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1.
J Child Sex Abus ; : 1-21, 2024 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-39400250

RESUMO

We aimed to characterize and conceptually organize multilevel factors associated with the sexual victimization experiences of trans women and trans feminine people to advance violence prevention interventions for health-equity. Between October 2020 and July 2021, we conducted in-depth interviews with 17 expert informants in New York City, which we transcribed, coded, and analyzed. Qualitative insights were derived through an intensive, team-based iterative coding strategy resulting in the development of an exhaustive set of consensus codes which were organized and interpreted in a multi-level structure. Findings revealed a complex constellation of intersecting macro- and micro-structural mechanisms reinforcing sexual violence. Unique characteristics of this violence were characterized hierarchically in terms of: 1) violence forms (e.g. murder, fetishization), 2) perpetrators (e. g. safety-staff; group assault), 3) contexts (e.g. public accommodations), 4) functions (e.g. gender policing), 5) ideological reinforcers (e.g. transphobia, racism), and 6) structural reinforcers (e.g. legislation; linking access to material means of survival to poverty/illness). Results indicate that acute incidents of sexual victimization are "the tip of the iceberg" of the violence impacting trans communities. The community experts we interviewed (e.g. trans women, violence prevention practitioners, social workers) understand chronic functional, ideological, and structural oppression as inextricable from sexual violence. Multi-level determinants of violence therefore constitute essential targets of sexual violence prevention intervention for this population.

2.
Adm Policy Ment Health ; 48(5): 793-809, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33813717

RESUMO

PURPOSE: Peer providers represent a growing sector of the U.S. workforce, yet guidance is needed on best practices for adapting behavioral health interventions for peer delivery. METHODS: We utilized the Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME; Wiltsey Stirman et al. 2013, 2019) to describe how we systematically adapted Skills Training in Affective and Interpersonal Regulation (STAIR) for posttraumatic stress disorder (PTSD) for peer delivery. Our process was iterative and relied on engagement of multiple stakeholders, including a work group of organizational leaders (N = 5), peer interventionists (N = 4), intervention experts (N = 2), and trial participants (N = 18). The FRAME was used to guide rapid coding across multiple data sources, including researcher field notes, meeting minutes, and intervention manual documents, and content analysis of semi-structured interviews with peer interventionists and trial participants. RESULTS: Phase 1 (pre-trial) focused on modifications for fit with the local context and peer model. Key modifications focused on improving intervention design and packaging, removing clinical and stigmatizing language, and addressing peer interventionist training gaps. We used a hybrid approach to delivery, whereby we integrated peer model principles (self-disclosure, mutuality) into a directive approach. Phase 2 (trial) included reactive fidelity-consistent adaptations, such as additional educational resources. Phase 3 (post-trial) focused on adaptations to support roll-out of the intervention at the peer organization (e.g., group format). CONCLUSION: Our stakeholder-engaged process may serve as a helpful exemplar to others tailoring interventions for peer delivery. Future research is needed to understand the role of stakeholder engagement and adaptation in implementation success.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Medicina Baseada em Evidências , Humanos , Grupo Associado , Participação dos Interessados , Transtornos de Estresse Pós-Traumáticos/terapia
3.
Biomed Microdevices ; 18(1): 22, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26876965

RESUMO

The quantitative and qualitative analysis of circulating tumor cells (CTCs) has the potential to improve the clinical management of several cancers, including prostate cancer. As such, there is much interest in the isolation of CTCs from the peripheral blood of cancer patients. We report the design, fabrication, and proof-of-principle testing of an integrated permalloy-based microfluidic chip for immunomagnetic isolation of blood-borne prostate cancer cells using an antibody targeting prostate surface membrane antigen (PSMA). The preliminary results using spiked blood samples indicate that the proposed device is consistently capable of isolating prostate cancer cells with high sensitivity (up to 98 %) at clinically relevant low concentrations (down to 20 cells/mL) and an acceptable throughput (100 µL/min).


Assuntos
Separação Imunomagnética , Dispositivos Lab-On-A-Chip , Células Neoplásicas Circulantes , Neoplasias da Próstata/sangue , Animais , Linhagem Celular Tumoral , Feminino , Humanos , Separação Imunomagnética/instrumentação , Separação Imunomagnética/métodos , Masculino , Ratos
4.
J Behav Health Serv Res ; 51(4): 561-587, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38982024

RESUMO

To support implementation of integrated behavioral health care (IBHC) models in local settings, providers may benefit from clinical decision-making support. The present analysis examines perspectives on patient characteristics appropriate or inappropriate for, and currently managed within, IBHC at a large medical center to inform recommendations for provider decision-making. Twenty-four participants (n = 13 primary care providers; n = 6 behavioral health providers; n = 5 administrators) in an IBHC setting were interviewed. Thematic analysis was conducted with acceptable interrater reliability (κ = 0.75). Responses indicated behavioral health symptom and patient characteristics that impact perceptions of appropriateness for management in IBHC, with high variability between providers. Many patients with characteristics identified as inappropriate for IBHC were nonetheless currently managed in IBHC. Interactions between patient ability to engage in care and provider ability to manage patient needs guided decisions to refer a patient to IBHC or specialty care. A heuristic representing this dimensional approach to clinical decision-making is presented to suggest provider decision-making guidance informed by both patient and provider ability.


Assuntos
Tomada de Decisão Clínica , Prestação Integrada de Cuidados de Saúde , Atenção Primária à Saúde , Pesquisa Qualitativa , Humanos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Serviços de Saúde Mental , Pessoal de Saúde/psicologia
5.
Arch Physiother ; 14: 11-19, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38707914

RESUMO

Introduction: The Fear of Falling Avoidance Behavior Questionnaire (FFABQ) has good psychometric properties. However, we have recently modified the FFABQ (mFFABQ) to improve the clarity of the questions and Likert responses. This study aimed to examine the reliability and validity of this modified version in older adults and people with Parkinson's disease (PD). Methods: A total of 88 participants, 39 with PD (age = 72.2 ± 9.5; 29 males, 10 females) and 49 older adults (age = 72.8 ± 5.0; 13 males, 36 females), answered the mFFABQ twice, separated by 1 week, for test-retest reliability. Construct validity was evaluated through correlational analyses with fall history, Activities-Specific Balance Confidence Scale (ABC), Berg Balance Scale (BBS), Timed Up and Go, 30-Second Sit to Stand, Sensory Organization Test, Zung Anxiety Scale, Beck Depression Inventory, Consequences of Falling Questionnaire (CoFQ), and average daily activity levels using an activity monitor. Results: The mFFABQ had good overall test-retest reliability (intraclass correlational coefficient [ICC] = 0.822; older adult ICC = 0.781, PD ICC = 0.806). The mFFABQ correlated with fall history (r = -0.430) and exhibited high correlation with the ABC (rho = -0.804) and moderate correlations with CoFQ (rho = 0.582) and BBS (rho = -0.595). The mFFABQ also correlated with time stepping (rho = -0.298) and number of steps (rho = -0.358). Conclusion: These results provide supportive evidence for the reliability and validity of the mFFABQ in older adults and people with PD, which supports its suitability as a clinical and research tool for the assessment of fear of falling avoidance behavior.

6.
Psychol Trauma ; 15(4): 648-655, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-35254848

RESUMO

OBJECTIVE: Sexual minority individuals are exposed to traumatic harms unique to the shared cultural experience of living under conditions of identity-based stigma, discrimination, and marginalization. However, the context and characteristics by which this culture shapes traumatic experiences among sexual minority people are poorly specified in the research literature, leaving even well-intentioned mental health professionals inadequately prepared to treat sexual minority trauma survivors in a culturally affirming, tailored, and evidence-based manner. METHOD: To begin to address this gap, we conducted a thematic analysis of descriptions of 52 Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Criterion A (traumatic) events described by sexual minority participants during administration of the Clinician-Administered PTSD Scale for DSM-5. RESULTS: Probing for identity relatedness of Criterion A trauma produced a rich and reliable (κ = .83-.86) coding scheme reflecting the cultural context and characteristics of these experiences. CONCLUSIONS: Clinicians working with sexual minority and other marginalized trauma survivors should specifically assess for the role of culture in traumatic experiences to inform case conceptualization and treatment plans supporting recovery of the whole survivor. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Minorias Sexuais e de Gênero , Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/psicologia , Grupos Minoritários/psicologia , Estigma Social , Sobreviventes/psicologia
7.
Psychol Assess ; 35(5): 383-395, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36656725

RESUMO

Posttraumatic stress disorder (PTSD) assessment among transgender and gender diverse (TGD) adults is complex because the literature offers little guidance on affirming assessment that accurately captures both trauma- and discrimination-related distress. This study aimed to characterize threats to precise PTSD assessment that arose during the Clinician-Administered PTSD Scale for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (CAPS-5). Our sample (N = 44) included trans women (38%), trans men (25%), nonbinary people (23%), and other TGD identities (14%). Participants were mostly White (75%), non-Latinx (82%), educated (91% at least some college), with a mean age of 37 years (SD = 15.5). Demographic and CAPS-5 scoring data as well as content analysis of audio-recorded CAPS-5 interviews are reported. All participants reported trauma exposure, and nearly half met PTSD diagnostic criteria (49%). Interpersonal assault was a common trauma type linked to posttraumatic symptoms (77%); 41% were sexual assaults; and 41% were discrimination-based (e.g., linked to gender identity) physical or sexual assaults. Qualitative findings suggest how and when discrimination-related experiences may threaten PTSD assessment accuracy, leading to overpathologizing or underdetection of symptoms, for example, (a) initial selection of a noncriterion A discrimination event as "worst event," (b) linking symptoms to internalized transphobia (rather than trauma), and (c) linking victimization to gender identity/expression. Threats to PTSD assessment were more common when symptoms were linked to discrimination-based traumatic events, suggesting the importance of understanding contextual factors of index events. We offer a framework for understanding unique challenges to the assessment of PTSD among TGD people and provide recommendations for improving assessment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Vítimas de Crime , Delitos Sexuais , Transtornos de Estresse Pós-Traumáticos , Pessoas Transgênero , Humanos , Adulto , Masculino , Feminino , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Identidade de Gênero
8.
Am Psychol ; 78(2): 186-198, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37011169

RESUMO

Effective violence prevention interventions are largely inaccessible to trans women and trans femmes, despite clear evidence that disproportionate exposure to experiences of victimization is a social determinant of health disparity. Community-engaged implementation science paradigms hold promise for guiding research psychologists in the delivery of evidence-based programming to address drivers of health disparities impacting trans women and trans femmes. Unfortunately, guidance on how to engage in a process of real-time self-reflection to note where implementation is failing in its goals to establish reciprocal and sustainable (i.e., nonexploitative) community partnerships are lacking. We describe our application of a modified failure modes and effects analysis to guide data-informed adaptations to our community-engaged implementation research project, tailoring and delivering an evidence-based intervention to prevent victimization of trans women and trans femmes. By mapping our failure modes, we offer a blueprint for other research psychologists invested in advancing nonexploitative research in partnership with community. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Vítimas de Crime , Ciência da Implementação , Humanos , Feminino , Violência , Pesquisa Participativa Baseada na Comunidade , Projetos de Pesquisa
9.
Behav Res Ther ; 165: 104310, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37040669

RESUMO

OBJECTIVE: This study is a non-randomized pragmatic trial to assess the feasibility and acceptability of the Primary Care Intervention for Posttraumatic stress disorder (PCIP) (Srivastava et al., 2021), an Integrated Behavioral Health Care treatment for PTSD in adolescents. METHOD: Following routine clinic procedures, youth who were suspected of having trauma-related mental health symptoms were referred by their primary care providers to integrated care social workers for evaluation. The integrated care social workers referred the first 23 youth whom they suspected of having PTSD to the research study. Twenty youth consented to the study and 19 completed the pre-assessment (17 female; mean age = 19.32, SD = 2.11; range 14-22 years). More than 40% identified as Black and a third as Hispanic/Latinx. PCIP mechanisms and clinical outcomes were assessed pre- and post-treatment, and at one-month follow-up. Participants and therapists completed post-treatment qualitative interviews to assess feasibility and acceptability, and treatment sessions were audio recorded to assess fidelity. RESULTS: Findings suggest high acceptability, satisfaction, and feasibility of the PCIP delivered in "real-life" safety net pediatric primary care. Integrated care social workers had high treatment fidelity. Despite the small sample size, there was significant improvement in symptom scores of anxiety (g = 0.68, p = 0.02) and substance use (g = 0.36, p = 0.04) from pre to post, and depression symptoms (g = 0.38, p = 0.04) from pre to follow-up. Qualitative data from patients who completed exit interviews and integrated social workers indicated high satisfaction with the treatment, with some participants reporting that the integrated intervention was more acceptable and less stigmatizing than seeking mental health care outside of primary care. CONCLUSIONS: The PCIP may improve treatment engagement and access for vulnerable youth. Promising findings of high acceptability, feasibility, and initial clinical effectiveness suggest that PCIP warrants larger-scale study as part of routine care in pediatric integrated care.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Humanos , Feminino , Adolescente , Criança , Adulto Jovem , Adulto , Transtornos de Estresse Pós-Traumáticos/terapia , Estudos de Viabilidade , Serviços de Saúde , Transtornos de Ansiedade , Atenção Primária à Saúde
10.
Implement Res Pract ; 2: 26334895211017280, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-37090008

RESUMO

Background: Despite promising findings regarding the safety, fidelity, and effectiveness of peer-delivered behavioral health programs, there are training-related challenges to the integration of peers on health care teams. Specifically, there is a need to understand the elements of training and consultation that may be unique to peer-delivered interventions. Methods: As part of a pilot effectiveness-implementation study of an abbreviated version of Skills Training in Affective and Interpersonal Regulation (STAIR) for posttraumatic stress disorder (PTSD), we conducted a mixed-methods process evaluation utilizing multiple data sources (questionnaires and field notes) to characterize our approach to consultation and explore relations between fidelity, treatment outcome, and client satisfaction. Results: Peer interventionists exhibited high fidelity, defined by adherence (M = 93.7%, SD = 12.3%) and competence (M = 3.7 "competent," SD = 0.5). Adherence, ß = .69, t(1) = 3.69, p < .01, and competence, ß = .585, t(1) = 2.88, p < .05, were each associated with trial participant's satisfaction, but not associated with clinical outcomes. Our synthesis of fidelity-monitoring data and consultation field notes suggests that peer interventionists possess strengths in interpersonal effectiveness, such as rapport building, empathy, and appropriate self-disclosure. Peer interventionists evidenced minor challenges with key features of directive approaches, such as pacing, time efficiency, and providing strong theoretical rationale for homework and tracking. Conclusion: Due to promise of peers in expanding the behavioral health workforce and engaging individuals otherwise missed by the medical model, the current study aimed to characterize unique aspects of training and consultation. We found peer interventionists demonstrated high fidelity, supported through dynamic training and consultation with feedback. Research is needed to examine the impact of consultation approach on implementation and treatment outcomes. Plain Language Summary: Peers-paraprofessionals who use their lived experiences to engage and support the populations they serve-have been increasingly integrated into health care settings in the United States. Training peers to deliver interventions may provide cost savings by way of improving efficient utilization of professional services. Despite promising findings in regard to safety, intervention fidelity, and effectiveness of peer delivery, there are important challenges that need to be addressed if peers are to be more broadly integrated into the health care system as interventionists. These include challenges associated with highly variable training, inadequate supervision, and poor delineation of peer's roles within the broader spectrum of care. Thus, there is a need to understand the unique components of training and consultation for peers. We report key findings from an evaluation of a pilot study of an abbreviated version of Skills Training in Affective and Interpersonal Regulation (STAIR) for posttraumatic stress disorder (PTSD), adapted for peer delivery. We characterize our approach to consultation with feedback and explore relations between fidelity, treatment outcome, and client satisfaction. Our study extends the small yet growing literature on training and consultation approaches to support fidelity (adherence and competence) among peer interventionists. Organizations hoping to integrate peers on health care teams could utilize our fidelity-monitoring approach to set benchmarks to ensure peer-delivered interventions are safe and effective.

11.
Ergonomics ; 53(4): 559-85, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20309751

RESUMO

A community of highly qualified employees is desirable for the workforce to become a competitive business advantage, improving and sustaining corporate health. Currently, the scientific literature is limited on information comparing the assessment of expert and qualified workers for the employee-work environment interface. Such information would be valuable for industrial managers to obtain and act on the different perspectives of its workers for business improvement and survivability. A primary objective of this study is to explore the perspectives of expert and qualified workers on the quality of the employee-work environment interface in a manufacturing enterprise. This investigation was performed in a production department in a small manufacturing enterprise. Two expert workers participated in the study, with each being in the company for 30 years and having performed all jobs in the production department as well as supervisory and line management responsibilities. A total of 13 qualified workers from day and night shifts were used in the study, with the great majority of workers possessing 10 or more years of on-the-job experience but not acquiring the same specialised knowledge required for operating the technological resources in the department. The work compatibility methodology was used to assess the quality of employee-work environment interface for both expert and qualified workers. Both expert and qualified workers provided similar trends in terms of their compatibility assessment of experienced and acting work domains. In general, the compatibility levels for the day shift were poorer than those obtained for the night shift for acting work domains. The similarities in assessment between the expert and qualified workers were much closer for factors impacting job performance at the task and immediate surrounding levels (i.e. physical and mental task content, physical environment). There were greater differences at the macro level, that is, at the process and enterprise levels, in terms of organisational/social/technological environment. This is particularly noted for the organisational environment. The compatibility values obtained for the experienced domains mirror those obtained for acting domains. The overall workload was assessed as requiring major redesign during the day shift and needing added responsibilities for the night shift according to both expert and qualified workers. The assessment of qualified workers is comparable with that of expert workers for the job content and immediate surroundings. Differences are more observed for process- and enterprise-based factors; thereby, providing company management different perspectives in order to devise organisational strategies conducive for optimum human and corporate health and pointing to the probable interactions of the different systems impacting individual and enterprise performance. STATEMENT OF RELEVANCE: This research examines similarities and differences between qualified and expert workers in their assessment of the worker-work environment interface. The contribution to improved understanding of the complex interactions of human-at-work and enterprise systems should be beneficial to organisations in their quest to remain competitive in a global economy.


Assuntos
Emprego/organização & administração , Indústrias , Local de Trabalho/organização & administração , Adulto , Emprego/psicologia , Emprego/normas , Feminino , Humanos , Indústrias/normas , Masculino , Pessoa de Meia-Idade , Desenvolvimento de Pessoal , Recursos Humanos , Local de Trabalho/normas , Adulto Jovem
12.
Diabetologia ; 52(10): 2079-86, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19641896

RESUMO

AIMS/HYPOTHESIS: Central obesity, insulin resistance and beta cell dysfunction are independent risk factors for incident type 2 diabetes, although few studies have used detailed measures of these disorders. Our objective was to study the association of directly measured visceral and subcutaneous adipose tissue (VAT, SAT), insulin sensitivity (S (I)) and the acute insulin response (AIR) with incident type 2 diabetes. METHODS: Participants were 1,230 Hispanic-Americans and African-Americans in the Insulin Resistance Atherosclerosis Study (IRAS) Family Study who were free of type 2 diabetes at baseline (2000-2002). S (I) and AIR were determined from frequently sampled IVGTTs with minimal model analysis. VAT and SAT were determined by computed tomography. Impaired fasting glucose and type 2 diabetes were defined according to American Diabetes Association criteria. RESULTS: Incident type 2 diabetes was diagnosed in 90 participants after 5 years. After adjustment for age, sex, ethnicity, centre, impaired fasting glucose, triacylglycerol, HDL-cholesterol and systolic BP, both S(I) and AIR were inversely associated with type 2 diabetes (S (I), OR 0.53, 95% CI 0.39-0.73; AIR, OR 0.22, 95% CI 0.14-0.34 per SD; both p < 0.001), while both VAT and SAT were positively associated with type 2 diabetes (VAT, OR 1.68, 95% CI 1.22-2.33; SAT, OR 1.49, 95% CI 1.13-1.99; both p < 0.01). In a model including all four factors, S (I) and AIR (S (I), OR 0.55, 95% CI 0.37-0.80; AIR, OR 0.21, 95% CI 0.13-0.33; both p < 0.01) were significant predictors of type 2 diabetes, although associations with VAT and SAT were no longer significant. A significant sex x VAT interaction indicated a stronger association of VAT with type 2 diabetes in women than in men. CONCLUSIONS/INTERPRETATION: Insulin resistance, beta cell dysfunction and VAT predicted incident type 2 diabetes, with evidence of a stronger association of VAT with type 2 diabetes among women.


Assuntos
Adiposidade/fisiologia , Diabetes Mellitus Tipo 2/epidemiologia , Resistência à Insulina/fisiologia , Células Secretoras de Insulina/patologia , Gordura Intra-Abdominal/patologia , Adulto , Negro ou Afro-Americano , Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/etiologia , Feminino , Hispânico ou Latino , Humanos , Insulina/metabolismo , Insulina/fisiologia , Células Secretoras de Insulina/metabolismo , Masculino , Pessoa de Meia-Idade , Fatores Sexuais
13.
Diabetologia ; 52(7): 1326-33, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19430760

RESUMO

AIMS/HYPOTHESIS: This study sought to identify genes and regions in the human genome that are associated with the acute insulin response to glucose (AIRg), an important predictor of type 2 diabetes, in Hispanic-American participants from the Insulin Resistance Atherosclerosis Family Study (IRAS FS). METHODS: A two-stage genome-wide association scan (GWAS) was performed in IRAS FS Hispanic-American samples. In the first stage, 317K single nucleotide polymorphisms (SNPs) were assessed in 229 Hispanic-American DNA samples from 34 families from San Antonio, TX, USA. SNPs with the most significant associations with AIRg were genotyped in the entire set of IRAS FS Hispanic-American samples (n = 1,190). In chromosomal regions with evidence of association, additional SNPs were genotyped to capture variation in genes. RESULTS: No individual SNP achieved genome-wide levels of significance (p < 5 x 10(-7)); however, two regions (chromosomes 6p21 and 20p11) had multiple highly ranked SNPs that were associated with AIRg. Additional genotyping in these regions supported the initial evidence of variants contributing to variation in AIRg. One region resides in a gene desert between PXT1 and KCTD20 on 6p21, while the region on 20p11 has several viable candidate genes (ENTPD6, PYGB, GINS1 and RP4-691N24.1). CONCLUSIONS/INTERPRETATION: A GWAS in Hispanic-American samples identified several candidate genes and loci that may be associated with AIRg. These associations explain a small component of variation in AIRg. The genes identified are involved in phosphorylation and ion transport, and provide preliminary evidence that these processes are important in beta cell response.


Assuntos
Aterosclerose , Estudo de Associação Genômica Ampla , Hispânico ou Latino/genética , Resistência à Insulina/etnologia , Resistência à Insulina/genética , Adulto , Aterosclerose/etnologia , Aterosclerose/genética , Aterosclerose/metabolismo , Glicemia/metabolismo , Feminino , Predisposição Genética para Doença/etnologia , Genótipo , Humanos , Insulina/sangue , Células Secretoras de Insulina/fisiologia , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Texas/epidemiologia
14.
Science ; 160(3831): 985-7, 1968 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-17768889

RESUMO

The Venus radius of 6085 +/- 10 kilometers, deduced from combining observations made with the Venera 4 and Mariner V space probes is incompatible with the value of 6050 +/- kilometers determined from Earth-based radar mesurements.

15.
Science ; 290(5498): 1959-62, 2000 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-11110661

RESUMO

Genetic engineering of non-beta cells to release insulin upon feeding could be a therapeutic modality for patients with diabetes. A tumor-derived K-cell line was induced to produce human insulin by providing the cells with the human insulin gene linked to the 5'-regulatory region of the gene encoding glucose-dependent insulinotropic polypeptide (GIP). Mice expressing this transgene produced human insulin specifically in gut K cells. This insulin protected the mice from developing diabetes and maintained glucose tolerance after destruction of the native insulin-producing beta cells.


Assuntos
Diabetes Mellitus Experimental/terapia , Células Enteroendócrinas/citologia , Células Enteroendócrinas/metabolismo , Terapia Genética , Glucose/metabolismo , Insulina/metabolismo , Animais , Glicemia/metabolismo , Linhagem Celular , Clonagem Molecular , Diabetes Mellitus Experimental/metabolismo , Polipeptídeo Inibidor Gástrico/biossíntese , Polipeptídeo Inibidor Gástrico/genética , Expressão Gênica , Engenharia Genética , Glucose/administração & dosagem , Teste de Tolerância a Glucose , Humanos , Insulina/biossíntese , Insulina/genética , Camundongos , Camundongos Transgênicos , Proinsulina/genética , Regiões Promotoras Genéticas , Precursores de Proteínas/genética , Células-Tronco/citologia , Células-Tronco/metabolismo , Estreptozocina , Transfecção , Transgenes , Células Tumorais Cultivadas
16.
Biomicrofluidics ; 13(1): 014110, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30867880

RESUMO

Efforts to further improve the clinical management of prostate cancer (PCa) are hindered by delays in diagnosis of tumours and treatment deficiencies, as well as inaccurate prognoses that lead to unnecessary or inefficient treatments. The quantitative and qualitative analysis of circulating tumour cells (CTCs) may address these issues and could facilitate the selection of effective treatment courses and the discovery of new therapeutic targets. Therefore, there is much interest in isolation of elusive CTCs from blood. We introduce a microfluidic platform composed of a multiorifice flow fractionation (MOFF) filter cascaded to an integrated microfluidic magnetic (IMM) chip. The MOFF filter is primarily employed to enrich immunomagnetically labeled blood samples by size-based hydrodynamic removal of free magnetic beads that must originally be added to samples at disproportionately high concentrations to ensure the efficient immunomagnetic labeling of target cancer cells. The IMM chip is then utilized to capture prostate-specific membrane antigen-immunomagnetically labeled cancer cells from enriched samples. Our preclinical studies showed that the proposed method can selectively capture up to 75% of blood-borne PCa cells at clinically-relevant low concentrations (as low as 5 cells/ml), with the IMM chip showing up to 100% magnetic capture capability.

17.
Animal ; 11(3): 493-499, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27481403

RESUMO

A stochastic risk model was developed to estimate the time elapsed before overcrowding (TOC) or feed interruption (TFI) emerged on the swine premises under movement restrictions during a classical swine fever (CSF) outbreak in Indiana, USA. Nursery (19 to 65 days of age) and grow-to-finish (40 to 165 days of age) pork production operations were modelled separately. Overcrowding was defined as the total weight of pigs on premises exceeding 100% to 115% of the maximum capacity of the premises, which was computed as the total weight of the pigs at harvest/transition age. Algorithms were developed to estimate age-specific weight of the pigs on premises and to compare the daily total weight of the pigs with the threshold weight defining overcrowding to flag the time when the total weight exceeded the threshold (i.e. when overcrowding occurred). To estimate TFI, an algorithm was constructed to model a swine producer's decision to discontinue feed supply by incorporating the assumptions that a longer estimated epidemic duration, a longer time interval between the age of pigs at the onset of the outbreak and the harvest/transition age, or a longer progression of an ongoing outbreak would increase the probability of a producer's decision to discontinue the feed supply. Adverse animal welfare conditions were modelled to emerge shortly after an interruption of feed supply. Simulations were run with 100 000 iterations each for a 365-day period. Overcrowding occurred in all simulated iterations, and feed interruption occurred in 30% of the iterations. The median (5th and 95th percentiles) TOC was 24 days (10, 43) in nursery operations and 78 days (26, 134) in grow-to-finish operations. Most feed interruptions, if they emerged, occurred within 15 days of an outbreak. The median (5th and 95th percentiles) time at which either overcrowding or feed interruption emerged was 19 days (4, 42) in nursery and 57 days (4, 130) in grow-to-finish operations. The study findings suggest that overcrowding and feed interruption could emerge early during a CSF outbreak among swine premises under movement restrictions. The outputs derived from the risk model could be used to estimate and evaluate associated mitigation strategies for alleviating adverse animal welfare conditions resulting from movement restrictions.


Assuntos
Bem-Estar do Animal , Vírus da Febre Suína Clássica/fisiologia , Peste Suína Clássica/prevenção & controle , Surtos de Doenças/veterinária , Modelos Teóricos , Doenças dos Suínos/prevenção & controle , Criação de Animais Domésticos , Animais , Peso Corporal , Peste Suína Clássica/epidemiologia , Peste Suína Clássica/virologia , Simulação por Computador , Surtos de Doenças/prevenção & controle , Comportamento Alimentar , Abrigo para Animais , Densidade Demográfica , Suínos , Doenças dos Suínos/virologia , Fatores de Tempo
18.
Med Biol Eng Comput ; 55(10): 1735-1741, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28083733

RESUMO

Biologists frequently collect and analyze biospecimens in naturalistic (i.e., field) conditions to ascertain information regarding the physiological status of their study participants. Generally, field-collected biospecimens need to be stored frozen in the field and then transported frozen to laboratory facilities where traditional biomarker assays, such as enzyme-linked immunosorbent assays (ELISAs), are conducted. As proper storage and transport of frozen specimens is often logistically difficult and expensive, particularly in nonurban field settings, methods that reduce the need for specimen storage and transport would benefit field-research dependent disciplines such as biology, ecology and epidemiology. One limiting factor to running assays in the field is the use of large and expensive equipment to visualize and quantify the assays, such as microplate readers. Here, we describe an implementation of colorimetric ELISA visualization and quantification using two novel and portable imaging instrumentation systems and data processing techniques for the determination of women's reproductive steroid hormone profiles. Using the light absorbance and transmittance properties of the chemical compounds that make up the hormone assay, we were able to estimate unknown hormone concentrations using a smartphone system and a webcam system. These estimates were comparable to those from a standard laboratory multiple reader (smartphone: accuracy = 82.20%, R 2 > 0.910; webcam: accuracy = 87.59%, R 2 > 0.942). This line of applied research, in the long run, is expected to provide necessary information for examining the extent to which reproductive function varies within and between populations and how it is influenced by psychosocial, energetic and environmental challenges. Our validation of these novel, portable visualization and quantification systems allows for the eventual development of a compact and economical closed system which can be used to quantify biomarker concentrations in remote areas.


Assuntos
Colorimetria/instrumentação , Colorimetria/métodos , Ensaio de Imunoadsorção Enzimática/instrumentação , Ensaio de Imunoadsorção Enzimática/métodos , Hormônios Esteroides Gonadais/metabolismo , Smartphone/instrumentação , Humanos , Mulheres
19.
J Occup Environ Med ; 48(11): 1189-202, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17099456

RESUMO

OBJECTIVE: The objective of this study was to review 32 studies on firefighters and to quantitatively and qualitatively determine the cancer risk using a meta-analysis. METHODS: A comprehensive search of computerized databases and bibliographies from identified articles was performed. Three criteria used to assess the probable, possible, or unlikely risk for 21 cancers included pattern of meta-relative risks, study type, and heterogeneity testing. RESULTS: The findings indicated that firefighters had a probable cancer risk for multiple myeloma with a summary risk estimate (SRE) of 1.53 and 95% confidence interval (CI) of 1.21-1.94, non-Hodgkin lymphoma (SRE = 1.51, 95% CI = 1.31-1.73), and prostate (SRE = 1.28; 95% CI = 1.15-1.43). Testicular cancer was upgraded to probable because it had the highest summary risk estimate (SRE = 2.02; 95% CI = 1.30-3.13). Eight additional cancers were listed as having a "possible" association with firefighting. CONCLUSIONS: Our results confirm previous findings of an elevated metarelative risk for multiple myeloma among firefighters. In addition, a probable association with non-Hodgkin lymphoma, prostate, and testicular cancer was demonstrated.


Assuntos
Incêndios , Modelos Estatísticos , Neoplasias/epidemiologia , Doenças Profissionais/epidemiologia , Estudos de Casos e Controles , Estudos de Coortes , Razão de Chances , Risco
20.
Diabetes ; 42(10): 1528-35, 1993 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-8375594

RESUMO

These studies were undertaken to determine the distribution of insulin between the intravascular and interstitial compartments in 19 nondiabetic and 16 high-dose (60 mg/kg) STZ-induced diabetic rats. Anesthetized male rats underwent cannulation of the thoracic lymph duct with continuous collection of lymph by passive drainage; 90-min hyperinsulinemic (0, 14, 28, or 42 pmol.kg-1 x min-1) glucose clamps were performed with serum glucose held at the preinfusion level. Integrated lymph samples were collected, with serum collection at the midpoint. Before insulin infusion, insulin levels in lymph as a percentage of levels in serum were higher in the diabetic rats (lymph = 103 +/- 8% of 52 matched serum values, mean +/- SE) compared with nondiabetic rats (lymph = 83 +/- 3% of serum; n = 84, P < 0.008). Under steady-state conditions during insulin infusion (66-90 min), lymph insulin as a percentage of serum insulin decreased significantly in nondiabetic animals (range 53-62% in all insulin-infused groups, vs. 94% in the absence of insulin infusion, P < 0.0001). However, in the diabetic animals, the proportion was similar in the presence or absence of infused insulin (range 57-63% in insulin-infused groups vs. 70% in the absence of infused insulin, P = NS). Lymph flow rate was significantly higher in diabetic than nondiabetic rats (37.7 +/- 7.2 vs. 17.9 +/- 1.5 microliters/min [mean +/- SE], P < 0.02). Distribution of [14C]inulin was uniform between the two compartments in all animals.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Diabetes Mellitus Experimental/metabolismo , Espaço Extracelular/química , Insulina/análise , Insulina/sangue , Análise de Variância , Animais , Radioisótopos de Carbono , Diabetes Mellitus Experimental/sangue , Glucose/metabolismo , Insulina/metabolismo , Linfa/química , Linfa/metabolismo , Masculino , Ratos , Ratos Sprague-Dawley , Estreptozocina
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