Reported light in the sleep environment: enhancement of the sleep diary.

BackgroundLight is the primary synchronizing cue for the circadian timing system, capable of exerting robust physiological effects, even with very dim and/or brief photic exposure. Mammals, including humans, are particularly susceptible to light at night. As such, measures of light in the sleeping environment are critical for evaluating sleep health. Sleep diaries provide inexpensive measures of sleep, but do not typically include light information.MethodsFour questions probing visual perception of light in the bedtime and waking environments were added to the Consensus Sleep Diary for Morning administration. As part of a lighting intervention study, 18 hospital Labor and Delivery Department personnel completed the sleep diary for 1 week in each of two experimental conditions while wearing Actiwatch devices equipped with photosensors. Diary responses were evaluated against photosensor values from the beginning and end of each rest interval (n=194 rest intervals), as well as against sleep measures, utilizing linear mixed models.ResultsResponses to light questions were related to actual light measures at bedtime, controlling for shift type and experimental condition. In addition, subjective light information at bedtime and waking was related to both objective and subjective sleep parameters, with data generally indicating poorer sleep with light in the sleeping environment.ConclusionQuestions addressing perception of light in the sleeping environment may provide a crude yet affordable metric of relative photic intensity. Further, as responses relate to sleep outcomes, subjective light information may yield valuable insights regarding mechanisms and outcomes of clinical significance in sleep and circadian research

Reciprocal Relations Between Kinetic Curves

We study coupled irreversible processes. For linear or linearized kinetics with microreversibility, $\dot{x}=Kx$, the kinetic operator $K$ is symmetric in the entropic inner product. This form of Onsager's reciprocal relations implies that the shift in time, $\exp (Kt)$, is also a symmetric operator. This generates the reciprocity relations between the kinetic curves. For example, for the Master equation, if we start the process from the $i$th pure state and measure the probability $p_j(t)$ of the $j$th state ($j\neq i$), and, similarly, measure $p_i(t)$ for the process, which starts at the $j$th pure state, then the ratio of these two probabilities $p_j(t)/p_i(t)$ is constant in time and coincides with the ratio of the equilibrium probabilities. We study similar and more general reciprocal relations between the kinetic curves. The experimental evidence provided as an example is from the reversible water gas shift reaction over iron oxide catalyst. The experimental data are obtained using Temporal Analysis of Products (TAP) pulse-response studies. These offer excellent confirmation within the experimental error.Comment: 6 pages, 1 figure, the final versio

Community Support and Transition of Research to Operations for the Hurricane Weather Research and Forecasting Model

The Hurricane Weather Research and Forecasting Model (HWRF) is an operational model used to provide numerical guidance in support of tropical cyclone forecasting at the National Hurricane Center. HWRF is a complex multicomponent system, consisting of the Weather Research and Forecasting (WRF) atmospheric model coupled to the Princeton Ocean Model for Tropical Cyclones (POM-TC), a sophisticated initialization package including a data assimilation system and a set of postprocessing and vortex tracking tools. HWRF’s development is centralized at the Environmental Modeling Center of NOAA’s National Weather Service, but it incorporates contributions from a variety of scientists spread out over several governmental laboratories and academic institutions. This distributed development scenario poses significant challenges: a large number of scientists need to learn how to use the model, operational and research codes need to stay synchronized to avoid divergence, and promising new capabilities need to be tested for operational consideration. This article describes how the Developmental Testbed Center has engaged in the HWRF developmental cycle in the last three years and the services it provides to the community in using and developing HWRF

Influence of silicone mammoplasty on the immunoendocrine status of female recipients

The article concerns a study of early influence of silicone breast implants on the development of autoimmune reactions and dynamics of prolactin and thyroid hormone levels in women after mammoplasty. At the present time, this issue remains relevant for several reasons: more than 20 million pairs of implants have been installed in the world and the number of their implantations is constantly growing. Despite relative safety of the silicone implants, some of them are periodically banned by regulatory bodies in various countries. At the same time, there is a growing number of controversial publications in the scientific literature, about potential adverse consequences of their use. Some authors suggest an association between the silicone implants and risk of developing autoimmune conditions, connective tissue disorders, and occasional malignancies. On the other hand, the journals are full of publications about the overall safe tolerance of such medical devices by the patients. These considerations served as a pre-requisite to our research. As part of this project, we have assayed serum levels of autoantibodies to ten antigens, as well as contents of prolactin and thyroid hormones by means of ELISA technique in 27 patients before, 3 and 6 months after aesthetic and reconstructive mammoplastics performed within a period of September 2018 to November 2019. As a result, it was found that 5 out of 27 patients exhibited changes in the autoimmunity spectrum and intensity after mammoplasty. In particular, the concentrations of autoantibodies to modified citrullinated vimentin and IgM autoantibodies to cardiolipin exceeded the normal level at 3 and 6 months. In addition, the initially high prolactin concentration in mammoplasty recipients dropped to normal ranges by 3 months after breast surgery, even after several-fold increased initial levels. As for thyroid hormones, there were no statistically significant changes in their dynamics. The increase of autoantibodies to various target antigens after mammoplasty was statistically significant and positively correlated with each other. This can be explained, for example, by dependence on the adjuvant effect of silicone, which is not associated with antigen specificity. However, it may generally stimulate the immune responses

Surface Phenotype and Functionality of WNV Specific T Cells Differ with Age and Disease Severity

West Nile virus (WNV) infection can result in severe neuroinvasive disease, particularly in persons with advanced age. As rodent models demonstrate that T cells play an important role in limiting WNV infection, and strong T cell responses to WNV have been observed in humans, we postulated that inadequate antiviral T cell immunity was involved in neurologic sequelae and the more severe outcomes associated with age. We previously reported the discovery of six HLA-A*0201 restricted WNV peptide epitopes, with the dominant T cell targets in naturally infected individuals being SVG9 (Env) and SLF9 (NS4b). Here, memory phenotype and polyfunctional CD8+ T cell responses to these dominant epitopes were assessed in 40 WNV seropositive patients displaying diverse clinical symptoms. The patients' PBMC were stained with HLA-I multimers loaded with the SVG9 and SLF9 epitopes and analyzed by multicolor flow cytometry. WNV-specific CD8+ T cells were found in peripheral blood several months post infection. The number of WNV-specific T cells in older individuals was the same, if not greater, than in younger members of the cohort. WNV-specific T cells were predominantly monofunctional for CD107a, MIP-1β, TNFα, IL-2, or IFNγ. When CD8+ T cell responses were stratified by disease severity, an increased number of terminally differentiated, memory phenotype (CD45RA+ CD27− CCR7− CD57+) T cells were detected in patients suffering from viral neuroinvasion. In conclusion, T cells of a terminally differentiated/cytolytic profile are associated with neuroinvasion and, regardless of age, monofunctional T cells persist following infection. These data provide the first indication that particular CD8+ T cell phenotypes are associated with disease outcome following WNV infection

Genome-Wide Mycobacterium tuberculosis Variation (GMTV) Database: A New Tool for Integrating Sequence Variations and Epidemiology

Background Tuberculosis (TB) poses a worldwide threat due to advancing multidrug-resistant strains and deadly co-infections with Human immunodeficiency virus. Today large amounts of Mycobacterium tuberculosis whole genome sequencing data are being assessed broadly and yet there exists no comprehensive online resource that connects M. tuberculosis genome variants with geographic origin, with drug resistance or with clinical outcome. Description Here we describe a broadly inclusive unifying Genome-wide Mycobacterium tuberculosis Variation (GMTV) database, (http://mtb.dobzhanskycenter.org) that catalogues genome variations of M. tuberculosis strains collected across Russia. GMTV contains a broad spectrum of data derived from different sources and related to M. tuberculosis molecular biology, epidemiology, TB clinical outcome, year and place of isolation, drug resistance profiles and displays the variants across the genome using a dedicated genome browser. GMTV database, which includes 1084 genomes and over 69,000 SNP or Indel variants, can be queried about M. tuberculosis genome variation and putative associations with drug resistance, geographical origin, and clinical stages and outcomes. Conclusions Implementation of GMTV tracks the pattern of changes of M. tuberculosis strains in different geographical areas, facilitates disease gene discoveries associated with drug resistance or different clinical sequelae, and automates comparative genomic analyses among M. tuberculosis strains

Возможности прогнозирования продолжительности жизни больных XOБЛ с целью уточнения показаний к трансплантации легких

The results of 58 COPD patients’ dynamic observation (56 males and 2 females) were analysed. The patients had been treated in the State Scientific Pulmonology Centre of Health Ministry of Russian Federation and the municipal pulmonology hospital N 2 of Sankt-Peterburg city in the years 1996-1998. The patients were examined using standard clinical techniques, lung function and diffusing capacity tests, blood gas analysis, echography of pulmonary circulation. Prognostic criteria were evaluated which enable to determine the optimal date for lung grafting.Initially all the patients were divided into two groups: 9 patients whose lifetime had not exceeded 18 months after their first examination and 49 patients who had lived more than 18 months after their first examination. The first group patients demonstrated the signs of right heart hypertrophy and overload significantly more often.Their pulmonary artery blood pressure was increased to 38 mm Hg and the capillary blood oxygen contents was greatly diminished. Lung function and diffusing capacity parameters, pCO2 did not differ in the groups.Next, the certain indices’ influence on the life-expectancy as well as the prognostic value of chronic cor pulmonale existence and severity were assessed.The correlation analysis displayed a strong tie between the COPD patients’ life-expectancy and the pulmonary artery blood pressure level, dyspnoe, heart beat rate, hypoxaemia level and also between the pulmonary artery blood pressure level and the capillary blood oxygen contents. The correlation between the severity of corpulmonale failure and the patients’ life-expectancy was faint.The pulmonary artery blood pressure proved to be the most important parameter for the patients’ prognosis: ones having it normal lived more than 2 years meanwhile the patients with the pulmonary artery blood pressure higher 50 mm Hg lived not more 18 months. The lung functional parametbrs were not found to be the independent prognostic factors.So, based on the result obtained the indications for lung grafting in COPD patients are thought to be the pulmonary artery blood pressure higher than 50 mm Hg, the pO2 level less than 60 mm Hg and the conservative therapy failure.Проанализированы материалы динамического наблюдения 58 больных ХОБЛ (56 мужчин и 2 женщины), пролеченных в ГНЦ пульмонологии М3 РФ и ГМПБ № 2 г. Санкт-Петербурга в 1986-1998 гг. Больным проведено стандартное общеклиническое обследование, исследование функции внешнего дыхания и диффузионной способности легких, газового состава крови, эхографическое исследование гемодинамики малого круга кровообращения. Оценивали прогностические критерии, позволяющие определить оптимальные сроки выполнения трансплантации легких. В начале исследования больные были разделены на 2 группы: прожившие не более 18 месяцев после первого обследования (9 человек) и прожившие более 18 месяцев (49 человек). В первой группе значительно чаще выявлялись признаки гипертрофии правых отделов сердца и их перегрузки, было повышено давление в легочной артерии в среднем до 38 мм рт.ст., напряжение кислорода в капиллярной крови было значительно ниже. Показатели функции внешнего дыхания, диффузионная способность легких, рСО2 в сравниваемых группах не различались. Далее оценивалось влияние ряда показателей на продолжительность жизни, а также прогностическое значение наличия и выраженности хронического легочного сердца.Корреляционный анализ показал сильную взаимосвязь между продолжительностью жизни больных ХОБЛ и уровнем давления в легочной артерии, одышкой и частотой пульса, выраженностью гипоксемии, а также - между давлением в легочной артерии и напряжением кислорода в капиллярной крови. Корреляция между степенью декомпенсации легочного сердца и продолжительностью жизни больных была слабой.Наиболее прогностически значимым показателем оказался уровень давления в легочной артерии: при нормальном давлении в легочной артерии все больные жили более 2 лет, а при давлении выше 50 мм рт. ст. - не более 18 месяцев. Функциональные показатели не имели самостоятельного прогностического значения.Таким образом, на основании полученных результатов показаниями для трансплантации легких при ХОБЛ можно считать давление в легочной артерии более 50 мм рт. ст., уровень рО2 менее 60 мм рт. ст., отсутствие эффекта от проводимой консервативной терапии

БАКТЕРИЦИДНАЯ АКТИВНОСТЬ ЛЕЙКОЦИТОВ У БОЛЬНЫХ ТУБЕРКУЛЕЗОМ ЛЕГКИХ

Bactericidal activity of leukocytes was investigated in 63 patients with new infiltrate pulmonary tuberculosis and 28 patients with fibrous cavernous pulmonary tuberculosis. The diverse oxygen-dependent bactericidal activity of phagocytes is typical of the patients suffering from both clinical forms of tuberculosis: reduction of nitrosative stress rates, which is more frequent in those suffering from fibrous cavernous tuberculosis, and increase of oxidative stress rates, which is more intensive in case of fibrous cavernous tuberculosis. The associated functions were detected among immune-competent cells, involved in the bactericidal function: in case of fibrous cavernous tuberculosis – between oxidative stress rates, and in case of infiltrate pulmonary tuberculosis – between nitrosative stress rates; the synergistic effect of respiratory burst was observed. In case of chronic pulmonary tuberculosis, both types of cells were equally responsible for bactericidal functions, while neutrophils were dominating in new infiltrate pulmonary tuberculosis, without prior treatment, being the cells of the first line of defense. The obtained results allowed concluding that in case of new pulmonary tuberculosis without prior treatment, nitrosative stress played the important role in the killing of tuberculous mycobacteria, while in case of chronic tuberculosis – it was oxidative stress.Бактерицидная активность лейкоцитов изучена у 63 больных впервые выявленным инфильтративным туберкулезом легких (ИТЛ) и 28 ‒ фиброзно-кавернозным туберкулезом легких (ФКТ). Для больных с обеими клиническими формами туберкулеза характерна разнонаправленная кислородзависимая бактерицидная активность фагоцитирующих клеток: снижение показателей нитрозилирующего стресса, в большей степени характерное для больных ФКТ, и рост показателей оксидативного стресса, больше выраженного при ФКТ. Выявлена сопряженность функционирования иммунокомпетентных клеток, участвующих в бактерицидной функции: при ФКТ ‒ между показателями оксидативного стресса, при ИТЛ – нитрозилирующего; отмечен синергический эффект респираторного взрыва. Если при хронической форме туберкулеза легких за бактерицидную функцию одинаково «отвечают» оба типа клеток, то при впервые выявленном нелеченном ИТЛ доминирующая роль отводится нейтрофилам как клеткам первой линии защиты. Полученные результаты дают основание полагать, что при впервые выявленном нелеченном туберкулезе легких важная роль в подавлении микобактерий туберкулеза отводится нитрозилирующему стрессу, а при хронической форме туберкулеза – оксидативному

Conflict and user involvement in drug misuse treatment decision-making: a qualitative study

<p>Abstract</p> <p>Background</p> <p>This paper examines client/staff conflict and user involvement in drug misuse treatment decision-making.</p> <p>Methods</p> <p>Seventy-nine in-depth interviews were conducted with new treatment clients in two residential and two community drug treatment agencies. Fifty-nine of these clients were interviewed again after twelve weeks. Twenty-seven interviews were also conducted with staff, who were the keyworkers for the interviewed clients.</p> <p>Results</p> <p>Drug users did not expect, desire or prepare for conflict at treatment entry. They reported few actual conflicts within the treatment setting, but routinely discussed latent conflicts – that is, negative experiences and problematic aspects of current or previous treatment that could potentially escalate into overt disputes. Conflict resulted in a number of possible outcomes, including the premature termination of treatment; staff deciding on the appropriate outcome; the client appealing to the governance structure of the agency; brokered compromise; and staff skilfully eliciting client consent for staff decisions.</p> <p>Conclusion</p> <p>Although the implementation of user involvement in drug treatment decision-making has the potential to trigger high levels of staff-client conflict, latent conflict is more common than overt conflict and not all conflict is negative. Drug users generally want to be co-operative at treatment entry and often adopt non-confrontational forms of covert resistance to decisions about which they disagree. Staff sometimes deploy user involvement as a strategy for managing conflict and soliciting client compliance to treatment protocols. Suggestions for minimising and avoiding harmful conflict in treatment settings are given.</p