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1.
Transfusion ; 2024 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-39139007

RESUMO

BACKGROUND: Balanced plasma/red blood cell transfusions have shown survival benefit in emergency scenarios. To improve plasma availability, we implemented 5-day group A thawed plasma at our pediatric hospital in February 2021. STUDY DESIGN AND METHODS: We maintain thawed group A plasma units (5-day shelf-life) ready for immediate issue in the blood bank (since February 2021) and trauma code room (since August 2022). Group A plasma (un-titered) is issued for patients with unknown blood type during emergencies. We retrospectively reviewed records and laboratory results of recipients to assess safety and identify possible adverse events related to incompatible plasma. RESULTS: Between February 2021 and December 2023, 173 emergency plasma requests occurred for 161 patients. Ninety-one occurred with massive transfusion protocol activations. Thirty-six patients (22.4%) were blood group B or AB, and 23 received incompatible plasma (age 0-21.3 years, weight 0.74-149.8 kg, incompatible plasma dose 4.0-428.4 mL/kg). These patients did not have any differences in survival outcomes or hospital lengths of stay (LOS) compared with compatible plasma recipients, mirroring the adult experience. None experienced adverse events related to group A plasma. No transfusion reactions were reported. No increase in wastage/outdate occurred upon thawed plasma implementation (2020 versus 2021 to 2023, 7.73% [133/1721] vs. 8.58% [497/5792], p = .284). CONCLUSIONS: We implemented 5-day group A thawed plasma. Units are rapidly available from the blood bank and trauma code room without increased wastage. We did not identify any transfusion-associated adverse events in pediatric recipients of incompatible group A plasma.

3.
Cytotherapy ; 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38944797

RESUMO

As the field of cell and gene therapy (CGT) continues to grow, so too must the infrastructure and regulatory guidance supporting the manufacture of these potentially life-saving products-especially early-phase products manufactured at an increasing number of academic or hospital-based facilities providing decentralized (or point of care) manufacturing. An important component of current good manufacturing practices, including those regulating cell and gene therapies, is the establishment of an effective environmental monitoring (EM) program. While several guidelines for establishing an EM program are available, these guidelines do not specifically address the unique aspects of manufacturing CGT products and they do not provide real-world evidence demonstrating the effectiveness of the program. Here, we describe the establishment and evolution of an EM program in a cell therapy manufacturing facility at an academic hospital. With 10 years of EM data, we analyze the effectiveness for identifying trends in environmental conditions and highlight important findings, with the aim of providing practical evidence and guidance for the development of future early-phase EM programs.

4.
Body Image ; 49: 101716, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38744195

RESUMO

Body image is an established public health concern and there is a pressing need for evidence-informed universal programmes for older adolescents. To ensure high standard, quality programmes, there have been calls to adapt existing programmes to different contexts in ways that ensure materials are relevant, but still aligned with their theoretical foundations. This study outlines the cultural adaptation of the BodyKind programme in Ireland, which was initially developed in the USA, to address an unmet need to provide an inclusive, strengths-focused, school-based body image intervention for older adolescents. After receiving BodyKind, codesign workshops were conducted with 12 adolescents aged 15-16 years, who provided feedback and designed content (examples/scenarios) to increase the programme's relevance for adolescents. Feedback on cultural appropriateness of programme materials were obtained via interviews with six female post-primary teachers and one mental health clinician. Qualitative data were analysed using thematic analysis. BodyKind was perceived as highly acceptable by stakeholders who offered suggestions for programme refinement. Themes included 1.) Programme acceptability, 2.) Implementation considerations, 3.) Programme refinement. This study used multi-stakeholder feedback to engage in cultural adaptation of BodyKind prior to further evaluation, thereby informing efforts to implement sustainable and scalable programmes in schools.


Assuntos
Imagem Corporal , Humanos , Adolescente , Irlanda , Feminino , Imagem Corporal/psicologia , Masculino , Serviços de Saúde Escolar , Avaliação de Programas e Projetos de Saúde/métodos , Pesquisa Qualitativa
5.
Nat Commun ; 15(1): 3258, 2024 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-38637498

RESUMO

Viral infections remain a major risk in immunocompromised pediatric patients, and virus-specific T cell (VST) therapy has been successful for treatment of refractory viral infections in prior studies. We performed a phase II multicenter study (NCT03475212) for the treatment of pediatric patients with inborn errors of immunity and/or post allogeneic hematopoietic stem cell transplant with refractory viral infections using partially-HLA matched VSTs targeting cytomegalovirus, Epstein-Barr virus, or adenovirus. Primary endpoints were feasibility, safety, and clinical responses (>1 log reduction in viremia at 28 days). Secondary endpoints were reconstitution of antiviral immunity and persistence of the infused VSTs. Suitable VST products were identified for 75 of 77 clinical queries. Clinical responses were achieved in 29 of 47 (62%) of patients post-HSCT including 73% of patients evaluable at 1-month post-infusion, meeting the primary efficacy endpoint (>52%). Secondary graft rejection occurred in one child following VST infusion as described in a companion article. Corticosteroids, graft-versus-host disease, transplant-associated thrombotic microangiopathy, and eculizumab treatment correlated with poor response, while uptrending absolute lymphocyte and CD8 T cell counts correlated with good response. This study highlights key clinical factors that impact response to VSTs and demonstrates the feasibility and efficacy of this therapy in pediatric HSCT.


Assuntos
Infecções por Vírus Epstein-Barr , Transplante de Células-Tronco Hematopoéticas , Viroses , Humanos , Criança , Herpesvirus Humano 4 , Fatores de Risco , Transplante de Células-Tronco Hematopoéticas/efeitos adversos
6.
Body Image ; 49: 101710, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38569448

RESUMO

Initial evidence suggests that body appreciation prospectively predicts intuitive eating. However, the limited number of longitudinal studies focused solely on girls and women, with a lack of evaluation among men. Furthermore, the underlying mechanisms explaining this relationship remain poorly understood. The present study examined whether body appreciation prospectively predicted intuitive eating facets among women and men in Germany. We also tested whether adaptive affect regulation skills (i.e., body image flexibility) mediated these relationships. We analyzed data from 1436 women and 704 men across three time points: Baseline (T1), 6-month (T2), and 12-month (T3) follow-up, using latent variable path models to assess direct and indirect effects. Among women, T1 body appreciation directly predicted T3 body-food choice congruence. Additionally, body appreciation indirectly predicted unconditional permission to eat, eating for physical rather than emotional reasons, and reliance on hunger and satiety cues at T3 via its effect on T2 body image flexibility. Among men, T1 body appreciation indirectly predicted T3 eating for physical rather than emotional reasons via T2 body image flexibility. Our findings suggest that body image flexibility plays a pivotal role in explaining why individuals who appreciate their bodies are more likely to eat intuitively.


Assuntos
Imagem Corporal , Comportamento Alimentar , Intuição , Humanos , Masculino , Feminino , Imagem Corporal/psicologia , Adulto , Adulto Jovem , Alemanha , Comportamento Alimentar/psicologia , Fome , Adolescente , Estudos Prospectivos , Preferências Alimentares/psicologia , Saciação , Ingestão de Alimentos/psicologia , Estudos Longitudinais
7.
J Chem Theory Comput ; 20(7): 2812-2819, 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38538531

RESUMO

Computer simulation methods can aid in the rational design of drugs aimed at a specific target, typically a protein. The affinity of a drug for its target is given by the free energy of binding. Binding can be further characterized by the enthalpy and entropy changes in the process. Methods exist to determine exact free energies, enthalpies, and entropies that are dependent only on the quality of the potential model and adequate sampling of conformational degrees of freedom. Entropy and enthalpy are roughly an order of magnitude more difficult to calculate than the free energy. This project combines a replica exchange method for enhanced sampling, designed to be efficient for protein-sized systems, with free energy calculations. This approach, replica exchange with dynamical scaling (REDS), uses two conventional simulations at different temperatures so that the entropy can be found from the temperature dependence of the free energy. A third replica is placed between them, with a modified Hamiltonian that allows it to span the temperature range of the conventional replicas. REDS provides temperature-dependent data and aids in sampling. It is applied to the bromodomain-containing protein 4 (BRD4) system. We find that for the force fields used, the free energies are accurate but the entropies and enthalpies are not, with the entropic contribution being too positive. Reproducing the entropy and enthalpy of binding appears to be a more stringent test of the force fields than reproducing the free energy.


Assuntos
Proteínas Nucleares , Fatores de Transcrição , Entropia , Simulação por Computador , Termodinâmica , Ligação Proteica , Simulação de Dinâmica Molecular
8.
Arch Clin Neuropsychol ; 39(1): 11-23, 2024 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-37565825

RESUMO

OBJECTIVE: Posttraumatic stress disorder (PTSD) is prevalent among U.S. combat Veterans, and associated with poor health and wellbeing. As combat experiences are likely to significantly modify self-, other-, and society-oriented cognitions and heighten risk for PTSD, examination of related cognitive processes may yield new treatment strategies. The cognitive model of PTSD suggests that persistent threat perceptions contribute to symptom worsening. Thus, cognitive processes of shifting perspectives or generating novel interpretations may be particularly relevant to lessen PTSD symptoms. This cross-sectional study examined executive functioning as a moderator to the relationship between combat exposure and PTSD symptom clusters among post-9/11 Veterans. METHOD: Data from 168 Veterans were drawn from a larger study examining post-deployment mental health and cognitive function. An executive functioning composite derived from Wisconsin Card Sorting Test Perseveration Errors, WAIS-III Similarities, Trail Making Test B, and Stroop Color-Word Inhibition scores was computed. Path analysis was used to test the moderation model. RESULTS: After accounting for age, sex, and estimated premorbid functioning, results indicated that combat exposure was associated with all symptom clusters on the PTSD Checklist-Military. Executive functioning was not significantly associated with the PTSD symptom clusters and did not moderate the relationship between combat exposure and any of the PTSD symptom clusters. CONCLUSIONS: Combat exposure is an important dimension of risk related to PTSD in Veterans that warrants regular screening. Moderation by executive functioning was not observed despite theoretical support. Future work could test methodological and sampling reasons for this finding to determine if theoretical adjustment is necessary.


Assuntos
Distúrbios de Guerra , Transtornos de Estresse Pós-Traumáticos , Veteranos , Humanos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Distúrbios de Guerra/complicações , Distúrbios de Guerra/diagnóstico , Distúrbios de Guerra/epidemiologia , Estudos Transversais , Síndrome , Testes Neuropsicológicos , Veteranos/psicologia
9.
Environ Sci Technol ; 57(48): 19912-19920, 2023 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-37962431

RESUMO

Chloroform (CF) and dichloromethane (DCM) contaminate groundwater sites around the world but can be cleaned up through bioremediation. Although several strains of Dehalobacter restrictus can reduce CF to DCM and multiple Peptococcaceae can ferment DCM, these processes cannot typically happen simultaneously due to CF sensitivity in the known DCM-degraders or electron donor competition. Here, we present a mixed microbial culture that can simultaneously metabolize CF and DCM and create an additional enrichment culture fed only DCM. Through genus-specific quantitative polymerase chain reaction, we find that Dehalobacter grows while either CF alone or DCM alone is converted, indicating its involvement in both metabolic steps. Additionally, the culture was maintained for over 1400 days without the addition of an exogenous electron donor, and through electron balance calculations, we show that DCM metabolism would produce sufficient reducing equivalents (likely hydrogen) for CF respiration. Together, these results suggest intraspecies electron transfer could occur to continually reduce CF in the culture. Minimizing the addition of electron donor reduces the cost of bioremediation, and "self-feeding" could prolong bioremediation activity long after donor addition ends. Overall, understanding this mechanism informs strategies for culture maintenance and scale-up and benefits contaminated sites where the culture is employed for remediation worldwide.


Assuntos
Clorofórmio , Cloreto de Metileno , Clorofórmio/metabolismo , Cloreto de Metileno/metabolismo , Biodegradação Ambiental , Halogenação , Peptococcaceae/metabolismo
10.
BMC Public Health ; 23(1): 2246, 2023 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-37964252

RESUMO

BACKGROUND: Poor body image is prevalent among adolescents and associated with several negative outcomes for their physical and psychological health. There is a pressing need to address this growing public health concern, yet there are few evidence-informed universal programmes for older adolescents that address contemporary body image concerns (i.e., social media). BodyKind is a four lesson, school-based, teacher led, universal body image programme that incorporates empirically supported principles of cognitive dissonance, self-compassion, compassion for others and social activism, to support positive body image development. Building on previous pilot trials in the USA, this paper outlines the protocol for a cluster randomised control trial (cRCT) and implementation evaluation of the BodyKind programme which was culturally adapted for the Irish cultural context. METHODS: We aim to recruit 600 students aged 15-17 years in Transition Year (4th year) across 26 second-level schools in Ireland. Using minimisation, schools will be randomly assigned to receive BodyKind (intervention condition, n=300) or classes as usual (waitlist control, n=300). Teachers in intervention groups will receive training and deliver the programme to students over four weeks, at a rate of one lesson per week. Primary outcomes of body appreciation, body dissatisfaction and psychological wellbeing and secondary outcomes of self-compassion, compassion for others, body ideal internalisation, social justice motives and appearance-based social media use will be assessed at pre-, post- and 2 month follow up. Mediation and moderation analyses will be conducted to identify how and for whom the intervention works best. An implementation evaluation will assess the quality of programme implementation across schools and how this may influence intervention outcomes. Waitlist control schools will receive the programme after the 2-month follow up. CONCLUSION: This study will be the first to implement a cRCT and an implementation evaluation to assess the impact of this multicomponent school-based body image programme designed to support healthy body image development. If shown to be effective, BodyKind will have the potential to improve adolescent body image and wellbeing and inform efforts to implement sustainable and scalable programmes in schools. TRIAL REGISTRATION: The trial was retrospectively registered on 10/10/2023 on ClinicalTrials.gov NCT06076993 .


Assuntos
Insatisfação Corporal , Imagem Corporal , Humanos , Adolescente , Instituições Acadêmicas , Estudantes/psicologia , Saúde Mental , Serviços de Saúde Escolar , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Body Image ; 47: 101636, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37812940

RESUMO

Body dissatisfaction is prevalent among adolescents and a primary risk factor for eating disorders, yet there are few body image interventions for older adolescents that support development of positive body image. Therefore, we assessed the feasibility, acceptability and preliminary effectiveness of BodyKind, a four-lesson, mixed gender, teacher-led, school-based curriculum for older adolescents, that combines principles of self-compassion, compassion for others, cognitive dissonance, and social activism to address contemporary adolescent body image concerns (i.e., appearance bias, comparisons on social media) and strengthen positive body image development. The sample contained 147 adolescents, predominantly racial/ethnic minorities (>95%), 54.8% male, 41.5% female and 4.1% gender-minority students aged 15-18 years (M=16.24, SD=.96) from a low-income, inner-city high school in the Midwestern US. Two teachers received training and delivered the curriculum to students. This single arm, mixed methods trial assessed student and teacher acceptability, teacher fidelity and student intervention outcomes. Despite reasonable teacher fidelity, recruitment/attendance rates, post-intervention data loss (35% attrition) limited evaluations of program effectiveness and study feasibility. Important learnings regarding study feasibility will inform optimisation for future school-based trials. Findings demonstrate high acceptability of BodyKind among teachers and adolescents in a lower socioeconomic school setting, and further randomized controlled effectiveness trials are required.


Assuntos
Imagem Corporal , Serviços de Saúde Escolar , Adolescente , Feminino , Humanos , Masculino , Imagem Corporal/psicologia , Estudos de Viabilidade , Instituições Acadêmicas , Meio Social
12.
Ind Eng Chem Res ; 62(28): 11067-11081, 2023 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-37484628

RESUMO

Fine chemicals produced via batch crystallization with properties dependent on the crystal size distribution require precise control of supersaturation, which drives the evolution of crystal size over time. Model predictive control (MPC) of supersaturation using a mechanistic model to represent the behavior of a crystallization process requires less experimental time and resources compared with fully empirical model-based control methods. Experimental characterization of the hexamine-ethanol crystallization system was performed in order to collect the parameters required to build a one-dimensional (1D) population balance model (PBM) in gPROMS FormulatedProducts software (Siemens-PSE Ltd.). Analysis of the metastable zone width (MSZW) and a series of seeded batch cooling crystallizations informed the suitable process conditions selected for supersaturation control experiments. The gPROMS model was integrated with the control software PharmaMV (Perceptive Engineering Ltd.) to create a digital twin of the crystallizer. Simulated batch crystallizations were used to train two statistical MPC blocks, allowing for in silico supersaturation control simulations to develop an effective control strategy. In the supersaturation set-point range of 0.012-0.036, the digital twin displayed excellent performance that would require minimal controller tuning to steady out any instabilities. The MPC strategy was implemented on a physical 500 mL crystallizer, with the simulated solution concentration replaced by in situ measurements from calibrated attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectroscopy. Physical supersaturation control performance was slightly more unstable than the in silico tests, which is consistent with expected disturbances to the heat transfer, which were not specifically modeled in simulations. Overall, the level of supersaturation control in a real crystallizer was found to be accurate and precise enough to consider future adaptations to the MPC strategy for more advanced control objectives, such as the crystal size.

13.
Body Image ; 46: 139-151, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37295122

RESUMO

The COVID-19 pandemic provided a context associated with negative consequences for body image and eating behavior. However, little is known about what factors helped to mitigate these consequences and build a positive body image. Previous research pointed to the significance of body image flexibility and perceived body acceptance by others in predicting body appreciation. However, as most of the studies have been cross-sectional, causal relationships are poorly understood. This longitudinal study tested the reciprocal association between body appreciation, body image flexibility, and perceived body acceptance by others during the COVID-19 pandemic in Germany. We analyzed data from a large community sample consisting of 1436 women and 704 men who were invited to complete the study measures (BAS-2, BI-AAQ-5, BAOS-2) at three time points, each approximately six months apart. Latent cross-lagged panel analyses revealed that greater T1 body appreciation predicted an increase in T2 body image flexibility among both genders, while for women, we additionally observed reciprocal effects between T2 and T3. Among both genders, we further found that greater body appreciation predicted increased perceived body acceptance by others over both measurement intervals (but not vice versa). Our findings are discussed in light of pandemical constraints during the studies' assessments.


Assuntos
Imagem Corporal , COVID-19 , Humanos , Feminino , Masculino , Imagem Corporal/psicologia , Estudos Transversais , Estudos Longitudinais , Pandemias , COVID-19/epidemiologia , Alemanha
14.
Body Image ; 45: 296-306, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37019057

RESUMO

Pregnancy embodiment describes the way a pregnant individual inhabits their body, including disconnection and connection, likely influencing both distress and well-being. Emerging work indicates that acceptance of pregnancy-related bodily change may support well-being, particularly when co-occurring with self-care behaviors. Yet, specific associations of pregnant embodiment and intentional, individualized self-care practices (mindful self-care; MSC) with well-being and distress remain unexamined. The present study tested independent and interactive associations between MSC and positive embodiment (body agency), and negative embodiment (body estrangement), respectively, with maternal distress and well-being in a sample of US pregnant women (N = 179; Mage = 31.3 years, aged 21-43; 85.6 % White, 4.9 % Hispanic/Latinx). Challenge and threat/harm appraisals of the COVID-19 pandemic were included in the model to represent responses to the unique sociohistorical context. Measurement-corrected path analytic models explained a substantial proportion of variation in well-being and a smaller proportion in prenatal distress. Among those with higher MSC, the association between body estrangement and prenatal distress was weaker. Results support mindful self-care as protective for pregnancy distress in the setting of body disconnection. Future individualized health promotion might consider how high-stress contexts influence application of self-care practices and impact distress and well-being during pregnancy.


Assuntos
COVID-19 , Pandemias , Feminino , Gravidez , Humanos , Autocuidado , COVID-19/epidemiologia , Imagem Corporal/psicologia , Gestantes
15.
Pediatr Blood Cancer ; 70(7): e30336, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37057741

RESUMO

BACKGROUND: Recent studies suggest that cerebral revascularization surgery may be a safe and effective therapy to reduce stroke risk in patients with sickle cell disease and moyamoya syndrome (SCD-MMS). METHODS: We performed a multicenter, retrospective study of children with SCD-MMS treated with conservative management alone (conservative group)-chronic blood transfusion and/or hydroxyurea-versus conservative management plus surgical revascularization (surgery group). We monitored cerebrovascular event (CVE) rates-a composite of strokes and transient ischemic attacks. Multivariable logistic regression was used to compare CVE occurrence and multivariable Poisson regression was used to compare incidence rates between groups. Covariates in multivariable models included age at treatment start, age at moyamoya diagnosis, antiplatelet use, CVE history, and the risk period length. RESULTS: We identified 141 patients with SCD-MMS, 78 (55.3%) in the surgery group and 63 (44.7%) in the conservative group. Compared with the conservative group, preoperatively the surgery group had a younger age at moyamoya diagnosis, worse baseline modified Rankin scale scores, and increased prevalence of CVEs. Despite more severe pretreatment disease, the surgery group had reduced odds of new CVEs after surgery (odds ratio = 0.27, 95% confidence interval [CI] = 0.08-0.94, p = .040). Furthermore, comparing surgery group patients during presurgical versus postsurgical periods, CVEs odds were significantly reduced after surgery (odds ratio = 0.22, 95% CI = 0.08-0.58, p = .002). CONCLUSIONS: When added to conservative management, cerebral revascularization surgery appears to reduce the risk of CVEs in patients with SCD-MMS. A prospective study will be needed to validate these findings.


Assuntos
Anemia Falciforme , Revascularização Cerebral , Doença de Moyamoya , Acidente Vascular Cerebral , Humanos , Criança , Estudos Retrospectivos , Doença de Moyamoya/etiologia , Revascularização Cerebral/efeitos adversos , Revascularização Cerebral/métodos , Estudos Prospectivos , Acidente Vascular Cerebral/etiologia , Anemia Falciforme/complicações , Resultado do Tratamento
16.
J Clin Apher ; 38(5): 514-521, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37042579

RESUMO

BACKGROUND: Cardiac transplants increasingly occur following placement of ventricular assist devices (VADs). A strong association exists between human leukocyte antigen (HLA) sensitization and VAD placement; however, desensitization protocols that utilize therapeutic plasma exchange (TPE) are fraught with technical challenges and are at increased risk of adverse events. In response to increased VAD utilization in our pre-transplant population, we developed a new institutional standard for TPE in the operating room. METHODS: Through a multidisciplinary effort, we developed an institutional protocol for intraoperative TPE immediately prior to cardiac transplantation after cannulation onto cardiopulmonary bypass (CPB). All procedures used the standard TPE protocol on the Terumo Optia (Terumo BCT, Lakewood, CO, USA), but incorporated multiple modifications to limit patients' bypass times, and to coordinate with the surgical teams. These modifications included deliberate misidentification of replacement fluid and maximization of the citrate infusion rate. RESULTS: These adjustments allowed the machine to run at maximal inlet speeds, minimizing duration of TPE. To date, 11 patients have been treated with this protocol. All survived their cardiac transplantation operation. Hypocalcemia and hypotension were noted; however, none of these adverse events appeared to have clinical impact. Technical complications included unexpected fibrin deposition in the TPE circuit and air in the inlet line due to surgical manipulation of the CPB cannula. No thromboembolic complications occurred in any patient. CONCLUSION: We feel that this procedure can be rapidly and safely performed in HLA sensitized pediatric patients on CPB to limit the risk of antibody mediated rejection of their heart transplant.


Assuntos
Transplante de Coração , Troca Plasmática , Humanos , Criança , Troca Plasmática/métodos , Ponte Cardiopulmonar , Estudos Retrospectivos , Plasmaferese
17.
Front Med (Lausanne) ; 10: 987194, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36873869

RESUMO

Background: COVID-19 was declared a global pandemic in March 2020. Early reports were primarily in adults, and sickle cell disease (SCD) was classified as a risk factor for severe COVID-19 disease. However, there are a limited number of primarily multi-center studies reporting on the clinical course of pediatric patients with SCD and COVID-19. Methods: We conducted an observational study of all patients with SCD diagnosed with COVID-19 at our institution between March 31, 2020, and February 12, 2021. Demographic and clinical characteristics of this group were collected by retrospective chart review. Results: A total of 55 patients were studied, including 38 children and 17 adolescents. Demographics, acute COVID-19 clinical presentation, respiratory support, laboratory findings, healthcare utilization, and SCD modifying therapies were comparable between the children and adolescents. Seventy-three percent (N = 40) of all patients required emergency department care or hospitalization. While 47% (N = 26) were hospitalized, only 5% (N = 3) of all patients required intensive care unit admission. Patients frequently had concurrent vaso-occlusive pain crisis (VOC) (N = 17, 43%) and acute chest syndrome (ACS) (N = 14, 35%). Those with ACS or an oxygen requirement had significantly higher white blood cell count, lower nadir hemoglobin, and higher D-dimers, supporting a pro-inflammatory and coagulopathic picture. Non-hospitalized patients were more likely to be on hydroxyurea than hospitalized patients (79 vs. 50%, p = 0.023). Conclusion: Children and adolescent patients with SCD and acute COVID-19 often present with ACS and VOC pain requiring hospital-level care. Hydroxyurea treatment appears to be protective. We observed no mortality despite variable morbidity.

18.
Body Image ; 45: 153-171, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36934560

RESUMO

We conducted one-on-one interviews with 25 Canadian cisgender women who self-identified as having (a) a condition or characteristic causing their body to deviate from societal norms and (b) overcome a negative body image to develop a positive body image. Using coding reliability thematic analyses, we identified 12 themes (italicised) involving processes and experiences associated with shifts in body image. Women had moments that sparked and confirmed the importance of building positive body image (Enough is Enough). They experienced accepting Social Connections and Community and Accessed Critical Knowledge conducive to body positivity. They engaged in Joyful Movement, Adaptive Appearance Investment, and Joyful and Intuitive Eating. They identified how Changing Societal Norms, Becoming Older and Wiser, COVID-19 Pandemic, having Illnesses and Medical Conditions, Pregnancy and Motherhood, and Spirituality, Religion, and Nature affected their body image, values, and valued action. As women engaged in these processes and experiences, shifts occurred in their perceptions of their embodied selves in the world, represented by four "Bigger Lessons:" I Am More Than My Looks, I Am More Than My Body, I am More Than My Self, and I am Inherently Worthy of Love, Respect, and Joy. These findings can inform body image programmes and clinical interventions.


Assuntos
Imagem Corporal , COVID-19 , Gravidez , Feminino , Humanos , Imagem Corporal/psicologia , Pandemias , Reprodutibilidade dos Testes , Normas Sociais , Canadá , Pesquisa Qualitativa
19.
Body Image ; 45: 201-209, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36958174

RESUMO

The modern millennial- and Gen Z-targeted Barbiecore feminist movement has emerged in tandem with Barbie®'s reinvention to inspire inclusion and active play. Stimulated by these media trends, the present study using a pre-post experimental design evaluated whether exposure to images depicting contemporary passively-posed Barbie Fashionista® (BF) dolls versus images of actively-posed Barbie Made to Move® (M2M) "fitspiration" dolls versus images of Lego Friends® (LF) scenes would differentially affect aspects of state body image and affect in a sample of 106 racially-diverse young adult college women (MAge = 19.2, SD = 1.39). ANCOVA models assessed the effects of condition on post state measures while controlling for baseline state measures. Results indicated that participants exposed to the BF images reported significantly lower body appreciation relative to those who viewed the LF play sets. A similar trend emerged for participants shown the newer M2M doll images. Additionally, viewing images of the actively-posed M2M dolls was associated with marginally higher appearance comparison scores versus the LF control. These initial findings have implications for considering the relevance of expanded digital strategies for marketing more realistically appearing and functioning Barbie® dolls in affecting the body image experiences and potential purchasing choices of young adult female consumers.


Assuntos
Imagem Corporal , Mídias Sociais , Adulto Jovem , Feminino , Humanos , Adulto , Imagem Corporal/psicologia , Feminismo , Satisfação Pessoal , Afeto
20.
FEMS Microbiol Ecol ; 98(8)2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35700008

RESUMO

Reductive dehalogenases (RDases) are corrinoid-dependent enzymes that reductively dehalogenate organohalides in respiratory processes. By comparing isotope effects in biotically catalyzed reactions to reference experiments with abiotic corrinoid catalysts, compound-specific isotope analysis (CSIA) has been shown to yield valuable insights into enzyme mechanisms and kinetics, including RDases. Here, we report isotopic fractionation (ε) during biotransformation of chloroform (CF) for carbon (εC = -1.52 ± 0.34‰) and chlorine (εCl = -1.84 ± 0.19‰), corresponding to a ΛC/Cl value of 1.13 ± 0.35. These results are highly suppressed compared to isotope effects observed both during CF biotransformation by another organism with a highly similar RDase (>95% sequence identity) at the amino acid level, and to those observed during abiotic dehalogenation of CF. Amino acid differences occur at four locations within the two different RDases' active sites, and this study examines whether these differences potentially affect the observed εC, εCl, and ΛC/Cl. Structural protein models approximating the locations of the residues elucidate possible controls on reaction mechanisms and/or substrate binding efficiency. These four locations are not conserved among other chloroalkane reducing RDases with high amino acid similarity (>90%), suggesting that these locations may be important in determining isotope fractionation within this homologous group of RDases.


Assuntos
Carbono , Corrinoides , Aminoácidos , Biodegradação Ambiental , Isótopos de Carbono , Domínio Catalítico , Cloro/química
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