Acute exacerbations of chronic obstructive pulmonary disease (COPD) are a major source of morbidity and contribute significantly to healthcare costs. Although bacterial infections are implicated in nearly 50% of exacerbations, only a handful of pathogens have been consistently identified in COPD airways, primarily by culturebased methods, and the bacterial microbiota in acute exacerbations remains largely uncharacterized. The aim of this study was to comprehensively profile airway bacterial communities using a culture-independent microarray, the 16S rRNA PhyloChip, of a cohort of COPD patients requiring ventilatory support and antibiotic therapy for exacerbation-related respiratory failure. PhyloChip analysis revealed the presence of over 1,200 bacterial taxa representing 140 distinct families, many previously undetected in airway diseases; bacterial community composition was strongly influenced by the duration of intubation. A core community of 75 taxa was detected in all patients, many of which are known pathogens. Bacterial community diversity in COPD airways is substantially greater than previously recognized and includes a number of potential pathogens detected in the setting of antibiotic exposure. Comprehensive assessment of the COPD airway microbiota using high-throughput, culture-independent methods may prove key to understanding the relationships between airway bacterial colonization, acute exacerbation, and clinical outcomes in this and other chronic inflammatory airway diseases.
Poly(3-hexylthiophene) (P3HT) in trichlorobenzene solution self-assembles and exhibits liquid crystal ordering when confined to rectangular capillaries. The relative proportion of polymer assemblies increases with time, as determined by UV−vis spectroscopic analysis. Polarized optical microscopy (POM) reveals development of birefringence and monodomainlike long-range ordering. Micro-Raman spectroscopy was used to calculate the orientational order parameters, ⟨P 2 ⟩ and ⟨P 4 ⟩, of the liquid-crystalline P3HT solutions. The order parameter ⟨P 2 ⟩ increased with time up to 0.35, indicating increased anisotropy. The calculated depolarization ratio (ρ v ) from depolarized dynamic light scattering measurements points to the time-dependent formation of highly ordered P3HT nanostructures, whereas cryogenic transmission electron microscopy was employed for the direct visualization of the rodlike assemblies. POM shows that the observed anisotropy can be preserved in P3HT films drawn from aged solutions. These results suggest that P3HT self-assembly leads to a liquid-crystalline solution of conjugated polymer aggregates, which may lead to a viable approach for optimization of processes for organic electronic device applications. Such ordered and oriented conjugated polymer assemblies have many desirable attributes for high-performance device applications, where the ability to control nanothrough macroscale molecular ordering is required.
Background: Alcohol consumption is commonly used as a primary outcome in randomized alcohol treatment studies. The distribution of alcohol consumption is highly skewed, particularly in subjects with alcohol dependence.
This study describes pain experience, analgesic use and barriers to pain control in African American cancer patients (N = 116). The overall adherence rate of analgesics was 46%. Constipation and nausea were the most commonly cited side effects of analgesics. Eighty-seven percent of patients reported concern about addiction to analgesics. Patients who believed their doctor needed to focus on curing illness rather than on controlling pain tended to comply with analgesic prescriptions (r = 0.20, p < 0.05). Patients with concerns that analgesics may cause confusion were less likely to take any type of analgesics (r = -0.16, p < 0.05). The study confirms that a patient's perceived barriers influence their decision to take analgesics, and also suggests that African American cancer patients may benefit from education that prevents misconceptions about analgesic use.
The role of antibodies in chronic injury to organ transplants has been suggested for many years, but recently emphasized by new data. We have observed that when immunosuppressive potency decreases either by intentional weaning of maintenance agents or due to homeostatic repopulation after immune cell depletion, the threshold of B cell activation may be lowered. In human transplant recipients the result may be donor-specific antibody, C4d+ injury, and chronic rejection. This scenario has precise parallels in a rhesus monkey renal allograft model in which T cells are depleted with CD3 immunotoxin, or in a CD52-T cell transgenic mouse model using alemtuzumab to deplete T cells. Such animal models may be useful for the testing of therapeutic strategies to prevent DSA. We agree with others who suggest that weaning of immunosuppression may place transplant recipients at risk of chronic antibody-mediated rejection, and that strategies to prevent this scenario are needed if we are to improve long-term graft and patient outcomes in transplantation. We believe that animal models will play a crucial role in defining the pathophysiology of antibody-mediated rejection and in developing effective therapies to prevent graft injury. Two such animal models are described herein.
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