Objective
We tested our hypothesis that abdominal obesity when associated with increased levels of systemic and CNS immuno-inflammatory mediators contributes to neurocognitive impairment (NCI).
Design
Cross-sectional
Setting
Six Academic Centers
Participants
152 patients with plasma HIV RNA <1,000copies/ml had clinical evaluations and cognitive function quantified by global deficit scores (GDS).
Outcome Measures
GDS, waist circumference (WC) and plasma IL-6, sCD163, and sCD14 and CSF sCD40L, sTNFrII, MCP-1, sICAM, and MMP-9.
Results
WC and plasma IL-6 levels positively correlated with GDS; the WC correlation was strongest in the high tertile of IL-6 (rho=0.39, p=0.005). IL-6 correlated with GDS only if WC was ≥99cm. In the high tertile of CSF sCD40L, a biomarker of macrophage and microglial activation, the correlation of IL-6 to GDS was strongest (rho=0.60, p<0.0001). Across 3-5 visits within ±1year of the index visit, GDS remained worse in patients with IL-6 levels in the high-versus-low tertile (p=0.02). Path analysis to explore potential mediators of NCI produced a strong, integrated model for patients in the high CSF sCD40L tertile. In this model, WC affected GDS both directly and via a second path that was mediated by IL-6. Inclusion of plasma sCD14 levels strengthened the model. NCI was more common in men and for individuals with components of the metabolic syndrome.
Conclusions
NC function was significantly linked to abdominal obesity, systemic inflammation (high IL-6), and immune activation in plasma (high sCD14) and CSF (high sCD40L). Abdominal obesity, inflammation, and CNS immune activation are potential therapeutic targets for NCI in HIV+ patients.
Creatine and whey protein supplementation may not provide additional benefits in older adults performing periodized RT to augment muscular and functional performance.
Efficient
planar heterojunction perovskite solar cells (PHJ–PSCs)
with a structure of ITO/PEDOT:PSS/CH3NH3PbI3/PCBM/Al were fabricated using air-induced high-quality CH3NH3PbI3 perovskite thin films, in which
the air-inducing process was controlled with a humidity of ∼40%.
The air exposure of CH3NH3PbI3 thin
films could dramatically improve their properties with large grains
and smooth surface, as well as uniform morphology, resulting in an
impressive enhancement in carrier lifetime. The ultraviolet photoelectron
spectroscopy and X-ray photoelectron spectroscopy results proved that
the CH3NH3PbI3 film was n-doped by the absorption of H2O on the surface but was
very stable without obvious degradation for 10 days’ exposure
in air. The power conversion efficiency (PCE) of PHJ–PSCs with
an air exposure process showed a significant increase up to 16.21%
as compared to reference PHJ–PSCs with a PCE of 12.02%. The
research work demonstrated that an air-exposure process with a suitable
humidity could produce high-quality perovskite thin film for efficient
PHJ–PSCs, which may pave a boulevard for fabricating high-efficiency
PHJ–PSCs in atmospheric environment.
To enhance muscle strength and physical function, threshold improvements in lean body mass and appendicular skeletal muscle mass are necessary and these can be achieved by targeting changes in testosterone levels. rhGH augments the effects of testosterone. To maximize functional improvements, the doses of anabolic hormones should be titrated to achieve target blood levels.
This paper presents the design of a wideband X-band microstrip 4×4 Butler matrix. The wideband performance of the Butler matrix means that it possesses equal coupling and difference of phases throughout the operating band. Design of the wideband components such as 3-branch branch line hybrid, crossover and Schiffman line phase shifter are presented in this paper. A final design of the Butler matrix is proposed. The Butler matrix exhibits couplings and phase errors within −6.7 ± 0.7 dB and 10 • over a 20% bandwidth with a center frequency at 10 GHz.
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