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1.
AIDS Care ; 29(8): 966-973, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28276255

RESUMEN

African-American females in the U.S. are disproportionately affected by HIV/AIDS, and a large majority of new infections in this population are attributed to heterosexual contact. Risk factors include substance abuse, lack of knowledge about male partners' possible HIV infection risk, incarceration, disruptions of social networks, and intimate partner violence. This study assessed the effects of a comprehensive, evidence-based prevention intervention, Creating Lasting Family Connections (CLFC) that was implemented with sensitivity to African-American females, using a quasi-experimental design. The CLFC program was implemented with 175 women and their results were compared to a convenience sample of 44 women who were similar on background characteristics. Results showed significant (p < .05, two-tailed) increases in the proportion of individuals getting HIV tested and getting the results from these tests, a larger decrease in intimate partner abuse within the past three months, and larger increases in three relationship skills (emotional expression, interpersonal skills, and relationship satisfaction) relative to the comparison group.


Asunto(s)
Negro o Afroamericano/psicología , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Relaciones Interpersonales , Maltrato Conyugal/prevención & control , Trastornos Relacionados con Sustancias/prevención & control , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Adolescente , Adulto , Negro o Afroamericano/educación , Femenino , Infecciones por VIH/etnología , Infecciones por VIH/etiología , Infecciones por VIH/psicología , Heterosexualidad , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Asunción de Riesgos , Parejas Sexuales , Trastornos Relacionados con Sustancias/etnología , Estados Unidos , Adulto Joven
2.
Foodborne Pathog Dis ; 14(9): 531-536, 2017 09.
Artículo en Inglés | MEDLINE | ID: mdl-28696788

RESUMEN

Studies indicate that persistent Salmonella colonization occurs in poultry that are infected early in life, leading to both food safety and public health concerns. Development of improved preharvest Salmonella management strategies is needed to reduce poultry product contamination. The objective of this study was to evaluate the efficacy of a product containing medium chain fatty acids (MCFA) for reducing early Salmonella colonization in turkey poults. Day-of-hatch turkeys were provided a standard starter diet supplemented with MCFA at 0 (negative and positive controls), 1.5, 3, 4.5, or 6 lbs/ton of feed. Positive control and MCFA treated birds were also crop-gavaged with 108 colony forming units (CFU) of bioluminescent Salmonella Typhimurium. Gastrointestinal tissue samples were collected at 3 days postinoculation for bioluminescence imaging (Meckel's diverticulum to the cloaca) and selective enumeration (cecal contents). Quantification of bioluminescence indicated that the 4.5 and 6 lbs/ton MCFA groups had significantly less colonization than the positive control group (p = 0.0412 and p < 0.0001, respectively). Similarly, significantly lower numbers (1-log10 CFU/g reduction) of Salmonella were observed in the ceca of the 6 lbs/ton MCFA group compared to the positive control group (p = 0.0153). These findings indicate that incorporation of MCFA in turkey diets can significantly reduce early Salmonella colonization. In addition, this study highlights the utility of bioluminescence imaging as a screening methodology for assessing the efficacy of treatments that may reduce Salmonella in poultry.


Asunto(s)
Suplementos Dietéticos , Ácidos Grasos/administración & dosificación , Contaminación de Alimentos/prevención & control , Enfermedades de las Aves de Corral/prevención & control , Salmonelosis Animal/prevención & control , Salmonella typhimurium/aislamiento & purificación , Alimentación Animal/análisis , Animales , Dieta/veterinaria , Femenino , Inocuidad de los Alimentos , Tracto Gastrointestinal/citología , Tracto Gastrointestinal/microbiología , Humanos , Mediciones Luminiscentes/veterinaria , Enfermedades de las Aves de Corral/microbiología , Distribución Aleatoria , Salmonelosis Animal/microbiología , Salmonella typhimurium/crecimiento & desarrollo , Pavos
3.
Analyst ; 139(6): 1292-302, 2014 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-24358459

RESUMEN

This review covers the latest developments and applications of porous layer open tubular columns in capillary liquid chromatography. Here, the authors provide a concise background on the fundamentals of porous layer open tubular columns, their fabrication and application. Over the past two decades, growing interest in the areas of proteomics and hyphenated LC-MS techniques have played a large part in the development of porous layer structures within capillary formats due to their high permeability, excellent efficiency and exceptional peak capacity. This review gives a brief overview of open tubular columns in general, however, it focuses predominantly on the applications of covalently bonded porous layer open tubular columns in liquid chromatography. Open tubular columns containing non-bonded or electrostatically attached layers will not be discussed in detail.

4.
Analyst ; 138(9): 2540-5, 2013 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-23397575

RESUMEN

A technique for the in-process measurement of polymer stationary phase growth inside fused silica capillaries during the fabrication of monolithic porous layer open tubular (monoPLOT) columns is presented. In this work, capacitively coupled contactless conductivity detection (C4D) was applied as an online measurement tool for porous polymer layer growth within fused silica capillaries. The relationship between effective capillary diameter and C4D response was investigated for two polymers, butyl methacrylate-ethylene dimethacrylate (BuMA-EDMA) and polystyrene-divinylbenzene (PS-DVB) over a range of capillary diameters and layer thicknesses. The described technique can be used with both thermal and photo-initiated approaches for monoPLOT fabrication and provides an accurate, real-time measurement of the porous layer growth within the capillary, which should vastly improve column-to-column reproducibility. The technique was shown to be very precise, with a measured %RSD < 10%.

5.
Fam Process ; 52(3): 477-98, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24033244

RESUMEN

Divorce proportions are currently high in the US and they are even higher among those who are incarcerated with substance abuse problems. Although much research has examined marital interventions, only two studies have examined marital interventions with prison populations. There is some empirical evidence that incarcerated couples benefit from traditional marital therapy (O'Farrell and Fals-Stewart, 1999, Addictions: A comprehensive guidebook, New York, Oxford University Press). An adaptation of the evidence-based Creating Lasting Family Connections program was implemented with 144 married couples, where one spouse was incarcerated, in a southern state with particularly high divorce and incarceration proportions. Results suggested that married men exposed to the program had larger improvements in some relationship skills relative to a convenience sample of men not so exposed. Both husbands and wives exposed to the program exhibited similar and significant increases in relationship skills. The results were comparable to a Prevention and Relationship Enhancement Program adaptation for inmates. The implications of the findings for prevention practitioners are discussed.


Asunto(s)
Relaciones Familiares , Terapia Conyugal/métodos , Matrimonio/psicología , Prisioneros/psicología , Socialización , Adulto , Comunicación , Divorcio/prevención & control , Divorcio/psicología , Tráfico de Drogas/prevención & control , Tráfico de Drogas/psicología , Femenino , Estudios de Seguimiento , Humanos , Kentucky , Masculino , Negociación , Evaluación de Procesos y Resultados en Atención de Salud , Satisfacción Personal , Factores Socioeconómicos , Trastornos Relacionados con Sustancias/psicología , Trastornos Relacionados con Sustancias/rehabilitación , Encuestas y Cuestionarios
6.
Life (Basel) ; 13(5)2023 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-37240795

RESUMEN

The search for life on other planets relies on the detection of biosignatures of life. Many macromolecules have been suggested as potential targets, among which are proteins that are considered vital components of life due to their essential roles in forming cellular structures, facilitating cellular communication and signaling, and catalyzing metabolic reactions. In this context, accurate quantification of protein signatures in soil would be advantageous, and while several proposed methods exist, which are limited by their sensitivity and specificity, their applicability needs further testing and validation. To this aim, we optimized a Bradford-based assay with high sensitivity and reproducibility and a simple protocol to quantify protein extracted from a Martian soil simulant. Methods for protein spiking, extraction, and recovery were optimized, using protein standards and bacterial proteins as representative models. The proposed method achieved high sensitivity and reproducibility. Taking into account that life remains could exist on the surface of Mars, which is subjected to UV radiation, a simulation of UV exposure was performed on a spiked soil simulant. UV radiation degraded the protein spike, thus highlighting the importance of searching for the remaining signal from degraded proteins. Finally, the applicability of the method was explored in relation to the storage of the reagent which was stable even up to 12 months, thus making its application possible for future planetary exploration missions.

7.
Materials (Basel) ; 16(23)2023 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-38068036

RESUMEN

This article proposes a generalizable, data-driven framework for qualifying laser powder bed fusion additively manufactured parts using part-specific in situ data, including powder bed imaging, machine health sensors, and laser scan paths. To achieve part qualification without relying solely on statistical processes or feedstock control, a sequence of machine learning models was trained on 6299 tensile specimens to locally predict the tensile properties of stainless-steel parts based on fused multi-modal in situ sensor data and a priori information. A cyberphysical infrastructure enabled the robust spatial tracking of individual specimens, and computer vision techniques registered the ground truth tensile measurements to the in situ data. The co-registered 230 GB dataset used in this work has been publicly released and is available as a set of HDF5 files. The extensive training data requirements and wide range of size scales were addressed by combining deep learning, machine learning, and feature engineering algorithms in a relay. The trained models demonstrated a 61% error reduction in ultimate tensile strength predictions relative to estimates made without any in situ information. Lessons learned and potential improvements to the sensors and mechanical testing procedure are discussed.

8.
Anal Chem ; 84(7): 3465-72, 2012 Apr 03.
Artículo en Inglés | MEDLINE | ID: mdl-22364508

RESUMEN

An automated column fabrication technique that is based on a ultraviolet (UV) light-emitting diode (LED) array oven, and provides precisely controlled "in-capillary" ultraviolet (UV) initiated polymerization at 365 nm, is presented for the production of open tubular monolithic porous polymer layer capillary (monoPLOT) columns of varying length, inner diameter (ID), and porous layer thickness. The developed approach allows the preparation of columns of varying length, because of an automated capillary delivery approach, with precisely controlled and uniform layer thickness and monolith morphology, from controlled UV power and exposure time. The relationships between direct exposure times, intensity, and layer thickness were determined, as were the effects of capillary delivery rate (indirect exposure rate), and multiple exposures on the layer thickness and axial distribution. Layer thickness measurements were taken by scanning electron microscopy (SEM), with the longitudinal homogeneity of the stationary phase confirmed using scanning capacitively coupled contactless conductivity detection (sC(4)D). The new automated UV polymerization technique presented in this work allows the fabrication of monoPLOT columns with a very high column-to-column production reproducibility, displaying a longitudinal phase thickness variation within ±0.8% RSD (relative standard deviation).

9.
Subst Use Misuse ; 47(12): 1339-48, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22943304

RESUMEN

This article presents results from a study of a home environmental strategy (HES) designed to reduce availability of harmful legal products (HLPs) in the home that can be used by youth to get high. HLPs include inhalants, prescription and nonprescription drugs, and household products that can be ingested to get high. Availability is one of the most consistent predictors of substance use among youth. Parents of 5th- to 7th-grade students in four Alaskan communities participated in telephone interviews as part of a larger study of a multicomponent community prevention model (CPM) that included a HES. The strategy was designed to encourage parents to reduce availability of HLPs by removing them from the home, and by locking up and monitoring the supplies of HLPs in the home. Data from 402 parents at Wave 1 and 371 parents at Wave 2 were analyzed using hierarchical non-Linear modeling (HNLM). Results show there was a significant decrease in HLPs in the home from Wave 1 to Wave 2, mostly inhalants and prescription and nonprescription drugs. Parents also reported a significant increase in locking up prescription and nonprescription drugs in the home. Parents' direct exposure to the HES was marginally associated with the change over time in HLP availability in the home. Indirect exposure through others and media was not associated with this change. Study lessons learned and conclusions are highlighted.


Asunto(s)
Reducción del Daño , Productos Domésticos/provisión & distribución , Medicamentos sin Prescripción/provisión & distribución , Medicamentos bajo Prescripción/provisión & distribución , Trastornos Relacionados con Sustancias/prevención & control , Alaska , Niño , Recolección de Datos , Productos Domésticos/efectos adversos , Vivienda , Humanos , Medicamentos sin Prescripción/efectos adversos , Mal Uso de Medicamentos de Venta con Receta , Medicamentos bajo Prescripción/efectos adversos , Seguridad
10.
Subst Use Misuse ; 46(13): 1604-12, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21899434

RESUMEN

Data were collected from samples of youth (ages 11-18; N = 38,268) and young 10 adults (ages 18-24; N = 602) across 30 Tennessee counties using surveys and telephone interviews conducted in 2006-2008. Data were analyzed using hierarchical nonlinear modeling to determine: (1) which risk and protective factors predicted alcohol and marijuana use, and (2) whether predictors differed as a function of developmental period. Findings provide preliminary evidence that prevention efforts need to take into consideration the changing environment and related influences as youth age, especially as they move from a more protected community environment to one where they live somewhat independently. Implications and limitations are discussed.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Encuestas Epidemiológicas/estadística & datos numéricos , Fumar Marihuana/epidemiología , Adolescente , Factores de Edad , Niño , Femenino , Encuestas Epidemiológicas/métodos , Humanos , Masculino , Dinámicas no Lineales , Factores de Riesgo , Tennessee/epidemiología , Adulto Joven
11.
Eur J Clin Pharmacol ; 66(1): 67-76, 2010 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-19756558

RESUMEN

PURPOSE: It is likely that the thrombopoietin receptor agonist eltrombopag will be administered concomitantly with other medications in the treatment of thrombocytopenia. Therefore the potential for eltrombopag to interact with cytochrome P450 activity was investigated. METHODS: Twenty-four healthy men received eltrombopag 75 mg/day on days 3-9, midazolam 5 mg (a probe for CYP3A4) on days 1 and 8 and a probe cocktail on days 2 and 9 that included caffeine 100 mg (CYP1A2), flurbiprofen 50 mg (CYP2C9) and omeprazole 20 mg (CYP2C19). RESULTS: Midazolam pharmacokinetic parameters were comparable before and after eltrombopag administration; geometric least squares (GLS) mean ratio (90% confidence intervals, CI) area under the curve from zero to infinity (AUC(0-infinity)) was 1.03 (0.94,1.12) and maximum plasma concentration (C(max)) was 0.98 (0.86,1.07). Metabolic indices for other CYP isozymes were also equivalent before and after eltrombopag. GLS mean ratio (90% CI) for the paraxanthine:caffeine concentration ratio at 8 h postdose was 0.97 (0.92,1.03), for conjugated + unconjugated and unconjugated 4-hydroxy-flurbiprofen recovery in urine over 0-8 h was 0.95 (0.93,0.97) and 0.93 (0.88,0.98), respectively, and for the plasma omeprazole:5-hydroxyomeprazole concentration ratio at 2- and 3-h postdose was 1.00 (0.93,1.08) and 1.02 (0.88,1.18), respectively. CONCLUSION: Once-daily administration of eltrombopag 75 mg for 7 days did not alter CYP3A4, CYP1A2, CYP2C9 or CYP2C19 activity in healthy volunteers.


Asunto(s)
Benzoatos/farmacocinética , Sistema Enzimático del Citocromo P-450/metabolismo , Hidrazinas/farmacocinética , Preparaciones Farmacéuticas/metabolismo , Pirazoles/farmacocinética , Receptores de Trombopoyetina/agonistas , Administración Oral , Adulto , Área Bajo la Curva , Hidrocarburo de Aril Hidroxilasas/metabolismo , Benzoatos/administración & dosificación , Cafeína/administración & dosificación , Cafeína/metabolismo , Cafeína/farmacocinética , Citocromo P-450 CYP1A2/metabolismo , Citocromo P-450 CYP2C19 , Citocromo P-450 CYP2C9 , Citocromo P-450 CYP3A/metabolismo , Interacciones Farmacológicas , Flurbiprofeno/administración & dosificación , Flurbiprofeno/metabolismo , Flurbiprofeno/farmacocinética , Humanos , Hidrazinas/administración & dosificación , Isoenzimas/metabolismo , Masculino , Midazolam/administración & dosificación , Midazolam/metabolismo , Midazolam/farmacocinética , Omeprazol/administración & dosificación , Omeprazol/metabolismo , Omeprazol/farmacocinética , Preparaciones Farmacéuticas/administración & dosificación , Pirazoles/administración & dosificación
12.
Prev Sci ; 11(3): 275-86, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20358287

RESUMEN

This study assesses the implementation quality of Think Smart, a school-based drug prevention curriculum that was designed to reduce use of harmful legal products (HLPs; e.g., inhalants and over-the-counter drugs), alcohol, tobacco, and other drugs among 5th- and 6th-grade students in frontier Alaska. Participating in the study were eight communities that took part in a larger randomized control trial to assess the short-term effects of the Think Smart curriculum. Video-recorded observations of the 12 core and 3 booster lessons were conducted in 20 classrooms. Ninety-five sessions were randomly selected from 228 usable videodiscs, and two pairs of researchers observed each video recording to code level of dosage, adherence to curriculum design, and teachers' delivery skills. Inter-rater reliability for all implementation quality measures was very high. An expert panel consisting of 16 scientists reviewed the results of the implementation study and concluded that the level of dosage and adherence to the curriculum design was at least as high as those yielded by similar studies. However, the panel assessed the delivery quality to be only marginal in comparison to results of other studies. The experts concluded that the implementation quality of the Think Smart curriculum was adequate even though the teachers' delivery skills were only marginal. A bootstrapping analysis, in which 1,000 samples were drawn for each implementation quality result, found the expert judgments to be reliable. The authors conclude that despite some limitations, video-recorded observations, as well as expert judgment, provide strong methodologies that should be considered for future implementation quality studies.


Asunto(s)
Curriculum , Servicios Preventivos de Salud/organización & administración , Población Rural , Instituciones Académicas , Trastornos Relacionados con Sustancias/prevención & control , Alaska , Niño , Humanos , Servicios Preventivos de Salud/normas , Evaluación de Programas y Proyectos de Salud
13.
Nat Commun ; 11(1): 2041, 2020 04 27.
Artículo en Inglés | MEDLINE | ID: mdl-32341341

RESUMEN

How complex, multi-component macromolecular machines evolved remains poorly understood. Here we reveal the evolutionary origins of the chemosensory machinery that controls flagellar motility in Escherichia coli. We first identify ancestral forms still present in Vibrio cholerae, Pseudomonas aeruginosa, Shewanella oneidensis and Methylomicrobium alcaliphilum, characterizing their structures by electron cryotomography and finding evidence that they function in a stress response pathway. Using bioinformatics, we trace the evolution of the system through γ-Proteobacteria, pinpointing key evolutionary events that led to the machine now seen in E. coli. Our results suggest that two ancient chemosensory systems with different inputs and outputs (F6 and F7) existed contemporaneously, with one (F7) ultimately taking over the inputs and outputs of the other (F6), which was subsequently lost.


Asunto(s)
Sustancias Macromoleculares/química , Methylococcaceae/fisiología , Pseudomonas aeruginosa/fisiología , Shewanella/fisiología , Vibrio cholerae/fisiología , Evolución Biológica , Quimiotaxis , Biología Computacional , Tomografía con Microscopio Electrónico , Escherichia coli/fisiología , Proteínas de Escherichia coli , Flagelos/fisiología , Gammaproteobacteria/fisiología , Genoma Bacteriano , Proteínas Quimiotácticas Aceptoras de Metilo/química , Filogenia
14.
Clin Ther ; 31(4): 764-76, 2009 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-19446149

RESUMEN

BACKGROUND: Eltrombopag is the first orally self-administered, small-molecule, nonpeptide thrombopoietin receptor agonist for the treatment of chronic idiopathic thrombocytopenic purpura. OBJECTIVE: The aim of these studies was to assess the effect of food and antacids on the pharmacokinetic and safety profiles of eltrombopag. METHODS: Two independent, single-dose, open-label, randomized-sequence, crossover studies of oral eltrombopag were conducted in healthy adult volunteers. The first study (study A) compared eltrombopag 50 mg (tablets or capsules) administered in the fasted state or tablets with a high-fat, high-calcium breakfast. The second study (study B) investigated eltrombopag tablets (75 mg) administered in the fasted state; immediately after a low-fat, low-calcium meal or a high-fat, low-calcium meal; 1 hour before a high-fat, low-calcium meal; or with an antacid containing aluminum hydroxide and magnesium carbonate. Vital signs were recorded and electrocardiogram and clinical laboratory tests were performed at screening, within 24 hours before and within 48 hours after each dose of study medication. Symptom assessment was performed and adverse events (AEs) were assessed previous to study drug administration through follow-up in terms of severity and relationship to study medication. RESULTS: In study A, 18 male subjects (mean age, 23.0 years; weight, 70.3 kg; white race, 94.4%) who received a high-fat, high-calcium breakfast had reduced bioavailability of eltrombopag in terms of AUC(0-infinity)) by 59% (geometric mean ratio [GMR], 0.41; 90% CI, 0.36-0.46) and C(max) by 65% (GMR, 0.35; 90% CI, 0.30-0.41) compared with subjects in a fasted state. In study B, the bioavailability in 26 subjects (14 male, 12 female; mean age, 35.6 years; weight, 76.0 kg; white race, 65.4%) was not significantly changed when administered with food that was low in calcium, despite the fat content (GMRs ranged from 0.87-1.03 for AUC(0-infinity) and 0.85-1.01 for C(max) across the 3 studied meals). Mean plasma AUC(0-infinity)) and C(max) values decreased by approximately 70% (GMR, 0.30; 90% CI, 0.24-0.36 for AUC(0-infinity)) and 0.24-0.38 for C(max)) when administered with a metal cation-containing antacid. No serious AEs were reported and all AEs were rated as mild to moderate in intensity. The most frequently reported AE was headache (study A, 6.3%; study B, 12.0%-29.2%). CONCLUSIONS: Concomitant administration of eltrombopag with high-calcium food or an antacid containing aluminum and magnesium was associated with significantly reduced systemic exposure, whereas low-calcium meals were not. A single dose of eltrombopag was generally well tolerated in these healthy volunteers.


Asunto(s)
Antiácidos/farmacología , Benzoatos/farmacocinética , Interacciones Alimento-Droga , Hidrazinas/farmacocinética , Pirazoles/farmacocinética , Administración Oral , Adulto , Hidróxido de Aluminio/farmacología , Área Bajo la Curva , Benzoatos/administración & dosificación , Benzoatos/efectos adversos , Disponibilidad Biológica , Calcio de la Dieta/farmacología , Cápsulas , Estudios Cruzados , Grasas de la Dieta/farmacología , Combinación de Medicamentos , Interacciones Farmacológicas , Femenino , Humanos , Hidrazinas/administración & dosificación , Hidrazinas/efectos adversos , Magnesio/farmacología , Masculino , Persona de Mediana Edad , Pirazoles/administración & dosificación , Pirazoles/efectos adversos , Receptores de Trombopoyetina/agonistas , Comprimidos , Adulto Joven
15.
J Healthc Inf Manag ; 23(4): 38-45, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19894486

RESUMEN

Effective clinical decision support (CDS) is essential for addressing healthcare performance improvement imperatives, but care delivery organizations (CDO) typically struggle with CDS deployment. Ensuring safe and effective medication delivery to patients is a central focus of CDO performance improvement efforts, and this article provides an overview of best-practice strategies for applying CDS to these goals. The strategies discussed are drawn from a new guidebook, co-published and co-sponsored by more than a dozen leading organizations. Developed by scores of CDS implementers and experts, the guidebook outlines key steps and success factors for applying CDS to medication management. A central thesis is that improving outcomes with CDS interventions requires that the CDS five rights be addressed successfully. That is, the interventions must deliver the right information, to the right person, in the right format, through the right channel, at the right point in workflow. This paper provides further details about these CDS five rights, and highlights other important strategies for successful CDS programs.


Asunto(s)
Sistemas de Apoyo a Decisiones Clínicas/normas , Sistemas de Medicación en Hospital/normas , Garantía de la Calidad de Atención de Salud , Humanos , Sistemas de Medicación en Hospital/organización & administración , Modelos Organizacionales , Resultado del Tratamiento , Estados Unidos
16.
J Clin Pharmacol ; 48(1): 108-16, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18094223

RESUMEN

The systemic exposure of fluticasone propionate with hydrofluoroalkane propellant compared with chlorofluoro-carbon propellant and the effect of fluticasone propionate hydrofluoroalkane on 24-hour urinary cortisol in children aged 4 to 11 years with asthma were evaluated. Study 1 was an open-label, 2-way crossover study in which 16 subjects were randomized to 7.5 days each of fluticasone propionate hydrofluoroalkane 88 mug twice a day or fluticasone propionate chlorofluorocarbon 88 mug twice a day. In study 2, 63 subjects received 13.5 days of placebo followed by 27.5 days of fluticasone propionate hydrofluoroalkane 88 mug twice a day. The main outcome measure for study 1 was the difference between fluticasone propionate hydrofluoroalkane and fluticasone propionate chlorofluorocarbon in fluticasone propionate AUC(last) (area under the plasma fluticasone propionate concentration-time curve from zero up to the last quantifiable plasma concentration), and for study 2, 24-hour overnight urinary cortisol excretion. In study 1, fluticasone propionate systemic exposure was significantly lower (55%) with hydrofluoroalkane metered dose inhaler compared with chlorofluorocarbon metered dose inhaler. Study 2 showed no statistically significant changes in 24-hour overnight urinary cortisol excretion and no relationship to fluticasone propionate systemic exposure at this dose. The results of these 2 studies showed that in children aged 4 to 11 years with asthma, fluticasone propionate hydrofluoroalkane has lower systemic exposure compared with chlorofluorocarbon and no hypothalamic-pituitary-adrenal axis effects as measured by 24-hour urinary cortisol excretion.


Asunto(s)
Androstadienos/uso terapéutico , Asma/tratamiento farmacológico , Hidrocarburos Fluorados/química , Hidrocortisona/orina , Administración por Inhalación , Propelentes de Aerosoles/química , Androstadienos/sangre , Androstadienos/farmacocinética , Antiasmáticos/administración & dosificación , Antiasmáticos/efectos adversos , Antiasmáticos/química , Área Bajo la Curva , Asma/metabolismo , Niño , Preescolar , Clorofluorocarburos/química , Tos/inducido químicamente , Estudios Cruzados , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Femenino , Fiebre/inducido químicamente , Fluticasona , Semivida , Cefalea/inducido químicamente , Humanos , Hidrocortisona/análogos & derivados , Masculino , Inhaladores de Dosis Medida , Náusea/inducido químicamente , Infecciones del Sistema Respiratorio/inducido químicamente
17.
Methods Enzymol ; 613: 349-383, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30509473

RESUMEN

Microbial methane utilization-a key node in the global carbon cycle-controls and often eliminates emission of methane into the atmosphere. The diversity and distribution of microbes capable of methane oxidation is astounding. However, from a biochemical point of view, only a very narrow set of unique enzymes underlies their metabolic capabilities. Despite this restriction, the successful integration of the enzymes into nonmethanotrophs, if judged by the ability of the trait to grow on methane, remains to be achieved. Failures and small victories with heterologous expression have highlighted a set of challenges linked to structure, compartmentalization, and regulation of the methanotrophic metabolic network. A better understanding of how these challenges are handled by cells of native methane-consuming bacteria is required. In this chapter we focus on key experimental aspects of working with native methanotrophic bacteria, including routine cultivation strategies, lab-scale bioreactor setups, genetic alteration, imaging, and basic -omic-level approaches.


Asunto(s)
Metano/metabolismo , Reactores Biológicos/microbiología , Methylococcaceae/metabolismo , Oxidación-Reducción
18.
J Evid Based Integr Med ; 23: 2515690X18801581, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30295047

RESUMEN

The purpose of the present study was to identify the factors that are the strongest predictors of intentions and use of integrative medicine approaches in clinical practice. Ajzen's theory of planned behavior was used to guide our examination of these questions. Health care professionals exposed to a Veterans Health Administration program (N = 288) who completed survey instruments prior to and immediately after the program and 3 months later were the participants for this study. Findings suggest that the theory of planned behavior performs reasonably well in explaining our data showing the integration of integrative medicine approaches into clinical practice. We found that self-efficacy to use integrative health approaches and perceived preparedness to discuss nonpharmaceutical approaches with patients were the strongest predictors of intentions to use integrative health approaches and self-reported change in clinical practice. The implications of these findings are discussed.


Asunto(s)
Personal de Salud/psicología , Medicina Integrativa/educación , Percepción , Adulto , Femenino , Personal de Salud/educación , Humanos , Intención , Masculino , Persona de Mediana Edad , Autoeficacia , Autoinforme , Encuestas y Cuestionarios
19.
Glob Adv Health Med ; 7: 2164957X18757463, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29468093

RESUMEN

BACKGROUND: Although studies of health coaching for behavior change in chronic disease prevention and management are increasing, to date no studies have reported on what concepts and skills providers integrate into their clinical practice following participation in health coaching courses. The purpose of this qualitative study was to assess Veterans Health Administration (VHA) providers' perceptions of the individual-level and system-level changes they observed after participating with colleagues in a 6-day Whole Health Coaching course held in 8 VHA medical centers nationwide. METHODS: Data for this study were from the follow-up survey conducted with participants 2 to 3 months after completing the training. A total of 142 responses about individual-level changes and 99 responses about system-level changes were analyzed using content analysis. RESULTS: Eight primary themes emerged regarding individual changes, including increased emphasis on Veterans' values, increased use of listening and other specific health coaching skills in their clinical role, and adding health coaching to their clinical practice.Four primary themes emerged regarding system-level changes, including leadership support, increased staff awareness/support/learning and sharing, increased use of health coaching skills or tools within the facility, and organizational changes demonstrating a more engaged workforce, such as new work groups being formed or existing groups becoming more active. CONCLUSIONS: Findings suggest that VHA providers who participate in health coaching trainings do perceive positive changes within themselves and their organizations. Health coaching courses that emphasize patient-centered care and promote patient-provider partnerships likely have positive effects beyond the individual participants that can be used to promote desired organizational change.

20.
Front Microbiol ; 9: 2735, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30542328

RESUMEN

Background: Rare Earth Elements (REEs) control methanol utilization in both methane- and methanol-utilizing microbes. It has been established that the addition of REEs leads to the transcriptional repression of MxaFI-MeDH [a two-subunit methanol dehydrogenase (MeDH), calcium-dependent] and the activation of XoxF-MeDH (a one-subunit MeDH, lanthanum-dependent). Both enzymes are pyrroquinoline quinone-dependent alcohol dehydrogenases and show significant homology; however, they display different kinetic properties and substrate specificities. This study investigates the impact of the MxaFI to XoxF switch on the behavior of metabolic networks at a global scale. Results: In this study we investigated the steady-state growth of Methylomicrobium alcaliphilum 20ZR in media containing calcium (Ca) or lanthanum (La, a REE element). We found that cells supplemented with La show a higher growth rate compared to Ca-cultures; however, the efficiency of carbon conversion, estimated as biomass yield, is higher in cells grown with Ca. Three complementary global-omics approaches-RNA-seq transcriptomics, proteomics, and metabolomics-were applied to investigate the mechanisms of improved growth vs. carbon conversion. Cells grown with La showed the transcriptional activation of the xoxF gene, a homolog of the formaldehyde-activating enzyme (fae2), a putative transporter, genes for hemin-transport proteins, and nitrate reductase. In contrast, genes for mxaFI and associated cytochrome (mxaG) expression were downregulated. Proteomic profiling suggested additional adjustments of the metabolic network at the protein level, including carbon assimilation pathways, electron transport systems, and the tricarboxylic acid (TCA) cycle. Discord between gene expression and protein abundance changes points toward the possibility of post-transcriptional control of the related systems including key enzymes of the TCA cycle and a set of electron-transport carriers. Metabolomic data followed proteomics and showed the reduction of the ribulose-monophosphate (RuMP) pathway intermediates and the increase of the TCA cycle metabolites. Conclusion: Cells exposed to REEs display higher rates of growth but have lower carbon conversion efficiency compared to cells supplemented with Ca. The most plausible explanation for these physiological changes is an increased conversion of methanol into formate by XoxF-MeDH, which further stimulates methane oxidation but limits both the supply of reducing power and flux of formaldehyde into the RuMP pathway.

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