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1.
BMC Public Health ; 22(1): 2097, 2022 11 17.
Artículo en Inglés | MEDLINE | ID: mdl-36384521

RESUMEN

BACKGROUND: Racial inequities in maternal mortality in the U.S. continue to be stark. METHODS: The 2015-2018, 4-year total population, county-level, pregnancy-related mortality ratio (PRM; deaths per 100,000 live births; National Center for Health Statistics (NCHS), restricted use mortality file) was linked with the Public Health Exposome (PHE). Using data reduction techniques, 1591 variables were extracted from over 62,000 variables for use in this analysis, providing information on the relationships between PRM and the social, health and health care, natural, and built environments. Graph theoretical algorithms and Bayesian analysis were applied to PHE/PRM linked data to identify latent networks. RESULTS: PHE variables most strongly correlated with total population PRM were years of potential life lost and overall life expectancy. Population-level indicators of PRM were overall poverty, smoking, lack of exercise, heat, and lack of adequate access to food. CONCLUSIONS: In this high-dimensional analysis, overall life expectancy, poverty indicators, and health behaviors were found to be the strongest predictors of pregnancy-related mortality. This provides strong evidence that maternal death is part of a broader constellation of both similar and unique health behaviors, social determinants and environmental exposures as other causes of death.


Asunto(s)
Exposoma , Salud Pública , Embarazo , Femenino , Estados Unidos/epidemiología , Humanos , Teorema de Bayes , Mortalidad Materna , Esperanza de Vida
2.
Biochim Biophys Acta Rev Cancer ; 1869(2): 310-320, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29684522

RESUMEN

The implementation of mammographic screening programmes in many countries has been linked to a marked increase in early detection and improved prognosis for breast cancer patients. Breast tumours can be detected by assessing several features in mammographic images but one of the most common are the presence of small deposits of calcium known as microcalcifications, which in many cases may be the only detectable sign of a breast tumour. In addition to their efficacy in the detection of breast cancer, the presence of microcalcifications within a breast tumour may also convey useful prognostic information. Breast tumours with associated calcifications display an increased rate of HER2 overexpression as well as decreased survival, increased risk of recurrence, high tumour grade and increased likelihood of spread to the lymph nodes. Clearly, the presence of microcalcifications in a tumour is a clinically significant finding, suggesting that a detailed understanding of their formation may improve our knowledge of the early stages of breast tumourigenesis, yet there are no reports which attempt to bring together recent basic science research findings and current knowledge of the clinical significance of microcalcifications. This review will summarise the most current understanding of the formation of calcifications within breast tissue and explore their associated clinical features and prognostic value.


Asunto(s)
Enfermedades de la Mama/diagnóstico por imagen , Neoplasias de la Mama/diagnóstico por imagen , Calcinosis/diagnóstico por imagen , Transformación Celular Neoplásica , Detección Precoz del Cáncer/métodos , Mamografía , Animales , Enfermedades de la Mama/patología , Enfermedades de la Mama/fisiopatología , Neoplasias de la Mama/patología , Neoplasias de la Mama/fisiopatología , Calcinosis/patología , Calcinosis/fisiopatología , Transformación Celular Neoplásica/patología , Femenino , Humanos , Valor Predictivo de las Pruebas , Pronóstico , Factores de Riesgo , Microambiente Tumoral
3.
Br J Anaesth ; 121(3): 605-615, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30115259

RESUMEN

BACKGROUND: Current concepts suggest that impaired representation of information in cortical networks contributes to loss of consciousness under anaesthesia. We tested this idea in rat auditory cortex using information theory analysis of multiunit responses recorded under three anaesthetic agents with different molecular targets: isoflurane, propofol, and dexmedetomidine. We reasoned that if changes in the representation of sensory stimuli are causal for loss of consciousness, they should occur regardless of the specific anaesthetic agent. METHODS: Spiking responses were recorded with chronically implanted microwire arrays in response to acoustic stimuli incorporating varied temporal and spectral dynamics. Experiments consisted of four drug conditions: awake (pre-drug), sedation (i.e. intact righting reflex), loss of consciousness (a dose just sufficient to cause loss of righting reflex), and recovery. Measures of firing rate, spike timing, and mutual information were analysed as a function of drug condition. RESULTS: All three drugs decreased spontaneous and evoked spiking activity and modulated spike timing. However, changes in mutual information were inconsistent with altered stimulus representation being causal for loss of consciousness. First, direction of change in mutual information was agent-specific, increasing under dexmedetomidine and decreasing under isoflurane and propofol. Second, mutual information did not decrease at the transition between sedation and LOC for any agent. Changes in mutual information under anaesthesia correlated strongly with changes in precision and reliability of spike timing, consistent with the importance of temporal stimulus features in driving auditory cortical activity. CONCLUSIONS: The primary sensory cortex is not the locus for changes in representation of information causal for loss of consciousness under anaesthesia.


Asunto(s)
Anestesia General/métodos , Anestésicos Generales/farmacología , Corteza Auditiva/efectos de los fármacos , Estado de Conciencia/efectos de los fármacos , Estimulación Acústica/métodos , Anestésicos por Inhalación/farmacología , Anestésicos Intravenosos/farmacología , Animales , Corteza Auditiva/fisiología , Estado de Conciencia/fisiología , Dexmedetomidina/farmacología , Electroencefalografía/efectos de los fármacos , Femenino , Hipnóticos y Sedantes/farmacología , Isoflurano/farmacología , Propofol/farmacología , Ratas Endogámicas ACI , Tiempo de Reacción/efectos de los fármacos , Reflejo de Enderezamiento/efectos de los fármacos , Reflejo de Enderezamiento/fisiología
4.
Allergy ; 72(10): 1521-1531, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28273344

RESUMEN

BACKGROUND: Interleukin (IL)-33 is implicated in the pathophysiology of asthma and allergic diseases. However, our knowledge is limited regarding how IL-33 release is controlled. The transcription factor nuclear factor-erythroid-2-related factor 2 (Nrf2) plays a key role in antioxidant response regulation. OBJECTIVE: The goal of this project was to investigate the role of cellular oxidative stress in controlling IL-33 release in airway epithelium. METHODS: Complementary approaches were used that included human bronchial epithelial cells and mouse models of airway type-2 immunity that were exposed to fungus Alternaria extract. The clinically available Nrf2 activator 2-cyano-3,12-dioxooleana-1,9-dien-28-oic acid methyl ester (CDDO-Me) was used to evaluate the role of Nrf2-induced antioxidant molecules. RESULTS: Human bronchial epithelial cells produced reactive oxygen species (ROS) when they were exposed to Alternaria extract. ROS scavengers, such as glutathione (GSH) and N-acetyl cysteine, prevented extracellular secretion of ATP and increases in intracellular calcium concentrations that precede IL-33 release. Administration of CDDO-Me to mice enhanced expression of a number of antioxidant molecules in the lungs and elevated lung levels of endogenous GSH. Importantly, CDDO-Me treatment reduced allergen-induced ATP secretion and IL-33 release by airway epithelial cells in vitro and protected mice from IL-33 release and asthma-like pathological changes in the lungs. CONCLUSIONS: The balance between oxidative stress and antioxidant responses plays a key role in controlling IL-33 release in airway epithelium. The therapeutic potential of Nrf2 activators needs to be considered for asthma and allergic airway diseases.


Asunto(s)
Interleucina-33/metabolismo , Estrés Oxidativo , Adenosina Trifosfato/metabolismo , Alérgenos/inmunología , Animales , Antioxidantes/metabolismo , Calcio/metabolismo , Células Epiteliales/metabolismo , Femenino , Humanos , Pulmón/efectos de los fármacos , Pulmón/inmunología , Pulmón/metabolismo , Ratones , Ratones Noqueados , Factor 2 Relacionado con NF-E2/metabolismo , Ácido Oleanólico/análogos & derivados , Ácido Oleanólico/farmacología , Especies Reactivas de Oxígeno/metabolismo , Mucosa Respiratoria/inmunología , Mucosa Respiratoria/metabolismo
5.
Community Dent Health ; 34(4): 208-225, 2017 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-29119741

RESUMEN

OBJECTIVE: In this article we report the findings of a scoping review that aimed to identify and summarise the range of programs and guidelines available for toothbrushing programs in schools and early childhood settings. Dental caries is one of the most common preventable diseases affecting children worldwide. Untreated caries can impact on child health and wellbeing, development, socialisation and school attendance. Supervised toothbrushing programs in schools and other early childhood settings can be effective in improving the oral health of young children. There is limited understanding of the salient issues to consider when developing such programs or how they are best implemented in real world settings. METHODS: A scoping review methodology was utilised to provide a summary of the guidelines and programs available. Key search terms were developed, mapped and utilised to identify guidelines and programs across 6 databases and key search engines. RESULTS: We located 26 programs and guidelines that met the inclusion and exclusion criteria for the review. These were collated and summarised across key countries and critical aspects of program development and implementation were identified. Toothbrush type and storage, toothpaste strength and method of dispensing, toothbrush storage, staff training and parental consent are key considerations that varied widely. CONCLUSIONS AND RECOMMENDATIONS: Guidelines for supervised toothbrushing programs vary within and across countries due to differences in water fluoridation and availability of low fluoride toothpastes. The results of this review provide critical information to be considered when establishing and implementing toothbrushing programs in these settings.


Asunto(s)
Salud Bucal , Cepillado Dental/normas , Niño , Preescolar , Caries Dental/prevención & control , Guías como Asunto , Humanos , Instituciones Académicas
6.
Org Biomol Chem ; 14(39): 9278-9286, 2016 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-27722734

RESUMEN

Antimicrobial Peptides (AMPs) have unique anticancer properties, but their clinical application is currently limited by an inadequate margin of safety. A prodrug strategy associated with a combination therapy approach could address this limitation by increasing their therapeutic index and their efficacy. Accordingly, the first targeted anticancer polymeric prodrug candidates of AMPs, intended for combination therapy with another polymeric prodrug of an approved antineoplastic agent (doxorubicin), were synthesized as either a PEG-based dual-release prodrug or two individual pegylated prodrugs. The latter are based on a cathepsin B-labile peptide linker and an acid-sensitive acyl hydrazone bond for the AMP and doxorubicin prodrugs, respectively. Anticancer activities and toxicity differentials achieved with the free peptide and its polymer conjugates against ovarian, cancer and non-malignant, cells, indicate that protease-dependent reversible pegylation could be implemented to increase the therapeutic indices of AMPs in cancer therapy. The results obtained also show that this approach can be developed if the releasable PEG linker can be optimised to conciliate the attributes and restrictions of pegylation against proteases. In addition, combination of the polymeric prodrugs of the AMP and of doxorubicin provides additive antitumor effects which could be exploited to enhance the efficacy of the AMP candidate.


Asunto(s)
Péptidos Catiónicos Antimicrobianos/farmacología , Protocolos de Quimioterapia Combinada Antineoplásica/farmacología , Profármacos/química , Péptidos Catiónicos Antimicrobianos/química , Protocolos de Quimioterapia Combinada Antineoplásica/química , Catepsina B/química , Línea Celular Tumoral , Supervivencia Celular/efectos de los fármacos , Doxorrubicina/química , Doxorrubicina/farmacología , Ensayos de Selección de Medicamentos Antitumorales/métodos , Humanos , Polietilenglicoles/química , Polímeros/química , Profármacos/síntesis química , Profármacos/farmacología
7.
Cytokine ; 72(1): 1-8, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25514671

RESUMEN

Gulf War illness (GWI) is a chronic disease of unknown etiology characterized by persistent symptoms such as cognitive impairment, unexplained fatigue, pervasive pain, headaches, and gastrointestinal abnormalities. Current reports suggest that as many as 200,000 veterans who served in the 1990-1991 Persian Gulf War were afflicted. Several potential triggers of GWI have been proposed including chemical exposure, toxins, vaccines, and unknown infectious agents. However, a definitive cause of GWI has not been identified and a specific biological marker that can consistently delineate the disease has not been defined. Myalgic encephalomyelitis (ME) is a disease with similar and overlapping symptomology, and subjects diagnosed with GWI typically fit the diagnostic criteria for ME. For these reasons, GWI is often considered a subgroup of ME. To explore this possibility and identify immune parameters that may help to understand GWI pathophysiology, we measured 77 serum cytokines in subjects with GWI and compared these data to that of subjects with ME as well as healthy controls. Our analysis identified a group of cytokines that identified ME and GWI cases with sensitivities of 92.5% and 64.9%, respectively. The five most significant cytokines in decreasing order of importance were IL-7, IL-4, TNF-α, IL-13, and IL-17F. When delineating GWI and ME cases from healthy controls, the observed specificity was only 33.3%, suggesting that with respect to cytokine expression, GWI cases resemble control subjects to a greater extent than ME cases across a number of parameters. These results imply that serum cytokines are representative of ME pathology to a greater extent than GWI and further suggest that the two diseases have distinct immune profiles despite their overlapping symptomology.


Asunto(s)
Biomarcadores/sangre , Citocinas/sangre , Síndrome de Fatiga Crónica/inmunología , Síndrome de Fatiga Crónica/fisiopatología , Síndrome del Golfo Pérsico/inmunología , Síndrome del Golfo Pérsico/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Algoritmos , Citocinas/inmunología , Femenino , Humanos , Interleucina-13/sangre , Interleucina-17/sangre , Interleucina-4/sangre , Interleucina-7/sangre , Masculino , Persona de Mediana Edad , Factor de Necrosis Tumoral alfa/sangre , Adulto Joven
8.
Proc Natl Acad Sci U S A ; 106(11): 4337-42, 2009 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-19246393

RESUMEN

For more than 2 centuries active immunotherapy has been at the forefront of efforts to prevent infectious disease [Waldmann TA (2003) Nat Med 9:269-277]. However, the decreased ability of the immune system to mount a robust immune response to self-antigens has made it more difficult to generate therapeutic vaccines against cancer or chronic degenerative diseases. Recently, we showed that the site-specific incorporation of an immunogenic unnatural amino acid into an autologous protein offers a simple and effective approach to overcome self-tolerance. Here, we characterize the nature and durability of the polyclonal IgG antibody response and begin to establish the generality of p-nitrophenylalanine (pNO(2)Phe)-induced loss of self-tolerance. Mutation of several surface residues of murine tumor necrosis factor-alpha (mTNF-alpha) independently to pNO(2)Phe leads to a T cell-dependent polyclonal and sustainable anti-mTNF-alpha IgG autoantibody response that lasts for at least 40 weeks. The antibodies bind multiple epitopes on mTNF-alpha and protect mice from severe endotoxemia induced by lipopolysaccharide (LPS) challenge. Immunization of mice with a pNO(2)Phe(43) mutant of murine retinol-binding protein (RBP4) also elicited a high titer IgG antibody response, which was cross-reactive with wild-type mRBP4. These findings suggest that this may be a relatively general approach to generate effective immunotherapeutics against cancer-associated or other weakly immunogenic antigens.


Asunto(s)
Aminoácidos/genética , Inmunoterapia/métodos , Ingeniería de Proteínas/métodos , Autotolerancia/inmunología , Aminoácidos/inmunología , Animales , Formación de Anticuerpos , Autoanticuerpos , Autoantígenos/genética , Inmunoglobulina G , Ratones , Fenilalanina/análogos & derivados , Fenilalanina/genética , Linfocitos T/inmunología , Factor de Necrosis Tumoral alfa/genética
9.
Front Immunol ; 13: 1023553, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36703990

RESUMEN

Neutrophil extracellular traps contribute to lung injury in cystic fibrosis and asthma, but the mechanisms are poorly understood. We sought to understand the impact of human NETs on barrier function in primary human bronchial epithelial and a human airway epithelial cell line. We demonstrate that NETs disrupt airway epithelial barrier function by decreasing transepithelial electrical resistance and increasing paracellular flux, partially by NET-induced airway cell apoptosis. NETs selectively impact the expression of tight junction genes claudins 4, 8 and 11. Bronchial epithelia exposed to NETs demonstrate visible gaps in E-cadherin staining, a decrease in full-length E-cadherin protein and the appearance of cleaved E-cadherin peptides. Pretreatment of NETs with alpha-1 antitrypsin (A1AT) inhibits NET serine protease activity, limits E-cadherin cleavage, decreases bronchial cell apoptosis and preserves epithelial integrity. In conclusion, NETs disrupt human airway epithelial barrier function through bronchial cell death and degradation of E-cadherin, which are limited by exogenous A1AT.


Asunto(s)
Asma , Trampas Extracelulares , Humanos , Trampas Extracelulares/metabolismo , Asma/metabolismo , Bronquios , Línea Celular , Cadherinas/metabolismo
10.
J Musculoskelet Neuronal Interact ; 11(3): 234-42, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-21885898

RESUMEN

OBJECTIVES: Neonatal stress impairs postnatal bone mineralization. Evidence suggests that mechanical tactile stimulation (MTS) in early life decreases stress hormones and improves bone mineralization. Insulin-like growth factor (IGF1) is impacted by stress and essential to bone development. We hypothesized that MTS administered during neonatal stress would improve bone phenotype in later life. We also predicted an increase in bone specific mRNA expression of IGF1 related pathways. METHODS: Neonatal stress (STRESS) and MTS (STRESS+10 min of MTS) were given from D6 to D10 of rat life and tissue was harvested on D60 of life. Dual energy x-ray absorptiometry (DXA), bone morphometry, serum osteocalcin, type I procollagen N-terminal propeptide (PINP), tartrate-resistant acid phosphatase (TRAP), and bone and liver mRNA levels of IGF1, IGF1 receptor (IGF1R), and growth hormone receptor (GHR) were measured. RESULTS: Stress resulted in reduced bone area and bone mineral content (BMC) compared to naive control (CTL). MTS intervention increased BMC and tibial growth plate width compared to STRESS. MTS also resulted in higher osteocalcin, and, in males, lower TRAP (p<0.05). MTS resulted in three-fold, two-fold, and six-fold higher bone specific IGF1, IGF1R, and GHR, respectively (p ≤ 0.001) compared to STRESS. CONCLUSIONS: MTS in early postnatal life improves long-term bone mineralization. IGF1 and related pathways may explain improved BMC.


Asunto(s)
Desarrollo Óseo/fisiología , Resorción Ósea/fisiopatología , Resorción Ósea/terapia , Estrés Psicológico/fisiopatología , Estrés Psicológico/terapia , Tacto/fisiología , Animales , Animales Recién Nacidos , Resorción Ósea/etiología , Modelos Animales de Enfermedad , Femenino , Masculino , Estimulación Física/métodos , Embarazo , Ratas , Ratas Sprague-Dawley , Estrés Psicológico/complicaciones
11.
Aviat Space Environ Med ; 82(12): 1143-7, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22195396

RESUMEN

INTRODUCTION: The well-established technique of mask-off hypoxia training in a hypobaric training environment elicits symptoms that are correlated with in-flight symptoms reported by aircrew. Aircrew receive training on recognition of symptoms and response early in their flying career and accomplish refresher training on a 5-yr cycle. The symptoms reported after acute hypoxia represent cognitive and psychomotor impairment. The purpose of this study was to evaluate the correlation of symptoms experienced during hypoxia training and recall of symptoms S from the training sessions 5 yr previously. METHODS: A survey listing 18 symptoms of hypoxia and severity of condition was presented to 1123 aircrew attending refresher training at 10 U.S. Air Force Aerospace Physiology Training Units prior to and immediately following hypoxia training in the hypobaric chamber. RESULTS: The five symptoms most commonly reported following hypoxia training are: lightheaded/dizzy, dizziness, mental confusion, visual impairment, and tingling. The hypoxia symptom "lightheaded/dizzy" recorded the highest frequency of all 18 symptoms. Lightheaded/dizzy frequencies for both previous and current hypoxia training were 67.2% and 72.3%, respectively. This symptom remained consistent throughout all data analysis, retaining the highest frequency in all levels of severity (mild, moderate, and extreme) for both the previous hypoxia training and current hypoxia training. DISCUSSION: The similarity of symptoms recalled between hypoxia training events provides strong evidence that hypoxia training is an effective method of establishing recognized decrements that may influence performance in flight.


Asunto(s)
Medicina Aeroespacial , Hipoxia/diagnóstico , Recuerdo Mental , Personal Militar , Adulto , Cámaras de Exposición Atmosférica , Disfunción Cognitiva/epidemiología , Femenino , Humanos , Masculino , Personal Militar/psicología , Desempeño Psicomotor
12.
J Cell Biol ; 71(1): 96-106, 1976 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-977656

RESUMEN

A species difference in the intercellular adhesive selectivity of mixtures of embryonic liver cells is reported. This is first quantitative assessment of species differences in the intercellular adhesive properties of embryonic cells. A collecting aggregate assay, a new double-label assay procedure, and histological and autoradiographic procedures were used to elucidate the intercellular adhesive selectivity of developing mammalian and avian liver cells. Evidence is presented that the reported adhesive differences are not due to the different cell types composing the respective embryonic mammalian and avian livers. Finally, such heterolgous-homotypic selectivity of adhesion is not a property of all tissues, since it is shown that developing brain cells (mesencephalon) do not exhibit the avove intercellular adhesive selectivity (mammalian vs. avian). These findings provide further support for the hypothesis that generic identity as well as cell type may play an important part in determining the intercellular adhesive behavior of heterologous-homotypic mixtures of embryonic cells. A possible evolutionary divergence of morphogenetic mechanisms is discussed.


Asunto(s)
Adhesión Celular , Hígado/enzimología , Animales , Evolución Biológica , Agregación Celular , Embrión de Pollo , Cobayas , Hígado/citología , Mesencéfalo/citología , Mesencéfalo/embriología , Ratones , Conejos , Ratas , Especificidad de la Especie
13.
Genes Brain Behav ; 17(7): e12474, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29573323

RESUMEN

A single nucleotide polymorphism (SNP) in CHRNA5 (rs16969968, change from an aspartic acid [D] to asparagine [N] at position 398 of the human α5 nicotinic acetylcholine receptor subunit) has been associated with increased risk for nicotine dependence. Consequently, carriers of the risk variant may be at elevated risk for in utero nicotine exposure. To assess whether this gene-environment interaction might impact nicotine intake in developmental nicotine-exposed offspring, we utilized a mouse expressing this human SNP. D and N dams drank nicotine (100 µg/mL) in 0.2% saccharin water or 0.2% saccharin water alone (vehicle) as their sole source of fluid from 30 days prior to breeding until weaning of offspring. The nicotine (D Nic, N Nic) or vehicle (D Veh, N Veh) exposed offspring underwent a 2-bottle choice test between postnatal ages of 30 to 46 days. N Nic offspring consumed the most nicotine at the highest concentration (400 µg/mL) compared with all other groups. In contrast, D Nic offspring drank the least amount of nicotine at all concentrations tested. Nicotine-stimulated dopamine (DA) release measured from striatal synaptosomes was increased in D Nic offspring, while decreased in N Nic offspring relative to their genotype-matched controls. These data suggest that the α5 variant influences the effect of developmental nicotine exposure on nicotine intake of exposed offspring. This gene-environment interaction on striatal DA release may provide motivation for increased nicotine seeking in N Nic offspring and reduced consumption in D Nic offspring.


Asunto(s)
Nicotina/administración & dosificación , Efectos Tardíos de la Exposición Prenatal/genética , Receptores Nicotínicos/genética , Receptores Nicotínicos/metabolismo , Tabaquismo/genética , Animales , Modelos Animales de Enfermedad , Femenino , Interacción Gen-Ambiente , Masculino , Ratones , Ratones Transgénicos , Nicotina/toxicidad , Polimorfismo de Nucleótido Simple/genética , Embarazo
14.
Simul Healthc ; 12(1): 28-40, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28146451

RESUMEN

INTRODUCTION: The success of war fighters and medical personnel handling traumatic injuries largely depends on the quality of training they receive before deployment. The purpose of this study was to gauge the utility of a Wide Area Virtual Environment (WAVE) as a training adjunct by comparing and evaluating student performance, measuring sense of realism, and assessing the impact on student satisfaction with their training exposure in an immersive versus a field environment. METHODS: This comparative prospective cohort study examined the utility of a three-screen WAVE where subjects were immersed in the training environment with medical simulators. Standard field training commenced for the control group subjects. Medical skills, time to completion, and Team Strategies and Tools to Enhance Performance and Patient Safety objective metrics were assessed for each team (n = 94). In addition, self-efficacy questionnaires were collected for each subject (N = 470). RESULTS: Medical teams received poorer overall team scores (F1,186 = 0.756, P = 0.001), took longer to complete the scenario (F1,186 = 25.15, P = 0.001), and scored lower on The National Registry of Emergency Medical Technicians trauma assessment checklist (F1,186 = 1.13, P = 0.000) in the WAVE versus the field environment. Critical thinking and realism factors within the self-efficacy questionnaires scored higher in the WAVE versus the field [(F1,466 = 8.04, P = 0.005), (F1,465 = 18.57, P = 0.000), and (F1,466 = 53.24, P = 0.000), respectively]. CONCLUSIONS: Environmental and emotional stressors may negatively affect critical thinking and clinical skill performance of medical teams. However, by introducing more advanced simulation trainings with added stressors, students may be able to adapt and overcome barriers to performance found in high-stress environments.


Asunto(s)
Competencia Clínica/normas , Simulación por Computador , Interfaz Usuario-Computador , Auxiliares de Urgencia , Femenino , Humanos , Masculino , Grupo de Atención al Paciente , Evaluación de Programas y Proyectos de Salud , Estudios Prospectivos , Encuestas y Cuestionarios
15.
Disaster Health ; 3(2): 45-56, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-28229014

RESUMEN

This article describes an application of the Communities Advancing Resilience Toolkit (CART) Assessment Survey which has been recognized as an important community tool to assist communities in their resilience-building efforts. Developed to assist communities in assessing their resilience to disasters and other adversities, the CART survey can be used to obtain baseline information about a community, to identify relative community strengths and challenges, and to re-examine a community after a disaster or post intervention. This article, which describes an application of the survey in a community of 5 poverty neighborhoods, illustrates the use of the instrument, explicates aspects of community resilience, and provides possible explanations for the results. The paper also demonstrates how a community agency that serves many of the functions of a broker organization can enhance community resilience. Survey results suggest various dimensions of community resilience (as represented by core CART community resilience items and CART domains) and potential predictors. Correlates included homeownership, engagement with local entities/activities, prior experience with a personal emergency or crisis while living in the neighborhood, and involvement with a community organization that focuses on building safe and caring communities through personal relationships. In addition to influencing residents' perceptions of their community, it is likely that the community organization, which served as a sponsor for this application, contributes directly to community resilience through programs and initiatives that enhance social capital and resource acquisition and mobilization.

16.
Biochim Biophys Acta ; 568(1): 234-42, 1979 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-375986

RESUMEN

Tritiated water and tritiated substrates have been used to study exchange reactions catalyzed by Escherichia coli 2-oxo-4-hydroxyglutarate aldolase (4-hydroxy-2-oxoglutarate glyoxylate-lyase, EC 4.1.3.16, 2-oxo-4-hydroxyglutarate in equilibrium pyruvate + glyoxylate). With pyruvate, the enzyme catalyzes a rapid first-order exchange of all three methyl hydrogens in the absence of added acceptor aldehyde (i.e. glyoxylate). This reaction is not rate limiting for aldol condensation or cleavage; quite different pH-activity profiles for the exchange reaction versus aldol cleavage and also comparative effects that pH changes have on Km and V values for the two processes favor this conclusion. The exchange reaction with 2-oxobutyrate, a substrate analog, is stereoselective; one methylene hydrogen is removed at a 6-fold faster rate than the other but eventually both are exchanged. No tritium exchange occurs with glyoxylate.


Asunto(s)
Escherichia coli/enzimología , Oxo-Ácido-Liasas/metabolismo , Marcaje Isotópico , Ácidos Cetoglutáricos , Cinética , Piruvatos , Tritio
17.
Biochim Biophys Acta ; 717(2): 322-6, 1982 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-7115772

RESUMEN

Many polar fishes synthesize a group of eight glycopeptides that exhibit a non-colligative lowering of the freezing point of water. These glycopeptides range in molecular weight between 2600 and 33 700. The largest glycopeptides [1-5] lower the freezing point more than the small ones on a weight basis and contain only two amino acids, alanine and threonine, with the disaccharide galactose-N-acetyl-galactosamine attached to threonine. The small glycopeptides, 6, 7, and 8, also lower the freezing point and contain proline, which periodically substitutes for alanine. Glycopeptides with similar antifreeze properties isolated from the saffron cod and the Atlantic tomcod contain an additional amino acid, arginine, which substitutes for threonine in glycopeptide 6. In this study we address the question of whether differences in amino acid composition or molecular weight between large and small glycopeptides are responsible for the reduced freezing point depressing capability of the low molecular weight glycopeptides. The results indicate that the degree of amino acid substitutions that occur in glycopeptides 6-8 do not have a significant effect on the unusual freezing point lowering and that the observed decrease in freezing point depression with smaller glycopeptides can be accounted for on the basis of molecular weight.


Asunto(s)
Glicopéptidos/metabolismo , Glicoproteínas/metabolismo , Aminoácidos/análisis , Animales , Proteínas Anticongelantes , Peces , Congelación , Cinética , Peso Molecular
18.
J Gen Physiol ; 114(4): 561-74, 1999 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-10498674

RESUMEN

The objective of this study was to investigate the effects of insulin and insulin-like growth factor I on transepithelial Na(+) transport across porcine glandular endometrial epithelial cells grown in primary culture. Insulin and insulin-like growth factor I acutely stimulated Na(+) transport two- to threefold by increasing Na(+)-K(+) ATPase transport activity and basolateral membrane K(+) conductance without increasing the apical membrane amiloride-sensitive Na(+) conductance. Long-term exposure to insulin for 4 d resulted in enhanced Na(+) absorption with a further increase in Na(+)-K(+) ATPase transport activity and an increase in apical membrane amiloride-sensitive Na(+) conductance. The effect of insulin on the Na(+)-K(+) ATPase was the result of an increase in V(max) for extracellular K(+) and intracellular Na(+), and an increase in affinity of the pump for Na(+). Immunohistochemical localization along with Western blot analysis of cultured porcine endometrial epithelial cells revealed the presence of alpha-1 and alpha-2 isoforms, but not the alpha-3 isoform of Na(+)-K(+) ATPase, which did not change in the presence of insulin. Insulin-stimulated Na(+) transport was inhibited by hydroxy-2-naphthalenylmethylphosphonic acid tris-acetoxymethyl ester [HNMPA-(AM)(3)], a specific inhibitor of insulin receptor tyrosine kinase activity, suggesting that the regulation of Na(+) transport by insulin involves receptor autophosphorylation. Pretreatment with wortmannin, a specific inhibitor of phosphatidylinositol 3-kinase as well as okadaic acid and calyculin A, inhibitors of protein phosphatase activity, also blocked the insulin-stimulated increase in short circuit and pump currents, suggesting that activation of phosphatidylinositol 3-kinase and subsequent stimulation of a protein phosphatase mediates the action of insulin on Na(+)-K(+) ATPase activation.


Asunto(s)
Endometrio/metabolismo , Activadores de Enzimas/farmacología , Células Epiteliales/metabolismo , Insulina/farmacología , Fosfoproteínas Fosfatasas/metabolismo , ATPasa Intercambiadora de Sodio-Potasio/metabolismo , Sodio/metabolismo , Amilorida/análogos & derivados , Amilorida/farmacología , Animales , Transporte Biológico Activo/efectos de los fármacos , Western Blotting , Permeabilidad de la Membrana Celular/efectos de los fármacos , Células Cultivadas , Electrofisiología , Endometrio/citología , Endometrio/efectos de los fármacos , Activación Enzimática/fisiología , Células Epiteliales/efectos de los fármacos , Células Epiteliales/enzimología , Femenino , Inmunohistoquímica , Factor I del Crecimiento Similar a la Insulina/fisiología , Ouabaína/metabolismo , Canales de Potasio/metabolismo , Estimulación Química , Porcinos
19.
Diabetes Care ; 26(8): 2383-8, 2003 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-12882866

RESUMEN

OBJECTIVE: The purpose of this study was to determine the relationships between plasma adiponectin and leptin levels, total and central obesity, and glucose utilization across the adult age span. RESEARCH DESIGN AND METHODS: We studied 148 women aged 18-81 years with a BMI range of 17.2-44.3 kg/m(2). Total percent body fat was determined by dual-energy X-ray absorptiometry and abdominal fat by computed tomography. Glucose tolerance in non-type 2 diabetic volunteers was determined with an oral glucose tolerance test. Glucose utilization (M) was measured during the last 60 min of hyperinsulinemic-euglycemic clamps (240 pmol x m(-2) x min(-1)). Plasma adiponectin levels were measured by radioimmunoassay. The women were separated into three age-groups: young, middle, and old (<40, 40-59, and >or=60 years, respectively), as well as by glucose tolerance status. RESULTS: Adiponectin concentrations did not differ by age-groups. There were significant age effects for BMI, percent body fat, visceral fat, subcutaneous abdominal fat, VO(2max), and M. Adiponectin levels were lower in the prediabetic women (n = 18) than in the normal glucose-tolerant women (n = 108) and the women with type 2 diabetes (n = 22) (both P < 0.05). Univariate correlations revealed significant negative relationships between plasma adiponectin levels and BMI, percent body fat, visceral fat, subcutaneous abdominal fat, fasting leptin, and fasting insulin and positive relationship with M (all P < 0.05). In a multiple stepwise regression model to predict adiponectin, only M remained in the model at P < 0.001. Multivariate analyses revealed a significant relation for M as a function of adiponectin, insulin, and VO(2max). CONCLUSIONS: The data suggest that plasma adiponectin does not change with age but levels are negatively associated with percent body fat, visceral fat, subcutaneous abdominal fat, insulin, and leptin levels in women. Adiponectin is positively associated with M across the age span in women.


Asunto(s)
Glucemia/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus/metabolismo , Péptidos y Proteínas de Señalización Intercelular , Leptina/sangre , Obesidad , Proteínas/metabolismo , Adiponectina , Tejido Adiposo/metabolismo , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Composición Corporal , Femenino , Técnica de Clampeo de la Glucosa , Prueba de Tolerancia a la Glucosa , Humanos , Insulina/metabolismo , Persona de Mediana Edad , Análisis de Regresión
20.
Clin Exp Metastasis ; 2(3): 213-22, 1984.
Artículo en Inglés | MEDLINE | ID: mdl-6549550

RESUMEN

Metastatic variant sublines of the murine RAW117 large cell lymphoma or lymphosarcoma have been established in vitro by sequential cycles of harvesting of liver tumor nodules after intravenous inoculation of tumor cell suspensions into syngeneic BALB/c mice. After five and ten in vivo selections for liver colonization, variant sublines RAW117-H5 and -H10, respectively, were established, and these formed significantly more surface liver tumors than the parental RAW117-P line. RAW117 sublines were tested for their abilities to adhere to embryonic mouse liver or brain cells in an in vitro cell-cell adhesion assay. Liver colonizing RAW117-H10 cells adhered with greater selectivity to liver cells than to brain cells. Parental RAW117-P cells were more homotypically adhesive, but they were nonselective in their organ cell adhesion properties. We examined RAW117 cells for the presence of liver cross-reactive antigens using polyclonal xenoantibody preparations directed against embryonic murine liver cells. These antibody preparations block organ-specific homotypic adhesion of embryonic murine liver cells in vitro. The amount of fetal liver antigen(s) expressed on RAW117 sublines correlated with liver colonization potentials (H10 greater than H5 greater than P) in quantitative absorption assays. Treatment of the highly metastatic RAW117-H10 subline with polyclonal anti-embryonic murine liver F(ab')2 or Fab' antibody fragments had no effect on RAW117-H10 cell viability or growth in vitro or in vivo, but inhibited liver colonization (median liver tumor colonies reduced from greater than 200 to 0) and prolonged life expectancy. In contrast, pretreatment of RAW117-H10 cells with polyclonal anti-H-2 did not modify the in vivo biologic properties of these metastatic cells.


Asunto(s)
Antígenos de Superficie , Comunicación Celular , Neoplasias Hepáticas/secundario , Linfoma no Hodgkin/patología , Linfoma/patología , Animales , Antígenos de Neoplasias/inmunología , Neoplasias Encefálicas/secundario , Moléculas de Adhesión Celular , Línea Celular , Supervivencia Celular , Reacciones Cruzadas , Femenino , Fragmentos Fab de Inmunoglobulinas/inmunología , Neoplasias Hepáticas/patología , Ratones , Ratones Endogámicos BALB C , Embarazo
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