RESUMO
Virulent Newcastle disease viruses (NDV) have been present in Mexico since 1946, and recently, multiple outbreaks have been reported in the country. Here, we characterized eleven NDV isolated from apparently healthy wild birds and backyard chickens in three different locations of Jalisco, Mexico in 2017. Total RNA from NDV was reverse-transcribed, and 1285 nucleotides, which includes 3/4 of the fusion gene, was amplified and sequenced using a long-read MinION sequencing method. The sequences were 99.99-100% identical to the corresponding region obtained using the Illumina MiSeq. Phylogenetic analysis using MinION sequences demonstrated that nine virulent NDV from wild birds belonged to sub-genotypes Vc and VIn, and two backyard chicken isolates were of sub-genotype Vc. The sub-genotype Vc viruses had nucleotide sequence identity that ranged from 97.7 to 98% to a virus of the same sub-genotype isolated from a chicken in Mexico in 2010. Three viruses from pigeons had 96.3-98.7% nucleotide identity to sub-genotype VIn pigeon viruses, commonly referred to as pigeon paramyxovirus, isolated in the USA during 2000-2016. This study demonstrates that viruses of sub-genotype Vc are still present in Mexico, and the detection of this sub-genotype in both chickens and wild birds suggests that transmission among these species may represent a biosecurity risk. This is the first detection and complete genome sequencing of genotype VI NDV from Mexico. In addition, the utilization of an optimized long-read sequencing method for rapid virulence and genotype identification using the Oxford nanopore MinION system is demonstrated.
Assuntos
Aves/virologia , Galinhas/virologia , Vírus da Doença de Newcastle/isolamento & purificação , Animais , Animais Selvagens/virologia , Columbidae/virologia , Genoma Viral , Genótipo , México , Vírus da Doença de Newcastle/classificação , Vírus da Doença de Newcastle/genética , Filogenia , Sequenciamento Completo do GenomaRESUMO
Inhibition of return (IOR) refers to slowed reaction times (RTs) when a target appears in the same rather than a different location as a preceding stimulus. The present study tested the hypothesis that IOR reflects a motor bias rather than a perceptual deficit. Two signals (S1 and S2) were presented on each trial. These signals were peripheral onsets or central arrows. The responses required to S1 and S2 were, respectively, no response-manual, manual-manual, saccadic-manual, no response-saccadic, manual-saccadic, and saccadic-saccadic. Uniting perceptual and motor bias views of IOR, the results demonstrated inhibition for responding to (a) peripheral signals when the eyes remained fixed (slowed visual processing) and (b) both peripheral and central signals when the eyes moved (slowed motor production). However, the results also emphasized that the nature of IOR depends fundamentally on the response modality used to reveal its influence.
Assuntos
Percepção Visual/fisiologia , Adulto , Feminino , Fixação Ocular/fisiologia , Humanos , Masculino , Distribuição Aleatória , Tempo de Reação , Movimentos Sacádicos/fisiologiaRESUMO
Native American physicians constitute less than 0.5% of the overall U.S. physician supply. Little is known about their professional practices in terms of location, specialty, practice setting, and amount of time allocated to professional activities. The Association of American Indian Physicians, AAIP, is a professional organization of physicians, each of whom is at least one-eighth American Indian. A survey of its 109 members in 1987 elicited 84 responses. The findings indicate that most respondents were American Indians to less than one-quarter degree, and although they were practicing in locations where large numbers of Indian people reside, 65% reported that less than 25% of their direct patient care activity involved Indian patients. In regard to Native American physicians, the survey findings and other published information contradict the view that minority medical practitioners are more likely than their white counterparts to practice in areas where large numbers of their respective minority populations reside and will, therefore, provide medical care to significant numbers of their respective minority populations.
Assuntos
Indígenas Norte-Americanos , Prática Profissional , Adulto , Feminino , Mão de Obra em Saúde , Humanos , Masculino , Especialização , Inquéritos e Questionários , Estados UnidosRESUMO
Although bleeding complications are relatively common in patients with chronic lymphocytic leukemia, they tend to be related to thrombocytopenia or an acquired clotting factor inhibitor. Chronic lymphocytic leukemia-associated thrombocytopenia, which may also contribute to the hemorrhagic risk, is generally caused by decreased production and immune-mediated destruction. This is the case of a 56-year-old man with longstanding chronic lymphocytic leukemia who developed thrombocytopenia (platelet counts of approximately 50,000/microL) with an associated abnormal platelet morphology. Although the patient did not suffer clinically significant bleeding, several tests of platelet function were grossly abnormal. Electron microscopic examination of the platelets revealed virtually complete absence of dense granules. Platelet aggregation did not occur with adenosine diphosphate (10 microM), collagen (2 micrograms/mL), or ristocetin (1 mg/mL). Doubling the agonist concentrations produced only minimal agglutination with ristocetin. The bleeding time was mildly prolonged at 9.0 and 10.5 minutes. Von Willebrand antigen and ristocetin cofactor levels were normal. Collagen-induced adenosine triphosphate secretion was less than 10% that of a matched normal control. In contrast, platelet force development was virtually normal, reaching 4,800 dynes at 1,200 seconds compared with 5,800 dynes for the healthy control. The patient's clots demonstrated enhanced clot modulus 44,000 dynes/cm2 versus 22,400 dynes/cm2 for the healthy control. The latter finding was primarily because of high fibrinogen concentration. This third report of storage pool disease in a patient with chronic lymphocytic leukemia demonstrates that dense granule release is not required for normal platelet-mediated force development.
Assuntos
Trifosfato de Adenosina/metabolismo , Plaquetas/metabolismo , Leucemia Linfocítica Crônica de Células B/sangue , Agregação Plaquetária , Deficiência do Pool Plaquetário/sangue , Plaquetas/ultraestrutura , Hemorragia/etiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The use of primary health care services by urban American Indians and their health problems were compared with national and regional data compiled by the Indian Health Service, Bureau of the Census, Office of Technology Assessment, and the National Center for Health Statistics. A survey of medical records was conducted at urban Indian health clinics, one located in Oklahoma City, OK, and the other in Wichita, KS. Health records of 500 patients from each clinic were reviewed. Information was gathered concerning reasons for visit, diagnoses, and number of physician visits. In addition, predisposing variables and enabling variables from each patient's registration form were reviewed. According to the data collected in the survey, the clientele of these urban Indian clinics have annual incomes well below the average income of the general population and the overall American Indian population in these cities. Their lack of health insurance and low education levels were also evident. Use of primary health services was below that of the general population, and lower, but relatively close, to use levels of American Indians residing in rural Oklahoma and Kansas. Information on health problems indicated high levels of diabetes mellitus and hypertension among the middle-age groups, and high levels of use by young women for prenatal care and contraception. The absence of systematically collected and comprehensive health and health care use information about urban American Indians, who now comprise more than half the U.S. American Indian population, and the limitations in the available information leave important questions unanswered. There are indications that large segments of urban Indian populations have difficulty obtaining primary and preventive health care services due to their general socioeconomic condition and the absence of the Indian Health Service in many urban areas.
Assuntos
Instituições de Assistência Ambulatorial/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde , Pesquisa sobre Serviços de Saúde , Nível de Saúde , Saúde , Indígenas Norte-Americanos , Adulto , Fatores Etários , Idoso , Estudos Transversais , Escolaridade , Feminino , Inquéritos Epidemiológicos , Humanos , Renda , Seguro Saúde , Kansas , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Oklahoma , Fatores Sexuais , Saúde da População UrbanaRESUMO
OBJECTIVE: The purpose of this study was to evaluate differences between American Indian and white adults in behavioral risk factors for chronic disease and injury. METHODS: Data were drawn from the 1992-1995 Behavioral Risk Factor Surveillance System, an ongoing telephone survey of health behaviors of adults. Prevalence estimates by sex were calculated for American Indian and white respondents in 15 states and the significance of their differences evaluated by chi-square tests. RESULTS: American Indians were found to be at significantly higher risk than whites for fair to poor general health status, medical cost difficulties, binge drinking, cigarette smoking, not always using safety belts, being diagnosed as diabetic, and obesity. CONCLUSIONS: To reduce the gap in behavioral risk factors between American Indians and whites, more resources need to be dedicated to American Indian health. Note. The term "American Indian" henceforth refers to those who identify themselves as American Indian or Alaska Native.
Assuntos
Comportamentos Relacionados com a Saúde/etnologia , Indígenas Norte-Americanos , Adolescente , Adulto , Alaska , Doença Crônica/epidemiologia , Feminino , Nível de Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Assunção de Riscos , Fatores Socioeconômicos , Estados UnidosRESUMO
In summary, factors to consider in treatment are (1) the patient's age; (2) the flexibility of the condition; (3) the severity of deformity; (4) the presence of equinus; (5) abnormal shoe wear; and (6) the symptoms. When a child presents with severe flexible flatfoot one should rule out an underlying neuromuscular disorder and perform a complete biomechanical evaluation to ascertain any rotational or angular conditions of the legs that might influence the treatment. If a child is in group 1 (ages 4 to 7), a Helfet heel seat with a medial plantar wedge is usually adequate treatment. In the group II (ages 8 to 12) adolescent with flexible flatfoot, more control of the calcaneal eversion is needed. This is obtained by using a device constructed from a plaster mold taken while the foot is in neutral position. This UCBL type of device must usually extend to the metatarsal heads and be elevated on the medial and lateral sides. The group III (ages 13 to 17) adolescent usually has the additional problem of a forefoot varus, which must be controlled using a forefoot post. It is also not unusual to have to add additional wedging inside the heel of the shoe to invert the heel.
Assuntos
Pé Chato/terapia , Adolescente , Criança , Pré-Escolar , Humanos , Aparelhos OrtopédicosRESUMO
We report the characterization of BMS-911543, a potent and selective small-molecule inhibitor of the Janus kinase (JAK) family member, JAK2. Functionally, BMS-911543 displayed potent anti-proliferative and pharmacodynamic (PD) effects in cell lines dependent upon JAK2 signaling, and had little activity in cell types dependent upon other pathways, such as JAK1 and JAK3. BMS-911543 also displayed anti-proliferative responses in colony growth assays using primary progenitor cells isolated from patients with JAK2(V617F)-positive myeloproliferative neoplasms (MPNs). Similar to these in vitro observations, BMS-911543 was also highly active in in vivo models of JAK2 signaling, with sustained pathway suppression being observed after a single oral dose. At low dose levels active in JAK2-dependent PD models, no effects were observed in an in vivo model of immunosuppression monitoring antigen-induced IgG and IgM production. Expression profiling of JAK2(V617F)-expressing cells treated with diverse JAK2 inhibitors revealed a shared set of transcriptional changes underlying pharmacological effects of JAK2 inhibition, including many STAT1-regulated genes and STAT1 itself. Collectively, our results highlight BMS-911543 as a functionally selective JAK2 inhibitor and support the therapeutic rationale for its further characterization in patients with MPN or in other disorders characterized by constitutively active JAK2 signaling.
Assuntos
Antineoplásicos/farmacologia , Compostos Heterocíclicos com 3 Anéis/farmacologia , Janus Quinase 2/antagonistas & inibidores , Inibidores de Proteínas Quinases/farmacologia , Antineoplásicos/química , Western Blotting , Proliferação de Células/efeitos dos fármacos , Perfilação da Expressão Gênica , Compostos Heterocíclicos com 3 Anéis/química , Humanos , Transtornos Mieloproliferativos/enzimologia , Transtornos Mieloproliferativos/patologia , Inibidores de Proteínas Quinases/químicaRESUMO
Systemic capillary leak syndrome, or the Clarkson syndrome, is an extremely rare condition in which increased capillary permeability results in a massive shift of fluid into the extravascular space. This is followed rapidly by hypotensive shock, haemoconcentration, and, potentially, substantial oedema of the limbs resulting in an acute compartment syndrome. It is important for orthopaedic surgeons to be aware of this syndrome as our medical colleagues, who initially care for these patients, are less familiar with the diagnosis and the need for emergency management of the associated compartment syndrome should it develop. There have been fewer than 100 cases of this entity reported. This case report is the first to describe the subsequent development of a compartment syndrome in all four limbs. Clinical vigilance and continuous monitoring of intracompartmental pressure is necessary in these patients in order to help reduce limb-threatening complications.
Assuntos
Síndrome de Vazamento Capilar/complicações , Síndromes Compartimentais/etiologia , Biomarcadores/sangue , Síndrome de Vazamento Capilar/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Neoplasias Brônquicas , Leiomioma , Adolescente , Adulto , Neoplasias Brônquicas/diagnóstico por imagem , Neoplasias Brônquicas/patologia , Neoplasias Brônquicas/cirurgia , Criança , Pré-Escolar , Feminino , Humanos , Leiomioma/patologia , Leiomioma/cirurgia , Masculino , Pessoa de Meia-Idade , RadiografiaRESUMO
In conclusion, the use of nystatin for fungal prophylaxis in hematology/oncology/bone marrow transplantation patients appears to convey little or no benefit over no therapy. Nystatin treatment significantly reduced the frequency of multiple-site colonization and of persistently positive oropharyngeal cultures, but was not able to prevent the occurrence of disseminated fungal infections. Other antifungal agents (e.g., ketoconazole, fluconazole, itraconazole, oral or intravenous amphotericin B) may be of benefit. Studies comparing nystatin with other agents are available in the literature but are beyond the scope of this review.
Assuntos
Antifúngicos/uso terapêutico , Candidíase/prevenção & controle , Hospedeiro Imunocomprometido , Nistatina/uso terapêutico , Agranulocitose/complicações , Transplante de Medula Óssea/efeitos adversos , Candidíase/etiologia , Criança , Humanos , Leucemia/complicaçõesRESUMO
A real-time, object-oriented solution for displaying stimuli on Windows 95/98, MacOS and Linux platforms is presented. The program, written in C++, utilizes a special-purpose window class (GLWindow), OpenGL, and 32-bit graphics acceleration; it avoids display timing uncertainty by substituting the new window class for the default window code for each system. We report the outcome of tests for real-time capability across PC and Mac platforms running a variety of operating systems. The test program, which can be used as a shell for programming real-time experiments and testing specific processors, is available at http://www.cs.dal.ca/~macinnwj. We propose to provide researchers with a sense of the usefulness of our program, highlight the ability of many multitasking environments to achieve real time, as well as caution users about systems that may not achieve real time, even under optimal conditions.
Assuntos
Microcomputadores , Software , Humanos , Fatores de TempoRESUMO
Parallel findings in the adult children of alcoholics (ACOA) and child abuse literatures are integrated and extended by assessing long-term adjustment and childhood histories of parental alcoholism and sexual, physical, and emotional abuse in college students (N = 333). Abuse histories were most strongly related to adult symptom distress and social maladjustment. Parental alcoholism had no independent effects when controlling for abuse history. Parental alcoholism interacted with abuse history in relation to social adjustment, exacerbating the effects of emotional abuse. This study adds to a growing literature calling for more complex models of ACOA development that can account for the diversity of this population.
Assuntos
Alcoolismo/psicologia , Maus-Tratos Infantis/psicologia , Filho de Pais com Deficiência/psicologia , Desenvolvimento da Personalidade , Ajustamento Social , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologiaRESUMO
It is well to understand that the consequences of burnout due to work-related stress are usually quite serious. Yet, this kind of burnout can and should be prevented; if detected early, it is manageable. Organizations should take steps to identify their executives who are most susceptible to burnout and offer them a broad range of assistance. There are, after all, no more important resources than human resources, and this, of course, includes an organization's executive-level employees.
Assuntos
Esgotamento Profissional/prevenção & controle , Administradores de Instituições de Saúde/psicologia , Humanos , Gestão de Recursos Humanos/normas , Estresse Psicológico/etiologia , Estresse Psicológico/prevenção & controle , Estados UnidosRESUMO
The observations from this study seem to suggest that there are some correlations between education, experience, age, and sex on the level of preparedness in the practice domains identified. Specifically, this study finds that years of experience have a significant negative correlation with the practice domains of physical plant/building management, fiscal reimbursement, financial management, and overall preparedness in both Oklahoma and Connecticut respondents. Experience level further correlates negatively with all other practice domains (except licensing standards) in Oklahoma respondents. Education level, on the other hand, did not correlate with any practice domain (except licensing standards among Oklahoma respondents). Age correlated positively with financial management activities but only with Oklahoma respondents, while sex correlated positively with physical plant/building management (Oklahoma and Connecticut) and with financial management in Connecticut only. Sex, however, had a negative correlation with basic nursing activities among Connecticut respondents. This study suggests that the nursing home administrators from Connecticut in our study felt that they were more prepared in the practice domains identified as compared to those responding from Oklahoma. This can be attributed to the fact that Connecticut respondents had almost a 13 percent higher average of experience years. This was also demonstrated in the correlation table. Other factors such as sex, age at onset of administrator career, and educational level had no or very limited effect on the practice domains identified in the study (p greater than 0.05). This holds true for both Oklahoma and Connecticut respondents. Therefore, the hypothesis stating that education has a direct effect on job performance and preparedness of nursing home administrators does not hold true with this study. It is the years of experience that has a direct effect on performance and preparedness of nursing home administrators.
Assuntos
Atitude do Pessoal de Saúde , Administradores de Instituições de Saúde/normas , Casas de Saúde/organização & administração , Competência Profissional/estatística & dados numéricos , Autoavaliação (Psicologia) , Adulto , Fatores Etários , Connecticut , Escolaridade , Feminino , Administradores de Instituições de Saúde/educação , Administradores de Instituições de Saúde/estatística & dados numéricos , Humanos , Licenciamento , Masculino , Pessoa de Meia-Idade , Oklahoma , Fatores Sexuais , Inquéritos e Questionários , Fatores de TempoRESUMO
Intelligent behaviour requires self-control based on the consequences of actions. The countermanding task is designed to study self-control; it requires subjects to withhold planned movements in response to an imperative stop signal, which they can do with varying success. In humans, the medial frontal cortex has been implicated in the supervisory control of action. In monkeys, the supplementary eye field in the dorsomedial frontal cortex is involved in producing eye movements, but its precise function has not been clarified. To investigate the role of the supplementary eye field in the control of eye movements, we recorded neural activity in macaque monkeys trained to perform an eye movement countermanding task. Distinct groups of neurons were active after errors, after successful withholding of a partially prepared movement, or in association with reinforcement. These three forms of activation could not be explained by sensory or motor factors. Our results lead us to put forward the hypothesis that the supplementary eye field contributes to monitoring the context and consequences of eye movements.
Assuntos
Mapeamento Encefálico , Movimentos Oculares/fisiologia , Lobo Frontal/fisiologia , Animais , Fixação Ocular , Macaca mulatta , Macaca radiata , Masculino , Neurônios/fisiologia , Desempenho Psicomotor , Reforço Psicológico , Movimentos Sacádicos/fisiologiaRESUMO
Relative to when a fixated stimulus remains visible, saccadic latencies are facilitated when a fixated stimulus is extinguished simultaneously with or prior to the appearance of an eccentric auditory, visual, or combined visual-auditory target. In a study of nine human subjects, we determined whether such facilitation (the "gap effect") occurs equivalently for the disappearance of fixated auditory stimuli and fixated visual stimuli. In the present study, a fixated auditory (noise) stimulus remained present (overlap) or else was extinguished simultaneously with (step) or 200 msec prior to (gap) the appearance of a visual, auditory (tone), or combined visual-auditory target 10 degrees to the left or right of fixation. The results demonstrated equivalent facilitatory effects due to the disappearance of fixated auditory and visual stimuli and are consistent with the presumed role of the superior colliculus in the gap effect.
Assuntos
Estimulação Acústica , Fixação Ocular/fisiologia , Estimulação Luminosa , Desempenho Psicomotor/fisiologia , Movimentos Sacádicos/fisiologia , Colículos Superiores/fisiologia , Adulto , Percepção Auditiva , Humanos , Ruído , Tempo de Reação , Localização de Som , Percepção EspacialRESUMO
Orally administered salbutamol (8 mg every six hours) is a simple, acceptable and effective method of inhibiting labour. Of 208 patients, 89.4% had pregnancy prolonged for longer than two days. The pregnancy was prolonged for one week in 77.5%, and for two weeks in 66.8% of patients. Tremor and anxiety occurred in 68.3% of patients, and tachycardia greater than 110 beats per minute in 21.2%, but these proved tolerable if the patient was forwarned. Haemorrhages, both ante partum, and post partum, were apparently reduced. Glycosuria and pre-eclampsia were uncommon. Urinary oestriol levels were not significantly altered. Perinatal mortality was 58 per 1000 live and still births. The babies were active at delivery, but prone to hypothermia. The incidence of respiratory distress syndrome (4.1%) was low, particularly in babies born within four hours of the last salbutamol administration. Low Apgar scores were also uncommon in this group.
Assuntos
Albuterol/uso terapêutico , Trabalho de Parto Prematuro/tratamento farmacológico , Aborto Espontâneo/epidemiologia , Administração Oral , Albuterol/administração & dosagem , Albuterol/efeitos adversos , Índice de Apgar , Feminino , Humanos , Recém-Nascido , Gravidez , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologiaRESUMO
Saccadic reaction time (RT) is reduced when the fixation point is removed shortly before target onset. Although Tam and Stelmach (1993) argued that this gap effect could not be explained solely by the idea that fixation offset disengaged visual attention and preferred an explanation based on disengagement of the oculomotor system, they felt that they could not rule out a hybrid model in which both oculomotor and attentional disengagement contribute to the gap effect. Our analysis of the dual response experiment (Experiment 4), upon which this hybrid model was based, shows that manual and saccadic responses were likely compromised by a grouping or delay strategy and that subjects may not have been attending as instructed. On these grounds, we argue that Tam and Stelmach (1993), like Kingstone and Klein (1990; 1993a) provide no evidence that attentional disengagement contributes to the gap effect. An alternative proposal (Klein & Kingstone, 1993), that motor preparation and oculomotor disengagement combine additively to produce the gap effect, is consistent with the data from Tam and Stelmach's Experiments 1-3, is similar to the explanation that they prefer, and has been strongly supported when directly tested (Kingstone, Klein, & Taylor, 1994).