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INTRODUCTION: Person-centered analyses examined the relationship between social media use and depression over an 8-year period. The purpose was to examine the varying ways early social media use was associated with the development of depressive symptoms with a hypothesis that social media would not have a uniform association with depressive symptoms across adolescents. METHODS: Participants included 488 adolescents (52% female), living in the United States, who were surveyed once a year for 8 years (beginning in 2010 when the average age for participants was 13.33 years old). RESULTS: Longitudinal mixture regression was used to identify classes of adolescents representing unique ways their early social media use was related to the development of depressive symptoms over an 8-year period. Five classes were found representing unique ways social media use was related to depression. Findings suggest social media use does not impact all adolescents in the same way. Social media use was related to increased depression for adolescents with greater parental hostility, peer bullying, anxiety, reactivity to stressors, and lower parental media monitoring. In other instances, social media use was related to less depression or was unrelated to depression. CONCLUSIONS: By identifying which adolescents may be most at risk from social media use, health providers, schools, and caregivers can tailor interventions to fit the needs of each adolescent.
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Although performing aerial maneuvers can increase wave score and winning potential in competitive surfing, the critical features underlying successful aerial performance have not been systematically investigated. This study aimed to analyze highly skilled aerial maneuver performance and to identify the critical features associated with successful or unsuccessful landing. Using video recordings of the World Surf League's Championship Tour, every aerial performed during the quarterfinal, semifinal, and final heats from the 11 events in the 2015 season was viewed. From this, 121 aerials were identified with the Frontside Air (n = 15) and Frontside Air Reverse (n = 67) being selected to be qualitatively assessed. Using chi-squared analyses, a series of key critical features, including landing over the center of the surfboard (FS Air χ2 = 14.00, FS Air Reverse χ2 = 26.61; P < .001) and landing with the lead ankle in dorsiflexion (FS Air χ2 = 3.90, FS Air Reverse χ2 = 13.64; P < .05), were found to be associated with successful landings. These critical features help surfers land in a stable position, while maintaining contact with the surfboard. The results of this study provide coaches with evidence to adjust the technique of their athletes to improve their winning potential.
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Rendimiento Atlético/normas , Deportes/normas , Adulto , Atletas , Humanos , Masculino , Equilibrio Postural , Rango del Movimiento Articular , Grabación en Video , Adulto JovenRESUMEN
BACKGROUND: Thrombolysis can significantly reduce the burden of stroke but the time window for safe and effective treatment is short. In patients travelling to hospital via ambulance, the sending of a 'prealert' message can significantly improve the timeliness of treatment. OBJECTIVE: Examine the prevalence of hospital prealerting, the extent to which prealert protocols are followed and what factors influence emergency medical services (EMS) staff's decision to send a prealert. METHODS: Cohort study of patients admitted to two acute stroke units in West Midlands (UK) hospitals using linked data from hospital and EMS records. A logistic regression model examined the association between prealert eligibility and whether a prealert message was sent. In semistructured interviews, EMS staff were asked about their experiences of patients with suspected stroke. RESULTS: Of the 539 patients eligible for this study, 271 (51%) were recruited. Of these, only 79 (29%) were eligible for prealerting according to criteria set out in local protocols but 143 (53%) were prealerted. Increasing number of Face, Arm, Speech Test symptoms (1 symptom, OR 6.14, 95% CI 2.06 to 18.30, p=0.001; 2 symptoms, OR 31.36, 95% CI 9.91 to 99.24, p<0.001; 3 symptoms, OR 75.84, 95% CI 24.68 to 233.03, p<0.001) and EMS contact within 5â h of symptom onset (OR 2.99, 95% CI 1.37 to 6.50 p=0.006) were key predictors of prealerting but eligibility for prealert as a whole was not (OR 1.92, 95% CI 0.85 to 4.34 p=0.12). In qualitative interviews, EMS staff displayed varying understanding of prealert protocols and described frustration when their interpretation of the prealert criteria was not shared by ED staff. CONCLUSIONS: Up to half of the patients presenting with suspected stroke in this study were prealerted by EMS staff, regardless of eligibility, resulting in disagreements with ED staff during handover. Aligning the expectations of EMS and ED staff, perhaps through simplified prealert protocols, could be considered to facilitate more appropriate use of hospital prealerting in acute stroke.
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Servicios Médicos de Urgencia/estadística & datos numéricos , Accidente Cerebrovascular/terapia , Anciano , Sistemas de Comunicación entre Servicios de Urgencia , Inglaterra/epidemiología , Femenino , Humanos , Entrevistas como Asunto , Masculino , Prevalencia , Estudios Retrospectivos , Accidente Cerebrovascular/epidemiología , Terapia Trombolítica , Factores de Tiempo , Transporte de Pacientes , Resultado del TratamientoRESUMEN
Growth and propagation of fish-infecting microsporidians within cell culture has been more difficult to achieve than for insect- and human-infecting microsporidians. Fish microsporidia tend to elicit xenoma development rather than diffuse growth in vivo, and this process likely increases host specificity. We present evidence that the fish microsporidian, Loma salmonae, has the capacity to develop xenomas within a rainbow trout gill epithelial cell line (RTG-1). Spore numbers increased over a 4 weeks period within cell culture flasks. Xenoma-like structures were observed using phase contrast microscopy, and then confirmed using transmission electron microscopy. Optimization of the L. salmonae-RTG-1 cell model has important implications in elucidating the process of xenoma development induced by microsporidian parasites.
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Células Epiteliales/citología , Branquias/citología , Loma/fisiología , Oncorhynchus mykiss , Animales , Línea Celular , Células Epiteliales/fisiología , Esporas/fisiologíaRESUMEN
BACKGROUND: Both mothers and fathers are at risk for experiencing postpartum depressive symptoms shortly after the birth of a child. Previous studies suggest mothers' and fathers' depressive symptoms to be interrelated. This study examined bidirectional relations between mothers' and fathers' depressive symptoms across four years postpartum. METHODS: Longitudinal data for this study were collected across five waves from 485 mothers and 359 fathers of infants when infants were on average 6 months-old until children were 54 months-old (1-year lags). Mothers and fathers reported on their depressive symptoms using the Center for the Epidemiological Studies Short Depression Scale (CES-D 10). A random intercept cross-lagged panel model (RICLPM) was specified to examine the bidirectional relations between mothers' and fathers' depressive symptoms over time. RESULTS: At the between-person level, mothers' and fathers' depressive symptoms were positively associated. At the within-person level, unique carry-over effects were found for mothers and fathers in that when reporting higher depressive symptoms than their trait levels, they were more likely to report higher depressive symptoms one year later. Moreover, intermittent cross-lagged effects were observed from mothers' depressive symptoms to fathers' depressive symptoms during toddlerhood. LIMITATIONS: The sample was not racially or structurally diverse thereby limiting the generalizations of the findings. CONCLUSIONS: After the birth of a child, mothers and fathers are at risk for experiencing chronic depressive symptoms which can have implications for individual, couple and child health. Mothers' depressive symptoms are related to fathers' depressive symptoms over time.
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Depresión Posparto , Depresión , Femenino , Niño , Lactante , Humanos , Preescolar , Depresión/diagnóstico , Depresión/epidemiología , Madres , Depresión Posparto/diagnóstico , Depresión Posparto/epidemiología , Periodo Posparto , Salud InfantilRESUMEN
Research on LGBTQ+ individuals, belonging, and religiosity has been mixed. Some studies have illustrated the ways religion can harm LGBTQ+ individuals while others suggest religion has positive impacts. In the current study, we sought to understand this complexity by examining the experiences of LGBTQ+ individuals who have been or currently are affiliated with The Church of Jesus Christ of Latter-day Saints (i.e. Mormon, LDS). A thematic analysis of 100 interviews with LGBTQ+ individuals currently or previously affiliated with the Church revealed various ways they feel belonging or the lack thereof in Latter-day Saint congregations and communities. These include sharing physical space, being invited to and included at events, receiving gifts or acts of service, seeing others' safety signals, hearing accepting and character-affirming language, and having others listen to them and give them voice. With the intent of fostering belonging, we discuss implications of this research for church communities and propose the belonging in practice: LGBTQ+ and religion model.
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The development of problematic media use in early childhood is not well understood. The current study examined long-term associations between parental media efficacy, parental media monitoring, and problematic media use across a three-year period of time during early childhood. Participants included 432 parents who reported on their own parenting and their child's use of problematic media once a year for three years (M age of child at Wave 1 = 29.68 months, SD = 3.73 months). Results revealed that early parental media efficacy predicted lower levels of child problematic media use over time. Restrictive media monitoring was also related to lower levels of child problematic media use over time. Additionally, general parental efficacy was related to parental media efficacy and lower child problematic media use, both at the cross-sectional and longitudinal levels. Discussion focuses on encouraging early parental media efficacy (and exploring other potential mechanisms) as a way to mitigate the development of problematic media use over time.
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Importance: Mental health among children and adolescents is a critical public health issue, and transgender and gender nonbinary youths are at an even greater risk. Social media has been consistently associated with youth mental health, but little is known about how gender identity interacts with this association. Objective: To use a risk and resilience approach to examine the association between social media use and mental health among transgender, gender nonbinary, and cisgender youths. Design, Setting, and Participants: This cross-sectional study analyzed data collected from an online survey between May and August 2021. Participants included a random sample of US youths; eligibility requirements included being aged 10 to 17 years and residing in the US. Statistical analysis was performed from February to April 2022. Main Outcomes and Measures: Social media use (time, type of use, favorite site, social comparisons, mindfulness, taking intentional breaks, cleaning and curating feeds, problematic use, and media literacy programs at their school) and mental health (depression, emotional problems, conduct problems, and body image) as main outcomes. Results: Participants included 1231 youths aged 10 to 17 years from a national quota sample from the United States; 675 (54.8%) identified as cisgender female, 479 (38.9%) as cisgender male, and 77 (6.3%) as transgender, gender nonbinary, or other; 4 (0.3%) identified as American Indian or Alaska Native, 111 (9.0%) as Asian, 185 (15.0%) as Black, 186 (15.1%) as Hispanic or Latinx, 1 (0.1%) as Pacific Islander, 703 (57.1%) as White, and 41 (3.3%) as mixed and/or another race or ethnicity. Gender identity moderated both the strength and the direction of multiple associations between social media practices and mental health: active social media use (eg, emotional problems: B = 1.82; 95% CI, 0.16 to 3.49; P = .03), cleaning and/or curating social media feeds (eg, depression: B = -0.91; 95% CI, -1.98 to -0.09; P = .03), and taking intentional breaks (eg, depression: B = 1.03; 95% CI, 0.14 to 1.92; P = .02). Conclusions and Relevance: In this cross-sectional study of gender identity, social media, and mental health, gender identity was associated with youths' experiences of social media in ways that may have distinct implications for mental health. These results suggest that research about social media effects on youths should attend to gender identity; directing children and adolescents to spend less time on social media may backfire for those transgender and gender nonbinary youths who are intentional about creating safe spaces on social media that may not exist in their offline world.
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Medios de Comunicación Sociales , Personas Transgénero , Niño , Humanos , Masculino , Femenino , Adolescente , Estados Unidos/epidemiología , Identidad de Género , Salud Mental , Estudios Transversales , Personas Transgénero/psicologíaRESUMEN
The ecological importance of submerged macrophyte beds to fishes within estuaries was investigated through the example of the ubiquitous Cape stumpnose Rhabdosargus holubi, an omnivorous, vegetation and estuary-dependent species, using stable-isotope techniques and long-term abundance (catch-per-unit-effort) data from the East Kleinemonde Estuary, South Africa. Outputs from a Bayesian mixing model using δ(13) C and δ(15) N signatures indicated that the submerged macrophytes Ruppia cirrhosa and Potamogeton pectinatus were not a primary source of nutrition for R. holubi, confirming previous work that revealed that macrophytes are consumed but not digested. Long-term seine netting data showed reduced abundance of R. holubi during a prolonged period of macrophyte senescence, suggesting that submerged macrophyte habitats provide shelter that reduces mortality (predation risk) and a food-rich foraging area.
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Alismatales/fisiología , Ambiente , Perciformes/fisiología , Potamogetonaceae/fisiología , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Teorema de Bayes , Conducta Alimentaria , SudáfricaRESUMEN
The purpose of this study was to examine whether time of day variations in power output can be accounted for by the diurnal fluctuations existent in body temperature. 8 recreationally trained males (29.8±5.2 yrs; 178.3±5.2 cm; 80.3±6.5 kg) were assessed on 4 occasions following a: (a) control warm-up at 8.00 am; (b) control warm-up at 4.00 pm; (c) extended warm-up at 8.00 am; and, (d) extended warm-up at 4.00 pm. The control warm-up consisted of dynamic exercises and practice jumps. The extended warm-up incorporated a 20 min general warm-up on a stationary bike prior to completion of the control warm-up, resulting in a whole body temperature increase of 0.3±0.2°C. Kinetic and kinematic variables were measured using a linear optical encoder attached to a barbell during 6 loaded counter-movement jumps. Results were 2-6% higher in the afternoon control condition than morning control condition. No substantial performance differences were observed between the extended morning condition and afternoon control condition where body temperatures were similar. Results indicate that diurnal variation in whole body temperature may explain diurnal performance differences in explosive power output and associated variables. It is suggested that warm-up protocols designed to increase body temperature are beneficial in reducing diurnal differences in jump performance.
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Temperatura Corporal/fisiología , Ritmo Circadiano/fisiología , Tolerancia al Ejercicio/fisiología , Contracción Isométrica/fisiología , Músculo Esquelético/fisiología , Adaptación Fisiológica , Adulto , Fenómenos Biomecánicos , Estudios Cruzados , Humanos , Pierna/fisiología , Masculino , Monitoreo Fisiológico , Análisis y Desempeño de Tareas , Factores de TiempoRESUMEN
The aim of this study was to assess the blood pressure (BP) measurement accuracy of the Kinetik Blood Pressure Monitor-Series 1 (BPM-1) for use in home or clinical settings according to the 2002 European Society of Hypertension International Protocol (ESH-IP). Forty-two participants were recruited to fulfil the required number of systolic and diastolic BP measurements according to the ESH-IP. Nine sequential same-arm BP readings were measured and analysed for each participant using the test device and observer mercury standard readings according to the 2002 ESH-IP. Forty one participants were used to obtain 33 sets of systolic and diastolic BP readings and were included in the analysis. Mean difference between the device measurements and the observer (mercury standard) measurements was 1.1 ± 7.2/1.1 ± 6.8 mmHg (mean ± standard deviation; systolic/diastolic). The number of systolic BP differences between the test and observer measurements that fell within 5, 10 and 15 mmHg was 65, 86 and 92. For diastolic readings, the number of test-observer measurement differences within 5, 10 and 15 mmHg was 77, 91 and 94. The number of participants with at least two out of three differences within 5 mmHg was 28 for systolic and 40 for diastolic BP readings. Three participants had no differences between the test and observer measurements within 5 mmHg in both the systolic and diastolic measurement categories. The Kinetik BPM-1 device fulfilled the requirements of the ESH-IP validation procedure and can be recommended for clinical use and self-measurement within the home.
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Monitores de Presión Sanguínea , Hipertensión , Adulto , Presión Sanguínea , Determinación de la Presión Sanguínea , Monitoreo Ambulatorio de la Presión Arterial , Humanos , Hipertensión/diagnóstico , EsfigmomanometrosRESUMEN
BACKGROUND: Studies have shown that self-monitoring of blood pressure (BP) is effective when combined with co-interventions, but its efficacy varies in the presence of some co-morbidities. This study examined whether self-monitoring can reduce clinic BP in patients with hypertension-related co-morbidity. METHODS: A systematic review was conducted of articles published in Medline, Embase, and the Cochrane Library up to January 2018. Randomized controlled trials of self-monitoring of BP were selected and individual patient data (IPD) were requested. Contributing studies were prospectively categorized by whether they examined a low/high-intensity co-intervention. Change in BP and likelihood of uncontrolled BP at 12 months were examined according to number and type of hypertension-related co-morbidity in a one-stage IPD meta-analysis. RESULTS: A total of 22 trials were eligible, 16 of which were able to provide IPD for the primary outcome, including 6,522 (89%) participants with follow-up data. Self-monitoring was associated with reduced clinic systolic BP compared to usual care at 12-month follow-up, regardless of the number of hypertension-related co-morbidities (-3.12 mm Hg, [95% confidence intervals -4.78, -1.46 mm Hg]; P value for interaction with number of morbidities = 0.260). Intense interventions were more effective than low-intensity interventions in patients with obesity (P < 0.001 for all outcomes), and possibly stroke (P < 0.004 for BP control outcome only), but this effect was not observed in patients with coronary heart disease, diabetes, or chronic kidney disease. CONCLUSIONS: Self-monitoring lowers BP regardless of the number of hypertension-related co-morbidities, but may only be effective in conditions such obesity or stroke when combined with high-intensity co-interventions.
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Monitoreo Ambulatorio de la Presión Arterial , Presión Sanguínea , Hipertensión/diagnóstico , Hipertensión/terapia , Autocuidado , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Hipertensión/epidemiología , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Multimorbilidad , Valor Predictivo de las Pruebas , Pronóstico , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo , Factores de TiempoRESUMEN
The adenylate cyclase of C6 glioma cell cultures was characterized for sensitivity to the beta-adrenergic agonist isoproterenol, as well as fluoride, and GTP as a function of the cell cycle. The mitotic phase of the cell cycle was emphasized because both the basal cellular cyclic AMP level and the intact C6 cell's capacity to accumulate cyclic AMP in response to isoproterenol decreased during mitosis. Basal and stimulated adenylate cyclase activities in mitotic cells were decreased relative to the enzyme activities in the G1, S, and G2 phases of the cell cycle. Analysis of the beta-adrenergic receptor using the radioligand(-)[3H]dihydroalprenolol showed that neither ligand affinity nor receptor density changed during the cell cycle, indicating that the reduced adenylate cyclase activity of the mitotic C6 cell was not caused by alterations in this hormone receptor. The reduction in the mitotic cell's basal adenylate cyclase activity was more prominent than the decrease in isoproterenol-, fluoride, or GTP-stimulated activities suggesting that the effectiveness of these enzymes activators (i.e., the efficiency of the coupling mechanism) was not attenuated during mitosis. These studies indicate that the intrinsic catalytic capacity (not the beta-adrenergic receptor or the coupling mechanism) of the C6 adenylate cyclase complex is reduced during mitosis and contributes to the mitotic cell's inability to accumulate and maintain the cyclic AMP concentration at the interphase level.
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Adenilil Ciclasas/metabolismo , Interfase , Mitosis , Animales , Línea Celular , AMP Cíclico/metabolismo , Dihidroalprenolol/metabolismo , Glioma , Guanosina Trifosfato/farmacología , Ratas , Receptores Adrenérgicos beta/metabolismo , Fluoruro de Sodio/farmacologíaRESUMEN
Normal and Plasmodium berghei (NYU-2 strain)-infected murine erythrocytes display substantially different patterns of plasma membrane phosphoproteins phosphorylation. Intact erythrocytes (normal and parasite infected) incubated with 32Pi and isolated washed erythrocyte plasma membranes incubated with gamma-32P-ATP were analyzed for phosphoproteins by SDS PAGE and autoradiography. Two new phosphoproteins of molecular weight 45,000 (pp45) and 68,000 (pp68), which are absent in normal erythrocyte membranes, are associated with the membranes of infected erythrocytes subjected to both intact-cell and isolated-membrane phosphorylation conditions. Two-dimensional gel electrophoresis indicates that pp45 and pp68 are of parasite origin. Partial or complete proteolytic digestion reveals that pp45 is phosphorylated at similar amino acid residues both in intact cells and in isolated membranes. The pp45 phosphoprotein can be detected at as low as 3% parasitemia and its phosphorylation is not affected by 10 microM cAMP, 1 mM Ca2+, or 5 mM EGTA. Extraction of isolated washed plasma membranes with 0.5% Triton X-100 or 0.1 M NaOH indicates that pp45 is detergent insoluble and only partially extractable with NaOH, suggesting that pp45 is closely associated with the host erythrocyte plasma membrane.
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Eritrocitos/parasitología , Fosfoproteínas/sangre , Plasmodium berghei/fisiología , Animales , Calcio/farmacología , AMP Cíclico/farmacología , Ácido Egtácico/farmacología , Membrana Eritrocítica/análisis , Ratones , Peso Molecular , Fosfoproteínas/análisis , Fosforilación , Cloruro de Sodio/farmacologíaRESUMEN
The transformed or normal phenotype of cultured normal rat kidney cells infected with a temperature-sensitive mutant of avian sarcoma virus is conditional on the temperature at which the cells are grown. Using dye injection techniques, we show that junction-mediated dye transfer is also temperature-sensitive. The extent and rate of transfer between infected cells grown at the transformation-permissive temperature (35 degrees C) is significantly reduced when compared to infected cells grown at the nonpermissive temperature (40.5 degrees C) or uninfected cells grown at either temperature. Infected cells subjected to reciprocal temperature shifts express rapid and reversible alterations of dye transfer capacities, with responses evident by 15 min and completed by 60 min for temperature shifts in either direction. These results suggest that altered junctional capacities may be fundamental to the expression of the ASV-induced, transformed phenotype.
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Alpharetrovirus/fisiología , Comunicación Celular , Transformación Celular Neoplásica , Transformación Celular Viral , Uniones Intercelulares/fisiología , Animales , Línea Celular , Permeabilidad de la Membrana Celular , Cinética , Mutación , Ratas , TemperaturaRESUMEN
The adenosine 3',5'-monophosphate (cyclic AMP) levels of mouse lymphocytes rose and fell sharply 10 hours after stimulation with concanavalin A. Treatment of the cells with indomethacin reversibly prevented the increase in cyclic AMP and the subsequent onset of DNA synthesis. When the heightened cyclic AMP before S phase was maintained by either inhibiting phosphodiesterase or by adding the 8-bromo derivative of cyclic AMP, DNA synthesis was also blocked. Both the increase and decrease in cyclic AMP appear to be required for progression of lymphocytes into the S phase of growth.
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División Celular , AMP Cíclico/metabolismo , ADN/biosíntesis , Activación de Linfocitos , Linfocitos/metabolismo , 4-(3-Butoxi-4-metoxibencil)-2-imidazolidinona/farmacología , Animales , Ciclo Celular/efectos de los fármacos , División Celular/efectos de los fármacos , Concanavalina A/antagonistas & inhibidores , AMP Cíclico/análogos & derivados , AMP Cíclico/farmacología , Indometacina/farmacología , Activación de Linfocitos/efectos de los fármacos , Ratones , ARN/biosíntesis , Bazo/citologíaRESUMEN
Dibutyryl adenosine 3',5'-monophosphate (dibutyrl cycle AMP) and 8-bromo cyclic AMP stimulated cells cultured from a rat Schwannoma to change their morphology from irregularly shaped to flattened circular and hollow circular forms within 30 minutes. The change in shape was specifically effected by analogs of cyclic AMP and cyclic AMP elevating agents, was reversible after removal of these additives, and was prevented by vinblastine and cytochalasin b, but was not affected by actinomycin D or cycloheximide.
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Células Cultivadas/efectos de los fármacos , AMP Cíclico/análogos & derivados , Neurilemoma , Bromo , Bucladesina/farmacología , Células Clonales , AMP Cíclico/metabolismo , Isoproterenol/farmacología , Neurilemoma/metabolismo , Prostaglandinas/farmacologíaRESUMEN
The change in the surface structure of cultutred mammalian cells infected with oncogenic DNA viruses was similar to that described for the fully and permanently transformed cell surfaces. The course of appearance of this change was established. Synthesis of host DNA is required for expression of the surface change triggered by infection with the oncogenic virus.
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Adenoviridae/metabolismo , Transformación Celular Neoplásica , ADN de Neoplasias/biosíntesis , Virus Oncogénicos/metabolismo , Virus 40 de los Simios/metabolismo , Propiedades de Superficie , Animales , Línea Celular/metabolismo , Línea Celular/microbiología , Haplorrinos , Riñón , Lectinas/farmacologíaRESUMEN
PURPOSE: With the increasing use of minimally invasive surgical techniques for intraocular pressure (IOP) lowering in glaucoma patients, there is a need to examine best practices regarding the postoperative management of these patients. Corticosteroids, though effective in controlling postoperative ocular pain and inflammation, present distinct challenges in glaucoma surgery patients, as their use can be associated with IOP elevation. Loteprednol etabonate (LE) is an ocular corticosteroid designed to have an improved safety profile relative to other corticosteroids. METHODS: We report here a representative selection of cases in which patients were successfully treated with LE ophthalmic gel 0.5% (LE gel) following a variety of minimally invasive glaucoma surgery (MIGS) procedures. Cases included patients undergoing various procedures including a Trabectome combined with cataract surgery; micro-stent surgery (iStent) combined with cataract surgery; supraciliary CyPass Micro-Stent placement combined with cataract surgery; Kahook Dual Blade goniotomy; and ab interno canaloplasty using the iTrack catheter. OBSERVATIONS: In all cases, use of LE gel during the postoperative period appeared effective and safe in reducing inflammation and controlling pain. No adverse events or IOP elevations were noted, even in those patients continuing use of LE gel past the postoperative period for longer than six months with documented follow-up. In two cases, patients with elevated IOP using either prednisolone or difluprednate postoperatively were switched to LE gel, with a subsequent reduction in IOP. CONCLUSIONS: This selection of cases involving patients undergoing MIGS suggests that LE gel may be an effective and safe option for treating postoperative inflammation and pain following such procedures with minimal to no effect on IOP or other negative sequalae.
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OBJECTIVE: Effective treatment can only be given during the early stages of RA if patients are seen early. However, many patients delay for prolonged periods before seeking medical advice. This study explores factors influencing the decision to seek medical advice in RA patients. METHODS: In-depth, semi-structured interviews were carried out with 24 patients. Purposive sampling ensured a cross-section in terms of time to presentation, gender, age and ethnic background. Interview transcripts were analysed and themes identified using established methods. RESULTS: Four main themes influenced the decision to seek medical advice: (i) symptom experience: the severity of symptoms and their impact on functional ability; (ii) symptom evaluation: the patient's explanation for their symptoms and recognition of their significance; (iii) knowledge of RA and available therapies; and (iv) experience of and attitudes towards health care providers. A significant and rapid impact of the disease on functional ability characterized those presenting early. Many developed an explanation for their symptoms that related to preceding activities. Recognition that this explanation was inadequate to explain symptom progression frequently prompted a consultation. Only one patient sought advice because she thought that she might have RA. CONCLUSIONS: Symptom evaluation is a key factor influencing how quickly medical advice is sought in other diseases. In contrast to the situation with many cancers where there is widespread association of symptoms and signs with the eventual diagnosis, this was not the case in RA. Our findings should inform strategies to reduce delays in help-seeking in people with early RA.