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1.
Mar Pollut Bull ; 203: 116442, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38718547

RESUMO

Plastic nurdles pose a significant environmental threat due to recurrent accidental spills into marine ecosystems. This report examines the nurdle pollution over the 1498 km of the Galician coastline (Spain) following the spill of 25 t of nurdles into the Northwest Atlantic after the loss of six containers from the Toconao vessel in December 2023. This accident highlights the urgent need for proactive, effective measures in maritime transport to prevent and mitigate such environmental catastrophes. The complexity of nurdle dispersion challenges the evaluation of their fate at sea, and the potential long-term consequences on the marine ecosystem and food web remain uncertain and yet to be investigated. This report also presents the VIEIRA collaborative and underscores the critical role of citizen-led initiatives in responding to such environmental disasters, and advocates for efficient policy reforms, involving cross-border collaboration. Furthermore, we call for greater international cooperation to underpin effective regulatory frameworks to address the growing hazard of plastic nurdle pollution worldwide.

2.
JAMA Psychiatry ; 2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38381417

RESUMO

Importance: Current interventions for posttraumatic stress disorder (PTSD) are efficacious, yet effectiveness may be limited by adverse effects and high withdrawal rates. Acupuncture is an emerging intervention with positive preliminary data for PTSD. Objective: To compare verum acupuncture with sham acupuncture (minimal needling) on clinical and physiological outcomes. Design, Setting, and Participants: This was a 2-arm, parallel-group, prospective blinded randomized clinical trial hypothesizing superiority of verum to sham acupuncture. The study was conducted at a single outpatient-based site, the Tibor Rubin VA Medical Center in Long Beach, California, with recruitment from April 2018 to May 2022, followed by a 15-week treatment period. Following exclusion for characteristics that are known PTSD treatment confounds, might affect biological assessment, indicate past nonadherence or treatment resistance, or indicate risk of harm, 93 treatment-seeking combat veterans with PTSD aged 18 to 55 years were allocated to group by adaptive randomization and 71 participants completed the intervention protocols. Interventions: Verum and sham were provided as 1-hour sessions, twice weekly, and participants were given 15 weeks to complete up to 24 sessions. Main Outcomes and Measures: The primary outcome was pretreatment to posttreatment change in PTSD symptom severity on the Clinician-Administered PTSD Scale-5 (CAPS-5). The secondary outcome was pretreatment to posttreatment change in fear-conditioned extinction, assessed by fear-potentiated startle response. Outcomes were assessed at pretreatment, midtreatment, and posttreatment. General linear models comparing within- and between-group were analyzed in both intention-to-treat (ITT) and treatment-completed models. Results: A total of 85 male and 8 female veterans (mean [SD] age, 39.2 [8.5] years) were randomized. There was a large treatment effect of verum (Cohen d, 1.17), a moderate effect of sham (d, 0.67), and a moderate between-group effect favoring verum (mean [SD] Δ, 7.1 [11.8]; t90 = 2.87, d, 0.63; P = .005) in the intention-to-treat analysis. The effect pattern was similar in the treatment-completed analysis: verum d, 1.53; sham d, 0.86; between-group mean (SD) Δ, 7.4 (11.7); t69 = 2.64; d, 0.63; P = .01). There was a significant pretreatment to posttreatment reduction of fear-potentiated startle during extinction (ie, better fear extinction) in the verum but not the sham group and a significant correlation (r = 0.31) between symptom reduction and fear extinction. Withdrawal rates were low. Conclusions and Relevance: The acupuncture intervention used in this study was clinically efficacious and favorably affected the psychobiology of PTSD in combat veterans. These data build on extant literature and suggest that clinical implementation of acupuncture for PTSD, along with further research about comparative efficacy, durability, and mechanisms of effects, is warranted. Trial Registration: ClinicalTrials.gov Identifier: NCT02869646.

3.
J Clin Med ; 13(2)2024 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-38256674

RESUMO

Fluid status (FS) is a diagnostic challenge in critically ill patients with COVID-19. Here, we compared parameters related to FS derived from cumulative fluid balance (CFB), bioelectrical impedance analysis (BIA) and venous congestion assessed by ultrasound (VExUS) to predict mortality. We retrospectively reviewed the medical records of individuals with severe pneumonia due to COVID-19 between July and November 2021 in a single center. Comorbidities, demographic, clinical and laboratory data as well as results from CFB, BIA and VExUS measurements were collected on admission and weekly afterwards for two consecutive evaluations. Seventy-nine patients were included, of which eighteen (14.2%) died. Abnormalities of FS were only identified by BIA. Extracellular water/total body water ratio (ECW/TBW) > 0.394 (overhydrated) by BIA was a good predictor of mortality (AUC = 0.78, 95% CI: 0.067-0.89). Mortality risk was higher in overhydrated patients (OR: 6.2, 95% CI: 1.2-32.6, p = 0.02) and in persistently overhydrated patients (OR: 9.57, 95% CI: 1.18-77.5, p = 0.03) even after adjustment to age, serum albumin and acute kidney injury (AKI) in stages 2-3. Time to death was shorter in overhydrated patients (HR: 2.82, 95% CI: 1.05-7.5, log-rank test p = 0.03). Abnormalities in FS associated with mortality were only identified by BIA in critically ill patients with COVID-19.

4.
Mol Biol Cell ; 34(12): ar124, 2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-37703099

RESUMO

Adipocyte dysfunction is a crucial driver of insulin resistance and type 2 diabetes. We identified EH domain-containing protein 2 (EHD2) as one of the most highly upregulated genes at the early stage of adipose-tissue expansion. EHD2 is a dynamin-related ATPase influencing several cellular processes, including membrane recycling, caveolae dynamics, and lipid metabolism. Here, we investigated the role of EHD2 in adipocyte insulin signaling and glucose transport. Using C57BL6/N EHD2 knockout mice under short-term high-fat diet conditions and 3T3-L1 adipocytes we demonstrate that EHD2 deficiency is associated with deterioration of insulin signal transduction and impaired insulin-stimulated GLUT4 translocation. Furthermore, we show that lack of EHD2 is linked with altered plasma membrane lipid and protein composition, reduced insulin receptor expression, and diminished insulin-dependent SNARE protein complex formation. In conclusion, these data highlight the importance of EHD2 for the integrity of the plasma membrane milieu, insulin receptor stability, and downstream insulin receptor signaling events, involved in glucose uptake and ultimately underscore its role in insulin resistance and obesity.


Assuntos
Diabetes Mellitus Tipo 2 , Resistência à Insulina , Camundongos , Animais , Proteínas de Transporte/metabolismo , Receptor de Insulina/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Membrana Celular/metabolismo , Insulina/metabolismo , Transdução de Sinais , Transportador de Glucose Tipo 4/metabolismo , Glucose/metabolismo
5.
BMC Vet Res ; 19(1): 113, 2023 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-37553700

RESUMO

BACKGROUND: Feline species undergo reproductive seasonality; thus, sperm characteristics, such as DNA integrity, can be affected by the photoperiod. This study was conducted to determine the effect of seasonal changes on sperm quality and on the dynamics of sperm DNA fragmentation. Epididymal spermatozoa were collected from 36 tomcats subjected to bilateral orchiectomy during breeding (BS) and non-breeding (NBS) seasons. Sperm samples were obtained by cutting the cauda epididymis and assessed for sperm motility, concentration, acrosome integrity, plasma membrane integrity and sperm morphology. Sperm DNA fragmentation was evaluated by the sperm chromatin dispersion test after 0, 6, and 24 h of incubation at 37 °C. RESULTS: The total sperm motility and plasma membrane integrity values were greater during the BS, while the percentages of abnormal sperm and head defects were lesser (p < 0.05). No significant differences in DNA fragmentation were found between seasons after sperm collection. DNA damage was greater after 24 h of incubation at 37 °C in both seasons, although the percentage of spermatozoa with fragmented DNA was significantly lesser in the BS than in the NBS at 24 h (p < 0.05). CONCLUSIONS: The study suggests seasonal changes in some of the quality parameters of cat sperm. DNA fragmentation dynamics were affected by the time of incubation and reproductive season; therefore, this technique might be used as an additional tool to test the potential fertility of semen samples used in feline-assisted reproduction.


Assuntos
Preservação do Sêmen , Sêmen , Masculino , Gatos , Animais , Estações do Ano , Motilidade dos Espermatozoides , Fragmentação do DNA , Análise do Sêmen/veterinária , Espermatozoides , DNA , Preservação do Sêmen/veterinária
6.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1514258

RESUMO

Comprender desde la determinación social de la salud el papel de los procesos generales, particulares y singulares sobre la realización del derecho a salud bucal de mujeres en periodo de post-parto en Santiago de Chile. Diseño cualitativo exploratorio con mujeres primíparas o multíparas en primer trimestre postparto, beneficiarias FONASA usuarias de Chile Crece Contigo. Se aplicó encuesta de clasificación social, exámenes clínicos, entrevistas semiestructuradas o grupos de discusión. Para el nivel general se analizó profusa información referencial. Existen procesos generales que favorecen la realización del derecho a salud bucal como las políticas de protección integral a la infancia, la priorización de la atención en salud en gestantes; la existencia de derechos adquiridos para la embarazada: permiso pre y post natal y fuero maternal. Desfavorece el modelo de desarrollo neoliberal y consecuentes condiciones de pobreza, la inequidad de género y el énfasis cultural en la responsabilidad femenina sobre el cuidado. Los procesos críticos actúan en los tres niveles del modelo teórico. Si bien en el nivel particular se identifica un avance en las políticas públicas, este no redunda en una efectiva realización del derecho a nivel singular pues enfrenta elementos estructurales del nivel general, sobre todo en el ámbito laboral y cultural.


Objective: To understand from the framework of social determination of health the role of general, particular and singular processes in the realization of the right to oral health for women in the postpartum period and their newborn children during the first year of life, in Santiago de Chile. Materials and Methods: Exploratory qualitative design with FONASA beneficiary women and newborn children. A social classification survey, semi-structured interviews and focus groups were applied to primiparous or multiparous women of childbearing age in the first postpartum trimester, beneficiaries of the Intersectoral Program ÒChile Crece ContigoÓ. Discussion: For the general level, extensive reference information was analyzed. Results: Some general processes favor the realization of the right to oral health, such as comprehensive protection policies for children, the dynamics of the health care system, and the existence of acquired rights for pregnant women, such as pre and post-natal, and maternity leave. The processes that disfavor its realization are the neoliberal development model, the conditions of poverty, gender inequity (income, employment/unemployment) and cultural factors such as the emphasis on female responsibility for care. Conclusions: The critical processes for the realization of the right to oral health act at the three levels of the theoretical model. There is an advance in public policies at the individual level. However, this does not result in an effective realization of the right at a singular level since it confronts structural elements of the general level, especially in the work and cultural field.

7.
Environ Monit Assess ; 195(8): 1004, 2023 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-37500928

RESUMO

The formation of natural lakes is a process that takes place over thousands of years, although the volumetric formation depends on hydrological and climatological phenomena, reaching a stationary hydraulic regime, the evolution of hydrochemistry is more complex and obeys not only phenomena of stoichiometry and chemical kinetics but also diffusion processes. Depending on the depth of the lakes, the anoxization process originating from the bottom is the first phase of the lake's methanogenesis. For this, the course of many thousands of years is necessary, so the studies carried out in the lakes are limited to the current knowledge of the state in which they are, without being able to have real information in this process of methanogenesis. There are no data available on the generation process of a natural lake in its primary stages. In this case, taking advantage of the rehabilitation of the old open-pit mining of Meirama (Northwest Spain), consisting of the controlled flooding of the hole by groundwater, by stopping the perimeter pumping, and the derivation of the nearby streams, whose contribution was the majority with respect to the subterranean contribution, there has been the opportunity to physically and chemically monitor the complete filling of the said hole. The present study focuses on the analysis of the evolution of the different processes initiated in the methanogenesis of the lake bottom identified in the well-known Redox ladder: obtaining oxygen from the reduction of nitrogenous compounds and metallic oxides, from the reduction of the sulfate and the generation of methane from carbon compounds, the latter phase without reaching. Although the methanization process is very slow, it has had the opportunity to know the formation of a lake at its origin, from the hydrochemical point of view. It has been possible to verify that the methanization processes at the bottom, given the anoxia conditions, are in a very primitive phase with the reduction of nitrate and nitrite to ammonium and beginning a reduction of metal oxides and sulfate.


Assuntos
Monitoramento Ambiental , Lagos , Lagos/química , Rios , Óxidos , Sulfatos/química
8.
Pacing Clin Electrophysiol ; 46(7): 598-606, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37310031

RESUMO

BACKGROUND AND OBJECTIVES: The common practice after atrial fibrillation ablation is to admit patients for an overnight stay. The aim of this study was to compare a strategy of vascular suture mediated closure system utilization and early discharge (strategy A) compared to traditional closure and overnight hospitalization (strategy B) regarding feasibility, safety, quality of life and health care cost effectiveness. METHODS AND RESULTS: Hundred patients were randomized to compare both strategies. No clinical differences were reported except diabetes mellitus. Six patients (6%) had and emergency visit or were admitted in the first 30 days after procedure. Three occurred in strategy A versus three in strategy B (p = 1) (p < .005 for non-inferiority). Forty out of 50 patients (80%) were safely discharged in a time frame of 3 h and 42 patients (84%) were discharged in the same day of the procedure in strategy A. Time to discharge was shorter in strategy A compared to strategy B. (5.89 ± 7.47 h vs. 27.09 ± 2.29 p < .005). No differences were obtained in quality-of-life outcomes. Mean (95% CI) euros cost saving per patient in strategy A was 379.16 ± 93.55 p < .001. Ten acute complications (10% patients CI 95% 4.02%-15.98%) were reported during the trial. Seven (14% CI 95% 4.04%-23.96%) occurred in strategy A patients versus 3 (6% CI 95% 0.8%-12.8%) in strategy B. (p = .182) CONCLUSION: A strategy of vascular suture mediated closure system utilization and early discharge was feasible, reduced time to discharge, saved costs and was not associated with more complications or admissions/emergency visits in a 30-day time frame after procedure compared to a strategy of regular admission and discharge after overnight stay. There were no differences regarding quality-of-life parameters between both strategies.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Humanos , Fibrilação Atrial/cirurgia , Fibrilação Atrial/etiologia , Alta do Paciente , Qualidade de Vida , Hospitalização , Punções , Resultado do Tratamento
9.
Ann Behav Med ; 57(10): 836-845, 2023 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-37061829

RESUMO

OBJECTIVE: Postpartum weight retention is associated with adverse health among both civilian and military women. PURPOSE: The current study evaluated a stepped-care weight management intervention, Moms Fit 2 Fight, adapted for use in a pregnant and postpartum military population. METHODS: Active duty women and other TRICARE beneficiaries (N = 430) were randomized to one of three conditions: gestational weight gain only (GWG-only) intervention (n =144), postpartum weight loss only (PPWL-only) intervention (n =142), or a combined GWG + PPWL intervention (n = 144). Those participants who received the PPWL intervention (i.e., the PPWL-only and GWG+PPWL conditions) were combined consistently with the pre-registered protocol and compared to those participants who did not receive the PPWL intervention in the primary analyses. Primary outcome data (i.e., postpartum weight retention) were obtained at 6-months postpartum by unblinded data collectors, and intent-to-treat analyses were conducted. RESULTS: Retention at 6-months postpartum was 88.4%. Participants who received the PPWL intervention retained marginally less weight (1.31 kg) compared to participants that received the GWG-only intervention (2.39 kg), with a difference of 1.08 kg (p = .07). None of the measured covariates, including breastfeeding status, were significantly associated with postpartum weight retention. Of the participants who received the PPWL intervention, 48.1% participants returned to their pre-pregnancy weight at 6-months postpartum, with no significant differences compared to those who received the GWG-only intervention. CONCLUSIONS: A behavioral intervention targeting diet and physical activity during the postpartum period had a trend for reduced postpartum weight retention. CLINICAL TRIAL INFORMATION: The trial is registered on clinicaltrials.gov (NCT03057808).


Since postpartum weight retention is associated with negative health outcomes among women in the military and women in the general population, the Moms Fit 2 Fight study evaluated a stepped-care weight management intervention among active duty women and other military health insurance beneficiaries. Participants (N = 430) were recruited in their first trimester of pregnancy and randomized to one of three conditions: pregnancy weight gain-only intervention, postpartum weight loss (PPWL)-only intervention, or a combined pregnancy weight gain and PPWL intervention. Participants who received the PPWL intervention (i.e., the participants who received the PPWL-only intervention or the combined intervention) were compared to the participants who did not receive the PPWL intervention, based on weight retention at 6-months postpartum. Participants who received the PPWL intervention retained marginally less weight compared to participants that did not receive the PPWL intervention. Thus, this behavioral intervention targeting diet and physical activity during the postpartum period had a trend for reducing postpartum weight retention, which may be beneficial for achieving military fitness standards and avoiding escalating obesity over multiple pregnancies.


Assuntos
Ganho de Peso na Gestação , Militares , Complicações na Gravidez , Gravidez , Feminino , Humanos , Obesidade/epidemiologia , Estilo de Vida , Período Pós-Parto , Redução de Peso , Sobrepeso , Índice de Massa Corporal
10.
Food Chem ; 404(Pt A): 134474, 2023 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-36244061

RESUMO

In this work, a new method has been developed to detect adulterations in avocado oil by combining optical images and their treatment with deep learning algorithms. For this purpose, samples of avocado oil adulterated with refined olive oil at concentrations from 1 % to 15 % (v/v) were prepared. Two groups of images of the different samples were obtained, one in conditions considered as bright and the other as dark, obtaining a total of 1,800 photographs. To obtain these images under both conditions, the exposure or shutter speed of the camera was modified (1/30 s for light conditions and 1/500 s for dark conditions). A residual neural network (ResNet34) was used to process and classify the images obtained. A different model was developed for each condition, and during blind validation of the models, ∼95 % of the images were correctly classified.


Assuntos
Persea , Óleos de Plantas , Óleos de Plantas/análise , Contaminação de Alimentos/análise , Azeite de Oliva/análise , Redes Neurais de Computação
11.
Am J Med Genet A ; 191(3): 711-717, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36461157

RESUMO

Natural history studies of pediatric rare neurometabolic diseases are important to understand disease pathophysiology and to inform clinical trial outcome measures. Some data collections require sedation given participants' age and neurocognitive impairment. To evaluate the safety of sedation for research procedures, we reviewed medical records between April 2017 and October 2019 from a natural history study for CLN3 (NCT03307304) and one for GM1 gangliosidosis (NCT00029965). Twenty-two CLN3 individuals underwent 28 anesthetic events (age median 11.0, IQR 8.4-15.3 years). Fifteen GM1 individuals had 19 anesthetic events (9.8, 7.1-14.7). All participants had the American Society of Anesthesiology classification of II (8/47) or III (39/47). Mean sedation durations were 186 (SD = 54; CLN3) and 291 (SD = 33; GM1) min. Individuals with GM1 (6/19, 31%) were more frequently prospectively intubated for sedation (CLN3 3/28, 11%). Minor adverse events associated with sedation occurred in 8/28 (28%, CLN3) and 6/19 (32%, GM1) individuals, frequencies within previously reported ranges. No major adverse clinical outcomes occurred in 47 anesthetic events in pediatric participants with either CLN3 or GM1 gangliosidosis undergoing research procedures. Sedation of pediatric individuals with rare neurometabolic diseases for research procedures is safe and allows for the collection of data integral to furthering their understanding and treatment.


Assuntos
Anestesia , Anestesiologia , Gangliosidose GM1 , Adolescente , Criança , Humanos , beta-Galactosidase , Gangliosídeo G(M1) , Gangliosidose GM1/genética , Lisossomos , Glicoproteínas de Membrana/genética , Chaperonas Moleculares/genética , Doenças Raras , Estudos Retrospectivos
13.
J Am Coll Health ; 71(7): 2106-2114, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34788562

RESUMO

Objective: We evaluated the Relaxation Zone (RZ), a room with "relaxation stations" designed to reduce stress in college students. Participants: Participants (N = 994) were enrolled during the 2019 calendar year. Most participants were female (62.8%), freshmen (59.3%), and African American (44.9%). Methods: Students visiting the RZ completed a brief pretest and posttest that measured self-reported stress. Results: Paired sample t-tests across class groups (e.g., freshman, sophomore) revealed a significant reduction in stress from pretest (Mpooled = 6.0) to posttest (Mpooled = 4.5), with medium to large effect sizes (Cohen's d ranging from 0.53 to 0.88) during their first visit. For students having at least two visits (N = 348), an exploratory dose-response analysis demonstrated that an optimal dose of self-guided relaxation ranged from two to eight visits. Conclusions: These findings provide initial evidence that programs like the RZ can reduce student stress within a few visits.

15.
Prog Community Health Partnersh ; 16(4): 503-515, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36533500

RESUMO

BACKGROUND: Few have examined factors associated with community advisory board (CAB) sustainability from the perspective of members. OBJECTIVES: We aimed to provide insight into the formation of a CAB and attributes and challenges to sustaining it in addressing Latino health disparities in Chicago. METHODS: The Little Village CAB was formed in 2009 with members representing a wide range of local organizations, including churches, nonprofit organizations, and health centers. We analyzed annual survey results sent to members over a 10-year period. Likert-type questions assessed five domains: mission, commitment, communication, respect/trust, and teamwork/balance of power. We also analyzed free-text responses to determine prevalent themes. Ten years of CAB monthly meeting minutes were used to form word clouds which were assessed for changes across years. RESULTS: Survey questions demonstrated high averages across all years for each domain with minimal variation. Free-text responses indicated that members initially joined the CAB owing to request or interest in community health. CAB attributes included mission, community focus, openness/respect, teamwork, and leadership. Areas for improvement included broadening membership, clarifying goals periodically, and meeting structure. Meeting minutes demonstrated a progression from program creation to maintenance across the years. CONCLUSIONS: The CAB rated openness/respect, community focus, and commitment to mission high across all 10 years. Areas for improvement included broadening membership and clarifying goals periodically. In forming a CAB to address health disparities in a Latino community, researchers must be aware of factors that motivated members to join and remain engaged with an academic team using an iterative evaluative process.


Assuntos
Participação da Comunidade , Pesquisa Participativa Baseada na Comunidade , Humanos , Pesquisa Participativa Baseada na Comunidade/métodos , Participação da Comunidade/métodos , Saúde Pública , Pesquisadores , Confiança
16.
Contemp Clin Trials Commun ; 30: 101037, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36387984

RESUMO

Background: Effective recruitment of representative and diverse samples in research trials is important to the generalizability of findings and in describing access to behavioral interventions. The current study evaluated the effectiveness of local and national recruitment strategies for a smoking cessation and weight management-focused randomized controlled trial (Fit & Quit). The overall cost-effectiveness of recruitment strategies was also evaluated. Methods: The study initially recruited participants locally in the Memphis, TN area and later transitioned to national recruitment, necessitated by the transition to remote assessment strategies due to the COVID-19 pandemic. The study evaluated effective recruitment strategies for randomized participants (n = 305) across gender, race, rurality, and recruitment method, as well as the cost-effectiveness of methods used during the recruitment period of this study. Results: The most effective recruitment strategies were local postcards, local radio advertisements, word-of-mouth referrals, and national internet advertisements, which resulted in a combined 71.8% (n = 219) of the total randomized sample (n = 305). Radio advertisements were the best method for recruiting Black participants. Electronic recruitment strategies were the most effective method for non-urban participants. Additionally, gender, recruitment method, race, and rurality predicted randomization. Overall, electronic media methods were more cost-effective ($430.97 per participant) compared to traditional media methods ($931.43 per participant); however, traditional media methods resulted in a greater number of recruited and randomized participants. Conclusion: Results provide information on effective and cost-effective local and national recruitment methods for recruiting underrepresented groups of participants in behavioral clinical intervention studies.

17.
Orphanet J Rare Dis ; 17(1): 342, 2022 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064725

RESUMO

BACKGROUND: Niemann-Pick disease type C1 (NPC1) is a rare autosomal recessive disease characterized by endolysosomal accumulation of unesterified cholesterol with progressive deterioration in swallowing, often leading to premature death. Although documented, the natural history of NPC1 swallowing dysfunction has yet to be delineated systematically. This manuscript aims to provide a comprehensive characterization of the phenotypic spectrum and progression of swallowing dysfunction in NPC1. METHODOLOGY: The National Institutes of Health (NIH) NPC1 natural history study (NCT00344331) enrolled 120 patients, who underwent comprehensive interpretative swallow assessments for swallowing safety, dietary modifications, and aspiration risk. Longitudinal statistical modeling accounted for all outcomes with NPC1 disease covariates (first symptom onset, age at neurological symptom onset, seizure history, duration of neurological symptoms) as well as miglustat use (a glucosylceramide synthase inhibitor) and NIH study duration (NIHSD; the length of time an individual participated in the NIH study). Probabilities for disease progression and time to swallowing decline were conducted for the entire cohort. RESULTS: Time to swallowing decline with American Speech-Language-Hearing Association National Outcome Measure (ASHA-NOMS) and the NIH-adapted Penetration Aspiration Scale (NIH-PAS) were identified: [Formula: see text] person-years and [Formula: see text] person-years, respectively. NIHSD and seizure history consistently and significantly were associated with decline (ORNIHSD = 1.34-2.10, 95% CI 1.04-3.4, p = 0.001-0.026; ORSeizure = 3.26-18.22, 1.03-167.79; p = 0.001-0.046), while miglustat use revealed protection (ORMiglustat = 0.01-0.43, 0.007-0.98; p = 0.001-0.044). The probability of decline with NPC1 neurological severity scale and annual severity increment scale were established with the aforementioned covariates, varying amongst subgroups. CONCLUSION: This study represents the most extensive collection of prospective, instrumental swallowing assessments in NPC1 to date with an interpretive analysis providing an improved understanding of NPC1 disease progression with swallowing function-serving as a foundation for clinical management and future NPC1 therapeutics.


Assuntos
Doença de Niemann-Pick Tipo A , Doença de Niemann-Pick Tipo C , Deglutição , Progressão da Doença , Humanos , Proteína C1 de Niemann-Pick , Doença de Niemann-Pick Tipo C/metabolismo , Estudos Prospectivos , Convulsões
18.
Front Cell Dev Biol ; 10: 942374, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36158197

RESUMO

To accommodate surplus energy, the adipose tissue expands by increasing adipocyte size (hypertrophy) and number (hyperplasia). The presence of hypertrophic adipocytes is a key characteristic of adipose tissue dysfunction. High-fat diet (HFD) fed C57BL/6J mice are a commonly used model to study obesity and obesity-related complications. In the present study, we have characterized adipose plasticity, at both the cellular and tissue level, by examining the temporal development of systemic insulin resistance and adiposity in response to HFD-feeding for 4, 8, and 12 weeks (4w, 8w, and 12w). Within the same time frame, we examined systemic metabolic flexibility and adipose plasticity when switching from HFD- to chow-diet during the last 2 weeks of diet intervention (referred to as the reverse (REV) group: 4wREV (2w HFD+2w chow), 8wREV (6w HFD+2w chow), 12wREV (10w HFD+2w chow)). In response to HFD-feeding over time, the 12w group had impaired systemic insulin sensitivity compared to both the 4w and 8w groups, accompanied by an increase in hypertrophic inguinal adipocytes and liver triglycerides. After reversing from HFD- to chow-feeding, most parameters were completely restored to chow control levels for 4wREV and 8wREV groups. In contrast, the 12wREV group had a significantly increased number of hypertrophic adipocytes, liver triglycerides accumulation, and impaired systemic insulin sensitivity compared to chow-fed mice. Further, image analysis at the single-cell level revealed a cell-size dependent organization of actin filaments for all feeding conditions. Indeed, the impaired adipocyte size plasticity in the 12wREV group was accompanied by increased actin filamentation and reduced insulin-stimulated glucose uptake compared with chow-fed mice. In summary, these results demonstrate that the C57BL/6J HFD-feeding model has a large capacity to restore adipocyte cell size and systemic insulin sensitivity, and that a metabolic tipping point occurs between 8 and 12w of HFD-feeding where this plasticity deteriorates. We believe these findings provide substantial understanding of C57BL/6J mice as an obesity model, and that an increased pool of hypertrophic ING adipocytes could contribute to aggravated insulin resistance.

19.
Rev Psiquiatr Salud Ment (Engl Ed) ; 15(3): 176-184, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36167643

RESUMO

INTRODUCTION: There is currently a growing interest in interventions aimed at the reduction of stigma towards people with emotional difficulties in adolescents. Unfortunately, the number of scales available in Spanish to assess stigma at these ages is limited. This paper aims to adapt and validate the scale of stigmatizing attitudes towards mental health among peers (Peer Mental Health Stigmatization Scale PMHSS-24). MATERIAL AND METHODS: A total of 443 adolescents (46.6% female and 53.7% male) between 13 and 17 years of age participated (Mage = 14.64; SD = 0.83) in the 3rd and 4th grades of Obligatory Secondary Education. The internal consistency of the test was calculated, an exploratory factorial analysis (EFA) was performed with half of the sample and a confirmatory one (CFA) with the other half, and the invariance of measurement of the scale through sex was found. RESULTS: The EFA showed a two-factor structure for the negative scale (53% of the variance explained) and another 2 for the positive scale (62% of the variance explained). The CFA corroborated the factor structure with appropriate goodness-of-fit indicators (CFI > 0.95; NNFI > 0.95, SRMR < 0.08, RMSEA < 0.08). Factor loads ranged from 0.49 to 0.89, with α factor correlation between r = 0.53 and 0.45. Both subscales exhibited optimal alpha values (negative 0.94 and positive 0.81). The scale was invariant between the sexes. CONCLUSIONS: The data suggest that PMHSS-24 may be a useful scale for the initial screening of the stereotypes exhibited by adolescents toward people with mental illness.


Assuntos
Saúde Mental , Estereotipagem , Adolescente , Masculino , Feminino , Humanos , Psicometria , Reprodutibilidade dos Testes , Estigma Social
20.
Rev. argent. microbiol ; 54(3): 11-20, set. 2022. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1407191

RESUMO

Resumen Trichophyton benhamiae es un dermatofito zoofílico. Puede causar tinea corporis, tinea faciei y tinea capitis. Se caracteriza por producir lesiones inflamatorias, sobre todo en niños. El objetivo de esta publicación es describir 7 casos clínicos de pacientes pediátricos atendidos entre julio del 2019 y enero del 2020 en nuestra institución. A los pacientes se les solicitó estudio micológico convencional, con posterior confirmación con MALDI-TOF MS y secuencia-ción del ADN ribosomal. Se aisló e identificó T. benhamiae como agente etiológico; el nexo epidemiológico fue el contacto con cobayos. Estas son las primeras descripciones de infecciones causadas por T. benhamiae en Argentina. Al realizar estudios micológicos convencionales, este agente puede confundirse con otros dermatofitos, por lo tanto, se requieren herramientas como MALDI-TOF MS o la secuenciación para llegar a un diagnóstico definitivo. Es importante contar con datos epidemiológicos, como el contacto con mascotas no tradicionales, para una presunción diagnóstica adecuada.


Trichophyton benhamiae is a zoonotic dermatophyte that can cause tinea corporis, tinea faciei and tinea capitis, producing inflammatory lesions, especially in children. In this publication, we describe 7clinical cases of pediatric patients that occurred in our institution between July 2019 and January 2020. All patients underwent a conventional mycological study. The identification of fungi isolates was confirmed by MALDI-TOF MS and sequencing of the ribosomal DNA. T. benhamiae was identified as the etiological agent, whose epidemiological link in all cases was the contact with Guinea pigs. This is the first description of infections caused by T. benhamiae in Argentina. This dermatophyte can be misidentified as other more frequent dermatophytes when performing conventional studies. Molecular technology should be used to reach a definitive diagnosis. It is important to have epidemiological data from patients such as contact with non-traditional pets, especially Guinea pigs, for an adequate presumptive diagnosis of this dermatophytosis.

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