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Background Type 2 diabetes (T2D) is characterized by co-morbid cardiometabolic abnormalities and elevated heart failure (HF) risk. Purpose The purpose of this study was to evaluate the associations of baseline and longitudinal changes in cardiometabolic health with risk of HF among adults with T2D. Methods Adults with T2D enrolled in the Look AHEAD (Action for Health in Diabetes) trial without prevalent HF were included. Adjusted Cox models were used to create a cardiometabolic health score incorporating target levels of parameters weighted based on relative risk for HF. The associations of baseline, 1- and 4-year changes in the cardiometabolic health score with risk of overall HF, HF with preserved ejection fraction (HFpEF; EF≥50%), and HF with reduced EF (HFrEF; EF Results Of the 5,080 participants included, there were 257 incident HF events during 12.4-year follow-up. The cardiometabolic health score included 2-points each for target levels of waist circumference, glomerular filtration rate, urine albumin-to-creatinine ratio and 1-point each for blood pressure and hemoglobin A1c at target (Table 1). Higher baseline cardiometabolic health score was significantly associated with lower risk of overall HF (adjusted hazard ratio [aHR] per 1-unit higher score, 0.72 [95% CI, 0.66–0.79]) with similar associations observed for HFpEF and HFrEF (Table 2). Improvement in cardiometabolic health over 1- and 4-years was significantly associated with lower risk of overall HF (aHR per 1-unit increase in score at 1- and 4-years, 0.82 [95% CI, 0.73–0.92] and 0.80 [95% CI, 0.70–0.91], respectively). Conclusions Among adults with T2D, achieving target levels of more cardiometabolic health parameters at baseline and sustained improvements were associated with lower HF risk. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Diabetes and Digestive and Kidney Diseases

A model of a stochastic froth is introduced in which the rate of random coalescence of a pair of bubbles depends on an inverse power law of their sizes. The main question of interest is whether froths with a large number of bubbles can grow in a stable fashion; that is, whether under some time-varying change of scale the distributions of rescaled bubble sizes become approximately stationary. It is shown by way of a law of large numbers for the froths that the question can be re-interpreted in terms of a measure flow solving a nonlinear Boltzmann equation that represents an idealized deterministic froth. Froths turn out to be stable in the sense that there are scalings in which the rescaled measure flow is tight and, for a particular case, stable in the stronger sense that the rescaled flow converges to an equilibrium measure. Precise estimates are also given for the degree of tightness of the rescaled measure flows.

Perfluorocarbons are now being used as oxygen carriers in clinical settings. Because these chemicals may have a role as a blood substitute, in organ preservation, and in the management of respiratory failure, we have reviewed some of the research leading to these applications.

Explosive field emission cathodes have been used extensively in high power microwave tubes. These cathodes emit electrons without the use of cathode heaters. Recently, some theoretical and simulation work has been performed to gain further understanding of the physics of these cathodes. The purpose of this letter is to provide the experimental background and justification for the theoretical work. The general idea of how explosive field emission cathodes operate is that plasma is rapidly formed, which provides the sea of electrons for space charge limited flow. However, recent theoretical and experimental work suggests edge effects, rather than plasma formation across the entire emission area, can also provide the same effect. In this letter we review three types of cathodes which have been tested. We provide optical data on the cathode emission uniformity as well as the electrical data for the same devices. In particular, we find that a large percentage of the cathode can fail to take part in the emissio...

Thioglycolate-elicited peritoneal macrophages from normal C57B1/6J mice were examined in vitro for bacterial lipopolysaccharide (LPS)-stimulated interleukin-1 (IL-1), IL-6, and tumor necrosis factor (TNF) production. Macrophages from mice administered a single oral dose of levamisole (3 mg/kg) 1 to 4 days prior to macrophage harvest demonstrated a twofold enhancement of IL-1 production compared to vehicle-treated mice. In contrast, IL-6 production and TNF production by the same macrophages were inhibited up to 36 and 62%, respectively, compared to production by macrophages harvested from vehicle-treated mice. Similar results were observed when IL-1 production and TNF production were followed in peritoneal exidate cells directly stimulated with levamisole in vitro. The ex vivo LPS-stimulated IL-1 production was enhanced 4 days after macrophage elicitation, whereas TNF and IL-6 production returned to baseline by 72 h after macrophage recruitment and augmentation. No evidence could be found for the presence of inhibitors of TNF or IL-6. The specificity of the IL-1, IL-6, and TNF bioactivities was demonstrated by neutralization with specific antisera. Immunoprecipitation studies of supernatants from biosynthetically labeled macrophages also revealed augmented IL-1 production and decreased IL-6 and TNF, indicating that levamisole may have affected cytokine production at the translational level. Kinetics studies revealed that ex vivo release of IL-6 and TNF by macrophages from levamisole-dosed mice was delayed compared to production of these cytokines by macrophages harvested from mice given vehicle only. The results may explain, in part, the reported ability of levamisole to ameliorate cases of rheumatoid arthritis or other autoimmune and inflammatory diseases by affecting the relative levels of cytokines produced by macrophages recruited to sites of injury, which are associated with inflammation and acute-phase protein synthesis.

We describe a pulsed power technique in which the conventional pulse forming network (PFN) is replaced with commercial metal oxide varistor (MOV) surge arrestors to provide wave shaping and pulse width control. This results in a very compact, simple system capable of driving a wide range of loads (∼10–10K Ohms) with pulse widths from a few hundred nanoseconds to many microseconds. Because the MOVs are readily stacked in series and in parallel, a wide range of voltages and currents are possible. The high power capability and fast response of MOV allows repetitive pulse operation. In this paper, we describe the concept theory of operation We discuss design techniques and compare circuit simulation to test data from a demonstration system. Finally, we show the first two commercial generators based on this concept.

The effectiveness of n-octyl(phenyl)-N,N′-diisobutylcarbamoyl-methylphosphine oxide, CMPO, as a neutral extractant for the trivalent actinides and lanthanides from strong acid media has been well established. This investigation characterized the use of CMPO as a synergistic agent in the extraction of Am(III) and Eu(III) by thenoyltrifluoroacetone (HTTA). The distributions of the metal ions were measured using radiotracer techniques as functions of HTTA concentration, CMPO concentration and pH. The results show that the presence of CMPO enhances the extraction of Eu(III) and Am(III) by 108. The synergistic adduct was M(TTA)3·CMPO with no indication of higher complexes being formed. Unlike previous studies, the extraction of Eu(III) was more strongly enhanced than that of Am(III). The results showed little, if any, enhancement in the extraction efficiency due to the bidentate nature of the CMPO.

While there are published correlations dealing with average natural convection coefficients from a single horizontal, vertical, or inclined cylinder, there do not appear to be any for vertically stacked inclined cylinders. This study investigates natural convection from parallel inclined cylinders spaced two diameters apart in a low Rayleigh number range and Nusselt-Rayleigh number correlations are presented for this case. Convection coefficients generally decreased for both rods as the angle of inclination increased (from horizontal to vertical) and were consistently higher for the bottom rod in all configurations except vertical. Convection from the top cylinder appears to be impaired at this close spacing. Comparisons of the data to modified versions of various horizontal and one inclined cylinder formulation show that while predicted Nusselt numbers have similar trends, no single equation is a good predictor for both rods in this Rayleigh number range.

A causal functional structure demonstrates how a perpetual process, like caregiving, maintains itself. The caregiver functional learning model was used to identify factors influencing caregivers when maintaining dependent elders in the community. These factors include seriousness of illness, power, burden, care quality, self-assurance, an understanding of the elder's needs, and time spent in caregiving. This five-stage theoretical model was tested using a sample of 70 caregivers. Findings supported two of the theoretical relationships: seriousness of illness (beta = .60) with burden (R2 = 0.35), and self-assurance (beta = .36) with time (R2 = 0.18). Three new relationships were added with the empirical model: power (beta = .48) with burden (R2 = 0.52), seriousness of illness (beta = .36) with self-assurance (R2 = 0.11), and burden (beta = .33) with time (R2 = 0.24). A causal functional structure can be used to explain how the phenomenon of caregiving maintains itself.

A high percentage of the estimated 500,000 traumatic brain injuries (TBI) in the US every year occur with young people who will face many years of neurobehavioral and economic consequences. This study examined the long-term stability of outcome after post-acute TBI rehabilitation and possible predictors of long-term outcome based on a 127-item survey of 332 clients up to 14 years post-discharge. Correlational, factor, and multiple regression analysis indicated positive long-term outcome stability following rehabilitation with the exception of vocational status, which decreased over the same time period. A number of possible explanations for this occupational anomaly are suggested. Rating scale scores and latency-to-rehabilitation proved to be better predictors of long-term outcome than demographic data.

THP-1 myelomonocytic leukemia cells cultured with either macrophage colony-stimulating factor (M-CSF) or interferon-gamma (IFN-gamma) alone produce, at best, only low levels of interleukin-1 beta (IL-1 beta) and tumor necrosis factor alpha (TNF-alpha). However, combinations of the two factors resulted in at least 3- to 20-fold greater amounts of IL-1 beta and TNF-alpha than would have been predicted by additive mechanisms. This enhanced cytokine production was observed when M-CSF and IFN-gamma were added simultaneously or when M-CSF was added 24 h after addition of IFN-gamma to the cells. Similar results were obtained with fresh human peripheral blood cells treated with IFN-gamma + M-CSF. Cycloheximide treatment of the cultures containing M-CSF and IFN-gamma inhibited the production of IL-1 beta and TNF-alpha. Northern blotting studies revealed no effect of IFN-gamma alone on IL-1 beta or TNF-alpha mRNA production. IL-1 beta and TNF-alpha mRNA expression was observed at 2 and 6 h after treatment with M-CSF or IFN-gamma + M-CSF. Higher TNF-alpha mRNA expression was observed at 2 and 6 h after treatment with IFN-gamma + M-CSF, and higher IL-1 beta mRNA expression was observed at 2 h after treatment with IFN-gamma + M-CSF compared with mRNA levels observed for cells cultured only with M-CSF. These results suggest that the augmented cytokine production resulting from treatments with combinations of M-CSF and IFN-gamma occurs due to increased cytokine mRNA and increased cytokine protein synthesis. In addition to up-regulating cytokines, combinations of IFN-gamma and M-CSF resulted in augmented cell surface expression of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1. This was accompanied by morphological and functional changes that included plastic adherence, extensive homotypic aggregation, and a macrophage-like appearance. These phenotypic changes and enhancements in cytokine expression and cell surface molecule expression may be related to activation of monocytic cells to become cytotoxic effectors by M-CSF and IFN-gamma combinations. In vitro cytotoxicity against A-375 melanoma cells was greatest for cultures that contained M-CSF and IFN-gamma in combination.

The enhancement of critical-thinking skills empowers students to participate in the building of healthy environments in a variety of settings. The authors describe the development and implementation of unique classroom strategies emphasizing the use of critical thinking by students, the forging of faculty-student partnerships in community health nursing, and the potential impact of these strategies on the expanding horizons of practice.

We review the progress towards developing epitaxial graphene as a material for carbon electronics. In particular, we discuss improvements in epitaxial graphene growth, interface control and the understanding of multilayer epitaxial graphene's (MEG's) electronic properties. Although graphene grown on both polar faces of SiC will be discussed, our discussions will focus on graphene grown on the C-face of SiC. The unique properties of C-face MEG have become apparent. These films behave electronically like a stack of nearly independent graphene sheets rather than a thin Bernal stacked graphite sample. The origins of multilayer graphene's electronic behaviour are its unique highly ordered stacking of non-Bernal rotated graphene planes. While these rotations do not significantly affect the inter-layer interactions, they do break the stacking symmetry of graphite. It is this broken symmetry that leads to each sheet behaving like isolated graphene planes.

The production of interleukin-1 (IL-1) by the P388D1 mouse macrophage cell line and by adherent peritoneal exudate cells (PMs) was examined. In vitro IL-1 production by P388D1 cells treated with lipopolysaccharide (LPS) was enhanced by coculture with levamisole (0.1 to 10 microM). Oral administration of levamisole (3 mg/kg) to mice also resulted in potentiation of in vitro IL-1 production by thioglycollate-elicited peritoneal macrophages in response to in vitro LPS stimulation. Potentiation was approximately twofold. IL-1 production in the absence of LPS by either the P388D1 cells or the PMs was nil, and levamisole did not directly stimulate IL-1 production in these cases. IL-1 activity in the culture supernatants was measured by thymocyte comitogenic assays. The immunochemical identify of the thymocyte comitogenic activity as IL-1 alpha was confirmed by neutralization with a specific goat anti-mouse IL-1 alpha antiserum. These results suggest that one mechanism by which levamisole acts to normalize and restore immune responses may be enhancing the signals which enable activated macrophages to secrete IL-1.

For steering a linear stochastic system with bounded controls so as to be as close as possible to a given hyperplane at the terminal time, Benes proved that the controller that predicts which side of the hyperplane the state would be on with no further control, and then applies full “bang” in the appropriate direction, optimal, a result conjectured y Hilborn. In this paper a different proof of this result is presented, using martingale-based optimality criteria.

Schmidt discovered in 1925 that an unusual arylation occurred when 1,5-diamino-4,8-dihydroxyanthraquinone-3,7-disulphonic acid dissolved in conc, sulphuric acid containing boric acid was treated with phenols or anisole. Schmidt incorrectly assumed that the p-hydroxyphenyl or anisyl group replaced a sulphonic acid group. It has now been shown that this reaction is a stereospecific Friedel-Crafts type arylation, the aryl moiety entering ortho to the amino group and trans to the sulphonic acid group. The corresponding 3-monosulphonic acid undergoes the same reaction.

The accumulation of hypoxanthine (6-hydroxypurine) in blighted potato leaves and its effect on spore germination in the late blight organism, Phytophthora infestans, were investigated. Preliminary experiments on the translocation of this compound in whole plants and detached leaves were also conducted.Under in vitro and in vivo conditions, hypoxanthine had a pronounced stimulatory effect on the indirect germination of sporangia. Studies on the movement of this base indicate that it is freely translocated, but fails to be exported from detached leaves into aqueous solution. These observations, coupled with the finding that hypoxanthine readily accumulated in blighted leaves, suggest that this compound could be of importance in predisposing uninfected portions of the host to invasion by the pathogen.

Analysis of the distribution of 14C in extracts prepared from leaf tissue which had been exposed to labelled adenine by petiolar uptake revealed that this purine is extensively metabolized in both healthy and Phytophthora-infected potato leaves. Incorporation of labelled adenine into the major ribonucleic acid species of the leaf was also extensive as determined by radioactive assays performed on individual fractions which were separated on columns of methylated albumin kieselguhr. Examination of individual nucleotides released by alkaline hydrolysis showed that both the adenylic and guanylic acid moieties were labelled. Although the labelling patterns were similar for RNA from healthy and infected leaf tissue, the specific activity of the latter was consistently higher than the former. When partially purified leaf extracts were assayed for phosphoribosyltransferase, they exhibited relatively high levels of activity with adenine as substrate, but were virtually devoid of activity with hypoxanthine and guanine. However, direct petiolar uptake of labelled hypoxanthine resulted in highly labelled RNA. A comparison of adenine phosphoribosyltransferase activity in extracts from healthy and blighted leaves failed to reveal measurable differences. Therefore, it was concluded that the differential incorporation of labelled adenine into the RNA of healthy and infected leaves was due neither to increased activity of this enzyme in response to infection nor to its differential activation. Apart from its role in the recovery of preformed purines for nucleic acid synthesis, adenine phosphoribosyltransferase may function as part of a mechanism for regulating levels of adenine in the potato leaf.

All sets mentioned in this paper will be assumed to be appropriately measurable without further comment, and events of probability zero will be neglected. We start with a fixed (large, convex) subset R of the plane, termed the “retina”.

D.C. ice-resistivity measurements on the polar Paris Gletscher in East Greenland are pre­ sented. It is found that the observed profile is well described by a four-layer system. Near the surface there are two layers resulting from the penetration of the summer temperatures into the polar ice. Below this the ice has constant resistivity until the bed is reached, where contrary to expectation a high-resistivity layer is found. ZUSAMMENFASSUNG. Widerstandsmessungen im Eis des Paris Cletscher, Ost-Croenland. Gleichstromwiderstands­ messungen im Eise des polaren Paris Gletscher in Ost-Groenland werden vorgelegt. Es ergibt sich, dass das beobachtete Profil gut durch ein System von 4 Schichten beschrieben werden kann. Nahe d er Oberflache wurden 2 Schichten gefunden, die durch das Eindringen der Sommertemperaturen in das Polareis entstanden sind. Darunter hat das Eis bis zum Untergrund konsta nten Widerstand. Wider Erwarten befindet sich dort eine Schicht mit hohem Widerstand.

The operation of a foilless diode to generate a hollow relativistic electron beam has been performed on the FX-25, a Van de Graaff charged 3 MV device. The diode consists of a cylinder of carbon (graphite) supporting either a cathode tip of larger diameter or a right circular cylinder of equal diameter and a coaxial anode guide wall having either an abrupt discontinuity in wall diameter or a smooth wall. Six configurations were employed to explore the emitted electron behavior in the crossed electric and magnetic fields. Finite gyroradius effects limit the transmitted current at low applied axial magnetic field strengths. The transmitted current increases with increasing field strength until a critical field is reached, when further increase in field strength results in a decrease to a plateau in transmitted current. This critical field produces an electron gyroradius equal to the gap between cathode guide wall (anode) and is found to satisfy ?c > 2 ?b where ?c is the electron gyro-frequency and ?b is the beam plasma frequency. At high applied field strengths a very thin beam is transmitted and bounded by the space charge limited current. These features agree qualitatively with recent computer simulations of Jones and Thode.

We report the first detailed x‐ray spectroscopic data from a fast (1.1 μsec) high‐energy (400 kJ) implosion of an aluminized formvar liner. The high‐energy (≳1 keV) x‐ray data indicate a 400‐eV electron temperature and a 3×1020 cm−3 electron density. These parameters pertain to the highest‐energy component of the radiation spectrum.

Schmidt discovered in 1925 that an unusual arylation occurred when 1,5-diamino-4,8-dihydroxyanthraquinone-3,7-disulphonic acid dissolved in conc, sulphuric acid containing boric acid was treated with phenols or anisole. Schmidt incorrectly assumed that the p-hydroxyphenyl or anisyl group replaced a sulphonic acid group. It has now been shown that this reaction is a stereospecific Friedel-Crafts type arylation, the aryl moiety entering ortho to the amino group and trans to the sulphonic acid group. The corresponding 3-monosulphonic acid undergoes the same reaction.

A 22-yr-old man developed severe pulmonary edema after blowing air into tubing connected to a catheter inserted in a vein in his forearm. Pulmonary edema was rapid in onset, peaking in intensity about 12 h after the air had been insufflated. The patient's edema fluid to plasma protein concentration ratio of 0.79 showed that the edema fluid was rich in protein. Vascular pressures were normal except for mild pulmonary arterial hypertension and systemic hypotension. The patient's clinical course, edema fluid protein concentration, and vascular pressures were characteristic of an increased microvascular permeability type of pulmonary edema. The patient recovered fully within 48 h of the air infusion. His response to venous air embolism was similar to findings in an experimental model of pulmonary edema in sheep infused with venous air emboli. As long as air is not infused continuously for long periods or in very large amounts, this disorder is probably self-limiting, and supportive care may be the only treatment necessary.

Ce nouveau cas rapporte presente une deletion particulierement grande (q11→q15) chez un garcon de 9 mois avec plusieurs anomalies congenitales. Deux autres cas ont ete rapportes montrant des deletions du chromosome 6 (q13.q15) chez des enfants de 3 a 4 ans. Tous ces cas presentent un retard mental psychomoteur, un poids de naissance bas, problemes d'alimentation, hernies

In recent years a variety of alternative theoretical models have been developed to aid our understanding and to guide research in this area. This essay considers in particular the psychiatric model and the social interactional model of child abuse, together with research studies comparing physically abusive and non-abusive families. It will be concluded that research has pinpointed several important distinguishing features in the behaviour of abusive versus non-abusive families. A pattern of behaviour with their child is displayed by abusers that is proportionately more aversive than for non-abusers, and observations of parent-child interactions have revealed qualitative differences in patterns of interaction which seem to be a significant factor in the differentiation of abusive from non-abusive families.

A method has been developed to produce seamless, freestanding plastic cylinders with dimensions up to 18 cm in diameter, 4 cm in height and with mass density from 15 mug/cm to 300 mug/cm (approximately 0.15 to 3 mu thick). The polyvinyl formal resin may be subsequently coated with a variety of material by vapor deposition. The method employs standard thin-foil fabrication techniques modified for use in cylindrical geometry and results in uniform reproducible cylinders.