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1.
J Community Health ; 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38466490

RESUMO

Children from diverse ethnic groups are at significantly increased risk for dental caries. In particular, American Indian (AI) children have the highest incidence of detal caries of any ethnic group. The COVID-19 pandemic dramatically restricted health care access, including preventive oral health care. Given this context, it is unclear whether or not preventive oral health care for AI children has resumed since lockdown. To address this question, we surveyed adult AI caregivers (N = 152) of children aged 0-5 years, assessing recent (12-month) and pre-COVID (for caregivers of children aged 3-5 years) preventive oral and medical health services. We also examined medical health care access and utilization among caregivers. Among children aged 3-5 years old, both pre-pandemic and past year medical care utilization were generally high (80 and 90%, respectively) as was any oral health care utilization (64 & 78%, respectively). Oral health check-ups were more common over the last year (62%) compared to pre-COVID (44%). Recent health care utilization among children 1-5 years old in this sample were generally comparable to national estimates, except for higher reported preventive medical care (99% vs. 87.6%, respectively) and higher preventive oral care (96% vs. 59.6%, respectively). More caregivers reported delaying or foregoing needed health care due to COVID (28-38%) versus due to cost (8-17%). In this survey of AI caregivers, recent child preventive health care utilization was high, and changes in utilization following the lockdown phases of the pandemic were comparable for oral and medical health care.

2.
Adv Exp Med Biol ; 1319: 105-135, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34424514

RESUMO

Naked mole-rats (Heterocephalus glaber) are small African rodents that have many unique behavioral and physiological adaptations well-suited for testing hypotheses about mammalian neural plasticity. In this chapter, we focus on three features of naked mole-rat biology and how they impact neural plasticity in this species: (1) their fossorial lifestyle, (2) their extreme longevity with a lack of demonstrable senescence, and (3) their unusual social structure. Critically, each of these features requires some degree of biological flexibility. First, their fossorial habitat situates them in an environment with characteristics to which the central nervous system is particularly sensitive (e.g., oxygen content, photoperiod, spatial complexity). Second, their long lifespan requires adaptations to combat senescence and declines in neural functioning. Finally, their extreme reproductive skew and sustained ability for release from reproductive suppression indicates remarkable neural sensitivity to the sociosexual environment that is distinct from chronological age. These three features of naked mole-rat life are not mutually exclusive, but they do each offer unique considerations for the possibilities, constraints, and mechanisms associated with adult neural plasticity.


Assuntos
Longevidade , Ratos-Toupeira , Animais , Encéfalo , Plasticidade Neuronal , Comportamento Social
3.
J Med Internet Res ; 23(11): e25287, 2021 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-34817389

RESUMO

BACKGROUND: Communicating official public health information about infectious diseases is complicated by the fact that individuals receive much of their information from their social contacts, either via interpersonal interaction or social media, which can be prone to bias and misconception. OBJECTIVE: This study aims to evaluate the effect of public health campaigns and the effect of socially communicated health information on learning about diseases simultaneously. Although extant literature addresses the effect of one source of information (official or social) or the other, it has not addressed the simultaneous interaction of official information (OI) and social information (SI) in an experimental setting. METHODS: We used a series of experiments that exposed participants to both OI and structured SI about the symptoms and spread of hepatitis C over a series of 10 rounds of computer-based interactions. Participants were randomly assigned to receive a high, low, or control intensity of OI and to receive accurate or inaccurate SI about the disease. RESULTS: A total of 195 participants consented to participate in the study. Of these respondents, 186 had complete responses across all ten experimental rounds, which corresponds to a 4.6% (9/195) nonresponse rate. The OI high intensity treatment increases learning over the control condition for all symptom and contagion questions when individuals have lower levels of baseline knowledge (all P values ≤.04). The accurate SI condition increased learning across experimental rounds over the inaccurate condition (all P values ≤.01). We find limited evidence of an interaction between official and SI about infectious diseases. CONCLUSIONS: This project demonstrates that exposure to official public health information increases individuals' knowledge of the spread and symptoms of a disease. Socially shared information also facilitates the learning of accurate and inaccurate information, though to a lesser extent than exposure to OI. Although the effect of OI persists, preliminary results suggest that it can be degraded by persistent contradictory SI over time.


Assuntos
Doenças Transmissíveis , Mídias Sociais , Humanos , Aprendizagem , Saúde Pública
4.
Horm Behav ; 121: 104720, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32081743

RESUMO

In many social species, hierarchical status within the group is associated with differences in basal adrenocortical activity. We examined this relationship in naked mole-rats (Heterocephalus glaber), eusocial rodents with arguably the most extreme social hierarchies of all mammals. This species lives in colonies where breeding is restricted to one socially dominant 'queen' and her male consorts, and all other individuals are reproductively suppressed 'subordinates'. The relationship between cortisol and social status in naked mole-rats has not fully been elucidated, as prior results on this topic have been contradictory. We used non-invasive feces sampling to measure baseline cortisol levels in eight laboratory colonies of naked mole-rats, to either replicate or reject rank differences. First, we successfully validated an assay to measure fecal cortisol metabolites (FCMs). Removal from the colony for the validation experiment, either alone or with an opposite sex conspecific, induced prolonged elevation of FCM levels on a scale of days to weeks. This increase in cortisol did not prevent the removed animals from sexually maturing. In colony-housed animals, we found no relationship between rank in the social hierarchy and FCM levels. Further, queens, breeding males, and reproductively suppressed subordinates all had equivalent FCM levels. We conclude that this species shows little evidence of the 'stress of dominance' or 'stress of subordination' and that reproductive suppression in naked mole-rats is not driven by elevated cortisol levels.


Assuntos
Fezes/química , Hierarquia Social , Hidrocortisona/análise , Ratos-Toupeira/fisiologia , Isolamento Social/psicologia , Animais , Feminino , Hidrocortisona/metabolismo , Masculino , Reprodução/fisiologia , Comportamento Social , Meio Social , Estresse Psicológico/etiologia , Estresse Psicológico/metabolismo , Regulação para Cima
5.
Neuroimage ; 197: 24-36, 2019 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-30928689

RESUMO

A recurrent theme of both cognitive and network neuroscience is that the brain has a consistent subnetwork structure that maps onto functional specialization for different cognitive tasks, such as vision, motor skills, and attention. Understanding how regions in these subnetworks relate is thus crucial to understanding the emergence of cognitive processes. However, the organizing principles that guide how regions within subnetworks communicate, and whether there is a common set of principles across subnetworks, remains unclear. This is partly due to available tools not being suited to precisely quantify the role that different organizational principles play in the organization of a subnetwork. Here, we apply a joint modeling technique - the correlation generalized exponential random graph model (cGERGM) - to more completely quantify subnetwork structure. The cGERGM models a correlation network, such as those given in functional connectivity, as a function of activation motifs - consistent patterns of coactivation (i.e., connectivity) between collections of nodes that describe how the regions within a network are organized (e.g., clustering) - and anatomical properties - relationships between the regions that are dictated by anatomy (e.g., Euclidean distance). By jointly modeling all features simultaneously, the cGERGM models the unique variance accounted for by each feature, as well as a point estimate and standard error for each, allowing for significance tests against a random graph and between graphs. Across eight functional subnetworks, we find remarkably consistent organizational properties guiding subnetwork architecture, suggesting a fundamental organizational basis for subnetwork communication. Specifically, all subnetworks displayed greater clustering than would be expected by chance, but lower preferential attachment (i.e., hub use). These findings suggest that human functional subnetworks follow a segregated highway structure, in which tightly clustered subcommunities develop their own channels of communication rather than relying on hubs.


Assuntos
Encéfalo/anatomia & histologia , Encéfalo/fisiologia , Cognição/fisiologia , Conectoma/métodos , Adulto , Interpretação Estatística de Dados , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Modelos Neurológicos , Vias Neurais/anatomia & histologia , Vias Neurais/fisiologia , Adulto Jovem
6.
Proc Natl Acad Sci U S A ; 112(38): 11812-6, 2015 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-26338977

RESUMO

Network science has spurred a reexamination of relational phenomena in political science, including the study of international conflict. We introduce a new direction to the study of conflict by showing that the multiplex fractionalization of the international system along three key dimensions is a powerful predictor of the propensity for violent interstate conflict. Even after controlling for well-established conflict indicators, our new measure contributes more to model fit for interstate conflict than all of the previously established measures combined. Moreover, joint democracy plays little, if any, role in predicting system stability, thus challenging perhaps the major empirical finding of the international relations literature. Lastly, the temporal variability of our measure with conflict is consistent with a causal relationship. Our results have real-world policy implications as changes in our fractionalization measure substantially aid the prediction of conflict up to 10 years into the future, allowing it to serve as an early warning sign of international instability.

7.
Microb Cell Fact ; 16(1): 171, 2017 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-28978312

RESUMO

BACKGROUND: Pyruvate decarboxylase (PDC) is a well-known pathway for ethanol production, but has not been demonstrated for high titer ethanol production at temperatures above 50 °C. RESULT: Here we examined the thermostability of eight PDCs. The purified bacterial enzymes retained 20% of activity after incubation for 30 min at 55 °C. Expression of these PDC genes, except the one from Zymomonas mobilis, improved ethanol production by Clostridium thermocellum. Ethanol production was further improved by expression of the heterologous alcohol dehydrogenase gene adhA from Thermoanaerobacterium saccharolyticum. CONCLUSION: The best PDC enzyme was from Acetobactor pasteurianus. A strain of C. thermocellum expressing the pdc gene from A. pasteurianus and the adhA gene from T. saccharolyticum was able to produce 21.3 g/L ethanol from 60 g/L cellulose, which is 70% of the theoretical maximum yield.


Assuntos
Clostridium thermocellum/enzimologia , Clostridium thermocellum/metabolismo , Etanol/metabolismo , Piruvato Descarboxilase/metabolismo , Acetobacteraceae/enzimologia , Álcool Desidrogenase/genética , Álcool Desidrogenase/metabolismo , Celulose/metabolismo , Clostridium thermocellum/genética , Fermentação , Engenharia Metabólica , Piruvato Descarboxilase/genética , Piruvato Descarboxilase/isolamento & purificação , Temperatura , Thermoanaerobacterium/genética , Thermoanaerobacterium/metabolismo , Zymomonas/genética , Zymomonas/metabolismo
8.
Horm Behav ; 79: 1-7, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26718226

RESUMO

The neuropeptide oxytocin (OT) influences prosocial behavior(s), aggression, and stress responsiveness, and these diverse effects are regulated in a species- and context-specific manner. The naked mole-rat (Heterocephalus glaber) is a unique species with which to study context-dependent effects of OT, exhibiting a strict social hierarchy with behavioral specialization within the subordinate caste: soldiers are aggressive and defend colonies against unfamiliar conspecifics while workers are prosocial and contribute to in-colony behaviors such as pup care. To determine if OT is involved in subcaste-specific behaviors, we compared behavioral responses between workers and soldiers of both sexes during a modified resident/intruder paradigm, and quantified activation of OT neurons in the hypothalamic paraventricular nucleus (PVN) and supraoptic nucleus (SON) using the immediate-early-gene marker c-fos co-localized with OT neurons. Resident workers and soldiers were age-matched with unfamiliar worker stimulus animals as intruders, and encounters were videorecorded and scored for aggressive behaviors. Colony-matched controls were left in their home colony for the duration of the encounters. Brains were extracted and cell counts were conducted for OT immunoreactive (ir), c-fos-ir, and percentage of OT-c-fos double-labeled cells. Results indicate that resident workers were less aggressive but showed greater OT neural activity than soldiers. Furthermore, a linear model including social treatment, cortisol, and subcaste revealed that subcaste was the only significant predictor of OT-c-fos double-labeled cells in the PVN. These data suggest that in naked mole-rats OT promotes prosocial behaviors rather than aggression and that even within subordinates status exerts robust effects on brain and behavior.


Assuntos
Comportamento Animal/efeitos dos fármacos , Hierarquia Social , Neurônios/efeitos dos fármacos , Ocitocina/farmacologia , Comportamento Social , Agressão/efeitos dos fármacos , Animais , Comportamento Animal/fisiologia , Encéfalo/efeitos dos fármacos , Feminino , Masculino , Ratos-Toupeira , Neurônios/fisiologia , Núcleo Hipotalâmico Paraventricular/citologia , Núcleo Hipotalâmico Paraventricular/efeitos dos fármacos , Núcleo Supraóptico/citologia , Núcleo Supraóptico/efeitos dos fármacos
9.
Diabetes Obes Metab ; 18(5): 463-74, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26749407

RESUMO

AIM: To report the results of two phase III trials assessing the efficacy of ranolazine for glycaemic control in patients with type 2 diabetes on metformin or glimepiride background therapy. METHODS: In two double-blind trials we randomized 431 and 442 patients with type 2 diabetes to ranolazine 1000 mg twice daily versus placebo added to either glimepiride (glimepiride add-on study) or metformin background therapy (metformin add-on study). Patients receiving ranolazine added to metformin had their metformin dose halved (with the addition of a metformin-matched placebo) relative to the placebo group to correct for a metformin-ranolazine pharmacokinetic interaction. The primary endpoint of the trials was the change from baseline in glycated haemoglobin (HbA1c) at week 24. RESULTS: When added to glimepiride, ranolazine caused a 0.51% least squares mean [95% confidence interval (CI) 0.71, 0.32] decrease from baseline in HbA1c at 24 weeks relative to placebo and roughly doubled the proportion of patients achieving an HbA1c of <7% (27.1 vs 14.1%; p = 0.001). When added to metformin background therapy, there was no significant difference in the 24-week HbA1c change from baseline [placebo-corrected LS mean difference -0.11% (95% CI -0.31, 0.1)]. CONCLUSIONS: Compared with placebo, addition of ranolazine in patients with type 2 diabetes treated with glimepiride, but not metformin, significantly reduced HbA1c over 24 weeks. The decreased dose of metformin used in the metformin add-on study complicates the interpretation of this trial. Whether an effective regimen of ranolazine added to metformin for glycaemic control can be identified remains unclear.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hiperglicemia/prevenção & controle , Hipoglicemiantes/uso terapêutico , Metformina/uso terapêutico , Ranolazina/uso terapêutico , Bloqueadores dos Canais de Sódio/uso terapêutico , Compostos de Sulfonilureia/uso terapêutico , Idoso , Doenças Cardiovasculares/induzido quimicamente , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/sangue , Método Duplo-Cego , Interações Medicamentosas , Monitoramento de Medicamentos , Resistência a Medicamentos , Quimioterapia Combinada/efeitos adversos , Feminino , Hemoglobinas Glicadas/antagonistas & inibidores , Humanos , Hipoglicemia/induzido quimicamente , Hipoglicemia/prevenção & controle , Hipoglicemiantes/efeitos adversos , Hipoglicemiantes/sangue , Hipoglicemiantes/farmacocinética , Masculino , Metformina/efeitos adversos , Metformina/sangue , Metformina/farmacocinética , Pessoa de Meia-Idade , Ranolazina/efeitos adversos , Ranolazina/sangue , Ranolazina/farmacocinética , Bloqueadores dos Canais de Sódio/efeitos adversos , Bloqueadores dos Canais de Sódio/sangue , Bloqueadores dos Canais de Sódio/farmacocinética , Compostos de Sulfonilureia/efeitos adversos , Compostos de Sulfonilureia/sangue , Compostos de Sulfonilureia/farmacocinética
10.
Horm Behav ; 65(4): 380-5, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24530845

RESUMO

The neuropeptide oxytocin regulates a wide variety of social behaviors across diverse species. However, the types of behaviors that are influenced by this hormone are constrained by the species in question and the social organization that a particular species exhibits. Therefore, the present experiments investigated behaviors regulated by oxytocin in a eusocial mammalian species by using the naked mole-rat (Heterocephalus glaber). In Experiment 1, adult non-breeding mole-rats were given intraperitoneal injections of either oxytocin (1mg/kg or 10mg/kg) or saline on alternate days. Animals were then returned to their colony and behavior was recorded for minutes 15-30 post-injection. Both doses of oxytocin increased huddling behavior during this time period. In Experiment 2, animals received intraperitoneal injections of either oxytocin (1mg/kg), an oxytocin-receptor antagonist (0.1mg/kg), a cocktail of oxytocin and the antagonist, or saline across 4 testing days in a counterbalanced design. Animals were placed in either a 2-chamber arena with a familiar conspecific or in a small chamber with 1week old pups from their home colony and behaviors were recorded for minutes 15-30 post-injection. Oxytocin increased investigation of, and time spent in close proximity to, a familiar conspecific; these effects were blocked by the oxytocin antagonist. No effects were seen on pup-directed behavior. These data suggest that oxytocin is capable of modulating affiliative-like behavior in this eusocial species.


Assuntos
Comportamento Animal/efeitos dos fármacos , Canfanos/farmacologia , Ratos-Toupeira/fisiologia , Ocitocina/farmacologia , Piperazinas/farmacologia , Receptores de Ocitocina/antagonistas & inibidores , Comportamento Social , Animais , Canfanos/administração & dosagem , Dominação-Subordinação , Feminino , Masculino , Ocitocina/administração & dosagem , Piperazinas/administração & dosagem
11.
Diabetes Obes Metab ; 16(11): 1065-9, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24840317

RESUMO

AIMS: Prandial treatment with human regular insulin for diabetes may result in early postprandial hyperglycaemia and late hypoglycaemia due to its slow onset and long duration of action. This study compared injections of recombinant human insulin (rHI) formulated with recombinant human hyaluronidase [rHuPH20] (INSULIN-PH20) to insulin lispro for prandial treatment in subjects with type 1 diabetes (T1D). METHODS: After a 1-month run-in period using twice-daily insulin glargine (or usual basal insulin therapy for pump users) with prandial lispro, 46 subjects with T1D (42 ± 13 years; body mass index: 26 ± 4 kg/m(2); A1c: 6.8 ± 0.5%) were assigned to INSULIN-PH20 or lispro in a random sequence for two consecutive, 12-week periods as the prandial insulin in an intensive treatment regimen. RESULTS: The mean glycaemic excursion for INSULIN-PH20 (0.96 ± 2.00 mmol/l) was comparable (p = 0.322) to lispro (0.80 ± 1.95 mmol/l). The 8-point self-monitored blood glucose profiles were also comparable in the two groups. Good glycaemic control (A1c) was maintained for both treatments at 12 weeks (INSULIN-PH20: 7.0 ± 0.5%; lispro: 6.9 ± 0.6%). Overall rates of hypoglycaemia (≤ 3.9 mmol/l) were 24 events per patient per 4 weeks for INSULIN-PH20 and 22 events for lispro. There were no significant differences in adverse events or immunogenicity between treatments and both treatments were well tolerated. CONCLUSIONS: Unlike commercially available formulations of regular human insulin, a formulation of rHI with rHuPH20 was comparable to lispro for postprandial glucose excursions in a basal-bolus treatment regimen for T1D patients. Glycaemic control, safety and tolerability profiles were comparable for both treatments.


Assuntos
Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 1/tratamento farmacológico , Hialuronoglucosaminidase/farmacocinética , Hiperglicemia/prevenção & controle , Hipoglicemiantes/farmacocinética , Insulina Lispro/farmacocinética , Insulina Regular Humana/farmacocinética , Adulto , Estudos Cross-Over , Diabetes Mellitus Tipo 1/sangue , Esquema de Medicação , Feminino , Humanos , Hialuronoglucosaminidase/administração & dosagem , Hiperglicemia/sangue , Hipoglicemia/sangue , Hipoglicemia/prevenção & controle , Hipoglicemiantes/administração & dosagem , Injeções Subcutâneas , Insulina Lispro/administração & dosagem , Insulina Regular Humana/administração & dosagem , Masculino , Refeições , Período Pós-Prandial , Resultado do Tratamento
12.
Diabetes Obes Metab ; 16(3): 206-14, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23711193

RESUMO

Integrating patient-centered diabetes care and algorithmic medicine poses particular challenges when optimized basal insulin fails to maintain glycaemic control in patients with type 2 diabetes. Multiple entwined physiological, psychosocial and systems barriers to insulin adherence are not easily studied and are not adequately considered in most treatment algorithms. Moreover, the limited number of alternatives to add-on prandial insulin therapy has hindered shared decision-making, a central feature of patient-centered care. This article considers how the addition of a glucagon-like peptide 1 (GLP-1) analogue to basal insulin may provide new opportunities at this stage of treatment, especially for patients concerned about weight gain and risk of hypoglycaemia. A flexible framework for patient-clinician discussions is presented to encourage development of decision-support tools applicable to both specialty and primary care practice.


Assuntos
Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Peptídeo 1 Semelhante ao Glucagon/análogos & derivados , Hipoglicemia/economia , Hipoglicemiantes/uso terapêutico , Insulina de Ação Prolongada/uso terapêutico , Peptídeos/uso terapêutico , Peçonhas/uso terapêutico , Glicemia/metabolismo , Sistemas de Apoio a Decisões Clínicas , Diabetes Mellitus Tipo 2/sangue , Relação Dose-Resposta a Droga , Esquema de Medicação , Quimioterapia Combinada , Exenatida , Jejum , Feminino , Humanos , Hipoglicemia/sangue , Insulina Detemir , Masculino , Refeições , Preferência do Paciente , Assistência Centrada no Paciente , Aumento de Peso/efeitos dos fármacos
13.
Plants (Basel) ; 13(4)2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38498467

RESUMO

Conservation actions for rare species are often based on estimates of population size and number, which are challenging to capture in natural systems. Instead, many definitions of populations rely on arbitrarily defined distances between occurrences, which is not necessarily biologically meaningful despite having utility from a conservation management perspective. Here, we introduce a case study using the narrowly endemic and highly geographically disjunct leafy prairie-clover (Dalea foliosa), for which we use nuclear microsatellite loci to assess the current delimitations of populations and management units across its entire known range. We model future potential suitable niche space for the species to assess how currently defined populations could fare under predicted changes in climate over the next 50 years. Our results indicate that genetic variation within the species is extremely limited, particularly so in the distal portions of its range (Illinois and Alabama). Within the core of its range (Tennessee), genetic structure is not consistent with populations as currently defined. Our models indicate that predicted suitable niche space may only marginally overlap with the geology associated with this species (limestone glades and dolomite prairies) by 2070. Additional studies are needed to evaluate the extent to which populations are ecologically adapted to local environments and what role this could play in future translocation efforts.

14.
Curr Pharm Teach Learn ; 16(4): 244-254, 2024 04.
Artigo em Inglês | MEDLINE | ID: mdl-38423845

RESUMO

Problem description\The University of Nebraska College of Pharmacy is interested in conducting and learning from an inventory of Justice, Equity, Diversity, and Inclusion (JEDI) within the college. QUALITY IMPROVEMENT METHODS: An extensive literature review was undertaken to define the terms included in JEDI and to craft a listing of ideal inventory components. RESULTS OF CQI INQUIRY: The terms used in JEDI were defined and a list of 148 ideal inventory components was created. This list is further segmented by the JEDI components themselves and by five assessment factors including: representation, curriculum & education, policies & procedures, support & resources, and college climate. INTERPRETATION AND DISCUSSION: The attempt to create an ideal listing of JEDI inventory components resulted in an unusably large number of potential items. This occurred intentionally to allow the next steps in the longitudinal creation of a workable, quantifiable, and evaluative JEDI inventory process. Describing these preliminary efforts are important in the ultimate acceptance of the results of the JEDI inventory. CONCLUSION: Deliberate and extensive listing of initial aspirations for a JEDI inventory of a College of Pharmacy or any institution allows for sufficient input and breadth to help assure that no significant factor is overlooked as the process is refined.


Assuntos
Assistência Farmacêutica , Farmácia , Humanos , Currículo
15.
Open Forum Infect Dis ; 11(2): ofad679, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38370292

RESUMO

Background: Severe coccidioidomycosis presenting with respiratory failure is an uncommon manifestation of disease. Current knowledge of this condition is limited to case reports and small case series. Methods: A retrospective multicenter review of patients with coccidioidomycosis-associated acute respiratory distress syndrome (CA-ARDS) was conducted. It assessed clinical and laboratory variables at the time of presentation, reviewed the treatment course, and compared this cohort with a national database of patients with noncoccidioidomycosis ARDS. Survivors and nonsurvivors of coccidioidomycosis were also compared to determine prognostic factors. Results: In this study, CA-ARDS (n = 54) was most common in males, those of Hispanic ethnicity, and those with concurrent diabetes mellitus. As compared with the PETAL network database (Prevention and Early Treatment of Acute Lung Injury; n = 1006), patients with coccidioidomycosis were younger, had fewer comorbid conditions, and were less acidemic. The 90-day mortality was 15.4% for patients with coccidioidomycosis, as opposed to 42.6% (P < .0001) for patients with noncoccidioidomycosis ARDS. Patients with coccidioidomycosis who died, as compared with those who survived, were older, had higher APACHE II scores (Acute Physiology and Chronic Health Evaluation), and did not receive corticosteroid therapy. Conclusions: CA-ARDS is an uncommon but morbid manifestation of infection. When compared with a national database, the overall mortality appears favorable vs other causes of ARDS. Patients with CA-ARDS had a low overall mortality but required prolonged antifungal therapy. The utility of corticosteroids in this condition remains unconfirmed.

16.
Diabet Med ; 30(2): 161-9, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23231526

RESUMO

Since type 1 diabetes is an immunologically mediated disease, immune intervention should alter the natural history of the disease. This article reviews prevention studies undertaken either prior to any evidence of autoimmunity (primary prevention) or after the development of islet autoantibodies (secondary prevention). Most immune intervention studies have been conducted in recent-onset type 1 diabetes (tertiary prevention), and these are not reviewed herein. The goal of primary and secondary intervention is to arrest the immune process and thus prevent or delay clinical disease. Primary prevention studies have been conducted in infants with high genetic risk. Interventions tested include several dietary manipulations, including infant formulas free of either cow's milk or of bovine insulin, infant formula supplemented with the omega-3-fatty acid docosahexaenoic acid, delayed introduction of gluten-containing foods, and vitamin D supplementation. Secondary prevention studies have been conducted in both children and adults with diabetes autoantibodies. Interventions tested include nicotinamide, insulin injections, oral insulin, nasal insulin, glutamic acid decarboxylase, and cyclosporine. Underway are secondary prevention studies with teplizumab and with abatacept.


Assuntos
Diabetes Mellitus Tipo 1/prevenção & controle , Dieta/métodos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Prevenção Primária , Prevenção Secundária , Vitamina D/uso terapêutico , Abatacepte , Adolescente , Adulto , Anticorpos Monoclonais Humanizados/uso terapêutico , Autoanticorpos/sangue , Criança , Pré-Escolar , Ciclosporina/uso terapêutico , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 1/terapia , Ácidos Graxos Ômega-3/administração & dosagem , Feminino , Glutamato Descarboxilase/uso terapêutico , Glutens/administração & dosagem , Humanos , Imunoconjugados/uso terapêutico , Lactente , Fórmulas Infantis/farmacologia , Recém-Nascido , Masculino , Niacinamida/uso terapêutico
17.
Clin Exp Immunol ; 170(2): 131-8, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23039883

RESUMO

The mRNA levels of a set of immune-related genes were analysed with peripheral blood samples from at-risk, new-onset and long-term type 1 diabetes (T1D) patients, in comparison to those from healthy controls. The selected set includes T lymphocyte genes [CD3G and cytotoxic T lymphocyte-associated antigen 4 (CTLA4)], B lymphocyte genes (CD19 and CD20) and myeloid cell-related genes [CD11b, Toll-like receptor (TLR)-9, arginase (ARG1)]. Also included is a subset of the S100 family members that has been documented recently as regulatory elements of innate immunity. Samples from patients with long-term T1D had a reduced level of mRNA for most of selected innate and adaptive immune genes. No such reduction was detected in samples collected from at-risk or new-onset T1D patients. Analyses of regulatory gene expression ratios revealed a dynamic disproportion of CTLA4 versus CD3G expression in samples from at-risk, new-onset and long-term T1D patients. These changes could serve as immunological biomarkers for the status of the immune system during T1D progression and therapeutic interventions.


Assuntos
Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/imunologia , Imunidade Adaptativa/genética , Imunidade Adaptativa/imunologia , Adolescente , Adulto , Antígenos CD/sangue , Antígenos CD/genética , Antígenos CD/imunologia , Antígenos CD/metabolismo , Arginase/sangue , Arginase/genética , Arginase/imunologia , Arginase/metabolismo , Biomarcadores/sangue , Antígeno CTLA-4/sangue , Antígeno CTLA-4/genética , Antígeno CTLA-4/imunologia , Antígeno CTLA-4/metabolismo , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/metabolismo , Feminino , Perfilação da Expressão Gênica/métodos , Regulação da Expressão Gênica/genética , Regulação da Expressão Gênica/imunologia , Humanos , Imunidade Inata/genética , Imunidade Inata/imunologia , Masculino , Pessoa de Meia-Idade , RNA Mensageiro/genética , RNA Mensageiro/imunologia , Proteínas S100/sangue , Proteínas S100/genética , Proteínas S100/imunologia , Proteínas S100/metabolismo , Linfócitos T/imunologia , Linfócitos T/metabolismo , Receptor Toll-Like 9/sangue , Receptor Toll-Like 9/genética , Receptor Toll-Like 9/imunologia , Receptor Toll-Like 9/metabolismo , Adulto Jovem
18.
Twin Res Hum Genet ; 15(1): 52-9, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22784453

RESUMO

Attitudes towards foreign policy have typically been explained by ideological and demographic factors. We approach this study from a different perspective and ex amine the extent to which foreign policy preferences correspond to genetic variation. Using data from the Minnesota Twin Family Study, we show that a moderate share of individual differences in the degree to which one's foreign policy preferences are hawkish or dovish can be attributed to genetic variation. We also show, based on a bivariate twin model, that foreign policy preferences share a common genetic source of variation with political ideology. This result presents the possibility that ideology may be the causal pathway through which genes affect foreign policy preferences.


Assuntos
Genética Comportamental , Política , Gêmeos Dizigóticos , Gêmeos Monozigóticos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Meio Social , Inquéritos e Questionários , Gêmeos Dizigóticos/educação , Gêmeos Dizigóticos/genética , Gêmeos Monozigóticos/educação , Gêmeos Monozigóticos/genética , Guerra/ética
19.
Front Microbiol ; 13: 1005871, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36845972

RESUMO

Leveraging the capabilities of microorganisms to reduce (degrade or transform) concentrations of pollutants in soil and groundwater can be a cost-effective, natural remedial approach to manage contaminated sites. Traditional design and implementation of bioremediation strategies consist of lab-scale biodegradation studies or collection of field-scale geochemical data to infer associated biological processes. While both lab-scale biodegradation studies and field-scale geochemical data are useful for remedial decision-making, additional insights can be gained through the application of Molecular Biological Tools (MBTs) to directly measure contaminant-degrading microorganisms and associated bioremediation processes. Field-scale application of a standardized framework pairing MBTs with traditional contaminant and geochemical analyses was successfully performed at two contaminated sites. At a site with trichloroethene (TCE) impacted groundwater, framework application informed design of an enhanced bioremediation approach. Baseline abundances of 16S rRNA genes for a genus of obligate organohalide-respiring bacteria (i.e., Dehalococcoides) were measured at low abundances (101-102 cells/mL) within the TCE source and plume areas. In combination with geochemical analyses, these data suggested that intrinsic biodegradation (i.e., reductive dechlorination) may be occurring, but activities were limited by electron donor availability. The framework was utilized to support development of a full-scale enhanced bioremediation design (i.e., electron donor addition) and to monitor remedial performance. Additionally, the framework was applied at a second site with residual petroleum hydrocarbon (PHC) impacted soils and groundwater. MBTs, specifically qPCR and 16S gene amplicon rRNA sequencing, were used to characterize intrinsic bioremediation mechanisms. Functional genes associated with anaerobic biodegradation of diesel components (e.g., naphthyl-2-methyl-succinate synthase, naphthalene carboxylase, alkylsuccinate synthase, and benzoyl coenzyme A reductase) were measured to be 2-3 orders of magnitude greater than unimpacted, background samples. Intrinsic bioremediation mechanisms were determined to be sufficient to achieve groundwater remediation objectives. Nonetheless, the framework was further utilized to assess that an enhanced bioremediation could be a successful remedial alternative or complement to source area treatment. While bioremediation of chlorinated solvents, PHCs, and other contaminants has been demonstrated to successfully reduce environmental risk and reach site goals, the application of field-scale MBT data in combination with contaminant and geochemical data analyses to design, implement, and monitor a site-specific bioremediation approach can result in more consistent remedy effectiveness.

20.
Nat Commun ; 13(1): 4907, 2022 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-35987899

RESUMO

While inequalities in science are common, most efforts to understand them treat scientists as isolated individuals, ignoring the network effects of collaboration. Here, we develop models that untangle the network effects of productivity defined as paper counts, and prominence referring to high-impact publications, of individual scientists from their collaboration networks. We find that gendered differences in the productivity and prominence of mid-career researchers can be largely explained by differences in their coauthorship networks. Hence, collaboration networks act as a form of social capital, and we find evidence of their transferability from senior to junior collaborators, with benefits that decay as researchers age. Collaboration network effects can also explain a large proportion of the productivity and prominence advantages held by researchers at prestigious institutions. These results highlight a substantial role of social networks in driving inequalities in science, and suggest that collaboration networks represent an important form of unequally distributed social capital that shapes who makes what scientific discoveries.


Assuntos
Pesquisadores , Rede Social , Humanos
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