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BACKGROUND: The Internet Plus Nursing Service (IPNS) is being instigated in all provincial-level regions throughout China, in which registered nurses (with more than five years of experience from qualified medical institutions) will provide services to those in their communities or homes after receiving online applications. The growing shortage of human resources in nursing is a critical issue for this project, so effective policies for recruiting and retaining nurses are critical. OBJECTIVE: This study aims to pinpoint the significant job characteristics that play a crucial role in shaping the job decisions of sharing nurses in the IPNS program, and to estimate the strength of job attributes. METHODS: A discrete choice experiment (DCE) was used to assess job attributes influencing sharing nurses' preferences. A qualitative design, including in-depth interview and focus interview methods, was conducted to determine the inclusion of attributes. The final included six attributes were: work modes, duration per visit, income per visit, personal safety, medical risk prevention, and refresher training. This study was conducted at 13 hospitals in Guangdong Province, China, from April to June 2022, and a total of 220 registered sharing nurses participated in the survey. The multinomial logit model explored attributes and relative valued utility. Preference heterogeneity is explored via latent class analysis (LCA) models. RESULTS: A total of 220 participants answered the questionnaire. Income was the most influential characteristic of a sharing nursing position, followed by personal safety management, duration per visit, medical risk prevention, and refresher training, and nurses' preferences differed among different types of classes. CONCLUSIONS: Sharing nurses place most value on income and personal safety with career-related decisions, which indicates an urgent need to develop complete security for personal safety. This study can be helpful to decision-makers in the Chinese government.
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Functionalized with the Au-S bond, gold nanoflares have emerged as promising candidates for theranostics. However, the presence of intracellular abundantly biothiols compromises the conventional Au-S bond, leading to the unintended release of cargoes and associated side-effects on non-target cells. Additionally, the hypoxic microenvironment in diseased regions limits treatment efficacy, especially in photodynamic therapy. To address these challenges, high-fidelity photodynamic nanoflares constructed on Pt-coated gold nanoparticles (Au@Pt PDNF) were communicated to avoid false-positive therapeutic signals and side-effects caused by biothiol perturbation. Compared with conventional photodynamic gold nanoflares (AuNP PDNF), the Au@Pt PDNF were selectively activated by cancer biomarkers and exhibited high-fidelity phototheranostics while reducing side-effects. Furthermore, the ultrathin Pt-shell catalysis was confirmed to generate oxygen which alleviated hypoxia-related photodynamic resistance and enhanced the antitumor effect. This design might open a new venue to advance theranostics performance and is adaptable to other theranostic nanomaterials by simply adding a Pt shell.
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Antineoplásicos , Ouro , Nanopartículas Metálicas , Platina , Nanomedicina Teranóstica , Ouro/química , Humanos , Platina/química , Nanopartículas Metálicas/química , Antineoplásicos/química , Antineoplásicos/farmacologia , Fotoquimioterapia , Sobrevivência Celular/efeitos dos fármacos , Fármacos Fotossensibilizantes/química , Fármacos Fotossensibilizantes/farmacologia , Linhagem Celular Tumoral , Ensaios de Seleção de Medicamentos Antitumorais , Proliferação de Células/efeitos dos fármacosRESUMO
Triplex DNA switches are attractive allosteric tools for engineering smart nanodevices, but their poor triplex-forming capacity at physiological conditions limited the practical applications. To address this challenge, we proposed a low-entropy barrier design to facilitate triplex formation by introducing a hairpin duplex linker into the triplex motif, and the resulting triplex switch was termed as CTNSds. Compared to the conventional clamp-like triplex switch, CTNSds increased the triplex-forming ratio from 30 % to 91 % at pHâ 7.4 and stabilized the triple-helix structure in FBS and cell lysate. CTNSds was also less sensitive to free-energy disturbances, such as lengthening linkers or mismatches in the triple-helix stem. The CTNSds design was utilized to reversibly isolate CTCs from whole blood, achieving high capture efficiencies (>86 %) at pHâ 7.4 and release efficiencies (>80 %) at pHâ 8.0. Our approach broadens the potential applications of DNA switches-based switchable nanodevices, showing great promise in biosensing and biomedicine.
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DNA , Concentração de Íons de Hidrogênio , DNA/química , Humanos , Entropia , Conformação de Ácido Nucleico , Técnicas BiossensoriaisRESUMO
BACKGROUND: Dementia has become a global public health problem, and general practitioners (GPs) play a key role in diagnosing and managing dementia. However, in Chinese primary care settings, dementia is underdiagnosed and inefficiently managed, and dementia screening and management services provided by GPs are suboptimal. The reasons underlying this gap are poorly understood. This study aimed to determine the barriers that hinder GPs from actively promoting dementia screening and management, and thereby provide insights for the successful promotion of dementia screening and management services in primary care. METHODS: Purposive sampling was used. And focus groups and in-depth interviews were conducted face-to-face among GPs from community health service centers (CHSCs) in South China. Thematic analysis was used to identify barriers to screening and managing dementia and map them to the Capability/Opportunity/Motivation-Behavior model (COM-B model). RESULTS: Fifty-two GPs were included. The COM-B model found nine barriers to implementing dementia screening and management services in primary healthcare: (1) poor capability: lack of systematic knowledge of dementia and inadequate dementia screening skills; (2) little opportunity: unclear pathways for referral, insufficient time for dementia screening and management, lack of dementia-specific leaders, and no guarantee of services continuity; (3) low motivation: outside of GP scope, worries associated with dementia stigma rooted in culture beliefs, and insufficient financial incentives. CONCLUSIONS: Our study concluded that GPs were not yet ready to provide dementia screening and management services due to poor capability related to knowledge and skills of dementia, little opportunity associated with an unsupportive working environment, and low motivation due to unclear duty and social pressure. Accordingly, systematic implementation strategies should be taken, including standardized dementia training programs, standardized community-based dementia guidelines, expansion of primary care workforces, development of dedicated leaders, and the eradication of stigma attached to dementia to promote dementia screening and management services in primary care.
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Demência , Clínicos Gerais , Humanos , Motivação , Pesquisa Qualitativa , Grupos Focais , Demência/diagnóstico , Demência/epidemiologia , Demência/terapiaRESUMO
With the advance of genetic technologies, the use of expanded carrier screening (ECS) in the prenatal setting is growing. ECS tests for a wide range of inherited genetic disorders regardless of racial/ethnic background and family history. Latinxs are an important ECS stakeholder group as they are the largest minority group with the highest fertility rate in the United States. Yet, the Latinx population has, to date, been underrepresented and understudied in genetics/genomics research. We conducted a study to explore the knowledge and perspectives of pregnant Latinas regarding ECS in which descriptive statistics and content analysis were used to analyze the data. Thirty-two pregnant Latinas - mostly of low educational levels (no education beyond high school) and with less than $20,000 annual household income living in rural areas were surveyed, provided with education about ECS, and interviewed. Participants were found to possess limited knowledge about ECS prior to being interviewed. Most (68.8%), however, expressed interest in pursuing ECS following the educational component that explained ECS. Their interest was mainly driven by the desire to know their baby's chance of developing a genetic disorder, the low risk of ECS procedures for both pregnant Latinas and their fetus, and the opportunity to better prepare for raising a child with a genetic condition. Our findings contribute to the limited research in the genetics/genomics field by providing in-depth insights into the perspectives of pregnant Latinas regarding ECS. Obstetric providers and genetic counselors should provide culturally appropriate education and counseling to empower pregnant Latinas to make informed decisions about the use of ECS.
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Conselheiros , Aconselhamento Genético , Gravidez , Feminino , Criança , Humanos , Aconselhamento Genético/métodos , Triagem de Portadores Genéticos/métodos , Aconselhamento , Hispânico ou Latino/genéticaRESUMO
BACKGROUND: The diabetes disease burden in China is heavy, and medical standards such as diabetes guidelines are the core reference guidelines for diabetes management for health care providers and patients. However, patients' guideline compliance is too low, which correlates with the gap between guidelines and patients' self-management needs. Incorporating patient needs into the guideline development would reduce this gap. OBJECTIVE: We sought to capture the needs of patients with diabetes for self-management in everyday situations and to clarify the contradictions and misalignments between medical standards, such as guidelines, and patient needs. METHODS: This study collected crawler-based data from 4 online health communities. We selected 1605 text records collected from Chinese patients with diabetes between March 2020 and July 2020 for analysis. The text analysis applied grounded theory to separate issues that concerned patients into 3 themes, 7 subthemes, and 25 entries. RESULTS: Altogether, 69.03% (1108/1605) of texts were related to issues concerning disease treatment (theme B) and mainly inquired about medication use (B2 and B3; 686/1108, 61.91%), including medication choice, change in medication administration, side effects, and postmedication effects. In addition, 222 (N=1605, 13.8%) texts (theme A) concerned the explanation of disease etiology and knowledge of diabetes, and 275 (N=1605, 17.1%) texts (theme C) discussed lifestyle changes and various restrictions on life brought about by the disease. CONCLUSIONS: Our findings suggest an urgent need to improve diabetes health education and guideline development strategies and to develop health management strategies from a patient perspective to bridge the misalignment between patient needs and current medical standards.
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Diabetes Mellitus Tipo 2 , Envio de Mensagens de Texto , Humanos , Diabetes Mellitus Tipo 2/terapia , Pesquisa Qualitativa , Cooperação do Paciente , Estilo de VidaRESUMO
The American Academy of Pediatrics, the American College of Medical Genetics and Genomics, and the American Academy of Neurology recommend genetic testing, as a genetic evaluation tool, for children diagnosed with autism spectrum disorders (ASD). Despite the potential benefits, the utilization of genetic testing is low. We proposed an integrated theoretical framework to examine parents' intention and associated psychosocial factors in pursuing genetic testing for their children with ASD. Recruiting primarily from the Interactive Autism Network, a nationwide sample of 411 parents of children with ASD who had never pursued genetic testing for their children completed our theory-based online survey. Data were analyzed using structural equation modeling. About half of the parents were willing to pursue genetic testing for their children with ASD. Findings of the structural equation modeling suggested a good model fit between our integrated theoretical framework and survey data. Parents' intention was significantly and positively associated with their attitudes toward genetic testing, subjective norm, and self-efficacy in having their children tested. This study serves as an initial window to understand parental intention to pursue genetic testing for their children with ASD. Our findings can help physicians and genetic counselors understand, educate, counsel, and support parents' decision-making about having their children with ASD genetically tested. Furthermore, our study can also assist physicians and genetic counselors in developing theory- and evidence-based patient education materials to enhance genetic testing knowledge among parents of children with ASD.
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Transtorno do Espectro Autista , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/genética , Criança , Testes Genéticos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pais , Inquéritos e QuestionáriosRESUMO
We reveal by high-throughput screening that activating transcription factor 1 (ATF1) is a novel pluripotent regulator in human embryonic stem cells (hESCs). The knockdown of ATF1 expression significantly up-regulated neuroectoderm (NE) genes but not mesoderm, endoderm, and trophectoderm genes. Of note, down-regulation or knockout of ATF1 with short hairpin RNA (shRNA), small interfering RNA (siRNA), or clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) was sufficient to up-regulate sex-determining region Y-box (SOX)2 and paired box 6 (PAX6) expression under the undifferentiated or differentiated conditions, whereas overexpression of ATF1 suppressed NE differentiation. Endogenous ATF1 was spontaneously down-regulated after d 1-3 of neural induction. By double-knockdown experiments, up-regulation of SOX2 was critical for the increase of PAX6 and SOX1 expression in shRNA targeting Atf1 hESCs. Using the luciferase reporter assay, we identified ATF1 as a negative transcriptional regulator of Sox2 gene expression. A novel function of ATF1 was discovered, and these findings contribute to a broader understanding of the very first steps in regulating NE differentiation in hESCs.-Yang, S.-C., Liu, J.-J., Wang, C.-K., Lin, Y.-T., Tsai, S.-Y., Chen, W.-J., Huang, W.-K., Tu, P.-W. A., Lin, Y.-C., Chang, C.-F., Cheng, C.-L., Lin, H., Lai, C.-Y., Lin, C.-Y., Lee, Y.-H., Chiu, Y.-C., Hsu, C.-C., Hsu, S.-C., Hsiao, M., Schuyler, S. C., Lu, F. L., Lu, J. Down-regulation of ATF1 leads to early neuroectoderm differentiation of human embryonic stem cells by increasing the expression level of SOX2.
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Fator 1 Ativador da Transcrição/metabolismo , Diferenciação Celular , Regulação da Expressão Gênica no Desenvolvimento , Células-Tronco Embrionárias Humanas/citologia , Neurônios/citologia , RNA Interferente Pequeno/genética , Fatores de Transcrição SOXB1/metabolismo , Fator 1 Ativador da Transcrição/antagonistas & inibidores , Fator 1 Ativador da Transcrição/genética , Células Cultivadas , Regulação para Baixo , Endoderma/citologia , Endoderma/metabolismo , Células-Tronco Embrionárias Humanas/metabolismo , Humanos , Mesoderma/citologia , Mesoderma/metabolismo , Neurônios/metabolismo , Fatores de Transcrição SOXB1/genéticaRESUMO
Mitophagy, as a crucial metabolic process, plays an essential role in maintaining cellular and tissue homeostasis. Various stresses especially hypoxia could improve intracellular reactive oxygen species (ROS) level to induce mitophagy. However, high-specific fluorescence imaging of mitophagy in living cells under hypoxia is still a challenge. Based on this, we report an azoreductase-responsive nanoprobe (termed Micelle@Mito-rHP@TATp, MCM@TATp) by encapsulating cationic spiropyrane derivative (Mito-rHP) to realize specific imaging of mitophagy in living cells under hypoxia. An azoreductase-responsive amphiphilic polymer, 1,2-distearoyl- sn-glycero-3-phosphoethanolamine-azo- N-[maleimide(polyethylene glycol-2000) (Mal-PEG2000-Azo-DSPE), was first self-assembled into a micelle in aqueous solution. Meanwhile, the synthetic Mito-rHP encapsulated into this formed micelle to construct MCM. By modifying the surface of MCM with cell-penetrating peptide (TATp) to form MCM@TATp, the nanoprobe could avoid endolysosomal trapping. Under hypoxic conditions, the azobenzene moiety-contained MCM@TATp would be disrupted by the highly expressed azoreductase, then the encapsulated Mito-rHP would be released. Since Mito-rHP is a mitochondria-targeted and pH-sensitive probe, thus it could target into mitochondria and displayed a desirable "off-on" fluorescence response to mitophagy during which mitochondria were regarded to undergo acidification. The results indicated that the MCM@TATp in our design could image mitophagy under hypoxia in high-specificity. As further application, we have also demonstrated that this MCM@TATp can perform well to realize mitophagy imaging under the photodynamic therapy (PDT) which can induce hypoxia in treatment of cancer. We expect this new strategy would be a powerful tool for hypoxia-related fundamental and clinical research.
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Compostos Azo/metabolismo , Mitofagia/fisiologia , NADH NADPH Oxirredutases/metabolismo , Fosfatidiletanolaminas/metabolismo , Polietilenoglicóis/metabolismo , Compostos de Espiro/metabolismo , Animais , Compostos Azo/síntese química , Corantes Fluorescentes/química , Células Hep G2 , Humanos , Hipóxia/metabolismo , Micelas , Microscopia Confocal/métodos , Microscopia de Fluorescência/métodos , Microssomos Hepáticos/metabolismo , Nitrorredutases , Fosfatidiletanolaminas/síntese química , Fotoquimioterapia , Polietilenoglicóis/síntese química , Ratos , Compostos de Espiro/síntese químicaAssuntos
Técnicas Biossensoriais , Imagem Óptica , Técnicas Biossensoriais/métodos , Humanos , AnimaisRESUMO
PURPOSE: With the increased advances in genomics, leading health authorities have advocated the importance of incorporating genomics content into health professional school education to ensure those students achieve adequate genomic competencies. Yet, information regarding the genomics education status for this particular group is lacking. We conducted a systematic literature review to summarize the characteristics and evaluation outcomes of genomics curricula for health professional students. METHODS: Medline (OVID), EMBASE, CAB (EBSCO), Global Health, MedEdPORTAL, Google Scholar, and Web of Science were searched for relevant articles. RESULTS: Forty-one articles met our inclusion criteria. The majority were conducted in the United States and offered to pharmacy and medical students (the number of students ranged from 10 to 2674). The effects of genomics curricula on students' knowledge (n = 36), attitudes (n = 16), self-efficacy (n = 14), comfort level (n = 4), intention (n = 3), motivation (n = 3), and behavior (n = 2) were assessed. Although those results were generally positive, 68.3% of the genomics curricula were not theory-based, and most studies did not report follow-up data (85.4%). CONCLUSION: Our findings provided information on the existing genomics curricula available for health professional students.
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Competência Clínica , Educação Médica , Genômica/educação , Estudantes de Medicina , Currículo/normas , Humanos , Conhecimento , MotivaçãoRESUMO
OBJECTIVE: To investigate the prevalence and correlates of excessive daytime sleepiness (EDS) in a population of hospital nurses in South China as well as the influence of EDS on the occurrence of adverse events. METHODS: A total of 1102 nurses working in a large medical center were invited to participate in this cross-sectional study (96.9% females, mean age 29.6 years). They all completed a self-reported questionnaire consisting of items on demographic variables, lifestyle factors, insomnia, anxiety, depression, and both work-related and sleep-related characteristics. RESULTS: A total of 1048 nurses gave a valid response (response rate 95.1%). Among them, 169 (16.1%) reported EDS as defined as an Epworth Sleepiness Scale ≥ 14. Depression (adjusted odds ratio = 2.24, 95% confidence interval 1.51-3.31), anxiety (1.65; 1.02-2.67), insomnia (2.29; 1.56-3.36), rotating shift work (1.98; 1.03-3.83), and low interest in work (1.74; 1.01-2.99) were all independent risk factors of the occurrence of EDS. EDS is associated with the occurrence of adverse events after controlling for confounding factors (adjusted OR 1.83, CI 1.26 to 2.67). CONCLUSIONS: EDS was common among this relatively young and healthy nurse population in south China. There were clear associations between EDS and depression, anxiety, insomnia, rotating shift work, and low work-related interest. Furthermore, EDS was an independent risk factor in the occurrence of adverse events (AEs) in our subjects.
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Acidentes de Trabalho/estatística & dados numéricos , Distúrbios do Sono por Sonolência Excessiva/enfermagem , Hospitais Gerais/estatística & dados numéricos , Erros Médicos/estatística & dados numéricos , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Doenças Profissionais/enfermagem , Adulto , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/enfermagem , China/epidemiologia , Correlação de Dados , Estudos Transversais , Transtorno Depressivo/complicações , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/enfermagem , Distúrbios do Sono por Sonolência Excessiva/complicações , Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Feminino , Humanos , Satisfação no Emprego , Masculino , Doenças Profissionais/complicações , Doenças Profissionais/epidemiologia , Fatores de Risco , Jornada de Trabalho em Turnos , Distúrbios do Início e da Manutenção do Sono/complicações , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/enfermagem , Inquéritos e QuestionáriosRESUMO
In China, community nurses do not have systematic training, and the nursing education curriculum focuses on clinical nursing both in vocational school and high school. Most nurses work at a hospital, and almost all community nurses lack systematic knowledge about community nursing. A training program for community nurses in Guangzhou City has been conducted since 2003. The training curriculum has evolved over the years, but is not standardized. This article describes research on improving community nurses' basic knowledge and practice skills. We modified the curriculum with a questionnaire and a modified Delphi method. First, 318 participating nurses and instructors were queried in December 2012. Then 22 experts modified the training program based on the results of the questionnaire and implementation since 2013. After 4 years, we followed up with the new participating nurses to evaluate the curriculum.
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Currículo/normas , Educação em Enfermagem/métodos , Satisfação no Emprego , Adulto , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVES: To assess the reliability, validity, and responsiveness of InFLUenza Patient-Reported Outcome (FLU-PRO©) scores for quantifying the presence and severity of influenza symptoms. METHODS: An observational prospective cohort study of adults (≥18 years) with influenza-like illness in the United States, the United Kingdom, Mexico, and South America was conducted. Participants completed the 37-item draft FLU-PRO daily for up to 14 days. Item-level and factor analyses were used to remove items and determine factor structure. Reliability of the final tool was estimated using Cronbach α and intraclass correlation coefficients (2-day reliability). Convergent and known-groups validity and responsiveness were assessed using global assessments of influenza severity and return to usual health. RESULTS: Of the 536 patients enrolled, 221 influenza-positive subjects comprised the analytical sample. The mean age of the patients was 40.7 years, 60.2% were women, and 59.7% were white. The final 32-item measure has six factors/domains (nose, throat, eyes, chest/respiratory, gastrointestinal, and body/systemic), with a higher order factor representing symptom severity overall (comparative fit index = 0.92; root mean square error of approximation = 0.06). Cronbach α was high (total = 0.92; domain range = 0.71-0.87); test-retest reliability (intraclass correlation coefficient, day 1-day 2) was 0.83 for total scores and 0.57 to 0.79 for domains. Day 1 FLU-PRO domain and total scores were moderately to highly correlated (≥0.30) with Patient Global Rating of Flu Severity (except nose and throat). Consistent with known-groups validity, scores differentiated severity groups on the basis of global rating (total: F = 57.2, P < 0.001; domains: F = 8.9-67.5, P < 0.001). Subjects reporting return to usual health showed significantly greater (P < 0.05) FLU-PRO score improvement by day 7 than did those who did not, suggesting score responsiveness. CONCLUSIONS: Results suggest that FLU-PRO scores are reliable, valid, and responsive to change in influenza-positive adults.
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Influenza Humana/fisiopatologia , Medidas de Resultados Relatados pelo Paciente , Índice de Gravidade de Doença , Adulto , Análise Fatorial , Feminino , Humanos , Influenza Humana/epidemiologia , Masculino , Estudos Prospectivos , Psicometria , Reprodutibilidade dos Testes , Estados Unidos/epidemiologiaRESUMO
By virtue of its high sensitivity and rapidity, Fenton reaction has been demonstrated as a powerful tool for in vitro biochemical analysis; however, in vivo applications of Fenton reaction still remain to be exploited. Herein, we report, for the first time, the design, formation and testing of Fenton reaction for in vivo fluorescence imaging of hydrogen peroxide (H2O2). To realize in vivo fluorescence imaging of H2O2 via Fenton reaction, a functional nanosphere, Fc@MSN-FDNA/PTAD, is fabricated from mesoporous silica nanoparticle (MSN), a Fenton reagent of ferrocene (Fc), ROX-labeled DNA (FDNA), and a cationic perylene derivative (PTAD). The ferrocene molecules are locked in the pore entrances of MSN, and exterior of MSN is covalently immobilized with FDNA. As a key part, PTAD acts as not only the gatekeeper of MSN but also the efficient quencher of ROX. H2O2 can permeate into the nanosphere and react with ferrocene to product hydroxyl radical (·OH) via Fenton reaction, which cleaves FDNA to detach ROX from PTAD, thus in turn, lights the ROX fluorescence. Under physiological condition, H2O2 can be determined from 5.0 nM to 1.0 µM with a detection limit of 2.4 nM. Because of the rapid kinetics of Fenton reaction and high specificity for H2O2, the proposed method meets the requirement for real applications. The feasibility of Fc@MSN-FDNA/PTAD for in vivo applications is demonstrated for fluorescence imaging of exogenous and endogenous H2O2 in cells and mice. We expect that this work will not only contribute to the H2O2-releated studies but also open up a new way to exploit in vivo Fenton reaction for biochemical research.
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Compostos Ferrosos/química , Fluorescência , Peróxido de Hidrogênio/análise , Ferro/química , Animais , Linhagem Celular Tumoral , Compostos Ferrosos/síntese química , Células HEK293 , Células HeLa , Humanos , Peróxido de Hidrogênio/síntese química , Peróxido de Hidrogênio/química , Metalocenos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Neoplasias Experimentais/química , EspectrofotometriaRESUMO
In a field-based trial among military trainees, personal hygiene measures, including chlorhexidine (CHG) body wash, did not prevent overall and methicillin-resistant Staphylococcus aureus (MRSA) skin and soft-tissue infections (SSTI). We conducted a secondary analysis of anterior nares cultures obtained during the trial to evaluate the impact of hygiene measures on Staphylococcus aureus colonization. A cluster-randomized trial for SSTI prevention was conducted among U.S. Army infantry trainees from May 2010 to January 2012. There were three study groups with incrementally increasing education- and hygiene-based components: standard (S), enhanced standard (ES), and CHG. Anterior nares cultures were obtained from participants to determine the prevalence of S. aureus colonization. A total of 1,706 participants (469 S, 597 ES, and 640 CHG) without SSTI were included in the colonization analysis. Of those randomized to the CHG group, 360 (56.3%) reported frequent use of body wash. Frequent use of body wash had no effect on overall S. aureus colonization (53.3% versus 56.8% among infrequent/nonusers; P=0.25). MRSA colonization prevalence was marginally lower among frequent users (2.5% versus 4.7%; P=0.07). In multivariable analysis, the odds of MRSA colonization were lower among frequent users (odds ratio [OR], 0.36; 95% confidence interval [CI], 0.16 to 0.77). This CHG-associated reduction was not observed when comparing colonization with USA300 to that with non-USA300 types (OR, 0.59; 95% CI, 0.06 to 5.76). Frequent use of CHG body wash was associated with a reduction in MRSA nasal colonization among high-risk military trainees. Topical chlorhexidine may contribute to MRSA SSTI prevention by reducing colonization. However, further studies evaluating the pathogenesis of SSTI are needed. (This study has been registered at ClinicalTrials.gov under registration no. NCT01105767).
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Anti-Infecciosos Locais/uso terapêutico , Clorexidina/uso terapêutico , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Adolescente , Adulto , Feminino , Humanos , Masculino , Militares/estatística & dados numéricos , Infecções dos Tecidos Moles/prevenção & controle , Infecções Cutâneas Estafilocócicas/prevenção & controle , Adulto JovemRESUMO
We propose and demonstrate a passively Q-switched 1900-nm thulium all-fiber laser using the mode-field-area mismatch method. A thulium fiber laser was core-pumped at 1590 nm and saturable-absorber Q-switched at 1900 nm through the use of a thulium saturable absorber fiber that had a relatively smaller mode field area than the gain medium. Sequential pulsing with a pulse energy of 12 µJ and a pulse duration of 160 ns was obtained. The pulse repetition rate was increased linearly with the applied pump power. With a pump power of 4.5 W, an average output power of 0.61 W and a pulse repetition rate of 50.7 kHz were achieved.
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Hedgehog (Hh) signaling relies on the primary cilium, a cell surface organelle that serves as a signaling hub for the cell. Using proximity labeling and quantitative proteomics, we identify Numb as a ciliary protein that positively regulates Hh signaling. Numb localizes to the ciliary pocket and acts as an endocytic adaptor to incorporate Ptch1 into clathrin-coated vesicles, thereby promoting Ptch1 exit from the cilium, a key step in Hh signaling activation. Numb loss impedes Sonic hedgehog (Shh)-induced Ptch1 exit from the cilium, resulting in reduced Hh signaling. Numb loss in spinal neural progenitors reduces Shh-induced differentiation into cell fates reliant on high Hh activity. Genetic ablation of Numb in the developing cerebellum impairs the proliferation of granule cell precursors, a Hh-dependent process, resulting in reduced cerebellar size. This study highlights Numb as a regulator of ciliary Ptch1 levels during Hh signal activation and demonstrates the key role of ciliary pocket-mediated endocytosis in cell signaling.
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Cerebelo , Cílios , Proteínas Hedgehog , Proteínas do Tecido Nervoso , Receptor Patched-1 , Transdução de Sinais , Proteínas Hedgehog/metabolismo , Proteínas Hedgehog/genética , Cílios/metabolismo , Animais , Receptor Patched-1/metabolismo , Receptor Patched-1/genética , Camundongos , Proteínas do Tecido Nervoso/metabolismo , Proteínas do Tecido Nervoso/genética , Cerebelo/metabolismo , Proteínas de Membrana/metabolismo , Proteínas de Membrana/genética , Humanos , Endocitose , Diferenciação Celular , Proliferação de Células , Células-Tronco Neurais/metabolismo , Células-Tronco Neurais/citologia , Camundongos KnockoutRESUMO
ObjectiveThe present study aims to examine the impacts of a mandatory physical activity (PA) course on exercise motivation among predominately Hispanic college students. The course was designed based on the Self-Determination Theory to increase students' PA motivation. Methods: A total of 383 college students (nmales=126; nfemales=257; Mage=19.6; 67.6% Hispanic/Latino[a]) participated in the course and completed the Behavioral Regulation to Exercise Questionnaire-2 at the beginning (pretest) and the end of the course (post-test). This questionnaire measured five motivation constructs: amotivation, intrinsic motivation, extrinsic motivation, introjected regulation, and identified regulation. Results: Findings showed significant increases from pretest to post-test in all five motivation constructs (ps < 0.01). Conclusions: Although the mandatory PA curriculum successfully increased the intrinsic motivation, extrinsic motivation, introjected regulation, and identified regulation among college students, amotivation was also increased. These outcomes suggested some positive impacts on Hispanic college students' motivation to participate in PA. Findings can assist researchers and educators in developing, implementing, and evaluating required PA courses in colleges and universities.