Impact of a Patient-Centered Behavioral Economics Intervention on Hypertension Control in a Highly Disadvantaged Population: a Randomized Trial.

BACKGROUND: Uncontrolled hypertension contributes to disparities in cardiovascular outcomes. Patient intervention strategies informed by behavioral economics and social psychology could improve blood pressure (BP) control in disadvantaged minority populations. OBJECTIVE: To assess the impact on BP control of an intervention combining short-term financial incentives with promotion of intrinsic motivation among highly disadvantaged patients. DESIGN: Randomized controlled trial. PARTICIPANTS: Two hundred seven adults (98% African American or Latino) aged 18 or older with uncontrolled hypertension attending Federally Qualified Health Centers. INTERVENTION: Six-month intervention, combining financial incentives for measuring home BP, recording medication use, BP improvement, and achieving target BP values with counseling linking hypertension control efforts to participants' personal reasons to stay healthy. MAIN MEASURES: Primary outcomes: percentage achieving systolic BP (SBP) < 140 mmHg, percentage achieving diastolic BP (DBP) < 90 mmHg, and changes in SBP and DBP, all after 6 months. Priority secondary outcomes were SBP < 140 mmHg, DBP < 90 mmHg, and BP change at 12 months, 6 months after the intervention ended. KEY RESULTS: After 6 months, rates of achieving target BP values for intervention and control subjects respectively was 57.1% vs. 40.2% for SBP < 140 mmHg (adjusted odds ratio (AOR) 2.53 (1.13-5.70)), 79.8% vs 70.1% for DBP < 90 mmHg (AOR 2.50 (0.84-7.44)), and 53.6% vs 40.2% for achieving both targets (AOR 2.04 (0.92-4.52)). However, at 12 months, the groups did not differ significantly in these 3 measures: 39.5% vs 35.0% for SBP (AOR 1.20 (0.51-2.83)), 68.4% vs 75.0% for DBP (AOR 0.70 (0.24-2.09)), and 35.5% vs 33.8% for both (AOR 1.03 (0.44-2.42)). Change in absolute SBP and DBP did not differ significantly between the groups at 6 or 12 months. Exploratory post hoc analysis revealed intervention benefit only occurred among individuals whose providers intensified their regimens, but not among those with intensification but no intervention. CONCLUSIONS: The intervention achieved short-term improvement in SBP control in a highly disadvantaged population. Despite attempts to enhance intrinsic motivation, the effect was not sustained after incentives were withdrawn. Future research should evaluate combined patient/provider strategies to enhance such interventions and sustain their benefit. TRIAL REGISTRATION: NCT01402453; http://clinicaltrials.gov/show/NCT01402453.

Impact of Melaleuca quinquenervia Biochar on Phaseolus vulgaris Growth, Soil Nutrients, and Microbial Gas Flux.

Biochar has been heralded for improving soil quality, sequestering C, and converting organic residues into value-added amendments. Biochar research in agricultural settings has been primarily conducted on acidic soils, with few studies evaluating biochar effects on alkaline soils. Given the rise of small-scale, sustainable farmers experimenting with biochar in South Florida's alkaline, carbonaceous soil, this study sought to assess biochar use in South Florida using an invasive plant species as a feedstock. (Cav.) S.T. Blake biomass was converted into biochar to measure how application at two rates, 2 and 5% (w/w), affects plant growth, soil macro- and micronutrients, and microbial gas flux (CO) in a potted greenhouse experiment using L. Plant growth was inhibited with biochar addition at the 2 and 5% rates. Dry shoot, pod weight, and pod length decreased significantly between treatments ( < 0.001). Significant reductions in plant-available P, Ca, Mg, Cu, and Zn were observed in the 5% biochar soil postharvest ( < 0.05). Compared with the control, addition of biochar at 2 and 5% rates significantly reduced CO flux during the growing season, but not at harvest ( < 0.01). Our results indicate that those considering biochar application in South Florida's alkaline soil should be cautious in selecting feedstock and temperature for biochar production. Biochar can be produced at lower temperatures to decrease pH, but the concomitant increase in volatile matter (VM) is of concern. Although CO flux may have decreased, the deleterious impacts of biochar (pH = 8.12, VM = 26.5%) on production should not be dismissed.

FOXO protects against age-progressive axonal degeneration.

Neurodegeneration resulting in cognitive and motor impairment is an inevitable consequence of aging. Little is known about the genetic regulation of this process despite its overriding importance in normal aging. Here, we identify the Forkhead Box O (FOXO) transcription factor 1, 3, and 4 isoforms as a guardian of neuronal integrity by inhibiting age-progressive axonal degeneration in mammals. FOXO expression progressively increased in aging human and mouse brains. The nervous system-specific deletion of Foxo transcription factors in mice accelerates aging-related axonal tract degeneration, which is followed by motor dysfunction. This accelerated neurodegeneration is accompanied by levels of white matter astrogliosis and microgliosis in middle-aged Foxo knockout mice that are typically only observed in very old wild-type mice and other aged mammals, including humans. Mechanistically, axonal degeneration in nerve-specific Foxo knockout mice is associated with elevated mTORC1 activity and accompanying proteotoxic stress due to decreased Sestrin3 expression. Inhibition of mTORC1 by rapamycin treatment mimics FOXO action and prevented axonal degeneration in Foxo knockout mice with accelerated nervous system aging. Defining this central role for FOXO in neuroprotection during mammalian aging offers an invaluable window into the aging process itself.

Quasi-classical trajectories study of Ne2Br2(B) vibrational predissociation: kinetics and product distributions.

The vibrational predissociation of the Ne(2)Br(2)(B) van der Waals complex has been investigated using the quasi-classical trajectory method (QCT), in the range of vibrational levels v(') = 16-23. Extensive comparison is made with the most recent experimental observations [Pio et al., J. Chem. Phys. 133, 014305 (2010)], molecular dynamics with quantum transitions simulations [Miguel et al., Faraday Discuss. 118, 257 (2001)], and preliminary results from 24-dimensional Cartesian coupled coherent state (CCCS) calculations. A sequential mechanism is found to accurately describe the theoretical dynamical evolution of intermediate and final product populations, and both QCT and CCCS provide very good estimates for the dissociation lifetimes. The capabilities of QCT in the description of the fragmentation kinetics are analyzed in detail by using reduced-dimensionality models of the complexes and concepts from phase-space transport theory. The problem of fast decoupling of the different coherent states in CCCS simulations, resulting from the high dimensionality of phase space, is tackled using a re-expansion scheme. QCT ro-vibrational product state distributions are reported. Due to the weakness of the van der Waals couplings and the low density of vibrational states, QCT predicts a larger than observed propensity for Δv' = -1 and -2 channels for the respective dissociation of the first and second Ne atoms.

Cartesian coupled coherent states simulations: Ne(n)Br2 dissociation as a test case.

In this article, we describe coupled coherent states (CCS) simulations of vibrational predissociation of weakly bounded complexes. The CCS method is implemented in the Cartesian frame in a manner that is similar to classical molecular dynamics. The calculated lifetimes of the vibrationally excited Ne-Br(2)(ν) complexes agree with experiment and previous calculations. Although the CCS method is, in principle, a fully quantum approach, in practice it typically becomes a semiclassical technique at long times. This is especially true following dissociation events. Consequently, it is very difficult to converge the quantum calculations of the final Br(2) vibrational distributions after predissociation and of the autocorrelation functions. However, the main advantage of the method is that it can be applied with relative ease to determine the lifetimes of larger complexes and, in order to demonstrate this, preliminary results for tetra- and penta-atomic clusters are reported.

Water at an electrochemical interface--a simulation study.

The results of molecular dynamics simulations of the properties of water in an aqueous ionic solution close to an interface with a model metallic electrode are described. In the simulations the electrode behaves as an ideally polarizable hydrophilic metal, supporting image-charge interactions with charged species, and it is maintained at a constant electrical potential with respect to the solution so that the model is a textbook representation of an electrochemical interface through which no current is passing. We show how water is strongly attracted to and ordered at the electrode surface. This ordering is different to the structure that might be imagined from continuum models of electrode interfaces. Further, this ordering significantly affects the probability of ions reaching the surface. We describe the concomitant motion and configurations of the water and ions as functions of the electrode potential, and we analyze the length scales over which ionic atmospheres fluctuate. The statistics of these fluctuations depend upon surface structure and ionic strength. The fluctuations are large--sufficiently so that the mean ionic atmosphere is a poor descriptor of the aqueous environment near a metal surface. The importance of this finding for a description of electrochemical reactions is examined by calculating, directly from the simulation, Marcus free-energy profiles for transfer of charge between the electrode and a redox species in the solution and comparing the results with the predictions of continuum theories. Significant departures from the electrochemical textbook descriptions of the phenomenon are found and their physical origins are characterized from the atomistic perspective of the simulations.

Classical, quantum and statistical simulations of vibrationally excited HOSO(2): IVR, dissociation, and implications for OH + SO(2) kinetics at high pressures.

In this paper, we present classical and coupled coherent states quantum dynamics simulations to investigate intramolecular vibrational energy redistribution (IVR) from an excited (v = 1-10) OH stretch within the HOSO(2) complex to the other molecular bath modes. Using an analytical PES derived from electronic structure theory calculations, the results obtained from both the classical and quantum simulations are in reasonable agreement. The dynamics results suggest that statistical models overpredict HOSO(2) dissociation k(E)s, and underpredict the amount of vibrational excitation in the nascent OH formed following complex dissociation. In order to understand the dynamics results, we utilize a simple analytical model for describing energy flow from excited modes to bath modes, and show that IVR limits complex dissociation at short times. We also consider qualitative mass affects on IVR, and consider the implications of this work on previous measurements of the OH + SO(2) association k(infinity) using the proxy method.

Cultivar effect on Moringa oleifera glucosinolate content and taste: a pilot study.

Leaves of the tropical tree Moringa oleifera are widely promoted in areas of chronic malnutrition as nutritional supplements for weaning infants and nursing mothers. Adoption, in these circumstances may hinge upon taste, which can vary greatly amongst cultivars. It is widely assumed that this taste variation is primarily germplasm-dependent, and results from the breakdown of glucosinolates to isothiocyanates. Leaves of 30 accessions, grown at a single field plot, were sampled 3 times over the course of a year. Taste, assessed in a masked protocol, was not related to glucosinolate content of the leaves.

The interface between water and a hydrophobic gas.

Classical molecular dynamics simulations have been performed to investigate the interface between liquid water and methane gas under methane hydrate forming conditions. The local environments of the water molecules were studied using order parameters which distinguish between liquid water, ice and methane hydrate phases. Bulk water and water/air interfaces were also studied to allow comparisons to be made between water molecules in the different environments and to determine the effects of the different methane densities studied. Good agreement between experimental and calculated surface tensions is obtained if long range corrections are included. The water surface is found to have a structure which is very similar to that of bulk water, but more tetrahedral, and more clathrate-like than ice-like. In these simulations the concentration of methane in water at the interface is shown to be appropriate for clathrates at higher gas densities (pressures). The orientation of water molecules around methane molecules in the interfacial region appears to depend only weakly on pressure and one of the difficulties in forming hydrate is the availability of water molecules tangential to the hydrate cage. At the interface, the water structure is more disordered than in the bulk water region with increased occurrence compared with the bulk of those angles and orientations found in the clathrate structure.

Electrochemical charge transfer at a metallic electrode: a simulation study.

The calculation of the Marcus free energy curves for electron transfer events between a redox species and a metallic electrode in an atomistic simulation designed to model the electrochemical interface with an ionic liquid is described. The calculation is performed on a system comprising a molten salt mixture confined between model metallic electrodes [Reed et al., J. Chem. Phys. 126, 084704 (2007)] which are maintained at a constant electrical potential. The calculation therefore includes a self-consistent description of the screening of the electrode potential by the liquid and the polarization of the electrode by the ions (image charge effects). The purpose of the study was to examine how the Marcus curves depend on the applied potential and on the distance of the redox species from an electrode. The pronounced oscillations in the mean electrical potential seen in molten salt systems in the "double-layer" region are not reflected in the reaction free energy for the electron transfer event. The reorganization energy depends markedly on the distance of the redox ion from the electrode surface because of image charge effects.

Electrochemical interface between an ionic liquid and a model metallic electrode.

A molecular dynamics simulation model for an electroactive interface in which a metallic electrode is maintained at a preset electrical potential is described. The model, based on earlier work of Siepmann and Sprik [J. Chem. Phys. 102, 511 (1995)], uses variable charges whose magnitudes are adjusted on-the-fly according to a variational procedure to maintain the constant potential condition. As such, the model also allows for the polarization of the electrode by the electrolyte, sometimes described by the introduction of image charges. The model has been implemented in a description of an electrochemical cell as a pair of parallel planar electrodes separated by the electrolyte using a two-dimensional Ewald summation method. The method has been applied to examine the interfacial structure in two ionic liquids, consisting of binary mixtures of molten salts, chosen to exemplify the influences of dissimilar cation size and charge. The stronger coordination of the smaller and more highly charged cations by the anions prevents them from approaching even the negatively charged electrode closely. This has consequences for the capacitance of the electrode and will also have an impact on the rates of electron transfer processes. The calculated capacitances exhibit qualitatively the same dependence on the applied potential as has been observed in experimental studies.

Molecular dynamics study to identify the reactive sites of a liquid squalane surface.

Molecular dynamics simulations of liquid squalane, C30H62, were performed, focusing in particular on the liquid-vacuum interface. These theoretical studies were aimed at identifying potentially reactive sites on the surface, knowledge of which is important for a number of inelastic and reactive scattering experiments. A united atom force field (Martin, M. G.; Siepmann, J. I. J. Phys. Chem. B 1999, 103, 4508-4517) was used, and the simulations were analyzed with respect to their interfacial properties. A modest but clearly identifiable preference for methyl groups to protrude into the vacuum has been found at lower temperatures. This effect decreases when going to higher temperatures. Additional simulations tracking the flight paths of projectiles directed at a number of randomly chosen surfaces extracted from the molecular dynamics simulations were performed. The geometrical parameters for these calculations were chosen to imitate a typical abstraction reaction, such as the reaction between ground-state oxygen atoms and hydrocarbons. Despite the preference for methyl groups to protrude further into the vacuum, Monte Carlo tracking simulations suggest, on geometric grounds, that primary and secondary hydrogen atoms are roughly equally likely to react with incoming gas-phase atoms. These geometric simulations also indicate that a substantial fraction of the scattered products is likely to undergo at least one secondary collision with hydrocarbon side chains. These results help to interpret the outcome of previous measurements of the internal and external energy distribution of the gas-phase OH products of the interfacial reaction between oxygen atoms and liquid squalane.