High Glucose Levels Promote Switch to Synthetic Vascular Smooth Muscle Cells via Lactate/GPR81.

Hyperglycemia, lipotoxicity, and insulin resistance are known to increase the secretion of extracellular matrix from cardiac fibroblasts as well as the activation of paracrine signaling from cardiomyocytes, immune cells, and vascular cells, which release fibroblast-activating mediators. However, their influences on vascular smooth muscle cells (vSMCs) have not been well examined. This study aimed to investigate whether contractile vascular vSMCs could develop a more synthetic phenotype in response to hyperglycemia.

A Novel Meander Line Metamaterial Absorber Operating at 24 GHz and 28 GHz for the 5G Applications.

Fifth generation (5G) communication systems deploy a massive MIMO technique to enhance gain and spatial multiplexing in arrays of 16 to 128 antennas. In these arrays, it is critical to isolate the adjacent antennas to prevent unwanted interaction between them. Fifth generation absorbers, in this regard, are the recent interest of many researchers nowadays.

Relationship Between the Efficacy of Cardiac Cell Therapy and the Inhibition of Differentiation of Human iPSC-Derived Nonmyocyte Cardiac Cells Into Myofibroblast-Like Cells.

Rationale: Myofibroblasts are believed to evolve from precursor cells; however, whether noncardiomyocyte cardiac cells (NMCCs; ie, endothelial cells, smooth muscle cells, pericytes, and fibroblasts) that have been derived from human-induced pluripotent stem cells (hiPSCs) can transdifferentiate into myofibroblast-like cells, and if so, whether this process reduces the efficacy of hiPSC-NMCC therapy, is unknown.

Objective: To determine whether hiPSC-NMCCs can differentiate to myofibroblast-like cells and whether limiting the transdifferentiation of hiPSC-NMCCs can improve their effectiveness for myocardial repair.

Methods And Results: When endothelial cells, smooth muscle cells, pericytes, and fibroblasts that had been generated from hiPSCs were cultured with TGF-β (transforming growth factor-β), the expression of myofibroblast markers increased, whereas endothelial cell, smooth muscle cell, pericyte, and fibroblast marker expression declined.

Redesigning primary care in the safety net: A qualitative analysis of team-based care implementation.

Background: Team-based care is an innovative approach to primary care in which groups of health care professionals work collaboratively to manage care for groups of patients. Safety-net organizations face specific barriers to implementing health care innovations. More research is needed that documents the dynamics that inform implementation and sustainment of innovative practices in the safety net.

Accurate Measurement In California's Safety-Net Health Systems Has Gaps And Barriers.

Patient safety in ambulatory care has not been routinely measured. California implemented a pay-for-performance program in safety-net hospitals that incentivized measurement and improvement in key areas of ambulatory safety: referral completion, medication safety, and test follow-up. We present two years of program data (collected during July 2015-June 2017) and show both suboptimal performance in aspects of ambulatory safety and questionable reliability in data reporting.

Innovative Implementation Studies Conducted in US Safety Net Health Care Settings: A Systematic Review.

Little is known about dissemination and implementation in safety net settings. The authors conducted a literature review of innovation/implementation studies in US safety net health care settings between 2008 and 2017. Each article was coded for (1) intervention characteristics, (2) implementation stage, (3) internal versus external ownership, and (4) prespecified implementation outcomes (eg, acceptability and fidelity).

Safety-net institutions in the US grapple with new cholesterol treatment guidelines: a qualitative analysis from the PHoENIX Network.

Background: Clinical performance measures, such as for cholesterol control targets, have played an integral role in assessing the value of care and translating evidence into clinical practice. New guidelines often require development of corresponding performance metrics and systems changes that can be especially challenging in safety-net health care institutions. Understanding how public health care institutions respond to changing practice guidelines may be critical to informing how we adopt evolving evidence in clinical settings that care for the most vulnerable populations.

The effects of group size and subtherapeutic antibiotic alternatives on growth performance and morbidity of nursery pigs: a model for feed additive evaluation.

The objectives of this experiment were to evaluate the effects of alternatives to antibiotic growth promoters (), two group sizes, and their interaction on nursery pig performance to serve as a model for future AGP alternative studies. A 41-d experiment was conducted in a commercial wean-to-finish barn; 1,300 piglets weaned at 21 d of age (weaned 2 or 4 d prior to experiment; 6.14 ± 0.

Lactate Promotes Synthetic Phenotype in Vascular Smooth Muscle Cells.

Rationale: The phenotypes of vascular smooth muscle cells (vSMCs) comprise a continuum bounded by predominantly contractile and synthetic cells. Some evidence suggests that contractile vSMCs can assume a more synthetic phenotype in response to ischemic injury, but the mechanisms that activate this phenotypic switch are poorly understood.

Objective: To determine whether lactate, which increases in response to regional ischemia, may promote the synthetic phenotype in vSMCs.

Performance Measurement and Target-Setting in California's Safety Net Health Systems.

Health policies encourage implementing quality measurement with performance targets. The 2010-2015 California Medicaid waiver mandated quality measurement and reporting. In 2013, California safety net hospitals participating in the waiver set a voluntary performance target (the 90th percentile for Medicare preferred provider organization plans) for mammography screening and cholesterol control in diabetes.

Meaningful use in the safety net: a rapid ethnography of patient portal implementation at five community health centers in California.

Objective: US health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in "safety net" health care systems that provide services for low-income populations.

Materials And Methods: Our rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth.

Prediction of porcine carcass iodine value based on diet composition and fatty acid intake.

The pig industry uses a variety of fat sources (FS) and fat levels (FL) in diets to increase energy content. The objective was to investigate the impact of FS and FL on rate and efficiency of gain, apparent total tract digestibility of dietary fat, and pork fat composition and test dietary predictors of carcass iodine value (IV). A total of 1,213 pigs (PIC 280 × PIC Camborough 42; PIC, Inc.

Understanding the barriers to successful adoption and use of a mobile health information system in a community health center in São Paulo, Brazil: a cohort study.

Background: Mobile technology to support community health has surged in popularity, yet few studies have systematically examined usability of mobile platforms for this setting.

Methods: We conducted a mixed-methods study of 14 community healthcare workers at a public healthcare clinic in São Paulo, Brazil. We held focus groups with community healthcare workers to elicit their ideas about a mobile health application and used this input to build a prototype app.

Usability of Commercially Available Mobile Applications for Diverse Patients.

Background: Mobile applications or 'apps' intended to help people manage their health and chronic conditions are widespread and gaining in popularity. However, little is known about their acceptability and usability for low-income, racially/ethnically diverse populations who experience a disproportionate burden of chronic disease and its complications.

Objective: The objective of this study was to investigate the usability of existing mobile health applications ("apps") for diabetes, depression, and caregiving, in order to facilitate development and tailoring of patient-facing apps for diverse populations.

Online public reactions to frequency of diagnostic errors in US outpatient care.

Background: Diagnostic errors pose a significant threat to patient safety but little is known about public perceptions of diagnostic errors. A study published in in 2014 estimated that diagnostic errors affect at least 5% of US adults (or 12 million) per year. We sought to explore online public reactions to media reports on the reported frequency of diagnostic errors in the US adult population.

Cholestasis in Preterm Infants.

Cholestasis in preterm infants has a multifactorial etiology. Risk factors include degree of prematurity, lack of enteral feeding, intestinal injury, prolonged use of parenteral nutrition (PN), and sepsis. Soy-based parenteral lipid emulsions have been implicated in the pathophysiology of PN-associated liver injury.

Qualitative analysis of programmatic initiatives to text patients with mobile devices in resource-limited health systems.

Background: Text messaging is an affordable, ubiquitous, and expanding mobile communication technology. However, safety net health systems in the United States that provide more care to uninsured and low-income patients may face additional financial and infrastructural challenges in utilizing this technology. Formative evaluations of texting implementation experiences are limited.

Evaluation of standardized ileal digestible lysine requirement of nursery pigs from seven to fourteen kilograms.

Four experiments were conducted to determine the standardized ileal digestible (SID) Lys requirement of pigs (Sus scrofa) from 7 to 14 kg. In Exp. 1, 294 pigs (6.

Accessibility of antiretroviral therapy in Ghana: convenience of access.

The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants' perceived convenience of accessing ART by PLWHA in Ghana.

Predischarge screening for severe neonatal hyperbilirubinemia identifies infants who need phototherapy.

Objective: To test whether the combined use of total plasma/serum bilirubin (TSB) levels and clinical risk factors more accurately identifies infants who receive phototherapy than does the use of either method alone.

Study Design: We recruited healthy infants of ≥35 weeks' gestation at 6 centers that practiced universal predischarge TSB screening. Transcutaneous bilirubin (TcB) was measured at 24 hours, with TSB at 24-60 hours and at 3- to 5- and 7- to 14-day follow-up visits.