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Purpose: To assess whether exposure to the 2010 Deepwater Horizon oil spill (DHOS) was related to parents’ self-rated health over time. Design: 3 waves of panel data were drawn from the Gulf Coast Population Impact study (2014) and Resilient Children, Youth, and Communities study (2016, 2018). Setting: Coastal Louisiana communities in high-impact DHOS areas. Participants: Respondents were parents or guardians aged 18 - 84, culled from a probability sample of households with a child aged 4 to 18 (N = 526) at the time of the 2010 DHOS. Measures: Self-rated health was measured at each wave. Self-reported physical exposure to the DHOS, economic exposure to the DHOS, and control variables were measured in 2014. Analysis: We used econometric random effects regression for panel data to assess relationships between DHOS exposures and self-rated health over time, controlling for potentially confounding covariates. Results: Both physical exposure (b = −0.39; P < 0.001) and economic exposure (b = −0.34; P < 0.001) to the DHOS had negative associations with self-rated health over the study period. Physical exposure had a larger effect size. Conclusion: Parents’ physical contact with, and economic disruption from, the 2010 DHOS were tied to long-term diminished health.

The historic 2010 BP Deepwater Horizon Oil Spill (DHOS) led to public distress regarding potential impacts on children in nearby Gulf Coast communities. Using a community-based South Louisiana panel study of households with children, we examined the effect of fishing industry employment on changes in a subjective measure of general child health and whether economic and physical DHOS exposures played a mediating role. Fishing industry employment had a negative effect on child health compared to other industries. Economic exposure and physical exposure both mediated the effects of the fishing industry on child health, with economic exposure mediating a larger share (49.3%) of the relationship compared to physical exposure (40.5%). The importance of economic oil spill exposure in these findings highlights the significance of social determinants of health at the intersection of disasters and child vulnerability.

Purpose: To assess whether trajectories of children’s physical health problems differ by parental college degree attainment in Louisiana areas highly impacted by the 2010 BP Deepwater Horizon oil spill (BP-DHOS). Design: Three waves of panel data (2014, 2016, and 2018) from the Gulf Coast Population Impact / Resilient Children, Youth, and Communities studies. Setting: BP-DHOS-impacted communities in coastal Louisiana. Participants: Parents of children aged 4-18 in a longitudinal probability sample (n = 392). Measures: Reported child physical health problems from the BP-DHOS, parental college degree attainment, and covariates. Analysis: Linear growth curve models are used to assess initial levels of and the rate of change in child physical unknown. The current study uses 3 waves physical health problems by parental college degree attainment. Explanatory variables are measured at baseline and the outcome variable is measured at all 3 waves. Results: Compared to children of parents without college degrees, children of college graduates had fewer initial health problems in 2014 (b = −.33; p = .02). Yet, this health advantage decreased over time, as indicated by their positive rate of change (b = .22; p = .01), such that the higher education health advantage was not statistically significant by 2018. Conclusion: Children of college graduates experienced a physical health advantage following the BP-DHOS, but this gap closed over time. The closure of the gap was due to the children of college graduates experiencing significant increases in reported health problems over the study period.

Family resilience raises the question of how family units adapt to external shocks. One notable form of such shocks are disasters. Research shows that disasters are occurring with greater frequency and severity throughout the world. Natural and human-made hazards pose an ongoing threat to positive family functioning everywhere, making it difficult to ignore the importance of disaster resilience for research and practice concerning family wellbeing. In this chapter, we examine the issue of family resilience in the context of disaster. We begin by articulating what is meant by hazards and disasters and how that links to family resilience. In doing so, we stress the importance of adaptive capacity and trajectories over time. We then provide an illustration of ongoing research related to the Resilient Children, Youth, and Communities (RCYC) project, a joint venture between researchers at Louisiana State University (LSU) and Columbia University’s National Center for Disaster Preparedness (NCDP), concerning family resilience in the context of the BP Deepwater Horizon oil spill. We close by outlining considerations for research, policy, and practice.

Hypertension heralds the diagnosis of heart failure (HF) with preserved ejection fraction (HFpEF) in 75–85% of cases and shares many of its adverse outcomes as well as its acute and chronic symptoms. This review provides important new data about the pathophysiology and mechanisms that connect hypertension and HFpEF as well as therapy used in both conditions. The traditional model of HFpEF pathophysiology emphasizes the role of hypertension causing increased afterload on the left ventricle (LV), leading to LV hypertrophy (LVH) and subsequent LV diastolic dysfunction. Recent work has provided valuable insights into the mechanisms underlying the transition from hypertension to HFpEF, showing that the pathophysiology extends beyond LVH and diastolic dysfunction. An evolving paradigm suggests that HFpEF is inflammatory in nature with multifactorial pathophysiology, affected by age-related changes and comorbidities. Hypertension shares many of the proinflammatory mechanisms of HFpEF. Furthermore, hypertension precedes HFpEF in the majority of cases. Because of its clinically heterogeneous nature, development of standardized therapies for HFpEF has been challenging. As there are standardized approaches to hypertension, we suggest that similar approaches be used for the treatment of HFpEF, including medical and non-medical therapies. With medical therapies, a treat-to-target blood pressure (BP) strategy could be employed, such as systolic BP

The BP Deepwater Horizon oil spill (DHOS) created widespread concern about threats to health among residents of the Louisiana Gulf Coast. This study uses data from the Resilient Children, Youth, and Communities study—a longitudinal cohort survey of households with children in DHOS-affected areas of South Louisiana—to consider the effect of DHOS exposure on health trajectories of children, an especially vulnerable population subgroup. Results from latent linear growth curve models show that family DHOS exposure via physical contact and job/income loss both negatively influenced initial child health. However, the effects of physical exposure dissipated over time while the effects of job/income loss persisted. This pattern holds for both general child health and the number of recent physical health problems children had experienced. These findings help to bridge the literature on disaster impacts and resilience/vulnerability, with the literature on socioeconomic status as a fundamental cause of health outcomes over the life course.

In August 2017, Hurricane Harvey struck the US Gulf Coast and caused more than US $125 billion in damages in Texas. The loss of lives and the economic damages resulted in an outpouring of support for the recovery efforts in the form of federal assistance and private donations. The latter has supported more creative approaches to recovery. Organizations that normally would not receive funding were able to obtain resources to use in novel manners. Using the framework of Dynes typology to identify groups and their respective structures and tasks, this report from the field analyzes Hurricane Harvey and the financial support mechanisms used to support recovery efforts in Texas, what organizations were funded to do, and where they fit into Dynes typology. The authors close by noting the importance of these emerging organizations and the need to support diversity in funding disaster response and recovery efforts beyond large nonprofit organizations.

The purpose of this review is to answer the question whether left ventricular hypertrophy (LVH) could be considered a therapeutic target in patients with hypertension. To fulfill this purpose, we briefly outline different methods of measuring LVH, then discuss the current evidence and unresolved controversies regarding the relationships among LVH, blood pressure (BP), and cardiovascular disease (CVD) outcomes. The methods and criteria used for defining LVH in clinical studies lack consistency and are inherently different. Electrocardiogram (ECG) has been the most common method, but some studies used echocardiography, and recently, the cardiac magnetic resonance imaging was used by some studies as well. Regardless of the method, studies have shown that higher BP is a risk factor for LVH, regression of LVH is possible by successful BP lowering, and LVH is associated with CVD outcomes. Nevertheless, recent trials revealed that although intensive BP lowering (systolic BP target of

The placenta releases allogeneic trophoblast antigens into maternal circulation during pregnancy. Maternal antigen presenting cells present these antigens to T cells but fail to induce strong immunogenic responses, even in the presence of danger signals. While this observation illustrates the phenomenon of fetomaternal tolerance, its cellular and molecular basis remains largely unknown. By studying the pathways mediating adaptive immune responses to a surrogate trophoblast antigen in mice, we found that maternal B cells, and not regulatory T cells, directly underlie the impairments in CD4 T cell activation. Trophoblast-antigen specific B cells, rather than dendritic cells, are the main presenters of trophoblast antigen to CD4 T cells. The B cells are themselves profoundly suppressed, thus limiting their ability to activate cognate CD4 T cells. Mechanistically, B cell suppression occurs as the result of CD22/Lyn inhibitory signaling, likely induced by sialic acid residues that coat the trophoblast-derived antigen. These results not only identify maternal B cells as key players in fetomaternal tolerance but also provide a basis for further work on B cell responses during healthy and pathologic pregnancies. More broadly, these results suggest that exploiting antigen-intrinsic properties such as sialylation may provide new therapeutic ways to ignite or inhibit antigen-specific responses outside the context of pregnancy.

Recent studies continue to highlight the significance and prognosis of silent myocardial infarctions, but few studies identify the burden and significance of myocardial ischemia without symptoms. Patients with positive electrocardiography (ECG) and/or positive echocardiography stress test were

ObjectivesThe goal of this study was to assess the relationship among extracellular volume (ECV), native T1, and systolic strain in hypertensive patients with left ventricular hypertrophy (HTN LVH), hypertensive patients without LVH (HTN non-LVH), and normotensive controls.BackgroundDiffuse myocardial fibrosis in HTN LVH patients, as reflected by increased ECV and native T1, may be an underlying mechanism contributing to increased cardiovascular risk compared with HTN non-LVH subjects and controls. Furthermore, increased diffuse fibrosis in HTN LVH subjects may be associated with reduced peak systolic and early diastolic strain rate compared with the other 2 groups.MethodsT1 mapping was performed in 20 HTN LVH (mean age, 55 ± 11 years), 23 HTN non-LVH (mean age, 61 ± 12 years), and 22 control subjects (mean age, 54 ± 7 years) on a Siemens 1.5-T Avanto (Siemens Healthcare, Erlangen, Germany) using a previously validated modified look-locker inversion-recovery pulse sequence. T1 was measured pre-contrast and 10, 15, and 20 min after injection of 0.15 mmol/kg gadopentetate dimeglumine, and the mean ECV and native T1 were determined for each subject. Measurement of circumferential strain parameters were performed using cine displacement encoding with stimulated echoes.ResultsHTN LVH subjects had higher native T1 compared with controls (p < 0.05). HTN LVH subjects had higher ECV compared with HTN non-LVH subjects and controls (p < 0.05). Peak systolic circumferential strain and early diastolic strain rates were reduced in HTN LVH subjects compared with HTN non-LVH subjects and controls (p

Purpose To perform myocardial T1 mapping pre and post gadolinium (Gd) administration and determine the volume of distribution of Gd (VdGd) in patients with cardiac amyloidosis to assess extracellular space expansion from amyloid protein deposition.

Purpose To develop and validate modified Look-Locker (MOLLI) protocols to generate myocardial T1 maps within clinically acceptable breath-hold durations and to compare partition coefficients (\g=l\) of gadolinium (Gd)-DTPA determined from either bolus injection (BI) or continuous infusion (CI) techniques.

The present study was undertaken to gain insight into the associations of mercury(II) with dicysteinyl tripeptides in buffered media at pH 7.4. We investigated the effects of increasing the distance between cysteinyl residues on mercury(II) associations and complex formations. The peptide-mercury(II) formation constants and their associated thermodynamic parameters in 3-(N-morpholino)propanesulfonic acid (MOPS) buffered solutions were evaluated by isothermal titration calorimetry. Complexes formed in different relative ratios of mercury(II) to cysteinyl peptides in ammonium formate buffered solutions were characterized by LTQ Orbitrap mass spectrometry. The results from these studies show that n-alkyl dicysteinyl peptides (CP 1-4), and an aryl dicysteinyl peptide (CP 5) can serve as effective "double anchors" to accommodate the coordination sites of mercury(II) to form predominantly one-to-one Hg(peptide) complexes. The aryl dicysteinyl peptide (CP 5) also forms the two-to-two Hg(2)(peptide)(2) complex. In the presence of excess peptide, Hg(peptide)(2) complexes are also detected. Notably, increasing the distance between the ligating groups or "anchor points" in CP 1-5 does not significantly affect their affinity for mercury(II). However, the enthalpy change (ΔH) values (ΔH(1) ~ -91 kJ mol(-1) and ΔH(2) ~ -66 kJ mol(-1)) for complex formation between CP 4 and 5 with mercury(II) are about one and a half times larger than the related values for CP 1, 2 and 3 (ΔH(1) ~ -66 kJ mol(-1) and ΔH(2) ~ 46 kJ mol(-1)). The corresponding entropy change (ΔS) values (ΔS(1) ~ -129 J K(-1) mol(-1) and ΔS(2) ~ -116 J K(-1) mol(-1)) of the structurally larger dicysteinyl peptides CP 4 and 5 are less entropically favorable than for CP 1, 2 and 3 (ΔS(1) ~ -48 J K(-1) mol(-1) and ΔS(2) ~ -44 J K(-1) mol(-1)). Generally, these associations result in a decrease in entropy, indicating that these peptide-mercury complexes potentially form highly ordered structures. The results from this study show that dicysteinyl tripeptides are effective in binding mercury(II) and they are promising motifs for the design of multi-cysteinyl peptides for binding more than one mercury(II) ion per peptide.

The Intercollegiate Surgical Curriculum Programme (ISCP) is bringing about a change of learning culture for surgical trainees in which learning is transparent and there is explicit formative feedback. A key principle is that surgical trainees should be able to demonstrate that their learning has met defined standards of conduct and practice. The programme director (PD) is responsible for the training programme within which trainees now have regular appraisals with an assigned educational supervisor (AES) using a learning agreement (LA) and a review of progress through an annual review of competence progression (ARCP). These support trainees by helping them to identify their educational needs and then, in conjunction with their AES, to plan and manage their surgical training.

To develop and validate modified Look-Locker (MOLLI) protocols to generate myocardial T1 maps within clinically acceptable breath-hold durations and to compare partition coefficients (λ) of gadolinium (Gd)-DTPA determined from either bolus injection (BI) or continuous infusion (CI) techniques.T1 mapping was performed in phantoms and in 10 volunteers on a 1.5T scanner using the standard (3-3-5) MOLLI technique and two MOLLI schemes with shorter breath-hold durations. Imaging was performed precontrast and every 5 minutes following a bolus of 0.1 mmol/kg Gd-DTPA and a 15-minute delayed continuous infusion of 0.001 mmol/kg Gd-DTPA until equilibrium T1 in the myocardium was achieved to enable direct comparison of T1 relaxation times between techniques and λ's between the BI and CI methods.There was good agreement of T1 values between the 3-3-5 standard MOLLI protocol and the modified 3-5 MOLLI protocol in both phantom studies over a range of heart rates and in human subjects. Both MOLLI protocols produced similar measurements of λ using both the BI and CI methods.A reduced breath-hold MOLLI T1 mapping protocol combined with the BI method can accurately characterize T1 and λ in clinically applicable breath-hold durations without requiring a long equilibrium phase infusion.

Summary Diffuse myocardial fibrosis in hypertensive left ventricular hypertrophy (LVH) is not readily detected by conventional late gadolinium enhanced CMR. Our study was aimed to detect diffuse myocardial fibrosis in these patients as compared to age matched normal controls, using a T1 mapping technique. Fibrosis was quantified by calculating the partition coefficient (l) and volume of distribution (Vd) of gadolinium (Gd) following a bolus injection of Gd. We observed that the values for l and Vd were higher in LVH than controls. A positive association was also noted between LV mass and l. Background

Late gadolinium enhancement can evaluate focal, but not diffuse myocardial fibrosis. T1-mapping techniques can quantify fibrosis by calculating the partition coefficient (λ) of gadolinium (Gd). One method (CI) calculates λ at equilibrium following a continuous infusion of Gd, while the other, early post-contrast method (EPC), determines λ from multiple post-contrast time points after Gd injection. The Modified Look-Locker Inversion Recovery (MOLLI) technique accurately performs T1 mapping, but may be limited in practice due to the long breathhold required. A shortened-MOLLI technique (Sh-MOLLI) has been described, which only allows a single heart beat for magnetization recovery.

Molecular modeling has been a long-standing research area for biologists. However, the existing molecular modeling software lacks strong support for collaborative research. In this paper, we describe our effort to develop a collaborative multiview virtual environment for molecular visualization and modeling. In our virtual environment, the users are able to visualize large molecular structures in real-time, create their own view, or share their view with others in the system. The system allows for individual or coordinated collaborative manipulation of the virtual molecular model. Our virtual environment is integrated with a molecular dynamics simulator, and therefore our system is not merely a visualization tool, but an environment where biologists can collaboratively construct their models and test their hypotheses.

Although a great deal of research effort has been devoted to the realistic and efficient rendering of terrain data, the existing research mainly focuses on displaying static terrain. The realistic simulation of dynamic terrain, including vehicle-terrain interactions, is absent in most 3D graphical applications. In this paper, we present a new GPU-based algorithm for dynamic terrain simulation. A key component of this algorithm is a Dynamically-Displaced Height Map (DDHM) which is generated and manipulated on the GPU. In addition, our method achieves real-time performance by using new features of the latest graphics hardware and shader technology. We demonstrate our algorithm by simulating a ground vehicle traveling on soft terrain. Our algorithm is particularly useful for ground based visual simulation applications as well as 3D games.

Molecular modeling is an important research area, helping scientists develop new drugs against diseases such as AIDS and cancer. Prior studies have demonstrated that immersive virtual environments have unique advantages over desktop systems in visualizing molecular models. However, exploration and interaction in existing molecular modeling virtual environments is often limited to a single user, lacking strong support for collaboration. In addition, scientists are often reluctant to adopt these systems because of their lack of availability and high cost. We propose an affordable immersive system that allows biologists and chemists to manipulate molecular models via natural gestures, receive and visualize real-time feedback from a molecular dynamics simulator, allow the sharing of customized views, and provide support for both local and remote collaborative research.

Drug craving has purportedly been linked to relapse and to substance use. For over two decades, cue reactivity has been a viable method to assess craving and physiological reactions to drug stimuli. However, traditional cue reactivity has faced the following limitations: austere situations or stimuli, lack of complex cues, lack of standardization, and limited generalization outside of the lab setting. In order to improve cue methodologies, a virtual reality (VR) nicotine cue reactivity assessment system (VR-NCRAS) was developed and tested in a controlled experimental trial. Ten nicotine dependent smokers were exposed to VR smoking cues and VR neutral cues in a standardized, timed, computer controlled experiment. Subjective craving and physiological responses were recorded and compared across VR-NCRAS stimuli. Subjective cigarette craving increased significantly and corresponding physiological reactivity was observed in response to VR smoking cues. VR neutral cues did not result in subjective or physiological changes consistent with craving. Implications of these findings on substance abuse research and treatment are discussed.

This paper seeks to demonstrate the possibility of manipulating the frequency of stuttering using virtual reality environments (VREs). If stuttering manifests itself in VREs similarly to the way it manifests itself in real world interactions, then VREs can provide a controlled, safe, and confidential method for treatment practice and generalization. Though many researchers and clinicians recognize the need for generalization activities in the treatment of stuttering, achieving generalization in a clinical setting poses challenges to client confidentiality, safety, and the efficient use of a professionals’ time. Virtual reality (VR) technology may allow professionals the opportunity to enhance and assess treatment generalization while protecting the safety and confidentiality of their clients. In this study, we developed a VR job interview environment which allowed experimental control over communication style and gender of interviewers. In this first trial, persons who stutter (PWS) experienced both challenging and supportive VR job interview conditions. The percentage of stuttered syllables was calculated for both interviews for each participant. Self-reported ratings of communication apprehension and confidence were also obtained, and were not significantly correlated with stuttering severity. Results indicated that interviewer communication style affected the amount of stuttering produced by participants, with more stuttering observed during challenging virtual interviews. Additionally, the amount of stuttering observed during the VR job interviews was significantly, positively correlated with the amount of stuttering observed during an interview with the investigator prior to VR exposure. Participants’ subjective reports of the VR experience indicate reactions similar to those they report experiencing in the real world. Possible implications for the use of VR in the assessment and treatment of stuttering are discussed. Educational objectives: After reading this article, the reader will be able to—(1) list some of the challenges to treatment generalization; (2) describe how virtual reality technology can assist in alleviating some of these challenges; (3) describe how the frequency of stuttering varies across two different virtual environments.

Cigarette smoking in adolescents is a major public health problem. To address the increasing need for efficacious assessment and treatment methods, we developed and tested a novel virtual reality cue reactivity assessment system. A case study of a controlled virtual reality cue reactivity trial with a 17-year-old adolescent cigarette smoker is presented. During the trial, the participant was exposed to virtual reality (VR) smoking cues and VR neutral cues and assessments of subjective craving and skin conductance response (SCR) were recorded. Upon exposure to VR smoking cues, craving increased. A novel methodology for collecting and analyzing SCR in VR was developed and explored to expand the role of physiological variables in VR research. SCR data indicated specific reactions to smoking cue stimuli, with the subject experiencing increased reactivity to smoking cues (i.e., cigarettes) compared to food or drinks. Based on this case study, further research using VR cue reactivity assessment in adolescent smokers is warranted. The impact of VR in drug research and future applications in research are also discussed.

This poster presents a new technique for visualizing area of interest in a collaborative virtual environment for molecular modeling. The environment allows multiple participants to interact with molecular models while receiving real-time energy feedback from a molecular mechanics simulator. Interaction within the environment occurs primarily via a data glove and is visualized through an HMD (Head-Mounted Display). To interact with the molecule, users define an area of interest by pinching (index to thumb) and then dragging in 3D space. Scientists can then grab within the box to manipulate the molecule. When working with complex molecular models, however, where either the atom count is high, or atoms are clustered together, the area of interest may be occluded by atoms or bonds that fall within the line of site, making it difficult, if not impossible to view the area (Figure 1). While several physically-correct depth-of-focus algorithms have been created [Haeberli and Akeley 1990], we were interested in an efficient approximation specifically designed for this environment.

Traditional cue reactivity provides a methodology for examining drug triggers and stimuli in laboratory and clinical settings. However, current techniques lack standardization and generalization across research settings. Improved methodologies using virtual reality (VR) cue reactivity extend previous research standardizing exposure to stimuli and exploring reactions to drug cues in a controlled VR setting. In a controlled pilot trial, 13 nicotine-dependent participants were allowed to smoke ad libitum then exposed to VR smoking and VR neutral cues and compared on craving intensity. VR smoking cues significantly increased craving compared to VR neutral cues. On average, craving intensity increased 118% during exposure to VR smoking cues. Implications for substance abuse research and treatment using VR to assess cessation and anticraving medications are discussed.