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Background The treatment landscape for type 2 diabetes (T2D) is continually evolving; therefore, ongoing education of health care professionals (HCPs) is essential. There is growing interest in measuring the impact of educational activities, such as through use of the Moore framework; however, data on the benefits of continuing medical education (CME) in the management of T2D remain limited. Objective This study aimed to evaluate HCP satisfaction; measure improvements in knowledge, competence, and performance following short, case-based, multidisciplinary web-based CME activities; and identify the remaining educational gaps. Methods Two faculty-led, CME-accredited, web-based educational activities on T2D and obesity, touchIN CONVERSATION and touch MultiDisciplinary Team, were developed and made available on a free-to-access medical education website. Each activity comprised 3 videos lasting 10 to 15 minutes, which addressed learning objectives developed based on a review of published literature and faculty feedback. Participant satisfaction (Moore level 2) was evaluated using a postactivity questionnaire. For both activities, changes in knowledge and competence (Moore levels 3 and 4) were assessed using questionnaires completed by representative HCPs before or after participation in the activities. A second set of HCPs completed a questionnaire before and after engaging in activities that assessed changes in self-reported performance (Moore level 5). Results Each activity was viewed by approximately 6000 participants within 6 months. The participants expressed high levels of satisfaction (>80%) with both activities. Statistically significant improvements from baseline in knowledge and competence were reported following participation in touchIN CONVERSATION (mean score, SD before vs after activity: 4.36, 1.40 vs 5.42, 1.37; P Conclusions Short, case-based, web-based CME activities designed for HCPs to fit their clinical schedules achieved improvements in knowledge, competence, and self-reported performance in T2D management. Ongoing educational needs identified included setting individualized glycemic targets and the potential benefits of sodium-glucose cotransporter 2 inhibitor therapies.

The paper presents the sizing and profiling of charging systems for electric vehicles integrated into a smart grid in the town of Campobasso, in Molise. After having described and examined the main variables that characterize the system, the work focuses on the profiling of the electrical power absorbed by the building and the loads deriving from the charging stations of electric vehicles. The intensive use of software (especially MATLAB) and databases available online has been essential for the analysis of the random and stochastic values of the model developed. 4 different scenarios are studied, varying according to the number of charging electric vehicles. These scenarios are analyzed for three different typical days of winter, summer and mid-season. The different scenarios are compared qualitatively and quantitatively through the introduction of specific KPIs, which indicate the value of the power and the energy consumption of each specific asset, as can be seen in the results. Finally, various hypotheses are proposed regarding the integration of a storage system and the shifting of electric vehicles charges, for a more efficient energy exchange between the building and the network.

In this article, the properties of the (b, c)-inverse, the inverse along an element, the outer inverse with prescribed range and null space AT,S(2) and the Moore–Penrose inverse will be studied in ...

Our objective was to examine symptom-level changes in the course in posttraumatic stress disorder (PTSD) across the deployment cycle among combat-exposed Marines, and to determine the degree to which combat exposure and post-deployment stressor exposure predicted PTSD symptom profile transitions. We examined PTSD symptoms in a cohort of U.S. Marines (N = 892) recruited for the Marine Resiliency Study (MRS). Marines deployed as one battalion infantry unit to Afghanistan in 2010 and were assessed pre-deployment and one, five, and eight months post-deployment. We employed latent transition analysis (LTA) to examine Marines' movement across PTSD symptom profiles, determined by latent class analysis (LCA). LCAs revealed a 3-class solution one month pre-deployment, a 4-class solution at five months post-deployment, and a 3-class solution at eight months post-deployment. LTA revealed notable movement between classes over time, which depended chiefly on pre-deployment symptom presentation. Marines who reported few pre-deployment symptoms either maintained these low levels or returned to low levels by eight months. Marines who reported a moderate number of symptoms at pre-deployment had variable outcomes; 50% had reductions by eight months, and those who reported numbing symptoms at five months post-deployment tended to report more symptoms at eight months. Marines who reported more PTSD symptoms prior to deployment retained more symptoms eight months post-deployment. Combat exposure and post-deployment stressor exposure predicted profile transitions. Examining transitions between latent class membership over time revealed prognostic information about Marines' eight-month PTSD outcomes. The extent of pre-deployment PTSD symptoms was particularly informative of likely PTSD outcomes.

OBJECTIVE: There has been significant debate about the optimal factor structure of posttraumatic stress disorder (PTSD). In military and veteran samples, most available studies have employed self-report measures, assessed PTSD cross-sectionally, used treatment-seeking samples, and assessed symptoms years after deployment. We extend previous studies by comparing the factor structure of clinician-assessed and self-report Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) PTSD in a nontreatment seeking sample at 4 time points spanning the deployment cycle. METHOD: The data source for this study was the Marine Resiliency Study (MRS), a longitudinal study of 4 battalion cohorts of active-duty male Marines deployed to Iraq and Afghanistan between 2008 and 2012. We examined the fourth cohort (N = 892), which was evaluated 1 month predeployment, and 1, 5, and 8 months postdeployment. RESULTS: Confirmatory factor analyses (CFA) revealed that the 5-factor solution best fit the data across all time points, and across both interview and self-report assessments. CONCLUSION: The temporal consistency and convergence demonstrated by our analyses underscores the validity of the 5-factor model among service members exposed to warzone stressors. In particular, the findings suggest that diagnostic criteria for PTSD may benefit from disaggregating hyperarousal symptoms in military samples. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Language: en

The mechanisms underlying central nervous system (CNS) toxicities in antiretroviral-treated persons living with HIV (PLWH) remain elusive. We investigated the associations between markers of tryptophan metabolism and measurements of CNS toxicity in PLWH. In a prospective study, virologically suppressed PLWH receiving efavirenz-containing antiretroviral regimens with ongoing CNS toxicity were switched to dolutegravir-containing regimens and followed up for 12 weeks. Plasma tryptophan and kynurenine concentrations and the kynurenine/tryptophan ratio were calculated. Ten CNS toxicities were graded according to the ACTG adverse events scale. Scores ranged from 0 (none) to 3 (severe) and were summed, giving a total from 0 to 30. Paired-samples t tests and linear mixed model analyses were conducted to assess changes in, and relationships between, laboratory and clinical parameters. Mean kynurenine plasma concentration increased from baseline to week 12 (2.15 to 2.50 μmol/L, p = 0.041). No significant changes were observed for tryptophan (54.74 to 56.42 μmol/L, p = 1.000) or kynurenine/tryptophan ratio (40.37 to 41.08 μmol/L, p = 0.276). Mean CNS toxicity score decreased from 10.00 to 4.63 (p

Background: Symptom-level variation in posttraumatic stress disorder (PTSD) has not yet been examined in the early post-deployment phase, but may be meaningful etiologically, prognostically, and clinically. Methods: Using latent class analysis (LCA), we examined PTSD symptom heterogeneity in a cohort of participants from the Marine Resiliency Study (MRS), a longitudinal study of combat Marines deployed to Iraq and Afghanistan (N¼892). Typologies of PTSD symptom presentation were examined at one month pre-deployment and again one, five, and eight months post-deployment. Results: Heterogeneity in PTSD symptom presentation was evident at each assessment point, and the degree of symptom heterogeneity (i.e., the number of classes identified) differed by time point. Symptom patterns stabilized over time from notable symptom fluctuations during the early post-deployment period to high, medium, and low symptom severity by eight months post-deployment. Hypervigilance and exaggerated startle were frequently endorsed by participants in the initial month post-deployment. Flashbacks, amnesia, and foreshortened future were infrequently endorsed. Greater combat exposure, lifespan trauma, and avoidant coping generally predicted worse outcomes. Limitations: Data were self-report and may have limited generalizability due to our lack of women and inclusion of only combat Marines. Attrition and re-ranging of data resulted in significant missing data and affected the representativeness of the sample. Conclusions: Symptom-level variability is highest in the month following deployment and then stabilizes over time. Should post-deployment assessments occur too soon, they may capture common and transient early post-deployment reactions, particularly anxious arousal. Published by Elsevier B.V.

School satisfaction is linked to a number of important school outcomes like academic performance and school engagement. Following exposure to disasters, adolescents may undergo mental health challenges that threaten factors critical to school satisfaction, such as positive school climate and supportive school relationships. The current study examined the mediating role of posttraumatic stress symptoms on the relationship between exposure to a hurricane and school dissatisfaction. Regression analyses were used to test relationships in a large sample of predominately White female high school students who participated in a needs assessment 6 months after Hurricane Katrina. Results revealed a significant, direct association between hurricane exposure and dissatisfaction with school, as well as indirect associations via posttraumatic stress symptoms. These findings underscore the need for research to explicate the relationship between disasters and school satisfaction. Research is also needed to determine whether school-based interventions that have shown success in reducing anxiety symptoms in youth post-disaster also work to minimize disruptions in the school environment and ultimately reduce dissatisfaction with school.

Large cohort studies suggest that most military personnel experience minimal posttraumatic stress disorder (PTSD) symptoms following warzone deployment, an outcome often labeled resilience. Very low symptom levels, however, may be a marker for low exposure, not resilience, which requires relatively high-magnitude or high-frequency stress exposure as a precondition. We used growth mixture modeling (GMM) to examine the longitudinal course of lifetime PTSD symptoms following combat exposure by disaggregating deployed U.S. Marines into upper, middle, and lower tertiles of combat exposure. All factor models fit the data well; Tucker-Lewis Index (TLI) and comparative fit index (CFI) values ranged from .91 to .97. Three distinct trajectories best explained the data within each tertile. The upper tertile comprised True Resilience (73.2%), New-Onset Symptoms (18.3%), and Pre-existing Symptoms (8.5%) trajectories. The middle tertile also comprised True Resilience (74.5%), New-Onset Symptoms (16.1%), and Pre-existing Symptoms (9.4%) trajectories. The lower tertile comprised Artifactual Resilience (86.3%), Pre-existing Symptoms (7.6%), and New-Onset Symptoms (6.1%) trajectories. True Resilience involved a clinically significant symptom increase followed by a return to baseline, whereas Artifactual Resilience involved consistently low symptoms. Conflating artifactual and true resilience may inaccurately create the expectation of persistently low symptoms regardless of warzone exposure. Resumen Los grandes estudios de cohorte sugieren que la mayor parte del personal militar experimenta sintomas minimos de TEPT seguidos a la operacion militar, un resultado definido con frecuencia como resiliencia. Sin embargo, niveles de sintomas muy bajos, pueden ser un marcador de la baja exposicion, no de resiliencia, la cual requiere como precondicion, relativamente alta magnitud o frecuencia de exposicion al estres. Para examinar el curso longitudinal de sintomas de TEPT de vida seguido a combate, usamos el modelo de crecimiento mixto (GMM, por sus siglas en ingles) mediante la separacion de los marinos norteamericanos en operaciones de guerra, en tercios de exposicion a combate alto, medio y bajo. Todos los modelos factoriales se ajustaron bien a los datos. Los valores de los indice de Tucker Lewis (TLI) y del Indice de Ajuste Comparativo (CFI) variaron de .91 a .97. Los datos de cada tercio se explicaron mejor por tres trayectorias distintas. El tercio superior incluyo la trayectoria de Resiliencia Verdadera (73,2%), Sintomas Nuevos (18,3%) y Sintomas Preexistentes (8,5%). El tercio medio tambien incluyo la trayectoria de Resiliencia Verdadera (74,5%), Sintomas Nuevos (16,1%) y Sintomas Preexistentes (9,4%). El tercio bajo, incluyo la trayectoria Resiliencia Artificial (86,3%), Sintomas Preexistentes (7,6%) y Sintomas Nuevos (6,1%). La Resiliencia Verdadera involucro un aumento de sintomas clinicamente significativos seguido por un retorno al nivel basal, mientras que la Resiliencia Artificial involucro consistentemente pocos sintomas. La combinacion de la Resiliencia verdadera con la Resiliencia artificial puede crear incorrectamente la expectativa de que pocos sintomas persistentes existen pese a la exposicion a las operaciones de guerra. Traditional and Simplified Chinese Abstracts by AsianSTSS 標題 : 退役美國海軍的創傷後壓力症症狀過程跟戰鬥暴露水平的關係 撮要: 大型同代研究指出，大部份軍事人員從戰區退役後都經歷最低程度的創傷後壓力症(PTSD)症狀，這個結果常被標示為復原的象徵。極低水平的症狀卻可能標示著低暴露度而非復原力，而那需要相對較高量值或高頻的壓力暴露作為先決條件。本研究使用增長混合模型(GMM)，根據戰鬥暴露水平把退役的美國海軍分配於高、中、低三個分位，以檢視戰鬥暴露後PTSD症狀終生的縱貫過程 。所有因素模型跟數據都吻合；Tucker Lewis指數(TLI)和比較合配指數(CFI)數值範圍為.91至.97。每個三分位的數據有三種明顯的軌跡最合適用以來解釋。高水平分位由真正復原(73.2%)、新發作的症狀(18.3%)和早已存在的症狀(8.5%)三條軌跡構成。中水平分位亦由真正復原(74.5%)、新發作的症狀(16.1%)和早已存在的症狀(9.4%)三條軌跡構成。低水平分位則由人為復原(86.3%)、早已存在的症狀(7.6%)和新發作的症狀(6.1%)三條軌跡構成。真正復原中，臨床有明顯的症狀提升然後回到基線；人為復原中，症狀保持一貫低水平。不論有沒有考慮到戰區暴露水平，把人為復原和真正復原合併來看有可能不準確地預計持續低水平的症狀。 标题 : 退役美国海军的创伤后压力症症状过程跟战斗暴露水平的关系 撮要: 大型同代研究指出，大部份军事人员从战区退役后都经历最低程度的创伤后压力症(PTSD)症状，这个结果常被标示为复原的象征。极低水平的症状却可能标示着低暴露度而非复原力，而那需要相对较高量值或高频的压力暴露作为先决条件。本研究使用增长混合模型(GMM)，根据战斗暴露水平把退役的美国海军分配于高、中、低三个分位，以检视战斗暴露后PTSD症状终生的纵贯过程 。所有因素模型跟数据都吻合；Tucker Lewis指数(TLI)和比较合配指数(CFI)数值范围为.91至.97。每个三分位的数据有三种明显的轨迹最合适用以来解释。高水平分位由真正复原(73.2%)、新发作的症状(18.3%)和早已存在的症状(8.5%)三条轨迹构成。中水平分位亦由真正复原(74.5%)、新发作的症状(16.1%)和早已存在的症状(9.4%)三条轨迹构成。低水平分位则由人为复原(86.3%)、早已存在的症状(7.6%)和新发作的症状(6.1%)三条轨迹构成。真正复原中，临床有明显的症状提升然后回到基线；人为复原中，症状保持一贯低水平。不论有没有考虑到战区暴露水平，把人为复原和真正复原合并来看有可能不准确地预计持续低水平的症状。

The current study provides a comprehensive analysis and integration of the literature on the social network correlates of individual innovation. Reviewing the extant literature, we cluster existing network measures into five general properties—size, strength, brokerage, closure, and diversity. Using meta-analysis, we estimate the population effect sizes between these network properties and innovation. Results showed that brokerage had the strongest positive relation to innovation, followed by size, diversity, and strength. Closure, by contrast, had a weak, negative association with innovation. In addition, we offer a path-analytic integration of the literature proposing and testing the direct and indirect effects of the five properties on innovation. We suggest that network size and strength impact innovation through a web of relations with the more proximal features of brokerage, closure, and diversity. Our path-analytic integration considers the two dominant perspectives on the effects of social networks—brokerage versus closure—simultaneously allowing us to establish their relative efficacy in predicting innovation. In addition, our model highlights that network strength can have both negative and positive effects (via different direct and indirect pathways) and thus inherently involves a tradeoff. We discuss the implications of these results for future research and practice.

Shared trauma produces a unique dynamic in survivor–social supporter interactions because survivors may simultaneously act as support providers. We investigated people's reactions to simulated co-survivors’ trauma narratives and hypothesized that the narrator's vocal distress would result in agitation and that posttraumatic stress (PTS) symptoms would moderate this relationship. Eighty-four Hurricane Katrina survivors reported their mental health, listened to an ostensible co-survivor's trauma narrative, and reported their distress. When the narrator sounded distraught rather than recovered, people with higher PTS symptoms were increasingly reactive. Results provide preliminary evidence that interactions centered on disaster experiences may create distress rather than foster recovery.

HIV-1 causes a progressive impairment of immune function. HIV-2 is a naturally attenuated form of HIV, and HIV-2 patients display a slow-progressing disease. The leading hypothesis for the difference in disease phenotype between HIV-1 and HIV-2 is that more efficient T cell–mediated immunity allows for immune-mediated control of HIV-2 infection, similar to that observed in the minority of HIV-1–infected long-term nonprogressors. Understanding how HIV-1 and HIV-2 differentially influence the immune function may highlight critical mechanisms determining disease outcome. We investigated the effects of exposing primary human peripheral blood cells to HIV-1 or HIV-2 in vitro. HIV-2 induced a gene expression profile distinct from HIV-1, characterized by reduced type I IFN, despite similar upregulation of IFN-stimulated genes and viral restriction factors. HIV-2 favored plasmacytoid dendritic cell (pDC) differentiation into cells with an APC phenotype rather than IFN-α–producing cells. HIV-2, but not HIV-1, inhibited IFN-α production in response to CpG-A. The balance between pDC maturation into IFN-α–producing cells or development of an APC phenotype differentiates the early response against HIV-1 and HIV-2. We propose that divergent paths of pDC differentiation driven by HIV-1 and HIV-2 cause the observed differences in pathogenicity between the two viruses.

[EN] The continuity of the core inverse and the dual core inverse is studied in the setting of -algebras. Later, this study is specialized to the case of bounded Hilbert space operators and to complex matrices. In addition, the differentiability of these generalized inverses is studied in the context of -algebras., The third author is supported by the Scientific Research Foundation for doctorate programme at Huaiyin Institute of Technology [grant number Z301B18534]. The third author is grateful to China Scholarship Council for helping him pursue his further study at Universitat Politècnica de València, Spain

In this article properties of the $(b, c)$-inverse, the inverse along an element, the outer inverse with prescribed range and null space $A^{(2)}_{T, S}$ and the Moore-Penrose inverse will be studied in the contexts of Banach spaces operators, Banach algebras and $C^*$-algebras. The main properties to be considered are the continuity, the differentiability and the openness of the sets of all invertible elements defined by all the aforementioned outer inverses but the Moore-Penrose inverse. The relationship between the $(b, c)$-inverse and the outer inverse $A^{(2)}_{T, S}$ will be also characterized., Comment: 27 pages, original research article

Simian immunodeficiency virus (SIV) infection leads to AIDS in experimentally infected Rhesus macaques similarly to HIV-infected humans. In contrast, SIV infection of natural hosts is characterized by a down-regulation of innate acute responses to the virus within a few weeks of infection and results in limited pathology. Chloroquine (CQ) has been used in the treatment or prevention of malaria and has recently been shown to cause a decrease of immune activation and CD4 cell loss in HIV-infected individuals treated with antiretroviral therapy. Here, we treated Rhesus macaques with CQ during the acute phase of SIVmac251 infection with the intent to decrease viral-induced immune activation and possibly limit disease progression. Contrary to what was expected, CQ treatment resulted in a temporary increased expression of interferon (IFN)-stimulating genes and it worsened the recovery of CD4(+) T cells in the blood. Our findings confirm recent results observed in asymptomatic HIV-infected patients and suggest that CQ does not provide an obvious benefit in the absence of antiretroviral therapy.

Chronic activation of plasmacytoid dendritic cells (pDCs) is an important contributor to the immunopathogenesis of HIV infection. The quinolone derivative chloroquine (CQ) prevents endosomal acidification, required for toll-like receptor sensing of HIV by pDCs, and is currently under clinical trial as an immunotherapeutic approach. We tested three different 6-desfluoroquinolones (6-DFQs), structurally related to CQ and endowed with antiretroviral activity, for their ability to inhibit HIV-induced pDC activation and interferon (IFN)-α production in peripheral blood mononuclear cells (PBMCs) in vitro. PBMCs from six healthy donors were cultured overnight with aldrithiol-2 (AT-2)-inactivated HIV-1MN in the presence or absence of 6-DFQs or CQ. IFN-α production was measured by ELISA; pDC and monocyte activation was analyzed by flow cytometry. Incubation with HIV labeled with the fluorescent dye DyLight-488 (DL488) was used to test virus uptake by flow cytometry. We found that the 6-DFQs effectively inhibited HIV-induced IFN-α similar to CQ, but only 6-DFQs also inhibited the upregulation of the pDC activation marker CD83. Interestingly, HIV-induced expression of the costimulatory molecule CD80 and, to a lesser extent CD86, was further enhanced on pDCs by 6-DFQs, but not CQ. Conversely, 6-DFQs and CQ had similar inhibitory effects on HIV-induced monocyte activation, consistent with the primary mechanism being associated with IFN-α signaling. Finally, 6-DFQs interfered with HIV interaction with pDCs and monocytes, but not myeloid DCs. Our data indicate that 6-DFQs may interfere with pDC-mediated and IFN-α-dependent immunopathogenesis while supporting pDC differentiation into mature antigen-presenting cells by favoring expression of costimulatory molecules.

Given Banach spaces $${\mathcal{X}}$$ and $${\mathcal{Y}}$$ and Banach space operators $${A \in L (\mathcal{X})}$$ and $${B \in L (\mathcal{Y})}$$ , let $${\rho \colon L (\mathcal{Y},\mathcal{X})\to L(\mathcal{Y},\mathcal{X})}$$ denote the generalized derivation defined by A and B, i.e., $${\rho (U)=AU-UB}$$ ( $${U\in L(\mathcal{Y},\mathcal{X})}$$ ). The main objective of this article was to study Weyl and Browder type theorems for $${\rho \in L (L(\mathcal{Y},\mathcal{X}))}$$ . To this end, however, first the isolated points of the spectrum and the Drazin spectrum of $${\rho\in L (L(\mathcal{Y},\mathcal{X}))}$$ need to be characterized. In addition, it will be also proved that if A and B are polaroid (respectively, isoloid), then ρ is polaroid (respectively isoloid).

Aflatoxin M 1 (AFM 1 ), the main monohydroxylated of aflatoxin B 1 (AFB 1 ) formed in liver and excreted in the milk, has toxicological proprieties comparable to those of AFB 1 , albeit a lower carcinogenic potency. The presence of AFM 1 was investigated in 30 samples of powdered milk purchased in Argentina and Brazil. The samples were analyzed using an immunoaffinity column for cleanup and HPLC-FLD for determining AFM 1 . The quantification limit was 0.1 μg/kg. AFM 1 was found in all the samples at levels ranging from 0.1 to 0.92 μg kg −1 with average concentration of 0.39 μg kg −1 .

Given Banach spaces $X$ and $Y$ and operators $A\in B(X)$ and $B\in B(Y)$, property $(gw)$ does not in general transfer from $A$ and $B$ to the tensor product operator $A\otimes B\in B(X\overline{\otimes} Y)$ or to the elementary operator defined by $A$ and $B$, $\tau_{AB}=L_AR_B\in B(B(Y,X))$. In this article necessary and sufficient conditions ensuring that property $(gw)$ transfers from $A$ and $B$ to $A\otimes B$ and to $\tau_{AB}$ will be given., Comment: 14 pages, original research article

The transfer property for the generalized Browder’s theorem both of the tensor product and of the left-right multiplication operator will be characterized in terms of the B -Weyl spectrum inclusion. In addition, the isolated points of these two classes of operators will be fully characterized.

Achieving optimal human performance that involves cognitive or physical work requires quality sleep and a positive mental attitude. The ascending reticular activating system (RAS) represents a powerful set of endogenous neuromodulatory circuits that gate and tune global brain responses to internal and external cues, thereby regulating consciousness, alertness, and attention. The activity of two major RAS nuclei, the locus coeruleus (LC) and pedunculopontine nucleus (PPN), can be altered by trigeminal nerve modulation. Monosynaptic afferent inputs from the sensory components of trigeminal nerve branches project to the trigeminal sensory nuclear complex (TSNC), which has direct and polysynaptic connections to the LC and PPN. We previously found high-frequency (7 - 11 kHz) transdermal electrical neuromodulation (TEN) of the trigeminal nerve rapidly induces physiological relaxation, dampens sympathetic nervous system responses to acute stress, and suppresses levels of noradrenergic biomarkers. Given the established roles of LC and PPN neuronal activity in sleep regulation, psychophysiological arousal, and stress, we conducted three studies designed to test hypotheses that modulation of the TSNC can improve sleep quality and mood in healthy individuals (n = 99). Across a total of 1,386 days monitored, we observed TEN modulation of trigeminal and cervical nerves prior to sleep onset produced significant improvements in sleep quality and affective states, quantified using clinically validated surveys, overnight actigraph and heart rate recordings, and biochemical analyses compared to baseline or sham controls. Moreover, we observed some frequency dependence in that TEN delivered at lower frequencies (TENLF; 0.50 - 0.75 kHz) was significantly more effective at improving sleep quality and reducing anxiety than higher frequency TEN waveforms. Collectively our results indicate that transdermal electrical neuromodulation of trigeminal and cervical nerve branches can influence TSNC activity in a manner that significantly improves sleep quality and significantly reduces stress. We conclude that biasing RAS network activity to optimize sleep efficiency and enhance mood by electrically modulating TSNC activity through its afferent inputs holds tremendous potential for optimizing mental health and human performance.

VCU Theses and Dissertations

Given two complex Banach spaces $X_1$ and $X_2$, a tensor product $X_1\tilde{\otimes} X_2$ of $X_1$ and $X_2$ in the sense of [14], two complex solvable finite dimensional Lie algebras $L_1$ and $L_2$, and two representations $\rho_i\colon L_i\to {\rm L}(X_i)$ of the algebras, $i=1$, $2$, we consider the Lie algebra $L=L_1\times L_2$, and the tensor product representation of $L$, $\rho\colon L\to {\rm L}(X_1\tilde{\otimes}X_2)$, $\rho=\rho_1\otimes I +I\otimes \rho_2$. In this work we study the S{\l}odkowski and the split joint spectra of the representation $\rho$, and we describe them in terms of the corresponding joint spectra of $\rho_1$ and $\rho_2$. Moreover, we study the essential S{\l}odkowski and the essential split joint spectra of the representation $\rho$, and we describe them by means of the corresponding joint spectra and the corresponding essential joint spectra of $\rho_1$ and $\rho_2$. In addition, with similar arguments we describe all the above-mentioned joint spectra for the multiplication representation in an operator ideal between Banach spaces in the sense of [14]. Finally, we consider nilpotent systems of operators, in particular commutative, and we apply our descriptions to them., Comment: original research article, 46 pages

In this article the $(b, c)$-inverse will be studied. Several equivalent conditions for the existence of the $(b,c)$-inverse in rings will be given. In particular, the conditions ensuring the existence of the $(b,c)$-inverse, of the annihilator $(b,c)$-inverse and of the hybrid $(b,c)$-inverse will be proved to be equivalent, provided $b$ and $c$ are regular elements in a unitary ring $R$. In addition, the set of all $(b,c)$-invertible elements will be characterized and the reverse order law will be also studied. Moreover, the relationship between the $(b,c)$-inverse and the Bott-Duffin inverse will be considered. In the context of Banach algebras, integral, series and limit representations will be given. Finally the continuity of the $(b,c)$-inverse will be characterized, Comment: 20 pages, original research article

We consider the complex solvable non-commutative two dimensional Lie algebra $L$, $L=\oplus $, with Lie bracket $[x,y]=y$, as linear bounded operators acting on a complex Hilbert space $H$. Under the assumption $R(y)$ closed, we reduce the computation of the joint spectra $Sp(L,E)$, $\sigma_{\delta ,k}(L,E)$ and $\sigma_{\pi ,k}(L,E)$, $k= 0,1,2$, to the computation of the spectrum, the approximate point spectrum, and the approximate compression spectrum of a single operator. Besides, we also study the case $y^2=0$, and we apply our results to the case $H$ finite dimensional., Comment: 7 pages, original research article

The main objective of this article is to study several generalizations of the reverse order law for the Moore–Penrose inverse in ring with involution.

Several characterizations of EP and normal Moore-Penrose invertible Banach algebra elements will be considered. The Banach space operator case will be also studied. The results of the present article will extend well known facts obtained in the frames of matrices and Hilbert space operators., 15 pages; original research article

The main objective of this work is to study generalized Browder's and Weyl's theorems for the multiplication operators $L_A$ and $R_B$ and for the elementary operator $\tau_{A,B}=L_AR_B$., Comment: 16 pages, original research article

Given a Banach Algebra $A$ and $a\in A$, several relations among the Drazin spectrum of $a$ and the Drazin spectra of the multiplication operators $L_a$ and $R_a$ will be stated. The Banach space operator case will be also examined. Furthermore, a characterization of the Drazin spectrum will be considered., Comment: 16 pages; original research article

Cu and Ag–Cu mixed alloy nanoparticles displayed significant inhibition to HIV-1 replication with limited toxicity to human cells at relatively low concentrations of metal. A previous study (Elechiguerra et al. in J Nanobiotechnol 3:6–16, 2005) suggested a size-specific Ag nanoparticle can be tailored to block or damage the glycoprotein (gp) 120/gp41 spike or, more specifically, the invariant epitope at the gp120 binding site. Two different protocols were employed to test whether nanoparticles block entry of HIV-1, and in both instances the nanoparticles acted at some point other than initial binding. This work shows that Ag, Cu, and Ag–Cu mixed alloy metals display a chemically dependent inactivation of the target virus.

Systemic immunization of macaques with a combination of DNA-poxvirus-based vaccines confers protection from high level of both systemic and mucosal viral replication following rectal exposure to the pathogenic SIV(mac251). Here we investigated early post-infection events in rectal and vaginal tissues, and found that the loss of CCR5(+)CD4(+) T cells was equivalent in vaccinated and control macaques, despite a three logs reduction at mucosal sites of simian immunodeficiency virus (SIV) RNA in the vaccinated group. Even though a normal CD4 (+) T cell number is not reconstituted at mucosal sites in either group, vaccination appeared to confer a better preservation of the CD4 (+) CCR5(+) T cells that replenish these sites. Analysis of rectal tissues RNA following challenge exposure demonstrated a decreased expression in vaccinated macaques of transforming growth factor-β, cytotoxic T lymphocyte antigen-4, FoxP3, and indoleamine 2,3-dioxygenase, an immune suppressive enzyme expressed by dendritic cells that converts tryptophan to kynurenine and limits T-cell responses. Accordingly, the ratio of kynurenine and tryptophan in the plasma was significantly reduced in the vaccinated animals respect to the controls. Thus, preexisting adaptive immune responses induced by these vaccine modalities, although they do not protect from CD4 (+) T-cell depletion, nevertheless, they contain SIV(mac251) replication and delay expression of markers of T-cell activation and/or suppression at mucosal sites.

The programmed death (PD)-1 interacts with its ligand (PDL-1) delivering a negative signal to T cells. During human immunodeficiency virus (HIV)-1 infection PD-1 and PDL-1 expressions are increased. Here we show that monocytes and CCR5(+) T cells of HIV-uninfected donors upregulated PDL-1 upon in vitro exposure to HIV. HIV-induced PDL-1 required interferon (IFN)-alpha, but not IFN-gamma, production. Inhibition of endocytosis, required for HIV-induced IFN-alpha production, prevented PDL-1 upregulation. IFN-alpha-inducing Toll-like receptor (TLR) agonists increased PDL-1 on monocytes and CCR5(+) T cells. CD80 and CD86 were also increased on monocytes and CCR5(+) T cells after HIV exposure, but only CD80 was IFN-alpha-dependent. IFN-alpha-receptor subunit 2 (IFNAR2), was expressed only by CCR5(+) T cells and monocytes, explaining why these leukocytes responded to HIV-induced IFN-alpha. Finally, T cell proliferation was improved by PDL-1 blockade in HIV-treated PBMC. In the setting of HIV infection, IFN-alpha may negatively affect T cell responses by inducing PDL-1.

The incidence of maternal-to-fetal human immunodeficiency virus type 1 (HIV-1) transmission is 25-30% in absence of antiretroviral therapy, and is inversely associated with Human leukocyte antigens (HLA) class-I discordance. Based on our earlier report that mixed lymphocyte reactions (MLR) induce a ribonuclease (RNase) that inhibits HIV-1 replication, we proposed that maternal-fetal alloantigen stimulation activates factors that protect the fetus against vertically-transmitted infections. We investigate here whether the degree of mother-infant HLA discordance associates with the ability to produce anti-HIV-1 alloantigen-stimulated factor (ASF), and affects placental RNases. We also determine whether such HLA association is influenced by the mother's HIV-1 status. Paired maternal and cord blood leukocytes were tested for the induction of ASF by MLR, and typed for HLA-A and -B. The placentas were tested for mRNA expression of three RNases. Neonate anti-mother, but not mother anti-neonate MLR generated supernatants with anti-HIV-1 activity, that was associated with HLA class I discordance. This HLA association was not seen in the HIV-infected cohort. HLA class I discordance was also associated with expression of placental RNase 1. Our findings are consistent with the hypothesis that HLA class I discordance induces expression of RNases in the placenta that contribute to innate host resistance to HIV-1 and other viral infections.

Intrathecal production of neopterin, a pteridine produced by interferon (IFN)-gamma-stimulated monocyte-derived macrophages, is associated with neurological disorders and infections. We investigated whether IFN-alpha/beta, IFN-gamma, or human immunodeficiency virus (HIV) induce neopterin production by human astroglioma cells. IFN-alpha/beta and IFN-gamma, but not HIV, induced neopterin. Interestingly, IFN-gamma, but not IFN-alpha/beta, increased expression and activity of the tryptophan-catabolizing enzyme indoleamine (2,3)-dioxygenase. In contrast, IFN-alpha/beta, but not IFN-gamma, reduced the uptake of three aromatic amino acids in U87MG and U138 astroglioma cells. Thus type I and type II IFN stimulate astrocyte-derived cells to produce neopterin and exert differential effects on amino acid metabolism.

The main concern of this note is the Moore–Penrose inverse in the context of Banach spaces and algebras. Especially attention will be given to a particular class of elements with the aforementioned inverse, namely EP Banach space operators and Banach algebra elements, which will be studied and characterized extending well-known results obtained in the frame of Hilbert space operators and C ∗ -algebra elements.

High levels of viral replication occur in gut-associated lymphoid tissue (GALT) and other lymphoid tissues (LT) since the early phase of human/simian immunodeficiency virus (HIV/SIV) infection. Regulatory T cells (T reg ), a subset of immunosuppressive T cells expressing CTLA-4 and the FoxP3 transcription factor, accumulate in LT during HIV/SIV infection. Here we show that FoxP3 and CTLA-4 mRNA are increased in leukocytes from the spleens, lymph nodes (LN), and mucosal sites of chronically SIV-infected macaques with high viremia (SIV HI ) compared to animals with low viremia (SIV LO ). FoxP3 and CTLA-4 correlated with SIV RNA levels in tissues; SIV virus levels in the spleen, inguinal LN, mesenteric LN, colon, and jejunum directly correlated with the plasma virus level. Importantly, CTLA-4 and FoxP3 mRNA were predominantly increased in the CD25 − subpopulation of leukocytes from SIV HI , further challenging the classical definition of T reg as CD4 + CD25 + T cells. Similar to CTLA-4 and FoxP3, expression of indoleamine 2,3-dioxygenase (IDO), an immunosuppressive enzyme induced by T reg in antigen-presenting cells, was increased in the spleens, mesenteric LN, colons, and jejuna from SIV HI compared to SIV LO and directly correlated to SIV RNA in the same tissues. Accordingly, plasma kynurenine/tryptophan, a marker for IDO enzymatic activity, was significantly higher in SIV HI compared to SIV LO and correlated with plasma viral levels. Increased T reg and IDO in LT of SIV-infected macaques may be the consequence of increased tissue inflammation and/or may favor virus replication during the chronic phase of SIV infection.

Infection with the human immunodeficiency virus type 1 (HIV) results in a chronic infection that progressively cripples the host immune defenses. HIV infection is associated with increased tryptophan (trp) catabolism by the cytokine-inducible enzyme indoleamine 2,3-dioxygenase (IDO). IDO has powerful immune suppressive activity, which could contribute to the immune dysfunction observed in HIV-infected patients. In this review we discuss the immune mechanisms that could mediate the HIV-induced increase of IDO activity (such as IFN-gamma, IFN-alpha, CTLA-4/B7 and direct viral exposure). We then consider the current knowledge of IDO-mediated immune suppressive mechanisms with regard to different cell types (CD4(+) T cells, CD8(+) T cells, natural killer cells, B cells and regulatory T cells), from the perspective of their potential consequences for the HIV-infected host. HIV-induced, IDO-mediated trp catabolism may contribute to the perpetuation of HIV infection into its chronic phase by dampening efficient immune anti-viral responses. Therapeutic approaches aimed at manipulating this powerful immune suppressive mechanism might be considered in the setting of HIV infection.

We engineered a transdermal neuromodulation approach that targets peripheral (cranial and spinal) nerves and utilizes their afferent pathways as signaling conduits to influence brain function. We investigated the effects of this transdermal electrical neurosignaling (TEN) method on sympathetic physiology in human volunteers under different experimental conditions. In all cases, the TEN involved delivering high-frequency pulsed electrical currents to ophthalmic and maxillary divisions of the right trigeminal nerve (V1/V2) and cervical spinal nerve afferents (C2/C3). Under resting conditions when subjects were not challenged or presented with environmental stimuli, TEN significantly suppressed basal sympathetic tone compared to sham as indicated by functional infrared thermography of facial temperatures. In a different experiment conducted under similar resting conditions, subjects treated with TEN reported significantly lower levels of tension and anxiety on the Profile of Mood States scale compared to sham. In a third experiment when subjects were experimentally stressed by a classical fear conditioning paradigm and a series of time-constrained cognitive tasks, TEN produced a significant suppression of heart rate variability, galvanic skin conductance, and salivary α-amylase levels compared to sham. Collectively these observations demonstrate TEN can dampen basal sympathetic tone and attenuate sympathetic activity in response to acute stress induction. Our physiological and biochemical observations are consistent with the hypothesis that TEN modulates noradrenergic signaling to suppress sympathetic activity. We conclude that dampening sympathetic activity in such a manner represents a promising approach to managing daily stress.

Large cohort studies suggest that most military personnel experience minimal posttraumatic stress disorder (PTSD) symptoms following warzone deployment, an outcome often labeled resilience. Very low symptom levels, however, may be a marker for low exposure, not resilience, which requires relatively high-magnitude or high-frequency stress exposure as a precondition. We used growth mixture modeling (GMM) to examine the longitudinal course of lifetime PTSD symptoms following combat exposure by disaggregating deployed U.S. Marines into upper, middle, and lower tertiles of combat exposure. All factor models fit the data well; Tucker-Lewis Index (TLI) and comparative fit index (CFI) values ranged from .91 to .97. Three distinct trajectories best explained the data within each tertile. The upper tertile comprised True Resilience (73.2%), New-Onset Symptoms (18.3%), and Pre-existing Symptoms (8.5%) trajectories. The middle tertile also comprised True Resilience (74.5%), New-Onset Symptoms (16.1%), and Pre-existing Symptoms (9.4%) trajectories. The lower tertile comprised Artifactual Resilience (86.3%), Pre-existing Symptoms (7.6%), and New-Onset Symptoms (6.1%) trajectories. True Resilience involved a clinically significant symptom increase followed by a return to baseline, whereas Artifactual Resilience involved consistently low symptoms. Conflating artifactual and true resilience may inaccurately create the expectation of persistently low symptoms regardless of warzone exposure.

Given a (not necessarily continuous) homomorphism between Banach algebras $\T\colon\A\to\B$, an element $a\in\A$ will be said to be B-Fredholm (respectively generalized B-Fredholm) relative to $\T$, if $\T(a)\in \B$ is Drazin invertible (respectively Koliha-Drazin invertible). In this article, the aforementioned elements will be characterized and their main properties will be studied. In addition, perturbation properties will be also considered., Comment: 17 pages, original research article

In this note a characterization of anallytically Riesz operators is given. This work completes the article [1]., Comment: 4 pages, original research article

Given $L$ a solvable Lie Algebra of operators acting on a Banach space $E$, we study the action of the opposite algebra of $L$, $L'$, on $E^*$. Moreover, we extend S{\l}odkowski joint spectra, $\sigma_{\delta,k}$, $\sigma_{\pi,k}$, and we study its usual spectral properties., Comment: 10 pages, original research article