Disparities in arteriovenous fistula placement in older hemodialysis patients

The benefits of an arteriovenous fistula (AVF) as the preferred vascular access for hemodialysis have been clearly demonstrated. However, only about 20% of patients in the United States initiate hemodialysis with an AVF. In this study, we assessed whether disparities exist in the type of first hemodialysis access placed prior to dialysis start (rather than that used at dialysis initiation), to detect whether certain disadvantaged groups might have lower likelihood of AVF placement. Study cohort of 118,767 incident hemodialysis patients ≥67 years of age (1/2005–12/2008) derived from the United States Renal Data System was linked with Medicare claims data to identify the type of initial access placed predialysis. We used logistic regression model with outcome being the initial predialysis placement of an AVF as opposed to an arteriovenous graft or a central venous catheter. Increasing age, female sex, black race, lower body mass index, urban location, certain comorbidities, and shorter pre–end‐stage renal disease nephrology care are all associated with a significantly lower likelihood of AVF placement as initial access predialysis. Our study suggests the presence of significant disparities in the placement of an AVF as initial hemodialysis vascular access. We suggest that additional attention should be paid to these patient groups to improve disparities by patient education, earlier referral, and close follow‐up.     

Collaborative knowledge building using the Design Principles Database

In this study we describe a mechanism for supporting a community of learning scientists who are exploring educational technologies by helping them to share and collaboratively build design knowledge. The Design Principles Database (DPD) is intended to be built and used by this community to provide an infrastructure for participants to publish, connect, discuss and review design ideas, and to use these ideas to create new designs. The potential of the DPD to serve as a collaborative knowledge-building endeavor is illustrated by analysis of a CSCL study focused on peer-evaluation. The analysis demonstrates how the DPD was used by the researchers of the peer-evaluation study in three phases. In the first phase, design principles were articulated based on a literature review and contributed to the DPD. In the second phase, a peer-evaluation activity was designed based on these principles, and was enacted and revised in a three-iteration study. In the third phase, lessons learned through these iterations were fed back to the DPD. The analysis indicates that such processes can contribute to collaborative development of design knowledge in a community of the learning sciences. Readers of ijCSCL are invited to take part in this endeavor and share their design knowledge with the community.     

Control of Polymorph Selection in Amorphous Calcium Carbonate Crystallization by Poly(Aspartic Acid): Two Different Mechanisms

Poly(aspartic acid) (pAsp) is known to stabilize amorphous calcium carbonate (ACC) and affect its crystallization pathways. However, little is known about the mechanisms behind these phenomena. Here it is shown that ACC is stabilized by pAsp molecules in the solution rather than by the amount of pAsp incorporated into the ACC bulk, and that the effect of pAsp on the polymorph selection is entirely different at low and high concentration of pAsp. At low concentrations, pAsp is more effective in inhibiting the nucleation and growth of vaterite than calcite. At high concentrations, when calcite formation is prevented, the crystallization of vaterite proceeds via a pseudomorphic transformation of ACC nanospheres, where vaterite nucleates on the surface of ACC nanospheres and grows by a local transformation of the bulk ACC phase. These results shed some light on the function of pAsp during an ACC‐mediated biomineralization process and provide an explanation for the presence of metastable vaterite at conditions where calcite is thermodynamically favored.     

Development of a sweet pepper harvesting robot

This paper presents the development, testing and validation of SWEEPER, a robot for harvesting sweet pepper fruit in greenhouses. The robotic system includes a six degrees of freedom industrial arm equipped with a specially designed end effector, RGB‐D camera, high‐end computer with graphics processing unit, programmable logic controllers, other electronic equipment, and a small container to store harvested fruit. All is mounted on a cart that autonomously drives on pipe rails and concrete floor in the end‐user environment. The overall operation of the harvesting robot is described along with details of the algorithms for fruit detection and localization, grasp pose estimation, and motion control. The main contributions of this paper are the integrated system design and its validation and extensive field testing in a commercial greenhouse for different varieties and growing conditions. A total of 262 fruits were involved in a 4‐week long testing period. The average cycle time to harvest a fruit was 24 s. Logistics took approximately 50% of this time (7.8 s for discharge of fruit and 4.7 s for platform movements). Laboratory experiments have proven that the cycle time can be reduced to 15 s by running the robot manipulator at a higher speed. The harvest success rates were 61% for the best fit crop conditions and 18% in current crop conditions. This reveals the importance of finding the best fit crop conditions and crop varieties for successful robotic harvesting. The SWEEPER robot is the first sweet pepper harvesting robot to demonstrate this kind of performance in a commercial greenhouse.     

Adaptations for Wear Resistance and Damage Resilience: Micromechanics of Spider Cuticular “Tools”

In the absence of minerals as stiffening agents, insects and spiders often use metal‐ion cross‐linking of protein matrices in their fully organic load‐bearing “tools.” In this comparative study, the hierarchical fiber architecture, elemental distribution, and the micromechanical properties of the manganese‐ and calcium‐rich cuticle of the claws of the spider Cupiennius salei, and the Zn‐rich cuticle of the cheliceral fangs of the same animal are analyzed. By correlating experimental results to finite element analysis, functional microstructural and compositional adaptations are inferred leading to remarkable damage resilience and abrasion tolerance, respectively. The results further reveal that the incorporation of both zinc and manganese/calcium correlates well with increased biomaterial's stiffness and hardness. However, the abrasion‐resistance of the claw material cross‐linked by incorporation of Mn/Ca‐ions surpasses that of many other non‐mineralized biological counterparts and is comparable to that of the fang with more than triple Zn content. These biomaterial‐adaptation paradigms for enhanced wear‐resistance may serve as novel design principles for advanced, high‐performance, functional surfaces, and graded materials.     

Ceramide Synthase 2 Null Mice Are Protected from Ovalbumin-Induced Asthma with Higher T Cell Receptor Signal Strength in CD4+ T Cells

(1) Background: six mammalian ceramide synthases (CerS1–6) determine the acyl chain length of sphingolipids (SLs). Although ceramide levels are increased in murine allergic asthma models and in asthmatic patients, the precise role of SLs with specific chain lengths is still unclear. The role of CerS2, which mainly synthesizes C22–C24 ceramides, was investigated in immune responses elicited by airway inflammation using CerS2 null mice. (2) Methods: asthma was induced in wild type (WT) and CerS2 null mice with ovalbumin (OVA), and inflammatory cytokines and CD4 (cluster of differentiation 4)+ T helper (Th) cell profiles were analyzed. We also compared the functional capacity of CD4+ T cells isolated from WT and CerS2 null mice. (3) Results: CerS2 null mice exhibited milder symptoms and lower Th2 responses than WT mice after OVA exposure. CerS2 null CD4+ T cells showed impaired Th2 and increased Th17 responses with concomitant higher T cell receptor (TCR) signal strength after TCR stimulation. Notably, increased Th17 responses of CerS2 null CD4+ T cells appeared only in TCR-mediated, but not in TCR-independent, treatment. (4) Conclusions: altered Th2/Th17 immune response with higher TCR signal strength was observed in CerS2 null CD4+ T cells upon TCR stimulation. CerS2 and very-long chain SLs may be therapeutic targets for Th2-related diseases such as asthma.     

Harnessing Split-Inteins as a Tool for the Selective Modification of Surface Receptors in Live Cells

Biochemical studies of integral membrane proteins are often hampered by low purification yields and technical limitations such as aggregation causing in vitro manipulations to be challenging. The ability of controlling proteins in live cells bypasses these limitations while broadening the scope of accessible questions owing to the proteins being in their native environment. Here we take advantage of the intein biorthogonality to mammalian systems, site specificity, fast kinetics, and auto-processing nature as an attractive option for modifying surface proteins. Using EGFR as a model, we demonstrate that the split-intein pair Ava^N/Npu^C can be used to efficiently and specifically modify target membrane proteins with a synthetic adduct for downstream live cell application.