might conceivably drive large grains into "magnetic valleys". If the influx direction of interstellar gas and dust is varying on a ~10 yr timescale, as suggested by some observations, this would have dramatic implications for the small-scale structure of the interstellar medium.Comment: 13 pages. To appear in Space Science Review

Effect of humidity on nitric acid uptake to mineral dust aerosol particles

International audienceThis study presents the first laboratory observation of HNO3 uptake by airborne mineral dust particles. The model aerosols were generated by dry dispersion of Arizona Test Dust (ATD), SiO2, and by nebulizing a saturated solution of calcium carbonate. The uptake of 13N-labeled gaseous nitric acid was observed in a flow reactor on the 0.2?2 s reaction time scale at room temperature and atmospheric pressure. The amount of nitric acid appearing in the aerosol phase at the end of the flow tube was found to be a linear function of the aerosol surface area. SiO2 particles did not show any significant uptake, while the CaCO3 aerosol was found to be more reactive than ATD. Due to the smaller uncertainty associated with the reactive surface area in the case of suspended particles as compared to bulk powder samples, we believe that we provide an improved estimate of the rate of uptake of HNO3 to mineral dust. The fact that the rate of uptake was smaller at a concentration of 1012 than at 1011 was indicative of a complex uptake mechanism. The uptake coefficient averaged over the first 2 s of reaction time at a concentration of 1012 molecules cm-3 was found to increase with increasing relative humidity, from 0.022±0.007 at 12% RH to 0.113±0.017 at 73% RH , which was attributed to an increasing degree of solvation of the more basic minerals. The extended processing of the dust by higher concentrations of HNO3 at 85% RH led to a water soluble coating on the particles and enhanced their hygroscopicity

The structured environments of embedded star-forming cores. PACS and SPIRE mapping of the enigmatic outflow source UYSO 1

The intermediate-mass star-forming core UYSO 1 has previously been found to exhibit intriguing features. While deeply embedded and previously only identified by means of its (sub-)millimeter emission, it drives two powerful, dynamically young, molecular outflows. Although the process of star formation has obviously started, the chemical composition is still pristine. We present Herschel PACS and SPIRE continuum data of this presumably very young region. The now complete coverage of the spectral energy peak allows us to precisely constrain the elevated temperature of 26 - 28 K for the main bulge of gas associated with UYSO1, which is located at the interface between the hot HII region Sh 2-297 and the cold dark nebula LDN 1657A. Furthermore, the data identify cooler compact far-infrared sources of just a few solar masses, hidden in this neighbouring dark cloud.Comment: accepted contribution for the forthcoming Herschel Special Issue of A&A, 5 pages (will appear as 4-page letter in the journal), 6 figure file