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1.
Proc Natl Acad Sci U S A ; 120(43): e2313374120, 2023 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-37844220

RESUMO

Large increases in the number of low earth orbit satellites are projected in the coming decades [L. Schulz, K.-H. Glassmeier, Adv. Space Res. 67, 1002-1025 (2021)] with perhaps 50,000 additional satellites in orbit by 2030 [GAO, Large constellations of satellites: Mitigating environmental and other effects (2022)]. When spent rocket bodies and defunct satellites reenter the atmosphere, they produce metal vapors that condense into aerosol particles that descend into the stratosphere. So far, models of spacecraft reentry have focused on understanding the hazard presented by objects that survive to the surface rather than on the fate of the metals that vaporize. Here, we show that metals that vaporized during spacecraft reentries can be clearly measured in stratospheric sulfuric acid particles. Over 20 elements from reentry were detected and were present in ratios consistent with alloys used in spacecraft. The mass of lithium, aluminum, copper, and lead from the reentry of spacecraft was found to exceed the cosmic dust influx of those metals. About 10% of stratospheric sulfuric acid particles larger than 120 nm in diameter contain aluminum and other elements from spacecraft reentry. Planned increases in the number of low earth orbit satellites within the next few decades could cause up to half of stratospheric sulfuric acid particles to contain metals from reentry. The influence of this level of metallic content on the properties of stratospheric aerosol is unknown.

2.
J Biol Chem ; 299(1): 102780, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36496071

RESUMO

Ischemia and reperfusion affect multiple elements of cardiomyocyte electrophysiology, especially within the mitochondria. We previously showed that in cardiac monolayers, upon reperfusion after coverslip-induced ischemia, mitochondrial inner membrane potential (ΔΨ) unstably oscillates between polarized and depolarized states, and ΔΨ instability corresponds with arrhythmias. Here, through confocal microscopy of compartment-specific molecular probes, we investigate the mechanisms underlying the postischemic ΔΨ oscillations, focusing on the role of Ca2+ and oxidative stress. During reperfusion, transient ΔΨ depolarizations occurred concurrently with periods of increased mitochondrial oxidative stress (5.07 ± 1.71 oscillations/15 min, N = 100). Supplementing the antioxidant system with GSH monoethyl ester suppressed ΔΨ oscillations (1.84 ± 1.07 oscillations/15 min, N = 119, t test p = 0.027) with 37% of mitochondrial clusters showing no ΔΨ oscillations (versus 4% in control, odds ratio = 14.08, Fisher's exact test p < 0.001). We found that limiting the production of reactive oxygen species using cyanide inhibited postischemic ΔΨ oscillations (N = 15, t test p < 10-5). Furthermore, ΔΨ oscillations were not associated with any discernable pattern in cell-wide oxidative stress or with the changes in cytosolic or mitochondrial Ca2+. Sustained ΔΨ depolarization followed cytosolic and mitochondrial Ca2+ increase and was associated with increased cell-wide oxidative stress. Collectively, these findings suggest that transient bouts of increased mitochondrial oxidative stress underlie postischemic ΔΨ oscillations, regardless of Ca2+ dynamics.


Assuntos
Mitocôndrias Cardíacas , Estresse Oxidativo , Humanos , Cálcio/metabolismo , Isquemia/metabolismo , Potencial da Membrana Mitocondrial , Mitocôndrias Cardíacas/metabolismo , Miócitos Cardíacos/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Reperfusão
3.
Circulation ; 148(18): 1354-1367, 2023 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-37638389

RESUMO

BACKGROUND: The circuit boundaries for reentrant ventricular tachycardia (VT) have been historically conceptualized within a 2-dimensional (2D) construct, with their fixed or functional nature unresolved. This study aimed to examine the correlation between localized lines of conduction block (LOB) evident during baseline rhythm with lateral isthmus boundaries that 3-dimensionally constrain the VT isthmus as a hyperboloid structure. METHODS: A total of 175 VT activation maps were correlated with isochronal late activation maps during baseline rhythm in 106 patients who underwent catheter ablation for scar-related VT from 3 centers (42% nonischemic cardiomyopathy). An overt LOB was defined by a deceleration zone with split potentials (≥20 ms isoelectric segment) during baseline rhythm. A novel application of pacing within deceleration zone (≥600 ms) was implemented to unmask a concealed LOB not evident during baseline rhythm. LOB identified during baseline rhythm or pacing were correlated with isthmus boundaries during VT. RESULTS: Among 202 deceleration zones analyzed during baseline rhythm, an overt LOB was evident in 47%. When differential pacing was performed in 38 deceleration zones without overt LOB, an underlying concealed LOB was exposed in 84%. In 152 VT activation maps (2D=53, 3-dimensional [3D]=99), 69% of lateral boundaries colocalized with an LOB in 2D activation patterns, and the depth boundary during 3D VT colocalized with an LOB in 79%. In VT circuits with isthmus regions that colocalized with a U-shaped LOB (n=28), the boundary invariably served as both lateral boundaries in 2D and 3D. Overall, 74% of isthmus boundaries were identifiable as fixed LOB during baseline rhythm or differential pacing. CONCLUSIONS: The majority of VT circuit boundaries can be identified as fixed LOB from intrinsic or paced activation during sinus rhythm. Analysis of activation while pacing within the scar substrate is a novel technique that may unmask concealed LOB, previously interpreted to be functional in nature. An LOB from the perspective of a myocardial surface is frequently associated with intramural conduction, supporting the existence of a 3D hyperboloid VT circuit structure. Catheter ablation may be simplified to targeting both sides around an identified LOB during sinus rhythm.


Assuntos
Ablação por Cateter , Taquicardia Ventricular , Humanos , Cicatriz , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/cirurgia , Arritmias Cardíacas , Frequência Cardíaca/fisiologia , Bloqueio Cardíaco
4.
Am J Epidemiol ; 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38872334

RESUMO

In the article by Fitch et al. (Am J Epidemiol. 2024; 193(3):489-499) the authors highlight the concerning prevalence of suicide mortality among formerly incarcerated individuals in North Carolina. Their retrospective study reveals a doubled suicide risk post-release, with notable disparities among demographic groups. Urgent interventions are needed, including comprehensive re-entry programs and systemic reforms to address structural inequalities. I suggest tailored support services to mitigate suicide risks and promote successful community reintegration, advocating for equity, justice, and human dignity in post-release efforts.

5.
J Cell Sci ; 135(15)2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35781573

RESUMO

Adult stem cells persist in mammalian tissues by entering a state of reversible quiescence, referred to as G0, which is associated with low levels of transcription. Using cultured myoblasts and muscle stem cells, we report that in G0, global RNA content and synthesis are substantially repressed, correlating with decreased RNA polymerase II (RNAPII) expression and activation. Integrating RNAPII occupancy and transcriptome profiling, we identify repressed networks and a role for promoter-proximal RNAPII pausing in G0. Strikingly, RNAPII shows enhanced pausing in G0 on repressed genes encoding regulators of RNA biogenesis (such as Ncl, Rps24, Ctdp1), and release of pausing is associated with increased expression of these genes in G1. Knockdown of these transcripts in proliferating cells leads to induction of G0 markers, confirming the importance of their repression in establishment of G0. A targeted screen of RNAPII regulators revealed that knockdown of Aff4 (a positive regulator of elongation) unexpectedly enhances expression of G0-stalled genes and hastens S phase; however, the negative elongation factor (NELF) complex, a regulator of pausing, appears to be dispensable. We propose that RNAPII pausing contributes to transcriptional control of a subset of G0-repressed genes to maintain quiescence and impacts the timing of the G0-G1 transition. This article has an associated First Person interview with the first authors of the paper.


Assuntos
Regulação da Expressão Gênica , RNA Polimerase II , Animais , Ciclo Celular/genética , Mamíferos/metabolismo , Regiões Promotoras Genéticas/genética , RNA , RNA Polimerase II/genética , RNA Polimerase II/metabolismo , Transcrição Gênica , Fatores de Elongação da Transcrição/genética
6.
J Cardiovasc Electrophysiol ; 35(5): 942-949, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38462681

RESUMO

INTRODUCTION: Mapping system is useful in ablation of atrioventricular nodal reentry tachycardia (AVNRT) and localization of anatomic variances. Voltage mapping identifies a low voltage area in the Koch triangle called low-voltage-bridge (LVB); propagation mapping identifies the collision point (CP) of atrial wavefront convergence. We conducted a prospective study to evaluate the relationship between LVB and CP with successful site of ablation and identify standard value for LVB. MATERIALS AND METHODS: Three-dimensional (3D) maps of the right atria were constructed from intracardiac recordings using the ablation catheter. Cut-off values on voltage map were adjusted until LVB was observed. On propagation map, atrial wavefronts during sinus rhythm collide in the site representing CP, indicating the area of slow pathway conduction. Ablation site was selected targeting LVB and CP site, confirmed by anatomic position on fluoroscopy and atrioventricular ratio. RESULTS: Twenty-seven consecutive patients were included. LVB and CP were present in all patients. Postprocedural evaluation identified standard cut-off of 0.3-1 mV useful for LVB identification. An overlap between LVB and CP was observed in 23 (85%) patients. Procedure success was achieved in all patient with effective site at first application in 22 (81%) patients. There was a significant correlation between LVB, CP, and the site of effective ablation (p = .001). CONCLUSION: We found correlation between LVB and CP with the site of effective ablation, identifying a voltage range useful for standardized LVB identification. These techniques could be useful to identify ablation site and minimize radiation exposure.


Assuntos
Potenciais de Ação , Ablação por Cateter , Técnicas Eletrofisiológicas Cardíacas , Frequência Cardíaca , Taquicardia por Reentrada no Nó Atrioventricular , Humanos , Taquicardia por Reentrada no Nó Atrioventricular/cirurgia , Taquicardia por Reentrada no Nó Atrioventricular/fisiopatologia , Taquicardia por Reentrada no Nó Atrioventricular/diagnóstico , Masculino , Feminino , Estudos Prospectivos , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto , Valor Preditivo dos Testes , Idoso , Nó Atrioventricular/fisiopatologia , Nó Atrioventricular/cirurgia , Fatores de Tempo
7.
Catheter Cardiovasc Interv ; 103(1): 68-79, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37971155

RESUMO

Complex coronary total occlusion (CTO) lesions percutaneous treatment, especially in contexts where traditional antegrade strategies have failed and retrograde approaches are unsuitable, due to lack of interventional collaterals or high risk of complications, presents a considerable challenge for interventional cardiologists. Antegrade dissection reentry has historically offered a bailout strategy in cases with unsuccessful antegrade wire escalation. Nevertheless, the technique-whether employing dual-lumen microcatheters or dedicated reentry devices, such as Stingray-encounters several limitations, particularly when the delivery of the system is not possible, or extraplaque large hematomas, which complicates reentry. This paper introduces an innovative technique combining the use of the Recross MC Dual Microcatheter with real-time intravascular ultrasound guidance for refined re-wiring in CTO interventions. This approach facilitates accurate reentry zone selection and ensures precise, controlled puncturing into the true lumen, thereby enabling safe and predictable CTO recanalization.


Assuntos
Oclusão Coronária , Intervenção Coronária Percutânea , Humanos , Resultado do Tratamento , Ultrassonografia de Intervenção , Doença Crônica , Oclusão Coronária/diagnóstico por imagem , Oclusão Coronária/terapia , Angiografia Coronária
8.
Artigo em Inglês | MEDLINE | ID: mdl-39044659

RESUMO

BACKGROUND: Ten to fifteen percent of chronic total occlusion (CTO) percutaneous coronary interventions (PCIs) are unsuccessful in contemporary practice. Subintimal tracking and re-entry (STAR) (one form of "investment procedure") with staged reattempt and stenting may further increase the ultimate success and safety of CTO as a bailout strategy. The optimal timing for staged stenting after STAR is unknown. METHODS AND RESULTS: We designed a six-center, prospective randomized trial with a planned enrollment of 150 patients where STAR is utilized in case of impending failure. The primary aim is to evaluate the optimal timing of the staged PCI after STAR by randomizing the timing to earlier (5-7 weeks) versus later (12-14 weeks) staged PCI. The primary endpoint of the study is the technical success rate of the staged procedure. The secondary endpoints include: (1) the rate of thrombolysis in myocardial infarction 3 flow at the start of staged intervention, (2) rate of partial technical and procedural success of the staged procedure, (3) rate of in-hospital and 12-month major cardiac and cerebrovascular adverse events, and (4) change in patient-reported quality at 30 days, 6 months, and 12 months assessed by Seattle Angina Questionnaire. CONCLUSION: This study will ascertain the optimal timing of staged stenting after bail-out STAR approach in contemporary CTO PCI (ClinicalTrials.gov NCT05089864).

9.
Vox Sang ; 119(5): 447-459, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38419267

RESUMO

BACKGROUND AND OBJECTIVES: Exclusion of blood donors with hepatitis B virus (HBV) core antibodies (anti-HBc) prevents transfusion-transmitted HBV infection but can lead to significant donor loss. As isolated anti-HBc positivity does not always indicate true past HBV infection, we have investigated the effectiveness of confirmatory anti-HBc testing and the representation of rare blood groups in anti-HBc-positive donors. MATERIALS AND METHODS: Three hundred ninety-seven HBV surface antigen-negative and anti-HBc initially reactive blood donor samples were tested by five different anti-HBc assays. RESULTS: Eighty percentage of samples reactive in Architect anti-HBc assay were positive by the Murex assay and anti-HBc neutralization. Eleven out of 397 samples showed discordant results in supplementary testing from the Murex confirmatory test result, and five remained undetermined following extensive serological testing. Thirty-eight percentage of anti-HBc-positive donors identified as minority ethnic groups compared with 11% representation in anti-HBc-negative donors (p < 0.0001); the frequency of the Ro blood group in anti-HBc-positive donors was 18 times higher in non-white ethnic groups. CONCLUSION: Using two anti-HBc assays effectively enabled the identification of HBV-exposed and potentially infectious donors, their deferral and potential clinical follow-up. However, the exclusion of confirmed anti-HBc-positive donors will still impact the supply of rare blood such as Ro.


Assuntos
Doadores de Sangue , Anticorpos Anti-Hepatite B , Antígenos do Núcleo do Vírus da Hepatite B , Vírus da Hepatite B , Hepatite B , Humanos , Anticorpos Anti-Hepatite B/sangue , Hepatite B/sangue , Hepatite B/prevenção & controle , Feminino , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Antígenos do Núcleo do Vírus da Hepatite B/sangue , Masculino , Vírus da Hepatite B/imunologia , Seleção do Doador/métodos , Antígenos de Grupos Sanguíneos/imunologia , Doação de Sangue
10.
Eur J Vasc Endovasc Surg ; 67(5): 799-808, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38182107

RESUMO

OBJECTIVE: To investigate dissection severity, need for bailout stenting and limb outcomes in patients undergoing antegrade vs. retrograde revascularisation. METHODS: Consecutive patients who underwent either antegrade or retrograde revascularisation after failed antegrade recanalisation of long femoropopliteal chronic total occlusion (CTO) due to symptomatic peripheral artery disease between January 2017 and June 2022 were studied. Retrospective case control matching was used to adjust for lesion length and calcification using the peripheral artery calcification scoring system (PACSS). Procedural outcomes included severity of dissection (Type A to F dissections, numerically graded on a scale from 0 - 6 with increasing severity) after angioplasty and number and location of stents needed to be implanted during the index procedure. Additionally, clinically driven target lesion revascularisation (CD-TLR) and major (above ankle) amputation rates were assessed during follow up. RESULTS: A total of 180 patients were analysed who underwent antegrade (n = 90) or retrograde after failed antegrade (n = 90) recanalisation. The median patient age was 76.0 (interquartile range [IQR] 67.0, 82.0) years and 76 (42.2%) were female. Moreover, 78 patients (43.3%) had intermittent claudication, whereas 102 (56.7%) had chronic limb threatening ischaemia (CLTI). The mean lesion length was 30.0 (IQR 24.0, 36.0) cm with moderate to severe (3.0 [IQR 2.0, 4.0]) lesion calcification. Dissection severity after angioplasty was higher in the antegrade than retrograde after failed antegrade recanalisation group (4.0 [IQR 3.0, 4.0] vs. 3.0 [IQR 2.0, 4.0]; p < .001). Additionally, the number of stents in all segments and the rate of bailout stenting in popliteal segments was significantly higher with the antegrade strategy (2.0 [IQR 1.0, 3.0] vs. 1.0 [IQR 0, 2.0], p < .010; and 37% vs. 14%, p < .001). During a median follow up of 1.48 (IQR 0.63, 3.09) years, CD-TLR rates (p = .90) and amputation rates in patients with CLTI (p = .15) were not statistically significant. CONCLUSION: In complex femoropopliteal CTOs, retrograde after failed antegrade recanalisation, is safe for endovascular revascularisation, which in experienced hands may result in less severe dissections and lower rates of stent placement. However, considering the relatively short follow up, CD-TLR and amputation rates were not statistically different between the two approaches. [German Clinical Trials Register: DRKS00015277.].


Assuntos
Amputação Cirúrgica , Artéria Femoral , Doença Arterial Periférica , Artéria Poplítea , Stents , Humanos , Idoso , Feminino , Masculino , Estudos Retrospectivos , Artéria Femoral/cirurgia , Artéria Femoral/fisiopatologia , Artéria Femoral/diagnóstico por imagem , Artéria Poplítea/cirurgia , Artéria Poplítea/fisiopatologia , Artéria Poplítea/diagnóstico por imagem , Doença Arterial Periférica/cirurgia , Doença Arterial Periférica/fisiopatologia , Doença Arterial Periférica/terapia , Doença Arterial Periférica/diagnóstico por imagem , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Amputação Cirúrgica/estatística & dados numéricos , Salvamento de Membro/métodos , Resultado do Tratamento , Falha de Tratamento , Índice de Gravidade de Doença , Grau de Desobstrução Vascular , Procedimentos Endovasculares/instrumentação , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/métodos
11.
Environ Sci Technol ; 2024 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-39038811

RESUMO

Captan dislodgeable foliar residues (DFRs) were determined by following the applications of this fungicide in an apple orchard. The study comprised an investigation of the variability of captan DFR values and 14 days of DFR monitoring to assess kinetic modeling. A method combining solid-phase microextraction (SPME) gas chromatography and high-resolution mass spectrometry (GC-QTOF-MS) was developed for the quantification of captan residues from DFR aqueous extracts. The results evidenced that (1) sampling parameters such as the position of the tree in a row and the height of foliar significantly influenced captan DFR levels (247-1450 ng·cm-2), highlighting the need to implement a comprehensive sampling strategy; (2) the DFR captan dissipation kinetic model best matched with a biphasic one, with half-lives of DFRcaptan of 3.4 and 12.8 days, respectively, for the initial rapid phase 1 decline (day 0-5) and the slower phase 2 decline phase (day 6-14). Furthermore, through DFR measurements, the potential dermal exposure (PDE) of workers was assessed using transfer coefficients (TCs) from the literature. Compared to the acceptable operator exposure levels (AOELs), the results showed that the re-entry interval for captan may not sufficiently protect workers whose arms, hands, and legs are not covered.

12.
Artigo em Inglês | MEDLINE | ID: mdl-38214176

RESUMO

To date, there have been no reports of recording epicardial electrograms at the onset of spontaneous ventricular fibrillation (VF) in patients with Brugada syndrome (BrS). In the case of BrS, unipolar and bipolar electrogram recording on the right ventricular epicardium revealed that dispersion of repolarization with delayed potential was associated with spontaneous occurrence of VF. Phase 2 reentry associated with shortening and dispersion of action potential could have been recorded for the first time in BrS. Epicardial unipolar mapping can guide accurate and appropriate ablation for the elimination of arrhythmia substrate in J wave syndrome.

13.
Qual Life Res ; 33(5): 1287-1295, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38321193

RESUMO

PURPOSE: This study evaluated the association between social support during the re-entry period and long-term health-related quality of life (HRQoL) in breast cancer survivors using a longitudinal cohort study. METHODS: This is a prospective cohort study with 275 breast cancer survivors who reported HRQoL at 5 and 10 years after diagnosis. Social support for the re-entry period was measured 3 years after diagnosis using the Medical Outcome Study Social Support Survey (MOS-SSS). HRQoL was evaluated using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and Breast Cancer-Specific Module (BR-23). Multivariable linear regression analysis was performed to evaluate HRQoL at 5 and 10 years after diagnosis by level of social support during the re-entry period. RESULTS: The mean (SD) of social support during re-entry period was 68.5. The low social support (LSS, score < 55) group during the re-entry period had a significantly lower HRQoL (mean difference = - 12.93) compared to moderate or high social support (MHSS, score ≥ 55) group. 5 and 10 years after diagnosis, the LSS group continued to demonstrate lower HRQoL (5 years: - 7.17; 10 years: - 7.85) compared to the MHSS group. The LSS group were more likely to have lower role and social function scores, and higher fatigue, pain, and financial problems compared to the MHSS group at 10 years after diagnosis. CONCLUSIONS: Breast cancer survivors who received lower social support during the re-entry period were more likely to experience poorer HRQoL in the long term than those who did not.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Qualidade de Vida , Apoio Social , Humanos , Qualidade de Vida/psicologia , Feminino , Neoplasias da Mama/psicologia , Pessoa de Meia-Idade , Estudos Longitudinais , Sobreviventes de Câncer/psicologia , Estudos Prospectivos , Inquéritos e Questionários , Adulto , Idoso
14.
BMC Womens Health ; 24(1): 422, 2024 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-39054480

RESUMO

OBJECTIVE: To examine the challenges faced by Asian working mothers with a focus on re-entry to the workplace. In addition, we highlight potential supports that retain women in the workforce. DESIGN: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and registered with PROSPERO database (CRD42022341130). METHODS: Three independent reviewers were involved in the study selection to screen the search results sequentially by title, abstract, and full text using predefined inclusion and exclusion criteria. The methodological quality of each article was assessed via the Critical Appraisal Skills Programme (CASP) tool. RESULTS: We analysed a total of 36 studies conducted across different regions: 30 from the East and 6 from Southeast Asia. Among these studies, 20 were quantitative in nature, 15 were qualitative, and one intervention. The 36 studies cover five themes: 1) policies, 2) external support sources, 3) external pressure, 4) breastfeeding and 5) health status. Within each theme the same factor can have a positive or negative impact on the mother depending on her having a pro-career or pro-family mindset. Companies can take various initiatives to support working mothers, such as providing facilities for expressing breast milk at the workplace, educating staff to promote breastfeeding and accommodate childcare needs, and extending maternity leaves. However, there is a lack of literature that directly addresses the barriers and concrete support available to working mothers in Asia, beyond the scope of breastfeeding. CONCLUSIONS: Our findings underscore several obstacles that can impede a woman's seamless return to work. Pro-family and pro-career mothers have differing needs that cannot be addressed at the same time. There is a lack of comprehensive understanding regarding effective strategies or interventions that can support a positive reintegration into the workforce.


Assuntos
Mães , Mulheres Trabalhadoras , Local de Trabalho , Humanos , Feminino , Mães/psicologia , Mães/estatística & dados numéricos , Sudeste Asiático , Mulheres Trabalhadoras/estatística & dados numéricos , Mulheres Trabalhadoras/psicologia , Local de Trabalho/psicologia , Aleitamento Materno/estatística & dados numéricos , Ásia Oriental , Apoio Social , Nível de Saúde , Adulto , População do Sudeste Asiático
15.
Anaesthesia ; 79(7): 706-714, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38177064

RESUMO

Returning to work after maternity leave poses significant challenges, with potential long-term implications including decreased engagement or attrition of clinicians. Many quantitative studies have identified challenges and supports for women during pregnancy, maternity leave and re-entry to clinical practice. This qualitative study explored the experiences of anaesthetists returning to clinical work after maternity leave, to identify influential factors with the aim of providing a framework to assist planning re-entry. We conducted semi-structured interviews with 15 anaesthetists. Attendees of a re-entry programme were invited to participate, with purposive sampling and snowball recruitment to provide diversity of location and training stage, until data saturation was reached at 13 interviews. Five themes were identified: leave duration; planning re-entry; workplace culture; career impact and emotional impact. Leave duration was influenced by concerns about deskilling, but shorter periods of leave had logistical challenges, including fatigue. Most participants started planning to return to work with few or no formal processes in the workplace. Workplace culture, including support for breastfeeding, was identified as valuable, but variable. Participants also experienced negative attitudes on re-entry, including difficulty accessing permanent work, with potential career impacts. Many participants identified changes to professional and personal identity influencing the experience with emotional sequelae. This research describes factors which may be considered to assist clinicians returning to work after maternity leave and identifies challenges, including negative attitudes, which may pose significant barriers to women practising in anaesthesia and may contribute to lack of female leadership in some workplaces.


Assuntos
Licença Parental , Pesquisa Qualitativa , Retorno ao Trabalho , Humanos , Retorno ao Trabalho/psicologia , Feminino , Adulto , Local de Trabalho/psicologia , Gravidez , Anestesistas/psicologia , Atitude do Pessoal de Saúde , Masculino
16.
Regul Toxicol Pharmacol ; 150: 105628, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38621523

RESUMO

New transfer coefficient (TC) values were derived for vineyard workers handling treated grapevines during harvesting and crop maintenance activities. Re-entry exposure and dislodgeable foliar residue (DFR) studies were performed in Europe, covering hand harvesting, pruning/training, pruning/tying and pruning/shoot lifting. Foliar applications of fungicides (iprovalicarb, dimethomorph, dithianon, pyrimethanil and fenbuconazole) were made and 73 workers at 16 sites were monitored over one working day. Exposure was measured on inner and outer dosimeters, face/neck wipes and hand washes. In concurrent DFR studies, leaf punches were taken at each site during the time of worker re-entry. Potential exposure values correlated well with DFR values. TC values were derived for various re-entry activities for potential and actual exposure, with and without gloves. The harvesting task resulted in lower TC values than the other crop maintenance tasks. Additional TC values reflecting the use of protective gloves can be derived from the results. The TC values are much lower than current European Food Safety Authority (EFSA) default values. This project addresses a data gap identified by EFSA for specific EU TC values to permit more realistic and reliable re-entry worker exposure estimates for grapes.


Assuntos
Fungicidas Industriais , Exposição Ocupacional , Vitis , Humanos , Fazendas , Resíduos de Praguicidas/análise , Luvas Protetoras , Europa (Continente) , Agricultura , Medição de Risco
17.
Adv Exp Med Biol ; 1441: 1057-1090, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38884769

RESUMO

Arrhythmias account for over 300,000 annual deaths in the United States, and approximately half of all deaths are associated with heart disease. Mechanisms underlying arrhythmia risk are complex; however, work in humans and animal models over the past 25 years has identified a host of molecular pathways linked with both arrhythmia substrates and triggers. This chapter will focus on select arrhythmia pathways solved by linking human clinical and genetic data with animal models.


Assuntos
Arritmias Cardíacas , Modelos Animais de Doenças , Animais , Humanos , Arritmias Cardíacas/genética , Arritmias Cardíacas/fisiopatologia , Arritmias Cardíacas/metabolismo , Transdução de Sinais/genética
18.
Brain Inj ; 38(3): 202-209, 2024 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-38329082

RESUMO

OBJECTIVE: The goal of this study is to examine the effectiveness of case management services for a population of justice-involved individuals with TBI history. METHODS: Two thousand three hundred and eighty-nine records from statewide behavioral health and brain injury program databases were used in two studies. RESULTS: Participants with a reported TBI history were more likely to have experienced trauma and to have a behavioral health diagnosis relative to incarcerated persons without TBI. Six months after release, 56.8% of participants with a history of TBI were still receiving community treatment, 27.8% were not in treatment, and 3.4% had completed treatment. There was a high attrition rate; 70% of people referred for case management failed to maintain contact. CONCLUSIONS: For those that did receive services, these data suggest that it prevented an escalation of psychosocial needs. There were no differences in community participation as measured by the Mayo Portland Adaptability Index's Participation Index (M2PI) scores (t24 = .497, p = 0.624) at intake and after 6 months of case management. This study confirms that case management confers a benefit to persons with TBI who are released from the criminal justice system. Further, recidivism rates for this vulnerable group were no different from the larger population of returning citizens.


Assuntos
Lesões Encefálicas Traumáticas , Lesões Encefálicas , Prisioneiros , Humanos , Lesões Encefálicas Traumáticas/psicologia , Administração de Caso , Motivação
19.
Pediatr Cardiol ; 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38709261

RESUMO

Double ventricular response (DVR), where a single P wave results in two QRS complexes, is a rare presentation of dual AV node physiology. It has been associated with ventricular dysfunction in the setting of incessant tachycardia. We present the case of an otherwise healthy adolescent who had frequent DVR without tachycardia leading to left ventricular dysfunction. Slow pathway modification led to a significant reduction in ectopy and normalization of ventricular function. This highlights that DVR without tachycardia might lead to ventricular dysfunction in pediatric patients. Slow pathway modification with reduction of ectopy may be sufficient to restore ventricular function.

20.
J Adolesc ; 96(3): 485-500, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37661443

RESUMO

INTRODUCTION: Disparities in evaluating readiness to change and recidivism risk across diverse cultural groups can profoundly affect rehabilitation program efficacy. This study examines readiness to change and recidivism risk disparities between Israeli-Arabs and Israeli-Jews entering a re-entry program by the Prisoner Rehabilitation Authority postrelease. METHOD: The University of Rhode Island Change Assessment Scale questionnaire gauged readiness to change, whereas the Ohio Youth Assessment System-Residential tool assessed recidivism risk. The sample included 151 participants: 98 Israeli-Arabs and 53 Israeli-Jews. Mean differences in change readiness and recidivism risk were statistically assessed through t tests. RESULTS: Significant differences emerged in change readiness levels between Israeli-Arabs and Jews upon rehabilitation program entry, with Israeli-Jews exhibiting higher readiness. Additionally, a noteworthy divergence in recidivism risk was noted, indicating elevated average risk for Israeli-Jews. CONCLUSIONS: Findings underscore the vital need for cultural sensitivity during admission. Bias potential in assessing risk for Arab participants emphasizes the necessity of a comprehensive culturally sensitive approach. While focusing on admission, the Risk-Need-Responsivity model application could enhance risk evaluation and guide culturally tailored treatments.


Assuntos
Criminosos , Etnicidade , Adolescente , Humanos , Masculino , Israel , Árabes , Judeus
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