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The biological properties of human mesenchymal stromal cells (hMSCs) have been explored in over a thousand clinical trials in the last decade. Although hMSCs can be isolated from multiple sources, the degree of biological similarity between cell populations from these sources remains to be determined. A comparative study was performed investigating the growth kinetics and functionality of hMSCs isolated from adipose tissue (AT), bone marrow (BM) and umbilical cord tissue (UCT) expanded in monolayer over five passages. Adult hMSCs (AT, BM) had a slower proliferation ability than the UCT-hMSCs, with no apparent differences in their glucose consumption profile. BM-hMSCs produced higher concentrations of endogenous vascular endothelial growth factor (VEGF) compared to AT- and UCT-hMSCs. This study also revealed that UCT-hMSCs were more efficiently transduced by a lentiviral vector carrying a VEGF gene than their adult counterparts. Following cellular immunophenotypic characterization, no differences across the sources were found in the expression levels of the typical markers used to identify hMSCs. This work established a systematic approach for cell source selection depending on the hMSC's intended clinical application. [ABSTRACT FROM AUTHOR]

Human mesenchymal stromal cells (hMSCs) are a naturally adherent cell type and one of the most studied cellular agents used in cell therapy over the last 20 years. Their mechanism of action has been primarily associated with paracrine signaling, which has contributed to an increase in the number of studies focused on hMSC-related extracellular vesicles (EVs). In this study, we demonstrate for the first time that human telomerase reverse transcriptase (hTERT) immortalized hMSCs can be adapted to suspension culture, eliminating the need for microcarriers or other matrixes to support cell growth. This novel cell line, named suspension hMSCs (S-hMSCs), has a doubling time of approximately 55 hours, with a growth rate of 0.423/d. Regarding its immunophenotype characteristics, S-hMSCs retained close to 90% of CD73 and CD105 expression levels, with the CD90 receptor being downregulated during the adherent to suspension adaptation process. An RNA sequencing analysis showed an upregulation of the transcripts coding for CD44, CD46 and CD47 compared to the expression levels in AT-hMSCs and hTERT-hMSCs. The cell line herein established was able to generate EVs using a chemically defined medium formulation with these nanoparticles averaging 150 nm in size and displaying the markers CD63, CD81, and TSG101, while not expressing the negative marker calnexin. This body of evidence, combined with the visual confirmation of EV presence using transmission electron microscopy, demonstrates the EV-producing capabilities of the novel S-hMSCs. This cell line provides a platform for process development, drug discovery and translational studies in the EV field. [ABSTRACT FROM AUTHOR]

Cleft alveolar bone graft surgery is technically challenging to perform as well as difficult to learn and teach. A high-fidelity cleft alveolar bone graft simulator was previously developed. However, further evaluation of the simulator is necessary to assess its efficacy. Two cleft simulation workshops were conducted in which participants were led through a simulated cleft alveolar bone graft. The first simulation workshop involved six plastic surgery trainees. The second workshop involved 43 practicing cleft surgeons. The participants were provided with a Likert-type questionnaire assessing the simulators' features, realism, and value as a training tool. The change in self-reported confidence was assessed by providing each participant with a pre- and post-simulation confidence questionnaire. There was overall agreement in the realism of the simulators' features (average score of 4.67 and 3.80 out of 5 for the trainees and surgeons, respectively). There was overall agreement to strong agreement in the simulators value as a training tool (average score of 5 and 4.43 out of 5 for the trainees and surgeons, respectively). The self-reported confidence increased for all questionnaire items for both the trainees and surgeons. This was significant (p < 0.05) for five out of eight and all questionnaire items for the trainees and surgeons, respectively. The magnitude of the confidence increase was generally greater for less experienced participants. The cleft alveolar bone graft simulator was found to be realistic and valuable as a training platform. Use of the simulator improved self-reported confidence in cleft alveolar bone graft surgery. [ABSTRACT FROM AUTHOR]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ydbio.2009.02.035 Byline: Sarah Gibb (a), Anna Zagorska (a), Kristin Melton (b)(d), Gennady Tenin (a), Irene Vacca (a), Paul Trainor (b)(c), Miguel Maroto (a), J. Kim Dale (a) Keywords: Notch; Wnt; Embryo; Mouse; Chick; Somite; Segmentation clock Abstract: Somites are embryonic precursors of the ribs, vertebrae and certain dermis tissue. Somite formation is a periodic process regulated by a molecular clock which drives cyclic expression of a number of clock genes in the presomitic mesoderm. To date the mechanism regulating the period of clock gene oscillations is unknown. Here we show that chick homologues of the Wnt pathway genes that oscillate in mouse do not cycle across the chick presomitic mesoderm. Strikingly we find that modifying Wnt signalling changes the period of Notch driven oscillations in both mouse and chick but these oscillations continue. We propose that the Wnt pathway is a conserved mechanism that is involved in regulating the period of cyclic gene oscillations in the presomitic mesoderm. Author Affiliation: (a) Division of Cell and Developmental Biology, College of Life Sciences, University of Dundee, Dow Street, Dundee, DD1 5EH, Scotland, UK (b) Stowers Institute for Medical Research, 1000 E 50th Street, Kansas City, MO, 64110, USA (c) University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA (d) Cincinnati Children's Hospital Medical Center, Division of Neonatology 3333 Burnet Avenue, ML#7009 Cincinnati, OH 45229, USA Article History: Received 29 October 2008; Revised 25 February 2009; Accepted 26 February 2009

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jml.2007.09.002 Byline: Dale J. Barr Keywords: Eyetracking; Statistics; Multilevel modeling Abstract: A new framework is offered that uses multilevel logistic regression (MLR) to analyze data from 'visual world' eyetracking experiments used in psycholinguistic research. The MLR framework overcomes some of the problems with conventional analyses, making it possible to incorporate time as a continuous variable and gaze location as a categorical dependent variable. The multilevel approach minimizes the need for data aggregation and thus provides a more statistically powerful approach. With MLR, the researcher builds a mathematical model of the overall response curve that separates the response into different temporal components. The researcher can test hypotheses by examining the impact of independent variables and their interactions on these components. A worked example using MLR is provided. Author Affiliation: Department of Psychology, University of California, Riverside, CA 92521, USA Article History: Received 14 November 2006; Revised 17 August 2007 Article Note: (footnote) [star] The author thanks Robert Rosenthal and the members of the weekly seminar on statistical methods (MAMA) at UC Riverside for their input on this project. One-on-one discussions with Dan Ozer and Chandra Reynolds were quite valuable in developing the framework. Thanks to Boaz Keysar, Kevin Esterling, Timothy Gann, Edmundo Kronmuller, and Mandana Seyfeddinipur for helpful comments; also to Peter Dixon, Len Katz, and two anonymous reviewers.

Byline: Edmundo Kronmuller, Dale J. Barr Keywords: Language comprehension; Pragmatics; Common ground; Referential communication; Eye-tracking Abstract: When speakers refer to the same referent multiple times in a conversation, they tend to follow established patterns of usage, known as conversational precedents. Research has found that listeners expect speakers to follow precedents, and that this expectation guides their search for referents (Barr, D. J., & Keysar, B. (2002). Anchoring comprehension in linguistic precedents. Journal of Memory and Language, 46, 391-418). Recently, Metzing and Brennan (2003) (Metzing, C., & Brennan, S. E. (2003). When conceptual pacts are broken: partner-specific effects on the comprehension of referring expressions. Journal of Memory and Language, 49, 201-213) reported a speaker-specific effect for broken precedents that suggests early use of speaker information when precedents are broken. Results from two eyetracking experiments show that this speaker effect results from the late use of speaker information to recover from an early, partner-independent preemption effect. When a new description is heard, existing precedents preempt the mapping of the new description to an old referent. Later, listeners use speaker-information to inhibit precedents that are not known to the current speaker. Time-course data, as well as the results of a cognitive load manipulation, suggest that the preemption and speaker effects are supported by distinct processing systems. Our findings indicate that certain pragmatic effects in language comprehension are based on general expectations about language use, rather than assumptions about the beliefs and goals of particular speakers. Author Affiliation: Department of Psychology, University of California, Riverside, CA 92521, USA Article History: Received 9 February 2006; Revised 11 May 2006 Article Note: (footnote) [star] We thank the TalkLab undergraduate research assistants who assisted in collecting the data for these experiments: Lillian Farjeat, Karla Gonzalez, Alejandro Manzo, Wajeeha Munir, Vanessa Olguin, Jeff Olney, Marvin Sesuca, and Erica Severan.

A study investigating the effects of contract non-performance in a forward auction market, when the forward market is linked with a spot auction market, is presented. The results from the laboratory markets, which are considered as more reliable, suggest that the spot market becomes a backstop to failed units in the forward market.

A study using vitro assays of cell differentiation was conducted on the induction of forebrain ventral midline cells by prechordal mesoderm. The findings indicate that ventral midline cells develop distinct identities in response to the various signaling activities of underlying mesoderm. Signals from prechordal mesoderm were responsible for the differentiation of rostral diencephalic ventral midline cells while notochord induces floor plate cells caudally.

Context: Cancer and its treatment are inherently stressful and stress impacts important patient outcomes. Patients vary considerably in their response to stress. Understanding this variability requires a patient-centered multidimensional approach.Objectives: The objectives of this study were to identify and characterize patient subgroups with distinct multidimensional stress profiles (stress appraisal, exposure, and adaptation) during cancer treatment.Methods: Among 957 patients undergoing chemotherapy for breast, gastrointestinal, gynecological, or lung cancer, latent profile analysis was performed to identify patient subgroups using concurrent evaluations of global (Perceived Stress Scale) and cancer-specific (Impact of Events Scale-Revised) stress, lifetime stress exposure (Life Stressor Checklist-Revised), and resilience (Connor-Davidson Resilience Scale-10).Results: Three latent classes were identified: "Normative" (54.3%; intermediate global stress and resilience, lower cancer-related stress, lowest life stress); "Stressed" (39.9%; highest global and cancer-specific stress scores, lowest resilience, most life stress); and "Resilient" (5.7%; lowest global stress, cancer-specific stress comparable to Normative class, highest resilience, intermediate life stress). Characteristics that distinguished the Stressed from the Normative class included the following: younger age, female gender, lower socioeconomic status, unmarried/partnered, living alone, poorer functional status, and higher comorbidity burden. Compared to Stressed patients, Resilient patients were more likely to be partnered, to not live alone, and had a higher functional status. No demographic or clinical characteristics differentiated Normative from Resilient patients. Exposure to specific life stressors differed significantly among the classes.Conclusion: A subset of patients warrants intensive psychosocial intervention to reduce stress and improve adaptation to cancer. Intervention efforts may be informed by further study of Resilient patients. [ABSTRACT FROM AUTHOR]

Background: Transcatheter aortic valve replacement (TAVR) for degenerated surgical bioprosthetic aortic valves is associated with favorable early outcomes. However, little is known about the durability and longer-term outcomes associated with this therapy.Objectives: The aim of this study was to examine late outcomes after valve-in-valve TAVR.Methods: Patients with symptomatic degeneration of surgical aortic bioprostheses at high risk (≥50% major morbidity or mortality) for reoperative surgery were prospectively enrolled in the multicenter PARTNER (Placement of Aortic Transcatheter Valves) 2 valve-in-valve and continued access registries. Three-year clinical and echocardiographic follow-up was obtained.Results: Valve-in-valve procedures were performed in 365 patients. The mean age was 78.9 ± 10.2 years, and the mean Society of Thoracic Surgeons score was 9.1 ± 4.7%. At 3 years, the overall Kaplan-Meier estimate of all-cause mortality was 32.7%. Aortic valve re-replacement was required in 1.9%. Mean transaortic gradient was 35.0 mm Hg at baseline, decreasing to 17.8 mm Hg at 30-day follow-up and 16.6 mm Hg at 3-year follow-up. Baseline effective orifice area was 0.93 cm2, increasing to 1.13 and 1.15 cm2 at 30 days and 3 years, respectively. Moderate to severe aortic regurgitation was reduced from 45.1% at pre-TAVR baseline to 2.5% at 3 years. Importantly, moderate or severe mitral and tricuspid regurgitation also decreased (33.7% vs. 8.6% [p < 0.0001] and 29.7% vs. 18.8% [p = 0.002], respectively). Baseline left ventricular ejection fraction was 50.7%, increasing to 54.7% at 3 years (p < 0.0001), while left ventricular mass index was 136.4 g/m2, decreasing to 109.1 g/m2 at 3 years (p < 0.0001). New York Heart Association functional class improved, with 90.4% in class III or IV at baseline and 14.1% at 3 years (p < 0.0001), and Kansas City Cardiomyopathy Questionnaire overall score increased (43.1 to 73.1; p < 0.0001).Conclusions: At 3-year follow-up, TAVR for bioprosthetic aortic valve failure was associated with favorable survival, sustained improved hemodynamic status, and excellent functional and quality-of-life outcomes. (The PARTNER II Trial: Placement of Aortic Transcatheter Valves II - PARTNER II - Nested Registry 3/Valve-in-Valve [PII NR3/ViV]; NCT03225001). [ABSTRACT FROM AUTHOR]

Complementary therapies provide cancer survivors and clinicians with options for managing chronic pain. Recent published clinical guidelines and research findings support the use of relaxation therapy for managing chronic pain in cancer survivors. However, translating research findings into clinical practice remains a challenge. Using theory to guide implementation of a new practice can increase the likelihood of successful adoption. This article uses relaxation therapy for cancer survivors to describe how clinicians could use Rogers' Diffusion of Innovation Theory and the related Collaborative Research Utilization Model to implement a complementary therapy and ensure that it becomes standard practice. [ABSTRACT FROM AUTHOR]

Background: Severe mitral regurgitation (MR) conveys significant morbidity and mortality, and surgical repair or replacement may not be a desirable option.Objectives: The purpose of this study was to evaluate the feasibility of a percutaneous transseptal transcatheter mitral valve replacement (TMVR) system.Methods: This first-in-human study was conducted between August 2017 and August 2018. The system comprises a nitinol dock, which encircles the chordae tendineae, and a balloon-expandable transcatheter heart valve. The dock and transcatheter heart valve form an ensemble, with the native mitral valve leaflets secured in between, thereby abolishing MR. Key inclusion criteria were severe symptomatic MR and high surgical risk; exclusion criteria included left ventricular ejection fraction <30% or screening suggesting unfavorable anatomy. The primary endpoint was technical success as defined by Mitral Valve Academic Research Consortium (MVARC) criteria at completion of the index procedure. The secondary endpoint was freedom from mortality, stroke, and device dysfunction (MR grade >1, mitral gradient >6 mm Hg, left ventricular outflow tract gradient >20 mm Hg) at 30 days.Results: Ten patients with severe MR of various etiologies (4 degenerative, 4 functional, and 2 mixed) were treated. The device was successfully implanted and the primary endpoint was achieved in 9 of 10 patients (90%). By transesophageal echocardiography, total MR was reduced to ≤ trivial in all implanted patients, and mean transmitral gradient was 2.3 ± 1.4 mm Hg. A pericardial effusion occurred in 1 patient: pericardiocentesis was performed, and the device was not implanted. Median length of hospital stay was 1.5 days. At 30 days, there was no stroke, myocardial infarction, rehospitalization, left ventricular outflow tract obstruction, device migration, embolization, or conversion to mitral surgery. One patient had recurrent regurgitation due to a paravalvular leak, treated with a closure device. All other treated patients had ≤1+ MR. No patients died.Conclusions: Percutaneous transvenous transseptal TMVR is feasible and safe in patients with severe MR who are at high risk for mitral valve surgery. Further evaluation is warranted. [ABSTRACT FROM AUTHOR]

Abstract Direct measurement of the n -octanol partition coefficients (K OW) for highly hydrophobic organic chemicals is extremely difficult because of the extremely low concentrations present in the water phase. n -Butanol/water partition coefficients (K BW) are generally much lower than K OW due to the increased solubility of solute in the alcohol saturated aqueous phase, and therefore become easier to measure. We measured the K BW for 25 neutral organic chemicals having measured log K OW s ranging from 2 to 9 and 4 additional highly hydrophobic chemicals, with unmeasured K OW s, having estimated log K OW s ranging from 6 to 18. The measured log K BW and log K OW values were linearly related, r2 = 0.978, and using the regression developed from the data, K OW s were predicted for the 4 highly hydrophobic chemicals with unmeasured K OW s. The resulting predictions were orders of magnitude lower than those predicted by a variety of computational models and suggests the estimates of K OW in the literature for highly hydrophobic chemicals (i.e., log K OW greater than 10) are likely incorrect by several orders of magnitude. Highlights • n -Butanol/water partition coefficients are measurable for hydrophobic chemicals. • Plot of log K OW vs log K BW is linear, r2 = 0.98, for K OW s extending into 109 range. • K OW s were estimated using K OW -K BW relationship and measured K BW s. • K OW s estimated for highly hydrophobic chemicals are lower than their QSAR estimates. [ABSTRACT FROM AUTHOR]

Listeners reduce uncertainty in comprehension by using previously established linguistic precedents. The benefits of linguistic precedents are independent of mutual knowledge and are used by listeners merely because they are available.

Determination of the material properties of soft tissue is a growing area of interest that aids in the development of new surgical tools and surgical simulators. This study first aims to develop a robot-operated tissue testing system for determination of tissue cutting forces. Second, this system was used to ascertain the cutting properties of the hard and soft palate mucosa and soft palate musculature for the purpose of developing a robotic instrument for cleft palate surgery and a cleft-specific surgical simulator. The palate tissue was cut with a 15 blade mounted to the robot with varying angles (30°, 60°, 90°) and speeds (1.5, 2.5, 3.5 cm/s) of cutting to imitate typical operative tasks. The cutting force range for hard palate mucosa, soft palate mucosa and soft palate muscle were 0.98–3.30, 0.34–1.74 and 0.71–2.71 N, respectively. The break-in force of the cut (i.e. force required for the blade to penetrate the tissue) is significantly impacted by the angle of the blade relative to the tissue rather than the cutting speed. Furthermore, the total surface area of the tissue in contact with the blade during the cut has a significant impact on the total force expended on the tissue. [ABSTRACT FROM AUTHOR]

The objective of this study was to develop and pilot test a chronic pain empowerment and self-management platform, derived from acceptance and commitment therapy, in a pain specialty setting. A controlled, sequential, nonrandomized study design was used to accommodate intervention development and to test the efficacy of the PainTracker Self-Manager (PTSM) intervention (Web-based educational modules and outcome tracking combined with tailored patient coaching sessions and provider guidance). Generalized estimating equations evaluated changes over time (baseline, 3 months, 6 months) in pain self-efficacy (primary outcome), chronic pain acceptance (activity engagement and pain willingness), perceived efficacy in patient-provider interactions, pain intensity and interference, and overall satisfaction with pain treatment (secondary outcomes) between intervention (n = 48) and usual care control groups (n = 51). The full study sample (N = 99) showed greater improvements over time (significant Group × Time interactions) in pain self-efficacy and satisfaction with pain treatment. Among study completers (n = 82), greater improvement in activity engagement as well as pain intensity and interference were also observed. These preliminary findings support the efficacy of the PTSM intervention in a pain specialty setting. Further research is needed to refine and expand the PTSM intervention and to test it in a randomized trial in primary care settings.Perspective: We developed a Web-based patient empowerment platform that combined acceptance and commitment therapy-based educational modules and tailored coaching sessions with longitudinal tracking of treatments and patient-reported outcomes, named PTSM. Pilot controlled trial results provide preliminary support for its efficacy in improving pain self-efficacy, activity engagement, pain intensity and interference, and satisfaction with pain treatment. [ABSTRACT FROM AUTHOR]

Post-traumatic stress disorder (PTSD) commonly accompanies complex chronic pain, yet PTSD is often overlooked in chronic pain management. Using the 4-item Primary Care (PC)-PTSD screening tool, we evaluated the relationship between the number and type of PC-PTSD symptoms endorsed and a set of patient-reported outcomes, including: pain intensity and interference, function, mood, quality of life, and substance abuse risk in a consecutive sample of patients with chronic pain (n = 4,402). Patients completed PainTracker, a Web-based patient-reported outcome tool that provides a multidimensional evaluation of chronic pain, as part of their intake evaluation at a specialty pain clinic in a community setting. Twenty-seven percent of the sample met PC-PTSD screening criteria for PTSD by endorsing 3 of the 4 symptom domains. Significant ordinal trends were observed between increasing number of PTSD symptoms and all outcomes evaluated. The occurrence of even 1 PTSD symptom was associated with overall poorer outcomes, suggesting that subsyndromal PTSD is clinically significant in the context of chronic pain. Among the 4 PTSD domains assessed, "numbness/detachment" was most strongly associated with negative pain outcomes in relative weight analysis. Results from this cross-sectional study suggest that a range of pain-related outcomes may be significantly related to comorbid PTSD.Perspective: We present evidence that PTSD symptoms are significantly related to a broad set of pain-related patient-reported outcomes. These findings highlight the need to evaluate for PTSD symptoms in patients with chronic pain, especially feelings of numbness or detachment from others, to improve understanding and management of chronic pain. [ABSTRACT FROM AUTHOR]

Individuals with chronic pain who live in rural communities often lack access to pain specialists and rely on primary care providers who may be less prepared. Research has indicated that rural residents with chronic pain are more likely to receive an opioid prescription than nonrural residents. Although self-management approaches are available for chronic pain management, it is unclear to what extent rural residents use these interventions. This study compares usage of self-management interventions and opioid-based analgesics for chronic pain management between rural and nonrural residents. This study is a secondary analysis of baseline data from a randomized controlled trial evaluating a telehealth intervention for chronic pain management. Participants, recruited from primary care clinics, were 65 rural residents and 144 nonrural residents with similar demographic characteristics. Differences in the use of self-management interventions, pain intensity, and opioid dose were evaluated between rural and nonrural residents. Rural residents (n = 50, 77%) were less likely to use self-management interventions compared with nonrural residents (n = 133, 92%) ( p = .019). Opioids were taken for pain relief by 76% of the rural residents compared with 52% of the nonrural residents. A disparity exists in the use of self-management interventions for chronic pain management by rural residents compared with nonrural residents. Further study is needed to determine if this is related to the lack of access to specialists and/or pain management training of primary care providers. Nurses can play an essential role in addressing this disparity by educating patients about self-management interventions. [ABSTRACT FROM AUTHOR]

Our research seeks to expand the concept of urban environmental stewardship to include the everyday stewardship practices of urban nontimber forest products foragers. Ethnographic data from 58 urban foragers and 18 land stewards in the city of Seattle (USA) revealed that foragers reported using a variety of practices to enhance and minimize negative desirable species and their habitats. Many of these practices were identical to those practiced by restoration volunteers in formal programs and align with Seattle Parks Department management objectives. Foragers actively sought to learn more about what practices are sustainable; many mentored others in sustainable harvesting practices. Most foragers emphasized the importance of treating plants and their environment with respect. The land stewards voiced some concerns about foraging in city parks, but most were cautiously supportive of opening up the parks to foragers. The study results suggest that an opportunity exists for park managers to develop alliances with foragers so as to leverage foragers’ everyday stewardship practices and accomplish some of their park restoration objectives. Doing so will require park managers to acknowledge the positive contributions that humans can to make novel ecosystems and foragers to develop or strengthen self-regulation norms. [ABSTRACT FROM AUTHOR]

Cholesterol self-assembles into weakly ordered aggregates when tethered to a crosslinked hydrogel network of poly(ethylene glycol) (PEG). PEG-diacrylate and cholesterol-PEG-acrylamide (PEG-chol) were co-polymerized in organic solvent and transferred to water for equilibrium swelling. Small-angle x-ray scattering revealed self-assembled cholesterol structures not present during network synthesis. At lower ratios of PEG-tethered cholesterol to PEG (<12% cholesterol based on total solid content), cholesterol aggregates into the dense, weakly ordered crosslink junctions of the PEG network. The hydrogel networks exhibited classic affine behavior during compressive mechanical testing, and cholesterol aggregation enhanced the elastic modulus. At high PEG-chol to PEG ratios (12–20% cholesterol based on total solid content), cholesterol self-assembles into domains with lamellar-like meso-ordering. The structural transition causes network deswelling and significantly reduces material brittleness upon deformation. [ABSTRACT FROM AUTHOR]

Background Among health care-associated infections (HAIs), Clostridium difficile infections (CDIs) are a major cause of morbidity and mortality in the United States. As national progress toward CDI prevention continues, it will be critical to ensure that the benefits from CDI prevention are realized across different patient demographic groups, including any targeted interventions. Methods Through a comprehensive review of existing evidence for racial/ethnic and other disparities in CDIs, we identified a few general trends, but the results were heterogeneous and highlight significant gaps in the literature. Results The majority of analyzed studies identified white patients as at increased risk of CDIs, although there is a very limited literature base, and many studies had significant methodological limitations. Conclusion Key recommendations for future research are provided to address antimicrobial stewardship programs and populations that may be at increased risk for CDIs. [ABSTRACT FROM AUTHOR]

Objectives: Right ventricular failure is the primary reason for mortality in pulmonary hypertension (PH), but little is understood about the energetics of the failing right myocardium. Our aim was to examine mitochondrial function and proteomic signatures in paired remodeled right (RM-RV) and non-remodeled left (NRM-LV) ventricular tissue samples procured during heart-lung transplantation.Methods and Results: Contractile dysfunction in RM-RV and preserved contractile function in NRM-LV were determined clinically and by echocardiography. Mitochondria were isolated from fresh paired RV and LV wall specimens of explanted hearts. Respiratory states in response to 4 substrates and an uncoupler were analyzed. Proteomic analysis on the mitochondrial isolates was performed with the use of liquid chromatography-mass spectrometry. The RM-RV mitochondria exhibited higher succinate state 4 levels with lower respiratory control ratio (RCR) compared with state 4 levels for pyruvate-malate (PM) and glutamate-malate (GM). RM-RV mitochondria also exhibited lower state 3 for palmitoyl-carnitine (PC) and state 4 for all complex I substrates compared with NRM-LV. The mean RCR were greater in RM-RVs than in NRM-LVs for PM and GM, which is consistent with tight coupling (low state 4 rates, higher RCRs); however, low RM-RV state 3 rates suggest concurrent substrate-dependent impairment in respiratory capacity. Mitochondrial proteomics revealed greater levels of mitochondrial ADP-ATP translocase and proteins of ATP synthesis, mitochondrial pyruvate and short branched chain acyl-CoA metabolism in RM-RV.Conclusions: The mitochondrial respiration and proteomics in RM-RV are different from NRM-LV. These results have important implications in expanding our understanding of RV metabolism and future management of RV failure. [ABSTRACT FROM AUTHOR]