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1.
Plant J ; 109(3): 541-554, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34773305

RESUMO

Insulators characterized in Drosophila and mammals have been shown to play a key role in the restriction of promiscuous enhancer-promoter interactions, as well as reshaping the topological landscape of chromosomes. Yet the role of insulators in plants remains poorly understood, in large part because of a lack of well-characterized insulators and binding factor(s). In this study, we isolated a 1.2-kb RS2-9 insulator from the Oryza sativa (rice) genome that can, when interposed between an enhancer and promoter, efficiently block the activation function of both constitutive and floral organ-specific enhancers in transgenic Arabidopsis and Nicotiana tabacum (tobacco). In the rice genome, the genes flanking RS2-9 exhibit an absence of mutual transcriptional interactions, as well as a lack of histone modification spread. We further determined that O. sativa Homeobox 1 (OSH1) bound two regions of RS2-9, as well as over 50 000 additional sites in the rice genome, the majority of which resided in intergenic regions. Mutation of one of the two OSH1-binding sites in RS2-9 impaired insulation activity by up to 60%, whereas the mutation of both binding sites virtually abolished insulator function. We also demonstrated that OSH1 binding sites were associated with 72% of the boundaries of topologically associated domains (TADs) identified in the rice genome, which is comparable to the 77% of TAD boundaries bound by the insulator CCCTC-binding factor (CTCF) in mammals. Taken together, our findings indicate that OSH1-RS2-9 acts as a true insulator in plants, and highlight a potential role for OSH1 in gene insulation and topological organization in plant genomes.


Assuntos
Elementos Facilitadores Genéticos/fisiologia , Oryza/genética , Oryza/metabolismo , Regiões Promotoras Genéticas/fisiologia , Proteínas Repressoras/genética , Proteínas Repressoras/metabolismo , Produtos Agrícolas/genética , Produtos Agrícolas/metabolismo , Regulação da Expressão Gênica de Plantas , Genes de Plantas , Fatores de Transcrição/fisiologia
2.
AIDS Care ; 35(1): 78-82, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-34743619

RESUMO

Persons living with HIV (PLWH) experience symptoms from disease progression and side effects of antiretroviral treatment. This study examines in African American PLWH (N = 259) commonly-endorsed symptoms, types and self-rated efficacy of therapies for symptom alleviation. Analyses were stratified by gender (n = 178 males, n = 81 females) and cannabis use typology: non-users (n = 90), mostly recreational use (n = 46), mixed recreational/therapeutic use (n = 51), or mostly therapeutic use (n = 72). Females reported greater severity for pain, fatigue, depression, weight change and tingling in extremities, but there were no gender differences for ratings of poor sleep, anxiety, poor appetite, or headache. Both marijuana (used therapeutically by females more than males) and medication(s) were among the 3 top methods for managing pain, poor sleep, anxiety, and headache. Marijuana was most often used for poor appetite, and medications for depression. Perceived efficacy of self-treatment approaches was moderately good. Among African American PLWH, symptom severity was higher for females and for therapeutic users of cannabis. Marijuana and medicine were often used to self-treat symptoms, but many participants did nothing. These results highlight the need for careful evaluation and management of symptoms in this underserved population.


Assuntos
Cannabis , Infecções por HIV , Uso da Maconha , Feminino , Humanos , Masculino , Negro ou Afro-Americano , Cefaleia , Infecções por HIV/tratamento farmacológico , Dor
3.
Int J Mol Sci ; 23(9)2022 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-35563008

RESUMO

Molecular responses of plants to natural phytotoxins comprise more general and compound-specific mechanisms. How phytotoxic chalcones and other flavonoids inhibit seedling growth was widely studied, but how they interfere with seed germination is largely unknown. The dihydrochalcone and putative allelochemical myrigalone A (MyA) inhibits seed germination and seedling growth. Transcriptome (RNAseq) and hormone analyses of Lepidium sativum seed responses to MyA were compared to other bioactive and inactive compounds. MyA treatment of imbibed seeds triggered the phased induction of a detoxification programme, altered gibberellin, cis-(+)-12-oxophytodienoic acid and jasmonate metabolism, and affected the expression of hormone transporter genes. The MyA-mediated inhibition involved interference with the antioxidant system, oxidative signalling, aquaporins and water uptake, but not uncoupling of oxidative phosphorylation or p-hydroxyphenylpyruvate dioxygenase expression/activity. MyA specifically affected the expression of auxin-related signalling genes, and various transporter genes, including for auxin transport (PIN7, ABCG37, ABCG4, WAT1). Responses to auxin-specific inhibitors further supported the conclusion that MyA interferes with auxin homeostasis during seed germination. Comparative analysis of MyA and other phytotoxins revealed differences in the specific regulatory mechanisms and auxin transporter genes targeted to interfere with auxin homestasis. We conclude that MyA exerts its phytotoxic activity by multiple auxin-dependent and independent molecular mechanisms.


Assuntos
Germinação , Lepidium sativum , Chalconas , Regulação da Expressão Gênica de Plantas , Germinação/genética , Homeostase , Hormônios/metabolismo , Ácidos Indolacéticos/metabolismo , Lepidium sativum/metabolismo , Reguladores de Crescimento de Plantas/metabolismo , Reguladores de Crescimento de Plantas/farmacologia , Plântula/metabolismo , Sementes/genética
4.
Mol Genet Genomics ; 296(1): 155-164, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33118051

RESUMO

Sugar beets are attacked by several pathogens that cause root damages. Rhizoctonia (Greek for "root killer") is one of them. Rhizoctonia root rot has become an increasing problem for sugar beet production and to decrease yield losses agronomical measures are adopted. Here, two partially resistant and two susceptible sugar beet genotypes were used for transcriptome analysis to discover new defense genes to this fungal disease, information to be implemented in molecular resistance breeding. Among 217 transcripts with increased expression at 2 days post-infection (dpi), three resistance-like genes were found. These genes were not significantly elevated at 5 dpi, a time point when increased expression of three Bet v I/Major latex protein (MLP) homologous genes BvMLP1, BvMLP2 and BvML3 was observed in the partially resistant genotypes. Quantitative RT-PCR analysis on diseased sugar beet seedlings validated the activity of BvMLP1 and BvMLP3 observed in the transcriptome during challenge by R. solani. The three BvMLP genes were cloned and overexpressed in Arabidopsis thaliana to further dissect their individual contribution. Transgenic plants were also compared to T-DNA mutants of orthologous MLP genes. Plants overexpressing BvMLP1 and BvMLP3 showed significantly less infection whereas additive effects were seen on Atmlp1/Atmlp3 double mutants. The data suggest that BvMLP1 and BvMLP3 may contribute to the reduction of the Rhizoctonia root rot disease in sugar beet. Impact on the defense reaction from other differential expressed genes observed in the study is discussed.


Assuntos
Beta vulgaris/genética , Regulação da Expressão Gênica de Plantas/imunologia , Doenças das Plantas/genética , Proteínas de Plantas/genética , Rhizoctonia/patogenicidade , Transcriptoma/imunologia , Arabidopsis/genética , Arabidopsis/metabolismo , Beta vulgaris/imunologia , Beta vulgaris/microbiologia , Clonagem Molecular , Expressão Gênica , Redes Reguladoras de Genes , Vetores Genéticos/química , Vetores Genéticos/metabolismo , Doenças das Plantas/imunologia , Doenças das Plantas/microbiologia , Imunidade Vegetal/genética , Proteínas de Plantas/imunologia , Plantas Geneticamente Modificadas , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Rhizoctonia/crescimento & desenvolvimento , Plântula/genética , Plântula/imunologia , Plântula/microbiologia
5.
Cogn Neuropsychiatry ; 26(5): 307-320, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34058949

RESUMO

INTRODUCTION: Anomalous self-experiences (ASEs) are disturbances in the subjective experience of the self and are common in people with schizophrenia. Theorists have suggested that ASEs may underlie the neurocognitive deficits that are also common in people with schizophrenia; however, few studies have empirically investigated the relationship between these variables. Thus, the current study aimed to determine whether self-reported ASEs, particularly disturbances in cognitive or mental experiences, are meaningfully related to neurocognitive performance in individuals with schizophrenia. METHODS: 48 individuals with schizophrenia and 34 healthy comparison participants completed the Inventory of Psychotic-Like Anomalous Experiences (IPASE), which is composed of five subscales including disturbances in cognition, and the MATRICS Consensus Cognitive Battery (MCCB). RESULTS: Participants with schizophrenia performed worse than controls on each MCCB domain and had higher ASE scores on the total IPASE and all five subscales. Only the IPASE-Cognition subscale was associated with cognitive performance. Specifically, IPASE-Cognition was negatively correlated with scores in attention, visual learning, reasoning, and working memory. CONCLUSIONS: These results suggest that self-reported subjective disturbances in cognition may be meaningfully associated with several objectively-measured domains of neurocognition. Severity of ASEs may therefore be an important consideration when analysing the extent of cognitive deficits in schizophrenia.


Assuntos
Transtornos Cognitivos , Esquizofrenia , Cognição , Humanos , Memória de Curto Prazo , Testes Neuropsicológicos , Psicologia do Esquizofrênico
6.
J Exp Bot ; 71(1): 411-421, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31565749

RESUMO

The closely related sulphonamide safeners, metcamifen and cyprosulfamide, were tested for their ability to protect rice from clodinafop-propargyl, a herbicide normally used in wheat. While demonstrating that both compounds were equally bioavailable in planta, only metcamifen prevented clodinafop from damaging seedlings, and this was associated with the enhanced detoxification of the herbicide. Transcriptome studies in rice cultures demonstrated that whereas cyprosulfamide had a negligible effect on gene expression over a 4 h exposure, metcamifen perturbed the abundance of 590 transcripts. Changes in gene expression with metcamifen could be divided into three phases, corresponding to inductions occurring over 30 min, 1.5 h and 4 h. The first phase of gene induction was dominated by transcription factors and proteins of unknown function, the second by genes involved in herbicide detoxification, while the third was linked to cellular homeostasis. Analysis of the inducible genes suggested that safening elicited similar gene families to those associated with specific biotic and abiotic stresses, notably those elicited by abscisic acid, salicylic acid, and methyl jasmonate. Subsequent experiments with safener biomarker genes induced in phase 1 and 2 in rice cell cultures provided further evidence of similarities in signalling processes elicited by metcamifen and salicylic acid.


Assuntos
Resistência a Herbicidas/fisiologia , Herbicidas/farmacologia , Oryza/efeitos dos fármacos , Propionatos/farmacologia , Piridinas/farmacologia , Regulação da Expressão Gênica de Plantas/efeitos dos fármacos , Oryza/fisiologia , Plântula/efeitos dos fármacos , Plântula/fisiologia , Fatores de Transcrição/metabolismo
7.
Plant Physiol ; 176(4): 2623-2638, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29437777

RESUMO

Transgenic maize (Zea mays) that expresses rice (Oryza sativa) TREHALOSE PHOSPHATE PHOSPHATASE1 (TPP1) from the rice MADS6 promoter, which is active over the flowering period, produces higher yields than wild type. This yield increase occurs with or without drought conditions during flowering. To understand the mechanistic basis of the increased yield, we characterized gene expression and metabolite profiles in leaves and developing female reproductive tissue, comprising florets, node, pith, and shank, over the flowering period with and without drought. The MADS6 promoter was most active in the vasculature, particularly phloem companion cells in florets and pith, consistent with the largest decreases in trehalose 6-phosphate (T6P) levels (2- to 3-fold) being found in pith and florets. Low T6P led to decreased gene expression for primary metabolism and increased gene expression for secondary metabolism, particularly lipid-related pathways. Despite similar changes in gene expression, the pith and floret displayed opposing assimilate profiles: sugars, sugar phosphates, amino acids, and lipids increased in florets, but decreased in pith. Possibly explaining this assimilate distribution, seven SWEET genes were found to be up-regulated in the transgenic plants. SnRK1 activity and the expression of the gene for the SnRK1 beta subunit, expression of SnRK1 marker genes, and endogenous trehalose pathway genes were also altered. Furthermore, leaves of the transgenic maize maintained a higher photosynthetic rate for a longer period compared to wild type. In conclusion, we found that decreasing T6P in reproductive tissues down-regulates primary metabolism and up-regulates secondary metabolism, resulting in different metabolite profiles in component tissues. Our data implicate T6P/ SnRK1 as a major regulator of whole-plant resource allocation for crop yield improvement.


Assuntos
Flores/metabolismo , Fotossíntese/fisiologia , Folhas de Planta/metabolismo , Fosfatos Açúcares/metabolismo , Trealose/análogos & derivados , Flores/genética , Flores/crescimento & desenvolvimento , Regulação da Expressão Gênica no Desenvolvimento , Regulação da Expressão Gênica de Plantas , Oryza/enzimologia , Oryza/genética , Floema/genética , Floema/crescimento & desenvolvimento , Floema/metabolismo , Fosfatidato Fosfatase/genética , Fosfatidato Fosfatase/metabolismo , Fotossíntese/genética , Folhas de Planta/genética , Folhas de Planta/crescimento & desenvolvimento , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Plantas Geneticamente Modificadas , Transgenes/genética , Trealose/metabolismo , Zea mays/enzimologia , Zea mays/genética
8.
Cultur Divers Ethnic Minor Psychol ; 24(1): 101-111, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28394164

RESUMO

OBJECTIVES: Social-cognitive models of psychosis suggest that aberrant salience and self-concept clarity are related to the development and maintenance of psychoticlike experiences (PLEs). People with high aberrant salience but low self-concept clarity tend to have the highest levels of PLEs. Ethnic identity may also be related to PLEs. The current research aimed to (a) replicate the interaction between aberrant salience and self-concept clarity in their association with PLEs in an ethnically diverse sample, (b) examine whether ethnic identity and aberrant salience interact in their association with PLEs, and (c) determine if self-concept clarity and ethnic identity independently interact with aberrant salience in their association with PLEs. METHOD: An ethnically diverse group of undergraduates (n = 663) completed self-report measures of aberrant salience, self-concept clarity, ethnic identity, and PLEs. RESULTS: There was an interaction between aberrant salience and self-concept clarity such that people with high levels of aberrant salience and low levels of self-concept clarity had the highest levels of PLEs. Similarly, there was an interaction between aberrant salience and ethnic identity such that people with high aberrant salience but low ethnic identity had the highest PLEs. These interactions independently contributed to explaining variance in PLEs. This interaction was present for the Exploration but not Commitment subscales of ethnic identity. CONCLUSION: These results suggest that, in addition to low self-concept clarity, low ethnic identity may be a risk factor for the development of psychosis. (PsycINFO Database Record


Assuntos
Desenvolvimento do Adolescente , Etnicidade/psicologia , Transtornos Psicóticos/psicologia , Autoimagem , Adaptação Psicológica , Adolescente , Feminino , Humanos , Masculino , Autorrelato , Estudantes/psicologia
9.
J Gen Intern Med ; 31(10): 1141-7, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27197974

RESUMO

BACKGROUND: Substance use is associated with higher rates of antiretroviral non-adherence and poor HIV outcomes. This study examined how HIV care providers assess substance use, and which questions elicit accurate patient disclosures. METHODS: We conducted a conversation analysis of audio-recorded encounters between 56 providers and 162 patients living with HIV (PLWH) reporting active substance use in post-encounter interviews (cocaine or heroin use in the past 30 days, > 4 days intoxicated in past 30 days, or AUDIT score ≥ 8). We assessed the frequency of substance use discussion, characterized the types of questions used by providers, and determined the frequency of accurate patient disclosure by question type. RESULTS: In 55 reports of active substance use, providers already knew about the use (n = 16) or patients disclosed unpromptednn = 39). Among the remaining 155 instances of substance use in which providers had the opportunity to elicit disclosure, 78 reports (50 %) of substance use were not discussed. Of the remaining 77 reports in which the provider asked about substance use, 55 (71 %) patients disclosed and 22 (29 %) did not disclose. Questions were classified as: open-ended (n = 18, "How's the drinking going?"); normalizing (n = 14, "When was the last time you used?"); closed-ended (n = 36, "Have you used any cocaine?"); leading towards non-use (n = 9, "Have you been clean?"). Accurate disclosure followed 100 % of open-ended and normalizing questions, 58 % of closed-ended questions, and 22 % of leading questions. After adjusting for drug type, closed-ended questions were 41 % less likely (p < 0.001), and 'leading' questions 78 % less likely (p = 0.016) than broad and normalizing questions to elicit disclosures. CONCLUSION: Providers in this sample missed almost half of the opportunities to identify and discuss substance use with PLWH. Providers can increase the probability of patient disclosure by using open-ended or normalizing questions that ask about the "last time" that the patient used drugs or alcohol.


Assuntos
Infecções por HIV/complicações , Entrevista Psicológica , Relações Médico-Paciente , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Revelação da Verdade , Adulto , Feminino , Infecções por HIV/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Autorrevelação , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/psicologia
10.
MMWR Morb Mortal Wkly Rep ; 65(34): 920-1, 2016 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-27583686

RESUMO

Lymphogranuloma venereum (LGV) is a sexually transmitted disease (STD) caused by infection with invasive Chlamydia trachomatis serovars L1-L3 (1). LGV is characterized by inguinal and/or femoral lymphadenopathy, typically following a transient, self-limited genital ulcer or papule that might go unnoticed. Rectal infection can result in proctocolitis that can present with mucoid and/or hemorrhagic rectal discharge, anal pain, constipation, fever, and tenesmus, and signs of granulomas and/or ulcerations on anoscopy (1,2). LGV can be an invasive, systemic infection, and if it is not treated early, LGV proctocolitis can lead to chronic colorectal fistulas and strictures (2). In Europe, outbreaks of LGV have been reported among men who have sex with men (MSM), often in association with human immunodeficiency virus (HIV) coinfection (3-5). The prevalence of LGV in the United States is unknown (1), because diagnostic tests to differentiate LGV from non-LGV Chlamydia trachomatis are not widely available (6), and providers might not know that they should report cases that are presumptively treated.


Assuntos
Chlamydia trachomatis/isolamento & purificação , Homossexualidade Masculina/estatística & dados numéricos , Linfogranuloma Venéreo/diagnóstico , Adulto , Análise por Conglomerados , Diagnóstico Diferencial , Infecções por HIV/epidemiologia , Humanos , Linfogranuloma Venéreo/epidemiologia , Masculino , Michigan/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem
11.
AIDS Behav ; 20(5): 1108-15, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26499336

RESUMO

This study evaluated how clinicians assess antiretroviral (ARV) adherence in clinical encounters, and which questions elicit accurate responses. We conducted conversation analysis of audio-recorded encounters between 34 providers and 58 patients reporting ARV non-adherence in post-encounter interviews. Among 42 visits where adherence status was unknown by providers, 4 providers did not discuss ARVs (10 %), 6 discussed ARVs but did not elicit non-adherence disclosure (14 %), and 32 discussed ARVs which prompted disclosure (76 %). Questions were classified as: (1) clarification of medication ("Are you still taking the Combivir?"); (2) broad ("How's it going with your meds?"); (3) positively-framed ("Are you taking your medications regularly?"); (4) negatively-framed ("Have you missed any doses?"). Clinicians asked 75 ARV-related questions: 23 clarification, 12 broad, 17 positively-framed, and 23 negatively-framed. Negatively-framed questions were 3.8 times more likely to elicit accurate disclosure than all other question types (p < 0.0001). Providers can improve disclosure probability by asking directly about missed doses.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Comunicação , Revelação , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Relações Médico-Paciente , Adulto , Atitude do Pessoal de Saúde , Combinação de Medicamentos , Feminino , Infecções por HIV/psicologia , Humanos , Entrevistas como Assunto , Lamivudina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Visita a Consultório Médico , Assistência ao Paciente , Zidovudina/uso terapêutico
12.
BMC Genomics ; 15: 1056, 2014 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-25471115

RESUMO

BACKGROUND: Understanding gene expression and metabolic re-programming that occur in response to limiting nitrogen (N) conditions in crop plants is crucial for the ongoing progress towards the development of varieties with improved nitrogen use efficiency (NUE). To unravel new details on the molecular and metabolic responses to N availability in a major food crop, we conducted analyses on a weighted gene co-expression network and metabolic profile data obtained from leaves and roots of rice plants adapted to sufficient and limiting N as well as after shifting them to limiting (reduction) and sufficient (induction) N conditions. RESULTS: A gene co-expression network representing clusters of rice genes with similar expression patterns across four nitrogen conditions and two tissue types was generated. The resulting 18 clusters were analyzed for enrichment of significant gene ontology (GO) terms. Four clusters exhibited significant correlation with limiting and reducing nitrate treatments. Among the identified enriched GO terms, those related to nucleoside/nucleotide, purine and ATP binding, defense response, sugar/carbohydrate binding, protein kinase activities, cell-death and cell wall enzymatic activity are enriched. Although a subset of functional categories are more broadly associated with the response of rice organs to limiting N and N reduction, our analyses suggest that N reduction elicits a response distinguishable from that to adaptation to limiting N, particularly in leaves. This observation is further supported by metabolic profiling which shows that several compounds in leaves change proportionally to the nitrate level (i.e. higher in sufficient N vs. limiting N) and respond with even higher levels when the nitrate level is reduced. Notably, these compounds are directly involved in N assimilation, transport, and storage (glutamine, asparagine, glutamate and allantoin) and extend to most amino acids. Based on these data, we hypothesize that plants respond by rapidly mobilizing stored vacuolar nitrate when N deficit is perceived, and that the response likely involves phosphorylation signal cascades and transcriptional regulation. CONCLUSIONS: The co-expression network analysis and metabolic profiling performed in rice pinpoint the relevance of signal transduction components and regulation of N mobilization in response to limiting N conditions and deepen our understanding of N responses and N use in crops.


Assuntos
Regulação da Expressão Gênica de Plantas , Redes Reguladoras de Genes , Redes e Vias Metabólicas , Nitratos/metabolismo , Oryza/genética , Oryza/metabolismo , Análise por Conglomerados , Biologia Computacional , Epigênese Genética , Perfilação da Expressão Gênica , Metaboloma , Metabolômica , Anotação de Sequência Molecular , Família Multigênica , Especificidade de Órgãos , Folhas de Planta/genética , Folhas de Planta/metabolismo , Raízes de Plantas/genética , Raízes de Plantas/metabolismo , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo
13.
AIDS Behav ; 18(7): 1279-87, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24464408

RESUMO

Disparities in HIV care and outcomes negatively affect Black and Hispanic patients. Features of clinical communication may be a factor. This study is based on coding transcripts of 404 routine outpatient visits by people with HIV at four sites, using a validated system. In models adjusting for site and patient characteristics, with provider as a random effect, providers were more "verbally dominant" with Black patients than with others. There was more discussion about ARV adherence with both Black and Hispanic patients, but no more discussion about strategies to improve adherence. Providers made more directive utterances discussing ARV treatment with Hispanic patients. Possible interpretations of these findings are that providers are less confident in Black and Hispanic patients to be adherent; that they place too much confidence in their White, non-Hispanic patients; or that patients differentially want such discussion. The lack of specific problem solving and high provider directiveness suggests areas for improvement.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Negro ou Afro-Americano , Comunicação , Infecções por HIV/etnologia , Disparidades nos Níveis de Saúde , Hispânico ou Latino , População Branca , Adulto , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Humanos , Masculino , Adesão à Medicação/etnologia , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Avaliação das Necessidades , Relações Médico-Paciente
14.
Drug Alcohol Depend Rep ; 12: 100259, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39108608

RESUMO

Background: Stigma enacted in primary care settings remains a barrier to care for people who use drugs (PWUD). Little is known about the acceptability of potential stigma interventions to target structural drivers of stigma affecting the organizational- or provider-level. Methods: In-depth interview data were collected from 21 individuals working in Michigan primary care facilities. Participants included clinical (e.g., physicians, nurses) and non-clinical (e.g., administrators, receptionists) staff. Interviews explored perceptions of stigma toward PWUD and the acceptability of interventions to mitigate such stigma. Thematic analysis was used to identify stigma themes. Results: Participants largely reported substance-use stigma as a matter of individual attitudes or knowledge limitations and described such stigma as rarely occurring during interpersonal interactions. Participants were still acutely aware of upstream societal and organizational factors creating structural barriers to care and/or worsening outcomes among PWUD, but seldom labeled these as stigma. Some provider and structural stigma reduction interventions were enthusiastically supported because they address participant ideas of substance-use stigma drivers (e.g., lack of knowledge) or provide resources that could improve care quality or provide resources for PWUD. Conversely, participants opposed some potential stigma interventions, e.g., less-frequent urine drug testing and increasing clinical visit time, deemed infeasible because of outside forces like insurers or regulators. Conclusions: Although most participants conceptualized substance-use stigma as an individual or interpersonal process best addressed with training, their awareness of social determinants of health seemed to fuel an openness to some structural interventions to reduce organizational and provider stigma toward PWUD in primary care settings.

15.
BMC Genomics ; 14: 3, 2013 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-23324127

RESUMO

BACKGROUND: Water and nitrogen are two of the most critical inputs required to achieve the high yield potential of modern corn varieties. Under most agricultural settings however they are often scarce and costly. Fortunately, tremendous progress has been made in the past decades in terms of modeling to assist growers in the decision making process and many tools are now available to achieve more sustainable practices both environmentally and economically. Nevertheless large gaps remain between our empirical knowledge of the physiological changes observed in the field in response to nitrogen and water stresses, and our limited understanding of the molecular processes leading to those changes. RESULTS: This work examines in particular the impact of simultaneous stresses on the transcriptome. In a greenhouse setting, corn plants were grown under tightly controlled nitrogen and water conditions, allowing sampling of various tissues and stress combinations. A microarray profiling experiment was performed using this material and showed that the concomitant presence of nitrogen and water limitation affects gene expression to an extent much larger than anticipated. A clustering analysis also revealed how the interaction between the two stresses shapes the patterns of gene expression over various levels of water stresses and recovery. CONCLUSIONS: Overall, this study suggests that the molecular signature of a specific combination of stresses on the transcriptome might be as unique as the impact of individual stresses, and hence underlines the difficulty to extrapolate conclusions obtained from the study of individual stress responses to more complex settings.


Assuntos
Perfilação da Expressão Gênica , Genômica , Nitrogênio/farmacologia , Estresse Fisiológico/efeitos dos fármacos , Água/farmacologia , Zea mays/genética , Zea mays/fisiologia , Biotecnologia , Interações Medicamentosas , Ambiente Controlado , Análise de Sequência com Séries de Oligonucleotídeos , Estresse Fisiológico/genética , Fatores de Tempo , Transcrição Gênica/efeitos dos fármacos , Transcrição Gênica/genética , Zea mays/efeitos dos fármacos
16.
J Gen Intern Med ; 28(5): 622-9, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23307396

RESUMO

BACKGROUND: Health professional organizations have advocated for increasing the "cultural competence" (CC) of healthcare providers, to reduce racial and ethnic disparities in patient care. It is unclear whether provider CC is associated with more equitable care. OBJECTIVE: To evaluate whether provider CC is associated with quality of care and outcomes for patients with HIV/AIDS. DESIGN AND PARTICIPANTS: Survey of 45 providers and 437 patients at four urban HIV clinics in the U.S. MAIN MEASURES: Providers' self-rated CC was measured using a novel, 20-item instrument. Outcome measures included patients' receipt of antiretroviral (ARV) therapy, self-efficacy in managing medication regimens, complete 3-day ARV adherence, and viral suppression. KEY RESULTS: Providers' mean age was 44 years; 56 % were women, and 64 % were white. Patients' mean age was 45; 67 % were men, and 77 % were nonwhite. Minority patients whose providers scored in the middle or highest third on self-rated CC were more likely than those with providers in the lowest third to be on ARVs, have high self-efficacy, and report complete ARV adherence. Racial disparities were observed in receipt of ARVs (adjusted OR, 95 % CI for white vs. nonwhite: 6.21, 1.50-25.7), self-efficacy (3.77, 1.24-11.4), and viral suppression (13.0, 3.43-49.0) among patients of low CC providers, but not among patients of moderate and high CC providers (receipt of ARVs: 0.71, 0.32-1.61; self-efficacy: 1.14, 0.59-2.22; viral suppression: 1.20, 0.60-2.42). CONCLUSIONS: Provider CC was associated with the quality and equity of HIV care. These findings suggest that enhancing provider CC may reduce racial disparities in healthcare quality and outcomes.


Assuntos
Competência Cultural , Infecções por HIV/etnologia , Disparidades em Assistência à Saúde/etnologia , Atenção Primária à Saúde/normas , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Fármacos Anti-HIV/uso terapêutico , Uso de Medicamentos/estatística & dados numéricos , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Adesão à Medicação/etnologia , Pessoa de Meia-Idade , Relações Médico-Paciente , Psicometria , Qualidade da Assistência à Saúde , Autoeficácia , Resultado do Tratamento , Estados Unidos , Carga Viral
17.
J Gen Intern Med ; 28(5): 668-74, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23288378

RESUMO

BACKGROUND: The Patient Activation Measure (PAM) assesses several important concepts in chronic care management, including self-efficacy for positive health behaviors. In HIV-infected populations, better self-efficacy for medication management is associated with improved adherence to antiretroviral medications (ARVs), which is critically important for controlling symptoms and slowing disease progression. OBJECTIVE: To determine 1) characteristics associated with patient activation and 2) associations between patient activation and outcomes in HIV-infected patients. DESIGN: Cross-sectional survey. PARTICIPANTS: 433 patients receiving care in four HIV clinics. METHODS: An interviewer conducted face-to-face interviews with patients following their HIV clinic visit. Survey data were supplemented with medical record abstraction to obtain most recent CD4 counts, HIV viral load and antiretroviral medications. MAIN MEASURES: Patient activation was measured using the 13-item PAM (possible range 0-100). Outcomes included CD4 cell count > 200 cells/mL(3), HIV-1 RNA < 400 copies/mL (viral suppression), and patient-reported adherence. KEY RESULTS: Overall, patient activation was high (mean PAM = 72.3 [SD 16.5, range 34.7-100]). Activation was lower among those without vs. with a high school degree (68.0 vs. 74.0, p < .001), and greater depression (77.6 lowest, 70.2 middle, 68.1 highest tertile, p < .001). There was no association between patient activation and age, race, gender, problematic alcohol use, illicit drug use, or social status. In multivariable models, every 5-point increase in PAM was associated with greater odds of CD4 count > 200 cells/mL(3) (aOR 1.10 [95 % CI 1.01, 1.21]), adherence (aOR 1.18 [95 % CI 1.09, 1.29]) and viral suppression (aOR 1.08 [95 % CI 1.00, 1.17]). The association between PAM and viral suppression was mediated through adherence. CONCLUSIONS: Higher patient activation was associated with more favorable HIV outcomes. Interventions to improve patient activation should be developed and tested for their ability to improve HIV outcomes.


Assuntos
Infecções por HIV/tratamento farmacológico , HIV-1/isolamento & purificação , Autocuidado/normas , Autoeficácia , Adolescente , Adulto , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , Estudos Transversais , Feminino , Infecções por HIV/psicologia , Infecções por HIV/virologia , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Psicometria , Resultado do Tratamento , Carga Viral , Adulto Jovem
18.
Drug Alcohol Depend Rep ; 9: 100189, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37736522

RESUMO

Background: Antiretroviral medications have increased the lifespan of persons living with HIV (PLWH) thereby unmasking memory decline that may be attributed to chronological age, HIV symptomatology, HIV disease chronicity, and/or substance use (especially cannabis use which is common among PLWH). To date, few studies have attempted to disentangle these effects. In a sample of daily cannabis-using PLWH, we investigated whether hippocampal memory function, assessed via an object-location associative learning task, was associated with age, HIV chronicity and symptom severity, or substance use. Methods: 48 PLWH (12.9 ± 9.6 years since HIV diagnosis), who were 44 years old on average (range: 24-64 years; 58 % male) and reported daily cannabis use (recent use confirmed by urinalysis) completed the study. We assessed each participant's demographics, substance use, medical history, current HIV symptoms, and hippocampal memory function via a well-validated object-location associative learning task. Results: Multiple regression analyses found that living more years since HIV+ diagnosis predicted significantly worse associative learning total score (r=-0.40) and learning rate (r=-0.34) whereas chronological age, cannabis-use characteristics, and recent HIV symptom severity were not significantly related to hippocampal memory function. Conclusions: In daily cannabis-using PLWH, HIV chronicity was related to worse hippocampal memory function independent from cannabis use, age, and HIV symptomatology. Object-location associative learning performance could serve as an 'early-warning' metric of cognitive decline among PLWH. Future research should examine longitudinal changes in associative learning proficiency and evaluate interventions to prevent hippocampal memory decline among PLWH. ClinicalTrials.gov: NCT01536899.

20.
Personal Disord ; 13(6): 641-653, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-34843328

RESUMO

To improve understanding of emerging psychosis, researchers have identified potential precursory mechanisms that may momentarily precede psychotic-like experiences, including aberrant salience and anomalous self-experiences. Aberrant salience is the misattribution of significance to neutral stimuli and may be linked to atypical dopamine transmission. Anomalous self-experiences include changes in the experience of the self, which may alter top-down cognitive processes. The present study extends previous research on these phenomena by examining the momentary dynamics of aberrant salience, anomalous self-experiences, and psychotic-like experiences in daily life. Participants were 246 young adults who were prompted to complete 6 smartphone surveys daily for 7 days. Baseline measures of aberrant salience and anomalous self-experiences each predicted occurrence of the same phenomena in daily life, supporting the use of these measures to examine within-subject changes. Dynamic structural equation modeling was used to examine lagged effects. Both aberrant salience and anomalous self-experiences exhibited carryover effects across timepoints. Furthermore, aberrant salience and anomalous self-experiences were each associated with psychotic-like experiences at subsequent timepoints, above and beyond the carryover effects of psychotic-like experiences. These temporal relationships provide preliminary support consistent with social-cognitive models of psychosis and support further examination of the within-subject dynamics of aberrant salience and anomalous self-experiences at the momentary scale. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Transtornos Psicóticos , Adulto Jovem , Humanos , Transtornos Psicóticos/complicações , Transtornos Psicóticos/psicologia , Inquéritos e Questionários
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