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1.
Analyst ; 148(22): 5698-5706, 2023 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-37823883

RESUMEN

Characterizing resin extent of cure kinetics is critical to understanding the structure-property-processing relationships of polymers. The disorder band present in the low-frequency region of the Raman spectrum is directly related to conformational entropy and the modulus of amorphous materials, both of which change as the resin polymerizes. Normalizing the disorder band to its shoulder (∼85 cm-1) provides structural conversion kinetics, which we can directly correlate to chemical conversion kinetics for methacrylate and epoxy-amine based resin systems. In addition to fitting both the structural and chemical conversion data to a phenomenological kinetic rate equation, we also demonstrate a relationship between the chemical and structural kinetics which appears to relate to the softness of the material. Lastly, we use the method to investigate a methacrylate/epoxy interpenetrating polymer network resin system. We find that the structural and chemical conversions occur simultaneously during the formation of the primary (methacrylate) network, but there is a lag between the two during the formation of the secondary (epoxy-amine) network.

2.
Mil Psychol ; 34(6): 687-696, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-38536300

RESUMEN

Sexual dysfunction is associated with disorders commonly diagnosed in service members/veterans (SM/Vs; e.g., depression, posttraumatic stress disorder) and increased risk for suicide in service women. Theory indicates depression may play an important role in predicting sexual dysfunction in the presence of certain mental health challenges, such as disordered eating symptoms. Given the risk for depression and incidence of eating disorders in women SM/Vs, the current study examined whether depressive symptoms mediated the association of disordered eating symptoms and sexual dysfunction in women SM/Vs. Participants (n = 494) were recruited via social media and completed measures of sexual function, disordered eating symptoms, depressive symptom severity, a demographic inventory, and measures of relationship satisfaction and trauma exposure (covariates). Based on self-report measures, probable sexual dysfunction, eating disorder, and depressive disorders were found among 58.70%, 38.5%, and 44.13% of participants, respectively. The relationship of higher disordered eating symptoms and lower sexual function was indirect, through higher depressive symptoms (indirect effect: -0.57, 95% confidence interval: -0.82, -0.34). Findings underscore the importance of screening for sexual function, particularly when disordered eating behavior or depression is present. Integrating treatment for sexual function into existing treatments for women SM/Vs with disordered eating and depression symptoms may be valuable.

3.
J Clin Psychol ; 77(10): 2262-2287, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-33991354

RESUMEN

OBJECTIVE: The current study examined the moderating role of gender on the association of military sexual trauma (MST) type (harassment-only vs. assault) and posttraumatic stress symptoms (PTSS) using the 6-factor Anhedonia Model. METHODS: Participants were 1321 service members/veterans. Two-part hurdle models assessed the moderating role of gender on the association of MST type with the presence (at least "moderate" symptoms endorsed within each cluster) or severity of PTSS and symptom clusters. RESULTS: Among those who experienced assault MST, women were at higher risk for the presence of intrusive, avoidance, negative affect, and anhedonia symptoms, and higher risk for more severe negative affect symptoms. Among those who experienced harassment-only MST, men were at higher risk of more severe PTSS symptoms overall and in the intrusive and dysphoric arousal symptom clusters. No other significant differences were observed. CONCLUSIONS: Gathering information on MST type may be helpful in treatment planning.


Asunto(s)
Personal Militar , Trauma Sexual , Trastornos por Estrés Postraumático , Femenino , Humanos , Masculino , Personal Militar/psicología , Personal Militar/estadística & datos numéricos , Distribución por Sexo , Trauma Sexual/psicología , Trastornos por Estrés Postraumático/epidemiología
4.
J Emerg Nurs ; 47(1): 88-100.e3, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33023788

RESUMEN

INTRODUCTION: Motor vehicle crashes are the leading cause of adolescent death. Inattention to the roadway contributes to crash risk. The objective of this study was to deploy an initial study of a web-based intervention (Let's Choose Ourselves) designed to improve adolescent driver attention to the roadway. METHODS: We used a randomized controlled trial design in a sample of adolescent drivers to test if a web-based intervention decreased cell phone engagement in driving simulation at 3 months as compared with controls. As secondary hypotheses, we tested if the intervention increased the use of peer passengers to manage distractions and decreased eyes off the forward roadway in driving simulation and decreased self-reported risky driving behaviors. Adolescents, aged 16-17 years, licensed for ≤90 days were randomized to Let's Choose Ourselves with distractions in the simulator protocol at baseline, Let's Choose Ourselves with no distractions, an attention control intervention on healthy eating with distractions, or attention control with no distractions. We used Poisson regression modeling to test the primary and secondary hypotheses. RESULTS: The trial included 60 adolescents (66.7% female, 78.3% non-Hispanic white subjects, mean age 16.8 years, licensed 50.8 days). In Poisson regression, controlling for sex, we found no significant effects of Let's Choose Ourselves on primary or secondary outcomes. However, there was a significant effect of visit on self-report outcomes, with self-reported distracted driving behaviors increasing over time. DISCUSSION: Although there were no significant effects of Let's Choose Ourselves, self-reported risky driving behaviors increased over time. Further investigation of the relationship between driving experience and increasing inattention to the road in adolescents is warranted.


Asunto(s)
Conducta del Adolescente , Conducción Distraída/prevención & control , Educación en Salud/métodos , Internet , Adolescente , Teléfono Celular , Femenino , Humanos , Masculino , Pennsylvania
5.
Med Care ; 57 Suppl 6 Suppl 2: S149-S156, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31095054

RESUMEN

BACKGROUND: Despite national screening efforts, military sexual trauma (MST) is underreported. Little is known of racial/ethnic differences in MST reporting in the Veterans Health Administration (VHA). OBJECTIVE: This study aimed to compare patterns of MST disclosure in VHA by race/ethnicity. RESEARCH DESIGN: Retrospective cohort study of MST disclosures in a national, random sample of Veterans who served in Afghanistan and Iraq and completed MST screens from October 2009 to 2014. We used natural language processing (NLP) to extract MST concepts from electronic medical notes in the year following Veterans' first MST screen. MEASURE(S): Any evidence of MST (positive MST screen or NLP concepts) and late MST disclosure (NLP concepts following a negative MST screen). Multivariable logistic regressions, stratified by sex, tested racial/ethnic differences in any MST evidence, and late disclosure. RESULTS: Of 6618 male and 6716 female Veterans with MST screen results, 1473 had a positive screen (68 male, 1%; 1405 female, 21%). Of those with a negative screen, 257 evidenced late MST disclosure by NLP (44 male, 39%; 213 female, 13%). Late MST disclosure was usually documented during mental health visits. There were no significant racial/ethnic differences in MST disclosure among men. Among women, blacks were less likely than whites to have any MST evidence (adjusted odds ratio=0.75). In the subsample with any MST evidence, black and Hispanic women were more likely than whites to disclose MST late (adjusted odds ratio=1.89 and 1.59, respectively). CONCLUSIONS: Combining NLP results with MST screen data facilitated the identification of under-reported sexual trauma experiences among men and racial/ethnic minority women.


Asunto(s)
Revelación/estadística & datos numéricos , Documentación , Procesamiento de Lenguaje Natural , Delitos Sexuales , Veteranos/estadística & datos numéricos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Delitos Sexuales/etnología , Delitos Sexuales/estadística & datos numéricos , Estados Unidos , United States Department of Veterans Affairs
6.
Nurs Res ; 67(3): 202-211, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29701615

RESUMEN

BACKGROUND: Risky driving behaviors contribute to adolescent injury, disability, and death, yet little is known about how mental health factors are associated with adolescent driving behaviors. OBJECTIVES: The purpose of the research was to determine the association of risky driving behaviors and mental health symptoms in novice adolescent drivers. METHODS: We recruited a convenience sample (n = 60) of adolescents to complete an assessment of driving performance errors in a high-fidelity simulator (Simulated Driving Assessment [SDA] Error Score) and a self-report measure of risky driving (Behavior of Young Novice Drivers Survey [BYNDS]). Participants also completed a mental health assessment of self-reported symptoms of depression (Center for Epidemiologic Studies-Depression Scale) and attention-deficit/hyperactivity disorder (ADHD; inattention and hyperactivity-impulsivity), conduct disorder, and oppositional defiant disorder (Conners-3 self-report and parent report). We evaluated the cross-sectional relationships between SDA Error Score, BYNDS, and mental health survey data with descriptive statistics, bivariate correlations, and linear regression. RESULTS: In linear regression models, higher self-reported inattentive ADHD T-scores were associated with higher SDA Error Score (model adjusted R = .20). Higher self-reported T-scores of hyperactive-impulsive ADHD and conduct disorder were associated with higher BYNDS total scores (model adjusted R = .32). Parent report measures were not associated with adolescent BYNDS total score or SDA Error Score. DISCUSSION: These data highlight the association of risky driving with adolescent symptoms of inattention, hyperactivity, and conduct disorder. The early stage of independent driving is an important time for addressing the relationship between driving performance and mental health conditions.


Asunto(s)
Déficit de la Atención y Trastornos de Conducta Disruptiva/epidemiología , Conducción de Automóvil , Desempeño Psicomotor , Entrenamiento Simulado , Adolescente , Femenino , Humanos , Modelos Lineales , Masculino , Pennsylvania/epidemiología , Asunción de Riesgos , Muestreo , Autoinforme , Encuestas y Cuestionarios
7.
Med Care ; 55 Suppl 9 Suppl 2: S70-S77, 2017 09.
Artículo en Inglés | MEDLINE | ID: mdl-28806368

RESUMEN

BACKGROUND: The effects of sexual trauma on long-term health care utilization and costs are not well understood due to infrequent documentation of sexual trauma history in health care systems. The Veteran's Health Administration provides a unique opportunity to address this constraint as sexual trauma is actively screened for as part of routine care. METHODS: We used a retrospective cohort design to analyze Veteran's Health Administration mental health and medical service utilization and costs as a function of a positive screen for exposure to military sexual trauma (MST) among Veterans of recent conflicts in Iraq and Afghanistan. We computed adjusted 5-year estimates of overall utilization and costs, and utilization and costs determined not to be related to MST. RESULTS: The cohort included 426,223 men and 59,611 women. A positive MST screen was associated with 50% higher health care utilization and costs relative to a negative screen. Overall, a positive relative to negative MST screen was associated with a 5-year incremental difference of 34.6 encounters and $10,734 among women, and 33.5 encounters and $11,484 among men. After accounting for MST-related treatment, positive MST screen was associated with 11.9 encounters and $4803 among women, and 19.5 encounters and $8001 among men. CONCLUSIONS: Results demonstrate significant and consistent differences in health care utilization and costs between Veterans with a positive relative to negative MST screen. Even after accounting for MST-related care, a positive screen was associated with significantly higher utilization and costs. MST-related needs may be more readily recognized in women relative to men.


Asunto(s)
Trastornos Mentales/economía , Personal Militar/psicología , Aceptación de la Atención de Salud/psicología , Veteranos/psicología , Femenino , Humanos , Masculino , Tamizaje Masivo/métodos , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Violación/psicología , Estudios Retrospectivos , Factores Sexuales , Acoso Sexual/psicología , Estados Unidos , United States Department of Veterans Affairs
8.
Med Care ; 55 Suppl 9 Suppl 2: S104-S110, 2017 09.
Artículo en Inglés | MEDLINE | ID: mdl-28806373

RESUMEN

BACKGROUND: Veterans experiencing homelessness frequently use emergency and urgent care (ED). OBJECTIVE: To examine the effect of a Patient-aligned Care Team (PACT) model tailored to the unique needs of Veterans experiencing homelessness (H-PACT) on frequency and type of ED visits in Veterans Health Administration (VHA) medical facilities. RESEARCH DESIGN: During a 12-month period, ED visits for 3981 homeless Veterans enrolled in (1) H-PACT at 20 VHA medical centers (enrolled) were compared with those of (2) 24,363 homeless Veterans not enrolled in H-PACT at the same sites (nonenrolled), and (3) 23,542 homeless Veterans at 12 non-H-PACT sites (usual care) using a difference-in-differences approach. MEASURE(S): The primary outcome was ED and other health care utilization and the secondary outcome was emergent (not preventable/avoidable) ED visits. RESULTS: H-PACT enrollees were predominantly white males with a higher baseline Charlson comorbidity index. In comparing H-PACT enrollees with usual care, there was a significant decrease in ED usage among the highest ED utilizers (difference-in-differences, -4.43; P<0.001). The decrease in ED visits were significant though less intense for H-PACT enrollees versus nonenrolled (-0.29, P<0.001). H-PACT enrollees demonstrated a significant increase in the proportion of ED care visits that were not preventable/avoidable in the 6 months after enrollment, but had stable rates of primary care, mental health, social work, and substance abuse visits over the 12 months. CONCLUSIONS: Primary care treatment engagement can reduce ED visits and increase appropriate use of ED services in VHA for Veterans experiencing homelessness, especially in the highest ED utilizers.


Asunto(s)
Servicio de Urgencia en Hospital/estadística & datos numéricos , Personas con Mala Vivienda , Grupo de Atención al Paciente/organización & administración , Atención Dirigida al Paciente/organización & administración , Veteranos/psicología , Atención a la Salud/estadística & datos numéricos , Femenino , Hospitales de Veteranos , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos
9.
Microb Pathog ; 113: 269-275, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29101059

RESUMEN

Latent tuberculosis is caused by dormant Mycobacterium tuberculosis (Mtb) that is phenotypically tolerant to antibiotics. Dormant Mtb accumulates triacylglycerol (TAG) utilizing fatty acids obtained from macrophage lipid droplets. The Rv1551 (PlsB1) gene is annotated as a putative glycerol-3-phosphate acyltransferase (GPAT) in the Mtb genome. GPAT catalyzes the first step of the glycerophospholipid biosynthetic pathway that synthesizes the lipid precursors for triacylglycerol biosynthesis. Although triacylglycerol biosynthesis is associated with Mtb dormancy, the functionality of the Rv1551 acyltransferase has not been investigated. We cloned the open reading frame of the Rv1551 acyltransferase and expressed it in Escherichia coli to study its function. We observed that E. coli cell lysates expressing Rv1551 displayed increased synthesis of phosphatidylglycerol, phosphatidylethanolamine and cardiolipin from radiolabeled glycerol-3-phosphate and fatty acyl-coenzyme A precursors. When cultured in medium supplemented with long-chain fatty acids, E. coli expressing Rv1551 exhibited significantly higher viable cell counts during the exponential and stationary phases. These results suggest that Rv1551 displays function as a GPAT by enhancing the synthesis of phospholipids from exogenously provided fatty acids in E. coli cell lysates. This is the first report showing that Rv1551 is a functional GPAT that catalyzes the initial step of glycerophospholipid biosynthesis in the mycobacterial cell.


Asunto(s)
Escherichia coli/metabolismo , Glicerol-3-Fosfato O-Aciltransferasa/fisiología , Mycobacterium tuberculosis/enzimología , Mycobacterium tuberculosis/genética , Fosfolípidos/biosíntesis , Aciltransferasas/genética , Secuencia de Aminoácidos , Cardiolipinas/metabolismo , Clonación Molecular , Escherichia coli/genética , Escherichia coli/crecimiento & desarrollo , Ácidos Grasos/metabolismo , Regulación Bacteriana de la Expresión Génica , Genoma Microbiano , Glicerol-3-Fosfato O-Aciltransferasa/genética , Viabilidad Microbiana , Sistemas de Lectura Abierta , Fosfatidiletanolaminas/metabolismo , Fosfatidilgliceroles/metabolismo , Proteínas Recombinantes , Análisis de Secuencia de Proteína
10.
J Urban Health ; 94(1): 54-63, 2017 02.
Artículo en Inglés | MEDLINE | ID: mdl-28116585

RESUMEN

Housing instability is associated with costly patterns of health and behavioral health service use. However, little prior research has examined patterns of service use associated with higher costs among those experiencing ongoing housing instability. To address this gap, we compared inpatient and outpatient medical and behavioral health service utilization and costs between veterans experiencing brief and ongoing episodes of housing instability. We used data from a brief screening instrument for homelessness and housing instability that has been implemented throughout the US Department of Veterans Affairs (VA) health care system to identify a national sample of veterans experiencing housing instability. Veterans were classified as experiencing either brief or ongoing housing instability, based on two consecutive responses to the instrument, and we used a series of two-part regression models to conduct adjusted comparisons of costs between veterans experiencing brief and ongoing episodes of housing instability. Among 5794 veterans screening positive for housing instability, 4934 (85%) were experiencing brief and 860 (15%) ongoing instability. The average total annual incremental cost associated with ongoing versus brief episodes of housing instability was estimated at $7573, with the bulk of this difference found in inpatient services. Cost differences resulted more from a higher probability of service use among those experiencing ongoing episodes of housing instability than from higher costs among service users. Our findings suggest that VA programmatic efforts aimed at preventing extended episodes of housing instability could potentially result in substantial cost offsets for the VA health care system.


Asunto(s)
Atención a la Salud/economía , Atención a la Salud/estadística & datos numéricos , Personas con Mala Vivienda , Veteranos , Adolescente , Adulto , Anciano , Costos y Análisis de Costo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
11.
Int J Eat Disord ; 50(7): 808-816, 2017 07.
Artículo en Inglés | MEDLINE | ID: mdl-28401580

RESUMEN

OBJECTIVE: Evaluate the association of military sexual trauma (MST) screen status with eating disorder diagnoses among veterans within 1- and 5-years after initiating Veterans Health Administration (VHA) care, and whether the association varied by sex. METHOD: Retrospective cohort study of US Afghanistan/Iraq veterans who used VHA services between FY 2004 and 2014 (N = 595,525). This study used VHA administrative data to assess the presence of eating disorder diagnoses in medical records within 1- and 5-years of initiating VHA care, and whether a positive screen for MST was associated with eating disorders. RESULTS: Three percent (n = 18,488) screened positive for MST. At 1- and 5-year follow up, 0.1% (n= 513, 74% female), and 0.2% (n = 504, 71% female) were diagnosed with an eating disorder, respectively. In regression models adjusted for demographic variables, military service, and psychiatric comorbidities, the presence of an eating disorder diagnosis was nearly two times higher among those with a positive screen for MST in the 1-year (adjusted odds ratio [AOR] = 1.94, 95% confidence interval [CI] = 1.57-2.40) and 5-year (AOR = 1.86, 95%CI = 1.49-2.32) cohorts. The increased likelihood conferred by MST for an eating disorder diagnosis was differentially stronger among male veterans than female veterans in the 1-year cohort only (AOR = 2.13, 95%CI = 1.01-4.50). DISCUSSION: Veterans with a positive screen for MST, especially male veterans, had a nearly two-fold increased likelihood of having an eating disorder diagnosis. Screening for eating disorders may be important in both male and female veterans who report MST.


Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos/etiología , Personal Militar/psicología , Conducta Sexual/psicología , Trastornos por Estrés Postraumático/etiología , Veteranos/psicología , Adulto , Afganistán , Estudios de Cohortes , Comorbilidad , Trastornos de Alimentación y de la Ingestión de Alimentos/epidemiología , Trastornos de Alimentación y de la Ingestión de Alimentos/patología , Femenino , Humanos , Irak , Masculino , Estudios Retrospectivos , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/patología
12.
Community Ment Health J ; 52(2): 148-57, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26289119

RESUMEN

We identified correlates of unsheltered status among Veterans experiencing homelessness and described distinct subgroups within the unsheltered homeless Veteran population using data from a screening instrument for homelessness that is administered to all Veterans accessing outpatient care at a Veterans Health Administration (VHA) facility. Correlates of unsheltered homelessness included male gender, white race, older age, lower levels of VHA eligibility, substance use disorders, frequent use of VHA inpatient and infrequent use of VHA outpatient services, and residing in the West. We identified six distinct subgroups of unsheltered Veterans; the tri-morbid frequent users represented the highest need group, but the largest group was comprised of Veterans who made highly infrequent use of VHA healthcare services. Differences between sheltered and unsheltered Veterans and heterogeneity within the unsheltered Veteran population should be considered in targeting housing and other interventions.


Asunto(s)
Atención Ambulatoria/estadística & datos numéricos , Personas con Mala Vivienda/estadística & datos numéricos , Pacientes Internos/estadística & datos numéricos , Salud de los Veteranos/estadística & datos numéricos , Veteranos/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , Enfermedad Crónica/epidemiología , Enfermedad Crónica/terapia , Registros Electrónicos de Salud , Femenino , Personas con Mala Vivienda/psicología , Humanos , Modelos Logísticos , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Persona de Mediana Edad , Distribución por Sexo , Encuestas y Cuestionarios , Estados Unidos/epidemiología , United States Department of Veterans Affairs , Veteranos/psicología , Adulto Joven
13.
Inj Prev ; 20(6): 365-72, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24814717

RESUMEN

BACKGROUND: Health-compromising behaviours in adolescents and adults co-occur. Because motor vehicle crashes are the leading cause of death and disability for these age groups, understanding the association between risky driving and other health-compromising behaviours is critical. METHODS: We performed a secondary analysis of data from a randomised controlled trial of an intervention for participants who screened positive for risky driving and problem drinking. Using baseline data, we examined relationships among conduct behaviour problems before and after age 15 years, depressive symptoms, sleep, problem drinking, and risky driving (hostile, reckless and drinking and driving) in late adolescents ages 18-24 (n=110) years, and adults ages 25-44 (n=202) years. We developed a measurement model for the entire sample using confirmatory factor analysis, which was then specified as a multigroup structural equation model. RESULTS: Late adolescents and adults had some similar associations for pathways through problem drinking to drinking and driving; depression to reckless driving; and conduct behaviour problems after 15 years of age to hostile driving. Late adolescents, however, had more complex relationships: depressive symptoms and conduct behaviour problems before 15 years of age were associated with more risky driving behaviours through multiple pathways, and males reported more risky driving. CONCLUSIONS: Risky driving is associated with other health-compromising behaviours and mental health factors. It is a multidimensional phenomenon more pronounced in late adolescence than adulthood. In order to promote safe driving, the findings support the need to consider behaviours that are a health threat in the late adolescent population during driving training and licensure. TRIAL REGISTRATION NUMBER: NCT00164294.


Asunto(s)
Accidentes de Tránsito/prevención & control , Conducta del Adolescente/psicología , Consumo de Bebidas Alcohólicas/psicología , Conducción de Automóvil/psicología , Conducta Peligrosa , Depresión/psicología , Salud Mental , Asunción de Riesgos , Adolescente , Adulto , Factores de Edad , Consumo de Bebidas Alcohólicas/efectos adversos , Conducción de Automóvil/legislación & jurisprudencia , Análisis Factorial , Femenino , Humanos , Masculino , Medio Oeste de Estados Unidos/epidemiología , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo , Factores Sexuales , Adulto Joven
14.
J Neurosurg Sci ; 58(2): 65-76, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24819483

RESUMEN

First described over 25 years ago, epidural lysis of adhesions (LOA) involves the mechanical dissolution of epidural scar tissue, which may directly alleviate pain and facilitate the spread of analgesic substances to area(s) of pain generation. Although it most commonly performed for lumbar failed back surgery syndrome, there is a growing body of evidence that suggests it may be effective for spinal stenosis and radicular pain stemming from a herniated disc. There is weak positive evidence that LOA is more effective than conventional caudal epidural steroid injections for failed back surgery syndrome and spinal stenosis, and that LOA is more effective than sham adhesiolysis and conservative management for lumbosacral radiculopathy. For cervical disc herniation and spinal stenosis, there is only anecdotal evidence suggesting effectiveness and safety. Factors that may contribute to the enhanced efficacy compared to traditional epidural steroid administration include the high volume administered, the use of hypertonic saline, and to a lesser extent the use of hyaluronidase and a navigable catheter to mechanically disrupt scar tissue and guide medication administration. Although LOA is widely considered a safe intervention, the complication rates are higher than for conventional epidural steroid injection.


Asunto(s)
Cicatriz/tratamiento farmacológico , Espacio Epidural/efectos de los fármacos , Síndrome de Fracaso de la Cirugía Espinal Lumbar/tratamiento farmacológico , Hialuronoglucosaminidasa/uso terapéutico , Estenosis Espinal/tratamiento farmacológico , Adherencias Tisulares/tratamiento farmacológico , Cicatriz/patología , Espacio Epidural/patología , Medicina Basada en la Evidencia , Síndrome de Fracaso de la Cirugía Espinal Lumbar/patología , Humanos , Inyecciones Espinales , Radiculopatía/tratamiento farmacológico , Radiculopatía/patología , Estenosis Espinal/patología , Adherencias Tisulares/patología
15.
Appl Spectrosc ; : 37028241270637, 2024 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-39094000

RESUMEN

The development of non-contact in situ techniques for monitoring cure kinetics has the potential to greatly improve both resin formulation and processing. We have recently shown that low-frequency Raman spectroscopy is a viable method for assessing resin structural cure kinetics and complements the traditional chemical conversion determined from the fingerprint region of the spectrum. In this work, we further evaluate the relationship between structural and chemical conversion by investigating two chemically identical yet rheologically different interpenetrating polymer network resin formulations. Rheological analysis demonstrates a relationship between structural conversion and storage modulus, which is not observed in the chemical conversion data. We show that one can produce master cure kinetics curves with comparable kinetic constants using both the chemical and structural conversion methodologies. Parametric analysis of the structural conversion, chemical conversion, and photorheological conversion was combined with a semi-empirical model for the storage shear modulus as a function of the extent of cure.

16.
J Biol Chem ; 287(5): 3357-65, 2012 Jan 27.
Artículo en Inglés | MEDLINE | ID: mdl-22158622

RESUMEN

Microtubule-dependent transport is most often driven by collections of kinesins and dyneins that function in either a concerted fashion or antagonistically. Several lines of evidence suggest that cargo transport may not be influenced appreciably by the combined action of multiple kinesins. Yet, as in previous optical trapping experiments, the forces imposed on cargos will vary spatially and temporally in cells depending on a number of local environmental factors, and the influence of these conditions has been largely overlooked. Here, we characterize the dynamics of structurally defined complexes containing multiple kinesins under the controlled loads of an optical force clamp. While demonstrating that there are generic kinetic barriers that restrict the ability of multiple kinesins to cooperate productively, the spatial and temporal properties of applied loads is found to play an important role in the collective dynamics of multiple motor systems. We propose this dependence has implications for intracellular transport processes, especially for bidirectional transport.


Asunto(s)
Cinesinas/química , Microtúbulos/química , Transporte Biológico/fisiología , Humanos , Cinesinas/genética , Cinesinas/metabolismo , Microtúbulos/genética , Microtúbulos/metabolismo
17.
Am J Public Health ; 103 Suppl 2: S340-7, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24148057

RESUMEN

OBJECTIVES: We modeled rates of family and single-adult homelessness in the United States in metropolitan and nonmetropolitan regions and as a function of community-level demographic, behavioral, health, economic, and safety net characteristics. METHODS: We entered community-level characteristics and US Department of Housing and Urban Development point-in-time counts for a single night in January 2009 into separate mixed-effects statistical analyses that modeled homelessness rates for 4 subpopulations: families and single adults in metropolitan and nonmetropolitan regions. RESULTS: Community-level factors accounted for 25% to 50% of the variance in homelessness rates across models. In metropolitan regions, alcohol consumption, social support, and several economic indicators were uniquely associated with family homelessness, and drug use and homicide were uniquely associated with single-adult homelessness. In nonmetropolitan regions, life expectancy, religious adherence, unemployment, and rent burden were uniquely associated with family homelessness, and health care access, crime, several economic indicators, and receipt of Supplemental Security Income were uniquely associated with single-adult homelessness. CONCLUSIONS: Considering homeless families and single adults separately enabled more precise modeling of associations between homelessness rates and community-level characteristics, indicating targets for interventions to reduce homelessness among these subpopulations.


Asunto(s)
Familia , Personas con Mala Vivienda/estadística & datos numéricos , Características de la Residencia/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Alcoholismo/epidemiología , Crimen/estadística & datos numéricos , Economía/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Asistencia Pública/estadística & datos numéricos , Apoyo Social , Factores Socioeconómicos , Estados Unidos
18.
Am J Public Health ; 103 Suppl 2: S210-1, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24148032

RESUMEN

We examined data for all veterans who completed the Veterans Health Administration's national homelessness screening instrument between October 1, 2012, and January 10, 2013. Among veterans who were not engaged with the US Department of Veterans Affairs homeless system and presented for primary care services, the prevalence of recent housing instability or homelessness was 0.9% and homelessness risk was 1.2%. Future research will refine outreach strategies, targeting of prevention resources, and development of novel interventions.


Asunto(s)
Vivienda/estadística & datos numéricos , Personas con Mala Vivienda/estadística & datos numéricos , Tamizaje Masivo/organización & administración , United States Department of Veterans Affairs/estadística & datos numéricos , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Prevalencia , Asistencia Pública/estadística & datos numéricos , Factores de Riesgo , Estados Unidos/epidemiología , United States Department of Veterans Affairs/organización & administración , Adulto Joven
19.
Alcohol Clin Exp Res ; 37(10): 1753-62, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23802878

RESUMEN

BACKGROUND: Risky driving and hazardous drinking are associated with significant human and economic costs. Brief interventions for more than one risky behavior have the potential to reduce health-compromising behaviors in populations with multiple risk-taking behaviors such as young adults. Emergency department (ED) visits provide a window of opportunity for interventions meant to reduce both risky driving and hazardous drinking. METHODS: We determined the efficacy of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol addressing risky driving and hazardous drinking. We used a randomized controlled trial design with follow-ups through 12 months. ED patients aged 18 to 44 who screened positive for both behaviors (n = 476) were randomized to brief intervention (BIG), contact control (CCG), or no-contact control (NCG) groups. The BIG (n = 150) received a 20-minute assessment and two 20-minute interventions. The CCG (n = 162) received a 20-minute assessment at baseline and no intervention. The NCG (n = 164) were asked for contact information at baseline and had no assessment or intervention. Outcomes at 3, 6, 9, and 12 months were self-reported driving behaviors and alcohol consumption. RESULTS: Outcomes were significantly lower in BIG compared with CCG through 6 or 9 months, but not at 12 months: Safety belt use at 3 months (adjusted odds ratio [AOR], 0.22; 95% confidence interval [CI], 0.08 to 0.65); 6 months (AOR, 0.13; 95% CI, 0.04 to 0.42); and 9 months (AOR, 0.18; 95% CI, 0.06 to 0.56); binge drinking at 3 months (adjusted rate ratio [ARR] 0.84; 95% CI, 0.74 to 0.97) and 6 months (ARR, 0.81; 95% CI, 0.67 to 0.97); and ≥5 standard drinks/d at 3 months (AOR, 0.43; 95% CI, 0.20 to 0.91) and 6 months (AOR, 0.41; 95% CI, 0.17 to 0.98). No substantial differences were observed between BIG and NCG at 12 months. CONCLUSIONS: Our findings indicate that SBIRT reduced risky driving and hazardous drinking in young adults, but its effects did not persist after 9 months. Future research should explore methods for extending the intervention effect.


Asunto(s)
Consumo de Bebidas Alcohólicas/prevención & control , Consumo de Bebidas Alcohólicas/psicología , Conducción de Automóvil/psicología , Intervención Médica Temprana/métodos , Servicio de Urgencia en Hospital , Asunción de Riesgos , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Alcoholismo/epidemiología , Alcoholismo/prevención & control , Alcoholismo/psicología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Adulto Joven
20.
Food Chem ; 405(Pt A): 134846, 2023 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-36368107

RESUMEN

We have developed a method for complete dissolution of whole eggs in formic acid that provides a new approach to analyzing egg biomolecules. As expected from prior work with extracted lipids, phosphatidylcholine represents the most abundant 31P NMR signal. A simplified methanol/chloroform partitioning method for separating the dissolved egg solution into metabolites, lipids and protein was performed and after ultra-high mass resolution and tandem MS fragmentation analyses several phosphatidylcholine molecules containing different fatty acid chain lengths as well as number and position of double bonds was detected. The MS based proteomic analysis further revealed 6 Gallus sequences annotated as 'uncharacterized' because they show no sequence homology with any other protein found in nature and thus, may represent proteins uniquely evolved to perform functions specific to chickens. Overall, this procedure is a rapid and facile means of characterizing in a high throughput and comprehensive manner, the molecular components of whole eggs.


Asunto(s)
Pollos , Proteómica , Animales , Ácidos Grasos , Fosfatidilcolinas , Huevos/análisis , Cromatografía Líquida de Alta Presión/métodos
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