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Prion diseases are a unique group of infectious chronic neurodegenerative disorders to which there are no cures. Although prion infections do not stimulate adaptive immune responses in infected individuals, the actions of certain immune cell populations can have a significant impact on disease pathogenesis. After infection, the targeting of peripherally-acquired prions to specific immune cells in the secondary lymphoid organs (SLO), such as the lymph nodes and spleen, is essential for the efficient transmission of disease to the brain. Once the prions reach the brain, interactions with other immune cell populations can provide either host protection or accelerate the neurodegeneration. In this review, we provide a detailed account of how factors such as inflammation, ageing and pathogen co-infection can affect prion disease pathogenesis and susceptibility. For example, we discuss how changes to the abundance, function and activation status of specific immune cell populations can affect the transmission of prion diseases by peripheral routes. We also describe how the effects of systemic inflammation on certain glial cell subsets in the brains of infected individuals can accelerate the neurodegeneration. A detailed understanding of the factors that affect prion disease transmission and pathogenesis is essential for the development of novel intervention strategies.

More people globally depend on the water buffalo than any other domesticated species, and as the most closely related domesticated species to cattle they can provide important insights into the shared evolutionary basis of domestication. Here, we sequence the genomes of 79 water buffalo across seven breeds and compare patterns of between breed selective sweeps with those seen for 294 cattle genomes representing 13 global breeds. The genomic regions under selection between cattle breeds significantly overlap regions linked to stature in human genetic studies, with a disproportionate number of these loci also shown to be under selection between water buffalo breeds. Investigation of potential functional variants in the water buffalo genome identifies a rare example of convergent domestication down to the same mutation having independently occurred and been selected for across domesticated species. Cross-species comparisons of recent selective sweeps can consequently help identify and refine important loci linked to domestication., The comparative genomics of domesticated lineages can yield insights into the signatures of artificial selection. This study sequences 79 water buffalo genomes from 7 breeds and reveals examples of convergent domestication at the genetic level between water buffalo and cattle.

This study investigates how nonprofit organizations use hyperlinks embedded in tweets for strategic communication during global health crises. Within the 1,494 links included in tweets about Ebola,...

The Mount Sinai Acute GVHD International Consortium (MAGIC) algorithm probability (MAP), derived from 2 serum biomarkers, measures damage to crypts in the gastrointestinal tract during graft-versus-host disease (GVHD). We hypothesized that changes in MAP after treatment could validate it as a response biomarker. We prospectively collected serum samples and clinical stages of acute GVHD from 615 patients receiving hematopoietic cell transplantation in 20 centers at initiation of first-line systemic treatment and 4 weeks later. We computed MAPs and clinical responses and compared their abilities to predict 6-month nonrelapse mortality (NRM) in the validation cohort (n = 367). After 4 weeks of treatment, MAPs predicted NRM better than the change in clinical symptoms in all patients and identified 2 groups with significantly different NRM in both clinical responders (40% vs 12%, P < .0001) and nonresponders (65% vs 25%, P < .0001). MAPs successfully reclassified patients for NRM risk within every clinical grade of acute GVHD after 4 weeks of treatment. At the beginning of treatment, patients with a low MAP that rose above the threshold of 0.290 after 4 weeks of treatment had a significant increase in NRM, whereas patients with a high MAP at onset that fell below that threshold after treatment had a striking decrease in NRM that translated into clear differences in overall survival. We conclude that a MAP measured before and after treatment of acute GVHD is a response biomarker that predicts long-term outcomes more accurately than change in clinical symptoms. MAPs have the potential to guide therapy for acute GVHD and may function as a useful end point in clinical trials.

Acute graft-versus-host disease (GVHD) is treated with systemic corticosteroid immunosuppression. Clinical response after 1 week of therapy often guides further treatment decisions, but long-term outcomes vary widely among centers, and more accurate predictive tests are urgently needed. We analyzed clinical data and blood samples taken 1 week after systemic treatment of GVHD from 507 patients from 17 centers of the Mount Sinai Acute GVHD International Consortium (MAGIC), dividing them into a test cohort (n = 236) and 2 validation cohorts separated in time (n = 142 and n = 129). Initial response to systemic steroids correlated with response at 4 weeks, 1-year nonrelapse mortality (NRM), and overall survival (OS). A previously validated algorithm of 2 MAGIC biomarkers (ST2 and REG3α) consistently separated steroid-resistant patients into 2 groups with dramatically different NRM and OS (P < .001 for all 3 cohorts). High biomarker probability, resistance to steroids, and GVHD severity (Minnesota risk) were all significant predictors of NRM in multivariate analysis. A direct comparison of receiver operating characteristic curves showed that the area under the curve for biomarker probability (0.82) was significantly greater than that for steroid response (0.68, P = .004) and for Minnesota risk (0.72, P = .005). In conclusion, MAGIC biomarker probabilities generated after 1 week of systemic treatment of GVHD predict long-term outcomes in steroid-resistant GVHD better than clinical criteria and should prove useful in developing better treatment strategies.

Cyberbullying is an increasingly common experience that produces psychosocial consequences for targets. Interventions encouraging bystanders to support targets of cyberbullying are limited ...

Acute graft-versus-host disease (GVHD) is a major cause of mortality in patients undergoing hematopoietic cell transplantation (HCT) for hematologic malignancies. The skin is the most commonly involved organ in GVHD. Elafin, a protease inhibitor overexpressed in inflamed epidermis, was previously identified as a diagnostic biomarker of skin GVHD; however, this finding was restricted to a subset of patients with isolated skin GVHD. The main driver of nonrelapse mortality (NRM) in HCT recipients is gastrointestinal (GI) GVHD. Two biomarkers, Regenerating islet-derived 3a (REG3α) and Suppressor of tumorigenesis 2 (ST2), have been validated as biomarkers of GI GVHD that predict long-term outcomes in patients treated for GVHD. We undertook this study to determine the utility of elafin as a prognostic biomarker in the general population of acute GVHD patients in whom GVHD may develop in multiple organs. We analyzed serum elafin concentrations as a predictive biomarker of acute GVHD outcomes and compared it with ST2 and REG3α in a large group of patients treated at multiple centers. A total of 526 patients from the Mount Sinai Acute GVHD International Consortium (MAGIC) who had received corticosteroid treatment for skin GVHD and who had not been previously studied were analyzed. Serum concentrations of elafin, ST2, and REG3α were measured by ELISA in all patients. The patients were divided at random into equal training and validation sets, and a competing-risk regression model was developed to model 6-month NRM using elafin concentration in the training set. Additional models were developed using concentrations of ST2 and REG3α or the combination of all 3 biomarkers as predictors. Receiver operating characteristic (ROC) curves were constructed using the validation set to evaluate the predictive accuracy of each model and to stratify patients into high- and low-risk biomarker groups. The cumulative incidence of 6-month NRM, overall survival (OS), and 4-week treatment response were compared between the risk groups. Unexpectedly, patients in the low-risk elafin group demonstrated a higher incidence of 6-month NRM, although the difference was not statistically significant (17% versus 11%; P = .19). OS at 6 months (68% versus 68%; P > .99) and 4-week response (78% versus 78%; P = .98) were similar in the low-risk and high-risk elafin groups. The area under the ROC curve (AUC) was 0.55 for elafin and 0.75 for the combination of ST2 and REG3α. The addition of elafin to the other 2 biomarkers did not improve the AUC. Our data indicate that serum elafin concentrations measured at the initiation of systemic treatment for acute GVHD did not predict 6-month NRM, OS, or treatment response in a multicenter population of patients treated systemically for acute GVHD. As seen in previous studies, serum concentrations of the GI GVHD biomarkers ST2 and REG3α were significant predictors of NRM, and the addition of elafin levels did not improve their accuracy. These results underscore the importance of GI disease in driving NRM in patients who develop acute GVHD.

Background: A major cause of mortality in patients receiving hematopoietic stem cell transplantation (HCT) is acute graft-versus-host disease (GVHD), a multiorgan disorder that includes the skin, liver and gastrointestinal tract. We have previously identified elafin, a protease inhibitor overexpressed in inflamed epidermis, as a diagnostic biomarker of GVHD in the skin, the most commonly involved GVHD organ. However, our initial study was limited to a subset of patients with isolated skin GVHD. The main driver of nonrelapse mortality (NRM) in HCT patients is GI GVHD. Two biomarkers, Regenerating islet-derived 3a (REG3α) and Suppressor of tumorigenesis 2 (ST2), have since been validated as biomarkers of GI GVHD that predict long-term outcomes in patients treated for GVHD. We undertook this study to determine the utility of elafin as a prognostic biomarker of acute GVHD in the general population of previously unstudied acute GVHD patients, and to compare it to ST2 and REG3α. Study Design: 526 patients who received systemic corticosteroid treatment for skin GVHD were analyzed from the Mount Sinai Acute GVHD International Consortium (MAGIC), which includes patients from 25 HCT centers. We used ELISA to measure serum concentrations of elafin, ST2 and REG3α. Patients were divided randomly into equal training and validation sets; and we developed a competing risk regression model for 6-month NRM using elafin concentration in the training set. We developed additional models for 6-month NRM using concentrations of ST2 and REG3α, or the combination of all three biomarkers as predictors. We then constructed ROC curves to evaluate the predictive accuracy of each model and to analyze the ability of each model to stratify patients into high- and low-risk groups. We analyzed the cumulative incidence of 6-month NRM and overall survival in each model and compared the accuracy of each model in the validation set. Results: The area under the receiver operating curve (AUROC) for elafin alone was 0.55 whereas it was 0.75 and statistically superior (P = 0.02) for the combination of ST2 and REG3α. The combination of 3 biomarkers produced an AUROC of 0.76 that was not significantly better than the two biomarker model (P = 0.10). Elafin concentrations, either alone or in combination with ST2 and REG3α, did not produce higher hazard ratios of NRM (data not shown). Patients in the low-risk elafin group paradoxically demonstrated a higher incidence of 6-month NRM, although this difference was not statistically significant (17% vs. 11%, P=0.19), and both overall survival at 6 months (68% vs. 68%, P>0.99) and four-week response (78% vs. 78%, P=0.98) were similar in the low- and high-risk elafin groups (Figure 1). As demonstrated in previous data sets, the combination of ST2 and REG3α divided patients into two groups with a nearly five-fold difference in NRM (6.7% vs. 31%, P Conclusion: We demonstrated that serum elafin concentrations measured at the initiation of systemic treatment for acute GVHD in a multicenter population of patients treated systemically for acute GVHD do not predict 6-month NRM, overall survival, or treatment response. As seen in previous studies, serum concentrations of the GI GVHD biomarkers ST2 and REG3α were significant predictors of NRM and the addition of elafin levels did not improve their accuracy. These results underscore the importance of GI disease in driving NRM in patients who develop acute GVHD. Figure 1. Cumulative incidence of nonrelapse mortality and overall survival in high and low risk groups Six-month cumulative incidences of nonrelapse mortality (NRM) in high (solid line) and low (dotted line) risk groups defined by optimized biomarker thresholds (upper panels) and six-month overall survival estimated using the Kaplan-Meier method (lower panels). (A) Cumulative incidence of NRM (14%) and overall survival (75%) in the total validation set (N=263). (B) Cumulative incidence of NRM in the low (N=150) and high (N=113) elafin group (17% vs. 11%, P=0.19). Overall survival in the low and high elafin group (68% vs. 68%, P > 0.99). (C) Cumulative incidence of NRM in the low (N=175) and high (N=88) ST2 + REG3a group (6.7 vs. 31%, P < 0.001). Overall survival in the low and high ST2 + REG3a group (77% vs. 51%, P < 0.001). (D) Cumulative incidence of NRM in the low (N=180) and high (N=83) elafin + ST2 + REG3a group (7.0 vs. 30%, P < 0.001). Overall survival in the low and high elafin + ST2 + REG3a group (79% vs. 64%, P < 0.001). Figure 1 Figure 1. Disclosures Ozbek: Viracor: Patents & Royalties: GVHD biomarker patent with royalties from Viracor. DeFilipp: Omeros, Corp.: Consultancy; Incyte Corp.: Research Funding; Regimmune Corp.: Research Funding; Syndax Pharmaceuticals, Inc: Consultancy. Grupp: Novartis, Kite, Vertex, and Servier: Research Funding; Jazz Pharmaceuticals: Consultancy, Other: Steering committee, Research Funding; Novartis, Roche, GSK, Humanigen, CBMG, Eureka, and Janssen/JnJ: Consultancy; Novartis, Adaptimmune, TCR2, Cellectis, Juno, Vertex, Allogene and Cabaletta: Other: Study steering committees or scientific advisory boards. Hexner: Blueprint medicines: Membership on an entity's Board of Directors or advisory committees, Research Funding; Tmunity Therapeutics: Research Funding; PharmaEssentia: Membership on an entity's Board of Directors or advisory committees. Kitko: Co-investigator on two NIH grants as part of the cGVHD consortium: Research Funding; Vanderbilt University Medical Center: Current Employment; PER: Other: PER - CME educational talks about GVHD; Horizon: Membership on an entity's Board of Directors or advisory committees. Qayed: Novartis: Honoraria; Mesoblast: Honoraria; Medexus: Honoraria. Reshef: ilead, BMS, Precision, Immatics, Atara, Takeda, Shire, Pharmacyclics, Incyte: Research Funding; Bayer: Consultancy; Gilead and Novartis: Honoraria; BMS, Regeneron, TScan, Synthekine, Atara, Jasper, Bayer: Consultancy. Levine: Incyte: Consultancy, Research Funding; Viracor: Patents & Royalties: GVHD biomarker patent with royalties from Viracor; Mesoblast: Consultancy, Research Funding; Equillium Bio: Membership on an entity's Board of Directors or advisory committees; X4 Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Talaris Therapeutics: Membership on an entity's Board of Directors or advisory committees; Jazz Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Omeros: Membership on an entity's Board of Directors or advisory committees; Symbio: Membership on an entity's Board of Directors or advisory committees; Biogen: Research Funding; Kamada: Research Funding. Ferrara: Eurofins Viracor: Consultancy, Other: Royalties. Chen: Incyte: Consultancy; Gamida: Consultancy.

Many Native American communities experience severe health inequalities, including shorter average lifespan and higher rates of chronic illnesses. Journalism that serves Native Americans is a promising channel for heath communication, but only if scholars first understand the particular cultural contexts of indigenous communities. This research contributes to that goal by investigating how journalists serving Native American communities characterize health and the issues they identify with covering determinants of health. In in-depth interviews (N = 24), journalists contrasted how they cover health issues as embedded in cultural context with shallow, more negative coverage by non-Native media organizations. Interviews also revealed a tension between "medical" and "cultural" models of health, contributing to the oversaturation of certain issues, like diabetes, while other health topics are underrepresented. The journalists also expressed how social determinants and histories of oppression shape health inequalities, illuminating the roles of historical trauma and the destruction of indigenous health beliefs and behaviors. Failure to recognize these issues could stymie efforts to communicate about health issues facing Native American audiences.

Hens responded under multiple fixed-ratio schedules with equal response requirements and either a 1-s or a 6-s reinforcer. Upcoming reinforcer size was indicated by key color. Components were presented in a quasirandom series so that all four component transitions occurred. Postreinforcement pauses were affected by the upcoming and preceding reinforcer size, with longer pauses after large reinforcers followed by small reinforcers than when followed by large ones, and longer pauses after small reinforcers that were followed by small reinforcers rather than large ones. Pauses increased with fixed-ratio size and the effects of reinforcer size were larger the larger the ratio. When reinforcer size was not signaled-mixed fixed-ratio schedules-pauses were shorter after small than after large reinforcers. Signalling the upcoming reinforcer attenuated the effect of the previous reinforcer size on pause duration when small was followed by small and when either small or large by large, but enhanced the effect when large was followed by small. There was no effect of reinforcer size on pause duration when single fixed-ratio schedules were arranged. The effects of reinforcer size on pauses depends on the size and range of the fixed ratios as well as the exact procedures used in the study.

This study examines whether adolescent motivations for social media use, social comparison tendencies and gender are related to online aggression victimization and/or perpetration. Results from a national cross-sectional survey of adolescents (N = 340) reveal that social media use, romantic motivations, social belongingness motivations and greater social comparison tendencies are associated with online aggression victimization (R2 = 0.38). Information motivations and entertainment motivations are negatively associated with online aggression perpetration, but romantic motivations, social comparison, and social media use were positive predictors (R2 = 0.34). Further examination of interactions and indirect effects suggests that romantic motivations for social media use are an important predictor of involvement in online aggression among adolescents.

We present the design of a laboratory-astrophysics experiment to study magnetospheric accretion relevant to young, pre-main-sequence stars. Spectra of young stars show evidence of hotspots created when streams of accreting material impact the surface of the star and create shocks. The structures that form during this process are poorly understood, as the surfaces of young stars cannot be spatially resolved. Our experiment would create a scaled “accretion shock” at a major (several kJ) laser facility. The experiment drives a plasma jet (the “accretion stream”) into a solid block (the “stellar surface”), in the presence of a parallel magnetic field analogous to the star’s local field. We show that this experiment is well-scaled when the incoming jet has ρ ∼ 10 − 6 − 10 − 5 g cm − 3 and u ∼ 100 − 200 km s − 1 in an imposed field of B ∼ 10 T. Such an experiment would represent an average accretion stream onto a pre-main sequence star with B ∼ 700 G.

Although Twitter chats and other forms of social media engagement events are idealized in the literature as opportunities for dialogic communication between organizations and individuals, less is known about how engagement is operationalized within these spaces. Using textual and content analysis, we conducted two studies to explore how health organizations engage with the public via Twitter chats during the Ebola and Zika outbreaks. In official records of Ebola chats, the organization addressed both hostile and neutral public questions that pressed for specification of disease characteristics and protocol. However, in a content analysis of all public tweets sent during a later Zika chat, we found that questions were privileged, and other tweet forms and themes were excluded from the participatory space. Specifically, public comments demonstrating expertise or extending the topic of the chat were not addressed by the organization. Our analysis provides insight into the implicit rules governing how...

Specific Escherichia coli isolates lysogenised with prophages that express Shiga toxin (Stx) can be a threat to human health, with cattle being an important natural reservoir. In many countries the most severe pathology is associated with enterohaemorrhagic E. coli (EHEC) serogroups that express Stx subtype 2a. In the United Kingdom, phage type (PT) 21/28 O157 strains have emerged as the predominant cause of life-threatening EHEC infections and this phage type commonly encodes both Stx2a and Stx2c toxin types. PT21/28 is also epidemiologically linked to super-shedding (>103 cfu/g of faeces) which is significant for inter-animal transmission and human infection as demonstrated using modelling studies. We demonstrate that Stx2a is the main toxin produced by stx2a+/stx2c+ PT21/28 strains induced with mitomycin C and this is associated with more rapid induction of gene expression from the Stx2a-encoding prophage compared to that from the Stx2c-encoding prophage. Bacterial supernatants containing either Stx2a and/or Stx2c were demonstrated to restrict growth of bovine gastrointestinal organoids with no restriction when toxin production was not induced or prevented by mutation. Isogenic strains that differed in their capacity to produce Stx2a were selected for experimental oral colonisation of calves to assess the significance of Stx2a for both super-shedding and transmission between animals. Restoration of Stx2a expression in a PT21/28 background significantly increased animal-to-animal transmission and the number of sentinel animals that became super-shedders. We propose that while both Stx2a and Stx2c can restrict regeneration of the epithelium, it is the relatively rapid and higher levels of Stx2a induction, compared to Stx2c, that have contributed to the successful emergence of Stx2a+ E. coli isolates in cattle in the last 40 years. We propose a model in which Stx2a enhances E. coli O157 colonisation of in-contact animals by restricting regeneration and turnover of the colonised gastrointestinal epithelium., Author summary Enterohaemorrhagic E. coli (EHEC) O157 strains are found in cattle where they are asymptomatic, while human exposure can lead to severe symptoms including bloody diarrhoea and kidney damage due to the activity of Shiga toxin (Stx). The most serious symptoms in humans are associated with isolates that encode Stx subtype 2a. The advantage of these toxins in the animal reservoir is still not clear, however there is experimental evidence implicating Stx with increased bacterial adherence, immune modulation and suppression of predatory protozoa. In this study, the hypothesis that Stx2a is important for super-shedding and calf-to-calf transmission was tested by comparing excretion and transmission dynamics of E. coli O157 strains with and without Stx2a. While Stx2a did not alter excretion levels when calfs were orally challenge, it enabled colonisation of more in contact ‘sentinel’ animals in our transmission model. We show that Stx2a is generally induced more rapidly than Stx2c, resulting in increased levels of Stx2a expression. Both Stx2a and Stx2c were able to restrict cellular proliferation of epithelial cells in cultured bovine enteroids. Taken together, we propose that rapid production of Stx2a and its role in establishing E. coli O157 colonisation in the bovine gastrointestinal tract facilitate effective transmission and have led to its expansion in the cattle E. coli O157 population.

The domestic water buffalo (Bubalus bubalis) makes a major contribution to the global agricultural economy in the form of milk, meat, hides, and draught power. The global water buffalo population is predominantly found in Asia, and per head of population more people depend upon the buffalo than on any other livestock species. Despite its agricultural importance, there are comparatively fewer genomic and transcriptomic resources available for buffalo than for other livestock species. We have generated a large-scale gene expression atlas covering multiple tissue and cell types from all major organ systems collected from three breeds of riverine water buffalo (Mediterranean, Pandharpuri and Bhadawari) and used the network analysis tool Graphia Professional to identify clusters of genes with similar expression profiles. Alongside similar data, weand others have generated for ruminants as part of the Functional Annotation of AnimalGenomes Consortium; this comprehensive transcriptome supports functional annotation and comparative analysis of the water buffalo genome.

Tumor antigens are responsible for initiating an immune response in cancer patients, and their identification may provide new biomarkers for cancer diagnosis and targets for immunotherapy. The general use of serum antibodies to identify tumor antigens has several drawbacks, including dilution, complex formation, and background reactivity. In this study, antibodies were generated from antibody-secreting cells (ASC) present in tumor-draining lymph nodes of 20 breast cancer patients (ASC-probes) and were used to screen breast cancer cell lines and protein microarrays. Half of the ASC-probes reacted strongly against extracts of the MCF-7 breast cancer cell line, but each with a distinct antigen recognition profile. Three of the positive ASC-probes reacted differentially with recombinant antigens on a microarray containing cancer-related proteins. The results of this study show that lymph node-derived ASC-probes provide a highly specific source of tumor-specific antibodies. Each breast cancer patient reacts with a different antibody profile which indicates that targeted immunotherapies may need to be personalized for individual patients. Focused microarrays in combination with ASC-probes may be useful in providing immune profiles and identifying tumor antigens of individual cancer patients.

The creation and disruption of inertially collimated plasma flows are investigated through experiment, simulation, and analytical modeling. Supersonic plasma jets are generated by laser-irradiated plastic cones and characterized by optical interferometry measurements. Targets are magnetized with a tunable $B$ field with strengths of up to 5 T directed along the axis of jet propagation. These experiments demonstrate a hitherto unobserved phenomenon in the laboratory, the magnetic disruption of inertially confined plasma jets. This occurs due to flux compression on axis during jet formation and can be described using a Lagrangian-cylinder model of plasma evolution implementing finite resistivity. The basic physical mechanisms driving the dynamics of these systems are described by this model and then compared with two-dimensional radiation-magnetohydrodynamic simulations. Experimental, computational, and analytical results discussed herein suggest that contemporary models underestimate the electrical conductivity necessary to drive the amount of flux compression needed to explain observations of jet disruption.

Background: Results of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate of these effects.Methods: FOCUS was a pragmatic, multicentre, parallel group, double-blind, randomised, placebo-controlled trial done at 103 hospitals in the UK. Patients were eligible if they were aged 18 years or older, had a clinical stroke diagnosis, were enrolled and randomly assigned between 2 days and 15 days after onset, and had focal neurological deficits. Patients were randomly allocated fluoxetine 20 mg or matching placebo orally once daily for 6 months via a web-based system by use of a minimisation algorithm. The primary outcome was functional status, measured with the modified Rankin Scale (mRS), at 6 months. Patients, carers, health-care staff, and the trial team were masked to treatment allocation. Functional status was assessed at 6 months and 12 months after randomisation. Patients were analysed according to their treatment allocation. This trial is registered with the ISRCTN registry, number ISRCTN83290762.Findings: Between Sept 10, 2012, and March 31, 2017, 3127 patients were recruited. 1564 patients were allocated fluoxetine and 1563 allocated placebo. mRS data at 6 months were available for 1553 (99·3%) patients in each treatment group. The distribution across mRS categories at 6 months was similar in the fluoxetine and placebo groups (common odds ratio adjusted for minimisation variables 0·951 [95% CI 0·839–1·079]; p=0·439). Patients allocated fluoxetine were less likely than those allocated placebo to develop new depression by 6 months (210 [13·43%] patients vs 269 [17·21%]; difference 3·78% [95% CI 1·26–6·30]; p=0·0033), but they had more bone fractures (45 [2·88%] vs 23 [1·47%]; difference 1·41% [95% CI 0·38–2·43]; p=0·0070). There were no significant differences in any other event at 6 or 12 months.Interpretation: Fluoxetine 20 mg given daily for 6 months after acute stroke does not seem to improve functional outcomes. Although the treatment reduced the occurrence of depression, it increased the frequency of bone fractures. These results do not support the routine use of fluoxetine either for the prevention of post-stroke depression or to promote recovery of function.Funding: UK Stroke Association and NIHR Health Technology Assessment Programme.

This chapter explains the roles of self-study, teacher agency, and co-teaching as tools of critical pedagogy, to uncover and address hidden curriculum in the era of standardization. The authors provide examples of how critical pedagogy and teacher agency have been effective in teaching for social justice and countering hegemony. The authors also argue and support the idea that teacher agency and co-teaching must be fostered and practiced in teacher-preparation programs. Specifically, they argue that if future teachers are to enact and utilize critical pedagogy, teacher agency, and co-teaching in their own classrooms, they need the opportunity to learn about and practice those skills as student teachers. The authors also detail an experience in which student teachers had the opportunity to collectively engage in co-teaching and teacher agency, with immediate and direct consequences. Finally, they detail the benefits and detriments of implementing teacher agency in the teacher-education capstone course.

Cyberbullying has provoked public concern after well-publicized suicides of adolescents. This mixed-methods study investigates the social representation of these suicides. A content analysis of 184 U.S. newspaper articles on death by suicide associated with cyberbullying or aggression found that few articles adhered to guidelines suggested by the World Health Organization and the American Foundation for Suicide Prevention to protect against suicidal behavioral contagion. Few articles made reference to suicide or bullying prevention resources, and most suggested that the suicide had a single cause. Thematic analysis of a subset of articles found that individual deaths by suicide were used as cautionary tales to prompt attention to cyberbullying. This research suggests that newspaper coverage of these events veers from evidence-based guidelines and that more work is needed to determine how best to engage with journalists about the potential consequences of cyberbullying and suicide coverage.

Stories about climate change garner passionate comments from readers, ranging from acclaim to invective. This research is the first to investigate the effects of the rhetorical strategies of deploying anecdotal versus scientific evidence in comments. A between-subjects experiment with a U.S. adult sample (N = 363) tested whether user comments that support or contradict a climate news story, using either anecdotal or scientific evidence, have an effect on message reception. Individual difference variables in audience members have been shown to moderate the effects of comments in previous research. Findings show that political ideology is an important moderator of effects, particularly on the perception of climate change risk and story credibility. And when looking at the reactions of people who have low need for cognition and are highly conservative, climate uncertainty was diminished when anecdotal evidence appeared in comments. Taken together, these findings indicate that, in the context of climate change communication, comments from users can influence whether a climate story is perceived as credible by certain readers and can also disrupt a story’s intended message, particularly if comments attempt to invoke scientific proof for their claims.

Trust in many government organizations is low, creating a challenging environment for communication during outbreaks of emerging infectious diseases, like Ebola. In a thematic analysis of 1,010 tweets and four Twitter chats during the 2014-2015 Ebola outbreak, we found that the Centers for Disease Control and Prevention emphasized organizational competence, extant protocol, and facts about transmission to manage public fear. We argue that an emphasis on certainty in a rapidly changing situation leaves organizations vulnerable to charges of unpreparedness or obfuscation. Our results also speak to the contested definition of engagement online, particularly during health crises.

Recent experiments at the Jupiter Laser Facility investigated magnetization effects on collimated plasma jets. Laser-irradiated plastic-cone-targets produced collimated, millimeter-scale plasma flows as indicated by optical interferometry. Proton radiography of these jets showed no indication of strong, self-generated magnetic fields, suggesting a dominantly hydrodynamic collimating mechanism. Targets were placed in a custom-designed solenoid capable of generating field strengths up to 5 T. Proton radiographs of the well-characterized B-field, without a plasma jet, suggested an external source of trapped electrons that affects proton trajectories. The background magnetic field was aligned with the jet propagation direction, as is the case in many astrophysical systems. Optical interferometry showed that magnetization of the plasma results in disruption of the collimated flow and instead produces a hollow cavity. This result is a topic of ongoing investigation.

Interest in digital microfluidics (DMF), where discrete droplets are manipulated in a miniaturized device, has grown rapidly due to the versatility that arises from non-linear control of fluids. Adding superparamagnetic particles to the fluid allows the droplet to be manipulated by magnetic fields, such as that from a simple permanent magnet, removing some of the complexity of previous DMF devices and adding enhanced robustness. The magnetic field strength need not be high to control commercially available magnetic silica microparticles, however a hydrophobic surface is required to provide reduced friction. In this study, three types of hydrophobic surfaces were explored for their use in the magnetic actuation of water droplets containing magnetic particles. A conventional fluoropolymer film was found to have excessive frictional resistance to effectively actuate droplets. A natural superhydrophobic surface, the Colocasia leaf, was found to have too much surface microstructure to allow the magnetic particles to move freely over the surface. The commercially available Ultra-Ever Dry®, on the other hand, was suitable for effective magnetic actuation of aqueous and mixed droplets as it provided a robust, virtually frictionless surface. Based on fluorinated silica nanoparticles, this surface allowed a 20 μL water droplet to be manually pulled by a magnet at speeds in excess of 550 mm s−1.

We present the design of a plasma experiment scaled to be relevant to an interplanetary coronal mass ejection (ICME) traveling from the Sun to the Earth. The experiment would launch a compact torus of plasma (the scaled analog of the coronal mass ejected by the Sun) into a magnetized background plasma (the scaled analog of the interplanetary medium, the diffuse magnetized plasma that fills the Solar System). We present the complete process of scaling the ICME system to a laboratory experiment: beginning with the ICME features that we aim to replicate with a laboratory experiment, explaining how these desired features are translated into specific design constraints, and presenting a set of experimental parameters that meet those constraints. We find that the experiment would be possible with plasma conditions typically achieved in large-scale facilities such as the Big Red Ball at the University of Wisconsin or the LArge Plasma Device at the University of California, Los Angeles.

There are no validated biomarkers that measure a patient's response to therapy for acute graft-versus-host disease (GVHD), the leading cause of non-relapse mortality (NRM) after allogeneic hematopoietic cell transplant (HCT). Recent studies from the Mount Sinai Acute GVHD International Consortium (MAGIC) have validated an algorithm probability (MAP) that combines serum concentrations of two biomarkers of GVHD (REG3α and ST2) to generate an estimated probability of 6 month NRM for individual patients. The MAP estimates GVHD-mediated damage to crypts throughout the lower GI tract at single time points (Hartwell et al., JCI Insight, 2017; Major- Monfried et al., Blood, 2018). We hypothesized that the change in MAP between start of treatment and 28 days later could serve as a response biomarker and would compare favorably to clinical response, the gold standard which is widely used as a surrogate for long term survival and is the primary endpoint in most GVHD treatment trials (Martin et al., BBMT, 2009; MacMillan et al., Blood, 2010). We prospectively collected serum samples and clinical staging from 368 sequential HCT patients who received systemic treatment for acute GVHD in one of 20 MAGIC centers between January 2016 and February 2018. We computed MAPs and clinical responses for each patient. MAPs of patients who experienced 6 month NRM increased significantly compared to MAPs of patients who survived (p=0.0004). In patients whose initial MAPs were low (Ann Arbor 1, MAP 0.290), those who survived tended to have the largest decreases in MAP (Fig 1C). We found that patients whose MAPs rose above the previously determined high-risk threshold MAP of 0.290 had significantly worse survival compared to those who remained below it, whereas the large number patients with initially high MAPs that remained above the threshold had a large increase in mortality (Fig 2). When measured at day 28, MAPs predicted NRM more accurately than clinical responses, with areas under the receiver operating characteristic curve (AUC) of 0.86 and 0.70, respectively (p We conclude that the MAP is, to our knowledge, the first laboratory test validated as a response biomarker for acute GVHD treatment and more accurately predicts survival than clinical response after 28 days of treatment. The MAP may serve as a novel endpoint in future trials of GVHD treatment.

Rapid innovation in sequencing technologies and improvement in assembly algorithms have enabled the creation of highly contiguous mammalian genomes. Here we report a chromosome-level assembly of the water buffalo (Bubalus bubalis) genome using single-molecule sequencing and chromatin conformation capture data. PacBio Sequel reads, with a mean length of 11.5 kb, helped to resolve repetitive elements and generate sequence contiguity. All five B. bubalis sub-metacentric chromosomes were correctly scaffolded with centromeres spanned. Although the index animal was partly inbred, 58% of the genome was haplotype-phased by FALCON-Unzip. This new reference genome improves the contig N50 of the previous short-read based buffalo assembly more than a thousand-fold and contains only 383 gaps. It surpasses the human and goat references in sequence contiguity and facilitates the annotation of hard to assemble gene clusters such as the major histocompatibility complex (MHC). Despite technological advances, chromosome-level assemblies of mammalian genomes are still rare. Here, the authors use PacBio, Chicago and Hi-C approaches to generate a highly contiguous and partially-phased genome assembly for the water buffalo, Bubalus bubalis

Cattle are an economically important domestic animal species. In vitro 2D cultures of intestinal epithelial cells or epithelial cell lines have been widely used to study cell function and host–pathogen interactions in the bovine intestine. However, these cultures lack the cellular diversity encountered in the intestinal epithelium, and the physiological relevance of monocultures of transformed cell lines is uncertain. Little is also known of the factors that influence cell differentiation and homeostasis in the bovine intestinal epithelium, and few cell-specific markers that can distinguish the different intestinal epithelial cell lineages have been reported. Here we describe a simple and reliable procedure to establish in vitro 3D enteroid, or “mini gut”, cultures from bovine small intestinal (ileal) crypts. These enteroids contained a continuous central lumen lined with a single layer of polarized enterocytes, bound by tight junctions with abundant microvilli on their apical surfaces. Histological and transcriptional analyses suggested that the enteroids comprised a mixed population of intestinal epithelial cell lineages including intestinal stem cells, enterocytes, Paneth cells, goblet cells and enteroendocrine cells. We show that bovine enteroids can be successfully maintained long-term through multiple serial passages without observable changes to their growth characteristics, morphology or transcriptome. Furthermore, the bovine enteroids can be cryopreserved and viable cultures recovered from frozen stocks. Our data suggest that these 3D bovine enteroid cultures represent a novel, physiologically-relevant and tractable in vitro system in which epithelial cell differentiation and function, and host–pathogen interactions in the bovine small intestine can be studied. Electronic supplementary material The online version of this article (10.1186/s13567-018-0547-5) contains supplementary material, which is available to authorized users.

We present the design of two laboratory -astrophysics experiments with the goal of translating research performed at a major (several kJ) laser facility into the pulsed-power laboratory at the Michigan Accelerator for Inductive Z- Pinch Experiments (MAIZE). The experiments are designed to explore the interactions of magnetized plasma flows in astrophysical bow shocks and accretion shocks found in star formation, with a focus in the structure and development of shock instabilities. To accomplish this, we will be generating magnetized plasma flows via pulsed-power in the Linear Transformer Drive (LTD) at the University of Michigan, by ablating aluminum wire arrays with currents of up to 1 Mega-Amp. We have designed two different array geometries: a cylindrical wire array that will be used to study bow shock interactions against a variety of magnetized targets (conducting wires, electromagnets and permanent magnets), and a conical array that will drive a plasma jet into a solid target for the study accretion shocks.

Background/Aims: Participation in physical activity and exercise presents a challenge for adults with complex neurological impairment. Power-assisted exercise facilitates combined limb and trunk movement and may be an option for people with movement impairment. The aim of this study was to determine whether power-assisted exercise is a feasible activity option for people with complex neurological impairment. Methods: Seven adults with complex neurological impairment were recruited to take part in a 4-week programme of twice weekly power-assisted exercise. Programme attendance and completion was recorded and adverse events or effects documented. Mobility was monitored using the Timed Up and Go test (TUG). Upon completion of the programme, participants were interviewed regarding their experience of using the equipment. Findings: All seven participants completed the programme and the overall attendance was 96%. No adverse events occurred; two participants reported minor adverse effects, which were temporary. The TUG scores improved and participants enjoyed the programme, reporting perceived benefits in physical function and wellbeing. Conclusions: The findings of this study demonstrate that people with complex neurological impairment can participate in a programme of power-assisted exercise. Reported improvements in physical mobility suggest that further research in this area is indicated.

Activated mouse macrophages metabolize arginine via NO synthase (NOS2) to produce NO as an antimicrobial effector. Published gene expression datasets provide little support for the activation of this pathway in human macrophages. Generation of NO requires the coordinated regulation of multiple genes. We have generated RNA-sequencing data from bone marrow–derived macrophages from representative rodent (rat), monogastric (pig and horse), and ruminant (sheep, goat, cattle, and water buffalo) species, and analyzed the expression of genes involved in arginine metabolism in response to stimulation with LPS. In rats, as in mice, LPS strongly induced Nos2, the arginine transporter Slc7a2, arginase 1 (Arg1), GTP cyclohydrolase (Gch1), and argininosuccinate synthase (Ass1). None of these responses was conserved across species. Only cattle and water buffalo showed substantial NOS2 induction. The species studied also differed in expression and regulation of arginase (ARG2, rather than ARG1), and amino acid transporters. Variation between species was associated with rapid promoter evolution. Differential induction of NOS2 and ARG2 between the ruminant species was associated with insertions of the Bov-A2 retrotransposon in the promoter region. Bov-A2 was shown to possess LPS-inducible enhancer activity in transfected RAW264.7 macrophages. Consistent with a function in innate immunity, NO production and arginine metabolism vary greatly between species and differences may contribute to pathogen host restriction.

Relapse is most common cause of death after HCT. However, given the heterogeneity of diseases and disease states among patients (pts), risk for relapse is often difficult to manage in clinical trials when survival is the endpoint. The Disease Risk Index (DRI) predicts overall survival (OS) based on pre-HCT disease characteristics such as type of disease, remission status, and cytogenetic abnormalities and can be used to group heterogeneous diseases into 4 risk strata: very high risk [VHR, 1% of pts], high risk [HR, 23%], intermediate risk [IR, 64%], and low risk [LR, 12%] (Armand, Blood, 2014). OS for each of these strata is distinctly different. The DRI has been validated for adults, but not for children. Furthermore, the DRI cannot be calculated for some pediatric diseases like juvenile myelomonocytic leukemia (JMML). To determine its validity for children we calculated the DRI for 280 pediatric pts transplanted between 2008 and 2018 at Mount Sinai Acute GVHD International Consortium centers. The median age was 8.9 years (range, 0.4 - 17). The most common indications for HCT were ALL (51%), AML (31%), MDS (10%), and JMML (4%). Donors were adult unrelated donors (48%), unrelated cord blood (20%), haploidentical donors (17%), and matched siblings (15%). We first determined 2y survival by DRI for the 270 pts without JMML. Survival for JMML was closest to the VHR strata and we grouped JMML with VHR for all further analyses. The size of each of the risk strata were different for children compared to adults, VHR (n=32, 11%), HR (n=108, 39%), IR (n=128, 46%), and LR (n=12, 4%). Given the small number of LR pts, we excluded them from further analyses. We then determined that DRI effectively stratified pts into distinct strata for relapse (FIG 1A) and disease-free survival (FIG 1B). Because transplant practices are different for children compared to adults (e.g., more myeloablative conditioning), we examined whether DRI remained predictive of outcomes after adjustment for age, donor type, stem cell source, and conditioning intensity. We used IR as the reference group for these multivariate analyses. Children with HR DRI were significantly more likely to relapse (HR 2.1, 95% CI 1.2-3.7) and have worse DFS (HR 1.6, 95% CI 1.0-2.5). The risks for relapse and worse DFS were even greater for children with VHR DRI (relapse, HR 3.4, 95% CI 1.6-7.3, DFS 3.59, 95% CI 2.0-6.5). There were no significant differences in 2y non-relapse mortality by DRI. VHR pts had significantly worse 2y OS (HR 3.2, 95% CI 1.6-6.4) but HR pts were not significantly different for 2y OS than IR pts (HR 1.3, 95% CI 0.7-2.2). OS for HR and IR pts may diverge with longer follow-up. In summary, the LR strata is small and more pts are needed to determine their outcomes. However, for >95% of children the DRI creates 3 distinct risk strata. The DRI can be used in pediatric clinical trials to stratify for risk of relapse.

Sheep are a key source of meat, milk and fibre for the global livestock sector, and an important biomedical model. Global analysis of gene expression across multiple tissues has aided genome annotation and supported functional annotation of mammalian genes. We present a large-scale RNA-Seq dataset representing all the major organ systems from adult sheep and from several juvenile, neonatal and prenatal developmental time points. The Ovis aries reference genome (Oar v3.1) includes 27,504 genes (20,921 protein coding), of which 25,350 (19,921 protein coding) had detectable expression in at least one tissue in the sheep gene expression atlas dataset. Network-based cluster analysis of this dataset grouped genes according to their expression pattern. The principle of ‘guilt by association’ was used to infer the function of uncharacterised genes from their co-expression with genes of known function. We describe the overall transcriptional signatures present in the sheep gene expression atlas and assign those signatures, where possible, to specific cell populations or pathways. The findings are related to innate immunity by focusing on clusters with an immune signature, and to the advantages of cross-breeding by examining the patterns of genes exhibiting the greatest expression differences between purebred and crossbred animals. This high-resolution gene expression atlas for sheep is, to our knowledge, the largest transcriptomic dataset from any livestock species to date. It provides a resource to improve the annotation of the current reference genome for sheep, presenting a model transcriptome for ruminants and insight into gene, cell and tissue function at multiple developmental stages., Author summary Sheep are ruminant mammals kept as livestock for the production of meat, milk and wool in agricultural industries across the globe. Genetic and genomic information can be used to improve production traits such as growth rate and health and fitness traits including disease resilience. The sheep genome is, however, missing important information relating to gene function and many genes, which may be important for productivity, have no informative gene name. This can be remedied using RNA-Sequencing to generate a global expression profile of all protein-coding genes, across multiple organ systems and developmental stages. Clustering genes based on their expression profile across tissues and cells allows us to assign function to those genes. If, for example, a gene with no informative gene name is expressed in macrophages and is found within a cluster of known macrophage related genes it is likely to be involved in macrophage function and play a role in innate immunity. This information improves the quality of the reference genome and provides insight into biological processes underlying the complex traits that influence the productivity of sheep and other livestock species.

The dynamics of magnetized flows is of great interest to the astrophysics community as the formation and long collimation distances of jets in accretion systems are still open questions. In many of these systems, the background magnetic field is parallel to the jet propagation direction. Recent experiments [1] performed at the Jupiter Laser Facility investigated the effects of imposing a background magnetic field aligned with a collimated jet. Plastic cone targets were irradiated by a long-pulse laser as shown schematically in Fig. 1a. When the shock emerges from the backside of the cone, accelerated material accumulates on axis producing a collimated flow. Figure 1b demonstrates the collimation of the plasma without the background field and the disruption of the flow when applying a 5 T field. Experimental results will be discussed in detail with supporting numerical work describing the mechanisms causing the jet disruption.

Introduction Cardiomyopathy is a common cause of morbidity and death in patients with Duchenne muscular dystrophy (DMD).

Systemic glucocorticoids are the principal treatment for acute graft-versus-host disease (GVHD), which remains the major cause of non-relapse mortality (NRM) after allogeneic hematopoietic cell transplantation (HCT). However, there are no validated biomarkers that measure a patient's response to glucocorticoid therapy, and thus response is evaluated by the change in clinical symptom severity. A major weakness in the predictive power of clinical responses is that changes to all organs are weighted equally even though the major driver of NRM is irreversible damage to the crypts of the GI tract. Recent studies from the Mount Sinai Acute GVHD International Consortium (MAGIC) have validated an algorithm probability (MAP) that combines serum concentrations of two biomarkers of GVHD (REG3α and ST2) to generate an estimated probability of 6 month NRM for individual patients. The MAP has been considered a "liquid biopsy" that estimates the damage caused by GVHD to crypts throughout the lower GI tract (Hartwell et al., JCI Insight, 2017; Major-Monfried et al., Blood, 2018). We hypothesized that the change in MAP between start of treatment and 28 days later could serve as a response biomarker for GVHD and might compare favorably to the change in clinical symptoms that measures response to GVHD treatment, which is widely used as a surrogate for long term survival and is the primary endpoint in most GVHD treatment trials (Martin et al., BBMT, 2009; MacMillan et al., Blood, 2010). We prospectively collected serum samples and clinical staging from 368 sequential HCT patients who received systemic treatment for acute GVHD in one of 20 MAGIC centers between January 2016 and February 2018. We measured the serum concentrations of REG3α and ST2 before and after systemic therapy for acute GVHD and computed MAPs, the changes in MAPs, and clinical responses for each patient. MAPs of patients who experienced 6 month NRM showed significantly greater increases than MAPs of patients who survived (p=0.0004). In patients whose MAPs at the start of treatment were low (Ann Arbor 1, MAP < 0.141) or intermediate (Ann Arbor 2, 0.141 ≤ MAP ≤ 0.290), 6 month NRM clustered among those who had the greatest increases in MAP after 28 days (Fig 1A,B). In patients with high MAPs at the start of treatment (Ann Arbor 3, MAP > 0.290), those who survived tended to have the largest decreases in MAP (Fig 1C). These changes in MAP suggested crossing a single threshold could predict risk of mortality. We found that patients whose MAPs rose above a threshold MAP of 0.290 (5% of Ann Arbor 1, 27% of Ann Arbor 2) had significantly worse survival compared to those who remained below it, whereas the large number patients with initially high MAPs that remained above the threshold (66% of Ann Arbor 3) had a large increases in mortality (Fig 2). When measured at day 28, the MAP was significantly more accurate in predicting NRM than the gold standard of the clinical response, with areas under the receiver operating characteristic curve (AUC) of 0.86 and 0.70, respectively (p We conclude that the MAP is, to our knowledge, the first validated laboratory test to serve as response biomarker for the treatment for acute GVHD and a more accurate predictor of survival than clinical response after four weeks of treatment. The MAP may serve as a novel endpoint and an important complement to changes in clinical symptom severity in future trials of GVHD treatment. Disclosures Srinagesh: National Institutes of Health: Research Funding. Ozbek:Viracor: Patents & Royalties: Biomarker Patent. Ayuk:Novartis: Honoraria, Other: Advisory Board, Research Funding. Aziz:Doris Duke Charitable Foundation: Research Funding. Defilipp:Incyte: Research Funding. Grupp:Novartis: Consultancy, Research Funding; Roche: Consultancy; GSK: Consultancy; CBMG: Consultancy; Novartis: Research Funding; Kite: Research Funding; Servier: Research Funding; Jazz: Other: study steering committees or scientific advisory boards; Adaptimmune: Other: study steering committees or scientific advisory boards; Cure Genetics: Consultancy; Humanigen: Consultancy. Hexner:novartis: Research Funding. Kitko:Mallinckrodt: Honoraria; Novartis: Consultancy, Honoraria. Mielke:EBMT/EHA: Other: Travel support; ISCT: Other: Travel support; Miltenyi: Consultancy, Honoraria, Other: Travel and speakers fee (via institution), Speakers Bureau; Jazz Pharma: Honoraria, Other: Travel support, Speakers Bureau; IACH: Other: Travel support; Kiadis Pharma: Consultancy, Honoraria, Other: Travel support (via institution), Speakers Bureau; DGHO: Other: Travel support; Bellicum: Consultancy, Honoraria, Other: Travel (via institution); GILEAD: Consultancy, Honoraria, Other: travel (via institution), Speakers Bureau; Celgene: Honoraria, Other: Travel support (via institution), Speakers Bureau. Merli:Sobi: Consultancy; Amgen: Honoraria; Novartis: Honoraria; Bellicum: Consultancy. Pulsipher:Amgen: Other: Lecture; Miltenyi: Research Funding; Bellicum: Consultancy; Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Jazz: Other: Education for employees; CSL Behring: Membership on an entity's Board of Directors or advisory committees; Adaptive: Membership on an entity's Board of Directors or advisory committees, Research Funding; Medac: Honoraria. Qayed:Bristol-Myers Squibb: Honoraria. Reshef:Pfizer: Consultancy; Magenta: Consultancy; Kite: Consultancy, Research Funding; Atara: Consultancy, Research Funding; BMS: Consultancy; Pharmacyclics: Consultancy, Research Funding; Incyte: Consultancy, Research Funding; Celgene: Research Funding; Shire: Research Funding. Levine:Incyte: Consultancy, Research Funding; Biogen: Other: non-financial support; Viracor: Patents & Royalties: biomarker patent; Ironwood: Honoraria; bluebird bio: Consultancy; National Cancer Institute: Research Funding; Novartis: Honoraria; Kamada: Research Funding. Ferrara:National Institutes of Health: Research Funding; ViraCor: Consultancy; Incyte: Consultancy; Kamada: Consultancy; Mallinckrodt: Consultancy; Enlivex: Consultancy; Xenikos: Consultancy; CSL Behring: Consultancy.

This paper reports the results of an optical (526.5 nm) Thomson scattering investigation of low-Z (C5H8O2) plasma jets created on the OMEGA laser. We were able to measure the plasma parameters of individual jets and investigate the nature of the interaction when two jets were collided head-on. We found that the mass density of an individual jet increased from 10−7 to 10−4 g cm−3, while the velocity fell from 300 to 100 km s over the probed time period (12–18 ns). When two jets were collided, we were able to capture the transition from collisionless interaction (interpenetration) to collisional interaction (stagnation and shock formation). The timing of the collisionless-to-collisional transition was investigated with visible light self-emission images of the experiments, with streaked Thomson scattering of the interaction region, and by calculating the ion penetration depth based on the measured density and velocity of the jets. All three approaches broadly agree: the colliding jets transitioned from collisionless to collisional behavior around 16 ns after drive laser beams were fired.This paper reports the results of an optical (526.5 nm) Thomson scattering investigation of low-Z (C5H8O2) plasma jets created on the OMEGA laser. We were able to measure the plasma parameters of individual jets and investigate the nature of the interaction when two jets were collided head-on. We found that the mass density of an individual jet increased from 10−7 to 10−4 g cm−3, while the velocity fell from 300 to 100 km s over the probed time period (12–18 ns). When two jets were collided, we were able to capture the transition from collisionless interaction (interpenetration) to collisional interaction (stagnation and shock formation). The timing of the collisionless-to-collisional transition was investigated with visible light self-emission images of the experiments, with streaked Thomson scattering of the interaction region, and by calculating the ion penetration depth based on the measured density and velocity of the jets. All three approaches broadly agree: the colliding jets transitioned from coll...

Health journalists often use personal stories to put a “face” on a health issue. This research uses a sociology-of-news approach, based on data collected from 42 in-depth interviews and three surveys with health journalists and editors (national, N=774; state, N=55; and purposive, N=180), to provide a first look at how important journalists think exemplars are to their stories. Results show journalists select exemplars to serve the purposes of informing, connecting, and getting attention. Some of the strategies journalists use to locate exemplars pose ethical concerns. Further, journalists rank the use of exemplars lower in aiding audience understanding compared with the use of experts, data and statistics, and definitions of technical terms.

The potential harm and benefit associated with sharing personal information online is a topic of debate and discussion. Using survey methods (n=872), we explore whether attainment of social capital online relates to greater comfort with sharing personal information. We found that perceptions of bridging and bonding social capital earned from using Facebook are significant predictors of overall comfort levels with sharing personal information. This research raises timely questions about how the perceived benefits of social networking sites influence how personal information is shared online.

Background. Schools are often held responsible for preventing or addressing cyberbullying, yet little is known about school administrator perceptions of cyberbullying and the challenges they face in addressing this public health issue. Aims. The goal of this study is to examine school administrators’ perceptions of the facilitators of cyberbullying and barriers to primary and secondary prevention strategies. Method. Public school administrators ( N = 36) participated in in-depth interviews about bullying and discussed their experiences with cyberbullying and their perceptions of cyberbullying facilitators and barriers to prevention. Results. Three main themes arose from the analysis: (1) cyberbullying as a major challenge; (2) facilitators of cyberbullying and barriers to preventive action, including parents and technology; and (3) prevention efforts, including unclear jurisdiction for action, primary versus secondary prevention efforts, and technology attributes that facilitate school response to bullying. Discussion. Although administrators perceive cyberbullying as a major challenge facing their schools, they are often unsure about appropriate primary and secondary prevention efforts. Relationships with parents and police complicate response and prevention as schools attempt to navigate unclear jurisdiction. Additionally, technology presents a challenge to schools because it is seen as an enabler of cyberbullying, a facilitator of prevention, and a necessary part of education efforts. Conclusion. Lack of research on prevention strategies, parents’ knowledge and attitudes, and confusion about responsibility for addressing cyberbullying are barriers to action. Findings suggest administrators could benefit from additional clarity on which strategies are most effective for primary prevention of cyberbullying, and that prevention strategies should proactively involve parents to promote effective collaboration with schools.

Hens responded under multiple fixed-ratio schedules with equal response requirements and either a 1-s or a 6-s reinforcer. Upcoming reinforcer size was indicated by key color. Components were presented in a quasirandom series so that all four component transitions occurred. Postreinforcement pauses were affected by the upcoming and preceding reinforcer size, with longer pauses after large reinforcers followed by small reinforcers than when followed by large ones, and longer pauses after small reinforcers that were followed by small reinforcers rather than large ones. Pauses increased with fixed-ratio size and the effects of reinforcer size were larger the larger the ratio. When reinforcer size was not signaled-mixed fixed-ratio schedules-pauses were shorter after small than after large reinforcers. Signalling the upcoming reinforcer attenuated the effect of the previous reinforcer size on pause duration when small was followed by small and when either small or large by large, but enhanced the effect when large was followed by small. There was no effect of reinforcer size on pause duration when single fixed-ratio schedules were arranged. The effects of reinforcer size on pauses depends on the size and range of the fixed ratios as well as the exact procedures used in the study.

Acute graft-versus-host disease (GVHD) remains a leading cause of morbidity and nonrelapse mortality after allogeneic hematopoietic cell transplantation. The clinical staging of GVHD varies greatly between transplant centers and is frequently not agreed on by independent reviewers. The lack of standardized approaches to handle common sources of discrepancy in GVHD grading likely contributes to why promising GVHD treatments reported from single centers have failed to show benefit in randomized multicenter clinical trials. We developed guidelines through international expert consensus opinion to standardize the diagnosis and clinical staging of GVHD for use in a large international GVHD research consortium. During the first year of use, the guidance followed discussion of complex clinical phenotypes by experienced transplant physicians and data managers. These guidelines increase the uniformity of GVHD symptom capture, which may improve the reproducibility of GVHD clinical trials after further prospective validation.

This paper investigates the group-building potential of forwarded e-mails through a visual analysis of negative images about President Barack Obama. We argue that these e-mails are a form of political digital folklore that may contribute to constructing participants’ individual and group identities. Images amplify the impact and believability of the messages, especially when linked to familiar cultural references and experiences and may lead to increased political polarization and hostility.

Circulating tumor cells (CTCs) have emerged as potential biomarkers in several cancers such as colon, prostate, and breast carcinomas, with a correlation between CTC number and patient prognosis being established by independent research groups. The detection and enumeration of CTCs, however, is still a developing field, with no universal method of detection suitable for all types of cancer. CTC detection in lung cancer in particular has proven difficult to perform, as CTCs in this type of cancer often present with nonepithelial characteristics. Moreover, as many detection methods rely on the use of epithelial markers to identify CTCs, the loss of these markers during epithelial-to-mesenchymal transition in certain metastatic cancers can render these methods ineffective. The development of personalized medicine has led to an increase in the advancement of molecular characterization of CTCs. The application of techniques such as FISH and RT-PCR to detect EGFR, HER2, and KRAS abnormalities in lung, breast, and colon cancer, for example, could be used to characterize CTCs in real time. The use of CTCs as a ‘liquid biopsy’ is therefore an exciting possibility providing information on patient prognosis and treatment efficacy. This review summarizes the state of CTC detection today, with particular emphasis on lung cancer, and discusses the future applications of CTCs in helping the clinician to develop new strategies in patient treatment.