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1.
Proc Natl Acad Sci U S A ; 121(19): e2319937121, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38696469

RESUMO

Subtropical oceans contribute significantly to global primary production, but the fate of the picophytoplankton that dominate in these low-nutrient regions is poorly understood. Working in the subtropical Mediterranean, we demonstrate that subduction of water at ocean fronts generates 3D intrusions with uncharacteristically high carbon, chlorophyll, and oxygen that extend below the sunlit photic zone into the dark ocean. These contain fresh picophytoplankton assemblages that resemble the photic-zone regions where the water originated. Intrusions propagate depth-dependent seasonal variations in microbial assemblages into the ocean interior. Strikingly, the intrusions included dominant biomass contributions from nonphotosynthetic bacteria and enrichment of enigmatic heterotrophic bacterial lineages. Thus, the intrusions not only deliver material that differs in composition and nutritional character from sinking detrital particles, but also drive shifts in bacterial community composition, organic matter processing, and interactions between surface and deep communities. Modeling efforts paired with global observations demonstrate that subduction can flux similar magnitudes of particulate organic carbon as sinking export, but is not accounted for in current export estimates and carbon cycle models. Intrusions formed by subduction are a particularly important mechanism for enhancing connectivity between surface and upper mesopelagic ecosystems in stratified subtropical ocean environments that are expanding due to the warming climate.


Assuntos
Bactérias , Oceanos e Mares , Água do Mar , Água do Mar/microbiologia , Água do Mar/química , Bactérias/metabolismo , Carbono/metabolismo , Ciclo do Carbono , Clorofila/metabolismo , Ecossistema , Fitoplâncton/metabolismo , Estações do Ano , Biomassa , Microbiota/fisiologia , Oxigênio/metabolismo
2.
bioRxiv ; 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38559276

RESUMO

Adaptive immune cells are regulated by circadian rhythms (CR) under both steady state conditions and during responses to infection. Cytolytic CD8 + T cells display variable responses to infection depending upon the time of day of exposure. However, the neuronal signals that entrain these cyclic behaviors remain unknown. Immune cells express a variety of neurotransmitter receptors including nicotinic, glucocorticoid, and adrenergic receptors. Here, we demonstrate that the ß2-adrenergic receptor (ADRB2) regulates the periodic oscillation of select core clock genes, such as Per2 and Bmal1 , and selective loss of the Adrb2 gene dramatically perturbs the normal diurnal oscillation of clock gene expression in CD8 + T cells. Consequently, their circadian-regulated anti-viral response is dysregulated, and the diurnal development of CD8 + T cells into variegated populations of cytolytic T cell (CTL) effectors is dramatically altered in the absence of ADRB2 signaling. Thus, the Adrb2 directly entrains core clock gene oscillation and regulates CR-dependent T cell responses to virus infection as a function of time-of-day of pathogen exposure. One Sentence Summary: The ß2-adrenergic receptor regulates circadian gene oscillation and downstream daily timing of cytolytic T cell responses to virus infection.

3.
Front Immunol ; 14: 1271098, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38022663

RESUMO

Sepsis is a major health problem in the United States (US), constituting a leading contributor to mortality among critically ill patients. Despite advances in treatment the underlying pathophysiology of sepsis remains elusive. Reactive oxygen species (ROS) have a significant role in antimicrobial host defense and inflammation and its dysregulation leads to maladaptive responses because of excessive inflammation. There is growing evidence for crosstalk between the central nervous system and the immune system in response to infection. The hypothalamic-pituitary and adrenal axis and the sympathetic nervous system are the two major pathways that mediate this interaction. Epinephrine (Epi) and norepinephrine (NE), respectively are the effectors of these interactions. Upon stimulation, NE is released from sympathetic nerve terminals locally within lymphoid organs and activate adrenoreceptors expressed on immune cells. Similarly, epinephrine secreted from the adrenal gland which is released systemically also exerts influence on immune cells. However, understanding the specific impact of neuroimmunity is still in its infancy. In this review, we focus on the sympathetic nervous system, specifically the role the neurotransmitter norepinephrine has on immune cells. Norepinephrine has been shown to modulate immune cell responses leading to increased anti-inflammatory and blunting of pro-inflammatory effects. Furthermore, there is evidence to suggest that norepinephrine is involved in regulating oxidative metabolism in immune cells. This review attempts to summarize the known effects of norepinephrine on immune cell response and oxidative metabolism in response to infection.


Assuntos
Norepinefrina , Sepse , Humanos , Norepinefrina/metabolismo , Epinefrina , Inflamação , Estresse Oxidativo
4.
J Affect Disord ; 325: 55-61, 2023 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-36586601

RESUMO

BACKGROUND: The suicide rate in youth and young adults continues to climb - we do not understand why this increase is occurring, nor do we have adequate tools to predict or prevent it. Increased efforts to treat underlying depression and other disorders that are highly associated with suicide have had limited impact, despite considerable financial investments in developing and disseminating available methods. Thus, there is a tremendous need to identify potential markers of suicide behavior for youth during this high-risk period. METHODS: Funded by the American Foundation for Suicide Prevention (AFSP), this study aims to map immune dysfunction to suicidal behavior and establish a reliable immune signature of suicide risk that can 1) guide future research into fundamental pathophysiology and 2) identify targets for drug development. The study design is an observational study where blood samples and a comprehensive array of clinical measures are collected from three groups of adolescents (n = 75 each) (1) with suicidal behavior [recent (within 3 months) suicide attempt or suicidal ideation warranting urgent evaluation,] (2) at risk for mood disorders, and (3) who are healthy (no psychiatric history). Participants will complete self-report and clinical assessments, along with a blood draw, at baseline, 3 months, 6 months and 12 months, and online self-report assessments once a month. RESULTS: The recruitment for this study is ongoing. LIMITATIONS: Observational, variability in treatment regimens. CONCLUSIONS: This study will help elucidate immune mechanisms that may play a causal role in suicide and serve as targets for future therapeutic development.


Assuntos
Ideação Suicida , Tentativa de Suicídio , Adulto Jovem , Humanos , Adolescente , Fatores de Risco , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/psicologia , Transtornos do Humor/psicologia , Prevenção do Suicídio
5.
Clim Dyn ; 59(9-10): 2887-2913, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36196258

RESUMO

High-frequency precipitation variance is calculated in 12 different free-running (non-data-assimilative) coupled high resolution atmosphere-ocean model simulations, an assimilative coupled atmosphere-ocean weather forecast model, and an assimilative reanalysis. The results are compared with results from satellite estimates of precipitation and rain gauge observations. An analysis of irregular sub-daily fluctuations, which was applied by Covey et al. (Geophys Res Lett 45:12514-12522, 2018. 10.1029/2018GL078926) to satellite products and low-resolution climate models, is applied here to rain gauges and higher-resolution models. In contrast to lower-resolution climate simulations, which Covey et al. (2018) found to be lacking with respect to variance in irregular sub-daily fluctuations, the highest-resolution simulations examined here display an irregular sub-daily fluctuation variance that lies closer to that found in satellite products. Most of the simulations used here cannot be analyzed via the Covey et al. (2018) technique, because they do not output precipitation at sub-daily intervals. Thus the remainder of the paper focuses on frequency power spectral density of precipitation and on cumulative distribution functions over time scales (2-100 days) that are still relatively "high-frequency" in the context of climate modeling. Refined atmospheric or oceanic model grid spacing is generally found to increase high-frequency precipitation variance in simulations, approaching the values derived from observations. Mesoscale-eddy-rich ocean simulations significantly increase precipitation variance only when the atmosphere grid spacing is sufficiently fine (< 0.5°). Despite the improvements noted above, all of the simulations examined here suffer from the "drizzle effect", in which precipitation is not temporally intermittent to the extent found in observations.

6.
Brain Behav Immun Health ; 25: 100499, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36120101

RESUMO

Background: To address the need to identify potential markers of suicide behavior for adolescents (ages 12-18 years), mass cytometry was used to explore the cellular mechanisms that may underpin immune dysregulation in adolescents with recent suicidal behavior. Methods: Peripheral blood mononuclear cell (PBMC) samples from 10 female adolescents with a recent suicide attempt and 4 healthy female adolescents were used. A panel of 30 antibodies was analyzed using mass cytometry. We used two complementary approaches to 1) identify the cell types that significantly differed between the two groups, and 2) explore differences in the expression profile of markers on the surface of these cells. Mass cytometry data were investigated using (Center for Disease Control, 2021) Opt-SNE for dimension reduced (Curtin and Heron, 2019), FlowSOM for clustering, and (Bridge et al., 2006) EgdeR and SAM for statistical analyses. Results: Opt-SNE (a data driven clustering analysis) identified 15 clusters of distinct cell types. From these 15 clusters, cluster 5 (classical monocytes) had statistically lower abundance in suicidal adolescents as compared to healthy controls, whereas cluster 7 (gamma-delta T cells) had statistically higher abundance in suicidal adolescents compared to healthy control. Furthermore, across the 15 cell types, chemokine receptors, CXCR3 (cluster 5) and CXCR5 (clusters 4, 5, 7, and 9), had an elevated expression profile in those with a recent suicide attempt versus healthy controls. Conclusion: This report demonstrates the utility of high dimensional cell phenotyping in psychiatric disorders and provides preliminary evidence for distinct immune dysfunctions in adolescents with recent suicide attempts as compared to healthy controls.

7.
PLoS One ; 17(8): e0272017, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35944008

RESUMO

Norepinephrine is a key sympathetic neurotransmitter, which acts to suppress CD8 + T cell cytokine secretion and lytic activity by signaling through the ß2-adrenergic receptor (ADRB2). Although ADRB2 signaling is considered generally immunosuppressive, its role in regulating the differentiation of effector T cells in response to infection has not been investigated. Using an adoptive transfer approach, we compared the expansion and differentiation of wild type (WT) to Adrb2-/- CD8 + T cells throughout the primary response to vesicular stomatitis virus (VSV) infection in vivo. We measured the dynamic changes in transcriptome profiles of antigen-specific CD8 + T cells as they responded to VSV. Within the first 7 days of infection, WT cells out-paced the expansion of Adrb2-/- cells, which correlated with reduced expression of IL-2 and the IL-2Rα in the absence of ADRB2. RNASeq analysis identified over 300 differentially expressed genes that were both temporally regulated following infection and selectively regulated in WT vs Adrb2-/- cells. These genes contributed to major transcriptional pathways including cytokine receptor activation, signaling in cancer, immune deficiency, and neurotransmitter pathways. By parsing genes within groups that were either induced or repressed over time in response to infection, we identified three main branches of genes that were differentially regulated by the ADRB2. These gene sets were predicted to be regulated by specific transcription factors involved in effector T cell development, such as Tbx21 and Eomes. Collectively, these data demonstrate a significant role for ADRB2 signaling in regulating key transcriptional pathways during CD8 + T cells responses to infection that may dramatically impact their functional capabilities and downstream memory cell development.


Assuntos
Adrenérgicos , Viroses , Transferência Adotiva , Animais , Linfócitos T CD8-Positivos , Humanos , Camundongos , Camundongos Endogâmicos C57BL , Transdução de Sinais , Viroses/metabolismo
8.
Geophys Res Lett ; 49(2): e2021GL095920, 2022 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-35860604

RESUMO

The total rate of work done on the ocean by the wind is of considerable interest for understanding global energy balances, as the energy from the wind drives ocean currents, grows surface waves, and forces vertical mixing. A large but unknown fraction of this atmospheric energy is dissipated by turbulence in the upper ocean. The focus of this work is twofold. First, we describe a framework for evaluating the vertically integrated turbulent kinetic energy (TKE) equation using measurable quantities from a surface mooring, showing the connection to the atmospheric, mean oceanic, and wave energy. Second, we use this framework to evaluate turbulent energetics in the mixed layer using 10 months of mooring data. This evaluation is made possible by recent advances in estimating TKE dissipation rates from long-enduring moorings. We find that surface fluxes are balanced by TKE dissipation rates in the mixed layer to within a factor of two.

9.
Environ Toxicol Chem ; 41(5): 1260-1275, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35349191

RESUMO

Standard bioaccumulation tests are commonly conducted using Macoma nasuta (clam), and Alitta virens (polychaete) for marine tests, and Lumbriculus variegatus (an oligochaete) for freshwater tests. Because the interlaboratory variability associated with these tests is unknown, four experienced laboratories conducted standard 28-day bioaccumulation tests with the above species using sediments contaminated with polychlorinated biphenyls (PCBs) and polycyclic aromatic hydrocarbons (PAHs). Chemical analysis of tissue samples was performed by a single laboratory. The intralaboratory variance among replicates was relatively low for PCB tissue concentrations, with coefficients of variation (CVs) ranging from 9% to 28% for all laboratories and species, with the exception of one laboratory reporting higher variability for L. variegatus (CV = 51%). Intralaboratory variance for PCB tissue concentrations was higher than interlaboratory variance for A. virens and L. variegatus, and the magnitude of difference (MOD) for laboratory means ranged from 1.4 to 2.0 across species. Intralaboratory variability was also low for lipid content, and lipid normalization of PCB and PAH body residues generally had little impact on variability. In addition to variability across bioassay laboratories, analytical variability was evaluated by different laboratories measuring the concentration of PCBs and total lipids in a subsample of tissue homogenate of sediment-exposed test organisms. Variability associated with tissue analysis was higher than bioassay laboratory variability only in tests with L. variegatus. Statistical differences between samples may be observed due to the low intralaboratory variability; however, the biological significance of these differences may be limited because the MOD is low. Considering the MOD when comparing bioaccumulation across treatments accounts for uncertainty related to inherent variability of the test in the interpretation of statistically significant results. Environ Toxicol Chem 2022;41:1260-1275. © 2022 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC. This article has been contributed to by US Government employees and their work is in the public domain in the USA.


Assuntos
Bivalves , Oligoquetos , Bifenilos Policlorados , Poluentes Químicos da Água , Animais , Bioacumulação , Sedimentos Geológicos/química , Lipídeos/análise , Bifenilos Policlorados/análise , Poluentes Químicos da Água/análise
10.
Osteoarthritis Cartilage ; 30(4): 545-550, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34801670

RESUMO

OBJECTIVE: Knee osteoarthritis (OA) is predominantly characterized by pain with weight-bearing activities. Pain at rest also occurs but the mechanisms for this are not clear. We evaluated the relations of nociceptive signal alterations to weight-bearing and non-weight-bearing pain in knee OA. DESIGN: We used data from a NIH-funded longitudinal cohort of older adults with or at risk of knee OA. We evaluated quantitative sensory testing (QST) measures (pressure pain threshold (PPT) at patellae and the wrist; mechanical temporal summation (TS); conditioned pain modulation (CPM)). Each WOMAC pain question was dichotomized as having at least moderate pain, and we further categorized them as weight-bearing pain and non-weight-bearing pain. We evaluated the relation of QST measures to each pain outcome using logistic regression, adjusting for potential confounders. RESULTS: 2,749 participants (5,479 knees) were included (mean age 64 ± 11, 57% female). Each SD unit decrease in patellar PPT was associated with greater odds of both weight-bearing pain (OR 1.51 (95% CI 1.27, 1.79)) and non-weight-bearing pain (OR 1.46 (1.20-1.77)), while wrist PPT was associated with greater odds of weight-bearing pain (OR 1.27 (1.15, 1.39)) but only with pain during sitting/lying (OR 1.20 (1.01, 1.43)). TS was significantly associated with greater odds of pain with walking and stairs (OR 1.11 (1.01, 1.23), 1.11 (1.03, 1.20), respectively). CPM was not associated with any pain outcomes. CONCLUSIONS: Our findings challenge the hypothesis that non-weight-bearing pain may reflect greater pain sensitization and/or inefficient CPM than weight-bearing pain in knee OA, suggesting other mechanisms are likely responsible.


Assuntos
Osteoartrite do Joelho , Idoso , Artralgia/etiologia , Feminino , Humanos , Articulação do Joelho , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/complicações , Dor/etiologia , Limiar da Dor , Suporte de Carga
11.
J Immunother Cancer ; 9(12)2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34880115

RESUMO

Immune-related adverse events (irAE) may affect almost any organ system and occur at any point during treatment with immune checkpoint inhibitors (ICI). We present a patient with advanced lung cancer receiving antiprogrammed death 1 checkpoint inhibitor who developed a delayed-onset visual irAE treated with corticosteroids. Through assessment of longitudinal biospecimens, we analyzed serial autoantibodies, cytokines, and cellular populations. Months after ICI initiation and preceding clinical toxicity, the patient developed broad increases in cytokines (most notably interleukin-6 (IL-6), interferon-γ (IFNγ), C-X-C motif chemokine ligand 2 (CXCL2), and C-C motif chemokine ligand 17 (CCL17)), autoantibodies (including anti-angiotensin receptor, α-actin, and amyloid), CD8 T cells, and plasmablasts. Such changes were not observed in healthy controls and ICI-treated patients without irAE. Administration of corticosteroids resulted in immediate and profound decreases in cytokines, autoantibodies, and inflammatory cells. This case highlights the potential for late-onset changes in humoral and cellular immunity in patients receiving ICI. It also demonstrates the biologic effects of corticosteroids on these parameters. Application of humoral and cellular immune biomarkers across ICI populations may inform toxicity monitoring and management.


Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Antineoplásicos Imunológicos/efeitos adversos , Neoplasias Encefálicas/tratamento farmacológico , Carcinoma de Células Escamosas/tratamento farmacológico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Encefálicas/secundário , Carcinoma de Células Escamosas/patologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Feminino , Humanos , Neoplasias Pulmonares/patologia , Pessoa de Meia-Idade
12.
Environ Toxicol Chem ; 40(6): 1673-1677, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33595113

RESUMO

When terminating sediment bioaccumulation tests with the oligochaete Lumbriculus variegatus, varying amounts of detrital material are retained along with the recovered worms after sieving, necessitating time-consuming, labor-intensive manual separation of worms from detritus prior to tissue residue analysis. A method to facilitate the worms self-extracting out of the detrital material into a column of gravel was developed, resulting in approximately 90% recovery test organisms (on a mass basis) at test termination. Following exposure to contaminated sediment, polychlorinated biphenyl tissue residues and residual sediment in the gut of self-extracted animals were not significantly different compared to worms recovered by manual separation followed by purging of gut contents. Environ Toxicol Chem 2021;40:1673-1677. Published 2021. This article is a U.S. Government work and is in the public domain in the USA.


Assuntos
Oligoquetos , Poluentes Químicos da Água , Animais , Bioacumulação , Bioensaio , Água Doce/química , Sedimentos Geológicos/química , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/toxicidade
14.
Semin Immunopathol ; 42(6): 667-668, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33252709
15.
Semin Immunopathol ; 42(6): 709-717, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33219396

RESUMO

The sympathetic nervous system integrates the functions of multiple organ systems by regulating their autonomic physiological activities. The immune system is regulated both locally and systemically by the neurotransmitters epinephrine and norepinephrine secreted by the adrenal gland and local sympathetic neurons. Immune cells respond by activation of adrenergic receptors, primarily the ß2-adrenergic receptor, which signal through heterotrimeric G-proteins. Depending upon the cell type, adrenergic signaling regulates a variety of functions in immune cells ranging from cellular migration to cytokine secretion. Furthermore, due to the diurnal oscillation of systemic norepinephrine levels, various immune functions follow a circadian rhythmic pattern. This review will highlight recent advances in our understanding of how the sympathetic nervous system regulates both innate and adaptive immune functions and how this regulation is linked to circadian rhythms.


Assuntos
Adrenérgicos , Sistema Imunitário , Humanos , Inflamação , Norepinefrina , Receptores Adrenérgicos , Sistema Nervoso Simpático
16.
Eur J Immunol ; 50(10): 1550-1559, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32383224

RESUMO

Rhinovirus (RV) infections are linked to the development and exacerbation of allergic diseases including allergic asthma. IgE, another contributor to atopic disease pathogenesis, has been shown to regulate DC antiviral functions and influence T cell priming by monocytes. We previously demonstrated that IgE-mediated stimulation of monocytes alters multiple cellular functions including cytokine secretion, phagocytosis, and influenza-induced Th1 development. In this study, we investigate the effects of IgE-mediated stimulation on monocyte-driven, RV-induced T cell development utilizing primary human monocyte-T cell co-cultures. We demonstrate that IgE crosslinking of RV-exposed monocytes enhances monocyte-driven Th2 differentiation. This increase in RV-induced Th2 development was regulated by IgE-mediated inhibition of virus-induced type I IFN and induction of IL-10. These findings suggest an additional mechanism by which two clinically significant risk factors for allergic disease exacerbations-IgE-mediated stimulation and rhinovirus infection-may synergistically promote Th2 differentiation and allergic inflammation.


Assuntos
Hipersensibilidade/imunologia , Imunoglobulina E/metabolismo , Interleucina-10/metabolismo , Monócitos/imunologia , Infecções por Picornaviridae/imunologia , Rhinovirus/imunologia , Células Th2/imunologia , Diferenciação Celular , Células Cultivadas , Técnicas de Cocultura , Humanos , Hipersensibilidade/epidemiologia , Interferon Tipo I/metabolismo , Ativação Linfocitária , Infecções por Picornaviridae/epidemiologia , Risco , Estados Unidos/epidemiologia
17.
J Dent Res ; 99(7): 777-786, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32286125

RESUMO

Postsurgical dental pain is mainly driven by inflammation, particularly through the generation of prostaglandins via the cyclooxygenase system. Thus, it is no surprise that numerous randomized placebo-controlled trials studying acute pain following the surgical extraction of impacted third molars have demonstrated the remarkable efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen sodium, etodolac, diclofenac, and ketorolac in this prototypic condition of acute inflammatory pain. Combining an optimal dose of an NSAID with an appropriate dose of acetaminophen appears to further enhance analgesic efficacy and potentially reduce the need for opioids. In addition to being on average inferior to NSAIDs as analgesics in postsurgical dental pain, opioids produce a higher incidence of side effects in dental outpatients, including dizziness, drowsiness, psychomotor impairment, nausea/vomiting, and constipation. Unused opioids are also subject to misuse and diversion, and they may cause addiction. Despite these risks, some dental surgical outpatients may benefit from a 1- or 2-d course of opioids added to their NSAID regimen. NSAID use may carry significant risks in certain patient populations, in which a short course of an acetaminophen/opioid combination may provide a more favorable benefit versus risk ratio than an NSAID regimen.


Assuntos
Analgésicos Opioides , Dor Pós-Operatória/tratamento farmacológico , Preparações Farmacêuticas , Analgésicos Opioides/efeitos adversos , Anti-Inflamatórios não Esteroides/efeitos adversos , Diclofenaco , Humanos
18.
Am J Surg ; 220(4): 1076-1082, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32139102

RESUMO

AIM: To compare the efficacy of Negative Pressure Wound Therapy (NPWT) with and without irrigation with 0.1% polyhexanide-betaine. METHODS: We randomized 150 subjects in a 16-week RCT to compare healing in patients with diabetic foot infections. NPWT delivered at 125 mm Hg continuous pressure. NPWT-I were administered at 30 cc per hour. RESULTS: There were no differences clinical treatment or outcomes: wound area after surgery (18.5 ± 19.0 vs. 13.4 ± 11.1 cm2, p = 0.50), duration of antibiotics (39.7 ± 21.0 vs. 38.0 ± 24.6 days, p = 0.40), number of surgeries (2.3 ± 0.67 vs. 2.2 ± 0.59, p = 0.85), duration of NPWT (148.1 ± 170.4 vs. 114.5 ± 135.1 h, p = 0.06), healed wounds (58.7% vs. 60.0%, p = 0.86), time to healing (56.3 ± 31.7 vs. 50.7 ± 27.8, p = 0.53), length of stay (13.8 ± 6.4 vs. 14.5 ± 11.2 days, p = 0.42), re-infection (20.0% vs. 22.7%, p = 0.69, and re-hospitalization (17.3% vs. 18.7, p = 0.83). CONCLUSIONS: The addition of irrigation to NPWT did not change clinical outcomes in patients with diabetic foot infections. CLINICAL TRIAL NUMBER: NCT02463487, ClinicalTrials.gov.


Assuntos
Biguanidas/administração & dosagem , Pé Diabético/terapia , Tratamento de Ferimentos com Pressão Negativa/métodos , Irrigação Terapêutica/métodos , Cicatrização , Administração Tópica , Adulto , Desinfetantes/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
20.
J Geophys Res Oceans ; 124(8): 5723-5746, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31763113

RESUMO

Estimates of the kinetic energy transfer from the wind to the ocean are often limited by the spatial and temporal resolution of surface currents and surface winds. Here we examine the wind work in a pair of global, very high-resolution (1/48° and 1/24°) MIT general circulation model simulations in Latitude-Longitude-polar Cap (LLC) configuration that provide hourly output at spatial resolutions of a few kilometers and include tidal forcing. A cospectrum analysis of wind stress and ocean surface currents shows positive contribution at large scales (>300 km) and near-inertial frequency and negative contribution from mesoscales, tidal frequencies, and internal gravity waves. Larger surface kinetic energy fluxes are in the Kuroshio in winter at large scales (40 mW/m2) and mesoscales (-30 mW/m2). The Kerguelen region is dominated by large scale (∼20 mW/m2), followed by inertial oscillations in summer (13 mW/m2) and mesoscale in winter (-12 mW/m2). Kinetic energy fluxes from internal gravity waves (-0.1 to -9.9 mW/m2) are generally stronger in summer. Surface kinetic energy fluxes in the LLC simulations are 4.71 TW, which is 25-85% higher than previous global estimates from coarser (1/6-1/10°) general ocean circulation models; this is likely due to improved representation of wind variability (6-hourly, 0.14°, operational European Center for Medium-Range Weather Forecasts). However, the low wind power input to the near-inertial frequency band obtained with LLC (0.16 TW) compared to global slab models suggests that wind variability on time scales less than 6 hr and spatial scales less than 15 km are critical to better representing the wind power input in ocean circulation models.

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