While the antibacterial properties of graphene oxide (GO) have been demonstrated across a spectrum of bacteria, the critical role of functional groups is unclear. To address this important issue, we ...utilized reduction and hydration methods to establish a GO library with different oxidation, hydroxyl, and carbon radical (•C) levels that can be used to study the impact on antibacterial activity. Using antibiotic-resistant bacteria as a test platform, we found that the •C density is most proximately associated with bacterial killing. Accordingly, hydrated GO (hGO), with the highest •C density, had the strongest antibacterial effects through membrane binding and induction of lipid peroxidation. To explore its potential applications, we demonstrated that coating of catheter and glass surfaces with hGO is capable of killing drug-resistant bacteria. In summary, •C is the principle surface moiety that can be utilized for clinical applications of GO-based antibacterial coatings.
Interstitial cystitis/painful bladder syndrome affects more than 1 million persons in the United States, but the cause remains unknown. Most patients with interstitial cystitis/painful bladder ...syndrome are women with symptoms of suprapubic pelvic and/or genital area pain, dyspareunia, urinary urgency and frequency, and nocturia. It is important to exclude other conditions such as infections. Tests and tools commonly used to diagnose interstitial cystitis/painful bladder syndrome include specific questionnaires developed to assess the condition, the potassium sensitivity test, the anesthetic bladder challenge, and cystoscopy with hydrodistension. Treatment options include oral medications, intravesical instillations, and dietary changes and supplements. Oral medications include pentosan polysulfate sodium, antihistamines, tricyclic antidepressants, and immune modulators. Intravesical medications include dimethyl sulfoxide, pentosan polysulfate sodium, and heparin. Pentosan polysulfate sodium is the only oral therapy and dimethyl sulfoxide is the only intravesical therapy with U.S. Food and Drug Administration approval for the treatment of interstitial cystitis/painful bladder syndrome. To date, clinical trials of individual therapies have been limited in size, quality, and duration of follow-up. Studies of combination or multimodal therapies are lacking.
Hospitalized patients with DM are at high risk for early readmission. Improving inpatient education and discharge (DC) processes are proposed interventions for reducing this risk.
We examined the ...contribution of blood glucose (BG) 48 hr prior to DC (nadir, peak, STD, CV) and patient comprehension (PC) of instructions for home DM management following DC to risk for 30d readmission.
Insulin treated non-critically ill patients with DM (N=202) were recruited. Diabetes Early Readmission Risk Indicators (DERRI) were calculated for each participant, who were contacted within 48 hr of DC to complete a PC Questionnaire (PCQ).
Of 126 participants age mean (STD) 61(12) years, BMI 32.9 (9.6) kg/m2, A1c 8.0 (2.2%), 45% women, 22% black, 85% type 2DM who completed the PCQ, 42 (33%) required clarification of misunderstood DC instructions. PC scores were negatively correlated with BG STD (-0.17, 95% CI:-0.32,-0.02) and CV (-0.38, -0.7, -0.05).
There was no difference in median (25ile, 75ile) PC scores between patients with and without 30d readmission (79 (67, 93%) vs.83 (71,100%), p=0.19); however, there were more readmissions in those with PC scores <100% compared to scores of 100% (n = 34) (29% vs. 15%, OR=2.4, 95% CI: 0.83, 6.88).
Among all 202 participants, median DERRI scores were higher in the 25% with 30d readmission (27 (24, 30)) than those without (19 (20, 24), p = 0.002).
In summary, these results demonstrate deficiencies in the hospital DC process as demonstrated by the need for clarification of information in >30% of patients following DC. It is possible that this corrected information may have served as an intervention to reduce readmission risk. PC scores were negatively associated with glycemic variability preceding DC and scores <100% were associated with a higher risk for readmission. DERRI scores were strongly associated with risk for 30d readmissions, representing the first prospective external validation of this tool. These results support proposals to improve the DC process and post-DC follow-up of patients with DM.
Disclosure
D. Pinkhasova: None. J. Swami: None. N. Patel: None. A. Donihi: None. L.M. Siminerio: None. E. Karslioglu French: None. K. Delisi: None. D.S. Hlasnik: None. D.J. Rubin: Research Support; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc. M.T. Korytkowski: None.
Funding
National Institutes of Health (UL1-TR-001857)
Gender differences have been described for glycemic control and prevalence of diabetes related complications in the outpatient setting but have not been examined in the hospitalized population. To ...address this, we investigated gender differences in demographics, glycemic control and variability (GV), macrovascular and microvascular complications, and admission diagnosis in non-critically ill hospitalized patients with a secondary diagnosis of diabetes recruited for the Readmission and Comprehension of Diabetes Education at Discharge (ReCoDED) Study. To date, 111 men and 87 women have been recruited, with the majority having type 2 DM (86 vs. 79%). Participants age (men vs. women) was 60.6 ± 11.7 vs. 57.6 ± 11.8 years, BMI 32.2 ± 8.4 vs. 32.1 ± 10.6 kg/m2, systolic (SBP) 136 ± 26 vs. 127 ± 23 mmHg, diastolic (DBP) 77 ± 13 vs. 75 ± 14 mmHg, HbA1c 8.0 ± 2.3 vs. 8.3% ± 2.5%, and DM duration 14.5 ± 10.4 vs. 14.1 ± 11.6 years. Race, education, and employment were similar. Men had more retinopathy (23 vs. 16%) and nephropathy (40 vs. 28%), but not neuropathy (60 vs. 63%). Women had a lower prevalence of CAD (49 vs. 36%), but a similar prevalence of CHF (37 vs. 37%), stroke (15 vs. 18%), and PVD (18 vs. 17%). The most frequent admission diagnoses were CVD (37 vs. 22%) and infection (10 vs. 19%). Mean blood glucose (BG) (198 ± 51 vs. 200 ± 54 mg/dl), GV (177 ± 80 vs. 182 ± 112 mg/dl), frequency of hypoglycemia (BG < 70 mg/dl) and hyperglycemia (BG >250 mg/dl) were similar in the 48 hours prior to discharge. Length of stay was 7.8 ± 6.9 vs. 8.3 ± 7.4 days.
In summary, this gender-based description of glycemic control and prevalence of diabetes-related complications in an inpatient population demonstrates that hospitalized women with DM have fewer microvascular complications, a lower prevalence of CAD but a similar prevalence of CHF, stroke and PVD when compared to men, despite similar BMI and DM duration. These findings will be examined as a risk factor for hospital readmissions in this ongoing study.
Disclosure
N. Patel: None. D. Pinkhasova: None. A. Donihi: None. E. Karslioglu French: None. L.M. Siminerio: None. K. Delisi: None. D.S. Hlasnik: None. M.T. Korytkowski: None.
•We present new lightcurves for 19 jovian Trojans smaller than 30km in diameter.•∼40% of Trojans in this size range have rotation periods longer than 24h.•The YORP effect may be responsible for the ...slowly rotation of small Trojans.
Several lines of evidence support a common origin for, and possible hereditary link between, cometary nuclei and jovian Trojan asteroids. Due to their distance and low albedos, few comet-sized Trojans have been studied. We present new lightcurve information for 19 Trojans≲30km in diameter, more than doubling the number of objects in this size range for which some rotation information is known. The minimum densities for objects with complete lightcurves are estimated and are found to be comparable to those measured for cometary nuclei. A significant fraction (∼40%) of this observed small Trojan population rotates slowly (P>24h), with measured periods as long as 375h (Warner, B.D., Stephens, R.D. 2011. Minor Planet Bull. 38, 110–111). The excess of slow rotators may be due to the YORP effect. Results of the Kolmogorov–Smirnov test suggest that the distribution of Trojan rotation rates is dissimilar to those of Main Belt Asteroids of the same size. Concerted observations of a large number of Trojans could establish the spin barrier (Warner, B.D., Harris, A.W., Pravec, P. 2009. Icarus 202, 134–146), making it possible to estimate densities for objects near the critical period.
Objective To determine whether cognitive therapy is effective in preventing the worsening of emerging psychotic symptoms experienced by help seeking young people deemed to be at risk for serious ...conditions such as schizophrenia.Design Multisite single blind randomised controlled trial.Setting Diverse services at five UK sites.Participants 288 participants aged 14-35 years (mean 20.74, SD 4.34 years) at high risk of psychosis: 144 were assigned to cognitive therapy plus monitoring of mental state and 144 to monitoring of mental state only. Participants were followed-up for a minimum of 12 months and a maximum of 24 months.Intervention Cognitive therapy (up to 26 (mean 9.1) sessions over six months) plus monitoring of mental state compared with monitoring of mental state only. Main outcome measures Primary outcome was scores on the comprehensive assessment of at risk mental states (CAARMS), which provides a dichotomous transition to psychosis score and ordinal scores for severity of psychotic symptoms and distress. Secondary outcomes included emotional dysfunction and quality of life.Results Transition to psychosis based on intention to treat was analysed using discrete time survival models. Overall, the prevalence of transition was lower than expected (23/288; 8%), with no significant difference between the two groups (proportional odds ratio 0.73, 95% confidence interval 0.32 to 1.68). Changes in severity of symptoms and distress, as well as secondary outcomes, were analysed using random effects regression (analysis of covariance) adjusted for site and baseline symptoms. Distress from psychotic symptoms did not differ (estimated difference at 12 months −3.00, 95% confidence interval −6.95 to 0.94) but their severity was significantly reduced in the group assigned to cognitive therapy (estimated between group effect size at 12 months −3.67, −6.71 to −0.64, P=0.018).Conclusions Cognitive therapy plus monitoring did not significantly reduce transition to psychosis or symptom related distress but reduced the severity of psychotic symptoms in young people at high risk. Most participants in both groups improved over time. The results have important implications for the at risk mental state concept.Trial registration Current Controlled Trials ISRCTN56283883.
The aim of this study was to test a hypothesized positive association between low vitamin D (VitD) serum levels and the severity of periodontal disease in women with HIV infection.
This was a ...cross-sectional secondary analysis of data from an oral substudy conducted within the Chicago site of the Women's Interagency HIV Study. Serum VitD levels and clinical attachment loss (CAL) measurements were available for 74 women with HIV infection. VitD levels were treated as both continuous and categorical variables in bivariate and multivariate analyses. Mean clinical attachment loss (mCAL) was determined for each subject by obtaining the averages of measurements taken at 4 sites in each measured tooth.
Average age of study participants (n = 74) was 39.6 years (standard deviation 7.2), and the majority were African Americans (70.3%) with VitD deficiency (58.1%). VitD deficiency was positively associated with higher mCAL (P = .012). After adjustment for race, age, smoking, and HIV viral load, an association was found between VitD deficiency and mCAL (Beta 0.438; P = .036).
We identified a previously unreported association between VitD deficiency and mCAL in women with HIV infection. Larger and more inclusive, multisite, longitudinal studies are warranted to investigate whether these findings can be generalized to all individuals with HIV infection in the current treatment era and to determine causality.
•We present photometric color observations for the 42 largest L5 Jupiter Trojans.•We calculate a color principal component for separating DLike and XLike objects.•Our sample contains 76% redder DType ...objects and 24% less red X and Ctype objects.•Our sample shows no noticeable difference in color distribution with inclination.
The L5 Jupiter Trojan asteroids are minor bodies that orbit 60 degrees behind Jupiter. Because these orbits are stable over the lifetime of the Solar System, the properties of these objects may inform us about the conditions under which the Solar System formed. We present BVRKCIKC photometry for the 42 intrinsically brightest and presumably largest members of the L5 Jupiter Trojans. We define a new principal color component aT* that is indicative of taxonomic types relevant to the Jupiter Trojan asteroids. We find that 76% of the largest L5 Jupiter Trojans are consistent with a D-type classification, while 24% show shallower slopes more consistent with X-type and C-Type classifications. Such a breakdown is consistent with other surveys and will help to place the Trojans in the larger context of the Solar System.
We used long-term (20+ yr) datasets to determine how the sum of 209 polychlorinated biphenyl congeners ($\Sigma PCB$), dodecachloropentacyclodecane (mirex), para-para dichlorodiphenyltrichloroethane ...(p,p'-DDT), and total mercury (Tot-Hg) concentrations have changed in Lake Ontario chinook salmon (Oncorhynchus tshawytscha, 1983-2003) and coho salmon (Oncorhynchus kisutch, 1976-2003). Exponential decay models best describe temporal reductions of persistent organic pollutant concentrations POPs, including $\Sigma PCB$, mirex, and p,p'-DDT, in chinook ($r^2 = 0.68-0.77$, p < 0.001) and coho ($r^2 = 0.68-0.87$, p < 0.001$) salmon over the record. In comparison, declines in Tot-Hg were slight, with linear models best describing trends ($r^2 = 0.49-0.50$, p = <0.001-0.001). Rapid declines of POPs from the mid-1970s through the early 1980s were attributed mostly to Canada-United States bans on usage and sedimentation; subsequent concentration oscillations were linked to salmonine stocking and nutrient abatement programs, climatic cycles, and alewife (Alosa pseudoharengus) population dynamics.
Aims: Much research has begun to focus on the identification of people who are at high risk of developing psychosis, and clinical services have been initiated for this population. However, only a ...small number of studies have reported on the efficacy of interventions for preventing or delaying the onset of psychosis. The results of prior work suggest that cognitive therapy (CT) may be an effective, well‐tolerated treatment. We report on the rationale and design for a large‐scale, multi‐site randomized, controlled trial of CT for people who are assessed to be at high risk of psychosis because of either state or state‐plus‐trait risk factors.
Methods: The study employs a single‐blind design in which all participants receive frequent mental‐state monitoring, which will efficiently detect transition to psychosis, and half are randomized to weekly sessions of CT for up to 6 months. Participants will be followed‐up for a minimum of 12 months and to a maximum of 2 years.
Results: We report the characteristics of the final sample at baseline (n = 288).
Conclusions: Our study aimed to expand the currently limited evidence base for best practice in interventions for individuals at high risk of psychosis.
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