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1.
Anal Biochem ; 688: 115480, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38331373

RESUMO

Isothermal nucleic acid amplification methods have many advantages for use at the point of care. However, there is a lack of multiplexed isothermal amplification tests to detect multiple targets in a single reaction, which would be valuable for many diseases, such as infection with high-risk human papillomavirus (hrHPV). In this study, we developed a multiplexed loop-mediated isothermal amplification (LAMP) reaction to detect the three most common hrHPV types that cause cervical cancer (HPV16, HPV18, and HPV45) and a cellular control for sample adequacy. First, we characterized the assay limit of detection (LOD) in a real-time reaction with fluorescence readout; after 30 min of amplification the LOD was 100, 10, and 10 copies/reaction of HPV16, HPV18, and HPV45, respectively, and 0.1 ng/reaction of human genomic DNA (gDNA). Next, we implemented the assay on lateral flow strips, and the LOD was maintained for HPV16 and HPV18, but increased to 100 copies/reaction for HPV45 and to 1 ng/reaction for gDNA. Lastly, we used the LAMP test to evaluate total nucleic acid extracted from 38 clinical samples; compared to qPCR, the LAMP test had 89% sensitivity and 95% specificity. When integrated with sample preparation, this multiplexed LAMP assay could be useful for point-of-care testing.


Assuntos
Papillomavirus Humano 18 , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Neoplasias do Colo do Útero/diagnóstico , Papillomavirus Humano , Sensibilidade e Especificidade , Infecções por Papillomavirus/diagnóstico , Técnicas de Amplificação de Ácido Nucleico/métodos , Papillomavirus Humano 16/genética , Papillomaviridae/genética , DNA Viral/genética
2.
Am J Occup Ther ; 78(4)2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38899950

RESUMO

IMPORTANCE: Play has been viewed as a critical occupation supporting health since the founding of occupational therapy, but the complexity of play presents challenges to scholars who study adults. Researchers in occupational science and occupational therapy often address experiential qualities of occupations, including those considered to be play. However, the literature lacks clear descriptions of what constitutes adult play as well as the experiences of adults during preferred activities. OBJECTIVE: To contribute to the body of knowledge on the wide range of preferred activities adults in the United States pursue and may perceive as play experiences. We refer to these activities as adult play because they contain experiential qualities of play described in key play literature. DESIGN: Cross-sectional survey study. SETTING: A 31-item survey, the Daily Occupational Experience Survey-revised (DOESr), was uploaded to Qualtrics for data collection using snowball sampling. The online survey link was distributed to participants aged 18-64 years. PARTICIPANTS: The survey was completed by 491 participants. Exploratory factor analysis was used to extract the most prevalent patterns of play experiences reported. Internal consistency and content validity were also examined. RESULTS: The factor analysis yielded an optimal solution of five factors representing distinct patterns of adult play experiences: Creativity-Adventure, Restoration, Deep Engagement, Ludos, and Mastery. CONCLUSIONS AND RELEVANCE: The five factors identified by the DOESr represent distinct patterns of adult play experiences. The DOESr demonstrated acceptable internal consistency for three of the five factors as well as for the overall tool. Plain-Language Summary: Previous research on adult occupations has not addressed the array of experiences that adults seek or enjoy while engaging in play. This study identified five patterns of adult play experiences. Understanding these patterns may assist occupational therapy practitioners when tailoring clients' play experiences to promote optimal health and well-being.


Assuntos
Jogos e Brinquedos , Humanos , Adulto , Estudos Transversais , Masculino , Feminino , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Terapia Ocupacional , Inquéritos e Questionários , Análise Fatorial , Estados Unidos , Criatividade
3.
Pediatr Res ; 2023 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-38049646

RESUMO

BACKGROUND: To describe pediatric Produce Prescription (PRx) interventions and their study designs, outcomes, and opportunities for future research. METHODS: A scoping review framework was used to describe PRx interventions published between January 2000 and September 2023. Articles from online databases were uploaded into Covidence. Data on study characteristics, outcomes of interest (health, food insecurity (FI), nutritional and culinary efficacy, and fruit and vegetable (F/V) consumption), and feasibility were extracted. The Mixed Methods Appraisal Tool (MMAT) was used for quality assessment. RESULTS: 19 articles met inclusion criteria. Ten studies were quantitative, five were qualitative, and four used mixed-methods. Interventions included food vouchers (n = 14) or food box/pantries (n = 5). Four studies allowed food items in addition to F/Vs. Six studies measured changes in FI and five reported a statistically significant decrease. Seven studies measured changes in F/V consumption and five reported a statistically significant increase. One study reported a statistically significant reduction in child BMI z-score. Most studies reported high feasibility. Few studies used high-quality methods. CONCLUSIONS: Pediatric PRx interventions show promising potential to reduce FI and improve diet quality and health-related outcomes. Future studies should utilize rigorous study designs and validated assessment tools to understand the impact of pediatric PRx on health. IMPACT: This work offers a summary of programmatic outcomes including retention, redemption, incentives, nutrition education, study design and quality limitations to help inform future work. We found positive impacts of pediatric produce prescriptions (PRx) on FI, F/V consumption, and nutritional knowledge and culinary skills. More high-quality, rigorous studies are needed to understand the best delivery and design of PRx and their impact on child behavior and health outcomes. This work provides support for the need for rigorous studies and the potential for PRx to play a role in multi-pronged strategies that address pediatric FI and diet-related disease.

4.
Langmuir ; 38(51): 16014-16023, 2022 12 27.
Artigo em Inglês | MEDLINE | ID: mdl-36516863

RESUMO

In this work, surface-supportive MIL-88B(Fe) was explored as a pH-stimuli thin film to release ibuprofen as a model drug. We used surface plasmon resonance microscopy to study the pH-responsive behaviors of MIL-88B(Fe) film in real time. A dissociation constant of (6.10 ± 0.86) × 10-3 s-1 was measured for the MIL-88B(Fe) film in an acidic condition (pH 6.3), which is about 10 times higher than the dissociation of the same film in a neutral pH condition. MIL-88B(Fe) films are also capable of loading around 6.0 µg/cm2 of ibuprofen, which was measured using a quartz crystal microbalance (QCM). Drug release profiles were compared in both acidic and neutral pH conditions (pH 6.3 and 7.4) using a QCM cell to model the drug release in healthy body systems and those containing inflammatory tissues or cancerous tumors. It was found that the amount of drug released in acidic environments had been significantly higher compared to that in a neutral system within 55 h of testing time. The pH-sensitive chemical bond breaking between Fe3+ and the carboxylate ligands is the leading cause of drug release in acidic conditions. This work exhibits the potential of using MOF thin films as pH-triggered drug delivery systems.


Assuntos
Estruturas Metalorgânicas , Estruturas Metalorgânicas/química , Ibuprofeno , Sistemas de Liberação de Medicamentos , Concentração de Íons de Hidrogênio
5.
Anal Chem ; 93(11): 4832-4840, 2021 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-33689292

RESUMO

Sickle cell disease (SCD) is a group of common, life-threatening disorders caused by a point mutation in the ß globin gene. Early diagnosis through newborn and early childhood screening, parental education, and preventive treatments are known to reduce mortality. However, the cost and complexity of conventional diagnostic methods limit the feasibility of early diagnosis for SCD in resource-limited areas worldwide. Although several point-of-care tests are commercially available, most are antibody-based tests, which cannot be used in patients who have recently received a blood transfusion. Here, we describe the development of a rapid, low-cost nucleic acid test that uses real-time fluorescence to detect the point mutation encoding hemoglobin S (HbS) in one round of isothermal recombinase polymerase amplification (RPA). When tested with a set of clinical samples from SCD patients and healthy volunteers, our assay demonstrated 100% sensitivity for both the ßA globin and ßS globin alleles and 94.7 and 97.1% specificities for the ßA globin allele and ßS globin allele, respectively (n = 91). Finally, we demonstrate proof-of-concept sample-to-answer genotyping of genomic DNA from capillary blood using an alkaline lysis procedure and direct input of diluted lysate into RPA. The workflow is performed in <30 min at a cost of <$5 USD on a commercially available benchtop fluorimeter and an open-source miniature fluorimeter. This study demonstrates the potential utility of a rapid, sample-to-answer nucleic acid test for SCD that may be implemented near the point of care and could be adapted to other disease-causing point mutations in genomic DNA.


Assuntos
Anemia Falciforme , Recombinases , Alelos , Anemia Falciforme/diagnóstico , Anemia Falciforme/genética , Pré-Escolar , Hemoglobina Falciforme/análise , Humanos , Recém-Nascido , Técnicas de Amplificação de Ácido Nucleico , Sistemas Automatizados de Assistência Junto ao Leito , Sensibilidade e Especificidade
6.
BMC Psychiatry ; 21(1): 373, 2021 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-34311714

RESUMO

BACKGROUND: Sleep disruption is pervasive in people with schizophrenia, but few studies have explored their sleep experiences. This study aims to identify factors relevant to sleep problems and explore coping methods used by community-dwelling people with schizophrenia. METHODS: Eighteen participants with schizophrenia were recruited from three mental health centers in Taiwan. They completed a semi-structured interview and the Pittsburgh Sleep Quality Index (PSQI) assessment. The Person-Environment-Occupation model offered a framework to assess factors related to sleep. Thematic analysis was used for the qualitative data analysis. RESULTS: Factors related to sleep were classified under person, environment, and occupation domains. The person domain included three subthemes: psychiatric symptoms, unpleasant emotions, and frustration about sleep. The environment domain included three subthemes: sensory intrusions from the environment, quality of bedding, and roommates. The occupation domain included sleep interruption and sleep preparation. There were notable discrepancies in sleep quality between the participants' narratives and their PSQI global scores. Regarding coping methods for poor sleep, sleep medication was the primary strategy while some participants also used other strategies, such as modifying the environment, adjusting routines, or engaging in activities that improve sleep quality. CONCLUSIONS: Psychiatric symptoms and nightmares were identified as unique sleep disruptions in people with schizophrenia, and poor economic status was also found to impact their sleep. The sleep quality of people with schizophrenia tends to be poor, as identified by the PSQI, even though they may have positive perceptions of their sleep quality. Our participants appeared to prefer to take hypnotics to address their sleep problems, which may be due to limited knowledge about alternatives. Mental health professionals are encouraged to receive training in the application of non-pharmacological approaches to support their clients' issues related to sleep.


Assuntos
Esquizofrenia , Distúrbios do Início e da Manutenção do Sono , Adaptação Psicológica , Humanos , Esquizofrenia/complicações , Sono , Taiwan
7.
Int J Mol Sci ; 22(10)2021 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-34065616

RESUMO

We have performed 280 µs of unbiased molecular dynamics (MD) simulations to investigate the effects of 12 different cancer mutations on Kelch-like ECH-associated protein 1 (KEAP1) (G333C, G350S, G364C, G379D, R413L, R415G, A427V, G430C, R470C, R470H, R470S and G476R), one of the frequently mutated proteins in lung cancer. The aim was to provide structural insight into the effects of these mutants, including a new class of ANCHOR (additionally NRF2-complexed hypomorph) mutant variants. Our work provides additional insight into the structural dynamics of mutants that could not be analyzed experimentally, painting a more complete picture of their mutagenic effects. Notably, blade-wise analysis of the Kelch domain points to stability as a possible target of cancer in KEAP1. Interestingly, structural analysis of the R470C ANCHOR mutant, the most prevalent missense mutation in KEAP1, revealed no significant change in structural stability or NRF2 binding site dynamics, possibly indicating an covalent modification as this mutant's mode of action.


Assuntos
Proteína 1 Associada a ECH Semelhante a Kelch/genética , Neoplasias Pulmonares/genética , Mutação de Sentido Incorreto/genética , Sítios de Ligação/genética , Linhagem Celular Tumoral , Humanos , Simulação de Dinâmica Molecular , Ligação Proteica/genética , Estabilidade Proteica
8.
J Electrochem Soc ; 167(3)2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34326553

RESUMO

Nanosensors built with pre-pulled glass nanopipettes, including bare or chemically modified nanopipettes and fully or partially filled solid nanoelectrodes, have found applications in chemical and biological sensing via resistive-pulse, current rectification, and electrochemical sensing. These nanosensors are easily fabricated and provide advantages through their needle-like geometry with nanometer-sized tips, making them highly sensitive and suitable for local measurements in extremely small samples. The variety in the geometry and layout have extended sensing capabilities. In this review, we will outline the fundamentals in fabrication, modification, and characterization of those pre-pulled glass nanopipette based nanosensors and highlight the most recent progress in their development and applications in real-time monitoring of biological processes, chemical ion sensing, and single entity analysis.

9.
Am J Occup Ther ; 74(1): 7401185010p1-7401185010p18, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32078506

RESUMO

IMPORTANCE: The prevalence of low vision increases with age. Low vision has detrimental effects on older adults' independence. OBJECTIVE: To identify the effectiveness of interventions within the scope of occupational therapy practice to maintain, restore, and improve performance in daily activities for older adults with low vision. DATA SOURCES: Literature published between 2010 and 2017 was searched in CINAHL, Cochrane Databases, MEDLINE, OTseeker, and PsycINFO. STUDY SELECTION AND DATA COLLECTION: The authors screened and appraised studies following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Studies were eligible if the participants' mean age was 55 yr or older, the level of evidence was Level III or higher, the intervention was within the scope of occupational therapy practice, and the outcome measures assessed the performance of daily activities. FINDINGS: Fourteen studies met the review criteria. Three intervention themes were identified: low vision rehabilitation services (n = 6), self-management approach (n = 6), and tango (n = 2). Moderate evidence was found for low vision rehabilitation services. Low evidence was found for using the self-management approach or adding the self-management approach to existing low vision rehabilitation services. Low evidence was found for tango. CONCLUSION AND RELEVANCE: This systematic review supports the use of low vision rehabilitation services as an effective approach. Occupational therapy practitioners are encouraged to be part of multidisciplinary teams that offer comprehensive low vision evaluations and multicomponent services. WHAT THIS ARTICLE ADDS: Low vision rehabilitation that offers multidisciplinary services, including occupational therapy, is effective in promoting independence among older adults with low vision.


Assuntos
Terapia Ocupacional , Baixa Visão , Idoso , Humanos , Terapia Ocupacional/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde
10.
Faraday Discuss ; 210(0): 131-143, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-29974096

RESUMO

Parkinson's disease (PD) is recognized as the second most common neurodegenerative disorder and has affected approximately one million people in the United States alone. A large body of evidence has suggested that deposition of aggregated alpha-synuclein (α-Syn), a brain protein abundant near presynaptic termini, in intracellular protein inclusions (Lewy bodies) results in neuronal cell damage and ultimately contributes to the progression of PD. However, the exact mechanism is still unclear. One hypothesis is that α-Syn aggregates disrupt the cell membrane's integrity, eventually leading to cell death. We used scanning ion conductance microscopy (SICM) to monitor the morphological changes of SH-SY5Y neuroblastoma cells and observed dramatic disruption of the cell membrane after adding α-Syn aggregates to the culturing media. This work demonstrates that SICM can be applied as a new approach to studying the cytotoxicity of α-Syn aggregates.


Assuntos
Membrana Celular/patologia , Agregação Patológica de Proteínas/patologia , alfa-Sinucleína/metabolismo , Morte Celular , Linhagem Celular Tumoral , Membrana Celular/metabolismo , Humanos , Microscopia Eletroquímica de Varredura , Neuroblastoma/metabolismo , Neuroblastoma/patologia , Neurônios/metabolismo , Neurônios/patologia , Doença de Parkinson/metabolismo , Doença de Parkinson/patologia , Agregação Patológica de Proteínas/metabolismo , alfa-Sinucleína/análise
11.
Pediatr Emerg Care ; 34(5): 349-356, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-27482966

RESUMO

OBJECTIVE: This study aimed to assess if Michigan child care directors have created disaster management plans, and if local resources were used to develop and implement plans. METHODS: From December 2013 to March 2014, the Early Childhood Investment Corporation conducted a survey of licensed child care programs in Michigan. An online survey regarding disaster preparedness and training resources was distributed to the directors of a convenience sample of registered child care centers among the Early Childhood Investment Corporation's statewide network of 11 resource centers. RESULTS: A total of 210 child care programs responded. Most (91%) of respondents had a disaster plan, but 40% did not include accommodations for special needs children, 51% did not have a family/child identification or reunification plan, and 67% did not have car safety devices and a predetermined route for evacuation. Fewer than 9% made disaster plans available online. Few collaborated with local fire (22%), police (27%), or pediatric or emergency medicine organizations (11%). Online modules were the most desirable training format. CONCLUSIONS: In a state without mandated child care guidelines for disaster preparedness, a substantial proportion of child care programs were missing critical components of disaster planning. Future interventions must focus on increasing partnerships with local organizations and developing guidelines and training to include plans for special needs children, family/child identification and reunification, and evacuation/relocation.


Assuntos
Cuidado da Criança/estatística & dados numéricos , Planejamento em Desastres/estatística & dados numéricos , Alocação de Recursos/estatística & dados numéricos , Criança , Cuidado da Criança/normas , Pré-Escolar , Desastres , Pesquisas sobre Atenção à Saúde , Humanos , Lactente , Recém-Nascido , Michigan
12.
Am J Occup Ther ; 72(4): 7204190060p1-7204190060p11, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29953830

RESUMO

OBJECTIVE: This systematic review aimed to synthesize the effects of interventions within the scope of occupational therapy to improve performance of activities of daily living (ADLs) in community-dwelling older adults. METHOD: Searches were conducted in CINAHL, the Cochrane Database of Systematic Reviews, MEDLINE, PsycINFO, and OTseeker. Empirical studies published between 1995 and 2015 were individually screened and appraised by two reviewers. RESULTS: Forty-three studies met the review inclusion and exclusion criteria. Physical exercise was the most common intervention approach. Physical exercise interventions for frail older adults showed a moderate benefit, but no benefits were found for older adults without noticeable difficulty in ADLs. For older adults with difficulty in ADLs, there was a high benefit of using home-based intervention. CONCLUSION: The findings of this systematic review highlight the importance of addressing older adults' living environment in intervention to promote independence in ADLs.


Assuntos
Atividades Cotidianas , Idoso Fragilizado , Terapia Ocupacional , Idoso , Exercício Físico , Humanos , Vida Independente
13.
South Med J ; 110(8): 502-508, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28771646

RESUMO

OBJECTIVE: Children's summer camps are at risk for multiple pediatric casualties during a disaster. The degree to which summer camps have instituted disaster preparedness is unknown. We assessed disaster preparedness among selected camps nationally for a range of disasters. METHODS: We partnered with a national, web-based electronic health records system to send camp leadership of 315 camp organizations a 14-question online survey of disaster preparedness. One response from each camp was selected in the following order of importance: owner, director, physician, nurse, medical technician, office staff, and other. The results were analyzed using descriptive statistics. RESULTS: A total of 181 camps responses were received, 169 of which were complete. Camp types were overnight (60%), day (21%), special/medical needs (14%), and other (5%). Survey respondents were directors (52%), nurses (14%), office staff (10%), physicians (5%), owners (5%), emergency medical technicians (2%), and other (12%). Almost 18% of camps were located >20 mi from a major medical center, and 36% were >5 mi from police/fire departments. Many camps were missing emergency supplies: car/booster seats for evacuation (68%), shelter (35%), vehicles for evacuation (26%), quarantine isolation areas (21%), or emergency supplies of extra water (20%) or food (17%). Plans were unavailable for the following: power outages (23%); lockdowns (15%); illness outbreaks (15%); tornadoes (11%); evacuation for fire, flood, or chemical spill (9%); and other severe weather (8%). Many camps did not have online emergency plans (53%), plans for children with special/medical needs (38%), methods to rapidly communicate information to parents (25%), or methods to identify children for evacuation/reunification with parents (40%). Respondents reported that staff participation in disaster drills varied for weather (58%), evacuations (46%), and lockdowns (36%). The majority (75%) of respondents had not collaborated with medical organizations for planning. CONCLUSIONS: A substantial proportion of camps were missing critical components of disaster planning. Future interventions must focus on developing summer camp-specific disaster plans, increasing partnerships, and reassessing national disaster plans to include summer camp settings.


Assuntos
Planejamento em Desastres/normas , Instalações Esportivas e Recreacionais , Canadá , Criança , Necessidades e Demandas de Serviços de Saúde , Humanos , Estações do Ano , Inquéritos e Questionários , Estados Unidos
14.
Am J Occup Ther ; 70(5): 7005220010p1-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27548865

RESUMO

OBJECTIVE: The study's objective was to evaluate the effectiveness of the Interdisciplinary Sensory-Enriched Early Intervention (ISEEI) group program for children with developmental delays. METHOD: We conducted a retrospective chart review of 63 children ages 18-36 mo who participated in ISEEI. We evaluated participants with the Bayley Scales of Infant and Toddler Development III (Bayley-III) and the Infant/Toddler Sensory Profile (ITSP) at enrollment and after 3-9 mo. We conducted a paired t test to examine changes in the Bayley-III between pre- and posttests. RESULTS: At enrollment, 70% of children presented atypical scores in two or more areas of sensory processing in the ITSP. Results revealed that children with sensory processing difficulties demonstrated significant improvement in all areas of development except fine motor skills; children without sensory processing difficulties showed significant improvement in language and cognition. CONCLUSION: The ISEEI group program is an effective method to ameliorate developmental delays.

15.
Prostate ; 74(2): 149-63, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24122957

RESUMO

BACKGROUND: Bone marrow stromal cell (BMSC) paracrine factor(s) can induce apoptosis in bone metastatic prostate cancer (PCa) cell lines. However, the PCa cells that escape BMSC-induced apoptosis can upregulate cytoprotective autophagy. METHODS: C4-2, C4-2B, MDA PCa 2a, MDA PCa 2b, VCaP, PC3, or DU145 PCa cell lines were grown in BMSC conditioned medium and analyzed for mRNA and/or protein accumulation of p62 (also known as sequestome-1/SQSTM1), Microtubule-associated protein 1 light chain 3B (LC3B), or lysosomal-associated membrane protein 1 (LAMP1) using quantitative polymerase chain reaction (QPCR), Western blot, or immunofluorescence. Small interfering RNA (siRNA) was used to determine if p62 is necessary PCa cell survival. RESULTS: BMSC paracrine signaling upregulated p62 mRNA and protein in a subset of the PCa cell lines. The PCa cell lines that were insensitive to BMSC-induced apoptosis and autophagy induction had elevated basal p62 mRNA and protein. In the BMSC-insensitive PCa cell lines, siRNA knockdown of p62 was cytotoxic and immunostaining showed peri-nuclear clustering of autolysosomes. However, in the BMSC-sensitive PCa cell lines, p62 siRNA knockdown was not appreciably cytotoxic and did not affect autolysosome subcellular localization. CONCLUSIONS: A pattern emerges wherein the BMSC-sensitive PCa cell lines are known to be osteoblastic and express the androgen receptor, while the BMSC-insensitive PCa cell lines are characteristically osteolytic and do not express the androgen receptor. Furthermore, BMSC-insensitive PCa may have evolved a dependency on p62 for cell survival that could be exploited to target and kill these apoptosis-resistant PCa cells in the bone.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/fisiologia , Apoptose/fisiologia , Neoplasias Ósseas/secundário , Neoplasias da Próstata/patologia , Autofagia/efeitos dos fármacos , Linhagem Celular Tumoral , Sobrevivência Celular/fisiologia , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , Masculino , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/patologia , Invasividade Neoplásica/patologia , Proteína Sequestossoma-1
16.
Am J Occup Ther ; 68(5): 531-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25184465

RESUMO

This article describes the development of the Adult Sensory Processing Scale (ASPS), a sensory processing questionnaire for adults. The ASPS measures self-reported responses to input from distinct sensory systems and is intended to be sensitive to individual differences in the adult population. ASPS construction involved two phases: item development and instrument construction. During item development, content validity of 71 items was assessed by means of expert ratings. During instrument construction, items were evaluated using data from an online survey of 491 adults. Exploratory factor analysis and Rasch analysis yielded an optimal solution of eight factors representing vestibular overresponsiveness, auditory overresponsiveness, visual overresponsiveness, social tactile overresponsiveness, proprioceptive seeking, general underresponsiveness, vestibular--proprioceptive underresponsiveness affecting postural control, and vestibular overresponsiveness--intolerance to movement. The final ASPS contains 39 items and demonstrates acceptable internal consistency, strong content validity, and adequate construct validity.


Assuntos
Transtornos de Sensação , Inquéritos e Questionários , Atividades Cotidianas , Adolescente , Adulto , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Autorrelato , Transtornos de Sensação/fisiopatologia , Transtornos de Sensação/reabilitação , Adulto Jovem
17.
Endosc Int Open ; 12(5): E642-E648, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38707596

RESUMO

Background and study aims The Plan-Do-Study Act (PDSA) ramp is a framework that uses initial small changes to build consensus and momentum for subsequent, iterative process improvement. Our aim was to study its impact on endoscopy unit efficiency and throughput. Methods Following a granular time-and-motion analysis to evaluate baseline performance (phase 1) we instituted successive interventions and measured their impact on core efficiency metrics including procedure volume and turnover time (phases 2-3). Results We identified that inefficiency in turnover of anesthesia-supported endoscopy was the most crucial issue. Implementation of a pre-procedure anesthesia visit in phase 2 reduced turnover time by 15.5 minutes (95% confidence interval 3.9-27.1 minutes). Subsequent changes (phase 3) including front-loaded procedure scheduling and parallel in-room preparation resulted in an 18% increase in procedure volume. Conclusions The PDSA ramp model is an effective means of assessing operational processes, developing novel interventions, and building consensus to improve the real-world productivity in a resource-conscious manner.

18.
J Geriatr Psychiatry Neurol ; 26(1): 3-9, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23385362

RESUMO

BACKGROUND/AIM: Despite existing diagnostic criteria for Charles Bonnet syndrome (CBS), clinical manifestations vary greatly. We examined the clinical course and mortality of patients diagnosed with CBS. METHODS: We conducted a retrospective chart review of patients with CBS. We collected demographic and clinical information and medical burden scores. Kaplan-Meier mortality curves were compared using log-rank test. Cox proportional hazard model was used for multivariate analysis and hazard ratio (HR). Mortality was compared to expected mortality from Minnesota population. RESULTS: Seventy-seven patients with CBS had a mean age of 79.5 (standard deviation ± 13.0) and were predominantly Caucasian (97%) and female (73%). In all, 20 (26%) subsequently developed a dementia syndrome, most often Lewy body. A total of 46 (60%) deaths occurred with an average follow-up time of 33.0 months. Characteristics associated with mortality included older age (75-84 [HR 3.34, P = .029], >85 [HR 4.58, P = .007]) and renal disease (HR 3.39 with 95% confidence interval 1.31-8.80, P = .012). Medical burden scores were not associated with overall mortality. Mortality was high compared to Minnesota population (P < .0001). CONCLUSIONS: A large proportion of patients with CBS developed dementia, and there was a high mortality rate associated with older age and renal disease. Medical burden was not associated with mortality.


Assuntos
Cognição/fisiologia , Demência/mortalidade , Demência/psicologia , Alucinações/mortalidade , Alucinações/psicologia , Adulto , Idoso de 80 Anos ou mais , Comorbidade , Interpretação Estatística de Dados , Progressão da Doença , Feminino , Alucinações/etiologia , Humanos , Estimativa de Kaplan-Meier , Nefropatias/complicações , Doença por Corpos de Lewy/etiologia , Doença por Corpos de Lewy/psicologia , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Estudos Retrospectivos , Fatores Socioeconômicos , Síndrome
19.
Support Care Cancer ; 21(1): 229-33, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22915355

RESUMO

BACKGROUND: Fatigue among patients with cancer is prevalent, disabling, and treatable. While fatigue management guidelines have been in place for a decade, their use remains unclear. METHODS: We surveyed 160 patients with stage IV lung (40), breast (40), colon (40), and prostate (40) cancer who reported moderate to severe fatigue (i.e., >5 of 10 on an 11-point numerical rating scale). Participants were queried about receipt of treatments in fatigue management domains emphasized in the National Comprehensive Cancer Network guidelines: general management strategies, activity enhancement, psychosocial strategies, and pharmaceuticals. RESULTS: The cohort was half male, had a mean age of 67, and reported an average fatigue rating of 6.4. Participants reported treatment or receipt of specific guidance in the fatigue management domains as follows: general management strategies 16.8 %, activity enhancement 11.9 %, psychosocial strategies 9.9 %, and pharmaceuticals 37.3 %. Fatigue >7 of 10 increased the likelihood of instruction in activity enhancement but no other domain. CONCLUSION: The low rates of guideline-congruent treatment reported here are concerning, particularly as better validated behavioral treatments were the least prescribed.


Assuntos
Fadiga/terapia , Fidelidade a Diretrizes , Neoplasias/complicações , Padrões de Prática Médica , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/patologia , Estudos Prospectivos , Estados Unidos
20.
Sci Rep ; 13(1): 20397, 2023 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-37989845

RESUMO

Cervical cancer is a leading cause of death for women in low-resource settings despite being preventable through human papillomavirus (HPV) vaccination, early detection, and treatment of precancerous lesions. The World Health Organization recommends high-risk HPV (hrHPV) as the preferred cervical cancer screening strategy, which is difficult to implement in low-resource settings due to high costs, reliance on centralized laboratory infrastructure, and long sample-to-answer times. To help meet the need for rapid, low-cost, and decentralized cervical cancer screening, we developed tailed primer isothermal amplification and lateral flow detection assays for HPV16, HPV18, and HPV45 DNA. We translated these assays into a self-contained cartridge to achieve multiplexed detection of three hrHPV genotypes in a disposable cartridge. The developed test achieves clinically relevant limits of detection of 50-500 copies per reaction with extracted genomic DNA from HPV-positive cells. Finally, we performed sample-to-answer testing with direct lysates of HPV-negative and HPV-positive cell lines and demonstrated consistent detection of HPV16, HPV18, and HPV45 with 5000-50,000 cells/mL in < 35 min. With additional optimization to improve cartridge reliability, incorporation of additional hrHPV types, and validation with clinical samples, the assay could serve as a point-of-care HPV DNA test that improves access to cervical cancer screening in low-resource settings.


Assuntos
Ácidos Nucleicos , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Neoplasias do Colo do Útero/diagnóstico , Papillomavirus Humano 16/genética , Sistemas Automatizados de Assistência Junto ao Leito , Detecção Precoce de Câncer , Infecções por Papillomavirus/diagnóstico , Reprodutibilidade dos Testes , DNA Viral/genética , Genótipo , Papillomaviridae/genética
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